scholarly journals Rivastigmine as a Symptomatic Treatment for Apathy in Parkinson’s Dementia Complex: New Aspects for This Riddle

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Rita Moretti ◽  
Paola Caruso ◽  
Matteo Dal Ben
Keyword(s):  
Symptomatic Treatment ◽  
Neuropsychiatric Symptom ◽  
The Other ◽  
Nigrostriatal Pathway ◽  
One Year

Over 90% of PDD patients show at least one neuropsychiatric symptom (NPS); in the 60–70% two or more NPS are present. Their incidence is important in terms of prognosis and severity of pathology. However, among all NPS, apathy is often the most disturbing, associated with greater caregiver’s burden. Similar to other NPS, apathy may be due to a dysfunction of the nigrostriatal pathway, even though, not all the PD patients become apathetic, indicating that apathy should not entirely be considered a dopamine-dependent syndrome, and in fact it might also be related to acetylcholine defects. Apathy has been treated in many ways, without sure benefits; among these, Rivastigmine may present benefic properties. We present a series of 48 patients, suffering from PDD, treated with Rivastigmine, and followed-up for one year; they have been devotedly studied for apathy, even though all the other NPS disorders have been registered. Rivastigmine did not have a prolonged benefic effect on apathy, in our work, on the contrary of what had been observed in the literature, probably due to the longer follow-up of our patients.

scholarly journals SAT0540 ONE-YEAR OUTCOMES AFTER RHEUMATIC IMMUNE-RELATED ADVERSE EVENTS FROM CHECKPOINT INHIBITORS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1227.2-1227
Author(s):  
E. Berard ◽  
T. Barnetche ◽  
L. Rouxel ◽  
C. Dutriaux ◽  
L. Dousset ◽  
...  
Keyword(s):  
Adverse Events ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Progression Free Survival ◽  
Symptomatic Treatment ◽  
Musculoskeletal Symptoms ◽  
Day Range ◽  
One Year

Background:Description and initial management of rheumatic immune-related adverse-events (irAEs) from cancer immunotherapies have been reported by several groups but to date, few studies have evaluated the long-term outcomes and management of rheumatic irAEs (1).Objectives:To describe the long-term management and assess the one-year outcomes of patients who experienced rheumatic immune-related adverse events (irAEs) due to immune checkpoint inhibitors (ICI).Methods:This was a single-centre prospective observational study including patients referred for musculoskeletal symptoms while treated with ICI. After baseline rheumatological evaluation defining the clinical entity presented, follow-up visits were organised according to the type and severity of irAE. At one year, persistence of irAE, ongoing treatment, as well as cancer outcomes were assessed.Results:63 patients were included between September 2015 and June 2018. 24 patients (38%) presented with non-inflammatory musculoskeletal conditions managed with short-term symptomatic treatment and did not require specific follow-up. 39 patients (62%) experienced inflammatory manifestations, mimicking either rheumatoid arthritis (RA, n=19), polymyalgia rheumatica (PMR, n=16), psoriatic arthritis (PsA, n=3) and one flare of a preexisting axial spondyloarthritis. Overall, 32 patients (82%) received systemic glucocorticoids, with a median rheumatic dosage of 15mg/day (range: 5-60mg/day). None of the patients had to permanently discontinue ICI therapy for rheumatic irAE. 20 patients (67%) were still receiving glucocorticoids at one year, with a median dosage of 5mg/day (range: 2-20mg/day). Glucocorticoids were more frequently discontinued for patients with RA-like condition (44%) than PMR-like condition (23%), but no other predictive factor of glucocorticoids withdrawal could be identified. At one year, overall survival and progression-free survival were comparable between patients who were still receiving glucocorticoids for rheumatic irAE and patients who have discontinued. Eight patients required csDMARDs.Conclusion:At one year, a majority of patients required long-term low-dose glucocorticoids for chronic rheumatic irAE, which seems not altering oncological control.References:[1]Braaten TJ, Brahmer JR, Forde PM, et al. Immune checkpoint inhibitor-induced inflammatory arthritis persists after immunotherapy cessation. Ann Rheum Dis. 2019 Sep 20.Disclosure of Interests:None declared

