Pertinent role of maintenance dose of oral tofacitinib in a child with alopecia totalis with a 2.5‐year follow‐up on low dose

2022 ◽  
Author(s):  
Kabir Sardana ◽  
Sinu Rose Mathachan ◽  
Pulin Gupta
Keyword(s):  
Maintenance Dose ◽  
Low Dose

The role of androgen ablation with low dose rate brachytherapy in the treatment of prostate cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14546-14546
Author(s):  
A. B. Jani ◽  
A. Shoushtari ◽  
J. Feinstein
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
High Risk ◽  
Dose Rate ◽  
Low Dose ◽  
Androgen Ablation ◽  
Low Dose Rate ◽  
Low Dose Rate Brachytherapy

14546 Background: We report a single-institution analysis of the role of androgen ablation (AA) with low-dose rate brachytherapy. Methods: A cohort of 189 consecutive patients (AA: n = 68, no-AA: n = 121) receiving brachytherapy (iodine-125: n = 125; palladium-109: n = 64) at our institution who had demographic (age), disease (T-stage [T1–70%, T2–28%, T3–2%], Gleason Score [median score 6], PSA [median-7.7 ng/mL]), and treatment (isotope, dosimetric endpoints, use of supplemental external beam radiotherapy [EBRT, administered as 45 Gy/1.8 Gy to the pelvis using 4-field technique with isocentric prescription]) information available, and a minimum of 2 years of follow-up available, constitute the analysis study group (median follow-up - 4.0 years). This cohort was divided into 2 major groups based on the use of AA (leuprolide 22.5 mg IM injection(s) 3–6 months [mean 4.0 months] prior to brachytherapy). Using 2 successive PSA rises > 1 ng/mL as the failure definition, biochemical failure-free survival (BFFS) curves were constructed and compared using the logrank test; additionally, multivariate analysis of all major patient and treatment factors was performed using the Cox proportional hazards model. These analyses were done for the whole cohort as well as for subgroups defined by the use of EBRT and for subgroups of patients with low-, intermediate-, and high-risk prognostic factors (defined as the basis of 0, 1, or ≥ 2 prognostic factors [PSA > 10 ng/mL, Gleason score > 6, T-stage > T2a], repectively). Results: The 4-year BFFS in the AA vs no-AA groups was 76 vs 70% (p = 0.230) for the whole cohort, 75 vs 62% (p = 0.182) for EBRT patients, and 75 vs 82% (p = 0.764) for no-EBRT patients. For the whole cohort, the use of EBRT was the only factor reaching significance on multivariate analysis (p = 0.040). When analyzing the EBRT and no-EBRT subgroups separately, no factor, including AA, reached significance on multivariate analysis. 4Y-BFFS of the AA vs no-AA subgroups were 82 vs 76% (p = 0.236) for the low-risk, 76 vs 70% (p = 0.437) for the intermediate-risk, and 75 vs 70% (p = 0.185) for the high-risk subgroup. Conclusions: In our study, short-course AA conferred no significant biochemical control advantage when added to low-dose rate brachytherapy overall or for any subgroup based on prognostic risk. No significant financial relationships to disclose.

Lenalidomide and Dexamethasone Alone Is Equivalent To Lenalidomide and Dexamethasone With Autologous Stem Cell Transplant In Newly Diagnosed Multiple Myeloma: Interim Study Results Of a Randomized Trial

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3180-3180 ◽  
Author(s):  
Jordan M. Schecter ◽  
Kristen Kipps ◽  
Amy O'Sullivan ◽  
Kent A. Griffith ◽  
Daniel Normolle ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Interim Analysis ◽  
Research Funding ◽  
Low Dose ◽  
Secondary Malignancy ◽  
Similar Response ◽  
Newly Diagnosed

