scholarly journals Keratorefractive Surgery for Residual Refractive Error Correction in Pseudophakic Patients

2020 ◽  
Vol 17 (2) ◽  
pp. 209-215
Author(s):  
Е. P. Gurmizov ◽  
К. B. Pershin ◽  
N. F. Pashinova ◽  
А. Iu. Tsygankov
Keyword(s):  
Refractive Error ◽  
High Efficiency ◽  
Group Iii ◽  
Spherical Component ◽  
Cylindrical Component ◽  
Group I ◽  
Keratorefractive Surgery ◽  
Group Ii ◽  
Target Refraction

Purpose. Evaluation of the visual and refractive results of additional correction using LASIK and PRK methods in patients with residual refractive error after previous cataract surgery. Patients and methods. The prospective open study included 57 patients (79 eyes) who previously underwent cataract phacoemulsification (n = 37) or refractive lensectomy (n = 42) with various IOL models implantation (2012–2017). The average age of patients was 50.8 ± 13.9 (19–79) years. Operations LASIK (91.1 %) and PRK (8.9 %) were carried out according to standard methods. In 6 cases, femtosecond laser supported by laser correction. The target refraction ranged from –0.25 to 0.25 D in most (97.5 %) cases. The follow-up period ranged from 6 to 9 months. Results. The patients were divided into groups according to the type of residual refractive error (Group 1 — myopia, group II — emmetropia and group III — hyperopia). Statistically significant differences were determined for the species of previously implanted IOLs — in group II, the frequency of monofocal IOLs was significantly higher (p < 0.05). In group II, the values of the cylindrical component of refraction were significantly higher compared with groups I and III (p < 0.05). In group I, a significant (p < 0.05) decrease in the spherical component of refraction from –1.36 ± 0.92 to –0.2 ± 0.8 D was observed. In patients of group II, there was a slight increase in the spherical component of refraction from 0 ± 0.20 to 0.25 ± 0.29 D (p > 0.05). In group III, a significant (p < 0.05) decrease was observed in the spherical component of refraction from 1.27 ± 0.69 to 0.43 ± 0.49 D. When analyzing the cylindrical component of refraction in group I, its decline was noted from –0.69 ± 0.5 to –0.38 ± 0.46 D (p > 0.05). In group II, the largest decrease in the cylindrical component was observed from –1.6 ± 1.0 to 0.03 ± 1.10 Dptr (p < 0.01). In all the studied groups, a statistically significant (p < 0.05) increase in UCFVA was revealed in the postoperative period. Indicators K1 and K2 did not significantly change. Conclusion. The high efficiency of the correction using the LASIK, PRK and femtoLASIK methods on pseudophakic eyes with the achievement of the target refraction in most of the studied cases was shown. This method can be used as an alternative to spectacle and contact correction in patients with residual refractive error after cataract phacoemulsification and refractive lensectomy with IOL implantation.

Prospective Evaluation of Intravitreal Triamcinolone Acetonide Injection in Macular Edema Associated with Retinal Vascular Disorders

2005 ◽  
Vol 15 (5) ◽  
pp. 619-626 ◽  
Author(s):  
H.K. Tewari ◽  
P. Sony ◽  
R. Chawla ◽  
S.P. Garg ◽  
P. Venkatesh
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Macular Thickness ◽  
Intravitreal Triamcinolone ◽  
Group Iii ◽  
Vein Occlusion ◽  
Group I ◽  
Group Ii

Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal vascular disorders. Methods This prospective nonrandomized clinical interventional study included 81 eyes (76 patients) comprised of Group I, 57 eyes (51 patients) with diabetic macular edema; Group II, 10 eyes (10 patients) with branch retinal vein occlusion; and Group III, 13 eyes (13 patients) with central retinal vein occlusion. All eyes received an intravitreal injection of 4 mg triamcinolone acetonide (with the solvent) in the operation theater under sterile conditions. Results Mean preinjection central macular thickness was 531.84±132 μm in Group I, 458.4±149 μm in Group II, and 750.81±148 μm in Group III. All groups showed a statistically significant decrease in mean central macular thickness at 1 month (300.7±119 μM in Group I, 218.2±99 μm in Group II, and 210.5 ±56 μm in Group III) and 3 months (253.19±109 μm in Group I, 187±47 μm in Group II, and 182±50 μm in Group III) after injection (p<0.05). Mean follow-up was 22±2.4 weeks. Mean visual acuity increased in all three groups (preoperative visual acuity in Group I, 1.2±0.4 logMAR units; Group II, 1.24±0.5 logMAR units; Group III, 1.1 ±0.4 logMAR units; 1 month postinjection in Group I, 0.88±0.3 logMAR units; Group II, 0.67±0.3 logMAR units; Group III, 0.86±0.4 logMAR units; 3 months postinjection in Group I, 0.84±0.4 logMAR units; Group II, 0.59±0.3 logMAR units; Group III, 0.82±0.5 logMAR units) (p<0.05). Forty-one eyes completed 6 months and 20 eyes completed 9 months follow-up. Twelve of 20 (41%) eyes in Group I, 2/6 (33%) eyes in Group II, 3/6 (50%) eyes in Group III, and 8/15 (53%) eyes in Group I, 1/3 (33%) eyes in Group II, and 2/2 (100%) eyes in Group III developed recurrence of macular edema with worsening of visual acuity at 6 and 9 months, respectively. Thirty-three (40.7%) eyes developed IOP elevation (at least one reading > 24 mmHg). One eye developed infective endophthalmitis. Conclusions Intravitreal injection of triamcinolone acetonide may be considered as an effective treatment for reducing macular thickening due to diffuse diabetic macular edema, venous occlusion associated macular edema, and may result in increase in visual acuity at least in the short term. Further follow-up and analysis is required to demonstrate its long-term efficacy.

scholarly journals The Complete Normalization of the Adrenocortical Function as the Criterion of Cure after Transsphenoidal Surgery for Cushing’s Disease

2001 ◽  
Vol 86 (12) ◽  
pp. 5695-5699 ◽  
Author(s):  
Javier Estrada ◽  
José García-Uría ◽  
Cristina Lamas ◽  
José Alfaro ◽  
Tomás Lucas ◽  
...  
Keyword(s):  
Cushing’S Disease ◽  
Transsphenoidal Surgery ◽  
Plasma Cortisol ◽  
Cushing's Disease ◽  
Adrenocortical Function ◽  
Urinary Cortisol ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Transsphenoidal microsurgery is the standard treatment for patients with Cushing’s disease. However, there is general lack of agreement regarding the definition of cure. We studied 58 patients with corrected hypercortisolism after transsphenoidal surgery for Cushing’s disease. Plasma and urinary cortisol levels were measured after surgery. After the postsurgical hypocortisolism stage (or periodically in patients without hypocortisolism), urinary free cortisol, plasma cortisol at 0800 h and 2300 h, morning cortisol after 1 mg dexamethasone, and cortisol response to insulin-induced hypoglycemia were performed. Patients were classified in 3 groups: group I, patients with transient hypocortisolism and normal hypothalamus-pituitary-adrenal axis afterwards; group II, patients with transient hypocortisolism and abnormalities in the circadian rhythm or the stress response afterwards; and group III, patients without postoperative hypocortisolism. Thirty-three patients were included in group I, 8 in group II, and 17 in group III. Groups I and II were similar in postsurgical plasma cortisol (46.9 ± 30.3 vs. 60.7 ± 38.6 nm) and mean follow-up (69.8 vs. 68.8 months) but were significantly different in their recurrence rate (3.4% vs. 50%, P &lt; 0.001). Patients in group III had normal postsurgical plasma and urinary cortisol but persistent abnormalities in circadian rhythm and stress response. After a mean follow-up of 39.1 months, their recurrence rate was similar to that of group II (64.7% vs. 50%). The complete normalization of the adrenocortical function, which is always preceded by postsurgical hypocortisolism, is associated with a very low recurrence risk and should be considered, in our opinion, the main criterion of surgical cure in Cushing’s disease.

