Abstract:
OBJECTIVES:Pulmonary arterial hypertension (PAH) is a progressive disease that can be treated with several medications. Macitentan, an endothelin receptor antagonist (ERA), has received approval as a PAH therapy. We report our data regarding the tolerability in patients with PAH who were switched from bosentan to macitentan. METHODS:At the Baylor Pulmonary Hypertension Program, 24 patients with PAH who had been taking bosentan and were switched to macitentan were identified in this retrospective study. Data from these patients who switched from bosentan 125 mg orally twice per day to macitentan 10 mg orally daily (between October 2013 and February 2015) when macitentan became commercially available were collected. Patients were advised to take their last evening dose of bosentan and then take the first dose of macitentan the following morning within 12 to 24 hours of the last bosentan dose. Baseline data and postswitch data, including 6-minute walk distance, brain naturietic peptide, alanine transaminase (ALT) and aspartate transaminase (AST) levels, World Health Organization Functional Class (WHO FC), Borg dyspnea score, presence of peripheral edema. RESULTS:At the time of the switch, the mean age was 58 ± 13 (mean ± standard deviation) years, the duration of disease was 6.6 ± 4.4 years, 21 patients were women, 54% were white, and 25% had idiopathic PAH. The mean duration of follow-up after the switch was 5.7 ± 1.5 months. The 6-minute walk distance was 344 ± 106 m preswitch and 319 ± 85 m postswitch (P = 0.18). Brain naturietic peptide levels were 91 ± 170 pg/mL preswitch and 90 ± 137 pg/mL postswitch (P = 0.93). At the time of the switch, 42% were WHO FC II and 50% had edema, and 55% had edema. AST and ALT remained unchanged postswitch. Two patients did not tolerate the switch to macitentan and had to be returned to bosentan: one patient with portopulmonary hypertension developed elevated AST and ALT and the second patient's macitentan was stopped because of malaise and tachyarrhythmia. One patient who underwent a successful liver transplant had macitentan stopped following the transplant. CONCLUSIONS:A rapid switch from bosentan to macitentan was well tolerated and safe with maintained WHO FC, with no significant change in edema and liver enzyme levels. The switch from bosentan to macitentan eliminates the need for monthly liver function test monitoring and removes the potential for bosentan treatment interruption.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Safdar Z,Thakur A,Frost Adoi
10.14423/SMJ.0000000000000607subject
Has Abstractpub_date
2017-03-01 00:00:00pages
223-228issue
3eissn
0038-4348issn
1541-8243pii
SMJ50335journal_volume
110pub_type
杂志文章abstract::Methimazole is a widely used and generally well-tolerated antithyroid agent. A 43-year-old woman had severe jaundice and itching 1 month after receiving methimazole (10 mg tid) and propranolol (20 mg tid) for treatment of hyperthyroidism. The patient continued treatment for another 4 days after the appearance of jaund...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000054690.98272.B1
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:To evaluate the real-world use of various weight loss techniques and to compare the effectiveness of nontraditional methods with diet and exercise in helping nongeriatric adults lose weight. METHODS:A cross-sectional analysis of the 2005-2010 National Health and Nutrition Examination Survey was performed. A...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000130
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:Patients awaiting heart transplantation can be listed for prolonged periods of time and, as a result, the prevalence of anxiety and depression is high. Our study evaluates the feasibility of canine-assisted therapy (CAT) in this population. METHODS:A prospective, multicenter study was performed on all statu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000980
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:In this study, the clinical characteristics, survival, and prognostic factors of 200 patients diagnosed as having chronic lymphocytic leukemia (CLL) were analyzed. METHODS:The medical charts of 200 CLL patients registered to our center between 1984 and 2000 were retrospectively evaluated. RESULTS:Of all pa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000053674.03385.B7
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:In recent years, more and more discussions have arisen with regard to the role of (partially) hydrolyzed formulas as standard feedings for infants with a high risk to have allergy. METHODS:This review is based on an extensive overview of the literature dealing with the subjects of allergy prevention and hyd...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199712000-00002
更新日期:1997-12-01 00:00:00
abstract::Over the past 10 years, one of us (M.C.A.) has treated 92 patients who required operation for symptoms associated with alcohol-induced chronic fibrocalcific pancreatitis. Four of these patients had duodenal obstruction. All four had had lateral pancreaticojejunostomy to relieve pancreatic ductal obstruction and associ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1991-03-01 00:00:00
abstract::The rapid increase in the use of helicopters for hospital transport during the 1980s is the culmination of several hundred years of military medical innovation. Mass battefield casualties spurred both technologic and medical changes necessary for today's sophisticated helicopter systems in use worldwide, particularly ...
