epinephrine / Generic mfg. - LARVOL DELTA

Presentation and Management of Progestogen Hypersensitivity in a Male Patient in the Emergency Department and Intensive Care Unit. (PubMed, Cureus) - "Progestogen hypersensitivity (PH), historically termed autoimmune progesterone dermatitis, is an exceedingly rare condition documented almost exclusively in reproductive-age women...He presented to the emergency department with a diffuse rash, facial angioedema, and nausea, and received intravenous fluids, epinephrine, antihistamines, and corticosteroids...Inpatient management consisted of dexamethasone, cromolyn sodium, testosterone cypionate, analgesia, and supportive care, with rapid improvement and discharge on hospital day three. This report describes a symptom-directed approach to the management of PH in a male patient in the critical care setting and considers the comorbidities and possible mechanisms that may underlie his presentation. Given the rarity of the condition and the limited literature in men, effective management currently depends on an individualized, symptom-directed strategy."

Journal • Carcinoid Tumor • Cardiovascular • Coronary Artery Disease • Critical care • Dermatitis • Dermatology • Immunology • Oncology • Pain • Solid Tumor

In Vitro Experimental and Computational Studies of the Vasorelaxant Effects of Quinazolin-4(3H)-one and Its Interaction with α1-Adrenergic Receptors. (PubMed, Curr Issues Mol Biol) - "In vitro vasorelaxation effects were evaluated on isolated rat aortic rings that had been pre-contracted with Epinephrine (EP) and Potassium chloride (KCl)...Overall, quinazolin-4(3H)-one represents a promising lead compound for further investigation of its vasorelaxant and potential antihypertensive properties. Further pharmacological and in vivo studies are required to elucidate its precise mechanism of action and establish its safety and therapeutic potential."

Journal • Preclinical • Cardiovascular • Hypertension • ADRA1B

Lessons from In Utero and Postnatal Exposure to Pesticide DDT: Mechanisms of Chromaffin Cell Vulnerability and Altered Catecholamine Homeostasis. (PubMed, Int J Mol Sci) - "The second is embryonic and postnatal development of the adrenal medulla, and the third one is physiological cell renewal and maintenance of cell population, a novel enigmatic aspect of endocrine disruption. In conclusion, the authors present integrated mechanisms of disruption and indicate gaps in knowledge and directions for further investigations."

Journal • Review

Dietary Rumen-Protected Gamma-Aminobutyric Acid Supplementation to Alleviate Stress in Beef Cattle Caused by Long-Distance Transport by Improving Antioxidant Capacity, Immune Function, and Hormonal Balance: A Related Study. (PubMed, Animals (Basel)) - "The G-H group significantly decreased serum cortisol concentration after transport (Day 23), while reducing epinephrine levels and increasing glutathione peroxidase activity (all p < 0.001)...In contrast, the G-M group exhibited a relatively balanced response across stress hormone levels, antioxidant status, and immune regulation, characterized by higher T4 (p = 0.003), GSH-Px (p = 0.001), and IL-4 (p = 0.006) concentrations and lower alkaline phosphatase (p = 0.005) and tumor necrosis factor-alpha concentrations. Therefore, under the conditions of this study, dietary supplementation with 500 mg/kg RP-GABA in concentrate may represent a potential level for maintaining balanced physiological responses in beef cattle."

Journal • Oncology • IL4 • IL6 • TNFA

Vancomycin-Induced Type I Kounis Syndrome Mimicking Acute Inferolateral STEMI Prior to Spine Surgery. (PubMed, JACC Case Rep) - "KS should be suspected in any perioperative patient developing ST elevation after drug administration; emergent angiography is essential to differentiate vasospasm from obstructive disease and guide management."

Journal • Acute Coronary Syndrome • Cardiovascular • Hypertension • Immunology • Orthopedics • Respiratory Diseases

Nebulized Epinephrine Versus Placebo in Infants with Moderate-to-Severe Bronchiolitis: A Randomized Controlled Trial. (PubMed, Children (Basel)) - "FiO2 decreased over time (p = 1.99 × 10-4), but the group-by-time interaction was not significant (p = 0.108); no interaction was observed for SpO2, RR, or HR (p = 0.296, p = 0.187, and p = 0.352, respectively). Nebulized racemic epinephrine did not improve the trajectories of oxygen requirement, SpO2, RR, or HR compared with placebo; improvements over time were observed in both groups."

