Single Donor Plasma in Therapeutic Plasma Exchange for Myasthenia Gravis

1987 ◽  
Vol 10 (5) ◽  
pp. 315-318 ◽  
Author(s):  
R. Mantegazza ◽  
E. Bruzzone ◽  
B. Regi ◽  
D. Peluchetti ◽  
M. Marconi ◽  
...  
Keyword(s):  
Side Effects ◽  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Optimal Schedule ◽  
Therapeutic Plasma Exchange ◽  
Single Donor ◽  
Short And Long Term ◽  
Donor Plasma

Thirty-seven myasthenic patients were treated with therapeutic plasma exchange (TPE) on different performance schedules using either random or single donor plasma. The two schedules had the same effects in terms of efficacy but single donor replacement gave significantly less side effects in the short and long term. A two exchange procedure on alternate days associated with immunosuppression seems to be an optimal schedule for the treatment of myasthenic patients. A single donor two-exchange on alternate days procedure appears to be safe, useful and can be repeated in patients who need frequent TPE.

Short and Long-Term Clinical Effects of Plasma-Exchange in 33 Cases of Myasthenia Gravis

1985 ◽  
Vol 8 (3) ◽  
pp. 159-162 ◽  
Author(s):  
P.M. Fornasari ◽  
G. Riva ◽  
G. Piccolo ◽  
V. Cosi ◽  
M. Lombardi
Keyword(s):  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Clinical Effects ◽  
Short And Long Term

Therapeutic Plasma Exchange Application in Children Requires Individual Decision

2020 ◽  
Author(s):  
Gürkan Atay ◽  
Demet Demirkol
Keyword(s):  
Plasma Exchange ◽  
Vascular Access ◽  
Pediatric Patients ◽  
Demyelinating Disease ◽  
Pediatric Intensive Care ◽  
Therapeutic Plasma Exchange ◽  
Transplantation Rejection ◽  
Access Problems ◽  
Uremic Syndrome

AbstractTherapeutic plasma exchange (TPE) is a treatment administered with the aim of removing a pathogenic material or compound causing morbidity in a variety of neurologic, hematologic, renal, and autoimmune diseases. In this study, we aimed to assess the indications, efficacy, reliability, complications, and treatment response of pediatric patients for TPE. This retrospective study analyzed data from 39 patients aged from 0 to 18 years who underwent a total of 172 TPE sessions from January 2015 to April 2018 in a tertiary pediatric intensive care unit. Indications for TPE were, in order of frequency, macrophage activation syndrome (28.2%, n = 11), renal transplantation rejection (15.4%, n = 6), liver failure (15.4%, n = 6), Guillain–Barre's syndrome (15%, n = 6), hemolytic uremic syndrome (7.7%, n = 3), acute demyelinating disease (7.7%, n = 3), septic shock (5.1%, n = 2), and intoxication (5.1%, n = 2). No patient had any adverse event related to the TPE during the procedure. The TPE session was ended prematurely in one patient due to insufficient vascular access and lack of blood flow (2.6%). In the long term, thrombosis due to the indwelling central catheter occurred (5.1%, n = 2). TPE appears to be an effective first-stage or supplementary treatment in a variety of diseases, may be safely used in pediatric patients, and there are significant findings that its area of use will increase. In experienced hands and when assessed carefully, it appears that the rate of adverse reactions and vascular access problems may be low enough to be negligible.

scholarly journals Plasmapheresis in the treatment of myasthenia gravis: retrospective study of 26 patients

2004 ◽  
Vol 62 (2b) ◽  
pp. 391-395 ◽  
Author(s):  
Rosana Carandina-Maffeis ◽  
Anamarli Nucci ◽  
José F.C. Marques Jr ◽  
Eduardo G. Roveri ◽  
Beatriz H.M. Pfeilsticker ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Mortality Rates ◽  
Motor Deficit ◽  
Myasthenic Crisis ◽  
Clinical Hospital ◽  
The Mean ◽  
Mean Time

