scholarly journals Prevalence and clinical features of COVID-19 in a large cohort of 199 patients with sarcoidosis

2020 ◽  
Author(s):  
Anne-Claire Desbois ◽  
Cindy Marques ◽  
Leila Lefèvre ◽  
Serge Barmo ◽  
Camille Lorenzo ◽  
...  
Keyword(s):  
General Population ◽  
Clinical Features ◽  
Cardiac Involvement ◽  
Term Treatment ◽  
Hospitalized Patients ◽  
Large Cohort ◽  
University Hospital ◽  
Long Term Treatment ◽  
Higher Doses

Abstract Objective: To investigate the prevalence, clinical features and outcomes of coronavirus disease 2019 (COVID-19) among sarcoidosis patients. Methods: We retrospectively collected features of COVID-19 in a cohort of patients with sarcoidosis followed in a single tertiary university hospital. Results: Among 199 sarcoidosis patients [mean age 58.8 (±14) years, 86 (43.2%) men], 26 (13%) were diagnosed with COVID-19 [definite (n=7), probable (n=12) and possible (n=7)]. Twenty-four out of 26 patients (92%) had at least one comorbidity, and 11/26 (42%) had two or more comorbidities. Demographic and clinical features of COVID-19 positive patients were similar to those of COVID-19 negative patients. The administration of hydroxychloroquine or immunosuppressant was not associated with the occurrence or the severity of COVID-19. Four out of 26 (15.4%) COVID-19 positive patients required admission to hospital and two of them died. Hospitalized patients [mean age of 61 (±11.5) years] were receiving higher doses of long term treatment with corticosteroids than non-hospitalized patients; 4/4 had pulmonary and 2/4 cardiac involvement of sarcoidosis, and all one or more comorbidity. Conclusion: The prevalence of COVID-19 in sarcoidosis is slightly higher to that of the general population. Almost half of the COVID-19 positive patients have two or more comorbidities and about 15% present a severe course.

scholarly journals Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis

2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Andriko Palmowski ◽  
Frank Buttgereit
Keyword(s):  
Adverse Events ◽  
Takayasu Arteritis ◽  
Term Treatment ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Serious Adverse Events ◽  
Glucocorticoid Treatment ◽  
Long Term Treatment ◽  
Higher Doses

Abstract Purpose While glucocorticoids (GCs) are effective in large vessel vasculitis (LVV), they may cause serious adverse events (AEs), especially if taken for longer durations and at higher doses. Unfortunately, patients suffering from LVV often need long-term treatment with GCs; therefore, toxicity needs to be expected and countered. Recent Findings GCs remain the mainstay of therapy for both giant cell arteritis and Takayasu arteritis. In order to minimize their toxicity, the following strategies should be considered: GC tapering, administration of conventional synthetic (e.g., methotrexate) or biologic (e.g., tocilizumab) GC-sparing agents, as well as monitoring, prophylaxis, and treatment of GC-related AEs. Several drugs are currently under investigation to expand the armamentarium for the treatment of LVV. Summary GC treatment in LVV is effective but associated with toxicity. Strategies to minimize this toxicity should be applied when treating patients suffering from LVV.

Rotigotine use in long-term treatment of restless legs syndrome: Experience in General University Hospital of Castellon

2013 ◽  
Vol 14 ◽  
pp. e251-e252
Author(s):  
P. Ruiz-Elena ◽  
J. Pinzon-Martinez ◽  
A. Gomis-Devesa ◽  
I. Barreda-Altaba ◽  
J. Ortega-Albas ◽  
...  
Keyword(s):  
Restless Legs Syndrome ◽  
Term Treatment ◽  
University Hospital ◽  
Restless Legs ◽  
Long Term Treatment

Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska University Hospital experience

2007 ◽  
Vol 46 (6) ◽  
pp. 817-827 ◽  
Author(s):  
Zahra Taheri-Kadkhoda ◽  
Thomas Björk-Eriksson ◽  
Karl-Axel Johansson ◽  
Claes Mercke
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Term Treatment ◽  
University Hospital ◽  
Treatment Results ◽  
Hospital Experience ◽  
Long Term Treatment

Improving Survival in Lymphangioleio­myomatosis: A 16-Year Observational Study in a Large Cohort of Patients

Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Sergio Harari ◽  
Olga Torre ◽  
Davide Elia ◽  
Antonella Caminati ◽  
Giuseppe Pelosi ◽  
...  
Keyword(s):  
Natural History ◽  
Cumulative Incidence ◽  
Pulmonary Function Tests ◽  
Diagnostic Techniques ◽  
Term Treatment ◽  
Large Cohort ◽  
Clinical Aspects ◽  
Long Term Treatment ◽  
History Of