scholarly journals EFFICACY OF ATRIAL FIBRILLATION DETECTION IN CRYPTOGENIC STROKE ACCORDING TO DATA OF IMPLANTABLE LOOP RECORDERS: PILOT STUDY

2019 ◽  
Vol 34 (2) ◽  
pp. 47-53
Author(s):  
S. E. Mamchur ◽  
E. A. Ivanitskiy ◽  
O. M. Polikutina ◽  
T. Yu. Chichkova ◽  
I. N. Mamchur ◽  
...  
Keyword(s):  
Recurrent Stroke ◽  
Cryptogenic Stroke ◽  
Ecg Monitoring ◽  
Group Iii ◽  
External Monitoring ◽  
Group I ◽  
Monitoring Group ◽  
Group Ii

Aim. To estimate the efficacy of invasive and non-invasive long-term ECG monitoring in comparison with conventional follow-up for the detection of silent atrial fibrillation (AF)/atrial flutter (AFL)/atrial tachycardia (AT) in patients with a cryptogenic stroke.Methods. The randomized, prospective, two-center study enrolled 36 patients who suffered cryptogenic stroke (CS) or transient ischemic attack (TIA) without past history of AF/AFL/AT. Patients were randomized in a 1:1:1 ratio to one of the three ECG monitoring strategies: standard arrhythmia monitoring (group I, n=12), ECG-monitoring with implantable loop recorder (group II, n=12), and ambulatory noninvasive ECG monitoring (group III, n=12). The primary endpoint was the time to the first detection of AF/AFL/AT. Patients, assigned to the group I, underwent an assessment at scheduled and unscheduled visits and received ambulatory ECG monitoring 28 days and 1 year after randomization. Patients in the group II underwent implantation of Reveal XT (Medtronic, USA) with the daily remote data transmission to CareLink Network. In the group III, for long-term external monitoring, Spyder system (WEB Biotechnology, Singapore) was used for up to 28 days.Results. During the first 28 days of observation, there were no significant differences in AF detection rates between groups I, II, and III: 0 (0%), 1 (8%), and 2 (17%) cases, respectively, р=0.537. During the year of observation, AF/AFL/AT episodes were detected in 1 case (8%) in the group I, 6 cases (50%) in the group II, and 2 cases (17%) in the group III, p=0.0486. The mean time from enrollment into the study to detection of the first AF/AFL/AT episode was 67 days (15; 97) in all groups. In the groups II and III, the first arrhythmia episodes were detected by monitoring devices on days 24 and 6, respectively. In most cases, arrhythmia episodes detected by long-term monitoring were asymptomatic. Recurrent stroke or TIA events occurred in group I and III (1 case in each group), but not in the group with implantable cardiac monitors. Subgroup analysis showed that significantly higher AF/AFL/AT detection rate was associated with stroke, CHA2DS2VASc score ≥2, and the presence of hypertension. For the 12 months of follow-up, the mean AF burden in the group II was 0.4 (0.2; 0.5) hours per day (1.6%). In the patients with recurrent stroke, AF burden was 3.2% compared to 0.9% in the rest of patients.Conclusion. Detection of silent AF with implantable cardiac monitors is superior to standard and long-term external monitoring in cryptogenic stroke patients.

Incidence of Late Failure Following Myeloablative Conditioning with BuCy2 and Matched Sibling Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2172-2172
Author(s):  
Shubham Pant ◽  
Sayed Mehdi Hamadani ◽  
Pamela Crilley ◽  
Jeffrey Szer ◽  
Anthony J. Dodds ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Myeloid Leukemia ◽  
Chronic Gvhd ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Acute Myeloid

