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The causes and attributing factors of drug-induced liver injury (DILI) remain unclear as a result of exclusion-based diagnosis and low incidence. The aim of this study was to explore and evaluate potential drug-related causes and factors associated with DILI. Using electronic medical records (EMR) from the Seoul National University Bundang Hospital from 2003 to 2014, patients with DILI events were identified based on liver function test results. All patients with hepatic or biliary diseases were excluded. Patient characteristics, including demographics, clinical patterns, and severity of DILI were summarized and their associations were evaluated. Drugs frequently prescribed to patients exhibiting DILI within the month before their first DILI event compared to the total patient population were identified and the probabilities of hepatotoxicity associated with their use were assessed through examination of available reports. Among the 1,835 patients with laboratory test results, 1,023 were male and 1,053 were 65 years of age or older. Moderate DILI was dominant in older or male patients and cholestatic DILI tended to be more frequently identified in older patients of either sex. Cytarabine was the most frequently prescribed drug in DILI patients, followed by aprotinin and dopamine. Among the 30 most frequently prescribed drugs in DILI patients, 15 (50%) were identified as known hepatotoxic agents. In conclusion, this study evaluated differences in features of DILI among groups based on demographics and explored candidate drugs with possible associations with DILI, which has potential value reflecting real-world clinical practice. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented commenting on central retinal vein occlusion following liver transplantation.

This study examined the psychotherapy process-outcome of a man diagnosed with compulsive sexual behavior disorder and comorbid borderline personality disorder. This mentalization-informed psychodynamic therapy (N=52 sessions) was audio-recorded, transcribed, and coded for psychotherapy process using the Psychotherapy Process Q-Set (PQS). The patient completed the Outcome Questionnaire (OQ) prior to each session. A principal components factor analysis was conducted on the PQS data. A simulation modeling analysis was also conducted on the PQS and OQ data. Four process factors were identified, and psychological distress preceded the activation of one of these process factors observed in the following session. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus is a multifactorial condition characterized by high level of sugar in the blood. To control hyperglycemia, combination therapy is recommended if monotherapy fails to achieve glycemic control. The combination of a dipeptidyl peptidase-4 (DPP-4) inhibitor and a sodium-glucose cotransporter type 2 (SGLT2) inhibitor is a promising option of the combination therapies in terms of safety as well as efficacy. Despite of the value of combination therapy of these two agents, the pharmacokinetic drug interactions between these two classes of agents have been evaluated in a few drugs. Thus, we reviewed the potential pharmacokinetic drug interaction based on the in vitro metabolism- and transporter-mediated drug interaction information as well as drug interaction studies in human, between a DPP-4 inhibitor and a SGLT2 inhibitor which are marketed in South Korea. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about a unique case of a previously vitrectomized diabetic eye that developed a full-thickness macular hole which closed after intravitreal triamcinolone injection (IVTA), which appeared in the previous issue.