<b><i>Background:</i></b> Over the last 2 decades, great progress has been made in the understanding of the clinical aspects and pathogenesis of lymphangioleiomyomatosis (LAM), leading to publication of guidelines and approval of an effective therapy. <b><i>Objectives:</i></b> Aim of our study was to describe how the management and the natural history of this rare disease have changed after the publication of the ERS and American Thoracic Society/Japanese Respiratory Society guidelines and the introduction of sirolimus. <b><i>Methods:</i></b> We examined 162 LAM patients followed at our center between 2001 and 2017, reporting clinical characteristics and diagnostic approach. Response to sirolimus in patients undergoing long-term treatment and mortality risk, estimated in terms of cumulative incidence taking into account organ transplantation as a competing cause of the event, were evaluated. The difference in the cumulative incidence between the patients admitted to the observation before 2011 and after 2011, year of the publication of the MILES trial for the efficacy of sirolimus, has also been estimated. <b><i>Results:</i></b> Sixty-one patients had a histological diagnosis (22 from 2010 onward). 101 patients received a radiological diagnosis according to the guidelines criteria. Pulmonary function tests remained stable over a 3-year treatment period in patients who received sirolimus for over 12 months. The cumulative incidence of mortality after 10 years in the whole population was 25.5%. The cumulative incidence of mortality after 5 years was significantly lower in patients who entered the study since 2011 (after publication of the MILES trial) than in patients who entered the study before. <b><i>Conclusions:</i></b> We provide the data supporting the long-term efficacy of sirolimus therapy in a large cohort of patients with functional impairment and other manifestations of the disease. Our results also suggest that the advent of sirolimus and the publication of international guidelines changed the natural history of the disease lowering the mortality and reducing the need of invasive diagnostic techniques.

scholarly journals Autopsy findings after long-term treatment of COVID-19 patients with microbiological correlation

2021 ◽  
Author(s):  
Katja Evert ◽  
Thomas Dienemann ◽  
Christoph Brochhausen ◽  
Dirk Lunz ◽  
Matthias Lubnow ◽  
...  
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Fungal Infections ◽  
Diffuse Alveolar Damage ◽  
Fungal Species ◽  
Term Treatment ◽  
University Hospital ◽  
Long Term Treatment ◽  
The University

AbstractBetween April and June 2020, i.e., during the first wave of pandemic coronavirus disease 2019 (COVID-19), 55 patients underwent long-term treatment in the intensive care unit at the University Hospital of Regensburg. Most of them were transferred from smaller hospitals, often due to the need for an extracorporeal membrane oxygenation system. Autopsy was performed in 8/17 COVID-19-proven patients after long-term treatment (mean: 33.6 days). Autopsy revealed that the typical pathological changes occurring during the early stages of the disease (e.g., thrombosis, endothelitis, capillaritis) are less prevalent at this stage, while severe diffuse alveolar damage and especially coinfection with different fungal species were the most conspicuous finding. In addition, signs of macrophage activation syndrome was detected in 7 of 8 patients. Thus, fungal infections were a leading cause of death in our cohort of severely ill patients and may alter clinical management of patients, particularly in long-term periods of treatment.

scholarly journals Long-term treatment with antidepressants in primary care

1998 ◽  
Vol 22 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Imad M. Ali
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Depressive Symptoms ◽  
General Practitioner ◽  
Term Treatment ◽  
Postal Survey ◽  
Consultation Rate ◽  
Long Term Treatment ◽  
Higher Doses

A postal survey of 222 patients receiving long-term antidepressants in a training general practice showed that the majority were GHQ-12 cases and 62% of respondents reported moderate or severe depressive symptoms on the BDI-13. Although these patients received significantly higher doses than those reporting few or no symptoms, only 40% were prescribed at least a therapeutic antidepressant dose. All patients reporting mild, moderate or severe depressive symptoms consulted their general practitioner significantly more frequently than those without symptoms and the content of these consultations suggested that the general practitioners were aware of these patients' psychological morbidity. Monitoring and appropriate management of patients receiving long-term antidepressants could lead to reduction in morbidity and consultation rate.

scholarly journals Venlafaxine Extended Release (ER) in the Treatment of Generalised Anxiety Disorder

2001 ◽  
Vol 179 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Christer Allgulander ◽  
David Hackett ◽  
Eliseo Salinas
Keyword(s):  
Anxiety Disorder ◽  
Extended Release ◽  
Term Treatment ◽  
Double Blind Study ◽  
Generalised Anxiety Disorder ◽  
Double Blind ◽  
Treatment Groups ◽  
Long Term Treatment ◽  
Higher Doses

BackgroundGeneralised anxiety disorder (GAD) has received less study than other anxiety disorders, particularly its long-term treatment.AimsTo assess the efficacy and safety of venlafaxine extended release (ER) in patients with GAD.MethodA total of 541 out-patients, 18–86 years old, were recruited to this 24-week, placebo-controlled, double-blind study of three fixed doses (37.5, 75 and 150 mg/day) of venlafaxine ER.ResultsAll doses of venlafaxine ER showed efficacy superior to placebo, apparent from week 2, that was sustained throughout the 24-week study for the two higher doses. The discontinuation rate did not differ significantly among the treatment groups.ConclusionsVenlafaxine ER is an effective and safe treatment for GAD for up to 6 months.

