scholarly journals Low-dose subcutaneous immunoglobulin is an effective treatment for autoimmune bullous skin disorders: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X1990107 ◽  
Author(s):  
Erin Streu ◽  
Marni C Wiseman ◽  
James B Johnston
Keyword(s):  
Low Dose ◽  
Treatment Approach ◽  
Subcutaneous Tissue ◽  
Hospital Setting ◽  
Case Series ◽  
Novel Treatment ◽  
Autoimmune Bullous Diseases ◽  
Serum Trough ◽  
Bullous Diseases ◽  
High Doses

Intravenous immunoglobulin is a recognized treatment in recalcitrant autoimmune bullous diseases. Infusions are administered monthly over 1–5 days in the hospital setting and associated with mild to severe infusion-related systemic effects, in part due to the high doses necessary to induce and achieve remission. We present a case series of four patients with bullous diseases treated successfully with low-dose subcutaneous IgG who achieved remission with maintenance therapy. Patient-administered smaller, more frequent doses of IgG into subcutaneous tissue more closely mimics the body’s own antibody production and produces a more stable serum trough level. Subcutaneous IgG is a novel treatment approach in bullous diseases which can induce a state remission.

scholarly journals Case Report: Use of Liposomal Amphotericin B in Low Doses in Patients With Visceral Leishmaniasis

2021 ◽  
Vol 8 ◽  
Author(s):  
Danfeng Ren ◽  
Wenya Cao ◽  
Xiaojing Liu ◽  
Qunying Han ◽  
Wanhu Fan ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Liposomal Amphotericin ◽  
Low Dose ◽  
Hemophagocytic Syndrome ◽  
Treatment Protocol ◽  
Case Series ◽  
Low Doses ◽  
Case Presentation ◽  
Novel Treatment

Background: No consensus has been reached regarding the optimal therapy for visceral leishmaniasis (VL), which affects ~12 million people worldwide.Case Presentation: This report described four cases of VL encountered in the First Affiliated Hospital of Xi'an Jiaotong University between October 2019 and December 2020. Of the four patients, one patient experienced relapse after antimonial treatment, and the remaining patients had primary VL (including one patient with impaired kidney function and one patient with hemophagocytic syndrome). All patients received a novel treatment protocol, namely the low-dose L-AmB therapy, which was characterized by a low initial dose, cautious dose escalation, and low-dose therapy as maintenance. All patients were cured without severe complications, and there was no further recurrence during follow-up.Conclusions: This case series demonstrated the safety and efficacy of the low-dose L-AmB therapy for VL patients, providing novel treatment protocol for the VL.

scholarly journals Exploring the preliminary effectiveness and acceptability of food-based exposure therapy for eating disorders: A case series of adult inpatients

2019 ◽  
Vol 10 (1) ◽  
pp. 204380871882488 ◽  
Author(s):  
Nicholas R. Farrell ◽  
Owen R. Bowie ◽  
Maxine M. Cimperman ◽  
Brad E. R. Smith ◽  
Bradley C. Riemann ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Weight Control ◽  
Exposure Therapy ◽  
Treatment Approach ◽  
Hospital Setting ◽  
Case Series ◽  
Treatment Participation ◽  
Weight Control Behaviors ◽  
Inpatient Settings ◽  
Therapy Intervention

Although exposure therapy is effective in reducing eating-related fears and avoidance in individuals with eating disorders (EDs), there has been little study of this treatment in inpatient settings. To address this gap, we conducted a case series to evaluate the effects of a food-based exposure therapy intervention on eating-related fears and avoidant behaviors among adults being treated for an ED in an inpatient hospital setting. Patients ( N = 106) were provided psychoeducation on the treatment approach, aided in the development of an exposure hierarchy containing fear-evoking stimuli related to eating (e.g., feared foods), and guided in completing exposure exercises and gradually progressing through the hierarchy. Results showed that patients experienced significant reductions in eating-related fears and avoidant behaviors from pretreatment to posttreatment. Acceptability of the intervention was reasonably well-established by (a) acceptable rates of treatment participation and completion, (b) favorable ratings of the intervention provided in a posttreatment satisfaction survey, and (c) the absence of any exacerbations in the frequency of compensatory weight control behaviors (e.g., self-induced vomiting) over the course of treatment. Clinical implications of these findings are discussed in the light of clinicians’ concerns about and underutilization of food-based exposure therapy for EDs, particularly in inpatient settings.

