scholarly journals EFFECTIVENESS OF FIXED DOSES OF PROPRANOLOL IN THE TREATMENT OF HEMANGIOMAS REGARDLESS OF CHILD’S WEIGHT GAIN: A CASE REPORT

2019 ◽  
Vol 37 (3) ◽  
pp. 392-395
Author(s):  
Jaime Anger ◽  
Eduardo Mesquita de Oliveira ◽  
José Gabel
Keyword(s):  
Case Report ◽  
Weight Gain ◽  
Complete Remission ◽  
Rebound Effect ◽  
Oral Solution ◽  
Maximum Amount ◽  
Fixed Dose ◽  
Case Description ◽  
Upper Limit ◽  
Weight Gains

ABSTRACT Objective: To present the outcomes of fixed doses of propranolol tablets for the treatment of hemangiomas. Case description: Two illustrative cases of hemangioma in infant patients younger than six months old are described. Treatments were started in 2010 and 2011 and were monitored until August 2017. Patients were treated with fixed doses, initially calculated based on the upper limit of 3 mg/kg/day and administrated in two daily doses rounded down to the nearest multiple of five milligrams. Dosage was not adjusted to patients’ weight gain. The tablets were crushed and then diluted in a maximum amount of 3 mL of water. This procedure was necessary because propranolol was not available in oral solution in 2009, when dosages available in the Brazilian market were 10, 40 and 80 mg. Both patients presented significative improvement in the first 60 days and were in complete remission by the end of the treatment. Comments: It is possible to treat patients with Propranolol 10 mg tablets, even though the dosage is not as precise as when calculated according to patients’ weight. The maintenance of a fixed dose, ignoring the patient’s progressive weight gains, helps avoiding the rebound effect and decreases complications.

scholarly journals AB0235 RITUXIMAB (BIOSIMILAR) IN RHEUMATOID ARTHRITIS: CLINICAL & IMMUNOLOGICAL RESPONSE TO VARYING DOSES- EXPERIENCES FROM A TERTIARY CARE CENTER IN SOUTH INDIA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1143.2-1144
Author(s):  
J. Antony ◽  
R. Sankaralingam ◽  
R. Maheshwari ◽  
B. Chilukuri ◽  
S. Chinnadurai
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
Interstitial Lung Disease ◽  
Complete Remission ◽  
Lung Disease ◽  
Clinical Remission ◽  
Clinical Indication ◽  
Fixed Dose ◽  
Double Negative ◽  
Lung Involvement

Background:Rituximab (RTX) is a chimeric monoclonal antibody against CD20. There is a paucity of studies done with RTX biosimilars. This is a Retrospective and Observational study from January 2018 to December 2019 done in the Department of Clinical Immunology & Rheumatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.Objectives:1.To find the effects of varying doses of RTX in attaining clinical remission in RA.2.To find if CD19, CD20 & IgG help in identifying impending flare & if these levels help in deciding the timing of the next dose of RTX.Methods:Rheumatoid arthritis (RA) cases who were given Rituximab from January 2018 were selected. Clinical Response at 6 & 12 months & wherever feasible at 18 & 24 months was assessed by Simplified Disease Activity index (SDAI). RTX initial dose was given at 0 and 14 days followed by fixed dose at six months interval.CD19, CD20 B cell count, IgG levels were tested in patients in whom it was feasible at baseline & 6 months (select patients at 12,18 &24 months). Patients were divided in to 5 groups (DMARD naïve, DMARD resistant & Interstitial Lung disease (ILD) [Lung involvement>20% in Computed Tomography (CT)]) and (500mg & 1g). Patients were divided into three clinical groups, (DMARD naïve, DMARD resistant & Interstitial Lung disease (ILD) [Lung involvement>20% in Computed Tomography (CT)]) and two treatment groups (500mg & 1g) based on clinical indication for RTX and dose of RTX, respectively. In patients with ILD, CT scan & FVC were compared at baseline & 12 months.Results:29 patients (seropositive 28 (RF/Anti CCP/BOTH+VE), seronegative 1) were given RTX for RA over a 2-year period of which 12 had CD19, CD20 & IgG tested. Mean SDAI reduction from baseline to 6 months post treatment was 30%, 32% & 14% while complete remission (SDAI<3.3) was attained in 100%, 18% & 20% in DMARD naïve, DMARD resistant & ILD groups, respectively. CD19, CD20 & IgG reduced from 18.6%, 18.4% & 18.53g/L to 3.7%,3.7% & 9.7g/L respectively FVC improved from 62.4% to 67% at 12. The percentage of patients with lung involvement >20% reduced from 53.3% to 46.7%. Flare was observed in one patient who received 500mg RTX. CD19, CD20 & IgG levels increased from 7.9%, 8% & 9.8g/L to 27%, 25% & 13g/L respectively. 3 patients in the 1g group were followed up at 12,18 & 24 months. In these patients there were no flares or worsening symptoms. 1 patient was double negative for RF & Anti CCP and this patient did not attain clinical remission even after 2 doses of 1g RTX.Conclusion:[1]Patients with early arthritis (diagnosis made within 1 year) and who were DMARD naïve had an excellent response to Rituximab.[2]Complete remission was observed in more patients the 1g compared to 500mg group.[3]Reduction in CD19 & CD20 was associated with significant reduction in the SDAI score.[4]There was no significant reduction of CD19 & CD20 with 500mg dose of Rituximab where either a partial remission or mild flare was observed.[5]There was reduction in the lung involvement to less than 20%(CT) in few patients with 1g dose.[6]Double negative Rheumatoid arthritis poorly responded to Rituximab.[7]The positive effects of 1g Rituximab could be noted up to 24 months.[8]Flare of RA was associated with significant increase in CD19 & CD20.Disclosure of Interests:None declared

