Clinical assessment of Super bioavailable Itraconazole 50 mg in dermatophytosis (Clear 50)

Super bioavailable itraconazole (SBITZ) is a newer formulation of itraconazole which is recently launched in India. But there is no published clinical evidence of SBITZ in the management of dermatophytosis in Indian patients. A Real world retrospective data analysis was conducted with 346 dermatologists across India to assess the response of Indian patients with dermatophytosis who were prescribed super bioavailable itraconazole 50 mg twice a day for 4 weeks.Out of 4625 patients’ data, 2743 were included for final analysis. Mean age of patients was 36.17±12.05 years with male preponderance. Most of the patients were diagnosed as T. cruris. At the end of treatment, 51% of patients achieved complete clinical cure while 46% achieved clinical improvement (>50% symptom clearance) and 3% were labelled as clinical failure. About 70% patients achieved clearance in body surface area. Mean total symptom score (TSS) was reduced to 0.74±1.1 from 7.29±1.73 while mean BSA score was reduced from 1.96±0.83 to 0.38±0.65 (p<0.05). Similar type of improvements were seen in naïve, recurrent and chronic dermatophytosis patients. A total of 61 adverse effects (AE) were reported from 56 patients. All the AEs were mild to moderate in nature and did not require discontinuation of therapy.Patients treated with super bioavailable itraconazole showed greater improvement in clearance of symptoms as well as lesions. Additionally, it showed significant improvement in naïve, recurrent and chronic patients enabling its placement in armamentarium of management of all types of dermatophytosis.

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Serum levels and pharmacokinetic of rituximab in Bi-weekly R-CHOP in elderly patients with DLBCL treated in the RICOVER-60 trial:

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.7537 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 7537-7537 ◽

Cited By ~ 8

Author(s):

M. Reiser ◽

M. Wenger ◽

C. Nickenig ◽

N. Peter ◽

B. Metzner ◽

...

Keyword(s):

Elderly Patients ◽

Final Analysis ◽

Serum Levels ◽

Aggressive Lymphoma ◽

Serum Samples ◽

Elimination Phase ◽

End Of Treatment ◽

Pharmacokinetic Properties ◽

Before And After ◽

Dose Dense

7537 Background: The combination of Rituximab (R) and CHOP is considered the standard of treatment for DLBCL in elderly patients (pts) but there is hardly any data on the pharmacokinetic of Rituximab in aggressive lymphoma pts. The RICOVER-60 trial using Rituximab + bi-weekly CHOP-14 resulted in improved TTF in 828 elderly DLBCL pts (Blood 106:9a, 2005). Objective: To study serum levels and pharmacokinetic properties of Rituximab when combined with CHOP-14 in elderly DLBCL pts. Methods: Blood samples of 20 pts were taken before and after Rituximab infusion at each chemotherapy cycle. Additional samples were taken after the end of treatment and at the following time points: after 1 week, 1 month, 2 months, 3 months, 6 months and 9 months, respectively. Peak serum samples were taken within a maximum of 30 min, all samples were centrifuged at 1000 g for 10 min (room temperature) and stored at −20 degrees C. Batch samples were shipped to Xendo Laboratories, Groningen, The Netherlands, and analysed. Results: Samples from 20 pts were evaluable for this analysis with 16/20 pts having completed all 8 cycles of treatment, yet. The median (range) of serum Rituximab levels (μg/ml) before each cycle were: #1 0 (0–0); #2 39 (13–62); #3 74 (47–109); #4 95 (40–136); #5 111 (55–157); #6 114 (12–518); #7 125 (72–207);#8 116 (75–304). After therapy median (range) of serum Rituximab levels were: 163 (67–248) at 1 week; 101 (44–163) at 1 month; 55 (1–123) at 2 months; 34 (1–577) at 3 months; 5 (0–103) at 6 months; 1 (0–128) at 9 months. At 9 months samples from 7 pts were evaluable with detectable serum Rituximab levels in 4/7 pts. Conclusion: In the dose dense regimen R+CHOP-14 Rituximab levels increased after each subsequent cycle for the first 4 cycles. During cycle 5- 8 the serum Rituximab levels reached a plateau and decreased constantly after the end of treatment with detectable levels even after 9 months. Based on this data the German High Grade NHL Study Group (DSHNHL) further investigates a densification of Rituximab in the first cycles in order to improve treatment outcome. A final analysis of all 20 pts and a pharmacokinetic model of Rituximab distribution and elimination phase will be presented at the meeting. [Table: see text]