scholarly journals Myopia Control with Combination Low-Dose Atropine and Peripheral Defocus Soft Contact Lenses: A Case Series

2021 ◽  
pp. 548-554
Author(s):  
Nir Erdinest ◽  
Naomi London ◽  
Nadav Levinger ◽  
Yair Morad
Keyword(s):  
Low Dose ◽  
Contact Lenses ◽  
Case Series ◽  
Concentric Circle ◽  
Retrospective Case ◽  
Soft Contact ◽  
Myopia Progression ◽  
Soft Contact Lenses ◽  
Center Distance ◽  
Myopia Control

The goal of this retrospective case series is to demonstrate the effectivity of combination low-dose atropine therapy with peripheral defocus, double concentric circle design with a center distance soft contact lenses at controlling myopia progression over 1 year of treatment. Included in this series are 3 female children aged 8–10 years with progressing myopia averaging −4.37 ± 0.88 D at the beginning of treatment. Their average annual myopic progression during the 3 years prior to therapy was 1.12 ± 0.75 D. They had not attempted any myopia control treatments prior to this therapy. The children were treated with a combination of 0.01% atropine therapy with spherical peripheral defocus daily replacement soft lenses MiSight<sup>®</sup> 1 day (Cooper Vision, Phoenix, AZ, USA). They underwent cycloplegic refraction, and a slit-lamp evaluation every 6 months which confirmed no adverse reactions or staining was present. Each of the 3 children exhibited an average of 0.25 ± 0.25 D of myopia progression at the end of 1 year of treatment. To the best of the authors’ knowledge, this is the first published study exhibiting that combining low-dose atropine and peripheral defocus soft contact lenses is effective at controlling children’s moderate to severe myopia progression during 1 year of therapy.

Living With Both a Total Ankle Replacement and an Ankle Fusion: A Qualitative Study From the Patients’ Perspective

2021 ◽  
pp. 107110072110044
Author(s):  
Catherine Conlin ◽  
Ryan M. Khan ◽  
Ian Wilson ◽  
Timothy R. Daniels ◽  
Mansur Halai ◽  
...  
Keyword(s):  
Hospital Setting ◽  
Case Series ◽  
Total Ankle Replacement ◽  
Qualitative Description ◽  
Level Of Evidence ◽  
Foot Placement ◽  
Advantages And Disadvantages ◽  
Ankle Fusion ◽  
Ankle Replacement ◽  
Patient Reported

Background: Total ankle replacement (TAR) and ankle fusion are effective treatments for end-stage ankle arthritis. Comparative studies elucidate differences in treatment outcomes; however, the literature lacks evidence demonstrating what outcomes are important to patients. The purpose of this study was to investigate patients’ experiences of living with both a TAR and ankle fusion. Methods: This research study used qualitative description. Individuals were selected from a cohort of patients with TAR and/or ankle fusion (n = 1254). Eligible patients were English speaking with a TAR and contralateral ankle fusion, and a minimum of 1 year since their most recent ankle reconstruction. Surgeries were performed by a single experienced surgeon, and semistructured interviews were conducted by a single researcher in a private hospital setting or by telephone. Ankle Osteoarthritis Scale (AOS) scores, radiographs, and ancillary surgical procedures were collected to characterize patients. Themes were derived through qualitative data analysis. Results: Ten adults (8 men, 2 women), ages 59 to 90 years, were included. Average AOS pain and disability scores were similar for both surgeries for most patients. Participants discussed perceptions of each reconstructed ankle. Ankle fusions were considered stable and strong, but also stiff and compromising balance. TARs were considered flexible and more like a “normal ankle,” though patients expressed concerns about their TAR “turning” on uneven ground. Individuals applied this knowledge to facilitate movement, particularly during a first step and transitioning between positions. They described the need for careful foot placement and attention to the environment to avoid potential challenges. Conclusion: This study provides insight into the experiences of individuals living with a TAR and ankle fusion. In this unusual but limited group of patients, we found that each ankle reconstruction was generally perceived to have different characteristics, advantages, and disadvantages. Most participants articulated a preference for their TAR. These findings can help clinicians better counsel patients on expectations after TAR and ankle fusion, and improve patient-reported outcome measures by better capturing meaningful outcomes for patients. Level of Evidence: Level IV, case series.

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