journal_title:Southern medical journal
pub_type: 历史文章,杂志文章
doi:10.1097/00007611-198907000-00022
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVES:In this study, we determined patients' attitudes toward discussing firearms and issues of firearms safety with emergency department physicians. We assessed whether patients feel discriminated against should physicians discuss firearms safety, and whether they believed that physician counseling may change how...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000915
更新日期:2019-01-01 00:00:00
abstract::The predictability of a method of determining serum digoxin concentration was assessed in a retrospective study of 35 hospitalized patients taking digoxin orally for maintenance therapy. Simple pharmacokinetic expressions were used to estimate digoxin concentration. Clinically, the mean measured digoxin concentration ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198403000-00016
更新日期:1984-03-01 00:00:00
abstract::We recently managed a patient with diabetic ketoacidosis who had an exceptionally high arterial oxygen tension of 144 mm Hg while breathing room air. This was higher than the calculated alveolar oxygen tension and suggested the impossible situation of an uphill diffusion gradient. We were surprised to find this is a r...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197909000-00013
更新日期:1979-09-01 00:00:00
abstract::Nearly three million persons in the United States are viremic with hepatitis C (HCV). Despite a decreasing incidence of HCV in this country, the prevalence of HCV-related chronic liver disease is increasing. Most infections in the United States are acquired by intravenous drug use. The chronicity rate of HCV is high, ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000118903.35704.30
更新日期:2004-04-01 00:00:00
abstract::Seventeen patients with Crohn's disease requiring emergency operative procedures disclosed important factors leading to successful outcome. In seven of the ten patients not known to have Crohn's disease, the history strongly suggested this diagnosis. Two patients died; three others had major complications, including t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197810000-00010
更新日期:1978-10-01 00:00:00
abstract:OBJECTIVE:There is a relation between tumor stage and grade with the risk of cancer recurrence in patients undergoing surgical treatment for kidney cancer. The association of patient comorbidity with disease recurrence is less well characterized. The objective of this study was to explore the association between comorb...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000651
更新日期:2017-05-01 00:00:00
abstract::An 80-year-old man had acute pancreatitis during the fourth week of antibiotic therapy for enterococcal endocarditis and 12 days after initiation of ketoprofen therapy for osteoarthritis of the hip. Pancreatitis resolved after discontinuance of ketoprofen therapy and while continuing antibiotic therapy for endocarditi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199204000-00023
更新日期:1992-04-01 00:00:00
abstract::Coronary heart disease remains the major cause of mortality and morbidity in the United States and other western countries despite major advances in its treatment. During the last decades, many markers of coronary artery disease have been found which help predict future risk of cardiovascular events. High-sensitivity ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e31816c0195
更新日期:2008-05-01 00:00:00
abstract::Ovarian vein thrombophlebitis is often misdiagnosed because of vague symptoms leading to unnecessary surgery, morbidity, and mortality. CT findings in such a case are very useful in making a definite diagnosis of ovarian vein thrombophlebitis. We consider CT the preferred method for evaluating pain in the right lower ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198911000-00022
更新日期:1989-11-01 00:00:00
abstract::Of 72 patients with chronic myelogenous leukemia (CML), 37 were Ph1 positive, eight were negative, and 27 were not evaluated for the Ph1 chromosome. Of the 37 patients positive for Ph1, 31 had adequate evaluation. These 31 patients were reviewed for survival with reference to spleen size. Seventeen patients with splee...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197906000-00003
更新日期:1979-06-01 00:00:00
