scholarly journals Evaluation of the Efficiency of Treatment with Rituximab for Systemic Scleroderma (A Case Report)

2021 ◽  
Vol 11 (1) ◽  
pp. 72-75
Author(s):  
E. N. Harlamova ◽  
Ju. Ju. Karpenko
Keyword(s):  
Clinical Case ◽  
Vital Capacity ◽  
Early Stage ◽  
Genetically Engineered ◽  
Systemic Scleroderma ◽  
Rapid Progression ◽  
Positive Trend ◽  
Initial Decrease ◽  
Diffuse Form ◽  
Male Sex

The article describes a clinical case of a progressive form of systemic scleroderma in a 39-year-old man. The patient has an acute course and rapid progression of the disease with a significant initial decrease in the forced vital capacity of the lungs, with signs of an unfavorable prognosis, such as a diffuse form, a high skin count (> 14), male sex, and high positivity for antibodies to Scl-70. In connection with the ineffectiveness of standard therapy with glucocorticoids and immunosuppressants at an early stage of the disease, the option of treatment with genetically engineered drugs (rituximab) was considered. As a result of the therapy, a positive trend was noted.

A CLINICAL CASE OF PRIMARY HYPERPARATHYROIDISM OF THE OSTEO-VISCERAL FORM

2020 ◽  
pp. 155-161
Author(s):  
Poselyugina O.B. ◽  
Kulish A.S. ◽  
Vasiliev D.F.
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Case ◽  
Early Stage ◽  
Diagnostic Errors ◽  
Epidemiological Studies ◽  
Medical Documentation ◽  
Screening Methods ◽  
Internal Organs ◽  
Blood Calcium ◽  
Slow Development

Introduction. Primary hyperparathyroidism is an endocrine disease resulting from a primary pathology of the parathyroid gland, characterized by increased secretion of parathyroid hormone and increased blood calcium levels. Among the endocrine diseases, primary hyperparathyroidism is the third most common after diabetes mellitus and thyroid disease. In Russia, according to epidemiological studies, primary hyperparathyroidism is found in 1% of the population, women suffer 2-3 times more often than men do, and the average age of diagnosis is 54-59 years. In the absence of a timely diagnosis, primary hyperparathyroidism causes systemic damage to internal organs: renal impairment, nephrolithiasis, esophageal affection, cardiovascular and nervous system involvement, and it leads to a violation of bone tissue integrity. The aim is to demonstrate a clinical case of a patient with primary hyperparathyroidism and to analyze the stages of diagnosis of the disease and treatment. Material and methods. The review of medical literature on the problem of diagnostics and treatment of primary hyperparathyroidism was performed, as well as an analysis of the patient’s medical documentation with this pathology. Results and discussion. A variant of complicated course of primary hyperparathyroidism of bone and visceral form is considered. About 15 years passed from the moment of appearance of the first symptoms of the disease to the development of complications of renal and bone system. Despite the slow development of the disease and availability of screening methods, hyperparathyroidism was detected at the stage of complications. This article provides a detailed analysis of the primary hyperparathyroidism history, as well as analyzes the possibilities of diagnosis, treatment and prevention of this pathology. The efficacy of the therapy has been assessed, and ways of correction have been outlined. The analysis of the reasons that made it difficult to diagnose this pathology at an early stage, before the development of serious complications of internal organs, has been carried out. Conclusions: It can be assumed that the presented clinical case will increase the awareness of physicians, especially therapists, about the primary manifestations of this pathology and the peculiarities of its detection and routing the patient, which will allow avoiding many diagnostic errors.

scholarly journals Big Data Analytics in urology: the story so far and the road ahead

2021 ◽  
Vol 13 ◽  
pp. 175628722199813
Author(s):  
B. M. Zeeshan Hameed ◽  
Aiswarya V. L. S. Dhavileswarapu ◽  
Nithesh Naik ◽  
Hadis Karimi ◽  
Padmaraj Hegde ◽  
...  
Keyword(s):  
Big Data ◽  
Data Analytics ◽  
Early Stage ◽  
Big Data Analytics ◽  
Positive Trend ◽  
The Road ◽  
Healthcare Data ◽  
Urological Disorders ◽  
Different Sources