Abstract The current standard of care for patients with newly diagnosed multiple myeloma (MM) aged less than 65 years is high-dose chemotherapy combined with autologous stem cell transplantation (ASCT) based on improved progression free survival (PFS) and overall survival (OS) compared with conventional chemotherapy. The introduction of novel agents, for example lenalidomide and bortezomib over the last decade, has substantially improved MM outcomes providing similar response rates to ASCT. As a consequence, the role of upfront ASCT has become more controversial. Therefore, this randomized clinical trial aims to determine the role of upfront ASCT in patients with newly diagnosed MM patients receiving lenalidomide and low-dose dexamethasone as induction therapy. Patients enrolled into the study were aged ≥18 years with newly diagnosed MM, transplant eligible, and meeting CRAB criteria. Patients were randomized to receive 4 cycles of lenalidomide (25 mg days 1–21) plus low-dose dexamethasone (40 mg days 1, 8, 15, 22) followed by ASCT conditioned with 200 mg/m2 melphalan (Arm A; LD+ASCT) or 8 cycles of lenalidomide plus low-dose dexamethasone (Arm B; LD alone). Both groups received lenalidomide maintenance therapy 10-15 mg for up to 2 years. Patients in both treatment arms received stem cell collection after 4 cycles of lenalidomide plus dexamethasone if at least a partial response was achieved. Patients with stable disease or progressive disease (PD) went off study. The primary objective was to compare the best response between patients treated with lenalidomide plus dexamethasone followed by ASCT and patients treated with lenalidomide plus dexamethasone alone. Secondary objectives were to compare the duration of response (DOR), PFS, and OS between the two treatment arms and to evaluate the secondary malignancies in both arms. Fifty patients with newly diagnosed MM were randomized between February 2008 and May 2013, and 47 patients were eligible for evaluation in this interim analysis; 25 patients randomized to Arm A (LD+ASCT) and 22 patients randomized to Arm B (LD alone). Overall, patients had a median age of 61.6 years (range 48–75), 60% were male, 34% ISS Stage I, 49% ISS Stage II, 17% ISS Stage III. The data were analyzed according to the IMWG response criteria (Blood. 2011 May 5;117(18):4691-5). In an intention-to-treat analysis, there was a trend towards improved overall response rate (ORR) in patients receiving LD+ASCT (96%) compared with patients receiving LD alone (77%; p=0.08) (Table 1). After a median follow-up of 36.8 months (range 1.1–62.7), the median DOR was 13.9 months (95% confidence interval [CI] 4.0–34.1) in the LD+ASCT group compared with 21.2 months (95% CI 11.0–22.9) in the LD group. Overall, 18 patients have PD (10 patients in the LD+ASCT arm and 8 patients in LD arm), and 8 patients have died (4 patents in the LD+ASCT arm and 4 patients in the LD arm). Median PFS for LD+ASCT versus LD was 17.0 months (95% CI 15.5–not estimable) versus 25.2 months (95% CI 9.0–not estimable; p=0.94). Median OS for LD+ASCT versus LD was 57.6 months (95% CI 48.0–not estimable) versus not reached (p=0.94). Two patients in the LD alone arm developed a secondary malignancy, including 1 patient with myelodysplastic syndrome (MDS) 13 months after the start of therapy. This interim analysis of an ongoing randomized clinical study comparing lenalidomide plus low-dose dexamethasone induction with and without upfront ASCT in patients with newly diagnosed MM suggests that addition of ASCT resulted in a trend towards improved ORR. This did not result in a significant difference in terms of PFS or OS between the two treatment arms. In contrast there was a trend of better DOR in the LD alone arm. The data show that LD alone can achieve similar results as LD+ASCT, however careful interpretation is required due to the low patient number and relatively short follow-up. The incidence of secondary malignancy was low, including the development of 1 MDS. Disclosures: Schecter: Celgene: Honoraria, Speakers Bureau. Mapara:Celgene: Research Funding, RO1 Other. Lentzsch:Celgene: Research Funding.

scholarly journals Development of Central Serous Chorioretinopathy following Chalazion Removal with Intralesional Triamcinolone Injection: A Case Report

2018 ◽  
Vol 9 (3) ◽  
pp. 416-420 ◽  
Author(s):  
Luca Rosignoli ◽  
Stephen Myles Potter ◽  
Andres Gonzalez ◽  
Sarina Amin ◽  
Syed G. Khurshid
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Low Dose ◽  
Subretinal Fluid ◽  
Intralesional Injection ◽  
Short Term ◽  
Corticosteroid Administration ◽  
Triamcinolone Injection

We report a case of central serous chorioretinopathy (CSC) that developed 1 month after an intralesional injection of triamcinolone acetonide that was administered during removal of a chalazion. The subretinal fluid and ipsilateral visual acuity (VA) worsened with initial observation. The edema resolved with verteporfin photodynamic therapy (PDT) 1 month after diagnosis, but VA did not improve during short-term follow-up. We conclude that CSC can occur as a complication of low-dose intrapalpebral corticosteroid administration and provide another example of the therapeutic role of PDT in the management of this disease.