Journal • Critical care • Pediatrics • Pulmonary Disease • Respiratory Diseases

A Study on Reducing Injection Pain During Local Anesthesia for Double Eyelid Surgery (clinicaltrials.gov) - P=N/A | N=30 | Completed | Sponsor: okyo Chuo Beauty Clinic (TCB), BS Clinic, Umeda Osaka Ekimae Branch | Not yet recruiting ➔ Completed

Trial completion • Aesthetic Medicine • Anesthesia • Pain

SMAS Plication Facelift and Platysmaplasty Under Tumescent Local Anesthesia: a 10-Year Retrospective Evaluation of Safety, Efficacy, and Patient Satisfaction in an Outpatient Setting. (PubMed, Aesthetic Plast Surg) - "This ten-year case series demonstrates TLA as a safe and effective alternative to general anesthesia for SMAS plication facelift in selected patients. The technique provides adequate analgesia, supports precise dissection with less bleeding, and minimizes postoperative edema and ecchymosis, leading to quicker recovery and improved patient comfort and satisfaction."

Journal • Retrospective data • Aesthetic Medicine • Anesthesia • Infectious Disease • Pain

Distal Radius Fracture Fixation Using a Tourniquet versus Local Lidocaine with Epinephrine: A Prospective Randomized Trial. (PubMed, J Wrist Surg) - "ORIF of distal radius fractures without a tourniquet and with lidocaine/epinephrine is safe and effective and may contribute to early improvements in function and pain without prolonging operative time or increasing blood loss. Level IIB."

Journal • Musculoskeletal Diseases • Orthopedics • Pain

Sex differences in epidemiology, care, and outcomes in patients with out-of-hospital cardiac arrest in China. (PubMed, Resuscitation) - "In China, females demonstrated better prehospital resuscitation outcomes. However, this early advantage was lost by discharge. These findings highlight the need for integrated evaluation across prehospital and in-hospital care to inform disparity-reduction strategies."

Journal • Cardiovascular

A Rare Cause of Upper GI Bleeding: Metastatic Testicular Carcinoma (ACG 2026) - "Area was successfully injected with 4 mL of a 0.1 mg/mL solution of epinephrine for hemostasis...Endoscopic image of a single 8 mm mucosal nodule with an eroded bleeding vessel in the second portion of the duodenum Figure: Figure 2. Video capsule endoscopy image of a small polypoid lesion located in the distal jejunum or proximal ileum region"

Metastases • Addiction (Opioid and Alcohol) • Gastric Cancer • Gastrointestinal Disorder • Genito-urinary Cancer • Oncology • Solid Tumor • Testicular Cancer • SALL4

Rectal Bleeding as the Initial Presentation of Suspected Recurrent Prostate Adenocarcinoma (ACG 2026) - "(C) Appearance following epinephrine injection with interval improvement in bleeding. (D) Complete endoscopic hemostasis after argon plasma coagulation therapy."

Atrial Fibrillation • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Oncology • Prostate Adenocarcinoma • Prostate Cancer • Urology

The Culprit Behind the Clip: A Marginal Ulcer Causing Splenic Artery Hemorrhage (ACG 2026) - "This was treated with epinephrine injection and 1 clip...Figure: Figure 1: Forrest Class IIa Ulcer (A) and repeat EGD with 4 additional clips and hemostatic gel (B). Figure: Figure 2: CTA venous phase of abdomen and pelvis indicating active hemorrhage at GJ anastomosis (red arrow)."

Gastrointestinal Disorder • Genetic Disorders • Hematological Disorders • Hypotension • Obesity • Peptic Ulcer

When Ostomy Bleeding Isnât Surgical: Occult Helicobacter PyloriâAssociated Duodenal Ulcer Presenting After Colectomy (ACG 2026) - "Emergent EGD revealed a bleeding duodenal ulcer with a visible vessel, treated with epinephrine injection, gold probe thermal therapy, and endoclips (Figure 1, 2)...He improved on intravenous pantoprazole and antibiotics without recurrent bleeding...Figure: Figure 1: Endoscopic view of a bleeding duodenal ulcer. Figure: Figure 2: Post-intervention endoscopic image demonstrating successful hemostasis following clip placement."

Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hypotension • Infectious Disease • Peptic Ulcer • Stress Ulcer

Endoscopic Hemostasis of Diverticular Bleeding in the Third Portion of the Duodenum: A Rare Clinical Entity With Diagnostic and Therapeutic Challenges (ACG 2026) - "The patient was started on IV PPI, ceftriaxone, and octreotide drip given history of cirrhosis. We also demonstrate the feasibility and effectiveness of endoscopic hemostasis. Figure: Figure: Endoscopic images of an actively bleeding vessel in the diverticulum in the third portion of the duodenum (A-C), treated successfully with epinephrine injection followed by placement of four short hemoclips (D)."

Clinical • Cardiovascular • Diabetes • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Metabolic Disorders

When a Bleeding Esophageal Ulcer Is Not Benign: High-Grade GE Junction Carcinoma in an 18-Year-Old Male (ACG 2026) - "Active bleeding from a pulsatile vessel required epinephrine and hemostatic spray...Early repeat endoscopy and multidisciplinary evaluation led to diagnosis of an aggressive high-grade GEJ carcinoma with neuroendocrine differentiation and allowed timely initiation of definitive therapy. Figure: EGD finding mass"

Gastrointestinal Disorder • Neuroendocrine Carcinoma • Oncology • Solid Tumor • CDX2 • SYP

Beyond the Black Esophagus: Successful Hemostasis Achieved With Mini Over-the-Scope Clip Following a Bleeding Duodenal Ulcer (ACG 2026) - "Hemostasis was successfully achieved with epinephrine injection into the ulcer and placement of mOTSC...This case highlights the use of mOTSC clips as an alternative for high-risk bleeding lesions when tissue friability and ischemia raise concern for perforation with standard OTSC clips. Figure: mOTSC clip placed on a large 1.5 cm duodenal ulcer with a visible vessel Figure: Acute Esophageal Necrosis (Black Esophagus) Leading to Circumferential Mucosal Ulceration Involving the Entire Esophagus"

Addiction (Opioid and Alcohol) • Cardiovascular • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hematological Disorders • Pancreatitis • Peptic Ulcer • Rare Diseases • Thrombocytopenia

Helicobacter pylori -Associated Gastric Lymphoma Presenting as Upper Gastrointestinal Bleeding (ACG 2026) - "He w as given fluids, pantoprazole, octreotide, empiric antibiotics and three units of blood with Hgb improving to 8 .0 g/dL...He underwent esophagogastroduodenoscopy (EGD) that showed small esophageal varices, 3.5 x 2.5 cm ulcerated gastric mass in the mid body of the greater curvature with 3 nonbleeding visible vessels treated with epinephrine injection, 1 endoscopic clip, and cauterization, see figure 1...Oncology recommended a baseline echocardiogram and chemotherapy with prednisone, cyclophosphamide, doxorubicin, rituximab and vincristine...Figure: Figure 1: 3.5 x 2.5 cm mass along the greater curvature of the stomach, directly visualized during the EGD. An endoscopic clip over a non-bleeding visible vessel is also pictured."

B Cell Lymphoma • Diffuse Large B Cell Lymphoma • Extranodal Marginal Zone Lymphoma • Gastric Cancer • Gastroenterology • Gastrointestinal Disorder • Genito-urinary Cancer • Hematological Malignancies • Infectious Disease • Lymphoma • Marginal Zone Lymphoma • Non-Hodgkin’s Lymphoma • Pancreatitis • Peptic Ulcer • Prostate Cancer • Solid Tumor

Rapid Small Intestinal Metastasis Presenting as Hematemesis in Non-Small Cell Lung Cancer (ACG 2026) - "This case highlights the importance of considering metastatic disease in patients with NSCLC who present with upper GI bleeding. Figure: One nonbleeding cratered duodenal ulcer with a non bleeding visible vessel (Forrest Class IIA) in rim of the papilla, which was injected with epinephrine"

Chronic Lymphocytic Leukemia • Gastrointestinal Disorder • Hematological Malignancies • Leukemia • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Peptic Ulcer • Solid Tumor

A Rare Benign Behemoth: Ulcerated Brunner's Gland Hamartoma Presenting With Critical Iron Deficiency Anemia (ACG 2026) - "Epinephrine was injected and the lesion was resected via endoscopic mucosal resection (EMR)...Ultimately, in our case, a definitive diagnosis required complete resection that also proved therapeutic in addressing the source of the patientâs chronic bleeding and unexplained iron deficiency anemia. Figure: Figure 1: Large pedunculated polyp in the duodenal bulb Figure: Figure 2: High-power H&E (20Ã) showing bland Brunner glands with areas of cystic dilatation"