Abstract Allogeneic stem cell transplantation (ASCT) is an important curative modality for patients with acute myeloid leukemia (AML), but no large studies with mature followup after a uniform conditioning regimen and stem cell source have been reported. We previously published (Copelan EA. Blood; 78:838–43, 1992) the results of 127 patients with AML who underwent ASCT following preparation with oral busulfan (16 mg/kg) and cyclophosphamide (120mg/kg) (BuCy2) with a median follow-up of 3 years. We now present data on 316 AML patients, including the initial cohort, who underwent ASCT from 1984 to 1995 at 7 participating institutions the United States and Australia. All patients received bone marrow grafts from HLA-identical sibling donors following myeloablative preparation with BuCy2. One hundred fifty-seven patients were transplanted in first remission (CR1, group I), 49 in second remission (CR2, group II) and 110 patients were beyond CR2 or had refractory disease (group III). Cyclosporine or tacrolimus-based regimens were routinely administered to prevent graft-versus-host-disease (GVHD). Median follow-up of surviving patients exceeds 12 years (range 3 – 18 years). At the time of analysis 126 patients (40%) were alive. The estimated leukemia-free survival (LFS) for group I at 3 and 12 years is 63% (95% CI: 47 – 79%) and 49% (95% CI: 33 – 66%), for group II is 50% (95% CI 36 – 64%) and 33% (95% CI: 17 – 49%) and group III is 25% (95% CI: 17 – 32%) and 16% (95%CI: 8 – 24%) respectively. The estimated relapse rate for patients in group I at 3 and 12 years is 15% (95%CI: 9 – 21%) and 28% (95% CI: 20 – 36%), for group II is 38% (95% CI: 24 – 52%) and 48% (95% CI: 31 – 65%), and group III is 56% (95% CI: 4 – 68%) and 65% (95% CI: 53 – 77%). For the entire cohort (n=317), using multivariate analysis, younger age (p&lt;0.004) and transplantation in CR1 (p&lt;0.001) were predictive of long-term overall survival (OS) and LFS. Transplantation in CR1 (p&lt;0.001), and presence of chronic GVHD (p=0.003) were associated with decreased risk of relapse. One hundred forty-two patients were alive and free of leukemia at 3 years; of these patients, 75% are leukemia-free survivors at 12 years. Considering only these patients, the cumulative incidence of relapse beyond 3 years was 17% and the cumulative incidence of non-relapse mortality was 9%; only 2 patients died beyond 3 years from respiratory failure. For this group, none of the factors analyzed (including age, remission status at the time of transplantation or the presence of chronic GVHD) was predictive for OS, LFS or relapse. In conclusion, although most remissions in AML patients surviving leukemia-free for at least 3 years following ASCT are durable, late relapse occurs in 17%. One in four patients alive and free of leukemia at 3 years will relapse or die from NRM over the subsequent 9 years. Figure Figure

Neonatal intracranial hemorrhage

1980 ◽  
Vol 53 (5) ◽  
pp. 642-651 ◽  
Author(s):  
Richard Leblanc ◽  
Augustin M. O'Gorman
Keyword(s):  
Computerized Tomography ◽  
Intracranial Hemorrhage ◽  
Lateral Ventricle ◽  
Mass Effect ◽  
Ventricular System ◽  
Ct Scans ◽  
Group Iii ◽  
Group I ◽  
Group Ii

✓ Forty-six neonates with intracranial hemorrhage were classified into three groups on the basis of the major computerized tomography (CT) scan findings: Group I consisted of 24 cases of subarachnoid hemorrhage, Group II 20 cases of intracerebral and/or intraventricular hemorrhage, and Group III two cases of subdural hemorrhage. The initial scans in Group I showed blood in the interhemispheric fissure and the supratentorial recess. Sixty percent had an associated hypodensity in the frontal and/or parietal areas, thought to be an indication of ischemia. Changes in the configuration of the ventricular system were infrequent. Initial scans in Group II showed hematomas as follows: one in the brain stem, five in the basal ganglia, 10 in the temporal lobes, and 11 in the ventricles. In 70% of these cases, changes in the configuration of the ventricular system were seen, including compression of a lateral ventricle by mass effect, ventricular dilatation with blood, and obstructive hydrocephalus. Subarachnoid blood was an associated finding in 55% of cases, and focal and diffuse cerebral edema in 40%. Scans in both Group III patients initially showed a mass effect from a subdural clot. In all, 30 patients had one or more follow-up CT scans, and 13 of these were scanned at regular intervals. None of the Group I patients developed hydrocephalus, but 85% of Group II patients with intraventricular blood extending from an intracerebral hemorrhage had this complication. A seizure disorder occurred in 31% of Group I patients and 20% of Group II patients, where it was seen exclusively in those with an intralobar hematoma. A major motor disturbance occurred in 16% of patients; their CT scans showed evidence of brain destruction involving enlargement of a lateral ventricle, porencephaly, or focal atrophy. Computerized tomography is a useful adjunct to the diagnosis, management, and follow-up study of neonatal intracranial hemorrhage, and correlates well with the clinical findings.

