Intralesional Vitamin D3 Injection in the Treatment of Recalcitrant Warts: A Novel Proposition

2017 ◽  
Vol 21 (4) ◽  
pp. 320-324 ◽  
Author(s):  
Sonia Raghukumar ◽  
B. C. Ravikumar ◽  
K. N. Vinay ◽  
M. R. Suresh ◽  
Archit Aggarwal ◽  
...  
Keyword(s):  
Vitamin D ◽  
Complete Resolution ◽  
Treatment Options ◽  
Complete Response ◽  
Cell Mediated Immunity ◽  
Success Rates ◽  
Recurrence Rates ◽  
Intralesional Injections ◽  
Variable Success ◽  
Epidermal Cell Proliferation

Background: Verruca vulgaris (viral warts) is a fairly common condition with a plethora of treatment options having variable success rates. Recalcitrant warts are refractory to treatment with often disappointing response and high recurrence rates. Lately, treatment with intralesional injections has gained momentum due to its effectiveness in clearing warts by stimulating the cell-mediated immunity. Vitamin D, when applied topically, regulates epidermal cell proliferation and is involved in the formation of antimicrobial peptides. We have attempted to use vitamin D3 to exploit its reported action as an immunotherapeutic molecule in addition to its topical effects. To our knowledge, there are no reports of intralesional vitamin D3 injections used in the treatment of extragenital recalcitrant warts. Methods: Sixty-four patients with recalcitrant warts of varying sizes and duration were included in the study. About 0.2- to 0.5-mL vitamin D3 solution (600,000 IU, 15 mg/mL) was injected to the base of the wart. A maximum of 5 warts were injected per session at 3-week intervals until resolution or for a maximum of 4 treatments. Patients were followed up for 6 months after the last injection to detect any recurrence. Results: Sixty patients completed the study. Complete response was seen in 54 of 60 (90%), partial response in 4 of 60 (6.66%), and no response in 2 of 60 (3.33%). The average number of injections required to achieve a complete resolution was 3.66. Complete resolution of distant warts was noticed in all patients. Conclusions: Intralesional vitamin D3 is a safe, effective, and an inexpensive treatment option for recalcitrant warts.

scholarly journals Modern Treatments and Stem Cell Therapies for Perianal Crohn’s Fistulas

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Alghalya Khalid Sulaiman Al-Maawali ◽  
Phuong Nguyen ◽  
P. Terry Phang
Keyword(s):  
Stem Cells ◽  
Treatment Options ◽  
Success Rates ◽  
Hematopoietic Stem ◽  
Cell Therapies ◽  
Topical Tacrolimus ◽  
Complex Disorder ◽  
Fistula Plug ◽  
Variable Success

Crohn’s disease (CD) is a complex disorder with important incidence in North America. Perianal fistulas occur in about 20% of patients with CD and are almost always classified as complex fistulas. Conventional treatment options have shown different success rates, yet there are data indicating that these approaches cannot achieve total cure and may not improve quality of life of these patients. Fibrin glue, fistula plug, topical tacrolimus, local injection of infliximab, and use of hematopoietic stem cells (HSC) and mesenchymal stem cells (MSC) are newly suggested therapies with variable success rates. Here, we aim to review these novel therapies for the treatment of complex fistulizing CD. Although initial results are promising, randomized studies are needed to prove efficacy of these approaches in curing fistulizing perianal CD.

COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shrikant . ◽  
R.D. Mehta ◽  
B.C. Ghiya
Keyword(s):  
Partial Response ◽  
Comparative Study ◽  
Recurrence Rate ◽  
Vitamin D3 ◽  
Complete Response ◽  
Recurrence Rates ◽  
Additional Advantage ◽  
Cost Effective Treatment ◽  
Group A ◽  
Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

