scholarly journals Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid-responsive meningitis-arteritis

2020 ◽  
Vol 187 (1) ◽  
pp. e7-e7
Author(s):  
Christian Günther ◽  
Frank Steffen ◽  
Daniela S Alder ◽  
Laura Beatrice ◽  
Caroline Geigy ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cytosine Arabinoside ◽  
Clinical Remission ◽  
Clinical Signs ◽  
Specific Treatment ◽  
Blood Chemistry ◽  
Immunosuppressive Drugs ◽  
Laboratory Findings ◽  
Treatment Protocols ◽  
Ethical Approval

BackgroundRelapses in steroid-responsive meningitis-arteritis (SRMA) are frequently observed but specific treatment protocols to address this problem are sparsely reported. Standard treatment includes prolonged administration of glucocorticoids as monotherapy or in combination with immunosuppressive drugs. The aim of this study was to assess the safety and efficacy of cytosine arabinoside (CA) in combination with glucocorticoids for treatment of SRMA relapses in 12 dogs on a retrospective basis.MethodsDogs with recurrent episodes of SRMA and treated with a combination of CA and prednisolone were included. Information about clinical course, treatment response and adverse events was collected from medical records. Ethical approval was not required for this study.ResultsTen dogs (10/12) responded well to the treatment with clinical signs being completely controlled. One dog is in clinical remission, but still under treatment. One dog (8%) showed further relapse. Mean treatment period was 51 weeks. Adverse events of variable severity (grade 1–4/5) were documented in all dogs during treatment according to the veterinary cooperative oncology group grading. Three dogs developed severe adverse events. Laboratory findings showed marked changes up to grade 4. Diarrhoea and anaemia were the most often observed adverse events (6), followed by dermatitis (4), alopecia (3) and pneumonia (3). Including blood chemistry changes (13), 50 adverse events were found in total.ConclusionTreatment with CA and glucocorticoids resulted in clinical remission in 10/12 dogs, but a high incidence of adverse events occurred requiring additional measures. All adverse events could be managed successfully in all cases.

scholarly journals Clinical and Laboratory Findings in Dogs Undergoing Adjuvant Chemotherapy with Gemcitabine/Carboplatin Combination for Mammary Neoplasia

2021 ◽  
Vol 11 (2) ◽  
pp. 289-299
Author(s):  
Carolina Bistritschan Israel ◽  
Tábata Maués ◽  
Ana Maria Reis Ferreira ◽  
Maria de Lourdes Gonçalves Ferreira
Keyword(s):  
Clinical Trial ◽  
Adjuvant Chemotherapy ◽  
Adverse Events ◽  
Mammary Cancer ◽  
Clinical Signs ◽  
Metastatic Potential ◽  
Prospective Clinical Trial ◽  
Laboratory Findings ◽  
Chemotherapy Protocol ◽  
Mammary Neoplasia

Adjuvant chemotherapy might be indicated in some canine mammary cancer cases due to metastatic potential. In this regard, studies to determine adverse events following chemotherapy protocols are valuable. The purpose of this prospective clinical trial was to evaluate the safety and tolerability of gemcitabine and carboplatin combination in dogs with malignant mammary tumors. For this prospective clinical trial, 21 female dogs mastectomized due to malignant mammary neoplasia underwent adjuvant chemotherapy with gemcitabine (3 mg/kg, 60-minute IV infusion) and carboplatin (10 mg/kg, 20-minute IV infusion) based protocol every 21 days for three cycles. They were monitored periodically for treatment-related adverse events by clinical and laboratory evaluations. A total of 17 (80.9%) dogs developed leukopenia, 10 (47.6%) neutropenia, and 15 (71.4%) thrombocytopenia at least once along with the three chemotherapy cycles. All these hematologic toxicities were grade 1, 2, or 3. Two (9.5%) animals had evidence of gastrointestinal toxicity; however, clinical signs were mild to moderate (grades 1 and 2). No dog had life-threatening adverse events (grade 4) or even died (grade 5) of treatment-related complications. The adjuvant chemotherapy protocol with gemcitabine and carboplatin was well-tolerated and safe in female dogs for mammary cancer treatment with self-limiting hematological and gastrointestinal adverse events.

scholarly journals SARS-CoV-2/DENV co-infection: a series of cases from the Federal District, Midwestern Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Luise Schulte ◽  
José Diego Brito-Sousa ◽  
Marcus Vinicius Guimarães Lacerda ◽  
Luciana Ansaneli Naves ◽  
Eliana Teles de Gois ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Federal District ◽  
Therapeutic Interventions ◽  
Diagnostic Process ◽  
The Novel ◽  
Prevention Measures ◽  
Laboratory Findings ◽  
Novel Coronavirus ◽  
The Impact

Abstract Background Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections. Methods Thirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up. Results Of the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days. Conclusions The cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.

