scholarly journals Combination of vaping, cannabis and smoking exposure: shorter time to bullous lung disease and pneumothorax

2021 ◽  
Vol 5 (1) ◽  
pp. 8-10
Author(s):  
Farhan Ali
Keyword(s):  
Lung Disease ◽  
Addiction Medicine ◽  
Bullous Disease ◽  
Smoking Exposure ◽  
Multiplicative Effect ◽  
Patient Reported ◽  
History Of ◽  
One Year ◽  
Lung Health

We present a 25-year-old Hispanic man with left-sided pleuritic chest pain and dyspnea for three days. His Chest radiograph and CTA revealed bilateral apical bullous disease with a 2.5 cm deep left sided pneumothorax. He was managed with 100% oxygen via non-rebreather mask and did not require invasive decompression. Patient reported a one-year history of vaping along with tobacco and cannabis smoking exposure from his late teen years. The pneumothorax improved and he was discharged to the pulmonary clinic. The authors review the multiplicative effect of vaping on smoking cannabis and tobacco leading to early apical bullous lung disease. Patients with such significant smoking/vaping history may benefit from prolonged pulmonary and addiction medicine follow-up given the clinical bullous lung disease and risk for continued smoking/vaping. The case emphasizes the potential exponential effect of combining vaping with tobacco and marijuana smoke on lung health leading to disease at extremely young ages.

scholarly journals Management of a giant euthyroid goiter in limited resources settings: case report

2020 ◽  
Vol 6 (3) ◽  
pp. 574
Author(s):  
Nzanzu Kikuhe ◽  
Munyatwari Akomu ◽  
Sekabuhoro Safari ◽  
Tsongo Vululi Sosthene ◽  
Justine Namwagala
Keyword(s):  
Multinodular Goiter ◽  
Limited Resources ◽  
Regional Referral Hospital ◽  
Cervical Mass ◽  
Patient Reported ◽  
History Of ◽  
One Year ◽  
Clinical Conditions ◽  
The Voice

<p class="abstract">The cases of giant multinodular goiter are rare clinical conditions nowadays. We present here a case of giant multinodular goiter successfully treated at Hôpital Provincial du Nord Kivu (Regional referral hospital and Goma teaching hospital). A 59 years old man with 40 years’ history of gradual growing of an anterior cervical mass. The patient reported compressive symptoms such difficulty in breathing, hoarseness of the voice and difficulty in swallowing during the last nine months prior to our consultation. A total thyroidectomy was performed as well as a one year of follow-up, showing good evolution.</p>

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

scholarly journals AB0330 HIGH REMISSION RATES IN RA – REAL LIFE DATA FROM BARITICINIB

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1463.2-1464
Author(s):  
S. Bayat ◽  
K. Tascilar ◽  
V. Kaufmann ◽  
A. Kleyer ◽  
D. Simon ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cox Regression ◽  
Real Life ◽  
Inadequate Response ◽  
Research Support ◽  
Das 28 ◽  
Patient Reported ◽  
One Year

