Long-term Successful Control of Feline Malignant Insulinoma Solely by Oral Prednisolone Administration

✓ The role of radiosurgery in the treatment of patients with advanced-stage metastatic disease is currently under debate. Previous randomized studies have not consistently supported the use of radiosurgery to treat patients with numbers of brain metastases. In negative-results studies, however, intracranial tumor control was high but extracranial disease progressed; thus, patient survival was not greatly affected, although neurocognitive function was generally maintained until death. Because the future promises improved systemic (extracranial) therapy, the successful control of brain disease is that much more crucial. Thus, for selected patients with multiple metastases to the brain who remain in good neurological condition, aggressive lesion-targeting radiosurgery should be very useful. Although a major limitation to success of this therapy is the lack of control of extracranial disease in most patients, it is clear that well-designed, aggressive treatment substantially decreases the progression of brain metastases and also improves neurocognitive survival. The authors present the management and a methodology for rational treatment of a patient with breast cancer who has harbored 24 brain metastases during a 3-year period.

Download Full-text

Comparison of Oral Prednisolone, Budesonide and Probiotics in the Treatment of Canine Inflammatory Bowel Disease

Indian Journal of Animal Research ◽

10.18805/ijar.b-4424 ◽

2021 ◽

Author(s):

M. Sandhya Bhavani ◽

S. Kavitha ◽

B. Gowri ◽

Abid Ali Bhat

Keyword(s):

Inflammatory Bowel Disease ◽

Side Effects ◽

Bowel Disease ◽

Activity Index ◽

Disease Activity Index ◽

Oral Prednisolone ◽

Published Data ◽

Inflammatory Bowel ◽

Faecal Score

Background: Inflammatory bowel disease (IBD) is the common cause of chronic gastrointestinal signs in dogs. The treatment possesses numerous difficulties due to the idiopathic nature of the disease. Conventional steroid therapy usually produces side effects on long term usage. Thus, there is a need for alternative therapies. When compared to human medicine, there is no published data on the use of budesonide and probiotic in the treatment of canine IBD in India. The present study was proposed to compare oral prednisolone, budesonide and probiotics in the management of canine inflammatory bowel disease. Methods: Thirty dogs with idiopathic IBD were selected and randomly grouped. They were subjected to therapy involving prednisolone, budesonide or probiotics. Clinical assessment was performed by calculation of the post treatment Clinical Inflammatory Bowel Disease Activity Index (CIBDAI) score, faecal score and endoscopy. Biochemical analysis of alkaline phosphatase and alanine transaminase were done to record side effects of steroid administration. Result: It was observed from the present study that both prednisolone and budesonide are equally effective in the management of IBD in dogs. Probiotics were found to be less effective when compared to prednisolone and budesonide in the treatment of IBD.

Download Full-text

Long-Term Control of Macular Edema With Adalimumab After Cataract Surgery in a Japanese Child With Juvenile Idiopathic Arthritis: Case Report and Review of 26 Japanese Patients

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620953283 ◽

2020 ◽

Vol 8 ◽

pp. 232470962095328

Author(s):

Toshihiko Matsuo ◽

Masato Yashiro

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Case Report ◽

Cataract Surgery ◽

Macular Edema ◽

Japanese Literature ◽

Oral Prednisolone ◽

Japanese Patients ◽

Final Visit ◽

Oral Methotrexate

Juvenile idiopathic arthritis–associated uveitis is rare in the Japanese population. In this article, we report a child whose macular edema was controlled for years after cataract surgery with adalimumab, and reviewed 26 Japanese patients in the literature. In this case report, a 4-year-old boy developed band keratopathy, posterior iris synechiae, and complicated cataract in both eyes. Oral prednisolone prescribed at another hospital was discontinued due to high intraocular pressure in both eyes as a steroid responder. At the age of 5 years, he started oral methotrexate 8 mg weekly for recurrent bilateral iridocyclitis and then underwent lensectomy with core vitrectomy in both eyes. Planned intraocular lens implantation was cancelled at surgery because the anterior vitreous had severe inflammatory opacity with diffuse retinal edema in both eyes. Due to persistent macular edema in both eyes 5 months postoperatively, at the age of 6 years, he began to use adalimumab injection 20 mg every 2 weeks. The macular structure depicted by optical coherence tomography became normal in 2 months. At final visit at the age of 11 years, he had the best-corrected visual acuity of 0.8 in the right eye and 0.4 in the left eye, with adalimumab 40 mg every 2 weeks and methotrexate 8 mg weekly. In conclusion, macular edema persistent despite oral methotrexate after cataract surgery could be controlled for long term by adalimumab in a child with juvenile idiopathic arthritis. In the Japanese literature, only 26 additional cases with juvenile idiopathic arthritis–associated uveitis have been reported so far.