Objective: Distinguishing uterine sarcomas from leiomyomas preoperatively poses a significant challenge. This study aims to analyze patient characteristics in cases where uterine sarcoma was suspected prior to surgery. Methods: A retrospective review of medical records (2018-2023) was conducted, focusing on patients who underwent pelvis magnetic resonance imaging (MRI) for uterine masses with suspected sarcoma or due to clinical indications of the disease. Analyzed factors included age, preoperative imaging (particularly pelvis MRI), and preoperative and postoperative diagnoses. Results: Out of the 95 patients meeting inclusion criteria, 52 were suspected of sarcoma via pelvis MRI for uterine mass, while 43 underwent MRI due to clinical suspicion. Postoperative diagnoses revealed 15 malignant cases, including endometrial stromal sarcoma (n=6), leiomyosarcoma (n=3), poorly differentiated sarcoma (n=1), endometrial cancer (n=2), and lymphoma (n=3). During the same period, 21 patients were diagnosed with uterine sarcoma postoperatively. Misdiagnoses as leiomyoma were common in younger patients, with an age difference observed between those suspected (50.1 years) and not suspected (44.9 years) of sarcoma preoperatively. Single, large tumors (>5 cm) were significant predictors of sarcoma (p<0.05). MRI proved the most effective in diagnosing sarcoma, with 60% accuracy, compared to a 76.4% misdiagnosis rate when solely relying on ultrasonography. Six patients required re-staging surgery due to incomplete initial staging following myomectomy, revealing peritoneal seeding in two leiomyosarcoma cases. Conclusion: Uterine sarcomas, often misdiagnosed as leiomyomas, tended to be in younger patients with smaller (<5 cm) or multiple tumors, primarily evaluated using only ultrasonography. Comprehensive assessments, including MRI, are recommended for accurate differentiation of uterine sarcomas in women with uterine mass. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated psychometric properties of the Patient Health Questionnaire-9 (PHQ-9), the Center for Epidemiological Studies Depression Scale-10 (CESD-10), and the 8-item PROMIS Depression Short Form (PROMIS-D-8; 8b short form) in a sample of individuals living with multiple sclerosis (MS). Research Method: Data were collected by a self-reported mailed survey of a community sample of people living with MS (n = 455). Factor structure, interitem reliability, convergent/discriminant validity and assignment to categories of depression severity were examined. Results: A 1-factor, confirmatory factor analytic model had adequate fit for all instruments. Scores on the depression scales were more highly correlated with one another than with scores on measures of pain, sleep disturbance, and fatigue. The CESD-10 categorized about 37% of participants as having significant depressive symptoms. At least moderate depression was indicated for 24% of participants by PHQ-9. PROMIS-D-8 identified 19% of participants as having at least moderate depressive symptoms and about 7% having at least moderately severe depression. None of the examined scales had ceiling effects, but the PROMIS-D-8 had a floor effect. Conclusions: Overall, scores on all 3 scales demonstrated essential unidimensionality and had acceptable interitem reliability and convergent/discriminant validity. Researchers and clinicians can choose any of these scales to measure depressive symptoms in individuals living with MS. The PHQ-9 offers validated cutoff scores for diagnosing clinical depression. The PROMIS-D-8 measure minimizes the impact of somatic features on the assessment of depression and allows for flexible administration, including Computerize Adaptive Testing (CAT). The CESD-10 measures 2 aspects of depression, depressed mood and lack of positive affect, while still providing an interpretable total score. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the choroidal thickness changes after intravitreal bevacizumab injection (IVB), panretinal photocoagulation (PRP) or both for diabetic retinopathy treatment. Materials and Methods: The study included 31 eyes (31 patients) in the IVB group, 35 eyes (35 patients) in the PRP group and 35 eyes (35 patients) in the IVB-PRP group. Enhanced depth imaging optical coherence tomography(EDI-OCT) was performed before and 1 month after each treatment to measure subfoveal and extrafoveal(500 and 1000 μm) choroidal thicknesses. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) were also measured. Results: The choroidal thickness at all locations significantly decreased after treatment in all groups, but there was no significant difference in the amount of change among the three groups. The subfoveal choroidal thickness and CMT significantly decreased after treatment in the IVB and IVB-PRP groups. In the PRP group, the CMT significantly increased, while the choroidal thickness significantly decreased after treatment. The subfoveal choroidal thickness and CMT were significantly reduced after IVB, but there was no significant correlation between their changes. The BCVA was improved significantly in the IVB and IVB-PRP group, but not in the PRP group. Conclusions: The choroidal thickness decreased after all treatments, suggesting that IVB or PRP rapidly reduced choroidal vascular permeability. [ABSTRACT FROM AUTHOR]

The article presents two case studies showing rapid progression of subclinical age-related macular degeneration in the untreated fellow eye after intravitreal bevacizumab. The first case is about a 78 year old woman who reported a one month history of decreased visual acuity in the right eye. The second case study is about a 91 year old man with a five month history of visual decrease.