scholarly journals Developmental milestones of vertically HIV infected and seroreverters children: follow up of 83 children

2001 ◽  
Vol 59 (3B) ◽  
pp. 691-695 ◽  
Author(s):  
Isac Bruck ◽  
Tony Tannous Tahan ◽  
Cristina Rodrigues da Cruz ◽  
Luzilma Terezinha Flenik Martins ◽  
Sérgio Antonio Antoniuk ◽  
...  
Keyword(s):  
Screening Tests ◽  
Control Group ◽  
Basal Ganglia Calcification ◽  
Group Iii ◽  
Computed Tomographic ◽  
Group I ◽  
Immunodeficiency Virus ◽  
Neurological Exam ◽  
Group Ii

The aim of the study was to detect neurological abnormalities in human immunodeficiency virus (HIV) infected children. This was achieved by a prospective evaluation, from November/1995 to April/2000, of 43 HIV infected children (group I) and 40 HIV seroreverters children (group II) through neurological exam and neurodevelopmental tests: Denver Developmental Screening Test (DDST) and Clinical Adaptive Test / Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS). A control group (III), of 67 children, were evaluated by CAT/CLAMS. Hyperactivity, irritability and hypotonia were the findings on neurological examination, without statistical differences between group I and II. On CAT/CLAMS, the group I developmental quotient (DQ) was significantly lower than the other groups. The same occurred in DDST, with group I presenting significantly more failures than group II. Nineteen HIV children of group I had brain computed tomographic scan, with abnormalities in three of them (basal ganglia calcification, white matter hypodensity and asymmetry of lateral ventricles). We conclude that in HIV infected children a neurodevelopment delay occur early in the disease, and it can be detected by screening tests.

scholarly journals Results of the Intergroup Rhabdomyosarcoma Study Group D9602 Protocol, Using Vincristine and Dactinomycin With or Without Cyclophosphamide and Radiation Therapy, for Newly Diagnosed Patients With Low-Risk Embryonal Rhabdomyosarcoma: A Report From the Soft Tissue Sarcoma Committee of the Children's Oncology Group

2011 ◽  
Vol 29 (10) ◽  
pp. 1312-1318 ◽  
Author(s):  
R. Beverly Raney ◽  
David O. Walterhouse ◽  
Jane L. Meza ◽  
Richard J. Andrassy ◽  
John C. Breneman ◽  
...  
Keyword(s):  
Survival Rates ◽  
Embryonal Rhabdomyosarcoma ◽  
Study Group ◽  
Free Survival ◽  
Group Iii ◽  
Group I ◽  
Risk Patients ◽  
Group Ii ◽  
Stage 1