P089 REAL-WORLD EXPERIENCE: CLINICAL AND ENDOSCOPIC EFFECTIVENESS OF STANDARD VEDOLIZUMAB DOSING AND MODIFIED MAINTENANCE DOSING IN PATIENTS WITH MODERATE-SEVERE CROHN’S DISEASE

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S75-S75
Author(s):  
Scott D Lee ◽  
Anand Singla ◽  
Caitlin Kerwin ◽  
Kindra Clark-Snustad
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adverse Events ◽  
Real World ◽  
Clinical Remission ◽  
Mucosal Healing ◽  
Clinical Disease ◽  
Endoscopic Remission ◽  
Starting Dose

Abstract Background Vedolizumab (VDZ) is an effective treatment for Crohn’s disease (CD); however, inadequate and loss of response is common. Pivotal VDZ trials evaluated alternative dosing intervals, demonstrating numeric but not statistical superiority in efficacy as compared to FDA-approved dosing. The safety and effectiveness of FDA-approved and modified-dosing schedules in a real-world population are unknown. We aimed to evaluate clinical and endoscopic effectiveness & safety of standard and modified maintenance VDZ dosing in a real world cohort. Methods We retrospectively reviewed CD patients (pts) treated with >3 months VDZ, assessing Harvey Bradshaw Index (HBI), Simple Endoscopic Score for Crohn’s disease (SESCD), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), C-reactive protein (CRP), albumin and hematocrit prior to and following standard VDZ dosing, and prior to and following modified VDZ maintenance dosing. We measured duration on therapy and adverse events. Results We identified 226 eligible pts, mean age 41.5 years, 55.3% female, median disease duration 10 years, 88.9% with prior biologic exposure. Mean duration on VDZ was 28.3 months. Standard VDZ dosing: 61.5% of pts with active clinical disease and adequate follow up data achieved clinical response after 3–12 months; 41.0% had clinical remission. 51.9% of pts with active endoscopic disease and adequate follow up data achieved mucosal improvement; 42.3% had endoscopic remission; 26.0% had mucosal healing after 3–24 months. 50.0% of pts with elevated CRP and adequate follow up data normalized CRP after 3–12 months. Modified maintenance dosing: 72 non-remitters to standard VDZ dosing received modified VDZ maintenance dosing. 51.5% of pts with active clinical disease prior to starting dose modification and adequate follow up data achieved clinical response after 3–12 months of modified maintenance dosing; 42.4% had clinical remission. 22.2% of pts with SESCD ≥3 prior to starting dose modification achieved mucosal improvement after 3–24 months; 22.2% had mucosal healing. 26.7% of pts with SESCD ≥4 prior to starting modified dosing had endoscopic remission after 3–24 months. 50.0% of pts with elevated CRP and adequate follow up data normalized their CRP after 3–12 months. Safety: 82.7% of pts reported ≥1 adverse events, most commonly infection and worsening CD symptoms. Discussion Standard VDZ dosing resulted in clinical and endoscopic improvement in pts with moderate-severe CD, with prior exposure to multiple advanced therapies. For non-remitters to standard dosing, modified VDZ maintenance dosing improved clinical disease activity in ∼50% of pts and improved endoscopic disease activity in ∼20% of pts, suggesting that for pts who did not achieve remission with standard VDZ dosing, modified VDZ dosing may result in clinical and endoscopic improvement.

Comparison of the Safety of Standard and Triple Dose Gadodiamide Injection in MR Imaging of the Central Nervous System

1994 ◽  
Vol 35 (4) ◽  
pp. 396-399 ◽  
Author(s):  
M. G. Svaland ◽  
T. Christensen ◽  
E. Lundorf
Keyword(s):  
Mr Imaging ◽  
Adverse Events ◽  
Contrast Enhancement ◽  
Dose Group ◽  
Serum Bilirubin ◽  
Diagnostic Yield ◽  
Blood Chemistry ◽  
New Information ◽  
Safety Parameters ◽  
The Central Nervous System

