A controlled multicentre study comparing early treatment with polytetrafluoroethylene (PTFE) covered stents (Viator) versus optimised medical treatment in patients with cirrhosis and a high risk variceal bleeding episode

2013 ◽  
Author(s):  
Juan Carlos Garcia-Pagan
Keyword(s):  
High Risk ◽  
Multicentre Study ◽  
Medical Treatment ◽  
Variceal Bleeding ◽  
Early Treatment ◽  
Bleeding Episode ◽  
Covered Stents

scholarly journals What Is New in the Treatment of Smoldering Multiple Myeloma?

2021 ◽  
Vol 10 (3) ◽  
pp. 421
Author(s):  
Niccolo’ Bolli ◽  
Nicola Sgherza ◽  
Paola Curci ◽  
Rita Rizzi ◽  
Vanda Strafella ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Clinical Trials ◽  
High Risk ◽  
Early Treatment ◽  
Individual Case ◽  
Symptomatic Disease ◽  
Plasma Cell Neoplasm ◽  
Smoldering Multiple Myeloma ◽  
Wide Range ◽  
Critical Issues

Smoldering multiple myeloma (SMM), an asymptomatic plasma cell neoplasm, is currently diagnosed according to the updated IMWG criteria, which reflect an intermediate tumor mass between monoclonal gammopathy of undetermined significance (MGUS) and active MM. However, SMM is a heterogeneous entity and individual case may go from an “MGUS-like” behavior to “early MM” with rapid transformation into symptomatic disease. This wide range of clinical outcomes poses challenges for prognostication and management of individual patients. However, initial studies showed a benefit in terms of progression or even survival for early treatment of high-risk SMM patients. While outside of clinical trials the conventional approach to SMM generally remains that of close observation, these studies raised the question of whether early treatment should be offered in high-risk patients, prompting evaluation of several different therapeutic approaches with different goals. While delay of progression to MM with a non-toxic treatment is clearly achievable by early treatment, a convincing survival benefit still needs to be proven by independent studies. Furthermore, if SMM is to be considered less biologically complex than MM, early treatment may offer the chance of cure that is currently not within reach of any active MM treatment. In this paper, we present updated results of completed or ongoing clinical trials in SMM treatment, highlighting areas of uncertainty and critical issues that will need to be addressed in the near future before the “watch and wait” paradigm in SMM is abandoned in favor of early treatment.

scholarly journals Atrial Fibrillation as a Predictor of Mortality in High Risk COVID-19 Patients: A Multicentre Study of 171 Patients

2021 ◽  
Author(s):  
Randy J. Ip ◽  
Abbas Ali ◽  
Zulfiqar Qutrio Baloch ◽  
Abdullah Al-Abcha ◽  
Chris Jacob ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Multicentre Study

High-Risk Morphological and Physiological Coronary Disease Attributes as Outcome Markers After Medical Treatment and Revascularization

2021 ◽  
Author(s):  
Seokhun Yang ◽  
Bon-Kwon Koo ◽  
Doyeon Hwang ◽  
Jinlong Zhang ◽  
Masahiro Hoshino ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Treatment ◽  
Coronary Disease

scholarly journals Cardiovascular outcome in patients with high risk cardiovascular events in Nakornping Hospital

2021 ◽  
Vol 60 (1) ◽  
Author(s):  
K Siriwattana ◽  
◽  
K Siriaree ◽  
K Hinmali ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
High Risk ◽  
Medical Treatment ◽  
Cardiovascular Events ◽  
Atherosclerotic Disease ◽  
Disease Group ◽  
Multiple Risk Factors ◽  
Multiple Risk ◽  
Ischemic Events

