scholarly journals Shweta Pradara - A Localised Symptom of the Female Reproductive System or a Systemic Disease? - A Review

2020 ◽  
Vol 07 (3&4) ◽  
pp. 31-36
Author(s):  
Urvija . ◽  
Keyword(s):  
Pathological Condition ◽  
Systemic Disease ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Health Condition ◽  
Systemic Involvement ◽  
Oral Medications ◽  
General Health Condition ◽  
Important Symptom ◽  
Vaginal Canal

Shweta pradara is a pathological condition that is characterised by a localised symptom that is whitish discharge from the vaginal canal. The following are three criteria of leucorrhoea. 1) Excess secretion is evident from persistent vulvar moistness or staining of the undergarments or need to wear a vulvar pad, 2) It is non-purulent and non-offensive, 3) It is non-irritant and never causes pruritis, treatment of which includes to improvise the general health condition along with other specific management. Shweta pradara closely resembles leucorrhoea but does not completely fulfil the criteria. It has been explained mainly as a symptom in many diseases related to stree roga as well as prasuti tantra. Treatment options involve oral medications along with other lines of treatment like basti, lepa, varti, prakshalana and pichu. This indicates that the condition is more than just local. Very less has been explored about the systemic involvement in Shweta pradara which can be attempted to be established as the systemic disease as the acharyashave mentioned a separate classical treatment in order to combat the ailment, else can be understood as an important symptom of an underlying cause so as to attain symptomatic relief. Interpretation of Shweta pradara as a disease has been dealt in the article.

Trial in progress: Phase I/II study of radiation therapy followed by intrathecal trastuzumab/pertuzumab in the management of HER2+ breast leptomeningeal disease.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. TPS1099-TPS1099
Author(s):  
Kamran A. Ahmed ◽  
Youngchul Kim ◽  
Michelle DeJesus ◽  
Priya Kumthekar ◽  
Nicole Olivia Williams ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Phase I ◽  
Systemic Disease ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Leptomeningeal Disease ◽  
Breast Cancer Patients ◽  
Open Label

TPS1099 Background: HER2+ breast cancer patients with leptomeningeal disease (LMD) represent a poor prognosis population with a high unmet clinical need. Although a multitude of treatment options are available for the management of systemic disease, once metastases travel to the leptomeninges, patients have a lack of treatment options aside from traditional local approaches. Data from a phase I/II study reveals intrathecal (IT) trastuzumab to be well tolerated with improved overall survival (OS) compared to historical controls in HER2+ breast LMD. Radiotherapy can improve the flow of IT therapy through the cerebrospinal fluid (CSF) and provide symptomatic relief. The monoclonal antibody pertuzumab is used in conjunction with trastuzumab in the management of metastatic and localized HER2+ breast cancer. Given the role of radiotherapy in the management of LMD along with the role of pertuzumab in the management of HER2+ breast cancer, there is a strong clinical rationale to combine radiotherapy with IT trastuzumab/pertuzumab in the management of HER2+ breast LMD. Methods: The study is designed as a prospective, single-arm, nonrandomized, open-label, phase I/II trial of radiation therapy followed by IT trastuzumab/pertuzumab in the management of HER2+ breast LMD. HER2+ LMD patients identified by magnetic resonance imaging (MRI) and/or CSF cytology, ≥ 18, with a life expectancy > 8 weeks are eligible. Treatment is initiated with radiotherapy, whole brain radiotherapy and/or focal brain/spine radiation followed by IT trastuzumab/pertuzumab. Safety and feasibility will be monitored by a modified toxicity probability interval-2 (mTPI-2) design. Dose reductions of IT trastuzumab will not be allowed. Once the maximum tolerated dose of IT pertuzumab is determined, the phase II portion of the study will commence to determine OS. Secondary objectives involve defining the CSF pharmacokinetics of IT trastuzumab/pertuzumab, evaluating the response rate (leptomeningeal and parenchymal), and progression free survival (leptomeningeal and parenchymal) following IT trastuzumab/pertuzumab. In the phase 2 portion, a single-arm two-stage trial is designed using the Restricted-Kwak-and-Jung’s Method. The primary endpoint is one-year OS. An interim analysis will be performed after 20 patients are enrolled. This study is open with 1 patient enrolled at the time of submission. Clinical trial information: NCT04588545 .

