scholarly journals The Analysis of Dynamic Changes and Prognosis of Posner–Schlossman Syndrome with Cytomegalovirus Infection and Antiviral Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Qilian Sheng ◽  
Ruyi Zhai ◽  
Xintong Fan ◽  
Xiangmei Kong
Keyword(s):  
Treatment Time ◽  
Multidimensional Analysis ◽  
Eye Drops ◽  
Dynamic Changes ◽  
Positive Group ◽  
Keratic Precipitate ◽  
Pressure Lowering ◽  
Corneal Endothelial Cell Density ◽  
Medical Histories ◽  
Cup To Disc Ratio

Purpose. To analyze how keratic precipitate (KP) morphology changes during Posner–Schlossman syndrome (PSS) prognosis and raise medication suggestions on 2% ganciclovir eye drops. Materials and Methods. Clinical retrospective cohort study in the Eye & ENT Hospital of Fudan University, Shanghai, China. The attacked eyes of 98 eligible subjects diagnosed unilateral PSS were enrolled between 2016 and 2019. All patients were treated with intraocular pressure-lowering drugs and anti-inflammatory steroids. 2% ganciclovir eye drops were given to cytomegalovirus (CMV) immunoglobulin G (IgG) correction ratio positive patients. Frequent follow-ups and examinations were performed. KP morphology was focused and categorized into coin-shaped, mutton-fat, and pigmented. Medical histories were noted. Multidimensional analysis was given. Results. Totally 47 patients in 98 achieved all-KP disappearance. Mean treatment time was (5.13 ± 3.66) weeks. Total KP disappearance was negatively correlated with mutton-fat and pigmented KPs at the first visit ( P = 0.020 , P = 0.007 ) and treatment time was also longer ( P = 0.018 , P = 0.014 ). Mean cumulative steroids dosage for 47 subjects was (159.66 ± 161.84) drops. CMV IgG correction ratio positive patients had smaller corneal endothelial cell density ( P < 0.005 ) and larger cup-to-disc ratio ( P = 0.017 ) than negative subjects. Cumulative steroid treatment time was longer in the CMV-positive group, and overall dosage was also larger. However, due to 2% ganciclovir eye drops, daily steroid dosage was lower in the CMV-positive group. Conclusions. The disappearance of mutton-fat and pigmented KPs needed longer treatment time. Paired aqueous humor and serum CMV IgG tests were recommended in PSS patients with coin-shaped KPs. 2% ganciclovir eye drops improved prognosis; and steroids dosage reduced significantly.

Prognostic value of deep sequencing method for minimal residual disease (MRD) detection in multiple myeloma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8511-8511 ◽  
Author(s):  
Joaquin Martinez-Lopez ◽  
Ramon Garcia-Sanz ◽  
Francois Pepin ◽  
Rosa Ayala ◽  
Maria Angeles Montalban ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Value ◽  
Treatment Time ◽  
Group Versus ◽  
Response Criteria ◽  
Negative Group ◽  
Positive Group ◽  
Time Points ◽  
Diagnostic Samples

8511 Background: Most multiple myeloma (MM) patients will relapse due to persistence of residual tumor cells, or MRD. We compared the prognostic value of traditional response criteria and MRD measurement by a sequencing-based method, LymphoSIGHT, and multiparameter flow cytometry (MFC) in a cohort of 68 uniformly-treated MM patients from the Spanish Myeloma Group trials. Methods: Bone marrow samples were obtained from 68 patients at diagnostic and post-treatment time points on GEM clinical trials (GEM00 and GEM05). All patients were in CR or VGPR at the post-treatment time point. Using sequencing, we identified clonal rearrangements of immunoglobulin (IGH-VDJ, IGH-DJ, and IGK) genes in diagnostic samples. We assessed MRD in follow-up samples, analyzed concordance between sequencing and MFC MRD results, and compared the prognostic value of each method with traditional response criteria. Results: The sequencing assay detected a myeloma-specific gene rearrangement in diagnostic samples from 59 of 68 (87%) patients. We tested MRD in follow-up time points in 56 of the 59 patients. We observed high correlation between MFC and sequencing MRD results (r2=0.86), with MFC underestimating the myeloma burden (Slope=0.4). Of the 56 patients, 45 were positive by sequencing at MRD levels of 10-5 or higher and 11 were MRD negative. There was significantly improved overall survival (OS) in the MRD negative group versus the MRD positive group (median not reached vs. 86 mos, p=0.026). Similar differences were found in progression free survival. When limiting the analysis to the 35 patients in conventional CR, 24 of 35 patients were positive by sequencing at MRD levels at 10-5 and higher and 10 were MRD negative. There was significantly improved OS in the MRD negative group versus the MRD positive group (median not reached vs. 80.92 mos, p=0.041). Conclusions: Our data shows high correlation between MFC and sequencing MRD levels in MM patients. For patients in CR by traditional response criteria, the presence or absence of MRD by sequencing delineated 2 groups of patients with significantly different OS. MRD negativity by sequencing may be a better prognostic indicator than CR by traditional response criteria.