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The Effect of Phacoemulsification plus Goniosynechialysis in Acute and Chronic Angle Closure Patients with Extensive Goniosynechiae

10.21203/rs.2.58/v2 ◽

2019 ◽

Author(s):

Tian Tian ◽

MEI LI ◽

Yingzi Pan ◽

Yu Cai ◽

Yuan Fang

Keyword(s):

Success Rate ◽

Clinical Evidence ◽

Angle Closure ◽

Chronic Patients ◽

Surgical Time ◽

Treatment Protocols ◽

Chronic Group ◽

Primary Angle Closure Glaucoma ◽

Acute Group ◽

Time Period

Abstract Background Patients with primary angle closure/glaucoma (PAC/PACG) with extensive peripheral anterior synechiae (PAS), and coexisting cataract, increasingly have been treated with phacoemulsification combined with goniosynechialysis (Phaco-GSL). Since the mechanisms of acute and chronic PAC/PACG may differ, the treatment effect of this procedure also may differ. The purpose of this study was to establish whether there was a difference in the therapeutic effect of Phaco-GSL on these two groups of patients, the results of which could provide clinical evidence for improvement in treatment protocols for patients with PAC/PACG and extensive PAS. Methods This study was a retrospective cohort study. Twenty-seven patients, 13 with acute PAC/PACG and 14 with chronic PAC/PACG, were treated surgically by Phaco-GSL. The intraocular pressure (IOP), surgical success rate, the need of medication, the extent of PAS, the time and the rate of recurrence of PAS (re-PAS) and other indicators were observed post-operatively for at least three months. Results After surgery, IOP decreased (preoperative vs postoperative: 29.77±11.55 mmHg vs 14.92±1.66 mmHg in the acute group and 26.00±11.2 mmHg vs 14.93±2.7 mmHg in the chronic group), the extent of PAS reduced (preoperative vs. postoperative: 314.23±49.07° vs 116.54±73.78° in the acute group and 285.00±53.28° vs 156.43±56.35° in the chronic group), the topical and systemic anti-glaucoma drug requirements decreased, in both groups and in the acute group, respectively. Compared with the acute group, the success rate (acute vs chronic: 100% vs 64.3%) was lower in the chronic group, while the incidence of re-PAS (acute vs chronic: 30% vs 83.3%) were higher in the chronic group. All differences mentioned above were statistically significant (p < 0.05). In addition, there were five patients in total who showed re-PAS of more than 90° (4 in chronic group and 1 in acute group) and all these re-PASs formed within 1 week postoperatively. Conclusion Although Phaco-GSL is effective in both groups, there may be differences in the effect between the two groups. Chronic patients are more susceptible to re-PAS. Thus, these patients should be observed closely and treated appropriately in the early post-surgical time period.

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Risk Factors and Outcomes for Bloodstream Infections Secondary to Clostridium difficile Infection

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01927-15 ◽

2015 ◽

Vol 60 (1) ◽

pp. 252-257 ◽

Cited By ~ 20

Author(s):

Marco Falcone ◽

Alessandro Russo ◽

Federica Iraci ◽

Paolo Carfagna ◽

Paola Goldoni ◽

...