We analyzed the experience of Unicamp Clinical Hospital with plasma exchange (PE) therapy in myasthenia gravis (MG). About 17.8 % of a totality of MG patients had PE performed: 26 cases, 19 women and seven men. The mean age-onset of MG was 28 years, extremes 11 and 69. Minimum deficit observed in the group was graded IIb (O & G) or IIIa (MGFA scale). One patient had prethymectomy PE. In seven the procedures were performed due to myasthenic crisis and in 18 patients due to severe myasthenic symptoms or exacerbation of previous motor deficit. Two patients were also submitted to chronic PE considering refractoriness to other treatments. Twenty-six patients had 44 cycles of PE and 171 sessions. The mean number of sessions was 3.9 (SD ± 1.4) each cycle; median 5, extremes 2 and 6. The mean time by session was 106,5 minutes (SD ± 35.2); median 100.5 (extremes of 55 and 215). The mean volume of plasma exchanged in each session was 2396 ml (SD ± 561); median 2225 (extremes 1512 and 4500). Side effects occurred: reversible hypotension (seven cases), mild tremor or paresthesias (seven cases). Infection and mortality rates due to PE were zero. All patients had immediate benefit of each PE cycle and usually they also received prednisone or other immunosuppressors. Good acceptance of the procedure was observed in 80.7% of patients.

scholarly journals Influences on Attitudes Regarding Potential COVID-19 Vaccination in the United States

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 582 ◽  
Author(s):  
Kendall Pogue ◽  
Jamie L. Jensen ◽  
Carter K. Stancil ◽  
Daniel G. Ferguson ◽  
Savannah J. Hughes ◽  
...  
Keyword(s):  
United States ◽  
Structural Equation Modeling ◽  
Side Effects ◽  
Structural Equation ◽  
The United States ◽  
Equation Modeling ◽  
Vaccine Acceptance ◽  
The World ◽  
Short And Long Term

The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. However, to be effective, a vaccine must be accepted and used by a large majority of the population. The aim of this study was to understand the attitudes towards and obstacles facing vaccination with a potential COVID-19 vaccine. To measure these attitudes a survey was administered to 316 respondents across the United States by a survey corporation. Structural equation modeling was used to analyze the relationships of several factors with attitudes toward potential COVID-19 vaccination. Prior vaccine usage and attitudes predicted attitudes towards COVID-19 vaccination. Assessment of the severity of COVID-19 for the United States was also predictive. Approximately 68% of all respondents were supportive of being vaccinated for COVID-19, but side effects, efficacy and length of testing remained concerns. Longer testing, increased efficacy and development in the United States were significantly associated with increased vaccine acceptance. Messages promoting COVID-19 vaccination should seek to alleviate the concerns of those who are already vaccine-hesitant. Messaging directed at the benefits of vaccination for the United States as a country would address the second predictive factor. Enough time should be taken to allay concerns about both short- and long-term side effects before a vaccine is released.

scholarly journals Plasmapheresis in neurological disorders: six years experience from University Clinical center Tuzla

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1234 ◽  
Author(s):  
Osman Sinanović ◽  
Sanela Zukić ◽  
Adnan Burina ◽  
Nermina Pirić ◽  
Renata Hodžić ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Response ◽  
Plasma Exchange ◽  
Neurological Diseases ◽  
Therapeutic Plasma Exchange ◽  
Motor Neuropathy ◽  
Extracorporeal Blood Purification ◽  
Clinical Center ◽  
Plasma Factor ◽  
Neurological Patients

Background: Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique that is designed to remove substances with a large molecular weight. The TPE procedure includes removal of antibodies, alloantibodies, immune complexes, monoclonal protein, toxins or cytokines, and involves the replenishment of a specific plasma factor. The aim of the study was to describe the clinical response to TPE in various neurological patients, and to assess the clinical response to this therapy. Methods: The study was retrospective. We analyzed the medical records of 77 patients who were treated at the Department of Neurology, University Clinical Center (UCC) Tuzla from 2011 to 2016.   Results: 83 therapeutic plasma exchanges were performed in the 77 patients. There was a slight predominance of male patients (54.5%), with an average age of 51±15.9 years. The most common underlying neurological diseases were Guillain–Barré syndrome (GBS) (37.7%), then chronic inflammatory demyelinating polyneuropathy (CIDP) (23.4%), multiple sclerosis (MS) (11.7%) and myasthenia gravis (10.4%). Less frequent neurological diseases that were encountered were paraneoplastic polyneuropathies (5.2%), neuromyelitis optica (also known as Devic’s disease) (3.9%), motor neuron disease (3.9%), polymyositis (2.6%) and multifocal motor neuropathy (1.2%). Conclusions: Six years experience of therapeutic plasma exchange in neurological patients in our department have shown that, following evidence-based guidelines for plasmapheresis, the procedure was most effective in patients with GBS, CIDP and myasthenia gravis.