scholarly journals The Effect of Intraocular Pressure-lowering Eye Drops on Myopic RetinoschisisPatients

2020 ◽  
Vol 61 (4) ◽  
pp. 341-346
Author(s):  
Jung Hwa Lee ◽  
Kyu Hwan Jang ◽  
Suchan Lee ◽  
Mingui Kong ◽  
Joon Hong Sohn
Keyword(s):  
Intraocular Pressure ◽  
Eye Drops ◽  
Pressure Lowering

Who is a bone-predominant patient to maximize clinical benefits of radium-223 dichloride?

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 47-47
Author(s):  
Kohei Hashimoto ◽  
Yasuhide Miyoshi ◽  
Tetsuya Shindo ◽  
Naotaka Nishiyama ◽  
Shintaro Miyamoto ◽  
...  
Keyword(s):  
De Novo ◽  
Treatment Time ◽  
Subsequent Treatment ◽  
Optimal Decision ◽  
Castration Resistant Prostate Cancer ◽  
Visceral Metastasis ◽  
Dynamic Changes ◽  
Diagnostic Uncertainty ◽  
Radium 223 ◽  
Clinical Benefits

47 Background: Radium-223 dichloride (Ra-223) is used for patients with castration-resistant prostate cancer (CRPC) and bone metastasis (BM). However, some patients often have disease progression of non-BM during Ra-223 and may enable to receive no more other life-prolonging therapies. Thus, diagnostic uncertainty in bone-predominant CRPC yet needs to be determined. To maximize clinical benefits of Ra-223, we clarified how to identify patients with bone-predominant metastatic CRPC. Methods: This was a multi-center retrospective study. The 136 CRPC patients who received Ra-223 between 2012 and 2019 were reviewed. Patients without visceral metastasis and lymph node metastasis of more than 3 cm received Ra-223, 55kBq/kg, every 4 weeks for up to 6 cycles, and were required to continue androgen deprivation therapy alone. All patients were divided into 3 groups by the types of dynamic changes of BM compared to BM at diagnosis: i) only known lesions; ii) new progressive lesions; iii) de novo BM at CRPC. Time from initiation of Ra-223 to failure of subsequent treatment (time to FST), radiographic progression-free survival (rPFS) and overall survival (OS) were evaluated. Results: The median age was 76 years. Of all, 68% received all 6 planned cycles of Ra-223. Overall, PSA responses were observed in 26 (19%). During follow-up of 12 months, the median time of FST, rPFS and OS were 8.3, 10.6 and 16.4 months, respectively. The type of dynamic changes of BM (HR 3.65, p=0.004) and PSA doubling time (PSADT) just before Ra-223 (HR 4.35, p=0.006) were significantly associated with time to FST. The dynamic changes of BM combined with PSADT highlighted an optimal decision of Ra-223. Patients with only known lesions of BM had longer time to FST, better rPFS and OS regardless of PSADT. The same was true for patients with de novo or new progressive lesions of BM and a long PSADT. In contrast, patients with new progressive lesions of BM and PSADT< 3 months were presumably more likely to have the risk of FST and progression of visceral metastasis. Conclusions: Our findings suggest that the risk assessment with the type of dynamic changes of BM and PSADT could determine an ideal patient for Ra-223.