Keyword(s):

Risk Factors ◽

Clostridium Difficile ◽

Clinical Evidence ◽

Bloodstream Infections ◽

Final Analysis ◽

Enteric Bacteria ◽

Content Type ◽

Etiologic Agents ◽

Incidence Risk ◽

Poor Outcomes

ABSTRACTWe determined the incidence, risk factors, and outcomes of bloodstream infections (BSI) subsequent toClostridium difficileinfection (CDI). We performed a retrospective study of all patients with definite diagnosis of CDI admitted from January 2014 to December 2014 in two large hospitals in Rome. Two groups of patients were analyzed: those with CDI and subsequent BSI (CDI/BSI+) and those with CDI and no evidence of primary BSI (CDI/BSI−). Data about clinical features, microbiology, treatments, and mortality were obtained. Overall, 393 cases of CDI were included in the final analysis: 72 developed a primary nosocomial BSI, while 321 had CDI without microbiological and clinical evidence of BSI. Etiologic agents of BSI wereCandidaspecies (47.3%),Enterobacteriaceae(19.4%), enterococci (13.9%), and mixed infections (19.4%). In multivariate analysis, ribotype 027 status (odds ratio [OR], 6.5), CDI recurrence (OR, 5.5), severe CDI infection (OR, 8.3), and oral vancomycin at >500 mg/day (OR, 3.1) were recognized as factors independently associated with the development of nosocomial BSI. Thirty-day mortality from CDI diagnosis was higher for patients of the CDI/BSI+group than for the controls (38.9 versus 13.1%;P< 0.001). Among patients of the CDI/BSI+group, mortality attributable to primary BSI was as high as 57%. Our findings suggest that severe CDI is complicated by the development of nosocomial BSI.Candidaspecies and enteric bacteria appear to be the leading causative pathogens and are associated with poor outcomes.

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The Effect of Phacoemulsification plus Goniosynechialysis in Acute and Chronic Angle Closure Patients with Extensive Goniosynechiae

10.21203/rs.2.58/v1 ◽

2018 ◽

Author(s):

Tian Tian ◽

Mei Li ◽

Yingzi Pan ◽

Yu Cai ◽

Yuan Fang

Keyword(s):

Success Rate ◽

Clinical Evidence ◽

Angle Closure ◽

Chronic Patients ◽

Surgical Time ◽

Chronic Group ◽

Primary Angle Closure Glaucoma ◽

Acute Group ◽

Time Period ◽

Accurate Treatment

Abstract Background Patients with primary angle closure/glaucoma (PAC/PACG) with extensive peripheral anterior synechiae (PAS), and coexisting cataract, increasingly have been treated with phacoemulsification combined with goniosynechialysis (Phaco-GSL). Since the mechanisms of acute and chronic PAC/PACG may differ, the treatment effect of this procedure also may differ. The purpose of this study was to establish whether there was a difference in the therapeutic effect of Phaco-GSL on these patients, which might provide clinical evidence for giving more accurate treatment for them. Methods This study was a retrospective cohort study. Twenty-seven patients, 13 with acute PAC/PACG and 14 with chronic PAC/PACG, were treated surgically by Phaco-GSL. The intraocular pressure (IOP), surgical success rate, the need of medication, the extent of PAS, the time and the rate of recurrence of PAS (re-PAS) and other indicators were observed post-operatively for at least three months. Results After surgery, IOP decreased (preoperative vs postoperative: 29.77±11.55 mmHg vs 14.92±1.66 mmHg in the acute group and 26.00±11.2 mmHg vs 14.93±2.7 mmHg in the chronic group), the extent of PAS reduced (preoperative vs. postoperative: 314.23±49.07° vs 116.54±73.78° in the acute group and 285.00±53.28° vs 156.43±56.35° in the chronic group), the topical and systemic anti-glaucoma drug requirements decreased, in both groups and in the acute group, respectively. Compared with the acute group, the success rate (acute vs chronic: 100% vs 64.3%) was lower in the chronic group, while the incidence of re-PAS (acute vs chronic: 30% vs 83.3%) were higher in the chronic group. All differences mentioned above were statistically significant (p < 0.05). In addition, there were five patients in total who showed re-PAS of more than 90° (4 in chronic group and 1 in acute group) and all these re-PASs formed within 1 week postoperatively. Conclusion Although Phaco-GSL is effective in both groups, there may be differences in the effect between the two groups. Chronic patients are more susceptible to re-PAS. Thus, these patients should be observed closely and treated appropriately in the early post-surgical time period.