Gadodiamide injection was administered intravenously to 49 patients with known or suspected CNS lesions undergoing MR imaging. Two parallel groups were used to evaluate the efficacy and safety of single doses of 0.1 (25 patients) and 0.3 (24 patients) mmol/kg b.w. The principal measures of efficacy were diagnostic yield of MR and the overall contrast enhancement. Adverse events and serum bilirubin were the main safety parameters. Contrast enhancement of the lesion was observed for 16 patients in each dose group. Thirteen patients in the 0.1 and 17 in the 0.3 mmol/kg group had their diagnosis amended following the postcontrast image, but only one patient in each dose group had their management affected by new information from the postcontrast image. The overall diagnostic utility of gadodiamide injection was good, but there were no differences between the 2 doses studied in this respect. No injection-associated discomfort or other adverse events were reported. No clinically important changes in serum bilirubin, or other parameters of blood chemistry, or hematology were observed. Overall, the safety profile of gadodiamide injection 0.3 mmol/kg b.w. in this study was similar to that of 0.1 mmol/kg b.w.

The Role of CO-RADS Scoring System in the Diagnosis of COVID-19 Infection and its Correlation with Clinical Signs

2021 ◽  
Vol 17 ◽  
Author(s):  
Şenol Çomoğlu ◽  
Sinan Öztürk ◽  
Ahmet Topçu ◽  
Fatma Kulalı ◽  
Aydın Kant ◽  
...  
Keyword(s):  
Scoring System ◽  
Clinical Signs ◽  
Assessment System ◽  
Symptom Duration ◽  
Shortness Of Breath ◽  
Laboratory Findings ◽  
Ct Findings ◽  
Chronic Pulmonary Diseases ◽  
Ct Evaluation ◽  
The Difference

Background: Computed tomography (CT) evaluation systematics has become necessary to eliminate the difference of opinion among radiologists in evaluating COVID-19 CT findings. Introduction: The objectives of this study were to evaluate the efficiency of CO-RADS scoring system in our patients with COVID-19 as well as to examine its correlation with clinical and laboratory findings. Method: The CO-RADS category of all patients included in the study was determined by a radiologist who did not know the rtRT-PCR test result of the patients, according to the Covid-19 reporting and data system of Mathias Prokop et al. Results: A total of 1338 patients were included. CT findings were positive in 66.3%, with a mean CO-RADS score of 3,4 ± 1,7. 444 (33.1%) of the patients were in the CO-RADS 1-2, 894 (66.9%) were in the CO-RADS 3-5 group. There were positive correlations between CO-RADS score and age, CMI, hypertension, diabetes mellitus, chronic pulmonary diseases presence of symptoms, symptom duration, presence of cough, shortness of breath, malaise, CRP, and LDH, while CO-RADS score was negatively correlated with lymphocyte count. The results of the ROC analysis suggested that those with age ≥40 years, symptom duration >2 days, CMI score >1 and/or comorbid conditions were more likely to have a CO-RADS score of 3-5. Conclusion: The CO-RADS classification system is a CT findings assessment system that can be used to diagnose COVID-19 in patients with symptoms of cough, shortness of breath, myalgia and fatigue for more than two days.

Safety of a novel galacto-oligosaccharide: Genotoxicity and repeated oral dose studies

2009 ◽  
Vol 28 (10) ◽  
pp. 619-630 ◽  
Author(s):  
T. Kobayashi ◽  
N. Yasutake ◽  
K. Uchida ◽  
W. Ohyama ◽  
K. Kaneko ◽  
...  
Keyword(s):  
Oral Dose ◽  
Kluyveromyces Lactis ◽  
Clinical Signs ◽  
Chinese Hamster ◽  
Metabolic Activation ◽  
Blood Chemistry ◽  
Control Group ◽  
Sprague Dawley ◽  
Adverse Effect Level ◽  
Effect Level

A series of safety tests were undertaken on a novel galacto-oligosaccharide (GOS) produced from lactose by a two-step enzymatic process involving Sporobolomyces singularis and Kluyveromyces lactis. Bacterial reverse mutation and chromosomal aberration tests, with or without metabolic activation, were performed. These tests showed no mutagenesis in the Ames assay or in Escherichia coli WP2uvrA, and no chromosomal aberrations in cultured fibroblast cells from Chinese hamster lungs (CHL/IU). Micronuclei were not induced in the reticulocytes of mouse peripheral blood following oral administration of GOS. In a 90-day repeated oral dose toxicity study in rats, GOS was administered at 0, 500, 1000 and 2000 mg/kg to male and female Sprague-Dawley rats. There were no GOS-related changes in clinical signs, body weight, water intake, feed intake, urinalysis, ophthalmology, haematology, blood chemistry, organ weights, gross pathology or histopathology in any of the treatment groups compared to the control group. The no observed adverse effect level (NOAEL) of GOS was at least 2000 mg/kg/day in both males and females.

