Objective:Artemether is a semi-synthetic derivative of artemisinin and is widely used in the treatment of Plasmodium(P.)falciparum malaria.This study aimed to characterize the safety profile of artemether based on 15-...Objective:Artemether is a semi-synthetic derivative of artemisinin and is widely used in the treatment of Plasmodium(P.)falciparum malaria.This study aimed to characterize the safety profile of artemether based on 15-year data retrived from FDA adverse event reporting system(FAERS).Methods:This is a retrospective analysis on 15-year data of artemether-related adverse effects(AEs)retrieved from the FAERS.AEs were classified according to System Organ Class(SOC)and Preferred Terms(PT).Signal detection was performed using Reporting Odds Ratios(ROR),Proportional Reporting Ratios(PRR),and Empirical Bayes Geometric Mean(EBGM).Stratified analyses examined the impact of demographic factors such as sex,age,and time-to-onset.Temporal patterns and associated risk factors were also investigated.Results:Haemolytic anaemia and haemolysis emerged as the most frequently reported AEs,exhibiting significantly elevated RORs(males:ROR 381.36,95%CI 247.06-588.60;females:ROR 455.11,95%CI 286.43-723.12).Sex-specific differences were evident,with females showing a higher incidence of reproductive-related AEs,including spontaneous abortion and premature labour.Temporal trend analysis revealed that the majority of AEs occurred within the first 30 days after the initiation of artemether administration,indicating a rapid onset.The most affected SOCs were blood and lymphatic system disorders and hepatobiliary disorders.Conclusions:Artemether is associated with a notable frequency of early-onset AEs,particularly hematological and hepatobiliary disorders.The observed sex-specific vulnerability to reproductive AEs highlights the need for sex-conscious clinical approaches.Enhanced post-treatment monitoring and further investigations into the drug’s pharmacokinetics and mechanistic pathways are recommended.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
The numbers of testosterone prescriptions written have increased several-fold worldwide, but the incidence of pathological hypogonadism due to hypothalamic, pituitary, and testicular disease has remained unchanged. Mo...The numbers of testosterone prescriptions written have increased several-fold worldwide, but the incidence of pathological hypogonadism due to hypothalamic, pituitary, and testicular disease has remained unchanged. Most of these prescriptions are being dispensed to middle-aged and older men who have experienced age-related decline in serum testosterone levels; a subset of the population in which benefits of testosterone replacement is at best, modest. Recently, some randomized controlled trials have reported increased cardiovascular events in men （mainly older men and those with prevalent cardiovascular disease） with testosterone use, and a few recent meta-analyses have confirmed these findings, in this review, we discuss trials of testosterone therapy that have reported higher cardiovascular events, relevant trials that have not reported increased cardiovascular events and large trials that have focused on cardiovascular risk （mainly atherosclerosis progression） as their main outcome. We also review findings from meta-analyses that have evaluated cardiovascular events in various testosterone trials. Finally, we discuss some potential mechanisms by which testosterone use might result in an increased cardiovascular risk. As none of the trials conducted to date were adequately powered to evaluate cardiovascular events, no firm conclusions can be drawn regarding the cardiovascular safety of testosterone therapy at this time. In the interim, we hope that this review will help practitioners make informed decisions regarding the care of their patients.展开更多
Azoospermia,defined as the absence of sperm in the ejaculate,is a well-documented consequence of exogenous testosterone(ET)and anabolic–androgenic steroid(AAS)use.These agents suppress the hypothalamic–pituitary–go...Azoospermia,defined as the absence of sperm in the ejaculate,is a well-documented consequence of exogenous testosterone(ET)and anabolic–androgenic steroid(AAS)use.These agents suppress the hypothalamic–pituitary–gonadal(HPG)axis,leading to reduced intratesticular testosterone levels and impaired spermatogenesis.This review examines the pathophysiological mechanisms underlying azoospermia and outlines therapeutic strategies for recovery.Azoospermia is categorized into pretesticular,testicular,and post-testicular types,with a focus on personalized treatment approaches based on the degree of HPG axis suppression and baseline testicular function.Key strategies include discontinuing ET and monitoring for spontaneous recovery,particularly in patients with shorter durations of ET use.For cases of persistent azoospermia,gonadotropins(human chorionic gonadotropin[hCG]and follicle-stimulating hormone[FSH])and selective estrogen receptor modulators(SERMs),such as clomiphene citrate,are recommended,either alone or in combination.The global increase in exogenous testosterone use,including testosterone replacement therapy and AAS,underscores the need for improved management of associated azoospermia,which can be temporary or permanent depending on individual factors and the type of testosterone used.Additionally,the manuscript discusses preventive strategies,such as transitioning to short-acting testosterone formulations or incorporating low-dose hCG to preserve fertility during ET therapy.While guidelines for managing testosterone-related azoospermia remain limited,emerging research indicates the potential efficacy of hormonal stimulation therapies.However,there is a notable lack of well-structured,controlled,and long-term studies addressing the management of azoospermia related to exogenous testosterone use,highlighting the need for such studies to inform evidence-based recommendations.展开更多
Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies a...Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies associated with adverse geology provide a novel strategy for addressing these limitations.However,statistical methods for identifying geochemical anomalies are insufficient for tunnel engineering.In contrast,data mining techniques such as machine learning have demonstrated greater efficacy when applied to geological data.Herein,a method for identifying adverse geology using machine learning of geochemical anomalies is proposed.The method was identified geochemical anomalies in tunnel that were not identified by statistical methods.We by employing robust factor analysis and self-organizing maps to reduce the dimensionality of geochemical data and extract the anomaly elements combination(AEC).Using the AEC sample data,we trained an isolation forest model to identify the multi-element anomalies,successfully.We analyzed the adverse geological features based the multi-element anomalies.This study,therefore,extends the traditional approach of geological analysis in tunnels and demonstrates that machine learning is an effective tool for intelligent geological analysis.Correspondingly,the research offers new insights regarding the adverse geology and the prevention of hazards during the construction of tunnels and underground engineering projects.展开更多
BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent...Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.展开更多
Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have diffe...Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have different degrees of adverse reactions, which will cause damage to the patient’s body once they occur. This paper retrospectively analyzed the clinical data of patients with severe allergic reactions such as fecal incontinence and numbness of hands and feet caused by the use of paclitaxel liposome during postoperative chemotherapy in a case of ovarian cancer admitted to our hospital. The causes and corresponding treatment measures were analyzed, in order to provide the reference for medical staff to take effective countermeasures in advance in the future.展开更多
Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for me...Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for medication-induced urticaria through comprehensive analysis of the FDA Adverse Event Reporting System(FAERS)database.Methods:We employed reporting odds ratios(ROR)to evaluate drug-urticaria associations using FAERS data spanning from Q12004 to Q32024.Analytical approaches included univariate screening,LASSO regression,and multivariate logistic regression to identify potential risk factors.Multiple comparison adjustments were implemented using the Bonferroni method.Results:The study identified 1807 pharmaceutical agents potentially associated with urticaria development.Univariate analysis categorized these agents into several therapeutic classes:antimicrobials(19/85),biologics(16/85),analgesics(8/85),dermatologicals(3/85),anti-rheumatic agents(4/85),hormonal preparations(3/85),antihypertensives(2/85),neuropsychiatric medications(2/85),uric acid-lowering drugs(2/85),multiple sclerosis therapies(2/85),and miscellaneous agents(17/85).Multivariate analysis identified three significant risk determinants:middle-aged individuals(36-53 years),female gender,and exposure to any of 82 specific medications.Conclusion:These evidence-based findings provide valuable insights for early clinical recognition of drug-induced urticaria and establish a foundation for subsequent mechanistic investigations into medication-related hypersensitivity reactions.展开更多
Bite force is an important performance indicator of individual fitness that is closely related to food acquisition,male competition,and mating selection.It is also affected by a variety of factors and different mechan...Bite force is an important performance indicator of individual fitness that is closely related to food acquisition,male competition,and mating selection.It is also affected by a variety of factors and different mechanisms.Therefore,it is relatively difficult to understand the evolutionary driving forces of changes in bite force.In this study,the driving factors affecting the bite force of wild-derived red junglefowl(Gallus gallus jabouillei)were investigated from the aspects of morphological indicators and physiological characteristics.Results showed that the bite force of wild-derived red junglefowl was directly related to sex,showing obvious sexual differences.However,there was no correlation between the plasma testosterone level and bite force.The bite force of males was significantly greater than that of females,and the body index(i.e.,PC1 of five body measures,namely body mass,body length,wing length,tail length,and tarsus length),the grasp index(i.e.,tomial length×bill width)of males were significantly greater than those of females.Sexual selection may have played a key role in the evolution of bite force in the red junglefowl.Future studies should examine other key factors affecting changes in bite force to verify the correlation between secondary sexual characteristics and bite force in red junglefowls.展开更多
Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interle...Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.展开更多
The circadian clock is an important internal time regulatory system for a range of physiological and behavioral rhythms within living organisms.Testosterone,as one of the most critical sex hormones,is essential for th...The circadian clock is an important internal time regulatory system for a range of physiological and behavioral rhythms within living organisms.Testosterone,as one of the most critical sex hormones,is essential for the development of the reproductive system,maintenance of reproductive function,and the overall health of males.The secretion of testosterone in mammals is characterized by distinct circadian rhythms and is closely associated with the regulation of circadian clock genes.Here we review the central and peripheral regulatory mechanisms underlying the influence of circadian clock genes upon testosterone synthesis.We also examined the specific effects of these genes on the occurrence,development,and treatment of common male diseases,including late-onset hypogonadism,erectile dysfunction,male infertility,and prostate cancer.展开更多
BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study desc...BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.展开更多
Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to a...Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to antibiotics between August 2021 and August 2023.The types of antibiotics that caused adverse reactions were analyzed,and the symptoms of adverse reactions and measures for rational use of antibiotics were summarized.Results:Among the analyzed cases of adverse reactions to antibiotics,the highest rate was observed in patients aged 61–75 years,accounting for 38.33%,followed by patients aged 51–60 years,accounting for 20.00%.In terms of the types of antibiotics that caused adverse reactions,cephalosporins were the most common,accounting for 40.00%,followed by penicillins,accounting for 18.33%.Analysis of the systems involved in adverse reactions showed that skin and appendage disorders were the most common,accounting for 36.67%,followed by the digestive system,accounting for 28.33%.Conclusion:Irrational use of antibiotics can lead to adverse drug reactions.Therefore,it is necessary to analyze strategies for the rational use of antibiotics to reduce adverse drug reactions and ensure the safety of antibiotic use.展开更多
The aim of this study is to evaluate the characteristics and patterns of adverse drug reactions(ADRs)associated with antineoplastic drugs and provide insights for safer chemotherapy practices.Based on 979 ADR cases re...The aim of this study is to evaluate the characteristics and patterns of adverse drug reactions(ADRs)associated with antineoplastic drugs and provide insights for safer chemotherapy practices.Based on 979 ADR cases reported in our hospital from January 1,2022,to December 31,2023,an analysis was conducted.Statistical analysis of the data revealed that 72.73%of these ADR incidents occurred in a hospital setting.The incidence of ADRs was higher in female patients compared to males,with the majority of cases(59.14%)observed in individuals aged 51-70 years.Intravenous administration was the predominant route linked to ADRs,accounting for 69.66%of the cases.Serious ADRs represented 9.30%of the total,including one instance where symptoms did not improve despite drug discontinuation or treatment.Cytotoxic antineoplastic drugs were responsible for 97.85%of all ADRs,with oxaliplatin being the most frequently implicated agent(19.82%).Gastrointestinal system involvement was the most common ADR manifestation,observed in 60.79%of cases.These findings underscored the necessity of enhanced monitoring for ADRs associated with cytotoxic antineoplastic drugs,particularly platinum-based agents.Comprehensive risk assessments and tailored treatment plans should be implemented during chemotherapy to minimize the occurrence of ADRs and safeguard patient safety.展开更多
Objective:To investigate the various adverse reactions observed in cancer patients undergoing chemotherapy and provide a basis for developing rational chemotherapy regimens.Methods:A retrospective study was conducted ...Objective:To investigate the various adverse reactions observed in cancer patients undergoing chemotherapy and provide a basis for developing rational chemotherapy regimens.Methods:A retrospective study was conducted on 180 cancer patients treated between August 2014 and August 2016.All patients received chemotherapy,and the adverse reactions occurring during treatment were analyzed.Results:The types of adverse reactions in cancer patients after chemotherapy varied,but digestive system-related adverse reactions were more common,including nausea,hair loss,and diarrhea.In this study,the age distribution of the 180 cancer patients was analyzed.The results showed that 56 patients were aged 13-29 years,72 patients aged 30-47 years,and 52 patients aged 48-67 years.Conclusion:Cancer patients undergoing chemotherapy have a high probability of experiencing adverse reactions,which can cause signifi cant discomfort.In such cases,targeted interventions must be implemented to manage treatment-related adverse reactions and prevent their occurrence.展开更多