scholarly journals A Conservative Approach to a Peripheral Ameloblastoma

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Rocco Borrello ◽  
Elia Bettio ◽  
Christian Bacci ◽  
Marialuisa Valente ◽  
Stefano Sivolella ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Soft Tissues ◽  
Complete Removal ◽  
The Other ◽  
Conservative Approach ◽  
Choice Of Treatment ◽  
Long Term Follow Up ◽  
One Year

Peripheral Ameloblastoma (PA) is the rarest variant of ameloblastoma. It differs from the other subtypes of ameloblastoma in its localization: it arises in the soft tissues of the oral cavity coating the tooth bearing bones. Generally, it manifests nonaggressive behavior and it can be treated with complete removal by local conservative excision. In this study we report a case of PA of the maxilla in a 78-year-old female patient and we describe the four different histopathological patterns revealed by histological examination. After local excision and diagnosis, we planned a long term follow-up: in one year no recurrence had been reported. The choice of treatment is illustrated in Discussion.

A European multicentric experience using the CardioSEAL® and Starflex double umbrella devices to close interatrial communications holes within the oval fossa

2000 ◽  
Vol 10 (5) ◽  
pp. 519-526 ◽  
Author(s):  
M. Carminati ◽  
S. Giusti ◽  
G. Hausdorf ◽  
S. Qureshi ◽  
M. Tynan ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Surgical Repair ◽  
Clinical Success ◽  
The Other ◽  
Thromboembolic Events ◽  
Clinical Complications ◽  
The Mean ◽  
One Year ◽  
Flap Valve

AbstractIn this review, we describe the experience from 13 European centres using the CardioSEAL and Starflex double umbrella devices to close interatrial communications within the oval fossa (so-called ‘stcundum’ defects). Between October 1996 and April 1999, the procedure was attempted in 334 patients with a mean age of 12 years and a mean weight of 44kg. The mean measured stretched diameter of the defect was 15 mm. In the overall group, the defect was solitary in 245 patients (73%), multiple in 21 (6%), associated with an aneurysm of the flap valve in 15 (5%), was represented by patency of the oval foramen in 44 (13%), and was a fenestration in a Fontan repair in 9 (3%). In all patients, the devices were inserted under general anesthesia, using fluoroscopic and transesophageal echocardiographic control. Implantation was achieved in 325 (97,3%). The device embolized within either a few minutes or a few hours in 13 patients (4%). Of these, uncomplicated surgical repair was undertaken in 10, while the device was retrieved in 3 using catheters and a second device was successfully implanted. Residual shunting was detected immediately after the procedure in 41% of the patients, with the incidence decreasing to 31% at discharge, 24% at 1 month, 21% at 6 months, and 20.5% at one year. During the period of follow-up, elective surgical repair became necessary in two patients, due to malposition of the device in one, and late embolization in the other. Fractures of arms were seen in 6.1%, most commonly with the largest devices. All those with fractured arms of the device were asymptomatic, and no clinical complications related to the fractures were observed. There were no arrythmias, endocarditis, valvar distortion, thromboembolic events, or other complications. After one year of follow-up, clinical success, defined as complete closure of the defect or presence of only a trivial leak, had been obtained in 92.5% of the patients. We conclude, therefore, that these devices produce excellent results when used to close defects of small to moderate size. Results are less than optimal, or else complications ensure, when attempts are made to close very large defects.

