Search

Psychosis in patients with dementia‑related disorders has long been a challenging issue to be tackled by the medical fraternity. Although atypical antipsychotics (AP) are in use for the same reason, there has always been a question regarding their safety and tolerability in this group of patients. Pimavanserin, a serotonin receptor inverse agonist or antagonist, is the only drug that is Food and Drug Administration‑licensed to be used for the treatment of Parkinson’s disease psychosis. This systematic review, which was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta‑analyses 2020, had the objective of examining the effects of pimavanserin in patients with dementia‑related psychosis (DRP). Among the publications (January 1, 2013–July 12, 2023) we gathered and examined were case–control and cohort studies, systematic reviews, meta‑analyses, clinical trials, literature reviews, and randomized and nonrandomized control trials. The databases used to construct this list of publications were PubMed, Cochrane Library, and Google Scholar. These three databases yielded 157 reports in total once the relevant filters were applied. They were then further screened and put through quality evaluation processes, which led to the final nine papers that were included in this systematic review. We concluded from our review that pimavanserin proves to be a promising alternative for the treatment of DRP, showing significant improvements and fewer side effects compared to other atypical AP. [ABSTRACT FROM AUTHOR]

Hypoplastic left heart syndrome (HLHS) is a complex congenital heart defect (CHD) characterized by a spectrum of underdeveloped left-sided cardiac structures. It is a serious defect and warrants either 3-staged surgical palliation or a heart transplant. Despite numerous surgical advancements, long-term outcomes remain challenging and still have significant morbidity and mortality. There have been notable advancements in stem cell therapy for HLHS, including developments in diverse stem cell origins and methods of administration. Clinical trials have shown safety and potential benefits, including improved ventricular function, reduced heart failure, and fewer adverse events. Younger myocardium seems particularly receptive to stem cell signals, suggesting the importance of early intervention. This review explores the potential of emerging stem cell-based therapies as an adjunctive approach to improve the outcomes for HLHS patients. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Despite increasing dupilumab use for chronic rhinosinusitis with nasal polyps (CRSwNP), little is known about the factors influencing its use in real‐world practice. We aimed to identify factors that may predict dupilumab prescription in CRSwNP patients who have undergone endoscopic sinus surgery (ESS).A single‐institution, retrospective cohort study of patients who underwent ESS for CRSwNP between 2015 and 2023 was conducted. Demographics, comorbidities, 22‐item sinonasal outcome test (SNOT‐22) scores, and dupilumab prescription date were extracted from patient records. Intraoperative nasal mucus cytokine levels were measured using a multiplex bead assay. Univariate logistic regression analysis was performed to identify factors associated with dupilumab prescription, and multivariate logistic regression was used to adjust for surgery date.A total of 299 CRSwNP patients were included, including seventy (23.4%) who were prescribed dupilumab postoperatively. Patients were more likely to be prescribed dupilumab if they had asthma (odds ratio [OR] 2.304), aspirin‐exacerbated respiratory disease (AERD, OR 3.375), elevated tissue eosinophils (OR 1.005), and higher 3‐month postoperative SNOT‐22 scores (OR 1.027). Patients prescribed dupilumab also had greater odds of having elevated mucus interleukin (IL)‐5 (OR 1.128) and IL‐13 (OR 1.213). When adjusting for surgery date, associated factors included: asthma (OR 2.444), AERD (OR 3.750), allergic rhinitis (OR 1.833), higher tissue eosinophils (OR 1.005), elevated 3‐month SNOT‐22 scores (OR 1.028), and higher IL‐5 (OR 1.123) and IL‐13 (OR 1.202) levels.Asthma, AERD, allergic rhinitis, and elevated tissue eosinophil, IL‐5, and IL‐13 levels are predictive of dupilumab prescription in CRSwNP patients. These may serve as clinical and inflammatory biomarkers and can aid in counseling patients about expected disease trajectory. [ABSTRACT FROM AUTHOR]

Key points Frailty and aging are associated with a shift toward non‐type 2 inflammation in chronic rhinosinusitis (CRS).Frailty‐related shifts in sinonasal inflammatory mediators may be linked to biological senescence.Understanding the role of aging and frailty in CRS may have important treatment implications. [ABSTRACT FROM AUTHOR]

The article discusses the predictors of dupilumab prescription in patients with chronic rhinosinusitis with nasal polyps. The study, conducted by researchers from Vanderbilt University Medical Center and the University of Alabama-Birmingham, aimed to identify factors influencing the prescription of dupilumab. The study found that patients with higher postoperative SNOT-22 scores were more likely to be prescribed dupilumab, indicating a correlation between symptom severity and medication prescription. The researchers acknowledged limitations in their study design, such as the cross-sectional analysis and short follow-up timeframe, and suggested that further research with larger sample sizes and longer follow-up periods could provide more comprehensive insights into dupilumab prescription trends. [Extracted from the article]