The adverse-effect profile of lacosamide

ABSTRACT

Introduction: Lacosamide has been used in epilepsy patients in the United States, Europe and Asia since it was approved by the FDA in 2008. Many patients have benefited from this drug as a new generation of sodium channel blocker. With the worldwide use of this drug, its adverse effects have gradually emerged, especially some rare adverse events.

Areas covered: The present review aims to summarize the adverse effects of lacosamide reported in the literature in recent years to promote the safe clinical application of the drug.

Expert opinion: In more than 10 years of experience in drug usage, adverse reactions of lacosamide have also been gradually discovered. The review showed that lacosamide is safe and effective in antiepileptic treatment, and its common side effects are dizziness, headache, drowsiness, diplopia, and cardiovascular abnormalities. Skin rashes, hematotoxicity and heart damage, psychological symptoms and suicide risk have also been reported and emphasized.     

地黄饮子治疗暗痱证研究概况

地黄饮子是治疗暗痱证的重要方剂，但历代医家对其具体组方多有歧义，病因病机也较为混乱，令人难以理解与把握。其中《圣济总录》卷五十一方为常用方，主治瘖痱证，现代医家常将其应用于中风后遗症的诊疗中。本文从组方意义、药理机制、现代临床应用叙述地黄饮子治疗暗痱证的研究概况，以期更好地服务于临床。     

翻转课堂教学法在消化内科临床带教的应用评价

目的 探讨翻转课堂教学法在消化内科临床带教的教学效果.方法 选取2018年10月—2019年10月在消化内科进行临床见习的护生48人(全部为女生),按照实习先后顺序,前24人作为试验组,给予翻转课堂教学法教学;后24人作为对照组,采用传统的带教模式.讨论两组护生在理论和操作成绩和对带教满意度方面有无差异.两组学生在试验开始之前的成绩相比较,差异无统计学意义(P>0.05).结果 试验组在理论、操作、教学满意度等方面的成绩均高于对照组,P<0.05.结论 翻转课堂教学法在消化内科的临床带教中有较好的教学效果,可以提高学生的学习成绩和教学满意度.     

带中心孔植入式透镜（V4c-ICL）矫正高度近视的视觉质量研究

目的　观察高度近视患者植入带中心孔植入式透镜（implantable collamer lens，ICL）后的临床疗效和视觉相关的生活质量。方法　前瞻性病例研究。选取我院诊断为高度近视，并植入V4c-ICL患者25例（50眼）为研究对象。术前及术后1个月、3个月、6个月分别检查患者屈光状态，裸眼远、中、近视力，最佳矫正远视力，远视力矫正下中、近视力，双眼视力，眼压，角膜内皮细胞密度（corneal endothelial cell density，ECD），并进行国家眼科研究所视功能问卷-25（national eye institute-visual function questionnaire，NEI-VFQ-25）调查及评分。结果　高度近视患者植入V4c-ICL后不同时间球镜、柱镜、等效球镜（spherical equivalent，SE）度较术前均明显降低（F=884.35、17.15、810.25，均为P＜0.05）；术后不同时间裸眼远、中、近视力，最佳矫正远视力，远视力矫正下中、近视力和双眼视力较术前均明显改善（F=604.47、878.13、713.92、22.25、5.33、6.90、16.51，均为P＜0.05）。术前及术后随访期间眼压、ECD无明显变化（F=0.07、1.53，均为P＞0.05）；术后NEI-VFQ-25评分较术前明显提高（F=21.76，P＜0.05）。结论　高度近视患者植入V4c-ICL后屈光不正得到矫正、短期内屈光稳定，随访期间远、中、近视力明显提高，视觉相关的生活质量明显改善。V4c-ICL植入术治疗高度近视安全、有效。     

Molecular xenomonitoring and host identification of Leishmania sand fly vectors in a Mediterranean periurban wildlife park