Alternative medicine as a treatment options for COVID-19

2021 ◽  
Vol 07 ◽  
Author(s):  
Mahfuza Marzan ◽  
Md. Shahedur Rahman ◽  
Md. Abu Hena Mostofa Jamal ◽  
Mohammad Hossain Shariare ◽  
Md. Anowar Khasru Parvez
Keyword(s):  
Health Care ◽  
Vitamin D ◽  
Distress Syndrome ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Viral Disease ◽  
Global Pandemic ◽  
Medicinal Properties ◽  
Mode Of Transmission ◽  
High Infectivity

: COVID-19, a viral disease caused by SARS-CoV-2 is the reason of a global pandemic since the starting of the year 2020. The characteristic of the disease varies from mild common cold like symptoms to acute respiratory distress syndrome and multi-organ failure leading to death. World has already observed 213,453 deaths from this disease while 3,095,839 have been infected in 210 countries in total till 28 April, 2020. This disease has a devastating impact over the health care system because of its high infectivity, easy mode of transmission, lack of proper medicine and vaccine and deficiency of enough supportive healthcare arrangement. On verge of this situation scientists are searching the treatment options. However, nature has provided us with enormous herbs which have disease preventive as well as have medicinal properties. In this article we have reviewed several of these plants (ginger, clove, tea, black seed, tulsi, neem) and some vitamins (vitamin C and vitamin D) and zinc which have antiviral, anti-inflammatory, antioxidant, anti-asthmatic properties with scientific evidence. The intake of these products regularly to keep the immune system active, to experience its positive aspects might be supportive to prevent infection with the new coronavirus or to treat COVID-19.

scholarly journals Molecular Subtypes and Precision Oncology in Intrahepatic Cholangiocarcinoma

2021 ◽  
Vol 10 (13) ◽  
pp. 2803
Author(s):  
Carolin Czauderna ◽  
Martha M. Kirstein ◽  
Hauke C. Tews ◽  
Arndt Vogel ◽  
Jens U. Marquardt
Keyword(s):  
Clinical Care ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Growth Factor Receptor ◽  
Treatment Modalities ◽  
Precision Oncology ◽  
Recurrence Rates ◽  
Isocitrate Dehydrogenase 1 ◽  
Liver Cancers

Cholangiocarcinomas (CCAs) are the second-most common primary liver cancers. CCAs represent a group of highly heterogeneous tumors classified based on anatomical localization into intra- (iCCA) and extrahepatic CCA (eCCA). In contrast to eCCA, the incidence of iCCA is increasing worldwide. Curative treatment strategies for all CCAs involve oncological resection followed by adjuvant chemotherapy in early stages, whereas chemotherapy is administered at advanced stages of disease. Due to late diagnosis, high recurrence rates, and limited treatment options, the prognosis of patients remains poor. Comprehensive molecular characterization has further revealed considerable heterogeneity and distinct prognostic and therapeutic traits for iCCA and eCCA, indicating that specific treatment modalities are required for different subclasses. Several druggable alterations and oncogenic drivers such as fibroblast growth factor receptor 2 gene fusions and hotspot mutations in isocitrate dehydrogenase 1 and 2 mutations have been identified. Specific inhibitors have demonstrated striking antitumor activity in affected subgroups of patients in phase II and III clinical trials. Thus, improved understanding of the molecular complexity has paved the way for precision oncological approaches. Here, we outline current advances in targeted treatments and immunotherapeutic approaches. In addition, we delineate future perspectives for different molecular subclasses that will improve the clinical care of iCCA patients.

Two decades of experience on ablation in children with Ebstein’s anomaly

2021 ◽  
pp. 1-7
Author(s):  
Tevfik Karagöz ◽  
İlker Ertuğrul ◽  
Ebru Aypar ◽  
Aydın Adıgüzel ◽  
Hayrettin Hakan Aykan ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Atrial Tachycardia ◽  
Ebstein’S Anomaly ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Success Rates ◽  
Recurrence Rates ◽  
Ebstein's Anomaly ◽  
Accessory Pathways ◽  
Rare Occasion ◽  
The Right

