The safety of bee venom as a therapeutic compound has been extensively studied, resulting in the identification of potential adverse events, which range from trivial skin reactions that usually ...resolve over several days to life-threating severe immunological responses such as anaphylaxis. In this systematic review, we provide a summary of the types and prevalence of adverse events associated with bee venom therapy.
We searched the literature using 12 databases from their inception to June 2014, without language restrictions. We included all types of clinical studies in which bee venom was used as a key intervention and adverse events that may have been causally related to bee venom therapy were reported.
A total of 145 studies, including 20 randomized controlled trials, 79 audits and cohort studies, 33 single-case studies, and 13 case series, were evaluated in this review. The median frequency of patients who experienced adverse events related to venom immunotherapy was 28.87% (interquartile range, 14.57-39.74) in the audit studies. Compared with normal saline injection, bee venom acupuncture showed a 261% increased relative risk for the occurrence of adverse events (relative risk, 3.61; 95% confidence interval, 2.10 to 6.20) in the randomized controlled trials, which might be overestimated or underestimated owing to the poor reporting quality of the included studies.
Adverse events related to bee venom therapy are frequent; therefore, practitioners of bee venom therapy should be cautious when applying it in daily clinical practice, and the practitioner's education and qualifications regarding the use of bee venom therapy should be ensured.
The association between vitamin D deficiency in the first trimester and GDM development remains controversial in various ethnicities. We prospectively assessed whether pregnant women with vitamin D ...deficiency during early pregnancy had an increased likelihood of GDM development or poor fetal growth or pregnancy outcomes compared to those with sufficient vitamin D levels. Serum 25-OH-D measurements and fetal ultrasonograms were carried out at 12-14, 20-22, and 32-34 wk in 523 pregnant women. Each woman was screened for GDM at 24-28 wk. There were no differences in serum 25-OH-D levels at 12-14 wk or 22-24 wk of pregnancy between GDM and non-GDM women after adjusting for maternal age, BMI at prepregnancy, BMI at first visit, BMI at GDM screening, gestational age at sampling, previous history of GDM, vitamin D intake, and seasonal variation in sampling. The risk of GDM, insulin resistance, and impaired β-cell function had no association with serum 25-OH-D levels in crude or adjusted logistic regression analysis. GDM was not associated with maternal serum 25-OH-D deficiency during the first trimester or fetal growth during the first and second trimesters. Pregnancy outcomes such as miscarriage, Apgar 1, Apgar 5 and birth weight were independent of maternal serum 25-OH-D levels during the first, second and third trimester of pregnancy. In conclusion, neither GDM prevalence nor fetal growth during pregnancy is associated with vitamin D deficiency at the first trimester in Korean women. Pregnancy outcomes are also independent of maternal vitamin D status.
In infants with febrile urinary tract infection (UTI), the accurate rapid diagnosis of acute pyelonephritis (APN) would be valuable because early aggressive treatment reduces the risk of renal ...scarring. The objective of the study was to evaluate whether rapid plasma neutrophil gelatinase-associated lipocalin (NGAL) assay could be used as a diagnostic biomarker of renal parenchymal injury in infants with acute febrile UTI to distinguish APN at the bedside. This prospective observational study included 47 infants, who were admitted with a first episode of acute febrile UTI. Total UTI group was divided into the Cortical defect (UTI-CD,
n
= 24) group and Non-cortical defect (UTI-ND,
n
= 23) group, according to the result of renal scan. For the Control group, 15 infants who presented a febrile episode without any focus of bacterial infection were included. On admission, the median NGAL level (106.5 60–476 ng/mL) in the UTI-CD group was significantly higher than that (60 60–196 ng/mL) in the UTI-ND group and that (60 60–197 ng/mL) in the Control group and was significantly decreased to 60 60–306 ng/mL after an antibiotic treatment. The area under the receiver operating characteristic curves was 0.748 (95 % CI, 0.610–0.887;
P
= 0.003) for NGAL levels and 0.724 (95 % CI, 0.579–0.868;
P
= 0.009) for CRP levels. The best cutoff of NGAL level for detection of APN was founded to be 61.0 ng/mL (sensitivity, 75.0 %; specificity, 78.3 %). Although not a stand-alone test, the rapid determination of plasma NGAL level provides valuable information quickly, concerning the distinction of APN, for determining the clinical course of acute febrile UTI.
This study aimed to compare the accuracy of subjective memory complaints, informant-reports for cognitive declines, and their combination for screening cognitive disorders in memory clinic setting.
...One-hundred thirtytwo cognitively normal (CN), 136 mild cognitive impairment (MCI), and 546 dementia who visited the memory clinic in the Seoul National University Hospital underwent standardized clinical evaluation and comprehensive neuropsychological assessment. The Subjective Memory Complaints Questionnaire (SMCQ) and the Seoul Informant Report Questionnaire for Dementia (SIRQD) were used to assess subjective memory complaints and informant-reports for cognitive declines, respectively.
Both SMCQ and SIRQD showed significant screening ability for MCI, dementia, and overall cognitive disorder (CDall: MCI plus dementia) (screening accuracy: 60.1-94.6%). The combination of SMCQ and SIRQD (SMCQ+SIRQD) was found to have significantly better screening accuracy compared to SMCQ alone for any cognitive disorders. SMCQ+SIRQD also significantly improved screening accuracy of SIRQD alone for MCI and CDall, but not for dementia.
Our findings suggest that the combined information of both subjective memory complaints and informant-reports for cognitive declines can improve MCI screening by each individual information, while such combination appears not better than informant-reports in regard of dementia screening.
Background Vascular endothelial growth factor A (VEGFA), a critical mediator of tumor angiogenesis, is a well-characterized target of hypoxia-inducible factor 1 (HIF-1). Murine arrest-defective ...protein 1A (mARD1A225) acetylates HIF-1α, triggering its degradation, and thus may play a role in decreased expression of VEGFA. Methods We generated ApcMin/+/mARD1A225 transgenic mice and quantified growth of intestinal polyps. Human gastric MKN74 and murine melanoma B16F10 cells overexpressing mARD1A225 were injected into mice, and tumor growth and metastasis were measured. VEGFA expression and microvessel density in tumors were assessed using immunohistochemistry. To evaluate the role of mARD1A225 acetylation of Lys532 in HIF-1α, we injected B16F10-mARD1A225 cell lines stably expressing mutant HIF-1α/K532R into mice and measured metastasis. All statistical tests were two-sided, and P values less than .05 were considered statistically significant. Results ApcMin/+/mARD1A225 transgenic mice (n = 25) had statistically significantly fewer intestinal polyps than ApcMin/+ mice (n = 21) (number of intestinal polyps per mouse: ApcMin/+ mice vs ApcMin/+/mARD1A225 transgenic mice, mean = 83.4 vs 38.0 polyps, difference = 45.4 polyps, 95% confidence interval CI = 41.8 to 48.6; P < .001). The growth and metastases of transplanted tumors were also statistically significantly reduced in mice injected with mARD1A225-overexpressing cells than in mice injected with control cells (P < .01). Moreover, overexpression of mARD1A225 decreased VEGFA expression and microvessel density in tumor xenografts (P < .04) and ApcMin/+ intestinal polyps (P = .001). Mutation of lysine 532 of HIF-1α in B16F10-mARD1A225 cells prevented HIF-1α degradation and inhibited the antimetastatic effect of mARD1A225 (P < .001). Conclusion mARD1A225 may be a novel upstream target that blocks VEGFA expression and tumor-related angiogenesis.
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