Adverse Effects of Systemic Immunosuppression in Keratolimbal Allograft

Purpose. Keratolimbal allograft (KLAL) is a treatment for limbal stem cell deficiency. One disadvantage is systemic immunosuppression to avoid rejection. Our purpose was to examine the adverse effects of systemic immunosuppression in KLAL.Methods. A retrospective case review of 16 patients with KLAL who received systemic immunosuppression consisting of a corticosteroid, an antimetabolite, and/or a calcineurin inhibitor was performed. Patients were monitored for signs, symptoms, or laboratory evidence of toxicity.Results. Twelve of 16 patients (75%) experienced an adverse effect. The average age of those with adverse effects was 50.0 years (SD 17.8) and those without was 23.6 years (SD: 14.3), which was statistically significant (unpairedt-testP=0.022). Ten of 11 patients (91%) had resolution during mean followup of 16.4 months. No serious adverse effects occurred. The most common included anemia, hyperglycemia, elevated creatinine, and elevated liver function tests. Prednisone and tacrolimus were responsible for the most adverse effects. More patients with comorbidities experienced adverse effects (83%) than those without comorbidities (25%).Conclusions. KLAL requires prolonged systemic immunosuppression. Our data demonstrated that systemic immunosuppression did not result in serious adverse effects in our population and is relatively safe with monitoring for toxicity. In addition, we demonstrated that adverse effects occurred more frequently in older patients and those with comorbidities.

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Close Clinical Observation Minimizes the Complications of Beta-Blocker Withdrawal

Annals of Pharmacotherapy ◽

10.1177/106002809402800704 ◽

1994 ◽

Vol 28 (7-8) ◽

pp. 849-851 ◽

Cited By ~ 1

Author(s):

George Eisele ◽

Linda L. Gilmore ◽

Edward B. Blanchard

Keyword(s):

Adverse Effects ◽

Beta Blocker ◽

Beta Blockers ◽

Biofeedback Training ◽

Case Review ◽

Careful Monitoring ◽

Retrospective Case ◽

Antihypertensive Medications ◽

Blocker Therapy ◽

Medication Withdrawal

OBJECTIVE: To determine whether beta-blocker withdrawal under close medical supervision poses undue risks. DESIGN: Retrospective case review. Data extracted from previous study. SUBJECTS: 114 hypertensive subjects tapered from beta-blocker therapy. Subjects were a subset of patients originally studied for blood pressure medication withdrawal and biofeedback training. MAIN OUTCOME MEASURES: Frequency of symptoms and adverse effects reported by subjects during medication taper to the study nurse. RESULTS: Symptoms were no more likely to occur with beta-blocker withdrawal than with withdrawal of other types of antihypertensive medications. Most adverse effects were classified as minor. Two subjects experienced major symptoms. One subject required reinstitution of beta-blockers for palpitations, and another exhibited angina upon beta-blocker withdrawal. CONCLUSIONS: In well-screened patients under careful monitoring, withdrawal from beta-blockers appears to present a small, manageable risk.

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Assessment of Linezolid Efficacy, Safety and Tolerability in the Treatment of Tuberculosis: A Retrospective Case Review

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2013/535616 ◽

2013 ◽

Vol 24 (3) ◽

pp. e50-e52 ◽

Cited By ~ 5

Author(s):

Alena Tse-Chang ◽

Dennis Kunimoto ◽

Evelina Der ◽

Rabia Ahmed

Keyword(s):

Adverse Effects ◽

Treatment Success ◽

Effective Drug ◽

Drug Resistant ◽

Case Review ◽

Retrospective Case ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis

Linezolid is a potentially effective drug for the treatment of patients with drug-resistant tuberculosis. Among 13 patients treated for tuberculosis with linezolid in the present study, nine had treatment success and four remain on treatment. Adverse effects occurred in 11 (85%) patients, of whom three discontinued treatment because of adverse effects. The present study adds to the growing evidence supporting the efficacy of linezolid for tuberculosis, although treatment remains complicated by adverse effects.

