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Article: A case of drug-induced bullous pemphigoid secondary to immunotherapy treated with upadacitinib: A case report.

Gresham, Louise M / Kirchhof, Mark G

2023 Volume 11, Page(s) 2050313X231160926

Abstract: Bullous pemphigoid is an acquired autoimmune subepidermal blistering disease that can arise following exposure to systemic medication, referred to as drug-induced bullous pemphigoid. Drug-induced bullous pemphigoid is a rare but potentially serious ... ...

Abstract	Bullous pemphigoid is an acquired autoimmune subepidermal blistering disease that can arise following exposure to systemic medication, referred to as drug-induced bullous pemphigoid. Drug-induced bullous pemphigoid is a rare but potentially serious immune-related adverse event that should be considered in patients with advanced malignancies undergoing immunotherapy, with immune checkpoint inhibitors emerging in particular as a well-documented drug association in drug-induced bullous pemphigoid. We present a 74-year-old female with recurrent metastatic programmed cell death-ligand 1-positive squamous cell carcinoma of the head and neck area who developed drug-induced bullous pemphigoid in the setting of immunotherapy with a novel immunoglobulin-like transcript 4 inhibitor (MK-4830) in combination with pembrolizumab. Treatment with upadacitinib, a Janus-associated kinase-1 inhibitor, was pursued for significantly disabling disease that was recalcitrant to standard therapies and ultimately transition to palliative care. Follow-up at 4 weeks demonstrated good response. This is the first report describing the use of a Janus-associated kinase inhibitor for the treatment of bullous pemphigoid.
Language	English
Publishing date	2023-03-21
Publishing country	England
Document type	Case Reports
ZDB-ID	2736953-5
ISSN	2050-313X
ISSN	2050-313X
DOI	10.1177/2050313X231160926
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Article ; Online: Draping in Dermatology: A Physician's Perspective.

Gresham, Louise / Melkis, Justina / Choi, Bohmyi / Cyr, Janelle / Huang, Christina M / Beecker, Jennifer

Journal of cutaneous medicine and surgery

2023 Volume 27, Issue 6, Page(s) 579–583

Abstract: Background: Patient dignity is a core component of medicine and health care, yet maintaining patient dignity can be challenging in clinical settings in dermatology, specifically during a total body skin examinations (TBSE) for appropriate assessment and ...

Abstract	Background: Patient dignity is a core component of medicine and health care, yet maintaining patient dignity can be challenging in clinical settings in dermatology, specifically during a total body skin examinations (TBSE) for appropriate assessment and diagnosis. A recent study evaluated patient perspectives in dermatology. The purpose of this study was to investigate current draping practices and perspectives from a physicians' perspective. Methods: A cross-sectional study was performed with the use of study-specific questionnaire distributed to staff dermatologists and dermatology residents across Canada. Results: A total of 117 physicians were included (84 attending dermatologists and 33 dermatology residents). Nearly all staff and resident dermatologists (90.6%) indicated that draping was important. Specific practices differed between residents and staff ( Discussion: This study confirms that draping practices in dermatology are perceived as important by dermatologists, consistent with other reports emphasizing approaches to protect patient privacy and dignity. There is a shared value for draping and consistent integration of this within current practice of Canadian dermatologists. Formal and informal education incorporated in medical education and dermatology training is becoming more prominent. Major study limitations include sampling bias, convenience bias and nonresponse bias. Conclusion: This is the first study to evaluate physician perspectives on draping in dermatology or other areas in medicine. Findings from this study support a focus on draping in medical education.
MeSH term(s)	Humans ; Dermatology/education ; Cross-Sectional Studies ; Canada ; Delivery of Health Care ; Physicians ; Surveys and Questionnaires
Language	English
Publishing date	2023-08-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1361720-5
ISSN	1615-7109 ; 1203-4754
ISSN (online)	1615-7109
ISSN	1203-4754
DOI	10.1177/12034754231191479
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Article ; Online: Response to comment on "An evidence-based guide to SARS-Cov-2 vaccination of patients on immunotherapies in dermatology."

Gresham, Louise M / Marzario, Barbara / Dutz, Jan / Kirchhof, Mark G

Journal of the American Academy of Dermatology

2021 Volume 85, Issue 2, Page(s) e91

MeSH term(s)	COVID-19 ; COVID-19 Vaccines ; Dermatology ; Humans ; Immunotherapy ; SARS-CoV-2 ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2021-04-17
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2021.04.026
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Article ; Online: An evidence-based guide to SARS-CoV-2 vaccination of patients on immunotherapies in dermatology.