Treatment of chronic hepatitis C virus infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy tube in a patient with HIV coinfection

2020 ◽  
Vol 78 (1) ◽  
pp. 36-40
Author(s):  
Vanessa Huffman ◽  
Diana C Andrade ◽  
Elizabeth Sherman ◽  
Jianli Niu ◽  
Paula A Eckardt
Keyword(s):  
Case Report ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Fixed Dose ◽  
Pharmacokinetic Data ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Hiv Coinfection ◽  
Peg Tube

Abstract Purpose Ledipasvir/sofosbuvir is an oral combination therapy containing fixed doses of direct-acting antiviral agents indicated for the treatment of hepatitis C virus (HCV) infection. Currently there are limited data on the clinical efficacy of crushed ledipasvir/sofosbuvir administered via feeding tube. Summary This case report discusses the successful treatment of chronic HCV genotype 1b infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy (PEG) tube in a patient with human immunodeficiency virus (HIV) coinfection and high-grade sarcoma who had severe swallowing difficulties. The patient received crushed ledipasvir/sofosbuvir daily for a total of 12 weeks. At 12 weeks the patient had achieved a sustained virologic response. Conclusion Currently, ledipasvir/sofosbuvir is available only as a tablet, with limited pharmacokinetic data available to guide clinicians on use of the fixed-dose combination medication in crushed form. This case report highlights our experience treating a patient with HCV/HIV coinfection through administration of crushed ledipasvir/sofosbuvir via PEG tube, which we found to be a safe and effective therapeutic option.

scholarly journals The Impacts of Waterproof Insulated Jackets on Lamb Performance on a UK Lowland Farm

Animals ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 217
Author(s):  
Eleanor Brooke Collins ◽  
Nicola Blackie
Keyword(s):  
Weight Gain ◽  
Cold Stress ◽  
Morbidity And Mortality ◽  
Daily Weight Gain ◽  
Birth Date ◽  
Body Temperatures ◽  
Average Daily Weight Gain ◽  
Treatment Groups ◽  
Surface Temperatures ◽  
Weight Gains

The majority of lamb losses occur within the first two weeks of life, with cold stress being a major cause of lamb morbidity and mortality. This study investigated the effect of insulating lamb jackets on newborn lambs. One hundred and four newborn lambs were randomly allocated by birth date to two treatment groups, (a) non-jacketed (n = 52) or (b) jacketed (n = 52), for fourteen days after birth. The live weights of lambs were recorded regularly up to 21 days, and average daily weight gains were calculated from these data. For the first two days after recruitment to the study, surface and body temperatures of lambs were also recorded. The jackets significantly increased the lambs’ surface temperatures, providing a warmer microclimate and reduced cold stress for jacketed lambs. There was no significant effect of the insulating jackets on estimated body temperatures, live weights or average daily weight gain of the lambs in this study. There were no detrimental effects of the jackets, and no rejection of lambs occurred.