This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting S...This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS).By analyzing this extensive pharmacovigilance database,the study aimed to offer meaningful insights for improving the clinical safety of eltrombopag in children.Data covering eltrombopag-related ADEs from Q12004 to Q42023 were extracted from FAERS,and signal detection was conducted using both the reporting odds ratio(ROR)and proportional reporting ratio(PRR)methods.ADEs were categorized based on the System Organ Class(SOC)classification in MedDRA version 25.0.A total of 582 reports involving pediatric patients receiving eltrombopag were identified,encompassing 21 SOC categories.The analysis revealed that,in addition to the known ADEs listed in the drug label,clinicians should remain vigilant for potential off-label ADE signals.These included abnormal platelet counts,thrombocytosis,antiphospholipid syndrome,myelofibrosis,reduced serum iron levels,myelodysplastic syndrome,hepatic infections,and other related conditions.Given these findings,it is strongly recommended that serum iron and ferritin levels should be routinely monitored in pediatric patients undergoing eltrombopag therapy,particularly during long-term treatment.Such proactive surveillance may help prevent the onset of iron deficiency anemia and enhance overall treatment safety.展开更多
Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study anal...Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.展开更多
Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monit...Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monitoring systems,and low patient awareness.It is necessary to improve the level of ADR monitoring at the grassroots level and ensure the safety and effectiveness of medication through countermeasures such as strengthening personnel training,optimizing monitoring processes,and raising public awareness.展开更多
文摘Objective:Artemether is a semi-synthetic derivative of artemisinin and is widely used in the treatment of Plasmodium(P.)falciparum malaria.This study aimed to characterize the safety profile of artemether based on 15-year data retrived from FDA adverse event reporting system(FAERS).Methods:This is a retrospective analysis on 15-year data of artemether-related adverse effects(AEs)retrieved from the FAERS.AEs were classified according to System Organ Class(SOC)and Preferred Terms(PT).Signal detection was performed using Reporting Odds Ratios(ROR),Proportional Reporting Ratios(PRR),and Empirical Bayes Geometric Mean(EBGM).Stratified analyses examined the impact of demographic factors such as sex,age,and time-to-onset.Temporal patterns and associated risk factors were also investigated.Results:Haemolytic anaemia and haemolysis emerged as the most frequently reported AEs,exhibiting significantly elevated RORs(males:ROR 381.36,95%CI 247.06-588.60;females:ROR 455.11,95%CI 286.43-723.12).Sex-specific differences were evident,with females showing a higher incidence of reproductive-related AEs,including spontaneous abortion and premature labour.Temporal trend analysis revealed that the majority of AEs occurred within the first 30 days after the initiation of artemether administration,indicating a rapid onset.The most affected SOCs were blood and lymphatic system disorders and hepatobiliary disorders.Conclusions:Artemether is associated with a notable frequency of early-onset AEs,particularly hematological and hepatobiliary disorders.The observed sex-specific vulnerability to reproductive AEs highlights the need for sex-conscious clinical approaches.Enhanced post-treatment monitoring and further investigations into the drug’s pharmacokinetics and mechanistic pathways are recommended.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
文摘The numbers of testosterone prescriptions written have increased several-fold worldwide, but the incidence of pathological hypogonadism due to hypothalamic, pituitary, and testicular disease has remained unchanged. Most of these prescriptions are being dispensed to middle-aged and older men who have experienced age-related decline in serum testosterone levels; a subset of the population in which benefits of testosterone replacement is at best, modest. Recently, some randomized controlled trials have reported increased cardiovascular events in men （mainly older men and those with prevalent cardiovascular disease） with testosterone use, and a few recent meta-analyses have confirmed these findings, in this review, we discuss trials of testosterone therapy that have reported higher cardiovascular events, relevant trials that have not reported increased cardiovascular events and large trials that have focused on cardiovascular risk （mainly atherosclerosis progression） as their main outcome. We also review findings from meta-analyses that have evaluated cardiovascular events in various testosterone trials. Finally, we discuss some potential mechanisms by which testosterone use might result in an increased cardiovascular risk. As none of the trials conducted to date were adequately powered to evaluate cardiovascular events, no firm conclusions can be drawn regarding the cardiovascular safety of testosterone therapy at this time. In the interim, we hope that this review will help practitioners make informed decisions regarding the care of their patients.
