scholarly journals Are there overlapping clinical features between thoracic radiotherapy side effects and covid-19 pneumonia? Radiation pneumonitis outside the radiation ports: Three case reports

2020 ◽  
Vol 25 ◽  
pp. 107-111
Author(s):  
Grazia Lazzari ◽  
Elda Chiara Resta ◽  
Michelle Magli ◽  
Ernesto D'Ettorre ◽  
Giovanni Silvano
Keyword(s):  
Side Effects ◽  
Clinical Features ◽  
Radiation Pneumonitis ◽  
Case Reports ◽  
Thoracic Radiotherapy

scholarly journals Overlap time is an independent risk factor of radiation pneumonitis for patients treated with simultaneous EGFR-TKI and thoracic radiotherapy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wenxiao Jia ◽  
Qianqian Gao ◽  
Min Wang ◽  
Ji Li ◽  
Wang Jing ◽  
...  
Keyword(s):  
Risk Factors ◽  
First Generation ◽  
Kinase Inhibitors ◽  
Radiation Pneumonitis ◽  
Cell Cancer ◽  
Treatment Strategies ◽  
Thoracic Radiotherapy ◽  
Ipsilateral Lung ◽  
Nsclc Patients ◽  
Egfr Tki

Abstract Background The exact rate and relevant risk factors of radiation pneumonitis (RP) for non-small-cell cancer (NSCLC) patients treated with the combination of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and thoracic radiotherapy have not been reported. Thus, this study aimed to investigate the rate and risk factors of RP for EGFR-positive NSCLC patients simultaneously treated with first-generation EGFR-TKI and TRT. Patients and methods We retrospectively evaluated NSCLC patients simultaneously treated with first-generation EGFR-TKI and thoracic radiotherapy between January 2012 and December 2019 at Shandong Cancer Hospital and Institute, Shandong, China. RP was diagnosed via computed tomography and was classified according to the Common Terminology Criteria for Adverse Events v5.0. The risk factors of RP were identified using uni- and multivariate analyses. Results Of the 67 patients included, 44.78% (30/67) developed grade ≥ 2 RP. Grade ≥ 2 RP occurred within a median of 3.48 (range 1.07–13.6) months. The EGFR-TKI icotinib, ipsilateral lung V30 > 34%, and overlap time of > 20 days between EGFR-TKI and thoracic radiotherapy were identified to be independent predictive factors of grade ≥ 2 RP. Conclusions Grade ≥ 2 RP is highly frequent in NSCLC patients simultaneous treated with first-generation EGFR-TKI and thoracic radiotherapy. Icotinib, ipsilateral lung V30 ≤ 34%, and overlap time of ≤ 20 days for EGFR-TKI and thoracic radiotherapy will be helpful to lower the risk of RP in these patients. The addition of thoracic radiotherapy should be cautious, and the treatment strategies can be optimized to reduce the rate of RP for patients treat with simultaneous EGFR-TKI and thoracic radiotherapy.

scholarly journals Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature

2021 ◽  
pp. 1-4
Author(s):  
Simone Vidale
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Clinical Features ◽  
Case Reports ◽  
Clinical Severity ◽  
Large Artery ◽  
Causal Association ◽  
Review Of Literature ◽  
Increased Risk ◽  
Long Time

<b><i>Background and Purpose:</i></b> Coronavirus disease 2019 (CO­VID-19) infection is an ongoing pandemic and worldwide health emergency that has caused important changes in healthcare systems. Previous studies reported an increased risk of thromboembolic events, including stroke. This systematic review aims to describe the clinical features and etiological characteristics of ischemic stroke patients with CO­VID-19 infection. <b><i>Method:</i></b> A literature search was performed in principal databases for studies and case reports containing data concerning risk factors, clinical features, and etiological characteristics of patients infected with COVID-19 and suffering from stroke. Descriptive and analytical statistics were applied. <b><i>Results:</i></b> Overall, 14 articles were included for a total of 93 patients. Median age was 65 (IQR: 55–75) years with prevalence in males. Stroke occurred after a median of 6 days from COVID-19 infection diagnosis. Median National of Institute of Health Stroke Scale (NIHSS) score was 19. Cryptogenic (Cry) strokes were more frequent (51.8%), followed by cardioembolic etiology, and they occurred a long time after COVID-19 diagnosis compared with large-artery atherosclerosis strokes (<i>p</i><sub>trend</sub>: 0.03). The clinical severity of stroke was significantly associated with the severity grade of COVID-19 infection (<i>p</i><sub>trend</sub>: 0.03). <b><i>Conclusions:</i></b> Ischemic strokes in COVID-19-infected patients were clinically severe, affecting younger patients mainly with Cry and cardioembolic etiologies. Further multicenter prospective registries are needed to better describe the causal association and the effect of COVID-19 infection on stroke.