Purpose Patients with localized, grossly resected, or gross residual (orbital only) embryonal rhabdomyosarcoma (ERMS) had 5-year failure-free survival (FFS) rates of 83% and overall survival rates of 95% on Intergroup Rhabdomyosarcoma Study Group (IRSG) protocols III/IV. IRSG D9602 protocol (1997 to 2004) objectives were to decrease toxicity in similar patients by reducing radiotherapy (RT) doses and eliminating cyclophosphamide for the lowest-risk patients. Patients and Methods Subgroup A patients (lowest risk, with ERMS, stage 1 group I/IIA, stage 1 group III orbit, stage 2 group I) received vincristine plus dactinomycin (VA). Subgroup B patients (ERMS, stage 1 group IIB/C, stage I group III nonorbit, stage 2 group II, stage 3 group I/II) received VA plus cyclophosphamide. Patients in group II/III received RT. Compared with IRS-IV, doses were reduced from 41.4 to 36 Gy for stage 1 group IIA patients and from 50 or 59 to 45 Gy for group III orbit patients. Results Estimated 5-year FFS rates were 89% (95% CI, 84% to 92%) for subgroup A patients (n = 264) and 85% (95% CI, 74%, 91%) for subgroup B patients (n = 78); median follow-up: 5.1 years. Estimated 5-year FFS rates were 81% (95% CI, 68% to 90%) for patients with stage 1 group IIA tumors (n = 62) and 86% (95% CI, 76% to 92%) for patients with group III orbit tumors (n = 77). Conclusion Five-year FFS and OS rates were similar to those observed in comparable IRS-III patients, including patients receiving reduced RT doses, but were lower than in comparable IRS-IV patients receiving VA plus cyclophosphamide. Five-year FFS rates were similar among subgroups A and B patients.

scholarly journals SAT0407 FOLLOW-UP EXAMINATION FOR THE DETECTION OF POTENTIAL PSORIATIC ARTHRITIS BY FLUORESCENCE OPTICAL IMAGING – IN COMPARISON TO MUSCULOSKELETAL ULTRASOUND

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1155.2-1156
Author(s):  
J. Büttner ◽  
A. M. Glimm ◽  
G. Kokolakis ◽  
M. Erdmann-Keding ◽  
G. R. Burmester ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Optical Imaging ◽  
Dropout Rate ◽  
Musculoskeletal Ultrasound ◽  
Group Iii ◽  
Fluorescence Optical Imaging ◽  
Group I ◽  
Group Ii ◽  
Inflammatory Changes

Background:Up to 30% of all plaque-type psoriasis patients develop psoriatic arthritis (PsA) (1). Early diagnosis of PsA can be difficult due to its heterogenous manifestation and the lack of disease- specific biomarkers, but it is crucial for disease outcome. Recently, our group has shown that fluorescence optical imaging (FOI) can be a helpful diagnostic tool for early PsA diagnosis since it can differentiate between patients with confirmed PsA and suspected PsA (2).Objectives:To follow-up patients by FOI with confirmed and suspected PsA with special focus on the group of patients in which PsA could be confirmed between baseline and follow-up – and to compare with the findings of musculoskeletal ultrasound (US).Methods:Patients included in our previous study (1) were re-evaluated by FOI of both hands in a standardized manner using the predefined phases 1-3 (p1-p3) and the PrimaVistaMode (PVM). US in greyscale (GS) and power Doppler (PD) were performed of the clinically dominant hand (for tenderness and/or swelling) in the dorsal and palmar view at wrist, MCP, PIP and DIP 2-5 joint levels for synovitis and tenosynovitis.Subsequently, a comparison of the findings in the affected joints was performed using US as the reference method. Furthermore, AUC was calculated to show the extent to which a new joint inflammation was associated with a change in diagnosis.Results:Of the 60 patients initially examined (1), 30 patients (dropout rate 50%) were followed-up approximately 3 years later. The patients were newly divided into 3 groups: Diagnosed PsA (n=14, Group I), still suspected PsA, (n=6, Group II) and in-between diagnosed PsA (n=10, Group III). Patients with a change in the diagnosis from suspected to diagnosed PsA (Group III) showed a significantly increased prevalence of joints with pathological findings in FOI (46% at baseline, 88% at follow-up; p=0.046), with an unchanged joint distribution pattern, i.e. with a dominant involvement of the DIP joints. Compared to baseline, patients of group III were three times more common to show enrichment in p3 in FOI at follow-up (1.7% vs. 7.0%; p=n.s.). Newly detected pathologic joints by FOI (PVM, p2) and US at follow-up were positively associated with the change of diagnosis from suspected PsA to confirmed PsA (FOI: AUC 0.78; GSUS: AUC 0.77).Using US in greyscale as reference, inflammatory changes in the joints were diagnosed in all 3 cohorts by means of FOI in P1 and P3 with high specificity (Group III: 90.6%, Group II: 97.5%, Group I: 94.2%) and low sensitivity (Group III: 24.4%, Group II: 20.3%, Group I: 19.8%).Conclusion:FOI appears to be helpful to differentiate between acute and chronic disease stages. Furthermore, it is specific for detecting inflammatory changes in the joints of the hands in PsA – in comparison to US. FOI could thereby become a helpful tool as a “dermatological-screening” method to select psoriasis patients with indication for further rheumatological evaluation.References:[1]Zachariae H. Prevalence of Joint Disease in Patients with Psoriasis: Implications for therapy. Am J Clin Dermatol. 2003;4(7):441–447. Review.[2]Erdmann-Keding M, Ohrndorf S, Werner SG, et al. Fluorescence optical imaging for the detection of potential psoriatic arthritis in comparison to musculoskeletal ultrasound. J Dtsch Dermatol Ges. 2019;17(9):913-921.Disclosure of Interests:Juliane Büttner: None declared, Anne-Marie Glimm: None declared, Georgios Kokolakis: None declared, Magdalena Erdmann-Keding: None declared, Gerd Rüdiger Burmester Consultant of: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma, Speakers bureau: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma, Jens Klotsche: None declared, Sarah Ohrndorf: None declared

