Immunotherapy “Shock” a case series of PD-L1 100% and pembrolizumab first-line treatment

Objective: The authors reviewed the recent literature regarding the treatment of catatonia as a syndrome of multiple etiologies. Given the historical and clinical association of catatonia with schizophrenia, the authors' examined the assumption that the first-line treatment of catatonia is antipsychotic medication. Methods: Articles published between January 1, 1985 and December 31, 1994 were located using the Paperchase® medical literature search system. Additionally, references from those identified articles were examined for possible inclusion in this review. To be included in this review, articles had to be written in English and report specific symptoms of catatonia to determine, retrospectively, if DSM-IV criteria for catatonia were met. Results: Seventy publications met inclusion criteria and reported on a total of 178 patients and included 270 separate treatment episodes. Most of the articles were case-reports, although a few case-series were identified. Multiple causes of catatonia were identified in these reports. The most commonly reported treatment for catatonia was with benzodiazepines which were effective in 70 percent of the cases, with lorazepam demonstrating the highest frequency of use and a 79 percent complete response rate. Electroconvulsive therapy (ECT) was also efficacious (85%) and was more likely to provide a positive outcome in cases of malignant catatonia. Antipsychotics demonstrated poor efficacy. Conclusions: Catatonia is a nonspecific syndrome with multiple etiologies. Treatment of catatonia should be based on the underlying cause when it is identifiable. Lorazepam appears to offer a safe, effective first-line treatment of catatonia. ECT should be considered when rapid resolution is necessary (e.g., malignant catatonia) or when an initial lorazepam trial fails.

Download Full-text

Left Renal Vein Stenting in Nutcracker Syndrome: Outcomes and Implications

Vascular and Endovascular Review ◽

10.15420/ver.2020.12 ◽

2020 ◽

Vol 3 ◽

Author(s):

Patrick Cherfan ◽

Efthymios D Avgerinos ◽

Rabih A Chaer

Keyword(s):

Renal Vein ◽

Left Renal Vein ◽

Case Series ◽

Flank Pain ◽

Nutcracker Syndrome ◽

Line Treatment ◽

First Line ◽

Extrinsic Compression ◽

First Line Treatment

Nutcracker syndrome refers to the symptomatic extrinsic compression of the left renal vein presenting most commonly as flank pain and haematuria. While surgery remains the first-line treatment, stenting is gaining more acceptance and there are now several published case series. This article highlights the outcomes of left renal vein stenting in the setting of nutcracker syndrome.

Download Full-text

Propranolol as First-Line Treatment in Orbital Infantile Haemangiomas: A Case Series

Orbit ◽

10.3109/01676830.2014.884148 ◽

2014 ◽

Vol 33 (3) ◽

pp. 178-183 ◽

Cited By ~ 9

Author(s):

M. Levitt ◽

A. D. Coumou ◽

L. Groeneveld ◽

N. J. M. Freling ◽

C. M. van der Horst ◽

...

Keyword(s):

Case Series ◽

Line Treatment ◽

First Line ◽

First Line Treatment ◽

Infantile Haemangiomas

Download Full-text

A Nine Case Series of Ultrasound-Guided Hydrostatic Reduction of Intussusception by Saline Enema

The ASEAN Journal of Radiology ◽

10.46475/aseanjr.v19i1.23 ◽

2013 ◽

Vol 19 (1) ◽

pp. 61-71

Author(s):

Sornsupha Limchareon ◽

Adisorn Boonyarit

Keyword(s):

Case Series ◽

Teaching Hospitals ◽

Line Treatment ◽

Ultrasound Guided ◽

First Line ◽

Hydrostatic Reduction ◽

Pneumatic Reduction ◽

Reduction Techniques ◽

Enema Reduction ◽

First Line Treatment

Non-surgical reduction of the intussusception is the first line treatment in children with intussusception. Among various radiological reduction techniques, barium enema reduction of the intussusception under fluoroscopy has been widely used in Thailand while pneumatic reduction under fluoroscopy has become popular in teaching hospitals. To our knowledge, ultrasound-guided hydrostatic reduction of the intussusception by saline enema (UGHSE) has never been used in Thailand. We reported 9 cases using UGHSE with 100% success rate without complication.

Download Full-text

Endoscopic internal drainage as first-line treatment for fistula following gastrointestinal surgery: a case series

Endoscopy International Open ◽

10.1055/s-0042-105206 ◽

2016 ◽

Vol 04 (06) ◽

pp. E647-E651 ◽

Cited By ~ 14

Author(s):

Gianfranco Donatelli ◽

Jean-Loup Dumont ◽

Fabrizio Cereatti ◽

Parag Dhumane ◽

Thierry Tuszynski ◽

...

Keyword(s):

Gastrointestinal Surgery ◽

Case Series ◽

Line Treatment ◽

Internal Drainage ◽

First Line ◽

Endoscopic Internal Drainage ◽

First Line Treatment

Download Full-text

Targeted Combination Antibiotic Therapy Induces Remission in Treatment-Naïve Crohn’s Disease: A Case Series

Microorganisms ◽

10.3390/microorganisms8030371 ◽

2020 ◽

Vol 8 (3) ◽

pp. 371 ◽

Cited By ~ 6

Author(s):

Gaurav Agrawal ◽

Annabel Clancy ◽

Rijata Sharma ◽

Roy Huynh ◽

Sanjay Ramrakha ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Case Series ◽

