scholarly journals Repository corticotropin injection in patients with advanced symptomatic sarcoidosis: retrospective analysis of medical records

2019 ◽  
Vol 13 ◽  
pp. 175346661988812 ◽  
Author(s):  
Ishveen Chopra ◽  
Yimin Qin ◽  
John Kranyak ◽  
Jack R. Gallagher ◽  
Kylee Heap ◽  
...  
Keyword(s):  
Case Series ◽  
Patient Characteristics ◽  
Starting Dose ◽  
Daily Dose ◽  
Individualized Approach ◽  
Utilization Patterns ◽  
Large Case Series ◽  
The Mean ◽  
Large Case ◽  
Viable Treatment

Background: Repository corticotropin injection (RCI) has regulatory approval for many indications, including symptomatic sarcoidosis. This large case series of patients with advanced symptomatic sarcoidosis treated with RCI describes patient characteristics, RCI utilization patterns, concomitant therapies, and physicians’ assessments of treatment response. Methods: Patients ⩾18 years with symptomatic sarcoidosis, treated with RCI in the previous 36 months, who had completed a course of RCI or received RCI for ⩾6 months at the time of data collection were included. Results: The study included 302 patients (mean age, 51 years; 52%, women) with a mean 4.8 years since initial diagnosis of sarcoidosis. Most patients (76%) had extrapulmonary involvement, primarily in the skin (28%), joints (25%), heart (22%), and eyes (22%); 34% had multiple (⩾2) organ involvement. The mean duration of RCI treatment was 32.5 weeks, with 61.6% of patients continuing RCI therapy for ⩾6 months. The RCI utilization pattern indicated an individualized approach to therapy, with a higher starting dose associated with a shorter duration of therapy compared with a lower starting dose. The percentage of patients who used corticosteroids decreased from 61.3% during the 3 months before initiation of RCI to 12.9% 3 months after RCI therapy; the mean daily dose of corticosteroid decreased from 18.2 mg to 9.9 mg. The proportion of patients given <10 mg/day of prednisone increased from 21% before RCI use to 47% 3 months after RCI use. According to physicians’ assessments of change in patients’ health status after RCI therapy, overall status improved in 95% of patients, overall symptoms in 73%, lung function in 38%, and inflammation in 33%. Conclusions: The findings suggest that RCI is a viable treatment option for patients with advanced symptomatic sarcoidosis and provide insights on patient characteristics and practice patterns to help clinicians determine appropriate use. The reviews of this paper are available via the supplemental material section.

Aspetti positivi e limiti della telemedicina: esperienze di lavoro in Neuropsichiatria infantile in tempo di Covid-19

2021 ◽  
Vol 40 (9) ◽  
pp. 583-586
Author(s):  
Alessandro Albizzati ◽  
Cristina Riva Crugnola ◽  
Margherita Moioli ◽  
Elena Ierardi
Keyword(s):  
Airway Management ◽  
General Anaesthesia ◽  
Case Series ◽  
Patient Characteristics ◽  
Pulmonary Aspiration ◽  
Procedural Sedation ◽  
Main Concern ◽  
Large Case Series ◽  
Fasting Duration ◽  
Large Case

Fasting before procedural sedation is a hot topic in everyday medical life with the main concern regarding pulmonary aspiration. Fasting guidelines before procedural sedation have always been the same as those used for general anaesthesia. However, procedural sedation and general anaesthesia differ in terms of invasiveness, drugs, duration and patient characteristics. This results in lower risk of pulmonary aspiration during procedural sedation, when compared to general anaesthesia. Moreover, a large case series of sedations performed in the emergency department with no respect for the proper fasting times showed no association between fasting duration and any type of adverse event with the latter occurring also in patients that properly fasted. The type of procedure (with the need of airway management) and characteristics of the patient seem to matter more. Furthermore, prolonged fasting is uncomfortable and has been associated with hypoglycaemia and dehydration. For this reason, fasting guidelines before procedural sedation should be adapted on the presence of risk factors, such as ASA score, need for airway management, comorbidities, type of procedure and drug used.