Neoplasms of the thymus

2016 ◽  
pp. 655-658
Author(s):  
Rebecca Bütof ◽  
Axel Denz ◽  
Gustavo Baretton ◽  
Jan Stöhlmacher-Williams ◽  
Michael Baumann
Keyword(s):  
Treatment Options ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Health Condition ◽  
Incomplete Resection ◽  
Complete Surgical Resection ◽  
General Health Condition ◽  
Advanced Stages ◽  
Low Incidence ◽  
New Treatment

Thymic tumours are among the malignant diseases with very low incidence. Therefore clinical research and development of new treatment options pose an ongoing challenge. For treatment of thymomas the following methods are used: surgery, radiotherapy, chemotherapy, and targeted drugs. The optimal type and sequence of therapy depends on tumour stage, histological subtype, and general health condition of the patient. A complete surgical resection is still the mainstay of therapy. For patients with incomplete resection or in locally advanced stages adjuvant radio/chemotherapy is recommended. Neoadjuvant treatment approaches and novel targeted therapies are under investigation. Lifelong follow-up has to be preferred because of possible late recurrences.

scholarly journals Amyloidosis with Cardiac Involvement: Identification, Characterization, and Management

2021 ◽  
Author(s):  
Faizi Jamal ◽  
Michael Rosenzweig
Keyword(s):  
Cardiac Amyloidosis ◽  
Systemic Disease ◽  
Treatment Options ◽  
Diagnostic Algorithm ◽  
Transthyretin Amyloidosis ◽  
Cardiac Amyloid ◽  
Medical Interventions ◽  
Light Chain Disease ◽  
Organ Response ◽  
New Treatment

Abstract Purpose of Review Amyloidosis is a protein deposition disease whereby a variety of precursor proteins form insoluble fibrils that deposit in tissues, causing organ dysfunction and, many times, death. Accurate characterization of the disease based on the nature of the precursor protein, organ involvement, and extent of disease is paramount to guide management. Cardiac amyloidosis is critical to understand because of its impact on prognosis and new treatment options available. Recent Findings New imaging methods have proven to be considerably valuable in the identification of cardiac amyloid infiltration. For treating clinicians, a diagnostic algorithm for patients with suspected amyloidosis with or without cardiomyopathy is shown to help classify disease and to direct appropriate genetic testing and management. For patients with light chain disease, recently introduced treatments adopted from multiple myeloma therapies have significantly extended progression-free and overall survival as well as organ response. In addition, new medical interventions are now available for those with transthyretin amyloidosis. Summary Although cardiac amyloidosis contributes significantly to the morbidity and mortality associated with systemic disease, new tools are available to assist with diagnosis, prognosis, and management.

scholarly journals Focus on localized laryngeal amyloidosis: management of five cases

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 327-332
Author(s):  
Massimo Mesolella ◽  
Gerardo Petruzzi ◽  
Sarah Buono ◽  
Grazia Salerno ◽  
Francesco Antonio Salzano ◽  
...  
Keyword(s):  
Systemic Disease ◽  
Clinical Aspects ◽  
Benign Tumors ◽  
Local Form ◽  
Systemic Involvement ◽  
Clinical Syndromes ◽  
Laryngeal Amyloidosis ◽  
And Control ◽  
Localized Laryngeal Amyloidosis

AbstractAmyloidosis is a group of idiopathic clinical syndromes caused by the deposition of insoluble fibrillar proteins (amyloid) in the extracellular matrix of organs and tissues. These deposits disrupt the function of the target organ. Amyloidosis can manifest as a systemic disease or a single-organ involvement (local form). Its etiology still remains unclear. Deposits of amyloid in the larynx are rare, accounting for between 0.2 and 1.2% of benign tumors of the larynx. In this retrospective study, we report the clinical aspects, diagnosis, treatment and follow-up of five female patients with localized laryngeal amyloidosis without systemic involvement. The patients were all treated successfully using microlaryngoscopy with CO2 laser or cold instruments. Prognosis is excellent; however, appropriate follow-up is an important part of the long-term management of this disease in order to prevent and control the possibility of local recurrence.

scholarly journals Protection againstStaphylococcus aureusColonization and Infection by B- and T-Cell-Mediated Mechanisms

mBio ◽  
2018 ◽  
Vol 9 (5) ◽  
Author(s):  
Fan Zhang ◽  
Olivia Ledue ◽  
Maria Jun ◽  
Cibelly Goulart ◽  
Richard Malley ◽  
...  
Keyword(s):  
T Cell ◽  
Soft Tissue ◽  
Bacterial Infections ◽  
Vaccine Development ◽  
Pathological Condition ◽  
Treatment Options ◽  
Immune Defense ◽  
Invasive Infection ◽  
Content Type ◽  
Increased Risk