Role of low dose CT angiography in the follow-up after endovascular aneurysm repair of abdominal aorta

2014 ◽  
Vol 56 (12) ◽  
pp. 1471-1478 ◽  
Author(s):  
Monica Macchi ◽  
Chiara Floridi ◽  
Sabina Strocchi ◽  
Federico Fontana ◽  
Monica Mangini ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Abdominal Aorta ◽  
Low Dose ◽  
Endovascular Aneurysm Repair ◽  
Low Dose Ct ◽  
Aneurysm Repair

scholarly journals Role of ultra low dose CTKUB in follow-up of ureteric calculi not visible on plain X-ray

2016 ◽  
Vol 36 ◽  
pp. S124
Author(s):  
C. Jelley ◽  
L. Forster ◽  
J. Arad ◽  
G.S. Mudhar ◽  
H. Bardgett ◽  
...  
Keyword(s):  
Low Dose ◽  
X Ray ◽  
Ureteric Calculi

A Randomized Clinical Trial of Lenalidomide and Dexamethasone with and without Autologous Stem Cell Transplant in Patients with Newly Diagnosed Multiple Myeloma: Interim Study Results,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4142-4142 ◽  
Author(s):  
Lijun Dai ◽  
Amy O'Sullivan ◽  
Ryan Kennedy ◽  
Mohammad Abbas ◽  
Yongli Shuai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Stem Cell ◽  
Low Dose ◽  
Progression Free Survival ◽  
Newly Diagnosed ◽  
Free Survival

Abstract Abstract 4142 Introduction: High dose chemotherapy combined with autologous stem cell transplantation (ASCT) as opposed to conventional chemotherapy improved progression free survival (PFS) and overall survival (OS) in multiple myeloma (MM) and is currently the standard of care for newly diagnosed MM patients less than 65 years old. Over the last decade, novel agents such as lenalidomide or bortezomib have dramatically improved MM outcomes with similar response rates as ASCT and the role of upfront ASCT has become more controversial. Therefore the goal of this randomized clinical trial is to determine the role of upfront ASCT in newly diagnosed myeloma patients receiving novel agent lenalidomide and low-dose dexamethasone induction. Methods: Patients aged ≥18 years with newly confirmed, measurable MM in stage 2 and 3 (Salmon Durie) and meeting CRAB criteria were enrolled. Patients were randomized to transplant (Arm A) or to non-transplant (Arm B). Patients in Arm A received 4 cycles of lenalidomide (25mg days 1 – 21) plus low-dose dexamethasone (40mg days 1,8,15,22) followed by ASCT conditioned with 200 mg/m2 melphalan (LD+ASCT); Arm B patients received 8 cycles of lenalidomide plus low-dose dexamethasone (LD alone). Both arms received stem cell collection after 4 cycles of therapy if patients achieved at least a partial remission (PR). Patients with stable disease (SD) or progressive disease (PD) went off study. The primary objective was to compare best response. The secondary endpoints included duration of response (DOR), progression free survival (PFS), overall survival (OS) and evaluation of secondary malignancies in both arms. Results: From February 2008 to May 2011, 44 patients with newly diagnosed MM were randomized. The patient characteristics were as follow: median age of the patients was 61.7 years (range 48∼75), 45.5% female and 55.5% male patients, ISS stage I 31%, II 51% and III 18%. 40 patients were eligible for evaluation and 20 patients were randomized to Arm A or Arm B, respectively. The data were analyzed according to latest IMWG response criteria (Blood. 2011 May 5;117(18):4691–5). In an intention to treat analysis, patients in Arm A (LD + ASCT), achieved a 100% Overall Response Rate (ORR) with 40% PR (n=8) and 60% Very Good Partial Response (VGPR) (n=12). In Arm B (LD only) the ORR was 75% (n=15), including 15% CR (n=3), 35% VGPR (n=7), 25% PR (n=5), 20% SD (n=4) and 5% PD (n=1). The ORR was significantly superior in the LD+ASCT group compared to LD alone (p=0.047). After a median follow-up of 25.3 months, 17 patients have PD (8 in LD+ASCT and 9 in LD alone), 6 have died (1 in LD+ASCT and 5 in LD alone). DOR, PFS and OS were not significantly different in both groups. OS showed a trend to be superior in patients treated with LD+ASCT (p=0.08). (Table 1). One patient in the LD+ASCT arm developed MDS 13 months after start of therapy. Conclusion: Our interim analysis of an ongoing clinical study suggests that treatment of newly diagnosed MM patients with lenalidomide plus low-dose dexamethasone induction followed by upfront ASCT resulted in significantly improved ORR. There was no difference in terms of DOR or PFS with a trend of superior OS in the LD+ASCT group. The study requires careful interpretation based on the low patient number and relatively short follow up, but supports the continued role of upfront consolidative ASCT in newly diagnosed MM patients. The incidence of secondary malignancy was low with the development of 1 MDS. Updated data on response and overall survival will be available at the time of presentation. Disclosures: Roodman: Amgen: Consultancy; Millennium Pharmaceuticals: Consultancy. Raptis:Millennium: Speakers Bureau; Celgene Corp: Speakers Bureau; Eisai: Speakers Bureau. Lentzsch:Celgene Corp: Consultancy, Research Funding; Onyx: Consultancy; Genzyme: Consultancy; prIME Oncology: Honoraria; Imedex: Honoraria; Clinical Care Options: Honoraria.

