scholarly journals An Alternative Approach to Atopic Dermatitis: Part I—Case-Series Presentation

2004 ◽  
Vol 1 (1) ◽  
pp. 49-62 ◽  
Author(s):  
Hiromi Kobayashi ◽  
Kuniaki Takahashi ◽  
Nobuyuki Mizuno ◽  
Haruo Kutsuna ◽  
Masamitsu Ishii
Keyword(s):  
Atopic Dermatitis ◽  
Herbal Medicine ◽  
Conventional Therapy ◽  
Complex Disease ◽  
Case Series ◽  
Line Treatment ◽  
Second Line ◽  
Substantial Portion ◽  
Alternative Approach ◽  
Evidential Basis

Atopic dermatitis (AD) is a complex disease of obscure pathogenesis. A substantial portion of AD patients treated with conventional therapy become intractable after several cycles of recurrence. Over the last 20 years we have developed an alternative approach to treat many of these patients by diet and Kampo herbal medicine. However, as our approach is highly individualized and the Kampo formulae sometimes complicated, it is not easy to provide evidence to establish usefulness of this approach. In this Review, to demonstrate the effectiveness of the method of individualized Kampo therapy, results are presented for a series of patients who had failed with conventional therapy but were treated afterwards in our institution. Based on these data, we contend that there exist a definite subgroup of AD patients in whom conventional therapy fails, but the ‘Diet and Kampo’ approach succeeds, to heal. Therefore, this approach should be considered seriously as a second-line treatment for AD patients. In the Discussion, we review the evidential status of the current conventional strategies for AD treatment in general, and then specifically discuss the possibility of integrating Kampo regimens into it, taking our case-series presented here as evidential basis. We emphasize that Kampo therapy for AD is more ‘art’ than technology, for which expertise is an essential pre-requisite.

scholarly journals An Alternative Approach to Atopic Dermatitis: Part II—Summary of Cases and Discussion

2004 ◽  
Vol 1 (2) ◽  
pp. 145-155 ◽  
Author(s):  
Hiromi Kobayashi ◽  
Kuniaki Takahashi ◽  
Nobuyuki Mizuno ◽  
Haruo Kutsuna ◽  
Masamitsu Ishii
Keyword(s):  
Clinical Trial ◽  
Atopic Dermatitis ◽  
Conventional Therapy ◽  
Immunosuppressive Agents ◽  
Case Series ◽  
Special Care ◽  
Alternative Approach ◽  
Ad Therapy ◽  
Evidential Basis

In the first part of this Review, we presented case-series where Kampo treatment was introduced for those atopic dermatitis (AD) patients who had failed with conventional therapy, in an attempt to prove that there exists a definite subgroup of AD patients for whom Kampo treatment is effective. In this second part, we will first provide the summary of the results for 140 AD patients we treated in 2000. The results suggest that Kampo treatment is effective for more than half of AD patients who fail with conventional therapy. In the Discussion, we will examine the evidential basis for conventional AD therapy and discuss how Kampo treatment should be integrated into the guidelines for AD therapy. We contend that Kampo treatment should be tried before systematic immunosuppressive agents are considered. As each Kampo treatment is highly individualized, it should be regarded more as ‘art’ than technology, and special care should be taken to assess its efficacy in clinical trial.

EpiCO (epirubicin, cyclophosphamide and vincristine) as treatment for extrapulmonary high-grade neuroendocrine neoplasms

2020 ◽  
Vol 58 (02) ◽  
pp. 133-136
Author(s):  
Stefan Munker ◽  
Martin Vogelhuber ◽  
Jan Bornschein ◽  
Christian Stroszczynski ◽  
Matthias Evert ◽  
...  
Keyword(s):  
Case Series ◽  
Small Cell ◽  
Neuroendocrine Neoplasms ◽  
Significant Activity ◽  
High Grade ◽  
Line Treatment ◽  
Second Line ◽  
Small Cell Lung ◽  
First Line ◽  
Cell Lung Carcinoma