ABSTRACTStaphylococcus aureusis a major cause of morbidity and mortality worldwide.S. aureuscolonizes 20 to 80% of humans at any one time and causes a variety of illnesses. Strains that are resistant to common antibiotics further complicate management.S. aureusvaccine development has been unsuccessful so far, largely due to the incomplete understanding of the mechanisms of protection against this pathogen. Here, we studied the role of different aspects of adaptive immunity induced by anS. aureusvaccine in protection againstS. aureusbacteremia, dermonecrosis, skin abscess, and gastrointestinal (GI) colonization. We show that, depending on the challenge model, the contributions of vaccine-inducedS. aureus-specific antibody and Th1 and Th17 responses to protection are different: antibodies play a major role in reducing mortality duringS. aureusbacteremia, whereas Th1 or Th17 responses are essential for prevention ofS. aureusskin abscesses and the clearance of bacteria from the GI tract. Both antibody- and T-cell-mediated mechanisms contribute to prevention ofS. aureusdermonecrosis. Engagement of all three immune pathways results in the most robust protection under each pathological condition. Therefore, our results suggest that eliciting multipronged humoral and cellular responses toS. aureusantigens may be critical to achieve effective and comprehensive immune defense against this pathogen.IMPORTANCES. aureusis a leading cause of healthcare- and community-associated bacterial infections.S. aureuscauses various illnesses, including bacteremia, meningitis, endocarditis, pneumonia, osteomyelitis, sepsis, and skin and soft tissue infections.S. aureuscolonizes between 20 and 80% of humans; carriers are at increased risk for infection and transmission to others. The spread of multidrug-resistant strains limits antibiotic treatment options. Vaccine development againstS. aureushas been unsuccessful to date, likely due to an inadequate understanding about the mechanisms of immune defense against this pathogen. The significance of our work is in illustrating the necessity of generating multipronged B-cell, Th1-, and Th17-mediated responses toS. aureusantigens in conferring enhanced and broad protection againstS. aureusinvasive infection, skin and soft tissue infection, and mucosal colonization. Our work thus, provides important insights for future vaccine development against this pathogen.

scholarly journals Lobular panniculitis: A manifestation of pancreatic tumor with fatal outcome

2005 ◽  
Vol 13 (3-4) ◽  
pp. 153-155 ◽  
Author(s):  
Marina Jovanovic ◽  
Zoran Golusin ◽  
Aleksandra Petrovic ◽  
Nada Vuckovic ◽  
Silvija Brkic ◽  
...  
Keyword(s):  
Fatal Outcome ◽  
Subcutaneous Fat ◽  
Pancreatic Head ◽  
Skin Lesions ◽  
Skin Condition ◽  
Pancreatic Disease ◽  
Health Condition ◽  
Subcutaneous Fat Necrosis ◽  
General Health Condition ◽  
Lobular Panniculitis

Lobular panniculitis is a skin condition that may be the first sign of underlying pancreatic disease. Though rare, the condition has been sufficiently well defined and pathognomonic, thus making differentiation from idiopathic lobular panniculitis quite possible. A 77-year-old woman was in apparently good general health condition when developed skin lesions in a form of erythematous painful fluctuant nodules localized predominantly on the breast, but also present on the arms, thighs, and trunk. Her serum and urinary amylase levels were respectively 3 and 8 fold higher than normal. On histology, skin biopsy showed acute lobular panniculitis with large foci of adipocyte necrosis. Examination of the breast excluded any specific process other than nodular subcutaneous inflammation, but revealed a tumor of the pancreatic head. The nodules spontaneously ulcerated exuding an oily thick brownish material. Her condition deteriorated, and she became progressively debilitated. The patient died before operation, within the next 3 weeks. Subcutaneous fat necrosis was the first manifestation of an otherwise occult pancreatic disease with fatal outcome.

scholarly journals Pediatric Optic Neuritis: Description of Four Cases and Review of the Literature

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 855
Author(s):  
Anna Presicci ◽  
Maria Serra ◽  
Mariaclara Achille ◽  
Elvita Caputo ◽  
Lucia Margari
Keyword(s):  
Optic Neuritis ◽  
Recent Literature ◽  
Systemic Disease ◽  
Treatment Options ◽  
Igg Antibodies ◽  
Careful Evaluation ◽  
Demyelinating Disorders ◽  
Infective Etiology