Abstract Introduction: Accessory pathways are commonly seen due to delamination of tricuspid valve leaflets. In addition to accessory pathways, an enlarged right atrium due to tricuspid regurgitation and incisional scars creates substrates for atrial re-entries and ectopic tachycardia. We sought to describe our experience with catheter ablation in children with Ebstein’s anomaly. Methods and results: During the study period, of 89 patients diagnosed with Ebstein’s anomaly, 26 (30.9%) of them who underwent 33 ablation procedures were included in the study. Accessory pathways were observed in the majority of procedures (n = 27), whereas atrial flutter was observed in five, atrioventricular nodal reentrant tachycardia in five, and atrial tachycardia in two procedures. Accessory pathways were commonly localised in the right posteroseptal (n = 10 patients), right posterolateral (n = 14 patients), septal (n = two patients), and left posteroseptal (n = one patient) areas. Multiple accessory pathways and coexistent arrhythmia were observed in six procedures. All ablation attempts related to the accessory pathways were successful, but recurrence was observed in five (19%) of the ablations. Ablation for atrial flutter was performed in five patients; two of them were ablated successfully. One of the atrial tachycardia cases was ablated successfully. Conclusions: Ablation in patients with Ebstein’s anomaly is challenging, and due to nature of the disease, it is not a rare occasion in this group of patients. Ablation of accessory pathways has high success, but also relatively high recurrence rates, whereas ablation of atrial arrhythmias has lower success rates, especially in operated patients.

scholarly journals Vitamin D Supplementation Modulates T Cell–Mediated Immunity in Humans: Results from a Randomized Control Trial

2016 ◽  
Vol 101 (2) ◽  
pp. 533-538 ◽  
Author(s):  
Gauree Gupta Konijeti ◽  
Pankaj Arora ◽  
Matthew R. Boylan ◽  
Yanna Song ◽  
Shi Huang ◽  
...  
Keyword(s):  
Vitamin D ◽  
T Cell ◽  
Vitamin D Deficiency ◽  
T Cell Activation ◽  
Vitamin D3 ◽  
Cell Activation ◽  
Atp Release ◽  
High Dose ◽  
Cell Mediated Immunity ◽  
Ancillary Study

Abstract Context: Although studies have linked vitamin D deficiency with immune-mediated diseases, data demonstrating a direct effect on T-cell function are sparse. Objective: Our objective was to determine whether oral vitamin D3 influences T-cell activation in humans with vitamin D deficiency. Design: This was a single-center ancillary study within Vitamin D Therapy in Individuals at High Risk of Hypertension, a double-blind, multicenter, randomized controlled trial. Setting: This study was undertaken in a single academic medical center. Participants: Adults with vitamin D deficiency and untreated pre- or early stage I hypertension were included. Intervention: In Vitamin D Therapy in Individuals at High Risk of Hypertension, participants were randomized to either low- (400 IU daily) or high- (4000 IU daily) dose oral vitamin D3 for 6 months. In this ancillary study of 38 patients, we measured CD4+ T-cell activation estimated by intracellular ATP release after stimulation of whole blood with plant lectin phytohemagglutinin collected at baseline (pretreatment) and 2-month follow-up. Main Outcome Measure: Determining whether ATP level changes were significantly different between treatment groups was the main outcome measure. Results: Treatment with 4000 IU of vitamin D3 decreased intracellular CD4+ ATP release by 95.5 ng/ml (interquartile range, −219.5 to 105.8). In contrast, 400 IU of vitamin D3 decreased intracellular CD4+ ATP release by 0.5 ng/ml (interquartile range, −69.2 to 148.5). In a proportional odds model, high-dose vitamin D3 was more likely than low-dose vitamin D3 to decrease CD4+ ATP release (odds ratio, 3.43; 95% confidence interval, 1.06–1.11). Conclusions: In this ancillary study of a randomized controlled trial, we found that high-dose vitamin D3 significantly reduced CD4+ T-cell activation compared to low-dose vitamin D3, providing human evidence that vitamin D can influence cell-mediated immunity.