Artificial intelligence (AI) has a proven record of application in the field of medicine and is used in various urological conditions such as oncology, urolithiasis, paediatric urology, urogynaecology, infertility and reconstruction. Data is the driving force of AI and the past decades have undoubtedly witnessed an upsurge in healthcare data. Urology is a specialty that has always been at the forefront of innovation and research and has rapidly embraced technologies to improve patient outcomes and experience. Advancements made in Big Data Analytics raised the expectations about the future of urology. This review aims to investigate the role of big data and its blend with AI for trends and use in urology. We explore the different sources of big data in urology and explicate their current and future applications. A positive trend has been exhibited by the advent and implementation of AI in urology with data available from several databases. The extensive use of big data for the diagnosis and treatment of urological disorders is still in its early stage and under validation. In future however, big data will no doubt play a major role in the management of urological conditions.

scholarly journals Efficacy of early antifibrotic treatment for idiopathic pulmonary fibrosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keishi Sugino ◽  
Hirotaka Ono ◽  
Natsumi Watanabe ◽  
Masahiro Ando ◽  
Eiyasu Tsuboi ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Disease Progression ◽  
Vital Capacity ◽  
Early Stage ◽  
Japanese Patients ◽  
Oxygen Desaturation ◽  
Stage I ◽  
Relative Decline ◽  
Antifibrotic Drugs

Abstract Background Although antifibrotic drugs, including nintedanib and pirfenidone, slow the progression of idiopathic pulmonary fibrosis (IPF), there is little data about the timing of start of antifibrotic treatment in real-world clinical practice. The present study aimed to clarify the efficacy of nintedanib and pirfenidone in patients with early-stage IPF. Methods We compared survival and disease progression between patients with IPF with Japanese Respiratory Society (JRS) disease severity system stage I with and without oxygen desaturation on the 6-min walk test (6MWT) and increased the gender–age–physiology (GAP) staging. We examined the efficacy of antifibrotic drugs in patients with early-stage IPF. Results The severity of stage I IPF (n = 179) according to the JRS criteria consisted of the following GAP staging criteria: stage I, 111 cases; stage II, 58 cases; stage III, 10 cases. The duration from the initial visit to disease progression and survival time was significantly shorter in JRS stage I patients with oxygen desaturation on the 6MWT or with increased GAP staging (unfavorable group) compared with patients without those factors. In the unfavorable group, the relative decline in percentage predicted forced vital capacity (%FVC) over 6 months was significantly lower in patients undergoing antifibrotic treatment compared with non-treated patients. Conclusion Antifibrotic drugs have a beneficial effect on the decline in %FVC in Japanese patients with early-stage IPF who have oxygen desaturation on the 6MWT or increased GAP staging.

scholarly journals Association of Two Indices of Insulin Resistance Marker with Abnormal Liver Function Tests: A Cross-Sectional Population Study in Taiwanese Adults

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 4
Author(s):  
Adi Lukas Kurniawan ◽  
Chien-Yeh Hsu ◽  
Jane C.-J. Chao ◽  
Rathi Paramastri ◽  
Hsiu-An Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Function ◽  
Early Stage ◽  
Abnormal Liver Function ◽  
Low Grade ◽  
Positive Trend ◽  
Gamma Glutamyl Transferase ◽  
Cross Sectional ◽  
Tyg Index ◽  
Glutamyl Transferase

Background and objectives: Insulin resistance (IR) is frequently associated with chronic low-grade inflammation and has an important role as a mediator in the development of liver disease. Thus, this study aimed to explore the relationship between two indexes of IR and abnormal liver function parameters. Materials and Methods: This cross-sectional study obtained data of 41,510 men and 92,357 women aged ≥30 years from a private health screening institute in Taiwan. Two IR indexes namely triglyceride-glucose (TyG) index and triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio were used to examine their relationship to predict abnormal liver function parameters (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP)). Results: Positive trend was shown for the association of TyG index in the highest quintile (Q5) and risk of high AST (OR = 1.45, 95% CI: 1.33–1.57), high ALT (OR = 1.85, 95% CI: 1.73–1.97), high GGT (OR = 2.04, 95% CI: 1.93–2.15), and high ALP (OR = 1.13, 95% CI: 1.07–1.19) compared with the median quintile (Q3) in the fully adjusted model. Similarly, participants in the Q5 of the TG/HDL-C ratio were associated with 1.38 (95% CI: 1.27–1.49), 1.71 (95% CI: 1.61–1.82), 1.75 (95% CI: 1.66–1.84), and 1.21 (1.16–1.27) odds for having high AST, ALT, GGT, and ALP respectively. The AUC (95% CI) value of the TyG index for predicting high AST, high ALT, and high GGT was 0.699 (0.692–0.705), 0.738 (0.734–0.742), and 0.752 (0.749–0.755), respectively. Meanwhile, the AUC (95% CI) of the TG/HDL-C ratio for predicting high AST, high ALT, and high GGT was 0.680 (0.673–0.686), 0.738 (0.734–0.742), 0.734 (0.731–0.738), respectively. Conclusions: Our study supported that the TyG index and TG/HDL-C ratio may be useful as non-invasive methods to predict the existence of impaired liver function in the early stage.