Intraocular light scatter in patients on topical intraocular pressure–lowering medication

2018 ◽  
Vol 28 (6) ◽  
pp. 652-661
Author(s):  
Francisco Pérez-Bartolomé ◽  
Jose María Martínez de la Casa ◽  
Pedro Arriola-Villalobos ◽  
Cristina Fernández-Pérez ◽  
Julián García-Feijoó
Keyword(s):  
Intraocular Pressure ◽  
Light Scattering ◽  
Treatment Duration ◽  
Control Group ◽  
Eye Drops ◽  
Light Scatter ◽  
Non Invasive ◽  
Pressure Lowering ◽  
Breakup Time ◽  
Objective Scatter Index

Purpose: To quantify ocular light scattering in patients under treatment with intraocular pressure–lowering eye-drops. Methods: In this prospective, observational, cross-sectional case series study, 160 eyes of 160 patients with primary open angle glaucoma or primary ocular hypertension were consecutively recruited from our Glaucoma Department over 7 months. In total, 46 eyes of 46 healthy volunteers matched for age and sex served as the control group. The variables recorded in a single visit were as follows: drug and number of drops per day, treatment duration, OXFORD corneal staining grade, lower tear meniscus height as measured by spectral domain optical coherence tomography, ocular redness and non-invasive tear breakup time measured with the Oculus Keratograph 5M, ocular surface disease index questionnaire score and objective scatter index through a double-pass technique (Optical Analysis System II). Results: Objective scatter index was higher in the patient group (3.1, interquartile range = 1.8–5.47) than in the control group (1.95; interquartile range = 0.7–5; p = 0.017). In a multiple linear regression model, non-invasive tear breakup time was identified as the most influential variable on light scatter (mean ratio = −1.015; p = 0.003; 95% confidence interval = −1.025 to −1.005). No correlation with objective scatter index was observed for number of daily eye-drops, preservative concentration or treatment duration. Conclusion: Participants on anti-glaucoma medication showed a significantly higher objective scatter index than control group individuals. In the treated patient group, a lower non-invasive tear breakup time was associated with a higher objective scatter index. This suggests that lubricating eye-drops to improve tear breakup time could also improve vision quality in these patients by diminishing light scattering.

Prognostic Value Of Deep Sequencing Approach For Minimal Residual Disease (MRD) Detection In Multiple Myeloma Patients

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1848-1848
Author(s):  
Joaquin Martinez-Lopez ◽  
Juan José Laheurta ◽  
Francois Pepin ◽  
Marcos González ◽  
Santiago Barrio ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Value ◽  
Treatment Time ◽  
Negative Group ◽  
Employment Equity ◽  
Positive Group ◽  
Time Points ◽  
Diagnostic Samples ◽  
Equity Ownership

