scholarly journals Pediatric eosinophilic esophagitis: a review for the clinician

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Simona Barni ◽  
Stefania Arasi ◽  
Carla Mastrorilli ◽  
Luca Pecoraro ◽  
Mattia Giovannini ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Multidisciplinary Approach ◽  
Unmet Needs ◽  
Clinical Manifestations ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Therapy Option ◽  
Esophageal Dysfunction ◽  
Histological Remission

AbstractEosinophilic esophagitis (EoE) is a chronic clinical-pathologic disease characterized by eosinophilic infiltration of the esophageal epithelium with esophageal dysfunction symptoms.EoE can occur at any age and has different clinical manifestations depending on the age onset.To date, esophago-gastroduodenal endoscopy (EGD) with biopsy is the gold-standard for EoE diagnosis.According to the recent consensus guidelines, proton pump inhibitors, corticosteroids and elimination diets could be a first-line therapy option. The aim of the treatment is clinical and histological remission for preventing long-lasting untreatable fibrosis.A multidisciplinary approach (allergist, gastroenterology, dietitian, and pathologist) is recommended for managing patients affected by EoE, given the complexity of its treatment.This review will provide a practical guide to assist pediatricians treating children with EoE.Moreover, it highlights the unmet needs in diagnosis and treatment that require urgent attention from the scientific community in the aim of improving the management of patients with EoE.

scholarly journals Unique evolution of chronic lymphoproliferative disorders associated with hepatitis B virus infection and viral reactivation – a major concern with multidisciplinary approach

2015 ◽  
Vol 18 (4) ◽  
pp. 143-151
Author(s):  
Cristina Maria Ciufu ◽  
◽  
Lavinia Lipan ◽  
Minodora Onisâi ◽  
Mihaela Găman ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Multidisciplinary Approach ◽  
Lymphoproliferative Disorders ◽  
Hbv Infection ◽  
Viral Reactivation ◽  
Antiviral Prophylaxis ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
B Virus

Background. The association of hepatitis B virus (HBV) infection with chronic lymphoproliferative disorders becomes a matter of debate, with multidisciplinary approach due to possible viral reactivation after immuno-chemotherapy. Material and methods. We studied two patient groups with chronic lymphoproliferative disorders, one with HBV infection (HbsAg+ and HbsAg- HbcAb+ HBs+/-) – 43 patients and one without viral infection (104 patients). Clinical and paraclinical parameters, therapy, survival of both groups were compared; the occurrence of viral reactivation was followed. Data were statistically analyzed. Results and discussion. The HBV infection group included HbsAg+-ve patients (72%) and occult HBV infection patients. The median onset age for lymphoproliferative disorders HBV+-ve was significantly younger (55 vs. 61 years, p<0.05). Hepatomegaly and abdominal adenopathies were more frequent in HBV patients (p=0.003, respectively p=0.027). Hepatic function was altered in HBV patients both at disease onset (AST p=0.0213, GGT p=0.0002) and after first line therapy (AST p=0.0003, ALT p=0.019, FA p=0.008, GGT p=0.000, total bilirubine p=0.043, INR p=0.0003 and albumine p=0.05). The risk of hepatic dysfunction after first line therapy is increased 6 times by HBV infection (p=0.0009, OR=6.000, 95%CI: 1.9121-18.8272), which could negatively impact the hematological disease evolution by lowering therapeutic dose, leading to an inferior treatment result. Viral reactivation occurred both in HbsAg+-ve (21.42%) and HbsAg- HbcAb+-ve patients (60%). None of the occult carriers received antiviral prophylaxis. Whithin our occult carrier group, the viral reactivation percentage is high, therefore we would reccomand antiviral prophylaxis. The overall survival was similar in both group of patients. Conclusions. HBV-positive chronic lymphoproliferative disorders could become a new pathological entity, with individual clinical features and outcome and possibly with negative impact on long term survival. Antiviral prophylaxis for occult carriers could significantly reduce the viral reactivation rate and therefore the therapeutic guidelines should be revised.

