Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Though cardioprotective, niacin monotherapy is limited by unpleasant cutaneous symptoms mimicking dermatitis: niacin-associated skin toxicity (NASTy). Niacin is prototypical of several emerging drugs suffering off-target rubefacient properties whereby agonizing the GPR109A receptor on cutaneous immune cells provokes vasodilation, prompting skin plethora and rubor, as well as dolor, tumor, and calor, and systemically, heat loss, frigor, chills, and rigors. Typically, NASTy effects are described by subjective patient-reported perception, at best semi-quantitative and bias-prone. Conversely, objective, quantitative, and unbiased methods measuring NASTy stigmata would facilitate research to abolish them, motivating development of several objective methods. In early drug development, such methods might better predict clinical tolerability in larger clinical trials. Measuring cutaneous stigmata may also aid investigations of vasospastic, ischemic, and inflammatory skin conditions. We present methods to measure NASTy physical stigmata to facilitate research into novel niacin mimetics/analogs, detailing characteristics of each technique following niacin, and how NASTy stigmata relate to symptom perception. We gave niacin orally and measured rubor by colorimetry and white-light spectroscopy, plethora by laser Doppler flowmetry, and calor/frigor by thermometry. Surprisingly, each stigma's abruptness predicted symptom perception, whereas peak intensity did not. These methods are adaptable to study other rubefacient drugs or dermatologic and vascular disorders.
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PMID:Measuring niacin-associated skin toxicity (NASTy) stigmata along with symptoms to aid development of niacin mimetics. 2811 43

Research in health care occurs within interdisciplinary teams that include clinician-researchers who have multiple epistemological orientations. Rigor in collaborative projects requires reflexive attention to how the paradigmatic questions raised by diverse epistemological orientations, and the ethical stances of each researcher, shape findings. This methodological article draws on three events during an ethnography of stigma in psychiatry to define and illustrate how we used double hermeneutics in data analysis. This allowed us to examine the metaphors that emerged from what we are conceptualizing as "epistemological bumps." This heightened the team's awareness of the epistemological horizons and mixing that occurred, as well as revealing what mattered to each researcher, during the crafting of our research decisions and findings. We argue that interdisciplinary research on complex processes in health care requires this close examination of team experiences and moral stakes during collaborative analysis, and offer conceptual suggestions for reflexivity and rigor.
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PMID:View From the Penthouse: Epistemological Bumps and Emergent Metaphors as Method for Team Reflexivity. 2923 Nov 27