Fresh Symptom Emergence After Intensive Behaviour Therapy

1976 ◽  
Vol 129 (4) ◽  
pp. 378-383 ◽  
Author(s):  
R. Julian Hafner
Keyword(s):  
Symptomatic Treatment ◽  
Drop Out ◽  
Treatment Programme ◽  
Behaviour Therapy ◽  
Personal Adjustment ◽  
Drop Out Rate ◽  
Wide Range ◽  
One Year

SummaryThe outcome of a standard four-day intensive symptomatic treatment programme with 39 agoraphobics is examined in relation to the incidence of fresh symptom emergence. Twenty-six patients suffered fresh symptom emergence during follow-up, and there was a significant association of fresh symptom emergence with poorer outcome at one-year follow-up. About 18 per cent of patients were adversely affected by the treatment programme, as judged on a wide range of symptoms and measures of inter- and intra-personal adjustment. Sixteen individually treated patients are then compared with the 39 group-treated patients and differences in drop-out rate are discussed.

Prognosis of new-onset of atrial fibrillation in acute coronary syndrome: Portuguese experience

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
H Santos ◽  
M Santos ◽  
I Almeida ◽  
H Miranda ◽  
C Sa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Mortality Rates ◽  
The Other ◽  
Coronary Syndrome ◽  
Group A ◽  
One Year ◽  
Group B ◽  
New Onset

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background Acute coronary syndrome (ACS) and atrial fibrillation (AF) are common diseases in developed countries and in some cases, the first episode of AF can occur during the ACS. A stressful event like an ACS can be a trigger for AF, being important to realize its impact and prognosis in the short and long term. Objective Evaluate the impact and prognosis of new-onset AF in ACS. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided into two groups: A – patients without new-onset AF, and B – patients that presented new onset of AF. Were excluded patients without a previous cardiovascular history or clinical data during the admission and the follow-up period. Logistic regression was performed to assess if new-onset AF in ACS was a predictor of major adverse cardiac events and mortality. Kaplan-Meier test was performed to establish the survival rates and re-admission for one year of follow up. Results 9687 patients suffered ACS and had follow-up at 1 year, 9264 in group A (95.6%) and 423 in group B (4.4%). Both groups were similar regarding dyslipidemia, diabetes mellitus, previous coronary artery disease, multivessel disease after the cardiac catheterization. Group A had more smokers (28.2 vs 17.8%, p < 0.001) and left ventricular ejection fraction (LVEF) >50% (69.2 vs 45.1%, p < 0.001). On the other hand, group B was elderly (67 ± 14 vs 75 ± 12, p < 0.001), female (26.9 vs 34.0%, p < 0.001), arterial hypertension (70.5 vs 77.5%, p = 0.005), was more admitted directly to the cat lab (12.5 vs 17.7%, p = 0.002), ST-segment elevation myocardial infarction (40.2 vs 49.9%, p < 0.001), Killip-Kimball classification > I (12.8 vs 34.8%, p < 0.001) and hybrid revascularization (0.7 vs 2.4%, p = 0.002). Logistic regression revealed that new-onset of AF in ACS patients was a predictor of congestive heart failure (odds ratio (OR) 1.75, p < 0.001, confidence interval (CI) 1.47-2.09), cardiogenic shock (OR 3.08, p < 0.001, CI 2.37-4.01), sustained ventricular tachycardia (OR 2.29, p < 0.001, CI 1.61-3.25) and intrahospital mortality (OR 1.99, p < 0.001, CI 1.51-2.63). Nevertheless, new-onset of AF was not associated with re-infarction (p = 0.361), mechanical complications (p = 0.319), atrioventricular block (p = 0.574), stroke (p = 0.131) and cardiac arrest (p = 0.060) during the hospitalization for ACS. Mortality rates at one year of follow-up showed significant differences, p < 0.001, between the two groups (Figure 1). Similar results were found concerning re-admission for all causes, p = 0.021 (Figure 2), on the other causes, re-admission for cardiovascular causes do not reveal to be significant, p = 0.515. Conclusions New-onset of AF in ACS was a predictor of congestive heart failure, cardiogenic shock, sustained ventricular tachycardia and intrahospital mortality. AF was associated with higher mortality rates and re-admission for all causes at one year follow up.