scholarly journals Application of Double-Threaded Locking Adaptation Plates used to Repair a Radius and Ulna Fracture in a Domestic Rabbit (Oryctolagus Cuniculus)

VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e182-e186
Author(s):  
Anthony Malak ◽  
Andrew S. Levien
Keyword(s):  
Case Report ◽  
Clinical Significance ◽  
Oryctolagus Cuniculus ◽  
Clinical Report ◽  
Locking Plates ◽  
Case Description ◽  
Domestic Rabbit ◽  
Implant Complications ◽  
Osseous Union ◽  
Ulna Fractures

Abstract Objective This study is a case description of the clinical application of locking plates to repair fractures in the radius and ulna of a 9-month-old, male domestic rabbit. Study Design This study is a case report. Results Double-threaded locking adaptation plates of 1.5 mm were fixated to the radius and ulna of the rabbit using the principles of orthogonal plating. Radiographs of the left radius and ulna were obtained at 8 weeks postoperatively depicting complete osseous union of the fracture and no implant complications were observed. Clinical Significance The authors describe the first clinical report of 1.5 mm locking adaptation plates having been used in repairing radius and ulna fractures in a domestic rabbit.

scholarly journals Management of Retrograde Peri-Implantitis Using an Air-Abrasive Device, Er,Cr:YSGG Laser, and Guided Bone Regeneration

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Nikolaos Soldatos ◽  
Georgios E. Romanos ◽  
Michelle Michaiel ◽  
Ali Sajadi ◽  
Nikola Angelov ◽  
...  
Keyword(s):  
Case Report ◽  
Bone Density ◽  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Etiologic Factor ◽  
Ridge Preservation ◽  
X Rays ◽  
Case Description ◽  
Implant Placement ◽  
Maxillary Molar

Background. The placement of an implant in a previously infected site is an important etiologic factor contributing to implant failure. The aim of this case report is to present the management of retrograde peri-implantitis (RPI) in a first maxillary molar site, 2 years after the implant placement. The RPI was treated using an air-abrasive device, Er,Cr:YSGG laser, and guided bone regeneration (GBR). Case Description. A 65-year-old Caucasian male presented with a draining fistula associated with an implant at tooth #3. Tooth #3 revealed periapical radiolucency two years before the implant placement. Tooth #3 was extracted, and a ridge preservation procedure was performed followed by implant rehabilitation. A periapical radiograph (PA) showed lack of bone density around the implant apex. The site was decontaminated with an air-abrasive device and Er,Cr:YSGG laser, and GBR was performed. The patient was seen every two weeks until suture removal, followed by monthly visits for 12 months. The periapical X-rays, from 6 to 13 months postoperatively, showed increased bone density around the implant apex, with no signs of residual clinical or radiographic pathology and probing depths ≤4 mm. Conclusions. The etiology of RPI in this case was the placement of an implant in a previously infected site. The use of an air-abrasive device, Er,Cr:YSGG, and GBR was utilized to treat this case of RPI. The site was monitored for 13 months, and increased radiographic bone density was noted.

The effect of winter food level on compensatory growth of weaned, suckled calves grazed at two sward heights

1986 ◽  
Vol 43 (2) ◽  
pp. 211-223 ◽  
Author(s):  
I. A. Wright ◽  
A. J. F. Russel ◽  
E. A. Hunter
Keyword(s):  
Weight Gain ◽  
Compensatory Growth ◽  
Live Weight ◽  
Food Level ◽  
Live Weight Gain ◽  
Subsequent Performance ◽  
Herbage Intake ◽  
Winter Food ◽  
Weight Gains ◽  
Winter Feeding