An Audit of Treatment of Genital Warts: Opening the Feedback Loop

1993 ◽  
Vol 4 (4) ◽  
pp. 226-231 ◽  
Author(s):  
M Reynolds ◽  
M Murphy ◽  
M A Waugh ◽  
C J N Lacey
Keyword(s):  
Specific Treatment ◽  
Genital Warts ◽  
Therapeutic Modality ◽  
First Episode ◽  
Anogenital Warts ◽  
Treatment Protocols ◽  
Female Patients ◽  
General Infirmary ◽  
Male Patients ◽  
Time Of Presentation

An audit of the treatment of patients (100 men and 90 women) presenting with a first episode of anogenital warts to the Genitourinary Medicine Department at Leeds General Infirmary was performed. Treatment of patients was monitored for a period of 6 months from the time of presentation. The management of patients with genital warts lacked a clearly defined strategy and treatment was unselective and poorly monitored. Excluding patients who defaulted, at follow-up 44 (44%) men and 36 (38%) women still had genital warts at 3 months. Of those patients clear of warts at 3 months, the mean time to remission for men and women was 7.1 and 8.3 weeks respectively. Podophyllin 25% in tincture of benzoin was by far the predominant therapeutic modality used. A total of 96 (96%) men and 76 (84%) women received treatment with podophyllin. Both male and female patients had a mean of 5 treatments with podophyllin 25% (range 1–19 and 1–12 respectively). Physical methods of treatment i.e. cryotherapy and electrocautery, were underutilized, both as primary therapies and when topical agents had failed. Patients saw an average of 3 (range 1–7) doctors over the course of their treatment. Patients with warts affecting 2 or more sites, male patients with anal/perianal warts, and female patients with cervical and vaginal warts had higher failure rates from treatment at 3 months. On the basis of these findings, specific treatment protocols for the management of anogenital warts have been devised.

scholarly journals Case report: a 5-year-old with new onset nephrotic syndrome in the setting of COVID-19 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelsi M. Morgan ◽  
Peace D. Imani
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Pediatric Patient ◽  
Corticosteroid Therapy ◽  
Clinical Remission ◽  
Laboratory Findings ◽  
Case Presentation ◽  
The Third ◽  
First Case ◽  
New Onset

Abstract Background This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. Case presentation This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. Conclusions Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.

scholarly journals Brucellosis, Unravelling an Enigma: Eight Years of Experience from a Tertiary Care Hospital in Central Kerala, India

2020 ◽  
Author(s):  
M Ardra ◽  
Chithra Valsan ◽  
KA Sathiavathy
Keyword(s):  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Unknown Origin ◽  
Personal Contact ◽  
Human Brucellosis ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Middle East Countries

Introduction: Various emerging and re-emerging infectious diseases have made the existence of mankind in this world a great challenge. In the midst of these havocs, some important diseases has undermined in the dark. Brucellosis is an endemic zoonotic disease in most of the developing world and it has far-reaching and deleterious effects on humans and animals alike. In humans, brucellosis shows a variety of non-specific clinical signs. To recognise and diagnose this neglected but debilitating disease, the awareness and alertness of medical personnel has to be enhanced. Aim: To determine the prevalence of brucellosis in Tertiary Care Hospital. Materials and Methods: A retrospective study was conducted from June 2011 to May 2019, all culture proven cases of human brucellosis admitted in a Tertiary Care Hospital in central Kerala, India were reviewed. Demographic data, clinical presentations, laboratory parameters, treatment and outcomes of the same were analysed in Microsoft excel sheets as percentages. Results: Of the 12 culture proven Brucella cases, 11 presented as Pyrexia of Unknown Origin (PUO) cases and one was a soft tissue infection. Eleven patients had history of either consumption of unpasteurised milk products or had contact with animals before the symptoms developed. A 75% cases were imported cases from middle-east countries. In one case the route of entry was by close personal contact probably sexual transmission. All the patients complained of fever and malaise (100%), while low backache and arthralgia was noted in 83%. Most common clinical and laboratory findings associated with brucellosis were hepatosplenomegaly (41.7%) and anaemia (66.6%). Oral doxycycline for six weeks combined with either aminoglycoside or rifampicin was used for treatment. There was no death or relapses noted. Conclusion: This study emphasises the close collaboration of an alert clinician and an experienced microbiologist to correctly diagnose and treat an infection with multiple presentations as brucellosis, in endemic areas also.

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