scholarly journals Riedel's thyroiditis: diagnostic difficulties (clinical case and brief review)

2021 ◽  
pp. 166-171
Author(s):  
A. A. Rybakova ◽  
N. M. Platonova ◽  
T. V. Soldatova ◽  
N. V. Tarbaeva ◽  
T. S. Panevin ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Clinical Case ◽  
Clinical Performance ◽  
Fine Needle Biopsy ◽  
Morphological Description ◽  
Positive Trend ◽  
Riedel’S Thyroiditis ◽  
Compression Syndrome ◽  
Diagnostic Difficulties ◽  
Riedel's Thyroiditis

Riedel's thyroiditis is a rare disease characterized by chronic fibrosis. Clinical performance of this disease is dense stony goiter, which can poorly be displaced during palpation. The overgrowth of the goiter can lead to the development of compression syndrome. To diagnose we need to made fine needle biopsy and made the final diagnose according to its results or according to the morphological description of the postoperative material. An important step in the diagnosis of Riedel's thyroiditis is the determination of serum IgG and IgG4 to exclude an IgG4-associated disease. Treatment of this disease includes drug therapy, which is based on glucocorticosteroids administration or surgical treatment when develops compression syndrome. This article presents a clinical case of a patient with Riedel's thyroiditis; the main complaints were associated with the growth of goiter and the development of compression syndrome. In this regard, patient underwent surgery on the thyroid gland, and after this we get final diagnose. Due to feeling unwell, drug therapy with glucocorticosteroids was prescribed, against the background of which we noted a positive trend.

Commercialising genetically engineered animal biomedical products

2008 ◽  
Vol 20 (1) ◽  
pp. 61 ◽  
Author(s):  
Eddie J. Sullivan ◽  
Jerry Pommer ◽  
James M. Robl
Keyword(s):  
Biomedical Applications ◽  
Gap Analysis ◽  
Early Stage ◽  
Genetically Engineered ◽  
The Public ◽  
Public Benefit ◽  
The Past ◽  
Cell Banking ◽  
Stage Development ◽  
Founder Animal

Research over the past two decades has increased the quality and quantity of tools available to produce genetically engineered animals. The number of potentially viable biomedical products from genetically engineered animals is increasing. However, moving from cutting-edge research to development and commercialisation of a biomedical product that is useful and wanted by the public has significant challenges. Even early stage development of genetically engineered animal applications requires consideration of many steps, including quality assurance and quality control, risk management, gap analysis, founder animal establishment, cell banking, sourcing of animals and animal-derived material, animal facilities, product collection facilities and processing facilities. These steps are complicated and expensive. Biomedical applications of genetically engineered animals have had some recent successes and many applications are well into development. As researchers consider applications for their findings, having a realistic understanding of the steps involved in the development and commercialisation of a product, produced in genetically engineered animals, is useful in determining the risk of genetic modification to the animal v. the potential public benefit of the application.

scholarly journals Mild Encephalitis with a Reversible Splenial Lesion: A Clinical Benign Condition, often Underrecognized – Clinical Case and Literature Review

2017 ◽  
Vol 08 (02) ◽  
pp. 281-283 ◽  
Author(s):  
Sandro Zambito Marsala ◽  
Eleonora Antichi ◽  
Michele Pistacchi ◽  
Manuela Gioulis ◽  
Rosa Maria Candeago ◽  
...  
Keyword(s):  
Literature Review ◽  
Corpus Callosum ◽  
Clinical Case ◽  
Early Stage ◽  
Spontaneous Resolution ◽  
Electrolyte Disorders ◽  
Posterior Portion ◽  
Benign Condition ◽  
Diagnostic Panel ◽  
Reversible Lesion

ABSTRACTMild encephalitis with reversible lesion in the splenium is a clinicoradiological syndrome characterized by a variegated symptomatology with a solitary mass in the central portion of the splenium of the corpus callosum. Complete spontaneous resolution is the hallmark of this syndrome, though its pathogenesis is still unknown. We describe the clinical picture of a 51-year-old woman who developed a partial sensitive seizure, with MRI evidence of a lesion localized in the posterior portion of the corpus callosum. The patient made a full recovery thanks to the administration of antiepileptic drugs. Acquiring knowledge of this syndrome, in the wide diagnostic panel which includes vertebrobasilar diseases besides the broad range of metabolic and electrolyte disorders, is crucial to a prompt clinical diagnosis and in establishing a reliable prognosis at an early stage.

