scholarly journals Efficacy of Traditional Chinese Medicine Regimen Jian Pi Qu Shi Formula for Refractory Patients with Idiopathic Membranous Nephropathy: A Retrospective Case-Series Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Bin Shi ◽  
Rong-rong Zhang ◽  
Ying Liang ◽  
Xin-hui Wang ◽  
Rui Lang ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Adverse Events ◽  
Membranous Nephropathy ◽  
Partial Remission ◽  
Therapeutic Option ◽  
Case Series ◽  
Idiopathic Membranous Nephropathy ◽  
Case Series Study

Background. The treatment of adult refractory idiopathic membranous nephropathy with steroid and other immunosuppressant-resistant nephrotic syndromes can be a significant challenge. We evaluated the efficacy and safety of the traditional Chinese medicine Jian Pi Qu Shi Formula (JPQSF) as a promising regimen. Methods. We analyzed 15 consecutive patients with biopsy-proven idiopathic membranous nephropathy who failed immunosuppressive therapy from October 2013 to January 2017. JPQSF was administered orally two times per day, respectively, in the morning and at night for 6 months. All patients had at least 1 year of follow-up. The primary endpoints included complete or partial remission. Secondary endpoints included change of clinical parameters and adverse events after 12 months of treatment. Results. After 12 months, complete remission was achieved in 13.3% of patients and partial remission in 66.7%, yielding a response rate of 80%. Proteinuria, serum albumin, and cholesterol were improved significantly (P<0.001, P<0.001, and P<0.05, respectively). After 1 year of treatment, proteinuria (mean ± SD) decreased from 5.93 ± 2.54 g per 24 h to 1.99 ± 1.17 g per 24 h (P<0.001). No serious adverse events occurred during the observation. Conclusions. JPQSF may be an alternative therapeutic option for steroid and general immunosuppressant-resistant membranous nephrotic syndrome patients, with a favorable safety profile. Larger and longer follow-up studies evaluating this regimen are warranted.

scholarly journals Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients

2021 ◽  
Author(s):  
Ilkka Rauma ◽  
Tiina Mustonen ◽  
Juha Matti Seppä ◽  
Maritta Ukkonen ◽  
Marianne Männikkö ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Events ◽  
Case Series ◽  
Retrospective Case ◽  
Serious Adverse Events ◽  
Highly Active ◽  
Disease Modifying Therapy ◽  
Case Series Study ◽  
Multiple Sclerosis Patients

Abstract Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1–3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.

scholarly journals Chemical cauterization of peristomal granulomas with 50% trichloroacetic acid

2019 ◽  
Author(s):  
Rosaura Paczek ◽  
Luisa Passberg
Keyword(s):  
Trichloroacetic Acid ◽  
Therapeutic Option ◽  
Case Series ◽  
Clinical Results ◽  
Focal Lesions ◽  
Regular Treatment ◽  
Case Series Study ◽  
Chemical Cauterization ◽  
The Individual

Objetive: This study deals with the treatment of granulomas, one of the possible complications of the stomies, which are characterized as focal lesions, whose formation occurs due to the presence of aggressive agents to the tissues from the increase of the degree of cellularity and other tissue elements, generating annoyance and anxiety to patients. This study aims to describe the clinical results of the treatment of peristomal granulomas with the use of 50% trichloroacetic acid (TCA). Methods: This is a case series study, carried out by professionals in a referral center for the treatment of individuals with an ostomy in the city of Porto Alegre, state of Rio Grande do Sul. Results: The study sample consisted of 13 patients who underwent follow-up for treatment of peristomal granulomas with TCA. Data collection was performed during nursing consultations, based on the observation and photographic record of the granulomas, with subsequent evolution in the individual charts. Conclusion: It was concluded from this study that the regular treatment with TCA resulted in regression of the granulomas until their total disappearance, being this acid able to be considered, therefore, a potential therapeutic option; however, it is recommended to carry out further studies on its use in stomatherapy, seeking the use of more robust clinical research methodologies and with bias control.

scholarly journals Remissions in Patients with Idiopathic Membranous Nephropathy Treated with Rituximab in Senegal

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Moustapha Faye ◽  
Fabrice Arnold Tcheumagam Tiako ◽  
Ahmed Tall Lemrabott ◽  
Bacary Ba ◽  
Niakhaleen Keita ◽  
...  
Keyword(s):  
Side Effects ◽  
Membranous Nephropathy ◽  
Partial Remission ◽  
Analytical Study ◽  
Spontaneous Remission ◽  
Idiopathic Membranous Nephropathy ◽  
The Mean ◽  
Change In Mean

