scholarly journals Hipopara-Red, Real Life Experience in 322 Patients With Hypoparathyroidism

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
María Belén Zanchetta ◽  
Damián Robbiani ◽  
Beatriz Oliveri ◽  
Evangelina Giacoia ◽  
Adriana Frigeri ◽  
...  

Abstract Context Hypoparathyroidism is a rare disease and, as such, its natural history, long-term complications, and correct clinical management remain unclear. Objective To describe the natural history and clinical characteristics of the disease. Design and Setting To present a retrospective observational analysis from 7 specialized centers in Buenos Aires, Argentina. Patients Chronic hypoparathyroid patients followed-up between 1985 and December 2018. Main Outcome Measures Data on demographics, etiology, clinical complications, biochemical parameters, dual-energy x-ray absorptiometry (DXA) values, and treatment doses were collected. Results A total of 322 subjects with chronic hypoparathyroidism were included; 85.7% were female, the mean age was 55.2 ± 16.8 years, and the mean age at diagnosis was 43.8 ± 16.8 years. Prevalence of surgical hypoparathyroidism was 90.7%, with the most common causes being thyroid carcinoma and benign thyroid disease. A history of hypocalcemia requiring hospitalization was present in 25.7% of the whole group and in 4.3% of patients who had a history of seizures. Overall, 40.9% of our patients had reported at least 1 neuromuscular symptom. Renal insufficiency was present in 22.4% of our patients and was significantly associated with age (P < 0.0001). Hyperphosphatemia was present in 42% of patients. A history of severe hypocalcemia, paresthesias, tetany, ganglia calcifications, seizures, and cataracts was significantly higher in nonsurgical patients. Conclusion Although these patients were followed-up by experienced physicians, clinical management was heterogeneous and probably insufficient to assess all the potential complications of this chronic disease. Almost 70% of the study’s group of patients met the experts’ indications for considering the use of rhPTH 1–84. Being aware of this fact is the 1st step in improving our medical management of this disease in the future.

2018 ◽  
Vol 89 (10) ◽  
pp. A7.2-A7
Author(s):  
Hughes Rhiannon ◽  
Maguire Melissa ◽  
Geldard Jo ◽  
Reuber Markus

BackgroundBrivaracetam received its UK licence as an adjuvant drug for focal epilepsy in adults in 2016. There is little data on its efficacy and tolerability in ‘real life’ settings. We present an interim analysis of a multicentre service evaluation of brivaracetam.MethodsData was retrospectively collected from clinical records at two UK centres of consecutive patients treated with brivaracetam and at least one follow up. Data were also extracted on previous levetiracetam use. Seizure frequency was categorised at baseline and follow-up (daily/weekly/monthly/yearly/none).Results: Of the 44 patients identified (17 male, mean age 39, range 19–66), 75% had a history of levetiracetam exposure (LE+) and 25% did not (LE−). Mean brivaracetam exposure was 10.3 months (2–21), the mean daily dose was 200 mg (50–400). Retention was 91% vs 100% in LE+ versus LE− groups at 3 months and 82% in both groups at 6 months. Seizure category improvements were seen in 20%/36.4% in the LE+ vs LE− groups, seizure category deteriorations in 0% vs 9%. There were no serious adverse events.ConclusionBrivaracetam emerges as a potentially useful adjuvant medication for focal epilepsy. It may be better tolerated by some patients than Levetiracetam and more effective than this drug.


Author(s):  
J. Terrence Jose Jerome

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.


2019 ◽  
Author(s):  
Ayesha Shaikh ◽  
Natasha Shrikrishnapalasuriyar ◽  
Giselle Sharaf ◽  
David Price ◽  
Maneesh Udiawar ◽  
...  

Ophthalmology ◽  
2016 ◽  
Vol 123 (2) ◽  
pp. 425-433 ◽  
Author(s):  
Jeffrey P. Lienert ◽  
Laura Tarko ◽  
Miki Uchino ◽  
William G. Christen ◽  
Debra A. Schaumberg

1977 ◽  
Vol 23 (6) ◽  
pp. 550-554 ◽  
Author(s):  
William S. Stoney ◽  
Frederick E. Finger ◽  
William C. Alford ◽  
George R. Burrus ◽  
Robert A. Frist ◽  
...  

2015 ◽  
Vol 93 (8) ◽  
pp. 641-648 ◽  
Author(s):  
Azza Ramadan ◽  
Mark D. Wheatcroft ◽  
Adrian Quan ◽  
Krishna K. Singh ◽  
Fina Lovren ◽  
...  

Autophagy regulates cellular homeostasis and integrates the cellular pro-survival machinery. We investigated the role of autophagy in the natural history of murine abdominal aortic aneurysms (AAA). ApoE−/− mice were implanted with saline- or angiotensin II (Ang-II)-filled miniosmotic pumps then treated with either the autophagy inhibitor chloroquine (CQ; 50 mg·(kg body mass)–1·day–1, by intraperitoneal injection) or saline. Ang-II-elicited aneurysmal expansion of the suprarenal aorta coupled with thrombus formation were apparent 8 weeks later. CQ had no impact on the incidence (50% for Ang-II compared with 46.2% for Ang-II + CQ; P = NS) and categorical distribution of aneurysms. The markedly reduced survival rate observed with Ang-II (57.1% for Ang-II compared with 100% for saline; P < 0.05) was unaffected by CQ (61.5% for Ang-II + CQ; P = NS compared with Ang-II). CQ did not affect the mean maximum suprarenal aortic diameter (1.91 ± 0.19 mm for Ang-II compared with 1.97 ± 0.21 mm for Ang-II + CQ; P = NS). Elastin fragmentation, collagen accumulation, and smooth muscle attrition, which were higher in Ang-II-treated mice, were unaffected by CQ treatment. Long-term CQ administration does not affect the natural history and prognosis of experimental AAA, suggesting that global loss of autophagy is unlikely to be a causal factor in the development of aortic aneurysms. Manipulation of autophagy as a mechanism to reduce AAA may need re-evaluation.


2014 ◽  
Vol 113 (3) ◽  
pp. 171-176 ◽  
Author(s):  
Anne Roscher ◽  
Jaina Patel ◽  
Stacy Hewson ◽  
Laura Nagy ◽  
Annette Feigenbaum ◽  
...  

2021 ◽  
Vol 93 (6) ◽  
pp. AB350
Author(s):  
Achintya D. Singh ◽  
Amit Bhatt ◽  
Abel Joseph ◽  
Neal Mehta ◽  
Gautam N. Mankaney ◽  
...  

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