AbstractHigh-grade neuroendocrine neoplasms (NEN) comprise a rare entity. Due to the lack of randomized controlled trials, therapy recommendations were mainly extrapolated from its pulmonary analogue, small cell lung cancer and mostly validated in small retrospective case series. The multicentric Nordic NEC Study of gastro-entero-pancreatic (GEP) and cancer of unknown primary (CUP) high-grade neuroendocrine neoplasms showed a significant disease control upon treatment with etoposide and platinum-based chemotherapies 1. Such a combination with etoposide and a platinum (CE) compound is currently considered standard first-line treatment for high-grade GEP/CUP NEN. High-grade mixed-neuroendocrine-non-neuroendocrine neoplasms (MiNEN) formerly termed mixed adeno-neuroendocrine carcinomas (MANEC) also have a poor prognosis and are generally treated like other high-grade NEN. The CE protocol has significant activity in high-grade NEN and MiNEN, but the response is short-lived in most cases with response rates around 50–60 %. Second-line treatment alternatives are not established so far. The need for additional treatment options is evident.Combination chemotherapy with doxorubicin, cyclophosphamide and vincristine (CAV) showed efficacy in small cell lung carcinoma (SCLC) and was considered standard first-line therapy before the era of etoposide and platinum combinations. Due to a better toxicity profile, doxorubicin was replaced by epirubicin, resulting in the combination of epirubicin, cyclophosphamide and vincristine (abbreviated as EpiCO or CEV).In analogy to SCLC, selected patients with high-grade NEN were treated with the EpiCO regimen in second line (or in one patient first line) at our center. In this report we present the retrospective series of 5 cases with metastatic high-grade GEP/CUP NEN/MiNEN who received chemotherapy according to this protocol.

scholarly journals Transient Hypogammaglobulinemia and Severe Atopic Dermatitis: Open-label Treatment with Immunoglobulin in a Case Series

2016 ◽  
Vol 7 (2) ◽  
pp. ar.2016.7.0164 ◽  
Author(s):  
Moira E. Breslin ◽  
Joanna H. Lin ◽  
Robert Roberts ◽  
Kellie J. Lim ◽  
E. Richard Stiehm
Keyword(s):  
Atopic Dermatitis ◽  
Los Angeles ◽  
Intravenous Immunoglobulin ◽  
Conventional Therapy ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Immunoglobulin Therapy ◽  
Severe Atopic Dermatitis ◽  
Open Label ◽  
Intravenous Immunoglobulin Therapy

Background We reported on six infants between 5 and 11 months old, with transient hypogammaglobulinemia of infancy and severe refractory atopic dermatitis, who were treated with open-label immunoglobulin (Ig) after conventional therapy failed. All six infants had an IgG level of <225 mg/dL, elevated eosinophil and IgE levels, and no urine or stool protein losses, but they did exhibit hypoalbuminemia. Objective To evaluate the utility of open-label immunoglobulin in infants with severe atopic dermatitis for whom conventional therapy failed. We reviewed the clinical utility of intravenous immunoglobulin in the treatment of severe atopic dermatitis, the most recent research in the field, and suggested mechanisms for its benefit. Methods The six infants were identified from a retrospective chart review at the University of California Los Angeles Allergy and Immunology outpatient pediatric clinic. Results All six patients were treated with 400 mg/kg/month of intravenous immunoglobulin and had normalization of their IgG and albumin levels, and all but one had clinically improved atopic dermatitis. Conclusion Infants with severe atopic dermatitis who did not respond to conventional therapy avoidance may benefit from intravenous immunoglobulin therapy.

Poor efficacy of palbociclib in second‐line treatment of metastatic lobular breast cancer in a case series: Use before or never more?