Atypical Carcinoid Tumors of Lung: Clinicopathologic Study of Six Cases

2000 ◽  
Vol 8 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Girish Moghe ◽  
Nirmala A Jambhekar ◽  
Ramakant K Deshpande ◽  
Rahul Hejmadi ◽  
Jitendra Vyas
Keyword(s):  
Local Recurrence ◽  
Neuron Specific Enolase ◽  
Surgical Excision ◽  
The Other ◽  
Atypical Carcinoid ◽  
Typical Carcinoid ◽  
Clinicopathologic Study ◽  
One Year ◽  
And Behavior

This retrospective study of 6 cases of atypical carcinoid tumor was carried out to highlight their clinicopathological features and behavior. All patients were over 40 years of age and were treated by surgical excision of the tumor. Four tumors were central and 2 were peripherally located in the lung. Grossly, the tumors were large with spotted areas of necrosis. Microscopically, all tumors had a typical carcinoid pattern with spotted areas of necrosis and mitotic activity in the range of 2 to 5 per 10 high-power fields. On immunohistochemistry, the tumors were positive for neuron-specific enolase and cytokeratin. Follow-up ranging from 1 to 5 years was available in 4 patients; 2 are currently alive, 1 with local recurrence and distant metastasis one year postoperatively, the other with no disease after 5 years. Two patients died; one had a local recurrence at 2 years and the other had liver metastasis at 3 years.

scholarly journals The Impact of Coexistence of Smoking and Diabetes on the Coronary Artery Severity and Outcomes following Percutaneous Coronary Intervention: Results from the 1ST Jordanian PCI Registry

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mohamad I. Jarrah ◽  
Said Al-Khatib ◽  
Yousef Khader ◽  
Hanin N. AlKharabsheh ◽  
Ayman Hammoudeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Middle Eastern ◽  
Coronary Intervention ◽  
The Other ◽  
Percutaneous Coronary ◽  
One Year ◽  
The Impact ◽  
Nonsmoker Group

Introduction. Diabetes mellitus (DM) and smoking are highly prevalent among Middle Eastern patients admitted with acute coronary syndrome (ACS) or who undergo percutaneous coronary intervention (PCI). Methods. This study used the analysis of the data from the first Jordanian PCI registry (JoPCR1) to determine the impact of coexistence of smoking and diabetes mellitus on the coronary artery severity and outcome following percutaneous coronary intervention in Middle Eastern patients. Results. Of 2426 patients enrolled, 1300 (53.6%) and 1055 (43.5%) were diabetics and smokers, respectively. The patients’ age was 59.0±10.1 and ranged between 24 and 95 years. Males comprised 79.4% of all patients. The patients were divided into four groups: nondiabetic-nonsmokers (22.2%), diabetic-nonsmokers (34.3%), nondiabetic-smokers (24.2%), and diabetic-smokers (19.2%). Compared with the other three groups, patients in the diabetic-nonsmoker group were older, more likely to be females, and having a higher prevalence of hypertension, dyslipidemia, chronic renal disease, and history of CVD and revascularization. Consequently, the diabetic-nonsmoker patients (but not the diabetic-smokers) had a higher prevalence of multivessel CAD and PCI than the other three groups, highlighting the importance of other risk factors (age, gender, metabolic syndrome, and comorbidities) and not only smoking in predisposing for CAD. Furthermore, those patients had a higher incidence of ACS as an indication for PCI than the stable coronary disease (73% vs 27%) and the highest CRUSADE bleeding risk score (63.9%) among other groups. The in-hospital events including in-stent thrombosis and emergency CABG events did not significantly differ among groups (p=0.5 and 0.22). Heart failure and major bleeding events occurred significantly higher among diabetic-nonsmokers compared to other groups. In-hospital deaths occurred significantly more among diabetic-nonsmokers. Moreover, the one-month and one-year follow-up outcome events (the mortality rate, in-stent thrombosis, readmission for ACS, coronary revascularization, and major bleedings) occurred more frequently in the diabetic-nonsmoker group. However, the difference was statistically significant only for major bleeding incidences. Conclusions. In this analysis of a completed prospective Middle Eastern PCI registry, the majority of the diabetic-nonsmoker (and not the diabetic-smokers) patients (73%) presented with ACS. This group was the highest at risk for in-hospital PCI complications as well as the worst in outcomes after one year of follow-up. Those patients were more likely to be older, female, and have the worst cardiovascular baseline features, highlighting the importance of other risk factors (age, gender, metabolic syndrome, and comorbidities) and not only smoking in predisposing for CAD. Thus, more sufficient education about controlling CVD risk factors should be implemented in the Middle Eastern region.

