P.03.11 RESCUE THERAPEUTIC APPROACH BY DIRECT PERORAL CHOLANGIOSCOPY IN THE MANAGEMENT OF TRICKY BILIARY CONDITIONS: A CASE SERIES OF A SINGLE CENTER EXPERIENCE

Abstract Background and Aims Steroid-dependent nephrotic syndrome (SDNS) may require a prolonged multi-drug therapy with risk of drug toxicity and renal failure. Rituximab (RTX) treatment has been found to be helpful in reducing the steroid dosage and the need for immunosuppressants (ISs), but little data are currently available regarding very long-term outcomes in adults. We herein describe a long-term, single-center experience of RTX use in a large series of adults with SDNS. Method We studied 23 adult patients with SDNS (mean age 54.2±17.1 y; 65% male; BMI 28.5±4.7), mostly consequent to membranous (47.8%) or focal glomerulonephritis (30.2 %) who were eligible to start a RTX regimen. Before entering the RTX protocol, proteinuria and eGFR were 7.06±3.87 g/24h and 65.9±28.2 ml/min/1.73 m2, respectively; albumin and CD19/CD20 ratio were 2.9±0.9 g/L and 0.99±0.01 respectively; the mean number of ISs was 2.39±0.89 and the mean annual rate of relapses was 2.2±0.9. Results Patients were followed over a mean follow-up of 64 months (range: 12-144). After RTX (mean dose: 1202.1±372.4 mg) the rate of relapses was virtually nullified (p<0.001). eGFR remained roughly stable (62.1±19.8 ml/min/1.73 m2, p=NS), while proteinuria, albumin, CD19/CD20 and BMI all significantly improved (p ranging from 0.01 to 0.001). The mean number of additional ISs was also reduced (0.44±0.12; p<0.001) and RTX enabled discontinuation of steroids in 13/23 (56.5%) patients. No major adverse events related to therapy were recorded. Conclusion Findings from this large case-series with a remarkable very long follow-up reinforce the role of RTX as an efficient and safe weapon to improve outcomes in adult patients suffering from SDNS.

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Intralesional Bleomycin Injection and Skin Hyperpigmentation: A Case Series of a Single-Center Experience With a Standardized Skin-Protective Protocol

A & A Practice ◽

10.1213/xaa.0000000000001551 ◽

2022 ◽

Vol 16 (1) ◽

pp. e01551

Author(s):

Jacob Heninger ◽

Eric Cheon ◽

Jared Green ◽

John Hajduk ◽

Hubert Benzon

Keyword(s):

Case Series ◽

Single Center ◽

Single Center Experience ◽

Skin Hyperpigmentation

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Darbepoetin Alfa in Young Infants With Renal Failure: Single Center Experience, a Case Series and Review of the Literature

Frontiers in Pediatrics ◽

10.3389/fped.2018.00398 ◽

2018 ◽

Vol 6 ◽

Author(s):

Anna Maria Libudzic-Nowak ◽

Francois Cachat ◽

Manuel Pascual ◽

Hassib Chehade

Keyword(s):

Renal Failure ◽

Darbepoetin Alfa ◽

Case Series ◽

Review Of The Literature ◽

Single Center ◽

Single Center Experience ◽

Young Infants

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Case series of ventriculopleural shunts in adults: a single-center experience

Journal of Neurosurgery ◽

10.3171/2016.4.jns16641 ◽

2016 ◽

Vol 126 (6) ◽

pp. 2010-2016 ◽

Cited By ~ 6

Author(s):

Claudia Craven ◽

Hasan Asif ◽

Amna Farrukh ◽

Flavia Somavilla ◽

Ahmed K. Toma ◽

...

Keyword(s):

Survival Rates ◽

Case Series ◽

Mantel Test ◽

Single Center ◽

Retrospective Case ◽

Distal Catheter ◽

Single Center Experience ◽

Kaplan Meier ◽

Shunt Survival ◽

Ventriculopleural Shunt

OBJECTIVEThe peritoneal cavity is widely used as the destination of choice for cerebrospinal fluid shunts. Various alternative sites have been used, particularly in the presence of certain contraindications. The pleural cavity has been used; however, a paucity of evidence details ventriculopleural (VPL) shunt survival, complication, and revision rates in adults. The aim of this study was to present a single center's experience with VPL shunts, identifying complication, revision, and survival rates.METHODSA single-center, retrospective case series analysis was conducted for VPL shunt insertions and revisions over a period of 5 years. Demographic as well as clinical data were collected. Ventriculopleural shunt survival was assessed using Kaplan-Meier curves and the log rank (Cox-Mantel) test.RESULTSTwenty-two VPL shunts were inserted in 19 patients. Median survival of the VPL shunts was 14 months. Pathological indication for the VPL shunt did not significantly affect survival. A total of 10 complications was observed: 2 infections, 2 cases of overdrainage, 2 obstructions, 1 distal catheter retraction, 2 symptomatic pleural effusions, and 1 asymptomatic pleural effusion.CONCLUSIONSVentriculopleural shunting is a safe and viable second-line procedure for cases in which ventriculoperitoneal shunts are unsuitable. While VPL shunts have a high revision rate, their complication rate is comparable to that of VP shunts. Ventriculopleural shunt survival can be improved by careful patient selection and the implementation of a combination of valves with antisiphon devices.

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