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Symptoms, Causes, Risks Factors & More

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Drug-Induced Hypersensitivity Syndrome (DIHS) is a severe reaction to drugs that can cause serious problems in many different body systems. In some cases, the condition can cause complications that lead to death.

DIHS is rare. But because it can get so serious, it’s important to understand which drugs are most likely to trigger these reactions.

Read on to learn what medications can trigger a DIHS reaction, what risk factors can make you more vulnerable, and what to do if you suspect you or someone in your care is experiencing this type of reaction.

DIHS is a drug reaction. It happens when your body reacts to a drug the way it would react to an infection.

In response to the drug, infection-fighting T cells are released in your immune system, causing rashes and damage to your internal organs.

Several factors differentiate DIHS from a common drug response. At DIHS this includes:

  • reactivates common herpes viruses (especially HHV-6) that may be dormant in your body
  • includes more than one organ in your body
  • Symptoms seem to go into remission, but relapses can occur later
  • causing the development of autoimmune diseases across the board

DIHS vs. drug-induced eosinophilia

DIHS shares overlapping symptoms with another condition known as drug-induced eosinophilia with systemic symptoms (DRESS).

The main difference between the two conditions is that according to a 2019 review, DIHS involves reactivating herpes viruses in your body that DRESS does not. Some researchers believe that DIHS could be a more severe form of DRESS.

One of the things that make diagnosing DIHS and DRESS difficult is that symptoms do not appear immediately, so doctors may not immediately make a connection between the symptoms you are experiencing and the medications you are taking.

DIHS is also similar to several other diseases

Another difficulty is that DIHS is very similar to several other conditions, including:

While many drug allergies produce an immediate response, DIHS symptoms typically appear 3 weeks to 3 months after taking the medication. Symptoms can come and go for months or even years.

Symptoms can vary depending on which drug caused the reaction. Some symptoms are easier to notice while others may not be visible until laboratory tests reveal a problem.

Here is a list of the most common symptoms:

  • a pink or red rash with or without purulent bumps or blisters
  • scaly, scaly skin
  • fever
  • Facial swelling
  • swollen or tender lymph nodes
  • swollen salivary glands
  • dry mouth
  • White blood cell abnormalities
  • Difficulty moving normally
  • a headache
  • Seizures
  • coma

Damage to internal organs

DIHS and DRESS can damage your internal organs.

According to the 2019 review mentioned earlier, 75 to 94 percent of the time, it’s the liver that takes the most damage. The kidneys are involved about 12 to 40 percent of the time. The heart is impaired in 4 to 27 percent of cases. And about a third of those with DRESS have lung damage.

Researchers have found that genes play an important role in whether you’re likely to have a severe drug reaction like DIHS or DRESS. Genetics isn’t the only factor, however. Studies show you are more likely to have DIHS if:

  • You are over 20 years old.
  • You have had a viral infection in the past few weeks, particularly herpes zoster infection.
  • You have ever had a rheumatic or collagenous rheumatic disease.
  • You have a medical condition that requires frequent use of antibiotics.

Hypersensitivity syndrome is caused by a complex series of interactions between a drug, your own immune system, and viruses in your body, particularly herpes viruses.

Researchers are still learning about these interactions, but what they have discovered so far suggests that certain drugs are more likely to be involved in these reactions:

  • Seizure medications, including carbamazepine, lamotrigine, mexiletine, pheobarbitol, phenytoin, valproic acid, and zonisamidnis
  • Antibiotics such as dapsone (used to treat skin infections and leprosy), amoxicillin, ampicillin, azithromycin, levofloxacin, piperacillin / tazobactam, clindamycin, minocycline, and vancomycin
  • Drugs used to treat tuberculosis, including ethambutol, isoniazid, pyrazinamide, rifampin, and streptomycin
  • Sulfasalazine, an arthritis drug
  • antiretroviral drugs such as nevirapine and efavirenz
  • anti-inflammatory drugs, including ibuprofen, celecoxib, and diclofenac
  • Medicines used to treat hepatitis C, including boceprevir and telaprevir
  • Cancer therapies, including sorafenib, vismodegib, imatinib, and vemurafenib
  • Rivaroxaban, a blood thinner
  • Allopurinol and febuxostat, which lower uric acid in people with gout, kidney stones, and cancer
  • Omeprazole, an over-the-counter medicine for heartburn
  • Acetaminophen, an over-the-counter pain reliever

According to a 2019 study, more than 40 different drugs, including the ones listed above, have caused isolated cases of DIHS in children.