scholarly journals A large-scale experiment on New Year’s resolutions: Approach-oriented goals are more successful than avoidance-oriented goals

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0234097
Author(s):  
Martin Oscarsson ◽  
Per Carlbring ◽  
Gerhard Andersson ◽  
Alexander Rozental
Keyword(s):  
Weight Loss ◽  
Goal Setting ◽  
Large Scale ◽  
Eating Habits ◽  
Current Knowledge ◽  
The Other ◽  
Success Rates ◽  
Scale Experiment ◽  
One Year

Despite the popularity of New Year’s resolutions, current knowledge about them is limited. We investigated what resolutions people make when they are free to formulate them, whether different resolutions reach differing success rates, and whether it is possible to increase the likelihood of a resolution’s success by administering information and exercises on effective goal setting. Participants (N = 1066) from the general public were randomized into three groups: active control, some support, and extended support. The most popular resolutions regarded physical health, weight loss, and eating habits. At a one-year follow-up, 55% of responders considered themselves successful in sustaining their resolutions. Participants with approach-oriented goals were significantly more successful than those with avoidance-oriented goals (58.9% vs. 47.1%). The group that received some support was exclusively and significantly more successful compared to the other two. This study reveals that New Year’s resolutions can have lasting effects, even at a one-year follow-up.

scholarly journals Functional Comparison of Immediate and Late Weight Bearing after Ankle Bimalleolar Fracture Surgery

2015 ◽  
Vol 9 (1) ◽  
pp. 188-190 ◽  
Author(s):  
İsmail Ağır ◽  
Nejat Tunçer ◽  
Fatih Küçükdurmaz ◽  
Seyitali Gümüstaş ◽  
Esra Demirel Akgül ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Scoring System ◽  
Weight Bearing ◽  
Functional Results ◽  
The Other ◽  
Group 2 ◽  
One Year ◽  
Fracture Surgery ◽  
Group 1

Aim : The aim of the study is to compare immediate weight bearing with below-knee cast or immobilization with plaster splint in 6 weeks in patients after operative treatment for ankle bimalleolar fractures. Methods : Fifty-three patients with ankle bimalleolar fractures were treated operatively in 2005 to 2010 and then were randomly allocated to two groups. Immediately weight bearing in a below-knee cast (26 patients) and immobilization in a plaster splint for the first six postoperative weeks (27 patients). A mean age 37.9 (min 17; max 72). An average follow-up 26.1 months. (min 14; max 55). All fractures were classified with Lauge-Hansen classification. Functional results of both groups were evaluated with AOFAS for the postoperative one year after surgical treatment. Results : According to the AOFAS scoring system, results were excellent and good in 17 patients in group 1. On the other hand, results were excellent and good in 14 patients in group 2. Conclusion : As a result we think that weight bearing protocol should be advantaged for patients with ankle bimalleolar fractures after surgical treatment immediately.