scholarly journals EFFICACY AND SAFETY OF LOW DOSE ATROPINE 0.01% IN SLOWING OF PROGRESSION OF MYOPIA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Shalini Gupta ◽  
Poonam Gupta ◽  
Rashi Verma ◽  
Basudeb Gosh ◽  
Rakesh Bhardwaj
Keyword(s):  
Low Dose ◽  
Eye Drops ◽  
Efficacy And Safety ◽  
Visual Disability ◽  
Myopia Progression ◽  
Rapid Progressors ◽  
Significant Difference ◽  
Progressive Myopia

Background: Myopia, commonly referred to as short sightedness is a form of refractive error and is a very common cause of visual disability throughout the world. Methods: Hospital based prospective study conducted on 100 patients of Myopia attending to Department of Opthalmolgy. Results: There was no significant difference in the age, gender distribution, baseline myopia progression or follow-up duration between patients who used night application compared with daytime atropine. Effectiveness was better with daytime application. Conclusion: 1% atropine eye drops were well tolerated and efficacious for the retardation of progressive myopia in Indian eyes. Effectiveness was better with daytime application. Further studies are necessary to assess the role of 1% atropine in the rapid progressors and patients poorly responding to low-dose atropine. Keywords: Myopia, Atropine, low dose.

scholarly journals The role of high-dose steroid therapy in Covid-19 pneumonia

2021 ◽  
Author(s):  
Ayperi Ozturk ◽  
Figen Ozturk Ergur ◽  
Suna Kavurgacı ◽  
Melahat Uzel Şener ◽  
Murat Yıldız
Keyword(s):  
Mortality Rate ◽  
Low Dose ◽  
High Dose ◽  
Efficacy And Safety ◽  
Short Term ◽  
High Dose Steroid ◽  
Younger Age ◽  
Observation Period

Introduction: Today, whereas hypoxemia and respiratory failure is the major challenging problem in the course of severe COVID-19 pneumonia, to control the disease at a mild-moderate stage or to stop the inflammation by recognizing the cytokine storm early should be the most prominent goal. We aimed to reveal the clinical efficacy and safety of short-term high-dose corticosteroids in severe COVID-19. Material and Methods: This retrospective observational study consisted of 54 patients who were given high-dose steroid (HDS (>250 mg/day methylprednisolone, 3 days.). Low-dose steroid (LDS) therapy (dexamethasone 8 mg ) was applied to all patients. HDS group was reviewed in terms of decreasing hospital mortality and preventing fibrosis development in follow-up. Results: During the observation period, out of 317 severe COVID-19 pneumonia hospitalized, HDS and LDS were administered to 54 and 216 patients, respectively. Higher body mass index, younger age, more oxygen need of patients at admission, and more need for advanced oxygen therapy during hospitalization were found in the HDS group (p<0.001). Furthermore, 18.5% of patients in the HDS group had need transfer to the intensive care unit whereas it was 3.8% in LDS (p<0.001). Additionally, the mortality rate was determined higher in the HDS group (25. 9% vs 9.9%, p<0.001). The HDS group had lower saturated O2 [IQR, 85% (76-89), p <0.001], and higher ferritin at admission. It was found that HDS was given simultaneously with the increased ferritin with deepening lymphopenia on the third and fifth days. There was no difference in fibrosis development between HDS patients receive and not (15.4% vs 26.2%, p=0.11) Conclusion: The use of HDS in hospitalized COVID-19 patients remains unclear. Along with this, our study demonstrated the use of high-dose corticosteroids might not be associated with a lower mortality rate among hospitalized severe COVID-19 patients.

1172: Improved Recovery of Erectile Function with Nightly Low dose Sildenafil - 18 Months Follow-Up After Nerve-Sparing Radical Prostatectomy

2007 ◽  
Vol 177 (4S) ◽  
pp. 386-387
Author(s):  
Andreas Bannowsky ◽  
Heiko Schulze ◽  
Christof van der Horst ◽  
Stefan Hautmann ◽  
Klaus P. Juenemann
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Low Dose ◽  
Nerve Sparing
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