Re-use of erlotinib in a patient using osimertinib after erlotinib, case report

2021 ◽  
pp. 107815522110191
Author(s):  
Pinar Gursoy
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Treatment Options ◽  
Resistance Mutation ◽  
Growth Factor Receptor ◽  
Complete Response ◽  
Egfr Mutations ◽  
T790m Mutation ◽  
Development Of Resistance ◽  
Exon 19

Introduction Most patients with non-small-cell lung cancer tumors that have epidermal growth factor receptor (EGFR) mutations have deletion mutations in exon 19 or exon 21, or both.In recent years, targeted therapies in lung cancer have increased survival, but the development of resistance to these drugs poses a major problem. Thesubstitution of methionineforthreonine at position 790 (T790M) mutation,is primarily responsible for this resistance. However, after osimertinib used in T790M positivepatients treatment options are generally limited to chemotherapy. Case report We reported the efficacy of erlotinib, which we reapplied due to the disappearance of the resistance mutation after osimertinib in a 68-year-old patient using osimertinib after erlotinib. Management and outcome: In the patient using erlotinib due to exon 19 deletion when progression was observed and T790M positivity was detected, osimertinib treatment was initiated. However, when T790M was found to be negative with rebiopsy in progression after osimertinib, a complete response was achieved by restarting erlotinib. Discussion The strategy of restarting erlotinib treatment with negative T790M mutation detected in biopsies of patients with osimertinib resistance may be an acceptable treatment option.

The Correlation between Vitamin D Levels and the Risk of Postoperative Recurrence in Crohn’s Disease

Digestion ◽  
2021 ◽  
pp. 1-9
Author(s):  
Akihiro Yamada ◽  
Yuga Komaki ◽  
Fukiko Komaki ◽  
Haider Haider ◽  
Dejan Micic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Reactive Protein ◽  
Endoscopic Recurrence ◽  
Vitamin D Levels ◽  
Endoscopic Remission ◽  
The University

<b><i>Background and Aims:</i></b> Vitamin D deficiency has been associated with disease activity in Crohn’s disease (CD). We assessed whether there is a correlation between vitamin D levels and the risk of postoperative recurrence in CD. <b><i>Methods:</i></b> CD patients who underwent surgery were identified from a prospectively maintained database at the University of Chicago. The primary endpoint was the correlation of serum 25-hydroxy vitamin D levels measured at 6–12 months after surgery and the proportion of patients in endoscopic remission, defined as a simple endoscopic score for CD of 0. Clinical, biological (C-reactive protein), and histologic recurrences were also studied. <b><i>Results:</i></b> Among a total of 89 patients, 17, 46, and 26 patients had vitamin D levels of &#x3c;15, 15–30, and &#x3e;30 ng/mL, respectively. Patients with higher vitamin D levels were significantly more likely to be in endoscopic remission compared to those with lower levels (23, 42, and 67% in ascending tertile order; <i>p</i> = 0.028). On multivariate analysis, vitamin D &#x3e;30 ng/mL (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.07–0.66, <i>p</i> = 0.006) and anti-tumor necrosis factor agent treatment (OR 0.25, 95% CI 0.08–0.83, <i>p</i> = 0.01) were associated with reduced risk of endoscopic recurrence. Rates of clinical, biological, and histologic remission trended to be higher in patients with higher vitamin D levels (<i>p</i> = 0.17, 0.55, 0.062, respectively). <b><i>Conclusion:</i></b> In the present study, higher vitamin D level was associated with lower risk of postoperative endoscopic CD recurrence. Further, studies are warranted to assess the role of vitamin D in postoperative CD recurrence.

