scholarly journals Improved (4 Plus 2) Rituximab Protocol for Severe Cases of Mixed Cryoglobulinemia: A 6-Year Observational Study

2016 ◽  
Vol 43 (4) ◽  
pp. 251-260 ◽  
Author(s):  
Dario Roccatello ◽  
Savino Sciascia ◽  
Simone Baldovino ◽  
Daniela Rossi ◽  
Mirella Alpa ◽  
...  
Keyword(s):  
Mixed Cryoglobulinemia ◽  
Immunosuppressive Drugs ◽  
Long Term Effects ◽  
Beneficial Effects ◽  
Skin Ulcers ◽  
Long Term Follow Up ◽  
Open Prospective Study ◽  
Large Skin

Background: In a prospective, single-center open study, we evaluated the very long-term effects of rituximab (RTX) administered to patients with severe mixed cryoglobulinemia (MC). Methods: RTX was administered to 31 patients with MC (type II in 29 cases and type III in 2) with diffuse membranoproliferative glomerulonephritis (16 cases), peripheral neuropathy (26) and large skin ulcers (7). All but 4 patients had serum anti-hepatitis C virus antibodies. RTX was administered at a dose of 375 mg/m2, according to a ‘4 + 2' protocol (days 1, 8, 15 and 22 plus 1 dose 1 and 2 months later). No other immunosuppressive drugs were added. Response was evaluated over a very long-term follow-up (mean 72.47 months, range 30-148). Results: Complete remission of pretreatment active manifestations was observed in all cases of purpuric lesions and non-healing vasculitic ulcers, and in 80% of the peripheral neuropathies. Cryoglobulinemic nephropathy significantly improved during follow-up, starting from the 2nd month after RTX (serum creatinine from 2.1 ± 1.7 to 1.5 ± 1.6 mg/dl, p ≤ 0.05; 24-hour proteinuria from 2.3 ± 2.1 to 0.9 ± 1.9 g/24 h, p ≤ 0.05). Improvement of cryoglobulinemic serological hallmarks, such as cryocrit and low complement C4, were observed. No clinically relevant side effects were recorded. Re-induction with RTX was carried out in 9 relapsed patients after a mean of 31.1 months (12-54), again with beneficial effects. The survival rate was 75% at 6 years and the probability of remaining symptom-free for 10 years without any therapy was of about 60% after a single ‘4 + 2' infusion cycle, while the probability of living symptom-free 5 years after relapsing was 80% if given the same treatment. Conclusion: In this open, prospective study, RTX appeared to be very effective and safe in the treatment of the most severe cases of MC.

Long-Term Complications of Lymphoma and Its Treatment

2011 ◽  
Vol 29 (14) ◽  
pp. 1885-1892 ◽  
Author(s):  
Andrea K. Ng ◽  
Ann LaCasce ◽  
Lois B. Travis
Keyword(s):  
Late Effects ◽  
Hodgkin’S Lymphoma ◽  
Early Stage ◽  
Large Body ◽  
Hodgkin's Lymphoma ◽  
Long Term Effects ◽  
Early Stage Disease ◽  
Long Term Follow Up

As a result of therapeutic advances, there is a growing population of survivors of both Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). A thorough understanding of the late effects of cancer and its treatment, including the risk of developing a second malignancy and non-neoplastic complications, most notably cardiac disease, is essential for the proper long-term follow-up care of these patients. For HL survivors cured in the past 5 decades, a large body of literature describes a range of long-term effects, many of which are related to extent of treatment. These studies form the basis for many of the follow-up recommendations developed for HL survivors. As HL therapy continues to evolve, however, with an emphasis toward treatment reduction, in particular for early-stage disease, it will be important to rigorously observe this new generation of patients long term to document and quantify late effects associated with modern treatments. Although data on late effects after NHL therapy have recently emerged, the formulation of structured follow-up plans for this heterogeneous group of survivors is challenging, given the highly variable natural history, treatments, and overall prognosis. However, the chemotherapy and radiation therapy approaches for some types of NHL are similar to that for HL; thus, some of the follow-up guidelines for patients with HL may also be transferrable to selected survivors of NHL. Additional work focused on treatment-related complications after NHL will facilitate the development of follow-up programs, as well as treatment refinements to minimize late effects in patients with various types of NHL.