scholarly journals Eπώδυνες οστικές μεταστάσεις

2013 ◽  
Author(s):  
Παναγιώτης Σιδεράς
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Pain Relief ◽  
Karnofsky Performance Scale ◽  
Pain Palliation ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Grade Iii

Aim: The consecutive administration of two different bone seeking radio-pharmaceuticals such as 186Re-HEDP and 89Sr-Cl was compared with 89Sr-Cl plus chemotherapy and 186Re-HEDP alone were investigated to determine the effectiveness and toxicity in pain palliation of bone metastases in patients with prostate, breast and lung cancer.Material and Methods: The effect of treatment with consecutive infusions with 186Re-HEDP and 89Sr-Cl was compared with 89Sr-Cl plus chemotherapy and 186Re-HEDP alone on pain symptoms, quality of life and bone marrow function. In total, we treated 32 patients of which 11 (Group I) were treated (5 men with prostate cancer and 6 women with breast cancer) with consecutive infusions with 186Re-HEDP and 89Sr-Cl, 12(Group II) were mostly men with prostate cancer that received 89Sr-Cl plus chemotherapy and 9 patients (Group III) 6 women with stage IV breast cancer, 1 man with lung cancer and 2 men with hepatocellular cancer with 186Re-HEDP alone. The follow up period was 16 weeks. In Group I the patients received an infusion of 186Re-HEDP [(dose of 1200MBq (32.4 mCi) ±96.21 MBq (2.6mCi)] followed by bi-weekly blood counts until 8 weeks to measure myelotoxicity. At the end of this period 89Sr-Cl was infused at a dose of 137 MBq (3.7mCi) ± 3.63MBq (0.098mCi) followed in the same manner with bi-weekly measurement in blood counts to estimate overall patient responsiveness to therapy, increase in performance and toxicity. In Group II all patients received a standard dose of 89Sr-Cl [148MBq(4 mCi) ± 2.2 MBq (0.06 mCi). In Group III all patients received a standard 186Re-HEDP dose of 1480 MBq (40 mCi) ± 3.7MBq (0.01 mCi) and Zolendronate. All patients were interviewed using standardized form of questions before and after therapy weekly for 16 weeks.Results: In Group I 91%(10/11) of the patients reported pain relief after the end of 16 weeks whereas 18% (2/11) reported discontinuation of their analgesics and remained pain-free. Pain showed a decrease from 7.8±1.7 to a value of 2.8±1.2 on a visual analogue scale (p<0.0001). Patients also described an improvement on Karnofsky performance scale from 68±6 to 79±4 (p<0.005), 16 after completion of therapy. Myelotoxicity was observed in 2 patients (18%) manifesting as thrombocytopenia grade III, 4(36%) stage II and 5(45%) as stage I. The maximum nadir of platelets and leukocyte counts were observed at the end of 4 weeks of each therapy and was completely reversible at the end of each therapy. In Group II which was comprised mainly from prostate cancer patients 67%(8/12) reported pain relief at the end of 16 weeks with only 1 patient (8%) discontinued all analgesics. Pain score on VAS decreased from 8.3±1.8 to 3.7±1.7 (p<0.0001), improvement on Karnofsky performance scale was from 75 to 80. Myelotoxicity was seen in 4/12 (33%) of the patients and this could be attributed likely to the combined affect of chemotherapy and radioisotope treatment manifesting as grade III thrombocytopenia, grade II in 6/12 (50%) and only in 2/12 (16%) as grade I. In group III, which appeared a slightly more heterogenous than the other two groups, 1 lung cancer patient expired within the 16 weeks of follow up likely secondary to type I respiratory failure and 1 patient with hepatocellular carcinoma was lost to follow up. All other patients mainly breast cancer showed adequate analgesia with decrease of pain on VAS from 8.2±1.3 to 4.1±1.9 (p<0.008) with none discontinuing all analgesics. Improvement on Karnofsky scale was recorded as 75-80(p>0.2). Myelotoxicity was seen in 2/9 (22%) manifesting as grade III thrombocytopenia, 4/9 (44) as grade II and 3/9 (33%) as grade I.Conclusion: All radiopharmaceuticals used either consecutively or in combination with chemotherapy or alone were effective in metastatic bone pain palliation. There was no significant induction of Myelotoxicity except with a percentage of 33% seen in 89Sr-Cl plus chemotherapy group. In this small prospective study we achieved bone pain palliation with consecutive administration of 2 different radiopharmaceuticals. We modified slightly the dose of 186Re-HEDP such as to avoid serious and potentially lethal myelotoxicity. We achieved a greater and longer analgesic response as compared to the other two groups based on the fact that faster induction of analgesia was attained with the relatively low beta emitter 186Re-HEDP and greater pain relief with a longer duration of pain control the high beta emitter 89Sr-Cl.