Anemia • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Small Intestinal Carcinoma

A Novel Endoscopic Therapeutic Approach to Hemosuccus Pancreaticus Secondary to an Intraductal Pancreatic Varix (ACG 2026) - "Case Description/ A 50-year-old female with a past medical history of Multiple sclerosis & Optic Neuritis on Prednisone, peripheral neuropathy, and heart murmur presented with profound symptomatic anemia - hemoglobin level was 2 g/dL with a MCV of 68.2 fL. EGD revealed blood and bile oozing from the major duodenal papilla that was not hemostatic post-epinephrine injection...Successful PD stenting for controlling bleeding from an intraductal pancreatic varix introduces a novel therapeutic approach to expand the armamentarium for treatment of this rare cause of HP. Figure: Intraductal Pancreatic Varix on Cholangioscopy Figure: Follow-up Push Enteroscopy - Intact PD stents, no bleeding"

Cardiovascular • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Multiple Sclerosis • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pancreatitis • Portal Hypertension • Thrombosis • Varicose Veins

Duodenal Ulceration and Upper GI Bleeding From Erosion of a Prior Gastroduodenal Artery Embolization Coil: A Case Report (ACG 2026) - "Endoscopic hemostasis was successfully achieved with epinephrine injection, bipolar coagulation, and hot biopsy forceps...This case highlights the importance of considering coil-related ulceration in patients with a history of embolization who present with otherwise unexplained upper gastrointestinal bleeding. Figure: DISTAL DUODENAL COIL Figure: SECOND ENDOSCOPY VIEW"

Case report • Clinical • Cardiovascular • CNS Disorders • Diabetes • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Infectious Disease • Metabolic Disorders • Peptic Ulcer • Septic Shock

Rapid Identification of Occult Post-ERCP Hemorrhage Using Gastric Point-of-Care Ultrasound in a Patient With ESRD (ACG 2026) - "Hemostasis was achieved with an epinephrine injection and placement of a covered metal biliary stent...Figure: Figure 1 - Gastric POCUS revealing markedly distended antrum with heterogeneous mixed liquid and solid contents with âhematocrit signâ in a patient who was NPO after ERCP with sphincterotomy. The liquid gastric contents (red arrow) are superior to the gravity dependent solid gastric contents (green arrow)."

Clinical • Chronic Kidney Disease • Gastroenterology • Hematological Disorders • Renal Disease

Recurrent Upper Gastrointestinal Bleeding From a Gastrojejunal Anastomotic Ulcer With a Visible Vessel in a Post Roux-en-Y Gastric Bypass Patient: A Case Report (ACG 2026) - "Case Description/ A 73-year-old female with a history of long-standing RYGB, coronary artery disease on aspirin 81 mg, and prior gastrointestinal bleeding secondary to chronic gastrojejunal anastomotic ulcer (GJAU) presented with melena, epigastric pain, and symptomatic anemia with a hemoglobin of 8.8 g/dL with normocytic indices...Hemostasis was difficult to achieve with standard endoscopic techniques, including epinephrine injection, bipolar cauterization, and hemostatic clip placement, owing to the chronic and fibrotic nature of the ulcer...The patient was treated with high-dose proton pump inhibitor therapy, sucralfate, and intravenous iron, resulting in hemoglobin stabilization and symptom resolution...Gastrojejunal anastomotic ulcers should be considered in post-RYGB patients presenting with gastrointestinal bleeding. Optimization of acid suppression and modification of modifiable risk factors are essential to reduce the risk of recurrence."

Bariatric surgery • Case report • Clinical • Cardiovascular • CNS Disorders • Coronary Artery Disease • Diabetes • Dyslipidemia • Fibrosis • Gastroenterology • Genetic Disorders • Hematological Disorders • Hypertension • Metabolic Disorders • Obesity • Peptic Ulcer • Type 2 Diabetes Mellitus

From Refractory to Resolved: Over-the-Scope Clip Hemostasis After Failed Angioembolization of a Duodenal Ulcer (ACG 2026) - "Initial epinephrine injection and bipolar cautery failed to achieve durable hemostasis...Repeated flushing showed no bleeding. OTSC=Over-the-scope clip"

Breast Cancer • CNS Disorders • Fibrosis • Gastroenterology • Peptic Ulcer • Solid Tumor • Triple Negative Breast Cancer