There is no established treatment for severe fever with thrombocytopenia syndrome (SFTS). However, the potential role of tocilizumab (TCZ) in cytokine storm modulation warrants further investigation. In this study, we aimed to investigate the therapeutic potential of TCZ in adult patients with SFTS and provide valuable insights into the development of effective treatment strategies for this challenging infectious disease by assessing the impact of TCZ on cytokine dynamics and patient outcomes. This prospective longitudinal observational study included adult patients with SFTS at a teaching hospital in Korea between April 2013 and December 2023. Patients with SFTS and interleukin (IL)-6 levels ≥30 ng/mL received TCZ. The 14- and 28-day mortality rates were compared between the TCZ and therapeutic plasma exchange (TPE) groups during the study period. Among the total of 97 patients, the clinical characteristics showed no significant differences between the TCZ (n=10) and TPE groups (n=30). Compared with TPE, TCZ treatment showed a trend towards lower mortality rate (14-day mortality rate: 10.0% vs. 16.7%, p=0.608; 28-day mortality rate:10.0% vs. 20.0%, p=0.480). Both treatments showed the potential to reduce the viral load and IL-6 levels, indicating their efficacy in managing the disease course. TCZ is a potential therapeutic option for SFTS as it modulates IL-6 levels and improves clinical outcomes.

There is no established treatment for severe fever with thrombocytopenia syndrome (SFTS). However, the potential role of tocilizumab (TCZ) in cytokine storm modulation warrants further investigation. In this study, we aimed to investigate the therapeutic potential of TCZ in adult patients with SFTS and provide valuable insights into the development of effective treatment strategies for this challenging infectious disease by assessing the impact of TCZ on cytokine dynamics and patient outcomes. This prospective longitudinal observational study included adult patients with SFTS at a teaching hospital in Korea between April 2013 and December 2023. Patients with SFTS and interleukin (IL)-6 levels ≥30 ng/mL received TCZ. The 14- and 28-day mortality rates were compared between the TCZ and therapeutic plasma exchange (TPE) groups during the study period. Among the total of 97 patients, the clinical characteristics showed no significant differences between the TCZ (n=10) and TPE groups (n=30). Compared with TPE, TCZ treatment showed a trend towards lower mortality rate (14-day mortality rate: 10.0% vs. 16.7%, p=0.608; 28-day mortality rate:10.0% vs. 20.0%, p=0.480). Both treatments showed the potential to reduce the viral load and IL-6 levels, indicating their efficacy in managing the disease course. TCZ is a potential therapeutic option for SFTS as it modulates IL-6 levels and improves clinical outcomes.

There is no established treatment for severe fever with thrombocytopenia syndrome (SFTS). However, the potential role of tocilizumab (TCZ) in cytokine storm modulation warrants further investigation. In this study, we aimed to investigate the therapeutic potential of TCZ in adult patients with SFTS and provide valuable insights into the development of effective treatment strategies for this challenging infectious disease by assessing the impact of TCZ on cytokine dynamics and patient outcomes. This prospective longitudinal observational study included adult patients with SFTS at a teaching hospital in Korea between April 2013 and December 2023. Patients with SFTS and interleukin (IL)-6 levels ≥30 ng/mL received TCZ. The 14- and 28-day mortality rates were compared between the TCZ and therapeutic plasma exchange (TPE) groups during the study period. Among the total of 97 patients, the clinical characteristics showed no significant differences between the TCZ (n=10) and TPE groups (n=30). Compared with TPE, TCZ treatment showed a trend towards lower mortality rate (14-day mortality rate: 10.0% vs. 16.7%, p=0.608; 28-day mortality rate:10.0% vs. 20.0%, p=0.480). Both treatments showed the potential to reduce the viral load and IL-6 levels, indicating their efficacy in managing the disease course. TCZ is a potential therapeutic option for SFTS as it modulates IL-6 levels and improves clinical outcomes.

There is no established treatment for severe fever with thrombocytopenia syndrome (SFTS). However, the potential role of tocilizumab (TCZ) in cytokine storm modulation warrants further investigation. In this study, we aimed to investigate the therapeutic potential of TCZ in adult patients with SFTS and provide valuable insights into the development of effective treatment strategies for this challenging infectious disease by assessing the impact of TCZ on cytokine dynamics and patient outcomes. This prospective longitudinal observational study included adult patients with SFTS at a teaching hospital in Korea between April 2013 and December 2023. Patients with SFTS and interleukin (IL)-6 levels ≥30 ng/mL received TCZ. The 14- and 28-day mortality rates were compared between the TCZ and therapeutic plasma exchange (TPE) groups during the study period. Among the total of 97 patients, the clinical characteristics showed no significant differences between the TCZ (n=10) and TPE groups (n=30). Compared with TPE, TCZ treatment showed a trend towards lower mortality rate (14-day mortality rate: 10.0% vs. 16.7%, p=0.608; 28-day mortality rate:10.0% vs. 20.0%, p=0.480). Both treatments showed the potential to reduce the viral load and IL-6 levels, indicating their efficacy in managing the disease course. TCZ is a potential therapeutic option for SFTS as it modulates IL-6 levels and improves clinical outcomes.