Effects of irradiation using a radioisotope-filled balloon on tissue hyperplasia caused by stent placement in a canine urethral model

2006 ◽  
Vol 47 (4) ◽  
pp. 436-443 ◽  
Author(s):  
Ji Hoon Shin ◽  
Ho-Young Song ◽  
Dae Hyuk Moon ◽  
Seung-Jun Oh ◽  
Jung-Sun Kim ◽  
...  
Keyword(s):  
Stent Placement ◽  
Balloon Dilatation ◽  
Balloon Catheter ◽  
Inflammatory Cells ◽  
Group Iii ◽  
Group I ◽  
Papillary Projection ◽  
Group Ii ◽  
Urethral Model

Purpose: To evaluate 20 Gy and 40 Gy of intraluminal beta-irradiation using a 188Re-7mercaptoacetyltriglycine (MAG3)-filled balloon catheter to reduce tissue hyperplasia caused by covered stent placement for 12 weeks of follow-up in a canine urethral model. Material and Methods: Ten dogs underwent 188Re-MAG3-filled balloon dilatation immediately after stent placement; 20 Gy at 1-mm tissue depth in group I ( n = 5) and 40 Gy in group II ( n = 5), whereas 5 dogs (group III) underwent conventional balloon dilatation only. Results: There were no significant differences among the three groups for percentage diameter of stenosis, although this was highest in group III. There was a tendency toward lower mean thickness of the epithelial layer and the papillary projection for out-stent area, and thickness of the papillary projection and degree of inflammatory cells for in-stent area in groups I and II compared with group III. Thickness of the papillary projection in out-stent area was significantly different among the three groups ( P = 0.031). It was significantly less thick in group I than in group III ( P<0.05), whereas group II was not significantly different from group III. Conclusion:188Re-MAG3-filled balloon dilatation has the potential to reduce tissue hyperplasia after 12 weeks of follow-up in a canine urethral model. The use of 20 Gy compared to 40 Gy did not show significant differences.

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