Background:Recent developments of targeted treatments such as targeted synthetic DMARDs (tsDMARDs) increase the chances of a sustained low disease activity (LDA) or remission state for patients suffering rheumatoid arthritis (RA). tsDMARDs such as baricitinib, an oral inhibitor of the Janus Kinases (JAK1/JAK2) was recently approved for the treatment of RA with an inadequate response to conventional (cDMARD) and biological (bDMARD) therapy. (1, 2).Objectives:Aim of this study is to analyze the effect of baricitinb on disease activity (DAS28, LDA) in patients with RA in real life, to analyze drug persistance and associate these effects with various baseline characteristics.Methods:All RA patients were seen in our outpatient clinic. If a patient was switched to a baricitinib due to medical reasons, these patients were included in our prospective, observational study which started in April 2017. Clinical scores (SJC/TJC 76/78), composite scores (DAS28), PROs (HAQ-DI; RAID; FACIT), safety parameters (not reported in this abstract) as well as laboratory biomarkers were collected at each visit every three months. Linear mixed effects models for repeated measurements were used to analyze the time course of disease activity, patient reported outcomes and laboratory results. We estimated the probabilities of continued baricitinib treatment and the probabilities of LDA and remission by DAS-28 as well as Boolean remission up to one year using survival analysis and explored their association with disease characteristics using multivariable Cox regression. All patients gave informed consent. The study is approved by the local ethics.Results:95 patients were included and 85 analyzed with available follow-up data until November 2019. Demographics are shown in table 1. Mean follow-up duration after starting baricitinib was 49.3 (28.9) weeks. 51 patients (60%) were on monotherapy. Baricitinib survival (95%CI) was 82% (73% to 91%) at one year. Cumulative number (%probability, 95%CI) of patients that attained DAS-28 LDA at least once up to one year was 67 (92%, 80% to 97%) and the number of patients attaining DAS-28 and Boolean remission were 31 (50%, 34% to 61%) and 12(20%, 9% to 30%) respectively. Median time to DAS-28 LDA was 16 weeks (Figure 1). Cox regression analyses did not show any sufficiently precise association of remission or LDA with age, gender, seropositivity, disease duration, concomitant DMARD use and number of previous bDMARDs. Increasing number of previous bDMARDs was associated with poor baricitinib survival (HR=1.5, 95%CI 1.1 to 2.2) while this association was not robust to adjustment for baseline disease activity. Favorable changes were observed in tender and swollen joint counts, pain-VAS, patient and physician disease assessment scores, RAID, FACIT and the acute phase response.Conclusion:In this prospective observational study, we observed high rates of LDA and DAS-28 remission and significant improvements in disease activity and patient reported outcome measurements over time.References:[1]Keystone EC, Taylor PC, Drescher E, Schlichting DE, Beattie SD, Berclaz PY, et al. Safety and efficacy of baricitinib at 24 weeks in patients with rheumatoid arthritis who have had an inadequate response to methotrexate. Annals of the rheumatic diseases. 2015 Feb;74(2):333-40.[2]Genovese MC, Kremer J, Zamani O, Ludivico C, Krogulec M, Xie L, et al. Baricitinib in Patients with Refractory Rheumatoid Arthritis. The New England journal of medicine. 2016 Mar 31;374(13):1243-52.Figure 1.Cumulative probability of low disease activity or remission under treatment with baricitinib.Disclosure of Interests:Sara Bayat Speakers bureau: Novartis, Koray Tascilar: None declared, Veronica Kaufmann: None declared, Arnd Kleyer Consultant of: Lilly, Gilead, Novartis,Abbvie, Speakers bureau: Novartis, Lilly, David Simon Grant/research support from: Else Kröner-Memorial Scholarship, Novartis, Consultant of: Novartis, Lilly, Johannes Knitza Grant/research support from: Research Grant: Novartis, Fabian Hartmann: None declared, Susanne Adam: None declared, Axel Hueber Grant/research support from: Novartis, Lilly, Pfizer, EIT Health, EU-IMI, DFG, Universität Erlangen (EFI), Consultant of: Abbvie, BMS, Celgene, Gilead, GSK, Lilly, Novartis, Speakers bureau: GSK, Lilly, Novartis, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB

scholarly journals Impact of atrial fibrillation pattern on outcomes after left atrial appendage closure: lessons from the prospective LAARGE registry

2021 ◽  
Author(s):  
Shinwan Kany ◽  
Johannes Brachmann ◽  
Thorsten Lewalter ◽  
Ibrahim Akin ◽  
Horst Sievert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial Appendage ◽  
Systemic Embolism ◽  
Long Term Outcomes ◽  
Increased Risk ◽  
History Of ◽  
One Year ◽  
The One

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

Effectiveness of a Modified Version of Airflow Therapy

1982 ◽  
Vol 47 (2) ◽  
pp. 160-164
Author(s):  
Glenn L. Falkowski ◽  
Arthur M. Guilford ◽  
Jack Sandler
Keyword(s):  
Success Rate ◽  
Scientific Literature ◽  
Future Research ◽  
Relative Importance ◽  
Differential Effectiveness ◽  
History Of ◽  
One Year ◽  
Main Components

Utilizing airflow therapy, Schwartz (1976) has claimed an 89% success rate with stutterers following treatment and an 83% success rate at one year follow-up. Such claims have yet to be documented in the scientific literature. The purposes of this study were: (a) to investigate the effectiveness of a modified version of airflow therapy; (b) to examine the relative importance of its two main components—passive airflow and elongation of the first vowel spoken. The speech of two adult male stutterers with a lengthy history of stuttering, was assessed with spontaneous speaking and reading tasks. Results indicated marked improvement in both subjects' speech on the reading task was maintained at follow-up 10 weeks later. For spontaneous speech, results were generally weaker and less durable. Effects of the two treatment components were cumulative and did not allow determination of any differential effectiveness between components. Implications of these findings were considered and directions for future research discussed.