scholarly journals The beneficial effects of postinfarct cytokine combination therapy are sustained during long-term follow-up

2009 ◽  
Vol 47 (4) ◽  
pp. 528-535 ◽  
Author(s):  
Santosh K. Sanganalmath ◽  
Adam B. Stein ◽  
Yiru Guo ◽  
Sumit Tiwari ◽  
Greg Hunt ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Beneficial Effects ◽  
Long Term Follow Up ◽  
Cytokine Combination

Early beneficial effects of drug-eluting stents in vein grafts wane during long term follow-up

2012 ◽  
Vol 80 (7) ◽  
pp. 1112-1117 ◽  
Author(s):  
Vincenzo Pasceri ◽  
Giandomenico Tarsia ◽  
Giampaolo Niccoli ◽  
Nicola Viceconte ◽  
Italo Porto ◽  
...  
Keyword(s):  
Drug Eluting Stents ◽  
Vein Grafts ◽  
Beneficial Effects ◽  
Long Term Follow Up ◽  
Drug Eluting

Injuries to the Neonatal Larynx from Long-Term Endotracheal Tube Intubation and Suggested Tube Modification for Prevention

1975 ◽  
Vol 84 (6) ◽  
pp. 764-770 ◽  
Author(s):  
Arthur S. Hengerer ◽  
Marshall Strome ◽  
Burton F. Jaffe
Keyword(s):  
Endotracheal Tube ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Long Term Effects ◽  
Posterior Commissure ◽  
Long Term Follow Up ◽  
Initial Injury ◽  
Cartilage Erosion

Since the early 1960's nasotracheal tubes have been used for neonates with primary respiratory diseases which necessitated positive pressure ventilation. This therapy may be required for extended periods of weeks to months meaning prolonged trauma to the neonatal larynx. The initial injury and long-term effects of the endotracheal tube in this age group have not been adequately investigated. The acute findings can be arytenoid and posterior commissure ulcerations and, in some cases, cartilage erosion. Long-term follow-up in these children to age 3.5 years showed a persistent arytenoid defect with chronic hoarseness. The consideration of a change in the structure of the endotracheal tube is suggested as a possible means of avoiding these injuries.

Mixed cryoglobulinemia: Clinical aspects and long-term follow-up of 40 patients

1980 ◽  
Vol 69 (2) ◽  
pp. 287-308 ◽  
Author(s):  
Peter D. Gorevic ◽  
Hannah Jane Kassab ◽  
Yoram Levo ◽  
Robert Kohn ◽  
Martin Meltzer ◽  
...  
Keyword(s):  
Mixed Cryoglobulinemia ◽  
Clinical Aspects ◽  
Long Term Follow Up

Long-Term Effects of FloSeal™ Packing After Endoscopic Sinus Surgery

2005 ◽  
Vol 19 (3) ◽  
pp. 240-243 ◽  
Author(s):  
Rakesh K. Chandra ◽  
David B. Conley ◽  
G. Kenneth Haines ◽  
Robert C. Kern
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Scar Tissue ◽  
Sinus Surgery ◽  
Tissue Formation ◽  
Long Term Effects ◽  
Study Evaluation ◽  
Long Term Follow Up ◽  
The Mean

Background A previous study by our group showed increased adhesions and granulation tissue in ethmoid cavities packed with FloSeal (FS) compared with those packed with thrombin-soaked gelatin foam after endoscopic sinus surgery (ESS). That study included 20 patients whose cavities were graded 6–8 weeks postoperatively. The goal of this study was to report long-term follow-up on this cohort. Methods At least 1 year follow-up was available in 18/20 patients. The number of office procedures required to lyse adhesions during the follow-up period was tabulated also. Pathology was available from one patient who underwent lysis of adhesions on an FS side. The histopathological findings are presented. Results The mean follow-up period was 21.4 (±2.3) months, and none of the 18 patients required revision ESS during this interval. The overall incidence of adhesions (p = 0.013) and the number requiring lysis of adhesions (p = 0.046) were both greater in the FS group. During the interval between previous study evaluation (6–8 weeks postop) and last follow-up, five FS sides required a total of seven procedures to lyse adhesions. Silent adhesions were observed in an additional five FS sides. Although asymptomatic adhesions were observed in two thrombin-soaked gelatin sides at last examination, none underwent lysis. Biopsy of an adhesion from a patient packed with FS 25 months earlier revealed incorporated foreign material. Conclusion FS appears to be associated with scar tissue formation and may be incorporated into recovering mucosa. Use of FS may increase the degree of postoperative care required after ESS.