文摘Azoospermia,defined as the absence of sperm in the ejaculate,is a well-documented consequence of exogenous testosterone(ET)and anabolic–androgenic steroid(AAS)use.These agents suppress the hypothalamic–pituitary–gonadal(HPG)axis,leading to reduced intratesticular testosterone levels and impaired spermatogenesis.This review examines the pathophysiological mechanisms underlying azoospermia and outlines therapeutic strategies for recovery.Azoospermia is categorized into pretesticular,testicular,and post-testicular types,with a focus on personalized treatment approaches based on the degree of HPG axis suppression and baseline testicular function.Key strategies include discontinuing ET and monitoring for spontaneous recovery,particularly in patients with shorter durations of ET use.For cases of persistent azoospermia,gonadotropins(human chorionic gonadotropin[hCG]and follicle-stimulating hormone[FSH])and selective estrogen receptor modulators(SERMs),such as clomiphene citrate,are recommended,either alone or in combination.The global increase in exogenous testosterone use,including testosterone replacement therapy and AAS,underscores the need for improved management of associated azoospermia,which can be temporary or permanent depending on individual factors and the type of testosterone used.Additionally,the manuscript discusses preventive strategies,such as transitioning to short-acting testosterone formulations or incorporating low-dose hCG to preserve fertility during ET therapy.While guidelines for managing testosterone-related azoospermia remain limited,emerging research indicates the potential efficacy of hormonal stimulation therapies.However,there is a notable lack of well-structured,controlled,and long-term studies addressing the management of azoospermia related to exogenous testosterone use,highlighting the need for such studies to inform evidence-based recommendations.
基金the support from the National Natural Science Foundation of China(Nos.52279103,52379103)the Natural Science Foundation of Shandong Province(No.ZR2023YQ049)。
文摘Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies associated with adverse geology provide a novel strategy for addressing these limitations.However,statistical methods for identifying geochemical anomalies are insufficient for tunnel engineering.In contrast,data mining techniques such as machine learning have demonstrated greater efficacy when applied to geological data.Herein,a method for identifying adverse geology using machine learning of geochemical anomalies is proposed.The method was identified geochemical anomalies in tunnel that were not identified by statistical methods.We by employing robust factor analysis and self-organizing maps to reduce the dimensionality of geochemical data and extract the anomaly elements combination(AEC).Using the AEC sample data,we trained an isolation forest model to identify the multi-element anomalies,successfully.We analyzed the adverse geological features based the multi-element anomalies.This study,therefore,extends the traditional approach of geological analysis in tunnels and demonstrates that machine learning is an effective tool for intelligent geological analysis.Correspondingly,the research offers new insights regarding the adverse geology and the prevention of hazards during the construction of tunnels and underground engineering projects.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
文摘Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.
文摘Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have different degrees of adverse reactions, which will cause damage to the patient’s body once they occur. This paper retrospectively analyzed the clinical data of patients with severe allergic reactions such as fecal incontinence and numbness of hands and feet caused by the use of paclitaxel liposome during postoperative chemotherapy in a case of ovarian cancer admitted to our hospital. The causes and corresponding treatment measures were analyzed, in order to provide the reference for medical staff to take effective countermeasures in advance in the future.