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Hemorrhagic cholecystitis: ultrasound and CT imaging findings—a retrospective case review series

Emergency Radiology ◽

10.1007/s10140-020-01879-x ◽

2021 ◽

Author(s):

Jessie Z. Ramírez Calderón ◽

Elena Martínez Chamorro ◽

Laín Ibáñez Sanz ◽

José C. Albillos Merino ◽

Susana Borruel Nacenta

Keyword(s):

Ct Imaging ◽

Imaging Findings ◽

Case Review ◽

Retrospective Case ◽

Hemorrhagic Cholecystitis

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Multi-Disciplinary Skull Base Conference and its Effects on Patient Management

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211021251 ◽

2021 ◽

pp. 000348942110212

Author(s):

Nathan Kemper ◽

Scott B. Shapiro ◽

Allie Mains ◽

Noga Lipschitz ◽

Joseph Breen ◽

...

Keyword(s):

Skull Base ◽

Medical Center ◽

Academic Medical Center ◽

Significant Proportion ◽

Internal Auditory Canal ◽

Patient Characteristics ◽

Management Plan ◽

Case Review ◽

Retrospective Case ◽

Lateral Skull Base

Objective: Examine the effects of a multi-disciplinary skull base conference (MDSBC) on the management of patients seen for skull base pathology in a neurotology clinic. Methods: Retrospective case review of patients who were seen in a neurotology clinic at a tertiary academic medical center for pathology of the lateral skull base and were discussed at an MDSBC between July 2019 and February 2020. Patient characteristics, nature of the skull base pathology, and pre- and post-MDSBC plan of care was categorized. Results: A total of 82 patients with pathology of the lateral skull base were discussed at a MDSBC during an 8-month study period. About 54 (65.9%) had a mass in the internal auditory canal and/or cerebellopontine angle while 28 (34.1%) had other pathology of the lateral skull base. Forty-nine (59.8%) were new patients and 33 (40.2%) were established. The management plan changed in 11 (13.4%, 7.4-22.6 95% CI) patients as a result of the skull base conference discussion. The planned management changed from some form of treatment to observation in 4 patients, and changed from observation to some form of treatment in 4 patients. For 3 patients who underwent surgery, the planned approach was altered. Conclusions: For a significant proportion of patients with pathology of the lateral skull base, the management plan changed as a result of discussion at an MDSBC. Although participants of a MDSBC would agree of its importance, it is unclear how an MDSBC affects patient outcomes.

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Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0037-1601884 ◽

2018 ◽

Vol 11 (1) ◽

pp. 028-034 ◽

Cited By ~ 1

Author(s):

Stephanie M. Young ◽

Yan Tong Koh ◽

Errol W. Chan ◽

Shantha Amrith

Keyword(s):

Risk Factors ◽

Clinical Features ◽

Pediatric Patients ◽

Rectus Muscle ◽

Orbital Floor ◽

Case Review ◽

Inferior Rectus ◽

Retrospective Case ◽

Orbital Blowout Fractures ◽

Inferior Rectus Muscle

The aim of this study was to evaluate the incidence, clinical features, and risk factors of sustaining inferior rectus (IR) palsy in a group of pediatric patients with orbital floor blowout fractures. We performed a retrospective case review of sequential cases of pediatric orbital floor blowout fractures (<18 years old) from 2000 to 2013 in a tertiary ophthalmic center in Singapore. A total of 48 patients were included in our study, of whom 5 had IR palsy (10.4%). Patients with IR palsy had a higher mean age (16.4 ± 1.5 years) compared with patients without IR palsy (12.4 ± 3.3 years), had significantly ( p < 0.05) worse preoperative motility, and had significantly greater proportion developing postoperative hypertropia (100%) compared with patients without IR palsy (4.7%). Our series of pediatric blowout fractures demonstrated IR palsy prevalence and clinical features for IR palsy which may be distinct to the pediatric group.

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