ABSTRACTTwo experiments were conducted with weaned, suckled calves to investigate the effect of feeding level during the post-weaning winter on their subsequent performance when continuously grazed on pasture maintained at two sward heights. Low, medium and high levels of winter feeding resulted in winter live-weight gains of 0·31, 0·58 and 0·79 (s.e. 0·027) kg/day (P < 0·001) during the 152-day winter in experiment 1 and 0·44, 0·69 and 0·84 (s.e. 0·029) kg/day (P < 0·001) for 189 days in experiment 2. During summer (93 days in experiment 1 and 87 days in experiment 2) there was a significant effect of winter food level on performance when live-weight gains were 1·10, 1·02, 0·87 and 1·35, 1·23 and 1·19 (s.e. 0·060) kg/day for the low, medium and high winter food levels on the short and tall swards respectively in experiment 1 (P < 0·01) and 0·86, 0·66, 0·51 and 1·26, 1·18 and 0·91 (s.e. 0090) kg/day in experiment 2 (P < 0·001). The cattle showing compensatory growth had higher herbage intakes and it is postulated that this occurred because of a negative association between body fat and herbage intake. Sward height had a large positive effect on herbage intake and live-weight gain and it is concluded that for maximum intake on ryegrass swards, herbage height should be at least 8 cm. Lower levels of winter live-weight gain delayed the time to slaughter, but allowed cattle to achieve heavier carcass weights at a fixed level of fatness.It is concluded that there is no single optimum winter food level for weaned, suckled calves but that the choice will depend upon several factors, including availability of winter and summer food resources, the length of the winter feeding period, the desired date of slaughter and type of carcass to be produced.

Acquired acoria and iris pearls in leprosy: Case report

2021 ◽  
pp. 112067212110240
Author(s):  
Luciana Negrão Almeida Morais ◽  
Joacy Pedro Franco David ◽  
João Victor Peres Lima ◽  
Samia Demachki ◽  
Daniel Guerreiro Diniz ◽  
...  
Keyword(s):  
Case Report ◽  
Cataract Extraction ◽  
Ocular Involvement ◽  
Histopathological Diagnosis ◽  
Extracapsular Cataract Extraction ◽  
Ophthalmological Examination ◽  
Case Description ◽  
Leprosy Case ◽  
Proper Diagnosis

Purpose: To describe a case of a patient presenting with acquired acoria and iris pearls, a rare eye manifestation and pathognomonic finding for leprosy; to reinforce clinical, histopathological, and therapeutic aspects of ocular involvement in leprosy. Methods: Case report. Case description: A 62-year-old male presenting with acquired acoria and iris pearls in both eyes due to leprosy also had anterior uveitis and cataract. Histopathological diagnosis of iris pearls was confirmed by the presence of Hansen’s bacilli. Ophthalmological examination revealed improvement of the visual acuity after iridectomy and extracapsular cataract extraction. Conclusions: To our knowledge, this is the first reported case of acquired acoria in a leprosy patient. It led to impaired vision and reversible blindness. Proper diagnosis and ophthalmological treatment of patients with these conditions are essential for the maintenance of a good quality of life.

Micturition-triggered severe headache associated with bladder paraganglioma: A case report

Cephalalgia ◽  
2021 ◽  
pp. 033310242110361
Author(s):  
Yonghui Liu ◽  
Tianlu Wei
Keyword(s):  
Case Report ◽  
Neuroendocrine Tumors ◽  
Pain Syndrome ◽  
Signs And Symptoms ◽  
Headache Disorder ◽  
Severe Headache ◽  
Case Description ◽  
Middle Aged ◽  
Aged Woman ◽  
Middle Aged Woman

Background Paragangliomas are rare neuroendocrine tumors, especially in the bladder. Although many paragangliomas are non-functional, functioning paragangliomas present with many non-specific signs and symptoms, such as hypertension and headache, complicating their diagnosis. Here, we report a case of micturition-induced severe headache associated with a bladder paraganglioma. Case description: This report describes a severe headache disorder triggered by micturition and associated with a bladder paraganglioma in a middle-aged woman. Her pain occurred consistently after micturition, beginning from the left side of the nose and gradually extended to the forehead and the parietal and occipital regions. The headaches lasted 5–10 min. Removal of the paraganglioma completely eliminated the patient’s pain syndrome. Conclusion This case elucidates the association between micturition-triggered headaches and bladder paragangliomas. The presence of a post-micturition severe headache should suggest the possibility of a bladder paraganglioma.

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