Carboplatin, S-1 and concurrent thoracic radiotherapy for elderly patients with locally advanced non-small cell lung cancer: a multicenter Phase I/II study

2019 ◽  
Vol 49 (7) ◽  
pp. 614-619 ◽  
Author(s):  
Seiji Niho ◽  
Yukio Hosomi ◽  
Hiroaki Okamoto ◽  
Keiji Nihei ◽  
Hiroshi Tanaka ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Phase I ◽  
Phase Ii ◽  
Radiation Pneumonitis ◽  
Phase Ii Study ◽  
Locally Advanced ◽  
Small Cell ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung

Abstract Objectives We conducted a Phase I/II study of carboplatin, S-1 and concurrent thoracic radiotherapy (TRT) for elderly patients (71 years or older) with unresectable stage III non-small cell lung cancer (NSCLC). Materials and methods Patients received carboplatin (AUC 3-5) on Day 1 and S-1 (30–40 mg/m2 two times daily) on Days 1–14, every 2 weeks, for up to four cycles, plus concurrent TRT at a total dose of 60 Gy. The primary endpoint for the Phase II study was the 1-year progression-free survival (PFS) rate. Results Eighteen patients were enrolled in the Phase I study. Febrile neutropenia, a decreased platelet count and esophagitis were dose-limiting toxicities. The recommended doses for the Phase II study were determined to be an AUC of 3 for carboplatin, 40 mg/m2 twice daily for S-1. Twenty-eight patients were evaluated in the Phase II study. The 1-year PFS rate was 57.1% (90% CI 41.6–71.4%), and the median PFS was 16.8 months (95% CI 7.8–not assessable [NA]). The lower limit of the 90% CI for 1-year PFS exceeded the prespecified threshold value of 30%; therefore, the primary endpoint was met. Grades 3–4 toxicities included thrombocytopenia (21%) and hyponatremia (11%). Grade 3 radiation pneumonitis was observed in 18% of patients. No treatment-related deaths were observed. Conclusion Combination chemotherapy consisting of carboplatin plus S-1 and concurrent TRT had a promising efficacy in elderly patients with locally advanced NSCLC; however, radiation pneumonitis was frequently observed.

scholarly journals Cutaneous Side Effects of BRAF Inhibitors in Advanced Melanoma: Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Bilgen Gençler ◽  
Müzeyyen Gönül
Keyword(s):  
Side Effects ◽  
Metastatic Melanoma ◽  
Mapk Pathway ◽  
Case Reports ◽  
Mitogen Activated Protein Kinase ◽  
Braf V600e ◽  
Braf Inhibitors ◽  
Braf Mutations ◽  
Cutaneous Side Effects ◽  
Downstream Signaling

The incidence of melanoma has recently been increasing. BRAF mutations have been found in 40–60% of melanomas. The increased activity of BRAF V600E leads to the activation of downstream signaling through the mitogen-activated protein kinase (MAPK) pathway, which plays a key role as a regulator of cell growth, differentiation, and survival. The use of BRAF inhibitors in metastatic melanoma with BRAF mutation ensures clinical improvement of the disease. Vemurafenib and dabrafenib are two selective BRAF inhibitors approved by the Food and Drug Administration (FDA). Both drugs are well tolerated and successfully used in clinical practice. However, some adverse reactions have been reported in patients in the course of treatment. Cutaneous side effects are the most common adverse events among them with a broad spectrum. Both the case reports and several original clinical trials reported cutaneous reactions during the treatment with BRAF inhibitors. In this review, the common cutaneous side effects of BRAF inhibitors in the treatment of metastatic melanoma with BRAF V600E mutation were reviewed.

Non Odontogenic Soft Tissue Cysts of the Oral Cavity

1980 ◽  
Vol 66 (3) ◽  
pp. 218-222
Author(s):  
T. J. C. Hall
Keyword(s):  
Soft Tissue ◽  
Oral Cavity ◽  
Clinical Features ◽  
Case Reports ◽  
Tissue Cyst

AbstractThe aetiology and clinical features of five types of non odontogenic soft tissue cyst of the oral cavity are described and case reports presented.