Download Full-text

Long-term direct oral anticoagulation in primary osteonecrosis with elevated plasminogen activation inhibitor

SAGE Open Medical Case Reports ◽

10.1177/2050313x19827747 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1982774 ◽

Cited By ~ 1

Author(s):

Maria Monica Haydock ◽

Shahed Elhamdani ◽

Mohamed Alsharedi

Keyword(s):

Oral Anticoagulation ◽

Pathological Condition ◽

Anticoagulation Therapy ◽

Inherited Thrombophilia ◽

Traumatic Injuries ◽

Direct Injury ◽

Successful Control ◽

Mechanisms Of Development ◽

Bone Vasculature

Osteonecrosis is a pathological condition that could lead to a debilitating physical disease and impede daily activities. It is generally categorised into aetiology – primary (idiopathic) or secondary. When direct damage to the bone vasculature or direct injury of the bone marrow is related to an identifiable cause such as traumatic injuries, steroid or bisphosphonate use, increased alcohol intake, sickle cell disease, autoimmune diseases, chemotherapy or malignancy, it is categorised as secondary osteonecrosis. On the other hand, osteonecrosis wherein the mechanisms of development are not fully understood is categorised as primary or idiopathic osteonecrosis. This category includes inherited thrombophilia and hypofibrinolysis as potential causes. There are no clear guidelines or general agreements about anticoagulation treatment and duration in primary osteonecrosis due to thrombophilia or hypofibrinolysis. We report a case of primary osteonecrosis associated with hypofibrinolysis and successful control with lifelong direct oral anticoagulation therapy.

Download Full-text

Successful control of Scedosporium prolificans septic arthritis and probable osteomyelitis without radical surgery in a long-term renal transplant recipient

Transplant Infectious Disease ◽

10.1111/j.1399-3062.2007.00240.x ◽

2008 ◽

Vol 10 (1) ◽

pp. 63-65 ◽

Cited By ~ 37

Author(s):

J.Y.Z. Li ◽

T.Y. Yong ◽

D.I. Grove ◽

P.T.H. Coates

Keyword(s):

Renal Transplant ◽

Transplant Recipient ◽

Septic Arthritis ◽

Renal Transplant Recipient ◽

Radical Surgery ◽

Scedosporium Prolificans ◽

Successful Control

Download Full-text

Diffuse Alveolar Haemorrhage in Childhood Systemic Lupus Erythematous With Good Response to Oral Steroid Therapy

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v39i1.23145 ◽

2019 ◽

Vol 39 (1) ◽

pp. 56-59

Author(s):

Pushpa Gurudas Kini ◽

Karen Moras ◽

Sandeep Kumar ◽

Deepti Shetty

Keyword(s):

Lupus Erythematosus ◽

Oral Prednisolone ◽

Oral Steroid ◽

Alveolar Haemorrhage ◽

Systemic Lupus ◽

Long Term Follow Up ◽

Life Threatening ◽

Oral Steroid Therapy

Diffuse alveolar hemorrhage (DAH) is a relatively rare and life threatening complication of systemic lupus erythematosus (SLE) in childhood. We report two distinct cases of SLE presenting with DAH as the sole manifestation of the disease during long term follow up. Both were successfully treated with oral prednisolone.

Download Full-text

LONG-TERM EFFECT OF 177LU-DOTATATE ON SEVERE AND REFRACTORY HYPOGLYCEMIA ASSOCIATED WITH MALIGNANT INSULINOMA

AACE Clinical Case Reports ◽

10.4158/accr-2019-0086 ◽

2019 ◽

Vol 5 (6) ◽

pp. e330-e333 ◽

Cited By ~ 2

Author(s):

Pedro Iglesias ◽

Alberto Martínez ◽

Pablo Gajate ◽

Teresa Alonso ◽

Teresa Navarro ◽

...

Keyword(s):

Severe Hypoglycemia ◽

Somatostatin Analogues ◽

Term Effect ◽

Symptomatic Therapy ◽

Malignant Insulinoma ◽

Long Term Effect ◽

Life Threatening ◽

Symptomatic Control

Objective: Malignant insulinoma is an extremely uncommon tumor that is usually accompanied by severe hypoglycemia that is difficult to manage. At this time, the long-term effect of 177Lu-DOTATATE (lutetium [Lu-177]-DOTA-Tyr3-octreotate) on this tumor is not well known. Methods: We report a case of severe, life-threatening, and refractory hypoglycemia associated with malignant insulinoma treated with 177Lu-DOTATATE. Results: A 51-year-old woman was referred because of severe, life-threatening, and refractory hypoglycemia due to malignant insulinoma. The patient had been treated unsuccessfully with chemotherapy, targeted therapies, and symptomatic therapy with diazoxide, steroids, and somatostatin analogues without success. 177Lu-DOTATATE adequately controlled her hypoglycemia after the other conventional treatments failed. Conclusion: 177Lu-DOTATATE was effective in providing rapid and long-term symptomatic control of the hypoglycemia and significantly improved the quality of life of the patient.

Download Full-text