Abstract Background and Aim Most multiple myeloma (MM) patients will experience relapse due to the persistence of residual tumor cells, or MRD. We compared the prognostic value of traditional response criteria with MRD measured by three different methods: a sequencing-based method, termed the LymphoSIGHT™ platform, multiparameter flow cytometry (MFC) and ASO-PCR of Ig genes in a cohort of 133 uniformly-treated MM patients from the Spanish Myeloma Group trials. Methods Bone marrow samples were obtained from 133 patients at diagnostic and post-treatment time points on GEM clinical trials (GEM00 and GEM05). All 133 patients were either in CR or VGPR at the post-treatment time point. Using the sequencing assay, we identified clonal rearrangements of immunoglobulin (IGH-VDJ, IGH-DJ, and IGK) genes in diagnostic samples. We then assessed MRD in follow-up samples, analyzing concordance between: sequencing, MFC and ASO-PCR of Ig genes MRD results, and comparing the prognostic value of each method with traditional response criteria. Results The sequencing assay detected the presence of a myeloma-specific gene rearrangement in diagnostic samples from 121 of 133 (91%) patients. We tested MRD in follow-up time points in 109 of the 121 patients. Of the 109 patients, 79 were positive by sequencing at MRD levels of 10-5 or higher and 30 were MRD negative. The Time to Tumor Progression (TTP) and Overall Survival (OS) were significantly longer in the MRD negative group compared with the MRD positive group by sequencing (TTP, median 80 vs. 31 months, p<0.0001; and OS, median not reached vs. 80 months p=0.02) (Figures 1A and 1B). All patients in VGPR, with the exception of 4 cases, were MRD positive by sequencing (92%). Three of the 4 cases with MRD negative and positive immunofixation became immunofixation negative after maintenance treatment. When restricting the analysis to the 61 patients that were in conventional CR (negative immunofixation), 35 of 60 patients were positive by sequencing at MRD levels at 10-5 and higher and 26 were MRD negative. There was a significantly improved TTP in the MRD negative group compared with the MRD positive group (median 131 vs. 35 months, p=0.001) (Figure 1C). A high correlation between MFC and sequencing MRD results was observed (r2=0.87); as well as between ASO-PCR of Ig genes and sequencing (r2=0.89). Discordant results between FCM and sequencing (SEQ) included: 14 cases who were positive by SEQ and negative by FCM, and 5 cases negative by SEQ but positive by FCM; while the remaining cases were concordant: 63 cases were positive by both methods and 16 were negative by both methods. Correlation between ASO-PCR and SEQ was possible in 45 patients: 10 were discordant (9PCR-SEQ+ and 1 PCR+SEQ-) while 35 were concordant (20 PCR+SEQ+, 15 PCR-SEQ-). Conclusions The sequencing applicability for MRD studies in MM is 91%, which is essentially equivalent with that of MFC (96% Rawstron AC et al, JCO 2013). There is a high correlation between MRD levels by sequencing, ASO-PCR and MFC. Based on these results, MRD assessment by sequencing is a useful method for patient risk stratification and can be used to determine molecular CR in MM. Disclosures: Pepin: Sequenta, Inc.: Employment, Equity Ownership. Weng:Sequenta, Inc.: Employment, Equity Ownership. Faham:Sequenta, Inc.: Employment, Equity Ownership, Membership on an entity’s Board of Directors or advisory committees.

scholarly journals The Use of Generic Medications for Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Andrew J. Tatham
Keyword(s):  
Low Cost ◽  
Cost Savings ◽  
Eye Drops ◽  
Generic Medicines ◽  
Regulatory Requirement ◽  
Advantages And Disadvantages ◽  
Crossover Studies ◽  
Generic Medications ◽  
Pressure Lowering ◽  
Inactive Ingredients

The use of generic medicines has grown considerably in recent years providing considerable cost savings. In England, generic items represented 11.7% of prescriptions for glaucoma and ocular hypertension in 2009, increasing to 55.2% of prescriptions in 2018. Generics can be brought to the market quickly and at low cost as manufacturers are not required to repeat animal or clinical research on active ingredients already approved for safety and efficacy. Although there is no regulatory requirement for studies comparing branded and generic eye drops, several randomised crossover studies have been performed comparing branded and generic prostaglandin analogues. While most have shown similar intraocular pressure lowering, studies are of short duration and have not evaluated visual field endpoints. Furthermore, differences in inactive ingredients, pH, viscosity, levels of particulate matter, and degradation over time have been reported. Other potential problems with generic eye drops include differences in bottle design affecting adherence, problems with supply, and the possibility that reduced revenue for innovator companies will lead to reduced investment in new drug development. This article reviews the potential advantages and disadvantages of generic antiglaucoma medications.

scholarly journals Gram-negative Versus Gram-positive in Primary Pyogenic Spondylitis and Analysis of Risk Factors for Relapse

2020 ◽  
Author(s):  
Guohua Dai ◽  
Shu Zhong Li ◽  
Chuqiang Yin ◽  
Yuanliang Sun ◽  
Qizun Wang ◽  
...  
Keyword(s):  
Body Temperature ◽  
Independent Risk Factor ◽  
Treatment Time ◽  
Recurrent Infection ◽  
The Body ◽  
Negative Group ◽  
Gram Positive ◽  
Gram Negative ◽  
Positive Group ◽  
Pyogenic Spondylitis