A doctor or other healthcare professional can diagnose DIHS by doing the following:

  • a physical exam
  • Liver function test
  • Blood tests
  • Kidney function tests
  • Urinalysis
  • a skin biopsy

More testing may be needed if the doctor wants to rule out other conditions.

The first step in treating DIHS is to stop taking the drug that is causing the reaction. You should be prepared for your symptoms to worsen immediately after you stop taking the medication. This is one of the hallmarks of this type of drug reaction.

It’s also important to understand that your symptoms can come and go for some time after treatment. This pattern is common in this condition as well.

After you stop your medication, your doctor may treat you with corticosteroids to control some of your symptoms. However, treatment with corticosteroids is not suitable for everyone. According to a 2020 study, it may increase the risk of reactivating an Epstein-Barr virus or cytomegalovirus already in the body.

If you developed a secondary infection as a result of the reaction, you may also need antibiotic therapy.

In rare cases, DIHS or DRESS can cause complications that are potentially life-threatening. Some of these complications are:

These complications can occur long after your other symptoms have subsided.

About 10 percent of people with DIHS die from a complication that develops as a result of the initial reaction. People with affected hearts, livers, or kidneys are more likely than others to die from the disease.

Because drug reactions can get worse every time you are exposed to the medicine, it is important to speak to your doctor about any rash or reaction to a drug.

DIHS and DRESS are severe drug reactions. Although rare, they can cause permanent, sometimes life-threatening, organ damage.

Because symptoms are similar to other illnesses and drug reactions, it is important to speak to a doctor every time you develop a rash or other symptoms after taking a new medication – even if it has been weeks since you started taking the medication.

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Two-hour glucose tolerance test helps identify patients at heightened risk of cognitive decline

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Diabetes is a risk factor for cognitive decline. In a study by the University of Turku and the Finnish Institute for Health and Welfare, researchers observed that even a higher two-hour glucose level in the glucose tolerance test predicts poorer performance in a test measuring episodic memory after ten years. Episodic memory decline is one of the first symptoms of Alzheimer’s disease.

Diabetes is known to be an independent risk factor for memory impairment. Previous studies have shown that risk factors for diabetes such as obesity, metabolic syndrome, and decreased insulin sensitivity are linked to a decrease in cognitive function and an increased risk of developing memory disorders. Fasting blood sugar is not as good a risk measurement tool as this, and according to an earlier report from the Finnish Health 2000 study, it did not predict a decline in memory functions.

The two-hour glucose test in a glucose tolerance test is a commonly used test in healthcare that assesses whether the person being tested has diabetes or impaired glucose tolerance. By definition, a person has impaired glucose tolerance when glucose levels are elevated on the two-hour glucose tolerance test but the diagnostic criteria for diabetes are not met.

In the new study, the researchers investigated whether the glucose levels of the two-hour glucose tolerance test after a ten-year follow-up period are related to cognitive functions. The surveys were carried out in the years 2000-2002 and 2011 with a total of 961 participants. Memory and other cognitive functions were measured using three tests commonly used in the diagnosis and follow-up of patients with memory impairment.

The study suggested that higher blood sugar levels measured in a glucose tolerance test in 2001-2002 was linked to weaker performance in a 2011 memory test, in which participants had a delay in retrieving a previously learned word list.

The glucose level measured in the two-hour glucose tolerance test was also associated with a greater decrease in test results during the follow-up period. The analyzes took into account the most important known risk factors for memory disorders such as age, educational background, elevated blood pressure, elevated cholesterol levels, obesity, type 2 diabetes and smoking. “

Sini Toppala, first author, Turku PhD University

The study is based on the population-based survey “Health 2000” of the Finnish Institute for Health and Social Affairs and its supplementary data, which were collected in 2001-2002, as well as on its follow-up study, the study “Health 2011”. In the first survey, the participants were 45-74 years old (mean 55.6 years).