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A clinico pathological study of acute appendicitis with special reference to ultrasonography

International Surgery Journal ◽

10.18203/2349-2902.isj20171614 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1647

Author(s):

Mohammed Faheem Inamdar ◽

Sali Manjappa ◽

N. M. Inamdar

Keyword(s):

Acute Appendicitis ◽

Histopathological Examination ◽

Final Analysis ◽

Age Group ◽

Pathological Study ◽

Alvarado Score ◽

Male Predominance ◽

Male Preponderance ◽

Rule Out

Background: Acute appendicitis is one of the commonest conditions treated at emergency, despite of advances in diagnostic medicine and therapeutics, the diagnosis of appendicitis remains essentially clinical, requiring clinical acumen and surgical knowledge. Maximum incidence noted in second and third decade of life with male predominance. Ultrasonograpy is shown to be effective in the diagnosis of acute appendicitis with a sensitivity of 84 to 89% and specificity of 92 to 98%. Objectives of the study was to study the clinical features of acute appendicitis regarding Alvarado score. Role of USG and HPE Examination in supporting the clinical diagnosis of acute appendicitis and the morbidity, mortality of emergency appendicectomy.Methods: 100 patients who were admitted to VIMS hospital, Bellary, from November 2004 to April 2006 with a clinical suspicion of acute appendicitis were included in the present study. Ultrasonography and Histopathological Examination was done in all cases and results were correlated with final analysis. Results were analyzed using 'Z’ test, Chi-squire test, sensitivity and specificity.Results: In present study of 100 cases 77 were males and 23 Females patient. Out of which 60 are in 15 to 30 years, 21 patients are 10 to 15 years followed by 13 in the age group of 30-40 years. All are undergone appendicectomy. 11 patents undergone Elective, and 89 emergency appendicectomy. Ultrasound was coming positive in 92 cases and negative in 8 cases. The sensitivity and specificity of 95.7% and 80% Respectively. HPE was done in all 100 cases 95 were positive 5 were negative with sensitivity of 96.8% and specificity of 80%.Conclusions: Appendicitis is commonest in 2nd and 3rd decade followed by 4th decade with a male preponderance, Ultrasonography is useful in females to rule out any gynecological pathology. Patients who come early within 2 to 3 days of symptoms of acute appendicitis, emergency appendicectomy is the treatment of the choice and were will be less morbidity and mortality, post operatively.

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Dynamics of Liver Stiffness Values by means of Transient Elastography in Patients with HCV Liver Cirrhosis undergoing Interferon Free Treatment

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.262.dyn ◽

2017 ◽

Vol 26 (2) ◽

pp. 145-150 ◽

Cited By ~ 13

Author(s):

Ioan Sporea ◽

Raluca Lupușoru ◽

Ruxandra Mare ◽

Alina Popescu ◽

Liana Gheorghe ◽

...

Keyword(s):