Gresham, Louise M / Marzario, Barbara / Dutz, Jan / Kirchhof, Mark G

Journal of the American Academy of Dermatology

2021 Volume 84, Issue 6, Page(s) 1652–1666

Abstract: Immune-mediated diseases and immunotherapeutics can negatively affect normal immune functioning and, consequently, vaccine safety and response. The COVID-19 pandemic has incited research aimed at developing a novel severe acute respiratory syndrome ... ...

Abstract	Immune-mediated diseases and immunotherapeutics can negatively affect normal immune functioning and, consequently, vaccine safety and response. The COVID-19 pandemic has incited research aimed at developing a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. As SARS-CoV-2 vaccines are developed and made available, the assessment of anticipated safety and efficacy in patients with immune-mediated dermatologic diseases and requiring immunosuppressive and/or immunomodulatory therapy is particularly important. A review of the literature was conducted by a multidisciplinary committee to provide guidance on the safety and efficacy of SARS-CoV-2 vaccination for dermatologists and other clinicians when prescribing immunotherapeutics. The vaccine platforms being used to develop SARS-CoV-2 vaccines are expected to be safe and potentially effective for dermatology patients on immunotherapeutics. Current guidelines for the vaccination of an immunocompromised host remain appropriate when considering future administration of SARS-CoV-2 vaccines.
MeSH term(s)	COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Evidence-Based Medicine ; Humans ; Immunocompromised Host ; Immunologic Factors/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Risk Assessment ; SARS-CoV-2 ; Skin Diseases/immunology ; Skin Diseases/therapy
Chemical Substances	COVID-19 Vaccines ; Immunologic Factors ; Immunosuppressive Agents
Language	English
Publishing date	2021-01-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2021.01.047
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Article ; Online: Draping in Dermatology: A Patient's Perspective.

Cyr, Janelle / Choi, Bohmyi / Melkis, Justina / Gresham, Louise / Huang, Christina M / Beecker, Jennifer

Journal of cutaneous medicine and surgery

2022 Volume 26, Issue 6, Page(s) 569–574

Abstract: Background/objectives: Patient dignity is a core component of the Canadian health care system; however, there may be challenges to maintaining patient dignity in clinical settings requiring total body skin examination (TBSE) for adequate assessment and ... ...

Abstract	Background/objectives: Patient dignity is a core component of the Canadian health care system; however, there may be challenges to maintaining patient dignity in clinical settings requiring total body skin examination (TBSE) for adequate assessment and diagnosis. As standardized TBSE draping practices have not been investigated in a dermatology setting, we sought out to investigate subjective patient experiences of draping practices. Methods: A cross-sectional study was performed using a paper survey in dermatology hospital clinics over a 6-month period to 150 patients. Results: Draping was considered important by over 50% of patients surveyed (54.7%). Respondents who indicated that draping impacted their comfort level "a lot" or "very much" had a mean age of 52 and were more likely to be females ( Conclusions: Our study confirmed that most patients surveyed considered draping to be important. Our findings highlight the importance of adequate draping practices to maintain patient privacy and dignity for all patients, with special attention to younger female patients to ensure they feel as comfortable as possible. Future research should focus on how these identified patient comfort factors can be implemented into medical education.
MeSH term(s)	Male ; Humans ; Female ; Middle Aged ; Dermatology ; Cross-Sectional Studies ; Canada ; Physical Examination ; Surveys and Questionnaires
Language	English
Publishing date	2022-08-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1361720-5
ISSN	1615-7109 ; 1203-4754
ISSN (online)	1615-7109
ISSN	1203-4754
DOI	10.1177/12034754221119502
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Article: Reactive infectious mucocutaneous eruption following COVID-19 infection in vaccinated patients.

Aw, Michael / Gresham, Louise / Spurr, Alison / Gavigan, Genevieve

JAAD case reports

2022 Volume 31, Page(s) 35–41

Language	English
Publishing date	2022-10-29
Publishing country	United States
Document type	Case Reports
ZDB-ID	2834220-3
ISSN	2352-5126
ISSN	2352-5126
DOI	10.1016/j.jdcr.2022.10.018
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Article ; Online: Safety and efficacy of autologous cell vaccines in solid tumors: a systematic review and meta-analysis of randomized control trials.