MO847PREVALENCE OF FATIGUE REPORTED BY PATIENTS ON HEMODIALYSIS THERAPY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Mauricio Sanabria ◽  
Cesar Mauricio Doria ◽  
Edward Martinez ◽  
Carlos Simon ◽  
Jasmin Vesga ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Chronic Hemodialysis ◽  
Multicenter Cohort Study ◽  
Care Services ◽  
Protein Energy ◽  
Confounding Variables ◽  
Patient Reported ◽  
High Prevalence ◽  
One Year

Abstract Background and Aims Fatigue is a symptom with a high prevalence in patients on hemodialysis therapy due to uremic toxins, anemia, associated comorbidity, and hemodialysis treatment per se. Our objective is to evaluate the prevalence of fatigue reported by patients and their association with the nutritional status. Method This was a prospective observational, multicenter cohort study. Prevalent patients on HD therapy for at least 90 days, older than 18, at the Baxter Renal Care Services were included between September 1, 2017, to November 30, 2017 with one-year follow-up. Socio-demographic and clinical characteristics of all patients were summarized descriptively, the nutritional status was evaluated by protein Energy waste (PEW). Patient reported fatigue was measured with high flux membrane and medium cut-off membrane (Theranova). A generalized linear binomial multivariable model was conducted to assess the effect of PEW on fatigue symptom controlling for some confounding variables. Results We found that the fatigue reported by the patients has a prevalence of 55% [95% CI: 52.2 to 57.7] in our population, there are no statistical differences due to the use of different types of membranes p= 0.911, and neither did we find that the nutritional status is an independent factor that explains this symptom. If we find that women and diabetics have a higher risk of fatigue; RR=1.17 [95% CI: 1.06 to 1.29] and RR= 1.19 [95% CI: 1.00 to 1.42] respectively. Conclusion The fatigue is a prevalent symptom in the chronic hemodialysis population; being a woman and the diagnosis of diabetes are risk factors associated with this outcome. PEW and the type of dialysis membrane used were not associated with this symptom. Studies evaluating the recovery time from post-dialysis symptoms and its relationship with the type of membrane are necessary.

scholarly journals Methylmalonic Acidemia – Cause of Recurrent Neonatal Death and Its Social Implications

2014 ◽  
Vol 34 (2) ◽  
pp. 150-153
Author(s):  
Vasikarla Madhavi ◽  
Deepak Kumar Sharma ◽  
Srinivas Murki ◽  
Tejo Pratap
Keyword(s):  
Short Chain Fatty Acid ◽  
Neonatal Period ◽  
Chain Fatty Acid ◽  
Methylmalonic Acidemia ◽  
Acid Oxidase ◽  
Oxidase Deficiency ◽  
The Third ◽  
History Of ◽  
One Year

Mr and Mrs R, non-consanguineous couple had history of all their children during neonatal period. First two neonates were normal at birth, then presented with lethargy, vomiting and decreased acceptance of feeds. Both the babies expired after birth without being investigated for cause of death. The third neonate was investigated for inborn error of metabolism and found to be affected with methylmalonic acidemia. The couple departed away inspite of extensive counselling. In the fourth pregnancy antenatally fetus was diagnosed as carrier case of methylmalonic acidemia and short chain fatty acid oxidase deficiency. The fourth baby was normal and was in follow up till one year age. DOI: http://dx.doi.org/10.3126/jnps.v34i2.10577 J Nepal Paediatr Soc 2014;34(2):150-153 

scholarly journals One-Year Progression-Free Survival of Therapy-Naive Patients With Malignant Pheochromocytoma and Paraganglioma