Liver Cirrhosis ◽

Transient Elastography ◽

Antiviral Treatment ◽

Sustained Viral Response ◽

Liver Stiffness ◽

Final Analysis ◽

Viral Response ◽

Free Treatment ◽

End Of Treatment ◽

The Mean

Background & Aims: Liver stiffness (LS) measurement by Transient Elastography (TE) has been widely accepted as a tool for fibrosis assessment. The aim of this study was to assess LS dynamics in a group of patients with HCV liver cirrhosis after interferon free treatment (IFT).Methods: This two-center clinical trial included 225 patients with compensated HCV cirrhosis (all genotype 1b), who received IFT for 12 weeks. All patients were evaluated by means of TE at the beginning and at the end of treatment (EOT), and a subgroup (170 patients) also 12 weeks after EOT; all of them had sustained viral response (SVR). Reliable LS measurements (LSM) were defined as a median value of 10 valid LSM, with IQR <30% and SR ≥60%. Both M and XL probes were used. For diagnosing cirrhosis we used a cut-off value of 12kPa as proposed by the Tsochatzis meta-analysis. We considered a decrease or increase of more than 10% in LSM as being significant.Results: Out of 225 subjects, reliable measurements were obtained in 93.7%, so that the final analysis included 211 patients. The mean LS values decreased significantly after IFT: 26.4±11.7 vs. 23.5±13.3 kPa (p=0.01). Most patients, 59.2% (125/211) presented more than 10% decrease in LS values, 24.1% (51/211) had stable LS values, while in 16.4% (35/211) cases, the LS values increased. In the subgroup of 170 patients with LSM also performed 12 weeks after EOT (SVR), the mean LS values were significantly lower as compared to baseline: 21.3±11 kPa vs. 27.4±11.9 kPa (p<0.0001) and also as compared to EOT: 21.3±11 kPa vs. 23.7±13.3 kPa (p<0.0001).Conclusion: In our patients with HCV liver cirrhosis, the mean LS values evaluated by TE significantly decreased after antiviral treatment at EOT and also 12 weeks after EOT as compared to baseline. Overall, about 60% of patients had LS values at EOT lower than at baseline, while 12 weeks after EOT about 75% of patients had LS values lower than at baseline. –.Abbreviations: APRI: aspartate aminotransferase platelet ratio index; BMI: body mass index; DAA: direct acting agents; EOT: end of treatment; FIB-4: fibrosis 4; HBV: hepatitis B virus; HCV: hepatitis C virus; IFT: interferon free treatment; IQR: interquartile range; LS: liver stiffness; LSM: liver stiffness measurements; SR: success rate; SVR: sustained viral response; TE: Transient Elastography.

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Ultrastructural Study of Human Testicular Biopsies in Infertility

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100090762 ◽

1976 ◽

Vol 34 ◽

pp. 156-157

Author(s):

Shirley Siew ◽

Philip Troen ◽

Howard R. Nankin

Keyword(s):

Electron Microscopy ◽

Transmission Electron Microscopy ◽

Basement Membrane ◽

Leydig Cells ◽

Clinical Evidence ◽

Young Male ◽

Germinal Epithelium ◽

Transmission Electron ◽

Age Range ◽

Male Subjects

Testicular biopsies were obtained from six young male subjects (age range 24-33) who complained of infertility and who had clinical evidence of oligospermia. This was confirmed on histological examination which showed a broad spectrum from profound hypospermatogenesis to relatively normal appearing germinal epithelium. Thickening of the tubular walls was noted in half of the cases and slight peritubular fibrosis in one. The Leydig cells were reported as normal or unremarkable.Transmission electron microscopy showed that the thickening of the supporting tissue of the germinal epithelium was caused more by an increase in the thickness of the layers of the lamina propria than of the tubular wall itself. The changes in the basement membrane of the tubular wall consisted mostly of a greater degree of infolding into the tubule and some reduplication which gave rise to a multilayered appearance.

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Severe Drooling and Treatment With Botulinum Toxin

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.1.15 ◽

2012 ◽

Vol 21 (1) ◽

pp. 15-21

Author(s):

Merete Bakke ◽

Allan Bardow ◽

Eigild Møller

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Health Risk ◽

Flow Rate ◽

Clinical Evidence ◽

Acetylcholine Release ◽

Psychosocial Problems ◽

Rate Reduction ◽

Local Inhibition ◽

Surgical Treatments

Severe drooling is associated with discomfort and psychosocial problems and may constitute a health risk. A variety of different surgical and non-surgical treatments have been used to diminish drooling, some of them with little or uncertain effect and others more effective but irreversible or with side effects. Based on clinical evidence, injection with botulinum toxin (BTX) into the parotid and submandibular glands is a useful treatment option, because it is local, reversible, and with few side effects, although it has to be repeated. The mechanism of BTX is a local inhibition of acetylcholine release, which diminishes receptor-coupled secretion and results in a flow rate reduction of 25–50% for 2–7 months.

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