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Managing cardiotoxicity associated with immune checkpoint inhibitors

Chronic Diseases and Translational Medicine 2019年第1期5卷 6-14页

作者： Sireesha Upadhrasta Hadi Elias keval patel Lei Zheng Department of Internal Medicine Saint Agnes Hospital Baltimore MD 21229 USA Department of Internal Medicine University of Maryland Baltimore MD 21201 USA Departments of Oncology and Surgery The Pancreatic Cancer Precision Medicine Center of Excellence Program The Bloomberg-Kimmel Institute for Cancer Immunotherapy Baltimore MD 21287 USA

Immuno-oncology is a fast evolving field of cancer therapy and immune checkpoint inhibitors (ICIs) are clearly a breakthrough in this field. Cardiotoxicity with conventional anti-cancer therapies has been well studied in the past and clear guidelines for management of these side effects are available in the literature. However, cardiotoxicity with novel agents such as ICIs has been fairly under-reported and/or underestimated and we are yet to formulate clear guidelines for management of these rare side effects. In the last few years, there has been an overall increase in the number of cases of cardiotoxicity related to ICIs. In this literature review, we describe the mechanism of action of the most widely used ICIs and their related cardiotoxicities. The increase in number of case reports about the potential of cardiotoxicities with these novel agents clearly indicates the need for a new insight into the field of cardio-immuno-oncology.

关键词： Immune checkpoint inhibitor Cardiotoxicity Ipilimumab Nivolumab Pembrolizumab

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Evidence analysis on the utilization of platelet-rich plasma as an adjuvant in the repair of rotator cuff tears

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World Journal of Meta-Analysis 2022年第3期10卷 143-161页

作者： Sathish Muthu Naveen Jeyaraman keval patel Girinivasan Chellamuthu Vibhu Krishnan Viswanathan Madhan Jeyaraman Manish Khanna Department of Orthopaedics Government Medical College and HospitalDindigul 624001Tamil NaduIndia Department of Biotechnology School of Engineering and TechnologySharda UniversityGreater Noida 201306Uttar PradeshIndia Research Associate Indian Stem Cell Study GroupAssociationLucknow 226010Uttar PradeshIndia Research Associate Orthopaedic Research GroupCoimbatore 641001Tamil NaduIndia Fellow in Orthopaedic Rheumatology Dr Ram Manohar Lohiya National Law UniversityLucknow 226010Uttar PradeshIndia Fellow in Joint Replacement Atlas Hospitals(The Tamil Nadu Dr MGR Medical University)Tiruchirappalli 620002Tamil NaduIndia Fellow in Arthroscopy Ortho-One Orthopaedic Speciality Centre(The Tamil Nadu Dr MGR Medical University)Coimbatore 641005Tamil NaduIndia Department of Orthopaedics and Spine Surgery Ganga Medical Centre and HospitalsCoimbatore 641043Tamil NaduIndia Department of Orthopaedics Faculty of MedicineSri Lalithambigai Medical College and HospitalDr MGR Educational and Research InstituteChennai 600095Tamil NaduIndia South Texas Orthopaedic Research Institute LaredoTX 78045United States Department of Orthopaedics Autonomous State Medical CollegeAyodhya 224135Uttar PradeshIndia

BACKGROUND Platelet-rich plasma has been gaining popularity as an agent for biological augmentation either as the sole treatment modality or as an adjunct to surgical *** is substantial discrepancy in the results of the published meta-analyses;and the true efficacy and role of using autologous platelet-rich plasma(PRP)at the time of rotator cuff repair is still *** To performed this systematic overview on the overlapping meta-analyses that analyzed autologous PRP as an adjuvant in the repair of rotator cuff tears and identify the studies which provide the current best evidence on this subject and generate recommendations for the *** We conducted independent and duplicate electronic database searches in PubMed,Web of Science,Scopus,Embase,Cochrane Database of Systematic Reviews,Reference Citation Analysis and the Database of Abstracts of Reviews of Effects on September 8,2021 to identify meta-analyses that analyzed the efficacy of PRP as an adjuvant in the repair of rotator cuff *** quality assessment was made using Oxford Levels of Evidence,AMSTAR scoring and AMSTAR 2 *** then utilized the Jadad decision algorithm to identify the study with the highest quality to represent the current best evidence to generate the *** Twenty meta-analyses fulfilling the eligibility criteria were *** AMSTAR scores of the included studies varied from 6-10(mean:7.9).All the included studies had critically low reliability in their summary of results due to their methodological flaws according to AMSTAR 2 *** heterogeneity was observed in the reporting of VAS,function outcome scores(longterm UCLA score,ASES score,SST score),operative time and long-term re-tear *** metaanalyses are more supportive of the role of intra-operative administration of PRPs at the bonetendon interface in improving the overall healing and re-tear rates,functional outcome and *** initial size of the tear and

关键词： Platelet-rich plasma Rotator cuff tears Meta-analyses Functional outcome Re-tear Recommendation

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