The study shows that the glucose tolerance test helps identify patients with impaired glucose tolerance who are at increased risk of cognitive decline. This is important for targeted interventions, explains Toppala.

The research article was published as an online ahead-of-print version on August 15, 2021. The study will be published in a future issue of Diabetes Care.

Source:

Journal reference:

Toppala, S., et al. (2021) Oral Glucose Tolerance Test Predicts Episodic Memory Loss: A 10-Year Population-Based Follow-Up Study. Diabetes treatment. doi.org/10.2337/dc21-0042.

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John Whaite health: Bake Off star’s eating disorder has been ‘very difficult to overcome’

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The star baker, who became the 2012 Bake Off Champion, stunned Paul Hollywood and then judged Mary Berry on his culinary skills, but behind closed doors the star has struggled with his body image since he was a teenager. The star previously discussed his “serious” mental battle with depression, but when he appeared on Steph’s Packed Lunch on Channel 4, he wanted to raise awareness about eating disorders too.

The 32-year-old spoke openly about his struggles with bulimia in the hope that others would also speak out.

He said, “My body image growing up was very difficult … I was so aware that I was fat. But one thing that I was aware of as problematic for 12, 14 years was overeating and then cleaning. The painful pressing down on food and then the immediate need to get that out of me.

“If I bake a lot of muffins and something went wrong that day or time in my life, I would sit and eat all 12 muffins and then run to the bathroom and I would get sick.”

It is estimated that around one million people in the UK have an eating disorder, one in four of whom are men.

CONTINUE READING: Dementia Diet: 3 Foods To Remove From Your Diet To Stop The Risk

Bulimia nervosa is an eating disorder that is characterized by binge eating followed by purification, which may include vomiting, taking laxatives, fasting, or excessive exercise.

The chef, who is still struggling with his condition, said, “One of the things that I find myself very embarrassed about is that … my food every now and then makes me feel very guilty. But it’s not something that I can control.

“I’ve only really accepted it as an eating disorder for the past 18 months, two years, and it has been very, very raw.”

The feelings of guilt that the cook feels unnecessarily about his condition are underlined by his chosen career path.

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“It was very, very difficult to overcome and I think that’s because of the stigma of an eating disorder,” added John.

“Especially as a chef, I didn’t really want to talk about it because I felt like it undermined my entire career.

“How can a chef who writes recipe books and cooks on TV, how can he realistically have bulimia?”

When John first noticed the symptoms, he didn’t realize it was a major problem. Instead, I thought it was a way to deal with overeating. However, if people have the condition for a long time, it can become life-threatening.

The NHS lists several health risks that can arise from persistent vomiting or excessive laxative use.

Possible complications are:

  • feeling tired and weak
  • Dental problems – caused by stomach acid when vomiting persists, can damage tooth enamel
  • Bad breath, sore throat or even tears in the lining of the throat – also caused by stomach acid
  • Irregular or absent periods
  • Dry skin and hair
  • Brittle fingernails
  • Swollen glands
  • Seizures and muscle cramps
  • Heart, kidney, or bowel problems, including permanent constipation
  • Bone Problems – You are more likely to develop problems like osteoporosis, especially if you’ve had symptoms of both bulimia and anorexia.

Before an eating disorder turns into a life-threatening condition, there are general warning signs to look out for in yourself, as well as close friends and relatives.

These can be emotional and behavioral as well as physical in nature.

Emotional and behavioral warning signs include things like unusual swelling of the cheeks or jaw area, hiding or stealing food, excessive use of mouthwash, mints, or chewing gum, extreme mood swings.

Physical symptoms include fainting, muscle weakness, noticeable fluctuations in weight, and difficulty concentrating.

Treatment of the condition is often offered in the form of a guided self-help program. It involves working with a healthcare professional such as a therapist who will enable you to overcome the condition and understand why you are having this behavior.

You can trust an eating disorders charity advisor by calling the adult hotline 0808 801 0677 or the youth hotline 0808 801 0711.

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University of Utah study examines link between suicide risk, genetics | News, Sports, Jobs

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KERA WILLIAMS, special about the standard examiner

A candle is held during the candlelight vigil for World Suicide Prevention Day at Mount Ogden Park in Ogden on Thursday, September 10, 2015.