scholarly journals Paralytic ileus as the presenting symptom for Guillain–Barré syndrome: a case report

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989316
Author(s):  
Kuang-Heng Lee ◽  
Tsung-Han Ho ◽  
Jiunn-Tay Lee ◽  
Li-Fan Lin ◽  
Wei-Chou Chang ◽  
...  
Keyword(s):  
Paralytic Ileus ◽  
Early Recognition ◽  
Early Stage ◽  
Immunoglobulin Therapy ◽  
Guillain Barre Syndrome ◽  
Rapid Progression ◽  
Limb Weakness ◽  
Intravenous Immunoglobulin Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain–Barré syndrome (GBS) is an acute neuroimmunological disorder characterized by rapidly ascending symmetrical limb weakness, areflexia, and sensory deficits. Approximately 65% of patients with GBS present with autonomic dysfunction, which commonly occurs in advanced stages. However, paralytic ileus, a sign of gastrointestinal dysautonomia, is rare as the presenting feature in GBS before motor weakness becomes evident. We report the case of a 54-year-old man admitted to the Emergency Department with paralytic ileus as the prodromal feature in early-stage GBS. Total parenteral feeding and prokinetic use were initiated, but no clinical improvement was observed. The patient showed rapid progression to quadriplegia, which was ultimately determined to be respiratory muscle failure requiring mechanical ventilation and intensive care unit admission. He underwent 5 days of intravenous immunoglobulin therapy and muscle strength was partially improved thereafter. However, the patient’s enteral nutritional support was undesirable because of persistent poor gastric emptying complicated by fungemia and profound sepsis throughout the hospital course. Finally, he died 1 month after admission. Ignorance of this unusual prodrome to GBS could result in delayed treatment, along with potential progression to life-threatening events. Early recognition of GBS and prompt immunotherapy are critical for reducing morbidity and mortality.

DIAGNOSIS OF NONRENTHENOLOGICAL AXIAL SPONDYLITIS IN A YOUNG GIRL WITH A FAMILY HISTORY OF RHEUMATIC PATHOLOGY

2019 ◽  
Vol 5 (3) ◽  
pp. 19-25
Author(s):  
А. Демидова ◽  
A. Demidova
Keyword(s):  
Ankylosing Spondylitis ◽  
Family History ◽  
Clinical Case ◽  
Early Stage ◽  
Young Girl ◽  
Functional Disorders ◽  
Hip Joints ◽  
Lower Back ◽  
Initial Request ◽  
History Of

The article presents a clinical case of nonrenthenological ankylosing spondylitis (as). AU was diagnosed at the initial request for medical help for pain in the lower back and hip joints. Timely diagnosis was carried out taking into account the burdened hereditary anamnesis. AU was detected at an early stage of the disease, when persistent functional disorders in the spine and joints have not yet formed, which could later become irreversible.

scholarly journals Association Study between Promoter Polymorphism of TPH1 and Progression of Idiopathic Scoliosis

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Vasil Yablanski ◽  
Svetla Nikolova ◽  
Evgeni Vlaev ◽  
Alexey Savov ◽  
Ivo Kremensky
Keyword(s):  
Idiopathic Scoliosis ◽  
Early Stage ◽  
Population Sample ◽  
Promoter Polymorphism ◽  
European Population ◽  
Rapid Progression ◽  
Eastern European ◽  
Exact Test ◽  
Disease Modifier ◽  
Curve Severity

The concept of disease-modifier genes as an element of genetic heterogeneity has been widely accepted and reported. The aim of the current study is to investigate the association between the promoter polymorphism TPH1 (rs10488682) and progression of idiopathic scoliosis (IS) in Eastern European population sample. A total of 105 patients and 210 healthy gender-matched controls were enrolled in this study. The TPH1 promoter polymorphism was genotyped by amplification followed by restriction. The statistical analysis was performed by Fisher’s Exact Test. The results indicated that the genotypes and alleles of TPH1 (rs10488682) are not correlated with curve severity, curve pattern, or bracing. Therefore, the examined polymorphic variant could not be considered as a genetic factor with modifying effect of IS. In conclusion, this case-control study revealed no statistically significant association between TPH1 (rs10488682) and progression of IS in Eastern European population sample. These preliminary results should be replicated in extended population studies including larger sample sizes. The identification of molecular markers for IS could be useful for a more accurate prognosis of the risk for a rapid progression of the curve. That would permit early stage treatment of the patient with the least invasive procedures.

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