Midterm results of radiocapitellar arthroplasty of the elbow

2019 ◽  
Vol 101-B (11) ◽  
pp. 1362-1369 ◽  
Author(s):  
Giuseppe Giannicola ◽  
Piergiorgio Calella ◽  
Prospero Bigazzi ◽  
Alberto Mantovani ◽  
Paolo Spinello ◽  
...  
Keyword(s):  
Radial Head ◽  
Case Series ◽  
Dash Score ◽  
Mayo Elbow Performance Score ◽  
Elbow Function ◽  
Large Case Series ◽  
Post Traumatic ◽  
The Mean ◽  
Large Case

Aims The aim of this study was to analyze the results of two radiocapitellar prostheses in a large case series followed prospectively, with medium-term follow-up. Patients and Methods A total of 31 patients with a mean age of 54 years (27 to 73) were analyzed; nine had primary osteoarthritis (OA) and 17 had post-traumatic OA, three had capitellar osteonecrosis, and two had a fracture. Overall, 17 Lateral Resurfacing Elbow (LRE) and 14 Uni-Elbow Radio-Capitellum Implant (UNI-E) arthroplasties were performed. Pre- and postoperative assessment involved the Mayo Elbow Performance Score (MEPS), the Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score, and the modified American Shoulder Elbow Surgeons (m-ASES) score. Results The mean follow-up was 6.8 years (3.8 to 11.5). The mean MEPS, m-ASES, and Q-DASH scores improved significantly by 50 (p < 0.001), 55 (p < 0.001), and 54 points (p < 0.001), respectively, with no differences being detected between the implants. Preoperative pronation and supination were worse in patients in whom the UNI-E was used. Two patients with the UNI-E implant had asymptomatic evidence of gross loosening. Conclusion Radiocapitellar arthroplasty yielded a significant improvement in elbow function at a mean follow-up of 6.8 years, with a high implant survival rate when the LRE was used in patients with primary or post-traumatic OA, without radial head deformity, and when the UNI-E was used in patients in whom radial head excision was indicated. Cite this article: Bone Joint J 2019;101-B:1362–1369

Il digiuno del bambino prima di una sedazione procedurale

2021 ◽  
Vol 40 (9) ◽  
pp. 576-582
Author(s):  
Arturo Penco ◽  
Francesca Peri ◽  
Federico Poropat ◽  
Ester Conversano ◽  
Egidio Barbi ◽  
...  
Keyword(s):  
Airway Management ◽  
General Anaesthesia ◽  
Case Series ◽  
Patient Characteristics ◽  
Pulmonary Aspiration ◽  
Procedural Sedation ◽  
Main Concern ◽  
Large Case Series ◽  
Fasting Duration ◽  
Large Case

Fasting before procedural sedation is a hot topic in everyday medical life with the main concern regarding pulmonary aspiration. Fasting guidelines before procedural sedation have always been the same as those used for general anaesthesia. However, procedural sedation and general anaesthesia differ in terms of invasiveness, drugs, duration and patient characteristics. This results in lower risk of pulmonary aspiration during procedural sedation, when compared to general anaesthesia. Moreover, a large case series of sedations performed in the emergency department with no respect for the proper fasting times showed no association between fasting duration and any type of adverse event with the latter occurring also in patients that properly fasted. The type of procedure (with the need of airway management) and characteristics of the patient seem to matter more. Furthermore, prolonged fasting is uncomfortable and has been associated with hypoglycaemia and dehydration. For this reason, fasting guidelines before procedural sedation should be adapted on the presence of risk factors, such as ASA score, need for airway management, comorbidities, type of procedure and drug used.

scholarly journals Various Application of Corneal Tattooing

2018 ◽  
Author(s):  
Jinho Jeong ◽  
Jonathan D Fay ◽  
Jimmy K Lee ◽  
Roy S Chuck ◽  
Ji-won Kwon
Keyword(s):  
Case Series ◽  
Corneal Opacity ◽  
Phthisis Bulbi ◽  
Common Causes ◽  
Corneal Opacities ◽  
Large Case Series ◽  
Cosmetic Outcomes ◽  
The Mean ◽  
Large Case

Abstract Background: To evaluate the efficacy of corneal tattooing in a large case series. Methods: The medical charts of 62 eyes of 62 patients who underwent corneal tattooing between March 2016 and August 2017 were retrospectively reviewed. The causes of opacity and various methods of corneal tattooing applied were analyzed. Results: Among our 62 patients, 38 were male and 24 female. Average age was 48.47±15.30 (range, 12-74)years old. The mean follow-up period was 23.19 ±2.34 (range, 19-27) months. The most common causes of corneal opacity were ocular trauma (33 eyes, 53.2%), prior retinal surgery (9 eyes, 14.5%), congenital etiologies (8 eyes, 12.9%) and measles (5 eyes, 8.0%). The most common associated ocular findings were strabismus (23eyes, 37.0%), phthisis bulbi (17 eyes, 27.4%) and band keratopathy (13 eyes, 20.9%). Cosmetic outcomes improved without serious complications in all cases. Conclusions: Corneal tattooing is a viable option with an expanding set of indications, such as discolored corneal tattoos, white pupil due to inoperable cataract with clear cornea, and dense corneal opacities in blind eyes. Elective corneal tattooing seems to be a viable and convenient method to improve cosmesis with minimal complications and high patient satisfaction.