Objectives: This study aimed to evaluate the efficacy of Rituximab in the management of idiopathic membranous nephropathy (IMN) based on the following criteria: (I) Biological remission at three months (M3) and six months (M6); (II) change in mean proteinuria (24PU), mean serum albumin, and mean serum creatinine at M3 and M6; (III) and side effects. Methods: This retrospective descriptive and analytical study included patients with histologically confirmed IMN with positive plasma anti-PLA2R antibodies who received at least one dose of Rituximab after six months of follow-up without spontaneous remission. Patients with unexplainable records were not included. Results: A total of five patients (P1, P2, P3, P4, and P5), including four males and one female were analyzed. The mean age was 44.20 ± 23.14 years. All patients had IMN type 2. At inclusion, the mean albuminemia, mean creatinine, and mean 24hPU levels were 15.56 ± 5.27 g/L, 6.54 ± 1.13 g/24h, and 17.3 ± 7.60 mg/L, respectively. The median anti-PLA2R antibody titer was 100 IU with extremes of 10 and 800 IU. Partial remission was noted in three patients at M3 (P2, P4, and P5), and it was maintained until M6 in P2. No complete remission was observed. A significant decrease in mean 24hPU at M3 was noted (P < 0.001). Generalized pruritus associated with seizures was noticed in P4 after the first dose of Rituximab. Conclusions: Partial remission was noted in three patients at M3, and one patient maintained this remission at M6. Rituximab significantly reduced 24hPU at M3 after administration. Rituximab administration was well tolerated by the patients.

scholarly journals Research progress in the treatment of idiopathic membranous nephropathy using traditional Chinese medicine

2020 ◽  
Vol 8 (1) ◽  
pp. 3-8
Author(s):  
Rui Lang ◽  
Xinhui Wang ◽  
Ying Liang ◽  
Lei Yan ◽  
Bin Shi ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Membranous Nephropathy ◽  
Blood Circulation ◽  
Research Progress ◽  
Idiopathic Membranous Nephropathy ◽  
Clinical Aspects ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Nourishing Yin

AbstractThis article reviews the most significant literature of the recent years on the treatment of idiopathic membranous nephropathy (IMN) with traditional Chinese medicine (TCM). One major goal of the article is to classify and summarize the research on the clinical aspects and the associated mechanisms of the use of Chinese herbal compounds and single drugs to treat IMN. It was found that TCM treats IMN via two major approaches: by benefiting qi, activating blood circulation and eliminating dampness, or by benefiting qi and nourishing yin. The method of benefiting qi, to activate blood circulation and eliminate dampness for dredging channels, is the most popular. The commonly used drugs in this approach include Huang Qi (astragalus), Dang Shen (codonopsis root), Bai Zhu (white atractylodes rhizome), Fu Ling (poria cocos), Dang Gui (angelica sinensis), and so on. Several randomized, controlled, clinical trials are reviewed in the article, including a multicenter one.

scholarly journals Office Hysteroscopic Laser Enucleation of Submucous Myomas without Mass Extraction: A Case Series Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sergio Haimovich ◽  
Maite López-Yarto ◽  
Julio Urresta Ávila ◽  
Alejandro Saavedra Tascón ◽  
José L. Hernández ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Case Series ◽  
Uterine Cavity ◽  
Hysteroscopic Myomectomy ◽  
Submucous Myoma ◽  
Case Series Study ◽  
Laser Enucleation ◽  
A Prospective Study ◽  
Series Study

Background and Objectives. A new two-step hysteroscopic myomectomy carried out in the office setting and without anesthesia was feasible for the excision of submucous myomas. The objective of this study was to assess whether removal of submucous myomas from the uterine cavity after hysteroscopic laser enucleation is necessary.Methods. Between June 2009 and April 2013, all outpatients with symptomatic myomatosis (bleeding, pelvic pain, and infertility) assessed ultrasonographically were eligible to participate in a prospective study. All patients underwent office hysteroscopic enucleation of submucous myomas. Enucleated myomas were left in the uterine cavity. Neither anesthesia nor antibiotic prophylaxis was used.Results. Sixty-one women (mean age: 47.3 years) were included. Regardless of hysteroscopic localization and grading, all myomas were enucleated. The mean (standard deviation, SD) diameter of the myoma as measured by the ultrasound scan was 22.6 (8.5) mm. In 29 cases (47.5%), the diameter of the resected myoma was >20 mm and in 10 cases (16.4%) >30 mm. After a mean follow-up of 68.2 (16.5) days, none of the patients showed a residual myoma inside the uterine cavity.Conclusions. The present results indicate that leaving laser-enucleated submucous myoma in the uterine cavity is a feasible and safe therapeutic option.