SALT LAKE CITY – People who suffer from bipolar disorder and are genetically predisposed to post-traumatic stress disorder may have a higher risk of dying of suicide, according to a study conducted by researchers at the University of Utah.

The study looked at risk factors for completing suicide, not just attempting suicide, said Dr. Eric Monson, lead study author and co-chief physician in the Department of Psychiatry at the University of Utah, who suggested the results could lead to better screening measures to identify and identify those with previous trauma in people diagnosed with bipolar disorder the highest risk of suicide.

“Death rates from suicide are 10 to 30 times higher in people with bipolar disorder than in the general population. The suicide rate in Utah is about 22 per 100,000, or about 660 a year, “Monson said. “We found in this study that a combination of previous trauma, a genetic predisposition to PTSD, and a diagnosis of bipolar disorder can increase a higher risk of death from suicide.”

Monson said the results showed that 50% of those studied with bipolar disorder died of suicide without ever trying.

“The focus group was bipolar, but within that disorder we wanted to see if there were other factors like PTSD and severe anxiety,” said Monson. “Those with past trauma and great anxiety were much more likely to die of suicide than the other groups we studied. This is not entirely surprising, as anxiety is pretty closely linked to PTSD. “

The research team, which included Monson, U of U psychiatry professor Hilary Coon, and Virginia Willour, a University of Iowa psychiatry professor, used several thousand DNA samples from Utahners who died from suicide, along with electronic medical records. They also used data from the National Institute of Mental Health Genetics Initiative. Hundreds of people who died were diagnosed with bipolar disorder and had a higher rate of PTSD diagnoses.

According to brainline.org, PTSD is a mental illness that some people develop after experiencing or experiencing a traumatic event such as an accident, sexual assault, fight, or natural disaster. These events can cause flashbacks, nightmares, or triggers. Anyone can develop PTSD, but a number of factors play a role, such as whether the traumatic event was long-lasting. In the United States, it is estimated that about seven or eight in 100 people will develop PTSD at some point in their life. Approximately 8 million adults have PTSD during any given year. About 10% of women and 4% of men develop the disorder.

“People with PTSD tend to have more severe illnesses than other people and are harder to treat with medication,” said Monson.

The study showed some promising results, Monson said, but the problem still exists of helping people who are suicidal. His own sister took her own life when she was 15 and Monson was only 7. He also lost three coworkers to suicide.

“That was an important aspect of my life that drove me to keep digging. Suicide is very complex and there are undoubtedly other characteristics such as environmental factors, toxins and chronic stress, ”he said. “There’s also decent evidence that altitude can play a role. If you look at a map, you can see that the suicide belt is in the Rocky Mountains. These include Utah, Nevada, Wyoming, Colorado, and Idaho. When you are at a higher altitude, your oxygen levels are lower and this can affect the neurotransmitters in the brain. “

Monson also said that while the study is important, it doesn’t mean that a person will definitely commit suicide – and he added that suicide is preventable.

“We have limited mental health resources, but suicide is inherently preventable and we should take all measures to help those at risk,” Monson said. “I think it’s important now that we in the medical field ask people more about serious traumatic experiences in their lives, but it’s also important that people be direct when they suspect someone might be trying to commit suicide . There is a difference between saying, “Do you feel like you might be hurt” and “Do you have the thought of killing yourself”. Please be as straightforward as possible. “

But when all you’re doing to help someone fails, the important thing is not to blame yourself, Monson said.

“It’s not your fault. It’s never so easy to think that you said something or couldn’t have said something,” he said. “Please don’t get caught up in self-blame.”

What to look out for

September is Suicide Awareness Month. Here are the warning signs when someone thinks of suicide:

  • Increased isolation from the world.
  • Bringing matters in order.
  • Give things away.
  • Anxious, tired, or depressed behavior.
  • Talk about being a burden on others.
  • Feeling hopeless or feeling like they are no use.
  • Speaking of wanting to die.
  • Display of extreme mood swings.
  • Increase in the consumption of alcohol or drugs.
  • Anger or recklessness.

Other resources:

  • National Lifeline for Suicide Prevention, 1-800-273-8255
  • https://intermountainhealthcare.org/blogs/topics/live-well/2018/04/suicide-prevention-resources-in-utah/

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