Line Treatment ◽

First Line ◽

Rapid Improvement ◽

Line Therapy ◽

Treatment Naïve ◽

First Line Treatment

Prospective trials of anti-mycobacterial antibiotic therapy (AMAT) have proven efficacious in Crohn’s disease (CD) but use as first-line treatment in CD has not been evaluated. This paper reports the outcomes of patients with CD treated with first-line AMAT. This paper consists of a case series of treatment-naïve CD patients who received AMAT as first-line treatment between 2007 and 2014 at a single center. AMAT treatment consisted of rifabutin, clofazimine and clarithromycin, plus either ciprofloxacin, metronidazole or ethambutol. Symptoms, inflammatory blood markers, colonoscopy and histology results, in addition to, the Crohn’s Disease Activity Index (CDAI) were tabulated from patients’ clinical records, and descriptive statistics were conducted. A Wilcoxon signed-rank test assessed the difference in CDAI scores before and while on AMAT. The statistical significance was set at 5%. Clinical remission (CDAI < 150) with rapid improvement in clinical symptoms and inflammatory markers was seen in all eight patients receiving AMAT as sole therapy by 6 weeks. In all eight patients, the median CDAI score decreased significantly, from 289 prior to treatment to 62 at the 12-month follow-up (p < 0.001). Follow-up colonoscopies showed healing of CD ulcers, no visible mucosal inflammation, restoration of normal vascular patterns and complete mucosal healing on histology samples. AMAT as first-line therapy demonstrated a rapid improvement of Crohn’s disease (not previously seen when used as second-line therapy).

Download Full-text

Oral eplerenone as a first line treatment in chronic central serous chorioretinopathy: A case series evaluation

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2015.0629 ◽

2015 ◽

Vol 93 ◽

pp. n/a-n/a

Author(s):

D. Sendon ◽

M. Graber ◽

A. Chiche ◽

C. Rambaud ◽

M. Berguiga ◽

...

Keyword(s):

Central Serous Chorioretinopathy ◽

Case Series ◽

Line Treatment ◽

First Line ◽

Chronic Central Serous Chorioretinopathy ◽

Series Evaluation ◽

First Line Treatment

Download Full-text

Application of the capsaicin 8% cutaneous patch in neuropathic pain of the head and face: A case series

Cephalalgia ◽

10.1177/0333102414550107 ◽

2014 ◽

Vol 35 (6) ◽

pp. 545-550 ◽

Cited By ~ 7

Author(s):

Charly Gaul ◽

Sonja Resch

Keyword(s):

Neuropathic Pain ◽

Facial Pain ◽

Case Series ◽

Additional Treatment ◽

Line Treatment ◽

First Line ◽

Head Region ◽

Affected Area ◽

Pain Syndromes ◽

First Line Treatment

Introduction Treatment of neuropathic or neuralgic head and facial pain due to dental, traumatic or surgical nerve lesions or post-herpetic neuropathy is often challenging. Cases We are reporting on four patients with neuropathic pain syndromes successfully treated with a capsaicin 8% patch in the affected area of the head or face. Discussion Treatment with the capsaicin 8% patch seems to be effective and safe for application to the facial and head region. The capsaicin 8% patch might be an additional treatment option if first-line treatment with anticonvulsants or antidepressants was ineffective or limited by side effects.

Download Full-text

Prognosis of leptomeningeal metastases from melanoma: A case series of 28 patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e13550 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e13550-e13550

Author(s):

Sarah Oinino ◽

Isabelle Rodrigues ◽

Thomas Boulanger ◽

Charles Andre ◽

Jacques Bonneterre ◽

...

Keyword(s):

Targeted Therapy ◽

Metastatic Disease ◽

Systemic Treatment ◽

Case Series ◽

Braf Inhibitor ◽

Line Treatment ◽

First Line ◽

Melanoma Diagnosis ◽

Systemic Treatments ◽

First Line Treatment

e13550 Background: Leptomeningeal metastasis (LM) are reported in 5-25% of patients with melanoma. However, only very few large contemporary cohorts of melanoma patients with LM have been published. Methods: We report on a case series of 28 consecutive patients with LM from melanoma (BRAF mutated in 14 cases, of 19 tested) diagnosed between April 2007 and April 2016, and treated for LM using a combination of systemic treatment, intra-cerebrospinal fluid (CSF) therapy and radiotherapy according to prior treatments and the presentation of LM. Results: The median age at LM diagnosis was 49.5 years (range 27-73). Median ECOG-performance status was 2 (0-4). Concomitant brain metastases were present in all but 4 patients at LM diagnosis. LM was the first site of metastatic disease for only 2 patients. Median time from melanoma diagnosis to LM diagnosis was 0.33 years in patients with metastatic disease at melanoma diagnosis (4 patients) and 4.5 years in patients without metastatic disease at melanoma diagnosis (24 patients). First line treatment for LM was a combination of intra-CSF (liposomal cytarabine) and systemic treatments in 25 cases, and systemic treatment alone in 3 cases. Systemic treatments include chemotherapy (n = 18), targeted therapy (BRAF inhibitor n = 9; MEK inhibitor, n = 3) and immunotherapy (n = 4). No radiotherapy was performed. Ten patients received more than one line of treatment for LM. Median progression-free survival with first line treatment was 1.75 months. Responses or stabilization (for at least 2 months) were observed in only 7 patients. Median overall survival (OS) for the whole cohort was 3.08 months. Conclusions: The prognosis of patients with LM from melanoma remains poor. The role of new agents such as targeted therapies and immunotherapy for the treatment of LM is still not well defined. Adequate use of intrathecal chemotherapy, targeted therapy and immunotherapy could improve the survival of these patients.

Download Full-text