2013 ◽  
Vol 98 (10) ◽  
pp. 4006-4012 ◽  
Author(s):  
Ségolène Hescot ◽  
Sophie Leboulleux ◽  
Laurence Amar ◽  
Delphine Vezzosi ◽  
Isabelle Borget ◽  
...  
Keyword(s):  
Evaluation Criteria ◽  
Progression Free Survival ◽  
Malignant Pheochromocytoma ◽  
Inherited Disease ◽  
High Power Field ◽  
Free Survival ◽  
History Of ◽  
Wait And See ◽  
One Year

Abstract Context: The natural history of malignant pheochromocytoma or paragangliomas (MPP) remain unknown. Objective: The primary aim of this study was to define progression-free survival at 1 year in therapy-naive patients with MPP. Secondary objectives were to characterize MPP and to look for prognostic parameters for progression at 1 year. Design and Setting: The files of MPP followed up between January 2001 and January 2011 in two French Endocrine Networks were retrospectively reviewed. Therapy-naive patients were enrolled. Main Outcome Measures: The main outcome was progression-free survival at 1 year in therapy-naive MPP patients according to Response Evaluation Criteria In Solid Tumors 1.1 criteria. Results: Ninety files (46 men, 44 women, mean age of 47.5 ± 15 years) were reviewed on site by one investigator. MPP characteristics were as follows: presence of an adrenal primary, a mitotic count exceeding 5 per high power field, hypertension, inherited disease, and presence of bone metastases in 50%, 22%, 60%, 49%, and 56% patients, respectively. Fifty-seven of the 90 patients with MPP (63%) were classified as therapy-naive. The median follow-up of these 57 patients was 2.4 years (range, 0.4–5.7). At 1 year, progression-free survival was 46% (CI 95: 33–59). Twenty-six of 30 (87%) patients with progression at 1 year had exhibited progressive disease at the first imaging workup performed after a median of 5.7 months. No prognostic parameter was identified. Conclusions: Half of the therapy-naive patients with MPP achieved stable disease at 1 year. In symptom-free patients with MPP, a wait-and-see antitumor policy seems appropriate as first line. Modality for a prospective follow-up is proposed.

scholarly journals OSTEORADIONEKROSIS PASCA EKSTRAKSI GIGI PASIEN DENGAN RIWAYAT KANKER NASOFARING

2019 ◽  
Vol 6 (1) ◽  
pp. 19
Author(s):  
Yayun Siti Rochmah
Keyword(s):  
Neck Region ◽  
The Body ◽  
Dental Extraction ◽  
Head And Neck Region ◽  
Radio Therapy ◽  
Patient Reported ◽  
Immunity Factor ◽  
History Of ◽  
Post Radiation ◽  
One Year

Background: Osteoradionecrosis (ORN) post dental extraction is post dentalextraction complication with post radiation cancer theraphy. Objective : to present rare case, ORN post dental extraction with post radiation Ca nasopharing therapy 3 years ago.Case Management: A 54 years old patient reported to the dental out-patient department with a chief complaint of pus discharge from right buccal since post dental extraction 6 months ago. He gave a history of a nasopharing Carcinoma with histopatology as squamous cell carcinoms 3 years ago and radio therapy but no surgery. Intraoral examination, exposed necrotic bone found from right lower retromolar area 46 with pus discharge. Radiographic view was likely squester. Local surgical debridement and the sequestrectomy was undertaken with general anaesthesia. Antibiotic injection treatment was ceftriaxon 2x 1gram, infus metronidazol 3x500 mg and ketorolac 3x1 ampul, the patient was treated for 3 days and educated to maintain his oral hygiene with povidone iodine gargle.Discussion: Osteoradionecrosis (ORN) is late effect of radiation therapy thatresults in irreversible tissue death, which is clinically observed as bony exposure for more than 3 months duration. The mandible is affected more often than the maxilla or any other bones of head and neck region. The incidence of ORN in the mandible is reported to be between 2% and 22% and most often affects the body of the mandible. Ideal time is one year minimal post radiotherapy to get maximal vascularization for optimal healing. But immunity factor and radiation doses can trigger emergense ORN.Conclusion: Need time consideration, clinic analysis and pathologys before doing dental extraction for post radiotherapy cancer cases to prevent ORN.

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