Palbociclib (P) in patients (pts) with soft tissue sarcoma (STS) with CDK4 amplification: Results from the Targeted Agent and Profiling Utilization Registry (TAPUR) study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11565-11565
Author(s):  
Scott Schuetze ◽  
Michael Rothe ◽  
Pam K. Mangat ◽  
Liz Garrett-Mayer ◽  
Funda Meric-Bernstam ◽  
...  
Keyword(s):  
Treatment Options ◽  
Objective Response ◽  
Progression Free Survival ◽  
Complete Response ◽  
Stage Design ◽  
Secondary Endpoints ◽  
Grade 3 ◽  
Ecog Ps ◽  
Stage 1 ◽  
Anti Tumor Activity

11565 Background: TAPUR is a phase II basket study evaluating anti-tumor activity of commercially available targeted agents in pts with advanced cancers with genomic alterations. Results in a cohort of STS pts with CDK4 amplification treated with P are reported. Methods: Eligible pts had advanced STS, no standard treatment options, measurable disease, ECOG PS 0-2, and adequate organ function. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. Pts received P at 125 mg orally once daily for 21 days, followed by 7 days off until disease progression. Pts matched to P had CDK4 amplification and no RB mutations. Simon 2-stage design tested the null disease control (DC) - defined as partial (PR), complete response (CR) or stable disease at 16+ weeks (SD 16+) - rate of 15% vs. 35% (power = 0.85; α = 0.10). If ≥2 of 10 pts in stage 1 have DC, 18 more pts are enrolled. If ≥7 of 28 pts have DC, the null DC rate is rejected. Secondary endpoints are progression-free survival (PFS), overall survival (OS) and safety. Results: 29 pts (66% male) with STS with CDK4 amplification were enrolled from July 2016 to Nov 2019. 1 pt was not evaluable and excluded from efficacy analyses. Demographics and outcomes are summarized in Table. One pt with partial response (PR) and 12 pts with SD16+ were observed for DC and objective response (OR) rates of 48% (95% CI: 31%, 62%) and 3.7% (95% CI: 0.1%, 19%), respectively, and the null DC rate of 15% was rejected (p<0.001). 9/13 pts with DC continued on treatment for >32 weeks. 14 pts had at least one grade 3-4 AE at least possibly related to P with the most common being low WBC/platelets. Other grade 3 AEs included increased alanine aminotransferase, anemia, and fatigue. Conclusions: Monotherapy P demonstrated anti-tumor activity in heavily pre-treated pts with STS with CDK4 amplification. Additional study is warranted to confirm the efficacy of P in pts with STS with CDK4 amplification. Clinical trial information: NCT02693535. [Table: see text]

Laboratory indicators predict axillary nodal pathologic complete response after neoadjuvant therapy in breast cancer

2021 ◽  
Author(s):  
Peng Chen ◽  
Tong Zhao ◽  
Zhao Bi ◽  
Zhao-Peng Zhang ◽  
Li Xie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Neoadjuvant Therapy ◽  
Predictive Factors ◽  
Molecular Subtype ◽  
Treatment Options ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Logistic Analysis

 The purpose was to integrate clinicopathological and laboratory indicators to predict axillary nodal pathologic complete response (apCR) after neoadjuvant therapy (NAT). The pretreatment clinicopathological and laboratory indicators of 416 clinical nodal-positive breast cancer patients who underwent surgery after NAT were analyzed from April 2015 to 2020. Predictive factors of apCR were examined by logistic analysis. A nomogram was built according to logistic analysis. Among the 416 patients, 37.3% achieved apCR. Multivariate analysis showed that age, pathological grading, molecular subtype and neutrophil-to-lymphocyte ratio were independent predictors of apCR. A nomogram was established based on these four factors. The area under the curve (AUC) was 0.758 in the training set. The validation set showed good discrimination, with AUC of 0.732. In subtype analysis, apCR was 23.8, 47.1 and 50.8% in hormone receptor-positive/HER2-, HER2+ and triple-negative subgroups, respectively. According to the results of the multivariate analysis, pathological grade and fibrinogen level were independent predictors of apCR after NAT in HER2+ patients. Except for traditional clinicopathological factors, laboratory indicators could also be identified as predictive factors of apCR after NAT. The nomogram integrating pretreatment indicators demonstrated its distinguishing capability, with a high AUC, and could help to guide individualized treatment options.

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