2019 ◽  
Vol 26 (7) ◽  
pp. 1458-1460 ◽  
Author(s):  
Armando Orlandi ◽  
Francesca Aroldi ◽  
Mattia Garutti ◽  
Carmela Di Dio ◽  
Giovanna Garufi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Series ◽  
Line Treatment ◽  
Second Line ◽  
Lobular Breast Cancer ◽  
Poor Efficacy

scholarly journals Phototherapy in Atopic Dermatitis

2020 ◽  
Author(s):  
Aleksandra Lesiak ◽  
Magdalena Ciazynska ◽  
Joanna Narbutt
Keyword(s):  
Atopic Dermatitis ◽  
Chronic Disease ◽  
Side Effects ◽  
Blue Light ◽  
Topical Therapy ◽  
Calcineurin Inhibitors ◽  
Line Treatment ◽  
Second Line ◽  
Topical Corticosteroids ◽  
Narrowband Uvb

Atopic dermatitis (AD) is an inflammatory, recurrent and chronic disease that occurs in 2–10% of the population. Therapy of AD could be divided into topical (corticosteroids, calcineurin inhibitors) and systemic (cyclosporine, methotrexate, azathioprine or biological treatment). Phototherapy is taken into consideration as a second-line treatment, when topical therapy is unsuccessful. We distinguish many types of phototherapy, e.g. narrowband UVB (311–313 nm), UVA-1 therapy (340–400 nm), UVA/B combination, UVA therapy plus 8-methoxypsoralens (PUVA), 308 nm excimer laser (EL) and blue light. Phototherapy is effective in many cases, whether in adults or in children. It should be remembered that during therapy possible side effects may occur. Among them the risk of carcinogenesis is the most severe.

scholarly journals EPID-12. TREATMENT OUTCOMES OF MIDLINE GLIOMAS WITH H3K27 M: OUR BARROW NEUROLOGICAL INSTITUTE EXPERIENCE

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii81-ii81
Author(s):  
Amir Azadi ◽  
Ekokobe Fonkem ◽  
Tejas Ranade
Keyword(s):  
Stable Disease ◽  
Progressive Disease ◽  
Clinical Status ◽  
Case Series ◽  
Response Assessment ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Multiple Treatment ◽  
First Line Treatment

Abstract BACKGROUND H3 K27M glioblastoma is an aggressive grade IV tumor located in midline structures, added in 2016 by the WHO. Current outcomes are poor. The rarity of these tumors presents a challenge for definitive research on developing optimal treatments. METHODS We conducted a case series of 12 patients at the Barrow Neurological Institute who were diagnosed with biopsy-proven H3 K27M glioblastoma. The clinical status of these patients was followed from dates of first and last contact. Factors included first line treatment, best response to first line treatment, recurrences, second line treatments, response assessment criteria for all treatment rounds, any discovered metastases, and vital status by date of last contact. RESULTS Of the initial 12 patients, 5 were lost to follow-up before meaningful clinical outcomes could be recorded. Of the remaining 7, all underwent temozolomide and radiation as components of first-line treatment. After first-line treatment, 1/7 (14.2%) had partial response, 3/7 (42.8%) had stable disease, and 3/7 (42.8%) had progressive disease. 4 patients elected to undergo second line treatment: 2 underwent bevacizumab with lomustine, 1 underwent bevacizumab and irinotecan, and 1 underwent surgery with carmustine. Of the 2 who underwent bevacizumab and lomustine, 1 (50%) improved from progressive to stable disease and 1 (50%) stayed at stable disease. Of the 1 patient who underwent bevacizumab and lomustine, outcome worsened from stable to progressive disease. Of the 1 patient who underwent surgery and carmustine, outcome improved from progressive to stable disease. CONCLUSIONS H3 K27M is a highly aggressive tumor with poor outcomes. This case series demonstrates that multiple treatment rounds with chemotherapy and radiation therapy may benefit patients, with bevacizumab/lomustine and surgery/carmustine appearing to lead to promising outcomes. Further research is needed to establish evidence-based protocols so quality of life and survival time in these patients may improve.

Response to entecavir treatment and evolution of HBV quasispecies in patients with failure to second line treatment with adefovir

2013 ◽  
Vol 51 (01) ◽  
Author(s):  
A Herber ◽  
K Deterding ◽  
C Jochum ◽  
B Kronenberger ◽  
HH Feucht ◽  
...  
Keyword(s):  
Line Treatment ◽  
Second Line
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