scholarly journals Denosumab in patients with aneurysmal bone cysts: A case series with preliminary results

2018 ◽  
Vol 104 (5) ◽  
pp. 344-351 ◽  
Author(s):  
Emanuela Palmerini ◽  
Pietro Ruggieri ◽  
Andrea Angelini ◽  
Stefano Boriani ◽  
Domenico Campanacci ◽  
...  
Keyword(s):  
Adverse Events ◽  
Therapeutic Option ◽  
Bone Cyst ◽  
Case Series ◽  
Disease Assessment ◽  
Gadolinium Contrast ◽  
Aneurysmal Bone Cysts ◽  
Denosumab Treatment ◽  
Disease Free

Purpose: Aneurysmal bone cyst (ABC) is a rare skeletal tumor usually treated with surgery/embolization. We hypothesized that owing to similarities with giant cell tumor of bone (GCTB), denosumab was active also in ABC. Methods: In this observational study, a retrospective analysis of ABC patients treated with denosumab was performed. Patients underwent radiologic disease assessment every 3 months. Symptoms and adverse events were noted. Results: Nine patients were identified (6 male, 3 female), with a median age of 17 years (range 14–42 years). Primary sites were 6 spine–pelvis, 1 ulna, 1 tibia, and 1 humerus. Patients were followed for a median time of 23 months (range 3–55 months). Patients received a median of 8 denosumab administrations (range 3–61). All symptomatic patients had pain relief and 1 had paresthesia improvement. Signs of denosumab activity were observed after 3 to 6 months of administration: bone formation by computed tomography scan was demonstrated in all patients and magnetic resonance imaging gadolinium contrast media decrease was observed in 7/9 patients. Adverse events were negligible. At last follow-up, all patients were progression-free: 5 still on denosumab treatment, 2 off denosumab were disease-free 11 and 17 months after surgery, and the last 2 patients reported no progression 12 and 24 months after denosumab interruption and no surgery. Conclusions: Denosumab has substantial activity in ABCs, with favorable toxicity profile. We strongly support the use of surgery and/or embolization for the treatment of ABC, but denosumab could have a role as a therapeutic option in patients with uncontrollable, locally destructive, or recurrent disease.

A 10-year follow-up of idiopathic membranous nephropathy patients on steroids and cyclophosphamide: a case series

Renal Failure ◽  
2015 ◽  
Vol 37 (3) ◽  
pp. 452-455 ◽  
Author(s):  
Rapur Ram ◽  
Swarnalatha Guditi ◽  
Dakshinamurty Kaligotla Venkata
Keyword(s):  
Membranous Nephropathy ◽  
Case Series ◽  
Idiopathic Membranous Nephropathy

scholarly journals Functional Neurorehabilitation in Dogs with an Incomplete Recovery 3 Months following Intervertebral Disc Surgery: A Case Series

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2442
Author(s):  
Ângela Martins ◽  
Débora Gouveia ◽  
Ana Cardoso ◽  
Carla Carvalho ◽  
Cátia Silva ◽  
...  
Keyword(s):  
Pain Perception ◽  
Therapeutic Option ◽  
Case Series ◽  
Spinal Reflex ◽  
Type I ◽  
Locomotor Training ◽  
Pharmacological Management ◽  
Case Series Study ◽  
Flexion Extension

This case series study aimed to evaluate the safety, feasibility, and positive outcome of the neurorehabilitation multimodal protocol (NRMP) in 16 chronic post-surgical IVDD Hansen type I dogs, with OFS 0/DPP− (n = 9) and OFS 1/DPP+ (n = 7). All were enrolled in the NRMP for a maximum of 90 days and were clinically discharged after achieving ambulation. The NRMP was based on locomotor training, functional electrical stimulation, transcutaneous electrical spinal cord stimulation, and 4-aminopyridine (4-AP) pharmacological management. In the Deep Pain Perception (DPP)+ dogs, 100% recovered ambulation within a mean period of 47 days, reaching OFS ≥11, which suggests that a longer period of time is needed for recovery. At follow-up, all dogs presented a positive evolution with voluntary micturition. Of the DPP− dogs admitted, all achieved a flexion/extension locomotor pattern within 30 days, and after starting the 4-AP, two dogs were discharged at outcome day 45, with 78% obtaining Spinal Reflex Locomotion (SRL) and automatic micturition within a mean period of 62 days. At follow-up, all dogs maintained their neurological status. After the NRMP, ambulatory status was achieved in 88% (14/16) of dogs, without concurrent events. Thus, an NRMP may be an important therapeutic option to reduce the need for euthanasia in the clinical setting.

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