Impact of tofacitinib on patient outcomes in rheumatoid arthritis: review of clinical studies

Rheumatoid arthritis is a chronic, progressive autoimmune disease associated with inflammation and destruction of joints and systemic effects, which result in significant impact on patient\u27s quality of life and function. Tofacitinib was approved for the treatment of rheumatoid arthritis in the USA in 2012 and subsequently in other countries, but not by the European Medicines Agency. The goal of this review was to evaluate the impact of tofacitinib on patient-reported and patient-specific outcomes from prior clinical studies, focusing on quality of life, functionality, pain, global disease assessment, major adverse consequences, and withdrawals. A total of 13 reports representing 11 clinical studies on tofacitinib in rheumatoid arthritis were identified through PubMed and reference lists in meta-analyses and other reviews. Data on improvements in patient-driven composite tools to measure disease activity in rheumatoid arthritis, such as the Health Assessment Questionnaire, served as a major outcome evaluated in this review and were extracted from each study. Additional data extracted from those clinical studies included patient assessment of pain (using a 0–100 mm visual analog scale), patient global assessment of disease (using a 0–100 mm visual analog scale), patient withdrawals, withdrawals due to adverse effects or lack of effect, and risk of serious adverse effects, serious infections, and deaths. Tofacitinib 5 mg bid appears to have a favorable impact on patient outcomes related to efficacy and safety when compared with baseline values and with comparator disease-modifying antirheumatic drugs and placebo. Improvements were seen in the composite and individual measures of disease activity. Serious adverse effects, other adverse consequences, overall withdrawals, and withdrawals due to adverse effects and lack of efficacy are similar or more favorable for tofacitinib versus comparator disease-modifying antirheumatic drugs and placebo. At this point, tofacitinib appears to have an important role in the treatment of rheumatoid arthritis through improvement in these patient outcomes. However, it may require years of additional clinical studies and postmarketing surveillance to fully characterize the benefit-to-risk ratio of tofacitinib in a larger and diverse patient population

Impact of High Volume Energy Drink Consumption on Electrocardiographic and Blood Pressure Parameters: A Randomized Trial

Background Energy drinks have been linked to an increase in emergency room visits and deaths. We aim to determine the impact of energy drinks on electrocardiographic and hemodynamic parameters in young healthy volunteers. Methods and Results A randomized, double-masked, placebo-controlled, crossover study was conducted in healthy volunteers. Participants consumed 32 oz of either energy drink A, energy drink B, or placebo within 60 minutes on 3 study days with a 6-day washout period in between. The primary end point of QT c interval and secondary end points of QT interval, PR interval, QRS duration, heart rate, and brachial and central blood pressures were measured at baseline, and every 30 minutes for 240 minutes. A repeated-measures 2-way analysis of variance was performed with the main effects of intervention, time, and an interaction of intervention and time. Thirty-four participants were included (age 22.1±3.0 years). The interaction term of intervention and time was statistically significant for Bazett\u27s corrected QT interval, Fridericia\u27s corrected QT interval, QT , PR , QRS duration, heart rate, systolic blood pressure, diastolic blood pressure, central systolic blood pressure, and central diastolic blood pressure (all

Jean-François Kosta-Théfaine, Le Chant de la douleur dans les poésies de Christine de Pizan

Cet essai propose un examen du thème de la douleur dans les poésies de Christine de Pizan. On sait combien le deuil marque l’œuvre de Christine et est la clé de voûte de son entrée en écriture. Deuil triple en quelque sorte avec la disparition première du roi modèle, Charles V, puis du père Thomas de Bologne, enfin de l’époux, Étienne du Castel. Peu à peu s’effondre la stabilité matérielle de Christine et, selon ce qu’elle dit, son univers affectif, puisque – fait rare à l’époque – elle prése..

Predictors of the pursuit and attainment of postgraduate residency positions by pharmacy students

Introduction: Attainment of postgraduate pharmacy residency is highly competitive. Although several studies have reported institutional characteristics associated with attaining a residency position, little is known about student-level predictors for residency match. This study aims to evaluate factors that predict the pursuit and attainment of pharmacy residency positions. Research Question or Hypothesis: Which variables predict pharmacy students\u27 pursuit and attainment of residency positions? Study Design: Survey-based cross-sectional study Methods: A web-based survey was administered in May 2020 to 396 students of the class 2019 and 2020 at University of the Pacific School of Pharmacy. The survey asked questions relating to students\u27 characteristics (e.g., resilience, as measured by the Academic Pharmacy Resilience Scale [APRS-16]), academic performance and experiences in pharmacy school (e.g., GPA, leadership, research, patientcare, etc.), and whether students applied to and matched with a residency program. Logistic regression modeling was used to evaluate whether students\u27 responses to survey questions predicted their pursuit and attainment of residency. Results: From 185 students that completed the survey (46.7% response rate), 129 applied to and 77 matched with a residency position. The logistic regression outcomes indicated that the model was a significant predictor of the residency pursuit (X2 [5, 185] = 55.4,P\u3c 0.0001) and attainment (X2 [3, 185] = 77.66,P\u3c 0.0001). Stu-dents with greater GPA, research experience, resilience scores and leadership in an organization or school committee were more likely to apply to a residency program (Odds Ratio \u3e 1.06). Students with greater GPA, self-rated performance score in the residency interview and leadership experience on a school committee were more likely to match with a residency program (Odds Ratio \u3e 5.31).Conclusion: This study identifies several variables that predict stu-dents\u27 application to and match with a postgraduate residency pro-gram, which could provide useful information to stakeholders, including students, educators, and residency program directors

Predictors of the pursuit and attainment of postgraduate residency positions by pharmacy students

Introduction: Attainment of postgraduate pharmacy residency is highly competitive. Although several studies have reported institutional characteristics associated with attaining a residency position, little is known about student-level predictors for residency match. This study aims to evaluate factors that predict the pursuit and attainment of pharmacy residency positions. Research Question or Hypothesis: Which variables predict pharmacy students\u27 pursuit and attainment of residency positions? Study Design: Survey-based cross-sectional study Methods: A web-based survey was administered in May 2020 to 396 students of the class 2019 and 2020 at University of the Pacific School of Pharmacy. The survey asked questions relating to students\u27 characteristics (e.g., resilience, as measured by the Academic Pharmacy Resilience Scale [APRS-16]), academic performance and experiences in pharmacy school (e.g., GPA, leadership, research, patientcare, etc.), and whether students applied to and matched with a residency program. Logistic regression modeling was used to evaluate whether students\u27 responses to survey questions predicted their pursuit and attainment of residency. Results: From 185 students that completed the survey (46.7% response rate), 129 applied to and 77 matched with a residency position. The logistic regression outcomes indicated that the model was a significant predictor of the residency pursuit (X2 [5, 185] = 55.4,P\u3c 0.0001) and attainment (X2 [3, 185] = 77.66,P\u3c 0.0001). Stu-dents with greater GPA, research experience, resilience scores and leadership in an organization or school committee were more likely to apply to a residency program (Odds Ratio \u3e 1.06). Students with greater GPA, self-rated performance score in the residency interview and leadership experience on a school committee were more likely to match with a residency program (Odds Ratio \u3e 5.31).Conclusion: This study identifies several variables that predict stu-dents\u27 application to and match with a postgraduate residency pro-gram, which could provide useful information to stakeholders, including students, educators, and residency program directors