There is no established treatment for severe fever with thrombocytopenia syndrome (SFTS). However, the potential role of tocilizumab (TCZ) in cytokine storm modulation warrants further investigation. In this study, we aimed to investigate the therapeutic potential of TCZ in adult patients with SFTS and provide valuable insights into the development of effective treatment strategies for this challenging infectious disease by assessing the impact of TCZ on cytokine dynamics and patient outcomes. This prospective longitudinal observational study included adult patients with SFTS at a teaching hospital in Korea between April 2013 and December 2023. Patients with SFTS and interleukin (IL)-6 levels ≥30 ng/mL received TCZ. The 14- and 28-day mortality rates were compared between the TCZ and therapeutic plasma exchange (TPE) groups during the study period. Among the total of 97 patients, the clinical characteristics showed no significant differences between the TCZ (n=10) and TPE groups (n=30). Compared with TPE, TCZ treatment showed a trend towards lower mortality rate (14-day mortality rate: 10.0% vs. 16.7%, p=0.608; 28-day mortality rate:10.0% vs. 20.0%, p=0.480). Both treatments showed the potential to reduce the viral load and IL-6 levels, indicating their efficacy in managing the disease course. TCZ is a potential therapeutic option for SFTS as it modulates IL-6 levels and improves clinical outcomes.

Severe fever with thrombocytopenia syndrome (SFTS) is a viral hemorrhagic disease prevalent in Asian countries with a fatality rate of approximately 10% to 30%. However, there are currently no definitive treatments for reducing mortality. Variable management strategies have been attempted to reduce the mortality rate associated with SFTS. Tocilizumab is an inhibitor of interleukin-6 and is used to treat rheumatologic and viral infectious diseases. This article presents two cases of SFTS in older patients with neurological symptoms and explores the potential use of tocilizumab, as a treatment option. The patient showed improved consciousness and clinical outcomes after tocilizumab administration. This report describes this condition and reviews related literature.

Purpose: Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer receiving cytotoxic chemotherapy. To prevent FN, standard precautions including hand and respiratory hygiene are generally recommended, but the exact effect of non-pharmacologic intervention has not been clearly proven in the clinical setting. We aimed to compare the incidence of FN between the pre-coronavirus disease 19 (COVID-19) era vs. the postCOVID-19 era. Methods: We retrospectively enrolled patients with breast cancer who received an adriamycin and cyclophosphamide (AC) regimen containing adjuvant chemotherapy at Jeju National University Hospital. We compared the incidence of FN between the pre- and post-COVID-19 period and analyzed characteristics of the event and other clinical risk factors. Results: In total, 149 patients were enrolled, including 94 who received AC chemotherapy in the pre-COVID-19 era and 55 who received it in the post-COVID-19 era. Sixteen patients (10.7%) experienced FN. Fourteen (14.9%) and 2 events (3.6%) occurred in pre-COVID-19 and post-COVID-19 eras, respectively. The post-COVID-19 era was the only risk factor for FN (P = 0.032). Conclusion We found an association between FN occurrence and the COVID-19 outbreak, providing indirect evidence of the importance of non-pharmacological measures to reduce FN risk in patients with breast cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Background: The distribution of species and characteristics of non-tuberculous mycobacteria (NTM) differ, and surveillance data for changes in antimicrobial susceptibilities of NTM is insufficient. This study analyzed the changes in antimicrobial susceptibility trends across NTM species and assessed the appropriateness of empirical antimicrobial drugs for NTM. Materials and Methods: We retrospectively analyzed the clinical characteristics, including demographics, distribution of NTM species, antimicrobial drug susceptibilities, and outcomes, at a teaching hospital in Jeju Island from 2009 - 2022. Results: Overall, 342 patients were included in the analysis; 93.0% were classified into the pulmonary group (PG) and 7.0% into the extrapulmonary group (EPG). The isolation rate of Mycobacterium avium was significantly higher in PG (36.8% vs. 0%, P = 0.001), while that of Mycobacterium fortuitum was significantly higher in EPG (4.5% vs.31.3%, P = 0.001). The antimicrobial susceptibility rate is higher against clarithromycin (89.9%) and amikacin (83.3%) and lower against rifampin (54.7%) and ethambutol (28.1%). The susceptibility rate to clarithromycin was over 80%, but those to rifampin and ethambutol showed decreasing annual trends. Of the 162 patients who received empirical antimicrobial therapy, actual antimicrobial susceptibility rates were high (90.1%) using empirical macrolide, and relatively low using ethambutol and rifampin (28.0% and 58.8%, respectively). Conclusion This is the first study of analysis of the distribution, baseline characteristics, and antimicrobial susceptibility of isolated NTM species in pulmonary and extrapulmonary patients in Jeju Island over 10 years. Policies that continuously monitor changes in susceptibility rate are required to ensure effective treatment strategies.

Severe fever with thrombocytopenia syndrome (SFTS) is a viral hemorrhagic disease prevalent in Asian countries with a fatality rate of approximately 10% to 30%. However, there are currently no definitive treatments for reducing mortality. Variable management strategies have been attempted to reduce the mortality rate associated with SFTS. Tocilizumab is an inhibitor of interleukin-6 and is used to treat rheumatologic and viral infectious diseases. This article presents two cases of SFTS in older patients with neurological symptoms and explores the potential use of tocilizumab, as a treatment option. The patient showed improved consciousness and clinical outcomes after tocilizumab administration. This report describes this condition and reviews related literature.