EFFECT OF SMALL DOSES OF OESTRADIOL BENZOATE ON PITUITARY PRODUCTION AND RELEASE OF I. C. S. H. IN GONADECTOMIZED MALE AND FEMALE RATS

1962 ◽  
Vol 39 (2) ◽  
pp. 245-252 ◽  
Author(s):  
E. Gans ◽  
G. P. van Rees
Keyword(s):  
Term Treatment ◽  
Female Rats ◽  
Male Rats ◽  
Male And Female ◽  
Male And Female Rats ◽  
Long Term Treatment ◽  
Oestradiol Benzoate ◽  
Small Doses ◽  
Higher Doses

ABSTRACT The influence on the I. C. S. H.-content of the pituitary gland and the blood serum of long-term treatment of gonadectomized male and female rats with several low doses of oestradiol benzoate was investigated. It was found that only in females treatment with 0.1 and 0.2 μg of oestradiol benzoate daily results in an increase of the pituitary I. C. S. H.-content, whereas in the serum content a (non-significant) decrease was observed. In male rats the pituitary I. C. S. H.-content was not influenced by treatment with these doses, but the serum content decreased. Higher doses of oestradiol (0.5 and 2.0 μg daily) caused, both in males and in females, a decrease of the I. C. S. H.-content in the hypophysis as well as in the serum. It is assumed that oestrogen, if chronically administered, exerts two different actions on pituitary I. C. S. H.: it depresses the production of I. C. S. H. and inhibits the release. In females, these two effects have different threshold levels, that for the release being the lower one. In males the threshold for the inhibition of production has to be lower.

scholarly journals Clinical Features and Therapeutic Effects of Anti-leucine-rich Glioma Inactivated 1 Encephalitis: A Systematic Review

2022 ◽  
Vol 12 ◽  
Author(s):  
Yuou Teng ◽  
Ting Li ◽  
Zhizhong Yang ◽  
Mingwan Su ◽  
Jingnian Ni ◽  
...  
Keyword(s):  
Clinical Features ◽  
Short Term Memory ◽  
Psychiatric Symptoms ◽  
Memory Loss ◽  
Term Treatment ◽  
Therapeutic Effects ◽  
Short Term ◽  
Term Memory ◽  
Long Term Treatment

Background: Clinical presentations and treatment programs about anti-leucine-rich glioma inactivated 1 (LGI1) encephalitis still remain incompletely understood.Objective: This study analyzed the clinical features and therapeutic effects of anti-LGI1 encephalitis.Methods: PubMed, EMBASE, and the Cochrane Library were searched to identify published English and Chinese articles until April 2021. Data were extracted, analyzed, and recorded in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.Results: A total of 80 publications detailing 485 subjects matched our inclusion criteria. Short-term memory loss (75.22%), faciobrachial dystonic seizures (FBDS) (52.53%), other seizures excluding FBDS (68.48%), psychiatric symptoms (57.67%), and sleep disturbances (34.30%) were the most frequently described symptoms in anti-LGI1 encephalitis. Hyponatremia (54.90%) was the most common hematologic examination change. The risk of incidence rate of malignant tumors was higher than in healthy people. The positive rate of anti-LGI1 in serum (99.79%) was higher than CSF (77.38%). Steroids (93.02%), IVIG (87.50%), and combined use (96.67%) all had a high remission rate in the initial visit. A total of 35 of 215 cases relapsed, of which 6/35 (17.14%) did not use first-line treatment, and 21 (60.00%) did not maintain long-term treatment. Plasma exchange (PE) could be combined in severe patients, immunosuppressant could be used for refractory patients or for recurrence and using an anti-epileptic drug to control seizures may benefit cognition.Conclusions: Short-term memory loss, FBDS, psychiatric symptoms, and hyponatremia were key features in identifying anti-LGI1 encephalitis. Serum and CSF antibody tests should be considered in diagnosis criteria. Steroids with IVIG should be recommended, PE was combined for use in severe patients, immunosuppressant therapy might improve outcomes if recurrence or progression occurred, and control seizures might benefit cognition. The useful ways to reduce relapse rate were early identification, clear diagnosis, rapid treatment, and maintaining long-term treatment. The follow-up advice was suggested according to the research of paraneoplastic syndrome, and concern about tumors was vital as well.

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