Bastin, Donald J / Montroy, Joshua / Kennedy, Michael A / Martel, Andre B / Shorr, Risa / Ghiasi, Maryam / Boucher, Dominique M / Wong, Boaz / Gresham, Louise / Diallo, Jean-Simon / Fergusson, Dean A / Lalu, Manoj M / Kekre, Natasha / Auer, Rebecca C

Scientific reports

2023 Volume 13, Issue 1, Page(s) 3347

Abstract: We conducted a systematic review and meta-analysis of randomized control trials to formally assess the safety and efficacy of autologous whole cell vaccines as immunotherapies for solid tumors. Our primary safety outcome was number, and grade of adverse ... ...

Abstract	We conducted a systematic review and meta-analysis of randomized control trials to formally assess the safety and efficacy of autologous whole cell vaccines as immunotherapies for solid tumors. Our primary safety outcome was number, and grade of adverse events. Our primary efficacy outcome was clinical responses. Secondary outcomes included survival metrics and correlative immune assays. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for studies published between 1946 and August 2020 using any autologous whole cell product in the treatment of any solid tumor. The Cochrane Randomized Controlled Trial risk of bias tool was used to assess risk of bias. Eighteen manuscripts were identified with a total of 714 patients enrolled in control and 808 in vaccine arms. In 698 patients receiving at least one dose of vaccine, treatment was well tolerated with a total of 5 grade III or higher adverse events. Clinical response was reported in a minority (n = 2, 14%) of studies. Autologous cell vaccines were associated with improved overall (HR 1.28, 95% CI 1.01-1.63) and disease-free survival (HR 1.33, 95% CI 1.05-1.67) over thirteen and ten trials respectively. Where reported, immune assays correlated well with clinical outcomes. Our results suggest that autologous whole cell vaccination is safe and efficacious in increasing survival in patients undergoing treatment for solid tumors.Registration: PROSPERO CRD42019140187.
MeSH term(s)	Humans ; Cancer Vaccines/adverse effects ; Immunotherapy ; Neoplasms/therapy
Chemical Substances	Cancer Vaccines
Language	English
Publishing date	2023-02-27
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-29630-9
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Article: Multicenter Surveillance of Antimicrobial Resistance among Gram-Negative Bacteria Isolated from Bloodstream Infections in Ghana.

Antibiotics (Basel, Switzerland)

2023 Volume 12, Issue 2

Abstract: Background: Antimicrobial resistance (AMR) in Gram-negative bacteria-causing bloodstream infections (BSIs), such as : Methods: A cross-sectional study was conducted between April and December 2021 at eleven sentinel health facilities across Ghana as ... ...

Abstract	Background: Antimicrobial resistance (AMR) in Gram-negative bacteria-causing bloodstream infections (BSIs), such as Methods: A cross-sectional study was conducted between April and December 2021 at eleven sentinel health facilities across Ghana as part of a pilot study on the feasibility and implementation of the human sector AMR surveillance harmonized protocol in sub-Saharan Africa. Gram-negative bacteria recovered from blood specimens of febrile patients were identified using MALDI-TOF and evaluated for antimicrobial resistance using the BD Phoenix M50 analyzer and Kirby-Bauer disc diffusion. The Department of Medical Microbiology at the University of Ghana served as the reference laboratory. Results: Out of 334 Gram-negative blood isolates, there were 18 (5.4%) NTS, 85 (25.5%) Conclusions: Multicenter AMR surveillance of Gram-negative blood isolates from febrile patients was well-received in Ghana, and the implementation of a harmonized protocol was feasible. High resistance and multidrug resistance to first- or second-choice antibiotics, including penicillins, third-generation cephalosporins, and fluoroquinolones, were found, implying that these antibiotics might have limited effectiveness in BSI treatment in the country. Continuation of AMR surveillance in Gram-negative blood isolates is essential for a better understanding of the extent of AMR in these pathogens and to guide clinical practice and policymaking.
Language	English
Publishing date	2023-01-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics12020255
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Article: Longitudinal Stability of Cognition in Early-Phase Relapsing-Remitting Multiple Sclerosis: Does Cognitive Reserve Play a Role?

Barbu, Roxana M / Berard, Jason A / Gresham, Louise M / Walker, Lisa A S

International journal of MS care

2018 Volume 20, Issue 4, Page(s) 173–179

Abstract: Background: Up to 70% of people with multiple sclerosis (MS) experience cognitive impairment. Some remain cognitively intact despite advanced disease. Cognitive reserve (CR) theory postulates that individuals with higher levels of intellectual ... ...