Objectives Patients with atherosclerosis are at different levels of elevated risk of ischemic events depending on the specific manifestation of the disease and may have varying degrees of future risk for ischemic events. This study evaluated the incidence of composite cardiovascular outcomes of patients with high risk cardiovascular events in Nakornping Hospital. Methods This prospective observational non-interventional cohort study enrolled patients age 45 years or more who met the inclusion criteria of the Outpatient Department of Medicine, Nakornping Hospital, between January 2008 and December 2009. The follow-up period for each patient was 60 months. The composite cardiovascular outcome of cardiovascular deaths, non-fatal myocardial infarctions, non-fatal strokes and hospitalizations for heart failure was determined. Results Of the 387 patients in the Outpatient Department of Medicine of Nakornping Hospital, 103 were in the established atherosclerotic disease group and 284 were in the multiple risk factors group. The rate of overall composite cardiovascular events (cardiovascular death, non-fatal MI, non-fatal stroke, and hospitalization for heart failure) was 3.83%. The rate was higher in the established atherosclerotic disease group than in the multiple risk factors group 6.79% vs. 1.41% (HR = 14.28; 95% CI, 2.26-90.02, p = 0.005) which was driven by hospitalization for heart failure, but the established atherosclerotic disease group had a lower rate of medical treatment for diabetes than the multiple risk factors group. The rate of receipt of anti-diabetic drugs was statistically significantly lower in the established atherosclerotic disease group than in the multiple risk factors group. Conclusions Patients with established atherosclerotic disease have a higher rate of composite cardiovascular outcomes than patients with multiple risk factors, but they have a lower rate of medical treatment for diabetes.

scholarly journals Manajemen Tatalaksana Neuritis Optik Demielinasi

2020 ◽  
Vol 8 (2) ◽  
pp. 73-79
Author(s):  
Okta Della Susmitha ◽  
Muhammad Yusran
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
Literature Review ◽  
Optic Neuritis ◽  
Early Treatment ◽  
Treatment Trial ◽  
Interferon Β ◽  
Prevention Study ◽  
Optic Neuritis Treatment Trial

Pendahulan: Neuritis Optik (ON) didefinisikan sebagai inflamasi pada saraf optik, yang sebagian besar idiopatik. Namun dapat dikaitkan dengan penyebab lain seperti lesi demielinasi, gangguan autoimun, infeksi dan inflamasi. Dari semua ini, multiple sclerosis (MS) adalah penyebab paling umum dari demielinasi ON. Tujuan: Untuk mengetahui diagnosis dan tatalaksana neuritis optik demielinasi. Metode: Artikel ini dibuat dengan metode literature review, melibatkan 29 pustaka baik buku dan jurnal nasional atau internasional. Hasil: ON terjadi karena proses inflamasi yang mengarah pada aktivasi sel-T yang dapat melewati sawar darah otak dan menyebabkan reaksi hipersensitivitas terhadap struktur saraf. Mekanisme pastinya belum diketahui. Diagnosis klinis ON terdiri dari tiga gejala klasik yaitu kehilangan penglihatan, nyeri periokular dan dischromatopsia. Hal ini membutuhkan pemeriksaan oftalmik, neurologis dan sistemik yang cermat untuk membedakan antara ON spesifik dan tidak. Diagnosis banding diperlukan untuk membuat rencana tatalaksana yang tepat. Pembahasan: Menurut Optic Neuritis Treatment Trial (ONTT), pengobatan pertama adalah metilprednisolon intravena dengan pemulihan yang lebih cepat dan lebih sedikit kemungkinan kasus relaps dan konversi ke MS. Namun prednisolon oral saja dikontraindikasikan karena peningkatan risiko relaps. Controlled High-Risk Subjects Avonex® Multiple Sclerosis Prevention Study (CHAMPS) dan Early Treatment of MS study (ETOMS) dan telah melaporkan bahwa pengobatan dengan interferon β-1a, dengan hasil pengurangan risiko karakteristik MS dari MRI. Sensitivitas kontras, penglihatan warna dan bidang visual adalah parameter yang sebagian besar tetap terganggu bahkan setelah pemulihan ketajaman visual yang baik. Simpulan: Tatalaksana pada neuritis optik demielinasi dominan diberikan steroid dan interferon β-1a.   Kata kunci: demielinasi, multipel skeloris, neuritis optik, tatalaksana  

Sign in / Sign up

Export Citation Format

Share Document