scholarly journals The Therapeutic Effects of Goreisan, a Traditional Japanese Herbal Medicine, on Lower-Limb Lymphedema after Lymphadenectomy in Gynecologic Malignancies: A Case Series Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Nobuhisa Yoshikawa ◽  
Hiroaki Kajiyama ◽  
Naoki Otsuka ◽  
Satoshi Tamauchi ◽  
Yoshiki Ikeda ◽  
...  
Keyword(s):  
Lower Limb ◽  
Gynecologic Cancer ◽  
Case Series ◽  
Patient Characteristics ◽  
Pelvic Lymphadenectomy ◽  
Whole Body ◽  
Therapeutic Effects ◽  
Retroperitoneal Lymphadenectomy ◽  
Number Of Patients ◽  
Case Series Study

Background. Lower-limb lymphedema (LLL) is a chronic and progressive complication of gynecologic cancer treatment, including pelvic lymphadenectomy. This study aims to investigate the therapeutic effect of goreisan, a traditional Japanese medicine, which has been used for hydrostatic modulation on patients with LLL. Methods. Patients diagnosed with LLL in our hospital in 2018 were included and principally treated with complex decongestive therapy (CDT), including elastic clothing and lymph drainage. The patients who received a combination therapy of CDT and goreisan (CDT-G group) were prescribed goreisan extract granules, with a dose of 7.5 g per os daily in three doses. Patients who were not prescribed goreisan received CDT alone (CDT group). The severity of lymphedema was evaluated by the estimated limb volume calculated by limb circumferences and the ratio of extracellular water (ECW) to total body water (TBW). Results. Nineteen women with LLL after pelvic lymphadenectomy were included in the study. The number of patients in the CDT and CDT-G groups was 8 and 11, respectively. There were no statistically significant differences between the CDT and CDT-G groups in terms of patient characteristics and severity of LLL before treatment. Reduction in ECW/TBW in the CDT-G group (in the whole body and the affected lower limb) after the intervention was significantly more remarkable than that in the CDT group. Conclusions. Goreisan-based Japanese herbal therapy may be effective in patients with LLL after retroperitoneal lymphadenectomy.

scholarly journals An Evaluation of Thrombotic Tendency by Whole-Body Enhanced CT Scan for Critical COVID-19 Pneumonia: A Case Series Study

2021 ◽  
Author(s):  
Fumihiro Ogawa ◽  
Yasufumi Oi ◽  
Kento Nakajima ◽  
Reo Matsumura ◽  
Tomoki Nakagawa ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Ct Scan ◽  
Clinical Symptoms ◽  
Degradation Products ◽  
Thrombus Formation ◽  
Case Series ◽  
Whole Body ◽  
Pathological Feature ◽  
Case Series Study ◽  
Enhanced Ct

Abstract Background: Coronavirus disease (COVID-19) pneumonitis associated with severe respiratory failure has a high mortality rate. Based on recent reports, the most severely ill patients present with coagulopathy, and disseminated intravascular coagulation (DIC)-like massive intravascular clot formation is frequently observed. Coagulopathy has emerged as a significant contributor to thrombotic complications. Although recommendations have been made for anticoagulant use for COVID-19, no guidelines have been specified.Case presentation: We describe four cases of critical COVID-19 with thrombosis detected by enhanced CT scan. The CT findings of all cases demonstrated typical findings of COVID-19 and pulmonary embolism or deep venous thrombus without critical exacerbation. Two patients died of respiratory failure due to COVID-19.Discussion: Previous reports have suggested coagulopathy with thrombotic signs as the main pathological feature of COVID-19, but no previous reports have focused on coagulopathy evaluated by whole-body enhanced CT scan. Changes in hemostatic biomarkers, represented by an increase in D-dimer and fibrin/fibrinogen degradation products, indicated that the essence of coagulopathy was massive fibrin formation. Although there were no clinical symptoms related to their prognosis, critical COVID-19-induced systemic thrombus formation was observed. Conclusions: Therapeutic dose anticoagulants should be considered for critical COVID-19 because of induced coagulopathy, and aggressive follow-up by whole body enhanced CT scan for systemic venous thromboembolism (VTE) is necessary.