The epidemiological cycle of zoonotic phlebotomine‐borne Leishmania infantum is a complex system in which domestic animals and wildlife interact and participate in its maintenance and transmission. In this study, we combined entomological surveillance, xenomonitoring of L. infantum and identification of host feeding sources of engorged females to investigate the potential contribution of a periurban wildlife park to leishmaniosis in neighbouring residential areas. Overall, 7,309 sand flies were collected in 111 trap‐days during the summers of 2016–2018 in an endemic area in south‐east Spain. Five different sand fly species were captured, with Phlebotomus perniciosus, the main L. infantum vector in this region, representing the most common species. Sand fly distribution was spatially heterogeneous in terms of species, sexes and female physiological stage (unfed, gravid and engorged females) and related to host distribution and management, and environmental features. None of the 602 sand flies analysed for L. infantum infection by kinetoplast real‐time PCR were positive. We used molecular tools to identify the vertebrate hosts of sand flies and identified 17 host species, mainly mammals. Human DNA was not identified in engorged sand flies. This study provides evidence that wildlife parks in south‐east Spain are ideal grounds for sand fly vectors but do not necessarily increase L. infantum infection risk to humans and dogs living in surrounding residential areas. This is probably because vectors feed mostly on non‐L. infantum competent hosts and this should be investigated for a better understanding of the contribution of wildlife parks to the local epidemiology of L. infantum.     

肾上腺髓质素在呼吸系统相关性疾病中的研究进展

【摘要】 血浆肾上腺髓质素（ADM）是一种具有多种生物学活性的内源性肽，以自分泌、旁分泌和内分泌的方式发挥功能和作用，包括舒张血管、降低血压、扩张支气管平滑肌细胞、改善微循环、稳定血管内皮功能、调节肺动脉压、调节炎症及免疫功能、参与多种激素的分泌和调节等作用，因最初在肾上腺嗜铬细胞瘤组织中发现而得名。后来发现其在多种器官、组织均有表达，包括心、脑、肾、肿瘤组织等，尤其在内皮细胞、血管平滑肌细胞等表达含量较高，在人体肺组织中也广泛存在。目前许多研究已发现肾上腺髓质素可能参与某些肺部疾病的病理生理过程，包括社区获得性肺炎、支气管哮喘、慢性阻塞性肺部疾病、肺动脉高压、肺部肿瘤等疾病。本文就肾上腺髓质素在呼吸系统相关性疾病方面的研究进展作一综述。     

Simulação de manejo de via aérea difícil para residentes: estudo comparativo prospectivo

Background and objectivesProcedural simulation training for difficult airway management offers acquisition opportunities. The hypothesis was that 3 hours of procedural simulation training for difficult airway management improves: acquisition, behavior, and patient outcomes as reported 6 months later.MethodsThis prospective comparative study took place in two medical universities. Second‐year residents of anesthesiology and intensive care from one region participated in 3 h procedural simulation (intervention group). No intervention was scheduled for their peers from the other region (control). Prior to simulation and 6 months later, residents filled‐out the same self‐assessment form collecting experience with different devices. The control group filled‐out the same forms simultaneously. The primary endpoint was the frequency of use of each difficult airway management device within groups at 6 months. Secondary endpoints included modifications of knowledge, skills, and patient outcomes with each device at 6 months. Intervention cost assessment was provided.Results44 residents were included in the intervention group and 16 in the control group. No significant difference was observed for the primary endpoint. In the intervention group, improvement of knowledge and skills was observed at 6 months for each device, and improvement of patient outcomes was observed with the use of malleable intubation stylet and Eschmann introducer. No such improvement was observed in the control group. Estimated intervention cost was 406€ per resident.ConclusionsA 3 h procedural simulation training for difficult airway management did not improve the frequency of use of devices at 6 months by residents. However, other positive effects suggest exploring the best ratio of time/acquisition efficiency with difficult airway management simulation.ClinicalTrials.gov IdentifierNCT02470195.     

西格列汀联合二甲双胍治疗肥胖型2型糖尿病的疗效及对体脂含量情况分析

目的研究肥胖型2型糖尿病患者联合采用西格列汀、二甲双胍治疗的临床效果。方法选择2018年10月—2020年4月该院100例肥胖型2型糖尿病患者为研究对象,采用随机数表法分成常规组和治疗组,每组50例。常规组予二甲双胍治疗,治疗组予二甲双胍+西格列汀治疗。比较两组治疗效果、血糖指标、体脂含量、胰岛功能指标及不良反应。。结果两组治疗效果比较,差异有统计学意义(P<0.05)。治疗后常规组血糖指标高于治疗组,差异有统计学意义(t=8.183、4.828、18.158,P<0.05)。治疗后常规组体脂含量高于治疗组,差异有统计学意义(t=5.993、7.657、4.420,P<0.05)。治疗后两组胰岛功能比较,差异有统计学意义(t=5.898、5.283、16.033,P<0.05)。常规组不良反应总发生率低于治疗组,但差异无统计学意义(χ²=0.136,P=0.712)。结论西格列汀、二甲双胍联合治疗肥胖型2型糖尿病效果确切。