SPECIAL REQUIREMENTS FOR TOXICITY TESTING OF ORAL COMPOUNDS ADMINISTERED CONTINUOUSLY OR CYCLICALLY

1974 ◽  
Vol 77 (1_Suppla) ◽  
pp. S387-S408 ◽  
Author(s):  
G. A. Overbeek ◽  
H. W. Hornstra ◽  
E. B. van Julsingha ◽  
J. P. Mumford ◽  
I. Zayed
Keyword(s):  
Side Effects ◽  
Oral Contraceptives ◽  
Predictive Value ◽  
Animal Studies ◽  
Toxicity Testing ◽  
Prolonged Treatment ◽  
Safety Studies ◽  
Short And Long Term ◽  
Dose Levels

ABSTRACT The authors feel that several reasons exist for considering contraceptives as a special class of drugs, which therefore require special safety studies. Apart from the usual short and long term studies, particular attention should be paid to the reversibility of the induced infertility, and to its possible consequences for subsequent offspring. A possible risk of damage to the foetus is partially outweighed by the low risk of pregnancy during the treatment periods with oral contraceptives. The procedures used in the Organon laboratories are briefly described. Principles on which we base the choice of dose levels and the duration of the various studies are discussed. The paucity of available data from toxicity studies in animals has prevented the presentation of a summary allowing an appraisal of the predictive value of the current methods in toxicology. Nevertheless, a few examples are given which demonstrate the need for more predictive methods. The present lack of knowledge on side effects in humans after prolonged treatment with oral contraceptives has created a feeling of uneasiness. This in its turn has resulted in some excessive regulatory requirements for very long term animal studies. In our opinion, the predictive value of these studies is extremely low because of the inadequacy of the available animal models. More value can be attached to the monitoring of side effects in humans and efforts in this direction should be increased. The Organon system of monitoring the side effects of its marketed preparations is briefly described. It is not considered feasible to standardize regulatory toxicity requirements for the time being, which should not prevent us from aiming at reasonable, more generally accepted methods of study.

scholarly journals Influences on Attitudes regarding Potential COVID-19 Vaccination in the United States

2020 ◽  
Author(s):  
Kendall Pogue ◽  
Jamie Jensen ◽  
Carter Stancil ◽  
Daniel Ferguson ◽  
Savannah Hughes ◽  
...  
Keyword(s):  
United States ◽  
Side Effects ◽  
Predictive Factor ◽  
Structural Equation ◽  
The United States ◽  
Vaccine Acceptance ◽  
Equation Modelling ◽  
The World ◽  
Short And Long Term

The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. However, to be effective, a vaccine must be accepted and used by a large majority of the population. Structural equation modelling was used to analyze the relationships of several factors with attitudes toward potential COVID-19 vaccination. The survey was administered to 316 respondents across the United States by a survey corporation. Prior vaccine usage and attitudes predicted attitudes towards COVID-19 vaccination. Assessment of the severity of COVID-19 for the United States was also predictive. Approximately 68% of all respondents were supportive of being vaccinated for COVID-19, but side effects, efficacy, and length of testing remained concerns. Longer testing, increased efficacy and development in the United States were significantly associated with increased vaccine acceptance. Messages promoting COVID-19 vaccination should seek to alleviate the concerns of those who are already vaccine-hesitant. Messaging directed at the benefits of vaccination for the United States as a country would address the second predictive factor. Enough time should be taken to allay concerns about both short and long-term side effects before a vaccine is released.

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