scholarly journals Frequency of Mortality in Patients with Post-Partum Eclampsia-A Study at Liaquat University Hospital, Hyderabad, Sindh, India

2019 ◽  
Vol 7 (03) ◽  
Author(s):  
Almas Almas ◽  
Naushaba Rizwan ◽  
Syed Farhan Uddin
Keyword(s):  
Post Partum ◽  
Case Series ◽  
University Hospital ◽  
Study Patient ◽  
Inclusion Criteria ◽  
Risks And Benefits ◽  
Number Of Patients ◽  
Case Series Study ◽  
Patient Will ◽  
Series Study

Postpartum preeclampsia is the occurrence of hypertension and proteinuria after delivery. Preeclampsia plus seizures after delivery is defined as postpartum eclampsia. Objective: To determine the frequency of mortality in patients with post-partum eclampsia; To determine the obstetrical factors leading to maternal mortality in patient with postpartum eclampsia. Methodology: The descriptive case series study was carried out in the department of Department of obstetrics and gynecology LUMHS Hospital Hyderabad from 1st January 2018 to 30 June 2018. All patients who fulfilled the inclusion criteria were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. All patients of postpartum eclampsia with increase blood pressure and proteinuria admitted through out-patient department or emergency within 48 hours of delivery will be included in the study. Patient will be followed for 10 days. All the collected data were entered into the proforma attached at the end. Results: Mean ± SD of age was 27.88±7.77 with C.I (27.02…….28.74) years. Mean ± SD of systolic B.P and urine protein was 161.46±22.09 mmhg and 1432.59±967.33 mg respectively. Out of 369 was occurred mortality in 190 (60%) women. Conclusion: It is to be concluded that mortality is most in eclampctic women followed by patients with Pre-eclampsia. However a study design comprising multiple centers, and a higher number of patients over a longer period of time will be more representative.

scholarly journals Initial Experience of Clinical Use of [99mTc]Tc-PSMA-T4 in Patients with Prostate Cancer. A Pilot Study

2021 ◽  
Vol 14 (11) ◽  
pp. 1107
Author(s):  
Jarosław B. Ćwikła ◽  
Marek Roslan ◽  
Iwona Skoneczna ◽  
Monika Kempińska-Wróbel ◽  
Michał Maurin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Biochemical Recurrence ◽  
Palliative Therapy ◽  
Case Series ◽  
Initial Therapy ◽  
Whole Body ◽  
Clinical Value ◽  
Case Series Study ◽  
Sensitivity Specificity

Background: Numerous different molecules of prostate-specific membrane antigen (PSMA) ligands are used to detect prostate cancer (PCa); most approaches utilize gallium PET and a few reports describe the role of SPECT/CT. [99mTc]Tc-PSMA-T4 is a new radiopharmaceutical designed for the diagnosis of patients with PCa. Methods: We conducted a single site, prospective, preliminary case series study that included 31 patients with PCa; all had undergone clinical, biochemical or imaging examination and exhibited clear or suspicious active disease or clinical/biochemical recurrence of PCa. Whole-body (WB) SPECT/CT after i.v. administration of [99mTc]Tc-PSMA-T4 was utilized; acquisition images were obtained at three time points. Results: The clinical value of the images was assessed in regard to the evaluation of tumor extent in patients with confirmed PC that qualified for initial therapy and the evaluation of tumor recurrence; both provided encouraging results. The late acquisition of WB-SPECT resulted in better lesions delineation. The results of the analysis of the sensitivity/specificity were: 92%/100% in cases of primary cancer, 83%/100% in terms of pelvic lymph nodes disease, 100%/95% in other lymph nodes and soft tissue involvement, respectively, and bone mets were both 100%. Conclusion: An oncotropic SPECT [99mTc]Tc-PSMA-T4 can help in selecting a rational therapeutic strategy for a patient with an initial diagnosis of PCa by assessing the extent of cancer and also after complex radical or palliative therapy in case of biochemical recurrence for re-staging.