文摘Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for medication-induced urticaria through comprehensive analysis of the FDA Adverse Event Reporting System(FAERS)database.Methods:We employed reporting odds ratios(ROR)to evaluate drug-urticaria associations using FAERS data spanning from Q12004 to Q32024.Analytical approaches included univariate screening,LASSO regression,and multivariate logistic regression to identify potential risk factors.Multiple comparison adjustments were implemented using the Bonferroni method.Results:The study identified 1807 pharmaceutical agents potentially associated with urticaria development.Univariate analysis categorized these agents into several therapeutic classes:antimicrobials(19/85),biologics(16/85),analgesics(8/85),dermatologicals(3/85),anti-rheumatic agents(4/85),hormonal preparations(3/85),antihypertensives(2/85),neuropsychiatric medications(2/85),uric acid-lowering drugs(2/85),multiple sclerosis therapies(2/85),and miscellaneous agents(17/85).Multivariate analysis identified three significant risk determinants:middle-aged individuals(36-53 years),female gender,and exposure to any of 82 specific medications.Conclusion:These evidence-based findings provide valuable insights for early clinical recognition of drug-induced urticaria and establish a foundation for subsequent mechanistic investigations into medication-related hypersensitivity reactions.
基金supported by the National Natural Science Foundation of China(no.31800320 and no.32360250 to XR)Natural Science Foundation of Hainan Province(no.320RC506 to XR)+3 种基金funded by the project supported by the Scientific Research start-up Fund of Hainan University[no.KYQD(ZR)20057]the Teaching Research of Hainan University(no.Hdsz20-9)supported by Hainan Tropical Rainforest Conservation Research Project,ZDYF2023RDYL01(supported by the Hainan Institute of National Park,HINP,KY-24ZK02)supported by the specific research fund of The Innovation Platform for Academicians of Hainan Province.
文摘Bite force is an important performance indicator of individual fitness that is closely related to food acquisition,male competition,and mating selection.It is also affected by a variety of factors and different mechanisms.Therefore,it is relatively difficult to understand the evolutionary driving forces of changes in bite force.In this study,the driving factors affecting the bite force of wild-derived red junglefowl(Gallus gallus jabouillei)were investigated from the aspects of morphological indicators and physiological characteristics.Results showed that the bite force of wild-derived red junglefowl was directly related to sex,showing obvious sexual differences.However,there was no correlation between the plasma testosterone level and bite force.The bite force of males was significantly greater than that of females,and the body index(i.e.,PC1 of five body measures,namely body mass,body length,wing length,tail length,and tarsus length),the grasp index(i.e.,tomial length×bill width)of males were significantly greater than those of females.Sexual selection may have played a key role in the evolution of bite force in the red junglefowl.Future studies should examine other key factors affecting changes in bite force to verify the correlation between secondary sexual characteristics and bite force in red junglefowls.
基金supported by Clinical Research Operating Fund of Central High Level Hospitals(2022-PUMCH-B-088).
文摘Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.
基金supported by grants from the National Natural Science Foundation of China(N0.82474525 and No.82074444)the Hunan Provincial Natural Outstanding Young People Science Foundation(2023JJ10032)the Hunan Province Health and High-Level Talent Medical Academic Leader Training Plan(20240304051).
文摘The circadian clock is an important internal time regulatory system for a range of physiological and behavioral rhythms within living organisms.Testosterone,as one of the most critical sex hormones,is essential for the development of the reproductive system,maintenance of reproductive function,and the overall health of males.The secretion of testosterone in mammals is characterized by distinct circadian rhythms and is closely associated with the regulation of circadian clock genes.Here we review the central and peripheral regulatory mechanisms underlying the influence of circadian clock genes upon testosterone synthesis.We also examined the specific effects of these genes on the occurrence,development,and treatment of common male diseases,including late-onset hypogonadism,erectile dysfunction,male infertility,and prostate cancer.
文摘BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.
文摘Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to antibiotics between August 2021 and August 2023.The types of antibiotics that caused adverse reactions were analyzed,and the symptoms of adverse reactions and measures for rational use of antibiotics were summarized.Results:Among the analyzed cases of adverse reactions to antibiotics,the highest rate was observed in patients aged 61–75 years,accounting for 38.33%,followed by patients aged 51–60 years,accounting for 20.00%.In terms of the types of antibiotics that caused adverse reactions,cephalosporins were the most common,accounting for 40.00%,followed by penicillins,accounting for 18.33%.Analysis of the systems involved in adverse reactions showed that skin and appendage disorders were the most common,accounting for 36.67%,followed by the digestive system,accounting for 28.33%.Conclusion:Irrational use of antibiotics can lead to adverse drug reactions.Therefore,it is necessary to analyze strategies for the rational use of antibiotics to reduce adverse drug reactions and ensure the safety of antibiotic use.