Methylene blue is not contraindicated to treat hemodynamic instability in pediatric and neonate patient

2021 ◽  
Vol 17 ◽  
Author(s):  
Walusa A. Gonçalves-Ferri ◽  
Agnes A.S. Albuquerque ◽  
Patricia Martinez Evora ◽  
Paulo R.B. Evora
Keyword(s):  
Methylene Blue ◽  
Side Effects ◽  
Infusion Rate ◽  
Case Reports ◽  
Hemodynamic Instability ◽  
Exclusion Criteria ◽  
Old Patients ◽  
Randomized Clinical Study ◽  
Dose Infusion ◽  
Administration Timing

: The present review was carried out to describe publications on the use of methylene blue (MB) in pediatrics and neonatology, discussing dose, infusion rate, action characteristics and possible benefits for a pediatric patient group. The research was performed on the data sources PubMed, BioMed Central, and Embase (updated on Aug 31, 2020) by two independent investigators. The selected articles included human studies that evaluated MB use in pediatric or neonatal patients with vasoplegia due to any cause, regardless of the applied methodology. The MB use and 0 to18-years-old patients with vasodilatory shock were the adopted criteria. Exclusion criteria were the use of MB in patients without vasoplegia and patients ≥ 18-years-old. The primary endpoint was the increase in mean arterial pressure (MAP). Side effects and dose were also evaluated. Eleven studies were found of which 10 were case reports and 1 was a randomized clinical study. Only two of these studies were with neonatal patients (less than 28 days-old), reporting a small number of cases (1 and 6). All studies described positive action of MB on MAP, allowing the decrease of vasoactive amines in several of them. No severe side effects or death related to the use of the medication was reported. The maximum dose used was 2 mg/kg, but there was no consensus on the infusion rate and drug administration timing. Finally, no theoretical or experimental basis sustains the decision to avoid MB in children claiming it can cause pulmonary hypertension. The same goes for the concern of a possible deleterious effect on inflammatory distress syndrome.

scholarly journals Antiviral Treatment on Pregnancy with COVID-19 Infection : A Systematic Review

2021 ◽  
Vol 4 (2s) ◽  
pp. 78-85
Author(s):  
Tigor Peniel Simanjuntak ◽  
◽  
Angela Putri Kakerissa ◽  
Grady Ivan Kurniawan
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Pregnant Women ◽  
Gestational Age ◽  
Treatment Duration ◽  
Case Reports ◽  
Antiviral Treatment ◽  
Inclusion Criteria ◽  
Duration Of Treatment ◽  
Retrospective Case

Abstract Objective to evaluate antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Method: a systematic review of antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement. Result 948 papers accessed through Pubmed, Scopus, Science Direct, Cohcrane, and other with keywords “Antiviral”, “Pregnancy” “Pregnant” “Coronavirus” “COVID-19” “SARS-CoV-2”. Duplicate papers were excluded (n=302), topics and abstracts that do not meet the criteria (n=612), and 25 papers that did not meet the inclusion criteria. 9 papers that meet the inclusion criteria (case reports and cohort retrospective case study) discussed 20 pregnant women with COVID-19 infection (16 moderate and severe cases received Remdesivir, 3 moderate and mild cases received Lopinavir-ritonavir combination, and 1 moderate case received Arbidol). Conclusion, remdesivir is an antiviral frequently used in pregnancy on trimester II and III with severe COVID-19 infection with a duration of treatment of 5-10 days. Remdesivir should be monitored because some show side effects of increasing liver function. Key word: Antiviral, Pregnant, COVID-19

scholarly journals Clinical Features of Coexisting Anti-NMDAR and MOG Antibody-Associated Encephalitis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiayue Ding ◽  
Xiangyu Li ◽  
Zhiyan Tian
Keyword(s):  
Optic Neuritis ◽  
Clinical Features ◽  
Antibody Titer ◽  
Fixed Effects ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Involuntary Movement ◽  
Meta Analysis ◽  
Abnormal Behavior ◽  
Fixed Effects Model