scholarly journals Therapeutic Effects of Saireito (Chai-Ling-Tang), a Traditional Japanese Herbal Medicine, on Lymphedema Caused by Radiotherapy: A Case Series Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Aiko Nagai ◽  
Yuta Shibamoto ◽  
Keiko Ogawa
Keyword(s):  
Herbal Medicine ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Case Series ◽  
Tumor Control ◽  
Therapeutic Effects ◽  
Case Series Study ◽  
Custom Made ◽  
Japanese Herbal Medicine ◽  
Series Study

Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT) is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale before and after SRT treatment. After the treatment with SRT, 2 of 4 patients (50%) showed apparent improvement in lymphedema. One of the cases had difficulty in wearing the custom-made thermoplastic cast, but after SRT administration, he could wear the mask easily. One case decided to stop taking SRT 3 days after initiation because cough and fever appeared. In conclusion, it is important to control the side effects of radiotherapy, which leads to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

scholarly journals Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions

2020 ◽  
Author(s):  
Giada Crescioli ◽  
Valentina Brilli ◽  
Cecilia Lanzi ◽  
Andrea Burgalassi ◽  
Alessandra Ieri ◽  
...  
Keyword(s):  
Adverse Drug Reactions ◽  
Case Series ◽  
University Hospital ◽  
Drug Reactions ◽  
Case Evaluation ◽  
Hospitalised Patients ◽  
Number Of Patients ◽  
Case Series Study ◽  
Caucasian Patients ◽  
Series Study

AbstractDue to the need of early and emergency effective treatments for COVID-19, less attention may have been paid to their safety during the global emergency. In addition, characteristics of drug–drug interaction (DDI)-related adverse drug reactions (ADRs) in COVID-19 patients have not yet been studied in depth. The aim of the present case-series study is to describe clinical and pharmacological characteristics of SARS-CoV-2 hospitalised patients, focusing on ADRs, particularly those related to DDIs. We evaluated all reports of COVID-19 medication-related ADRs collected within the COVID-19 Units of Careggi University Hospital, Florence (Italy), between January 1st and 31st May 2020. Information regarding COVID-19 medications, patients’ demographic and clinical characteristics, concomitant drugs, ADRs description and outcome, were collected. Each case was evaluated for the causality assessment and to identify the presence of DDIs. During the study period, 23 Caucasian patients (56.5% males, mean age 76.1 years) experienced one or more ADRs. The majority of them were exposed to polypharmacy and 17.4% presented comorbidities. ADRs were referred to cardiovascular, psychiatric and gastrointestinal disorders. The most frequently reported preferred term was QT prolongation (mean QT interval 496.1 ms). ADRs improved or resolved completely in 60.8% of cases. For all patients, a case-by-case evaluation revealed the presence of one or more DDIs, especially those related to pharmacokinetic interactions. Despite the small number of patients, our evidence underline the clinical burden of DDIs in SARS-CoV-2 hospitalised patients and the risk of unexpected and uncommon psychiatric ADRs.

scholarly journals An evaluation of venous thromboembolism by whole-body enhanced CT scan for critical COVID-19 pneumonia with markedly rises of coagulopathy related factors: a case series study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fumihiro Ogawa ◽  
Yasufumi Oi ◽  
Kento Nakajima ◽  
Reo Matsumura ◽  
Tomoki Nakagawa ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Respiratory Failure ◽  
Ct Scan ◽  
Clinical Symptoms ◽  
Thrombus Formation ◽  
Case Series ◽  
Whole Body ◽  
Pathological Feature ◽  
Case Series Study ◽  
Enhanced Ct