基金Collaborative Innovation Program of Jiangsu Pharmaceutical Vocational College(Grant No.20239120)。
文摘The aim of this study is to evaluate the characteristics and patterns of adverse drug reactions(ADRs)associated with antineoplastic drugs and provide insights for safer chemotherapy practices.Based on 979 ADR cases reported in our hospital from January 1,2022,to December 31,2023,an analysis was conducted.Statistical analysis of the data revealed that 72.73%of these ADR incidents occurred in a hospital setting.The incidence of ADRs was higher in female patients compared to males,with the majority of cases(59.14%)observed in individuals aged 51-70 years.Intravenous administration was the predominant route linked to ADRs,accounting for 69.66%of the cases.Serious ADRs represented 9.30%of the total,including one instance where symptoms did not improve despite drug discontinuation or treatment.Cytotoxic antineoplastic drugs were responsible for 97.85%of all ADRs,with oxaliplatin being the most frequently implicated agent(19.82%).Gastrointestinal system involvement was the most common ADR manifestation,observed in 60.79%of cases.These findings underscored the necessity of enhanced monitoring for ADRs associated with cytotoxic antineoplastic drugs,particularly platinum-based agents.Comprehensive risk assessments and tailored treatment plans should be implemented during chemotherapy to minimize the occurrence of ADRs and safeguard patient safety.
文摘Objective:To investigate the various adverse reactions observed in cancer patients undergoing chemotherapy and provide a basis for developing rational chemotherapy regimens.Methods:A retrospective study was conducted on 180 cancer patients treated between August 2014 and August 2016.All patients received chemotherapy,and the adverse reactions occurring during treatment were analyzed.Results:The types of adverse reactions in cancer patients after chemotherapy varied,but digestive system-related adverse reactions were more common,including nausea,hair loss,and diarrhea.In this study,the age distribution of the 180 cancer patients was analyzed.The results showed that 56 patients were aged 13-29 years,72 patients aged 30-47 years,and 52 patients aged 48-67 years.Conclusion:Cancer patients undergoing chemotherapy have a high probability of experiencing adverse reactions,which can cause signifi cant discomfort.In such cases,targeted interventions must be implemented to manage treatment-related adverse reactions and prevent their occurrence.
文摘This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS).By analyzing this extensive pharmacovigilance database,the study aimed to offer meaningful insights for improving the clinical safety of eltrombopag in children.Data covering eltrombopag-related ADEs from Q12004 to Q42023 were extracted from FAERS,and signal detection was conducted using both the reporting odds ratio(ROR)and proportional reporting ratio(PRR)methods.ADEs were categorized based on the System Organ Class(SOC)classification in MedDRA version 25.0.A total of 582 reports involving pediatric patients receiving eltrombopag were identified,encompassing 21 SOC categories.The analysis revealed that,in addition to the known ADEs listed in the drug label,clinicians should remain vigilant for potential off-label ADE signals.These included abnormal platelet counts,thrombocytosis,antiphospholipid syndrome,myelofibrosis,reduced serum iron levels,myelodysplastic syndrome,hepatic infections,and other related conditions.Given these findings,it is strongly recommended that serum iron and ferritin levels should be routinely monitored in pediatric patients undergoing eltrombopag therapy,particularly during long-term treatment.Such proactive surveillance may help prevent the onset of iron deficiency anemia and enhance overall treatment safety.
基金Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project(2025AFD278)Three Gorges University Scientific Fund Project(2022kj008)Three Gorges University Special Scientific Fund Project(2023kjzx001)。
文摘Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.
文摘Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monitoring systems,and low patient awareness.It is necessary to improve the level of ADR monitoring at the grassroots level and ensure the safety and effectiveness of medication through countermeasures such as strengthening personnel training,optimizing monitoring processes,and raising public awareness.
