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Drug interactions were extremely frequent among kidney transplant recipients, and responsible for potentially avoidable ADRs. They should be carefully considered when following kidney transplant recipients.

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Background: Central Nervous System (CNS) depressants like antipsychotics, opioids, benzodiazepines and zolpidem are frequently used by patients of a wide range of ages. Uncertainty remains about their effect in very old adults (>80 years old) and their potential for pharmacodynamic and pharmacokinetic drug-drug interactions in this population. Objective: To assess if the use of CNS depressants is associated with a higher risk of hospitalization due to community-acquired pneumonia (CAP) in very old patients. Methods: In this prospective study, 362 patients over 80 years of age who had been consequently admitted to the general ward of a teaching hospital were examined. Each patient was assessed, by our pharmacovigilance team within 24 hours of admission, to identify outpatient medication use and potential drug-drug interactions. Results: The overall use of CNS depressants as a group was not associated with a higher risk of admission due to CAP in very old patients (55% vs. 49%; OR=1.28 [0.76-2.16], p=0.34). However, the use of antipsychotics was associated with a higher rate of admissions due to CAP in this population (OR=1.98 [1.10-3.57], p=0.02). No association was seen between opioids (p=0.27), zolpidem (p=0.83), or benzodiazepines (p=0.15) and the rate of admissions due to CAP in these patients. Moreover, pharmacodynamic or pharmacokinetic interactions leading to CNS depression were equally found in patients admitted for CAP and those admitted for other reasons. Conclusion: The use of antipsychotics in very old adults was associated with an increased risk of hospital admission due to CAP. This suggests that the use of these medications in this population should be done with caution. No association was observed with opioids, benzodiazepines and zolpidem with the latter outcome.

Introduction: Few studies have investigated the hearing in familial Mediterranean fever (FMF), with conflicting results reported. The aim of this study was to compare the cochlear functions of FMF children with healthy controls and to evaluate any differences in the audiological outcomes of FMF patients during attack and attack-free periods. Material and methods: In this study were recruited 50 FMF children and 31 healthy children as controls. FMF patients that were in an attack period and a control group underwent audiometric evaluation including pure tone audiometry and Distortion Product Otoacoustic Emission (DPOAE) test. The evaluation was repeated in FMF patients in an attack-free period. Additionally, auditory brainstem response (ABR) test was performed during attack and attack-free periods. Results: Hearing thresholds of FMF patients, compared to the control group, were found to be increased at all frequencies on the left and at 1000, 4000, and 8000 Hz on the right (p < 0.05). This was supported by the DPOAE test, with lower values at all frequencies in FMF children (p < 0.05). In the attack period, compared to the attack-free period, hearing thresholds were found to be increased only at certain frequencies, but this was not supported by the DPOAE test (p > 0.05). No statistically significant difference between attack and attack-free period for ABR test were found (all p > 0.05). Conclusions: Our results demonstrated cochlear involvement in FMF patients, but no objective acute impairment in hearing in the attack period, which suggests that hearing impairment in FMF is due to chronic autoinflammation process.