Pediatric optic neuritis (PON) may be a clinically isolated and self-limiting event or may present in the context of underlying neurologic, infective, or systemic disease. PON has a high impact on the quality of life as it may or may not evolve into other acquired demyelinating syndromes (ADSs), such as multiple sclerosis (MS), neuromyelitis optica (NMO), or other syndromes related to the myelin oligodendrocyte glycoprotein IgG antibodies (MOG-IgG). These different PON phenotypes present variable clinical and radiological features, plasma and liquor biomarkers, and prognosis. We describe four pediatric cases presenting clinically with ON, with different etiopathogenetic pictures: one case had a probable infective etiology, while the others were associated with different demyelinating disorders (MS, NMO, syndrome related to MOG-IgG). We discuss the possible evolution of presenting ON in other ADSs, based on recent literature. A careful evaluation of the clinical and investigation findings and the natural course of PON is necessary to define its pathogenic pathway and evolution. Further prolonged follow-up studies are needed to highlight the predictors of PON evolution, its potential sequelae, and the best treatment options.

Conservative possibilities influencing PCOS syndrome – the importance of nutrition

2021 ◽  
Vol 86 (5) ◽  
pp. 343-348
Author(s):  
Dávid Líška ◽  
◽  
Jozef Záhumenský
Keyword(s):  
Metabolic Syndrome ◽  
Conservative Treatment ◽  
Polycystic Ovary Syndrome ◽  
Eating Habits ◽  
Polycystic Ovary ◽  
Pathological Condition ◽  
Treatment Options ◽  
Ovary Syndrome ◽  
Low Carbohydrate Diet ◽  
Therapeutic Diets

Polycystic ovary syndrome (PCOS) is a common pathological condition in women. Conservative treatment is used in the treatment of polycystic ovary syndrome. Conservative treatment options include increased physical activity and diet. The main aim of the article is to discuss the therapeutic treatment of infl uencing PCOS from a nutritional point of view. PCOS is associated with several comorbidities, including infertility, metabolic syndrome, obesity, impaired glucose tolerance, diabetes mellitus II, and increased cardiovascular risk. Several therapeutic diets can be used in the treatment of PCOS, such as the DASH diet, the low-carbohydrate diet, and a diet based on a low glycemic index. A change in eating habits is associated with improvement in PCOS symptoms. Key words: polycystic ovary syndrome – nutrition – diet – metabolic syndrome

Idiopathic condylar resorption in orthodontics

2021 ◽  
Vol 14 (2) ◽  
pp. 82-88
Author(s):  
Salwa El-Habbash ◽  
Timothy McSwiney
Keyword(s):  
Risk Factors ◽  
Orthognathic Surgery ◽  
Mechanical Load ◽  
Systemic Disease ◽  
Treatment Options ◽  
Open Bite ◽  
Mandibular Movement ◽  
Anterior Open Bite ◽  
Surgical Risk ◽  
Multiple Treatment

Condylar resorption (CR) can be categorized into functional and dysfunctional remodelling of the temporomandibular joint (TMJ). The literature describes dysfunctional remodelling of the TMJ as idiopathic condylar resorption (ICR). Idiopathic condylar resorption (ICR) is a well-documented but poorly understood pathological entity that can occur spontaneously or post-orthognathic surgery. It predominantly affects young women, with other risk factors including Class 2 malocclusion with steep mandibular plane angles. It is distinguished by a decreased condylar head volume and ramus height, progressive mandibular retrusion and an anterior open bite. Its aetiology can be categorized into surgical and non-surgical risk factors. These include hormones, systemic disease, trauma, mechanical load and surgical risk factors, such as magnitude and direction of mandibular movement, type of surgical fixation and length of post-operative maxilla-mandibular fixation. ICR is a diagnosis of exclusion, and identified by a combination of clinical, radiographic and haematological findings. Multiple treatment options have been described in the literature, including medical management, orthodontics, orthognathic surgery, TMJ surgery, TMJ and orthognathic surgery combined, and total joint prosthesis reconstruction. Further research is required to better understand the aetiology of ICR and more long-term, controlled, multicentre clinical studies are needed to evaluate the outcomes of surgical and non-surgical management of CR patients. CPD/Clinical Relevance: Idiopathic condylar resorption has many presentations and potential causes that can greatly impact the decisions and outcomes for orthodontic/orthognathic treatment.

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