scholarly journals Twenty-Five and Thirty-Five Year Follow up of First Admissions to Mental Hospital

1968 ◽  
Vol 13 (3) ◽  
pp. 219-229 ◽  
Author(s):  
M. N. Beck
Keyword(s):  
Prince Edward Island ◽  
Mental Hospital ◽  
Long Term Effects ◽  
Nineteen Thirties ◽  
Needed Information ◽  
Nineteen Forties ◽  
Long Term Follow Up ◽  
Very High

This has been a report of a study designed to assess the feasibility of long-term follow-up studies on Prince Edward Island. Cohorts of patients first admitted to the Island's only mental hospital during the early nineteen-thirties and early nineteen-forties were followed in retrospect in order to determine, a) the course and outcome of the major disorders over periods ranging up to thirty-five years and, b) the long-term effects of these disorders upon the families of the patients. Needed information was gathered through a review of hospital records, a search for death records and community interviews. The results of the study suggest that lifetime prognosis in the absence of modern treatment methods may be even worse than believed by most professionals working in the field. As might be expected the outlook was found to be particularly grave for schizophrenia. Success in following up a very high proportion of the cases over several decades supports the belief that Prince Edward Island offers unusual opportunities for studies of this kind.

scholarly journals Long-term follow-up of children exposed in-utero to progesterone treatment for prevention of preterm birth: study protocol of the AMPHIA follow-up

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053066
Author(s):  
Noor E Simons ◽  
Emilie V J van Limburg Stirum ◽  
Aleid G van Wassenaer-Leemhuis ◽  
Martijn J J Finken ◽  
Cornelieke S H Aarnoudse-Moens ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Randomised Trial ◽  
Multiple Gestation ◽  
Long Term Effects ◽  
Follow Up Study ◽  
Multiple Gestations ◽  
Progesterone Treatment ◽  
Long Term Follow Up

IntroductionPreterm birth is one of the main problems in obstetrics, and the most important cause of neonatal mortality, morbidity and neurodevelopmental impairment. Multiple gestation is an important risk factor for preterm birth, with up to 50% delivering before 37 weeks. Progesterone has a role in maintaining pregnancy and is frequently prescribed to prevent (recurrent) preterm birth and improve pregnancy outcomes in high-risk patients. However, little is known about its long-term effects in multiple gestations. The objective of this follow-up study is to assess long-term benefits and harms of prenatal exposure to progesterone treatment in multiple gestations on child development.Methods and analysisThis is a follow-up study of a multicentre, double-blind, placebo-controlled randomised trial (AMPHIA trial, ISRCTN40512715). Between 2006 and 2009 women with a multiple gestation were randomised at 16–20 weeks of gestation to weekly injections 250 mg 17α-hydroxyprogesterone caproate or placebo, until 36 weeks of gestation or delivery. The current long-term follow-up will assess all children (n=1355) born to mothers who participated in the AMPHIA trial, at 11–14 years of age, with internationally validated questionnaires, completed by themselves, their parents and their teachers.Main outcomes are child cognition and behaviourAdditional outcomes are death (perinatal and up to age 14), gender identity, educational performance and health-related problems. We will use intention-to-treat analyses comparing experimental and placebo group. To adjust for the correlation between twins, general linear mixed-effects models will be used.Ethics and disseminationAmsterdam UMC MEC provided a waiver for the Medical Research Involving Human Subjects Act (W20_234#20.268). Results will be disseminated through peer-reviewed journals and summaries shared with stakeholders, patients and participants. This protocol is published before analysis of the results.Trial registration numberNL8933.

Sign in / Sign up

Export Citation Format

Share Document