First-Line Therapy Option with Low-Dose Bisoprolol Fumarate and Low-Dose Hydrochlorothiazide in Patients with Stage I and Stage II Systemic Hypertension

1995 ◽  
Vol 35 (2) ◽  
pp. 182-188 ◽  
Author(s):  
William H. Frishman ◽  
James F. Burris ◽  
William J. Mroczek ◽  
Matthew R. Weir ◽  
Demissie Alemayehu ◽  
...  
Keyword(s):  
Low Dose ◽  
Stage I ◽  
Stage Ii ◽  
Systemic Hypertension ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Therapy Option

scholarly journals Clinical and treatment patterns in neuromyelitis optica: a retrospective study from a single centre

2019 ◽  
Vol 6 (4) ◽  
pp. 1277
Author(s):  
Kamlesh A. Jagiasi ◽  
Shashank Nagendra ◽  
Afroz Ansari ◽  
Prachi Barvalia ◽  
Vikram Aglave
Keyword(s):  
Neuromyelitis Optica ◽  
Oral Therapy ◽  
Clinical Manifestations ◽  
Tertiary Hospital ◽  
Treatment Patterns ◽  
Published Data ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Oral Agents

Background: The aim of the study was to study the different presentations, treatment patterns and relapses on therapy in patients of neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD).Methods: This is a retrospective, observational study in a tertiary hospital where Demographics, clinical manifestations at onset and at follow up and relapses, serum anti Aquaporin 4 antibody status, first line immunomodulatory therapy which was initiated and Relapses on first line therapy were noted.Results: Demographics and clinical presentation was largely similar to published data. 80% patients presented with LETM/ON at onset. Ten patients relapsed on oral therapy and trend was to shift from oral therapy to RTX after relapse on oral agent. No relapses were noted on RTX.Conclusions: Unaffordability and apprehension towards injections and cost were the factors affecting IMT decision, so majority received oral agents Aza/ MMF as first line therapy while remaining patients on oral therapy remained relapse free.

1904: Outcomes of Large Renal Calculi (>2-Cm) Treated with ESWL as First Line Therapy

2004 ◽  
Vol 171 (4S) ◽  
pp. 503-503
Author(s):  
Richard Vanlangendock ◽  
Ramakrishna Venkatesh ◽  
Jamil Rehman ◽  
Chandra P. Sundaram ◽  
Jaime Landman
Keyword(s):  
Renal Calculi ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Is digoxin still justifiable as single first-line therapy in fetal SVT associated with fetal hydrops?

2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
DJ Kersten ◽  
J McDougall ◽  
C Schuller ◽  
JP Pfammatter ◽  
L Raio ◽  
...  
Keyword(s):  
First Line ◽  
Fetal Hydrops ◽  
First Line Therapy ◽  
Line Therapy

EFFICACY OF MODIFIED BISMUTH QUADRUPLE THERAPY (RBMA) AS FIRST-LINE THERAPY FOR ERADICATION OF HELICOBACTER PYLORI IN PATIENTS WITH CHRONIC GASTRITIS

2019 ◽  
pp. 28-32
Author(s):  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
High Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Quadruple Therapy ◽  
First Line Therapy ◽  
Line Therapy

Background and aims: Efficacy with substitution of tetracycline with amoxicillin, an antibiotics having a very low resistance rate and a high tolerability, in bismuth quadruple therapy (BQT) have not been studied in Vietnam. Our study aimed to evaluate the efficacy and tolerability of modified BQT vs. standard BQT for first-line Helicobacter pylori eradication. Patients and methods: This is a randomized, prospective study. 120 patients with H.pylori positive-chronic gastritis were randomly divided into two groups. The RBMA group containing rabeprazole 20 mg, bismuth subsalicylic 524mg, metronidazole 500mg, amoxicillin 1000mg, all 2 times a day, for 14 days. The RBMT group received rabeprazole, bismuth subsalicylic, metronidazole and tetracycline. Evaluation for compliance and drug-related side effects were evaluated at the end of two weeks. 4-6 weeks after the end of treatment, the H.pylori eradication rate was determined by the C13urease breath test. Results: Eradication rate was not statistically significative different between the RBMA and the RBMT: 91.2%; 95% confidence interval, 78.2% - 96.7%) vs. 90%; 95% CI, 81.6% - 96.3%) by per-protocol analysis (p = 0.42) and 86.7% (95%CI, 75.84% - 93.09%) vs. 75% (95%CI, 62.1% - 85.3%) by intention-to-treat analysis (ITT, p = 0.06). Adverse effects were significant higher in the RBMT group than in the RBMA group (48.3% vs. 26.7%; p = 0.071) and rate of good compliance was significantly higher in RBMA group than in RBMT group (p < 0.05). Conclusion: The modified BQT including rabeprazole, bismuth, metronidazole and amoxicillin achieved a fairly high rate of H.pylori infection eradication with a higher compliance and lower rate of adverse effects compared to the BQT in patients with chronic gastritis. Further studies need to conduct to confirm this new regimens as a first-line therapy in our country. Key words: Modified bismuth quadruple therapy, BQT, Helicobacter pylori eradication

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