UTILITY OF NEWLY DEVELOPED SHORT TYPE DOUBLE BALLOON ENDOSCOPY FOR ERCP IN POSTOPERATIVE PATIENTS WITH SURGICAL ANATOMIC VARIATIONS: A LARGE CASE SERIES

2019 ◽  
Author(s):  
M Shimatani ◽  
T Mitsuyama ◽  
M Tokuhara ◽  
M Masuda ◽  
T Ito ◽  
...  
Keyword(s):  
Case Series ◽  
Anatomic Variations ◽  
Double Balloon Endoscopy ◽  
Double Balloon ◽  
Large Case Series ◽  
Large Case ◽  
Short Type

SARS-CoV-2 Viral Dynamic Shedding, Seroconversion, and Diseases Severity Among 3192 Patients Hospitalized with COVID-19: A Large Case Series Study in Wuhan

2020 ◽  
Author(s):  
Yu Fu ◽  
Yongsheng Li ◽  
Ensong Guo ◽  
Liang He ◽  
Jia Liu ◽  
...  
Keyword(s):  
Case Series ◽  
Viral Dynamic ◽  
Case Series Study ◽  
Large Case Series ◽  
Series Study ◽  
Large Case

Myelopathy Due to CAR-T Related Neurotoxicity Treated with Siltuximab

2021 ◽  
pp. 10.1212/CPJ.0000000000001078
Author(s):  
Yasmin Aghajan ◽  
Alison Yu ◽  
Caron A. Jacobson ◽  
Austin I. Kim ◽  
Leslie Kean ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cell Therapy ◽  
Chimeric Antigen Receptor ◽  
Hematologic Malignancy ◽  
Case Series ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Car T ◽  
Large Case Series ◽  
Large Case

Chimeric antigen receptor T (CART) cell therapy is highly effective for relapsed/refractory hematologic malignancy [1,2]; however, cytokine release syndrome (CRS) and neurotoxicity are observed in up to 77% of patients [3]. In large case series, the most common presentations of neurotoxicity were encephalopathy (57%), headache (42%), tremor (38%) and aphasia (35%). CART mediated spinal cord toxicity is not well characterized. Structural neurologic damage (stroke and intracranial hemorrhage) was only observed in 1-2% and seizures were seen in 1%-8% of cases [3, 4]. Neuroimaging findings in patients with neurotoxicity are rare and not specific.

scholarly journals Donor Screening for Fecal Microbiota Transplantation

2020 ◽  
Vol 95 (3) ◽  
pp. 181-187
Author(s):  
Han Hee Lee ◽  
Young-Seok Cho
Keyword(s):  
Randomized Clinical Trials ◽  
Fecal Microbiota Transplantation ◽  
Case Series ◽  
Fecal Microbiota ◽  
Resistant Bacteria ◽  
Screening Process ◽  
Antibiotic Resistant ◽  
Donor Screening ◽  
Large Case Series ◽  
Large Case

Fecal microbiota transplantation (FMT), which has been established as the standard treatment for recurrent <i>Clostroides</i> difficile infection, may also play a role in the management of other diseases associated with dysbiosis of the gut microbiota. To ensure efficacy and safety of FMT, an appropriate donor screening process is required. The main purpose of donor screening is to check for infectious diseases that could be transmitted to the recipient. The screening process involves a medical history questionnaire, and blood and stool testing. Several randomized clinical trials and large case series on FMT reported no, or few, adverse events related to infection by following this donor screening process. However, there is still concern over the transmission of antibiotic-resistant bacteria. In addition, a low donor acceptance rate due to rigorous screening makes donor recruitment difficult, and also imposes a significant cost burden. A consensus on the most crucial elements of donor screening is needed for wide application of FMT.

A Large Case-series of Successful Treatment of Patients Exposed to Mold and Mycotoxin

2018 ◽  
Vol 40 (6) ◽  
pp. 889-893 ◽  
Author(s):  
William J. Rea
Keyword(s):  
Successful Treatment ◽  
Case Series ◽  
Large Case Series ◽  
Large Case
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