Coexisting anti-NMDAR and MOG antibody (anti-NMDAR-IgG+/MOG-IgG+)-associated encephalitis have garnered great attention. This study aimed to perform a secondary analysis to determine the clinical features of this disease. We searched several databases for related publications published prior to April 2021. A pooled analysis was conducted with the fixed-effects model using the Mante-Haenszel method (I2 ≤ 50%), or the random-effects model computed by the DerSimonian–Laird method (I2 &gt; 50%). Stata software (version 15.0 SE) was used for the analyses. Nine observational studies and 16 case reports (58 cases with anti-NMDAR-IgG+/MOG-IgG+, 21.0 [8.5, 29.0] years, male 58.6%) were included. The incidences (95%CI) of anti-NMDAR-IgG+/MOG-IgG+ in the patients with serum MOG-IgG+ and CSF anti-NMDAR-IgG+ were 0.09 (0.02–0.19) and 0.07 (0.01–0.19), respectively. The median [IQR] of CSF anti-NMDAR antibody titer was 32 [10, 100], and the serum anti-MOG antibody titer was 100 [32, 320]. The prominent clinical symptoms were encephalitic manifestations, including seizures (56.9%) and abnormal behavior (51.7%), rather than demyelinating manifestations, such as speech disorder (34.5%) and optic neuritis (27.6%). Relapse occurred in 63.4% of anti-NMDAR-IgG+/MOG-IgG+ patients, in whom 50.0% of cases relapsed with encephalitic manifestations, and 53.8% relapsed with demyelinating manifestations. The common MRI changes were in the cortex or subcortex (70.7%) and brainstem (31.0%). 31.3% of patients presented with unilateral cerebral cortical encephalitis with epilepsy and 12.5% displayed bilateral frontal cerebral cortex encephalitis. Anti-NMDAR-IgG+/MOG-IgG+ patients showed more frequent mental behavior (OR, 95%CI, 68.38, 1.36–3,434.37), involuntary movement (57.86, 2.53–1,325.11), sleep disorders (195.00, 7.07–5,380.15), and leptomeninge lesions (7.32, 1.81–29.58), and less frequent optic neuritis (0.27, 0.09–0.83) compared to anti-NMDAR-IgG−/MOG-IgG+ patients and presented more common relapse (5.63, 1.75–18.09), preceding infection (2.69, 1.03–7.02), subcortical lesions (116.60, 4.89–2,782.09), basal ganglia lesions (68.14, 2.99–1,554.27), brainstem lesions (24.09, 1.01–574.81), and spinal cord lesions (24.09, 1.01–574.81) compared to anti-NMDAR-IgG+/MOG-IgG−. In conclusion, anti-NMDAR-IgG+/MOG-IgG+ was rarely observed, but the incidence rate of relapse was very high. The overall symptoms seemed to be similar to those of NMDAR encephalitis.

The Use of Methylphenidate for Cognitive Decline Associated with HIV Disease

1995 ◽  
Vol 25 (1) ◽  
pp. 21-37 ◽  
Author(s):  
George R. Brown
Keyword(s):  
Side Effects ◽  
Hiv Infection ◽  
Early Stage ◽  
Case Reports ◽  
English Literature ◽  
Pharmacokinetic Data ◽  
Hiv Disease ◽  
Cognitive Changes ◽  
Persons Living With Hiv ◽  
Hiv Aids

Objective: Complaints of cognitive changes are often expressed by patients at all stages of HIV infection. Such changes include decreased memory and attention span, diminished concentration, apathy, and “slowing.” Methylphenidate (MPD) has been used in several clinical studies in men with late-stage HIV disease in an attempt to ameliorate these difficulties. The objectives of this review article are to review salient psychopharmacological characteristics of MPD and to describe the research and clinical literature supporting the use of MPD in patients at all stages of HIV infection. Methods: Seven studies, case reports, or abstracts from International Conferences on AIDS were available in the English literature through August, 1993, directly addressing the use of MPD in patients with HIV disease. Twenty-nine papers were reviewed for pharmacokinetic data, eighteen for safety and side effects issues, and seventeen for relevant contributions from the neuropsychological testing literature. Results: Studies in clinical settings have used doses ranges from 10–90 mg. per day in two or three divided doses with reportedly good results in improving both affective and cognitive symptoms associated with HIV disease. Side effects have been relatively mild and patient satisfaction with treatment has been high. However, no studies have been conducted in early stage HIV disease, where a significant minority of patients have similar complaints in the absence of clinically apparent immunosuppression. Likewise, placebo-controlled, dose-finding studies in AIDS patients are entirely lacking, and no studies in women with HIV disease and cognitive changes have been published. Conclusions: In spite of these important research shortcomings, clinical experience with MPD treatment of cognitive changes in men with HIV/AIDS is consistent with the notion that this medication holds significant promise to improve the quality of life for persons living with HIV/AIDS. Controlled studies to test this hypothesis are warranted.

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