Impact of Minor Histocompatibility Antigens (mHAg) Mismatches On Gvhd Incidence in Non-Myeloablative or Reduced Intensity Allogeneic Stem Cell Transplantation.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4494-4494
Author(s):  
Cristiana Carniti ◽  
Francesco Spina ◽  
Antonio Vendramin ◽  
Simona Di Terlizzi ◽  
Anna Raganato ◽  
...  
Keyword(s):  
Stem Cell ◽  
Immune Responses ◽  
Stem Cell Transplantation ◽  
The Other ◽  
Histocompatibility Antigens ◽  
Minor Histocompatibility Antigens ◽  
Gvhd Prophylaxis ◽  
One Year ◽  
Reduced Intensity

Abstract Abstract 4494 1.Background Mismatches of minor Histocompatibility antigens (mHAg) have been considered as an important immunogenetic factor influencing outcomes and immune responses following allogeneic stem-cell transplantation (alloSCT) despite fully matched HLA of donor and recipient. 2. Aim Aim of this study was to assess whether mHAg incompatibilities may affect overall survival (OS), progression free survival (PFS) and GVHD incidence (acute and chronic, aGVHD and cGVHD) in patients receiving alloSCT for lymphoid malignancies. 3. Methods Sixty-four consecutive patients with B-cell lymphomas who underwent alloSCT were studied. Ten patients had chronic lymphocytic leukemia (CLL, 15.8%), 3 had follicular lymphoma (FCL, 4.7%), 1 had diffuse large B cell lymphoma (DLBCL, 1,5%), 17 had Hodgkin's lymphoma (26.5%) and 33 had multiple myeloma (51.5%). All underwent peripheral blood stem-cells allograft with non-myeloablative (13 patients, 20%) or reduced intensity (51 pts, 80%) Fludarabine-based conditioning; GVHD prophylaxis included methotrexate and oral cyclosporine +/- micomofetil fenolate in case of matched unrelated donors. Median age was 51 years (range 18-66); 35 patients were male (55%), median number of previous chemotherapies was 3 (0-7), 49 patients had a previous autologous transplant (76%). Twenty-five patients were in complete remission (CR, 39%), 30 and 9 were in partial response and progression (PR 47% and PD 14%). Karnofsky performance status (PS) was >80% in 50 patients (78%). Forty-four patients allografted from HLA-matched siblings (69%), 20 from matched unrelated donor (31%): all were matched at allelic level for HLA-A, -B, -Cw, -DRB1 and -DQB1 loci. Allelic mHAs typing was performed by PCR with sequence-specific primers for 14 autosomic mHAg and H-Y. Host versus Graft or Graft versus Host direction of immune responses in donor/recipient pairs was analyzed with use of the minor Histocompatibility Database of Leiden University Medical Center. OS and PFS were analyzed with Kaplan-Meier method and log-rank test. aGVHD and cGVHD were analyzed with a multivariate logistic regression including as covariates age, sex, previous lines of chemotherapy, disease, pre-transplant status, PS and mHAs mismatches; grade >=2 aGVHD and extensive cGVHD were considered events. 4. Results Median follow-up was 34 months (2-83). One-year OS was 85%, 2- and 3-years OS were 82% and 77%. One-year PFS was 61%, 2- and 3-years PFS were 49% and 41%. The univariate analysis which considered transplant characteristics showed that OS and PFS were significantly affected by disease status at transplant (p<0.001 for both OS and PFS) and PS (<=80 vs >80, p<0.001 for both OS and PFS). Donor-vs-recipient (DR) mHAs mismatches did not significantly impact OS and PFS. The multivariate analysis which considered aGVHD as the outcome of interest, showed that the presence of at least one DR mHAg mismatch, and the presence of DR hematopoietic-restricted mHA mismatches significantly increased aGVHD incidence (p=0.02 for both). On the other hand, broad DR mHA and H-Y disparities did not affect aGVHD. DR disparities at the LB-ADIR, HA-1, HA-2 and HA-8 mHAgs did not increase the incidence of aGVHD. Recipient-vs-donor (RD) mHAg mismatches did not significantly affect aGVHD as none of the other factors considered in the multivariate associated with increased risk of cGVHD of any grade. 5. Conclusions This study showed that in the non-myeloablative and RIC setting, mHAg mismatches may have a significant role in determining aGVHD. Assessing mHAg mismatches may be a useful tool to choose patient-specific GVHD prophylaxis in conditioning regimens and in post transplant follow-up. Larger prospective data are needed in order to confirm these results. Disclosures: No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document