Abstract Background Coronavirus disease (COVID-19) pneumonitis associated with severe respiratory failure has a high mortality rate. Based on recent reports, the most severely ill patients present with coagulopathy, and disseminated intravascular coagulation (DIC)-like massive intravascular clot formation is frequently observed. Coagulopathy has emerged as a significant contributor to thrombotic complications. Although recommendations have been made for anticoagulant use for COVID-19, no guidelines have been specified. Case summary We describe four cases of critical COVID-19 with thrombosis detected by enhanced CT scan. The CT findings of all cases demonstrated typical findings of COVID-19 and pulmonary embolism or deep venous thrombus without critical exacerbation. Two patients died of respiratory failure due to COVID-19. Discussion Previous reports have suggested coagulopathy with thrombotic signs as the main pathological feature of COVID-19, but no previous reports have focused on coagulopathy evaluated by whole-body enhanced CT scan. Changes in hemostatic biomarkers, represented by an increase in D-dimer and fibrin/fibrinogen degradation products, indicated that the essence of coagulopathy was massive fibrin formation. Although there were no clinical symptoms related to their prognosis, critical COVID-19-induced systemic thrombus formation was observed. Conclusions Therapeutic dose anticoagulants should be considered for critical COVID-19 because of induced coagulopathy, and aggressive follow-up by whole body enhanced CT scan for systemic venous thromboembolism (VTE) is necessary.

scholarly journals 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S809-S810
Author(s):  
Maria E Tello-Cajiao ◽  
Juan Camilo C Mosquera Hernandez ◽  
Santiago Ardila-Giraldo ◽  
Nelson Romero-Rosas ◽  
Luis Parra-Lara ◽  
...  
Keyword(s):  
Case Series ◽  
Drug Effects ◽  
Maintenance Phase ◽  
Patient Characteristics ◽  
Second Phase ◽  
Monitoring Strategy ◽  
Adverse Drug Effects ◽  
Travel Costs ◽  
Time Investment ◽  
Case Series Study

Abstract Background In Directly Observed Treatment (DOT) monitoring strategy for the treatment of tuberculosis (TB), the patient has to travel daily to the health institution to take the TB medication. Although has been usefulness, this strategy increases the catastrophic costs of the disease, rising the probability of rejection, abandonment, and failure to treatment. Therefore, a monitoring strategy was implemented through video calls phone known as Synchronous Video Observed Therapy (S-VOT), to document the experience and its results in a series of patients from a low-middle income country. Methods A prospective case series study was conducted involving 23 TB patients managed with standard treatment, who were supervised through daily video call phone, during 2019, Cali-Colombia. Adherence to VOT strategy and treatment were evaluated, as well as patient characteristics, adverse drug effects, perception and costs. Categorical variable data were summarized in absolute and relative frequency tables. Quantitative variables were described with median and Interquartile range. Proportional differences were calculated with Z test, risk opportunities and difference of medians with Mann Whitney’s U test were performed. We take p values < 0.05 as significant. Results Adherence to S-VOT monitoring strategy was 99.8% in first phase of treatment and 98.2% in second phase. All patients completed treatment, achieving 100% cure criteria in patients with pulmonary TB. Most adverse drug effects were reported on first month (31.6%, p=0.003). Skin changes were the most frequent complaint at the beginning of management (16.4%) and epigastralgia at the end (20%). The likelyhood of adverse effects was significantly reduced when patients started maintenance phase on third month (OR: 0.29, p = 0.0003). The experience of the strategy was generally positive for patients. Time savings was major advantage. Travel costs in S-VOT were lower than DOT for patients, as well as the daily time investment in TB treatment. Conclusion S-VOT strategy was well tolerated and accepted by all patients, allowing an excellent level of adherence, with reduction in travel costs and investment of time for treatment. S-VOT is proposed as a viable alternative to DOT in selected patients. Disclosures All Authors: No reported disclosures

scholarly journals The dynamics of the functional state of the cardio-respiratory system of patients hospitalized with pneumonia, exacerbation of COPD, and bronchial asthma