Abstract	Background: Up to 70% of people with multiple sclerosis (MS) experience cognitive impairment. Some remain cognitively intact despite advanced disease. Cognitive reserve (CR) theory postulates that individuals with higher levels of intellectual enrichment can tolerate more pathology than others before exhibiting cognitive impairment. Methods: Thirty-two individuals with early-phase relapsing-remitting MS with mild physical disability and disease duration less than 10 years and 32 controls were recruited. At baseline and after 3 years, participants completed neuropsychological tests evaluating several cognitive domains. The CR was assessed via a cognitive reserve index (CRI) using educational levels and North American Adult Reading Test scores. Change in cognition was assessed using a reliable change index. Results: At baseline, people with MS performed worse than controls on visual memory. There were no significant group differences on information processing speed, learning, language, and executive functions. Most cognitive domains showed no change over time, and CRI was not a significant predictor in the regression model. Conclusions: People with MS performed worse on memory tasks at baseline compared with controls. Cognitive change differed between people with MS and controls in executive functions. Although people with MS and controls improved over time, beyond practice effects, people with MS improved less than controls. Overall, no cognitive deterioration was noted over time, and CR did not predict change in cognition. Sample homogeneity in terms of disease stage and CR may explain these findings.
Language	English
Publishing date	2018-06-30
Publishing country	United States
Document type	Journal Article
ISSN	1537-2073
ISSN	1537-2073
DOI	10.7224/1537-2073.2016-073
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Article ; Online: Safety and efficacy of autologous whole cell vaccines in hematologic malignancies: A systematic review and meta-analysis.

Bastin, Donald J / Khan, Sarwat T / Montroy, Joshua / Kennedy, Michael A / Forbes, Nicole / Martel, Andre B / Baker, Laura / Gresham, Louise / Boucher, Dominique M / Wong, Boaz / Shorr, Risa / Diallo, Jean-Simon / Fergusson, Dean A / Lalu, Manoj M / Auer, Rebecca C / Kekre, Natasha

Hematological oncology

2021 Volume 39, Issue 4, Page(s) 448–464

Abstract: Autologous cell vaccines use a patient's tumor cells to stimulate a broad antitumor response in vivo. This approach shows promise for treating hematologic cancers in early phase clinical trials, but overall safety and efficacy remain poorly described. We ...

Abstract	Autologous cell vaccines use a patient's tumor cells to stimulate a broad antitumor response in vivo. This approach shows promise for treating hematologic cancers in early phase clinical trials, but overall safety and efficacy remain poorly described. We conducted a systematic review assessing the use of autologous cell vaccination in treating hematologic cancers. Primary outcomes of interest were safety and clinical response, with secondary outcomes including survival, relapse rate, correlative immune assays and health-quality related metrics. We performed a search of MEDLINE, Embase and the Cochrane Register of Controlled Trials including any interventional trial employing an autologous, whole cell product in any hematologic malignancy. Risk of bias was assessed using a modified Institute of Health Economics tool. Across 20 single arm studies, only 341 of 592 enrolled participants received one or more vaccinations. Primary reasons for not receiving vaccination included rapid disease progression/death and manufacturing challenges. Overall, few high-grade adverse events were observed. One death was reported and attributed to a GM-CSF producing allogeneic cell line co-administered with the autologous vaccine. Of 58 evaluable patients, the complete response rate was 21.0% [95% CI, 10.4%-37.8%)] and overall response rate was 35.8% (95% CI, 24.4%-49.0%). Of 97 evaluable patients for survival, the 5-years overall survival rate was 64.9% (95% CI, 52.6%-77.2%) and disease-free survival was 59.7% (95% CI, 47.7%-71.7%). We conclude that, in hematologic malignancies, based on limited available data, autologous cell vaccines are safe and display a trend towards efficacy but that challenges exist in vaccine manufacture and administration.
MeSH term(s)	Adult ; Aged ; Female ; Hematologic Neoplasms/therapy ; Humans ; Male ; Middle Aged ; Vaccines/pharmacology ; Vaccines/therapeutic use
Chemical Substances	Vaccines
Language	English
Publishing date	2021-05-08
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	604884-5
ISSN	1099-1069 ; 0278-0232
ISSN (online)	1099-1069
ISSN	0278-0232
DOI	10.1002/hon.2875
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