abstract::Seven patients with diabetes of ten to 24 years' duration and renal insufficiency were treated with fluphenazine and amitriptyline in an attempt to control severe pain in the extremities. Six patients had relief of pain within five days of initiation of therapy. One patient had no pain relief despite mood alteration. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::Inhalation abuse of volatile solvents, previously known generically as "glue sniffing," is typically pursued by adolescents. A wide range of legal, easily obtained products containing volatile substances are available for abuse. We report two illustrative cases of fatal volatile substance abuse: gasoline sniffing in a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000626
更新日期:2017-04-01 00:00:00
abstract::We have reported the case of a 19-year-old black man with sickle cell disease who had swelling over the right frontal and periorbital areas. Plain roentgenograms and CT scans were consistent with frontal sinus disease. At trephination, however, sterile liquescent blood clot was found in the frontal sinus. Awareness of...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198712000-00019
更新日期:1987-12-01 00:00:00
abstract:OBJECTIVES:Although we know much about work-related physician burnout and the subsequent negative effects, we do not fully understand work-related physician wellness. Likewise, the relation of wellness and burnout to physician happiness is unclear. The purpose of this study was to examine how physician burnout and well...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000437
更新日期:2016-04-01 00:00:00
abstract::The majority of abnormalities at the foramen of Monro identified by computed tomography (CT) are colloid cysts, but a number of other diseases in this location may produce a similar CT appearance. In a series of 21 patients the radiologic findings included six colloid cysts, two neoplasms, five vascular lesions, three...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198312000-00016
更新日期:1983-12-01 00:00:00
abstract::Coagulopathy due to tuberculosis is rare. We believe ours is only the second reported case of cavitary tuberculosis associated with disseminated intravascular coagulation. Our review of all 13 cases to date shows that the patients are generally black, middle-aged, male, alcoholic, and febrile. The tuberculosis is gene...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199001000-00019
更新日期:1990-01-01 00:00:00
abstract::With the intent of cost containment, we conducted a survey of cimetidine usage in the Ambulatory Care Service of our Veterans Administration Medical Center. During a period of six months, this drug was prescribed for 132 patients. Only about 20% received cimetidine for FDA approved conditions. Treated conditions not a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198410000-00019
更新日期:1984-10-01 00:00:00
abstract::Acquired immunodeficiency syndrome (AIDS) has engendered a crisis of fear among the public and health professionals alike. In addition to the myriad anxieties that generally accompany dying and death, AIDS patients must deal with numerous additional fears. In rushing to treat the physiologic aspects of AIDS, health pr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198702000-00022
更新日期:1987-02-01 00:00:00
abstract::Abscess of the spleen is uncommon and potentially lethal, but until recently it was rarely diagnosed except by exploratory celiotomy or at autopsy. Now, with the advent of radionuclide scanning, ultrasonography, and selective angiography, earlier diagnosis is possible in most cases. We report a case of traumatic absce...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197905000-00019
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:Conventional magnetic resonance imaging (MRI) of complex cervical spine disorders may underestimate the magnitude of structural disease because imaging is performed in a nondynamic non-weight-bearing manner. Myelography provides additional information but requires an invasive procedure. METHODS:This was a p...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/00007611-200405000-00008
更新日期:2004-05-01 00:00:00
abstract::Human ehrlichiosis is not a common cause of acute respiratory distress syndrome (ARDS). Physicians should be aware of this life-threatening but treatable entity. Progression to ARDS may be related to delay in diagnosis and treatment. Fever, leukopenia, thrombocytopenia, and a history of tick exposure in an endemic are...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199903000-00017
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:Our study aimed to investigate the association between maternal-perceived psychological stress and fetal telomere length. METHODS:We recruited women in labor upon hospital delivery admission. Based on responses to the Perceived Stress Scale, we categorized participants as having "high," "normal," or "low" pe...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000567
更新日期:2016-12-01 00:00:00