Abstract Purpose：In the present study, we aimed to compare and analyze the clinical features, diagnosis, treatment and prognosis of primary pyogenic spondylitis caused by Gram-positive and Gram-negative bacteria.Methods: A retrospective analysis consisting of 76 cases of primary pyogenic spondylitis with complete clinical information was carried out from January 2013 to January 2020 in our hospital. The patients were divided into two groups according to Gram staining: Gram-negative group (n=33) and Gram-positive group (n=43). The clinical characteristics, diagnosis, treatment and prognosis of the two groups were compared and analyzed.Results: Staphylococcus aureus accounted for the highest proportion of the Gram-positive group, while Escherichia coli accounted for the highest proportion of the Gram-negative group. Before treatment, there were no significant differences in terms of age, gender, affected segment, spinal abscess, diabetes mellitus, course of disease, admission erythrocyte sedimentation rate (ESR), admission C-reactive protein (CRP), and admission white blood cell (WBC) count between the two groups (P>0.05). After treatment, there were no statistically significant differences in discharge ESR, discharge CRP, ESR decline rate, CRP decline rate, surgery, recurrence, follow-up time, hospital stay, and body temperature ≥38℃ between the two groups (P>0.05). The body temperature of the Gram-negative group was higher compared with the Gram-positive group, and the number of patients with urinary tract infection in the Gram-negative group was significantly greater compared with the Gram-positive group (P<0.05). Antibiotic treatment time <6 weeks was an independent risk factor for recurrent infection.Conclusions: The body temperature of the Gram-negative group was higher compared with the Gram-positive group, and there were significantly more cases with urinary tract infection in the Gram-negative group compared with the Gram-positive group (P<0.05). Antibiotic treatment time <6 weeks was an independent risk factor for recurrent infection.

scholarly journals Keratoconus: cross-linking the window of the eye

2021 ◽  
Vol 2 ◽  
pp. 263300402110035
Author(s):  
Sally Hayes ◽  
Siân R. Morgan ◽  
Keith M. Meek
Keyword(s):  
Treatment Time ◽  
Standard Procedure ◽  
Clinical Effectiveness ◽  
Patient Comfort ◽  
Patient Treatment ◽  
Cross Linking ◽  
Corneal Transplant ◽  
Eye Drops ◽  
Plain Language ◽  
Cross Links

Keratoconus is a condition in which the cornea progressively thins and weakens, leading to severe, irregular astigmatism and a significant reduction in quality of life. Although the precise cause of keratoconus is still not known, biochemical and structural studies indicate that overactive enzymes within the cornea break down the constituent proteins (collagen and proteoglycans) and cause the tissue to weaken. As the disease develops, collagen fibres slip past each other and are redistributed across the cornea, causing it to change shape. In recent years, it was discovered that the photochemical induction of cross-links within the corneal extracellular matrix, through the use of riboflavin and ultraviolet (UVA) light, could increase the strength and enzymatic resistance of the tissue and thereby halt keratoconus progression. Worldwide acceptance and use of riboflavin/UVA corneal cross-linking therapy for halting keratoconus progression has increased rapidly, in accordance with the growing body of evidence supporting its long-term effectiveness. This review focusses on the inception of riboflavin/UVA corneal cross-linking therapy for keratoconus, its clinical effectiveness and the latest scientific advances aimed at reducing patient treatment time, improving patient comfort and increasing patient eligibility for treatment. Plain language summary Review of current treatments using cross-linking to halt the progress of keratoconus Keratoconus is a disease in which the curved cornea, the transparent window at the front of the eye, weakens, bulges forward into a cone-shape and becomes thinner. This change of curvature means that light is not focussed onto the retina correctly and vision is progressively impaired. Traditionally, the effects of early keratoconus were alleviated by using glasses, specialist contact lenses, rings inserted into the cornea and in severe cases, by performing a corneal transplant. However, it was discovered that by inducing chemical bonds called cross-links within the cornea, the tissue could be strengthened and further thinning and shape changes prevented. The standard cross-linking procedure takes over an hour to perform and involves the removal of the cells at the front of the cornea, followed by the application of Vitamin B2 eye drops and low energy ultraviolet light (UVA) to create new cross-links within the tissue. Clinical trials have shown this standard procedure to be safe and effective at halting keratoconus progression. However, there are many treatment modifications currently under investigation that aim to reduce patient treatment time and increase comfort, such as accelerated cross-linking procedures and protocols that do not require removal of the surface cells. This review describes the different techniques being developed to carry out corneal cross-linking efficiently and painlessly, to halt keratoconus progression and avoid the need for expensive surgery.

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