OBJECTIVE: Over a quarter million individuals in the United States have multiple sclerosis (MS). Chronic pain and depression are disproportionately high in this population. The purpose of this study was to examine the relationship between chronic pain and depression in MS and to examine potentially meditational effects of anxiety, fatigue, and sleep. METHOD: We used cross-sectional data from self-reported instruments measuring multiple symptoms and quality of life indicators in this study. We used structural equation modeling to model direct and indirect effects of pain on depression in a sample of 1,245 community-dwelling individuals with MS. Pain interference, depression, fatigue, and sleep disturbance were modeled as latent variables with 2 to 3 indicators each. The model controlled for age, sex, disability status (Expanded Disability Status Scale), and social support. RESULTS: A model with indirect effects of pain on depression had adequate fit and accounted for nearly 80% of the variance in depression. The effects of chronic pain on depression were almost completely mediated by fatigue, anxiety, and sleep disturbance. Higher pain was associated with greater fatigue, anxiety, and sleep disturbance, which in turn were associated with higher levels of depression. The largest mediating effect was through fatigue. Additional analyses excluded items with common content and suggested that the meditational effects observed were not attributable to content overlap across scales. CONCLUSION: Individuals living with MS who report high levels of chronic pain and depressive symptoms may benefit from treatment approaches that can address sleep, fatigue, and anxiety. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to calibrate the items for the Communicative Participation Item Bank (CPIB; Baylor, Yorkston, Eadie, Miller, & Amtmann, 2009; Yorkston et al., 2008) using item response theory (IRT ). One overriding objective was to examine whether the IRT item parameters would be consistent across different diagnostic groups, thereby allowing creation of a disorder-generic instrument. The intended outcomes were the final item bank and a short form ready for clinical and research applications. Method: Self-report data were collected from 701 individuals representing 4 diagnoses: multiple sclerosis, Parkinson's disease, amyotrophic lateral sclerosis, and head and neck cancer. Participants completed the CPIB and additional self-report questionnaires. CPIB data were analyzed using the IRT graded response model. Results: The initial set of 94 candidate CPIB items were reduced to an item bank of 46 items demonstrating unidimensionality, local independence, good item fit, and good measurement precision. Differential item functioning analyses detected no meaningful differences across diagnostic groups. A 10-item, disorder-generic short form was generated. Conclusions: The CPIB provides speech-language pathologists with a unidimensional, self-report outcomes measurement instrument dedicated to the construct of communicative participation. This instrument may be useful to clinicians and researchers wanting to implement measures of communicative participation in their work. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to calibrate the items for the Communicative Participation Item Bank (CPIB; Baylor, Yorkston, Eadie, Miller, & Amtmann, 2009; Yorkston et al., 2008) using item response theory (IRT ). One overriding objective was to examine whether the IRT item parameters would be consistent across different diagnostic groups, thereby allowing creation of a disorder-generic instrument. The intended outcomes were the final item bank and a short form ready for clinical and research applications. Method: Self-report data were collected from 701 individuals representing 4 diagnoses: multiple sclerosis, Parkinson's disease, amyotrophic lateral sclerosis, and head and neck cancer. Participants completed the CPIB and additional self-report questionnaires. CPIB data were analyzed using the IRT graded response model. Results: The initial set of 94 candidate CPIB items were reduced to an item bank of 46 items demonstrating unidimensionality, local independence, good item fit, and good measurement precision. Differential item functioning analyses detected no meaningful differences across diagnostic groups. A 10-item, disorder-generic short form was generated. Conclusions: The CPIB provides speech-language pathologists with a unidimensional, self-report outcomes measurement instrument dedicated to the construct of communicative participation. This instrument may be useful to clinicians and researchers wanting to implement measures of communicative participation in their work. [ABSTRACT FROM AUTHOR]