2020 ◽  
Vol 6 (1) ◽  
pp. 49
Author(s):  
K.A. Tymruk-Skoropad ◽  
I.O. Pavlova ◽  
N.Y. Sydoryk ◽  
Y. Kulitka ◽  
V. Romaniuk
Keyword(s):  
Physical Therapy ◽  
Acute Exacerbation ◽  
Functional State ◽  
Respiratory System ◽  
Case Series ◽  
Copd Patients ◽  
Number Of Patients ◽  
Case Series Study ◽  
Hospitalization Period ◽  
Exacerbation Of Copd

<p><strong>The purpose</strong> of the study is to analyze changes of the cardiopulmonary system indicators of hospitalized patients with respiratory diseases and underwent physical therapy.</p><p><strong>Materials and methods. </strong>The study was performed as a prospective case series study design. The study involved patients hospitalized with pneumonia, exacerbation of COPD and asthma, who had no contraindications to undergoing physical therapy. A total number of patients were 273 persons; 140 of them with pneumonia, 96 persons with exacerbation of COPD, 37 persons with asthma. Conducted surveys, anthropometric studies, clinical tests and instrumental studies.</p><p><strong>Results. </strong>COPD patients with acute exacerbation had a lower level of functional status of the cardio-respiratory system than patients with pneumonia or exacerbation of asthma. We found the lowest rates of excursion of the chest, blood saturation, VC, FEV1, PEF and higher than normal inhale rate. In addition, COPD patients did not experience statistically significant improvement during the assessment period in the majority of the analyzed parameters, except excursion of the chest and inhale rate.</p><p><strong>Conclusions.</strong> Acute exacerbation of COPD has a significant impact on the health of patients and significantly reduces the functional state of the respiratory system. The hospitalization period is not sufficient for full recovery. The rehabilitation of such patients should continue after discharge from the hospital.</p>

scholarly journals How to determine the amount of levator resection in congenital ptosis repair

2021 ◽  
Vol 25 (1) ◽  
pp. 415-422
Author(s):  
Muhamed Hamadamin ◽  
Jalal Fattah
Keyword(s):  
Case Series ◽  
Private Hospitals ◽  
Congenital Ptosis ◽  
Fascial Sling ◽  
Number Of Patients ◽  
Case Series Study ◽  
Levator Resection ◽  
Prospective Case Series ◽  
Series Study ◽  
Levator Aponeurosis

Background and objective: Levator aponeurosis resection is an effective technique to correct blepharoptosis when the levator function is fair to good. This study aimed to determine the amount of levator resection in congenital blepharoptosis repair. Methods: This is a prospective case series study conducted in Rizgary teaching hospital and private hospitals in Erbil city, Kurdistan Region, Iraq, from June 2011 to August 2019. The data of 53 patients (64 eyelids) affected by congenital blepharoptosis with poor to good levator function that underwent unilateral orbilateral levator resection blepharoptosis repair through the standard approach were included. The final outcome measures included postoperative eyelid height, contour, and symmetry. Results: This study includes a total of 53 patients with congenital blepharoptosis (64 eyelids); 20 males and 33 females. The age of the patients ranged from 3 years to 54 years, with a mean age ± SD of 14.11 ± 10.66 years. The ptosis was right sided in 22 patients (41.5%), left sided in 20 patients (37.7%), and bilateral in 11 patients (20.8%). The study showed good patient satisfaction in 66.03% of the cases, suboptimal satisfaction in 22.64% of the cases, and poor satisfaction in 11.32% of the cases. Conclusion: The levator resection for congenital ptosis is effective even with poor levator function and replaced in our practice the traditional fascial sling. We recommend that further studies be done on a larger number of patients to investigate the effectiveness of levator resection in patients with severe ptosis and very poor levator function. Keywords: Congenital blepharoptosis; Levator aponeurosis; Levator resection; Levator resection.

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