scholarly journals Patterns of Organ Involvement and Outcomes of SLE: A Real-Life Experience in Lupus Clinic

2020 ◽  
Vol 21 (2) ◽  
pp. 89-92
Author(s):  
Md Mujibur Rahman ◽  
Md Moniruzzaman ◽  
SK Jakaria Been Sayeed ◽  
Rashedul Hassan ◽  
Md Uzzwal Mallik ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Life Experience ◽  
Tertiary Care ◽  
Real Life ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Organ Involvement ◽  
Organ Systems ◽  
Major Organ ◽  
Tertiary Care Hospitals

SLE is one of the most common autoimmune disorders of women of childbearing age.It often manifests with various constitutional symptoms as well as combination of major organ involvement and outcome varies in different studies with current treatment. The present study is to see the patterns of organ involvement and outcomes at least after 6 months with standard treatment. This retrospective study was conducted in lupus clinic of two largest tertiary care hospitals in Dhaka city of Bangladesh over 2010 to 2019. It included 277 patients of SLE, diagnosed on the basis of ACR lupus diagnostic criteria and ACR lupus nephritis guideline and had received standard treatment. Outcomes were assessed by SLEDAI. The most common clinical manifestations were fever (71.8%), joint pain (71.4%), oral ulceration (54.8%), alopecia (36.4%), butterfly rash (28.5%), photosensitivity (32.1%) and Raynaud’s phenomenon (16.6%). Commonly involved major organ-systems were renal (41.5%), CNS (16.6%), pulmonary (7.2%), cardiac (3.2%) and hematological (12.2%). Renal biopsy was done in 91cases and the histology showed majority (37.3%) in class-IV. With standard treatment, a significant reduction of mean serum creatinine, proteinuria and SLEDAI was observed at least after 6 months. A total 35(12.63%) flares and 6 (2.17%) deaths occurred during the course of treatment. Renal and CNS are the most commonly involved major organ systems next to skin and joints. The overall outcome is favorable with standard treatment. J MEDICINE JUL 2020; 21 (2) : 89-92

Long-term follow-up of antiphospholipid syndrome: real-life experience from a single center

Lupus ◽  
2020 ◽  
Vol 29 (9) ◽  
pp. 1050-1059
Author(s):  
Rosa Serrano ◽  
Guillermo J Pons-Estel ◽  
Gerard Espinosa ◽  
Rosana M. Quintana ◽  
Joan C Reverter ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Life Experience ◽  
Disease Onset ◽  
Real Life ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Single Center ◽  
Live Births ◽  
Laboratory Features ◽  
Long Term Follow Up

Objective The objective of this paper is to assess the prevalence of the main clinical manifestations and laboratory features at disease onset and during the ensuing 10 years of a large cohort of patients with antiphospholipid syndrome (APS) from a single center. Methods The study included all consecutive APS patients followed longitudinally in our center from 2003 to 2013. Descriptive statistics for demographics, clinical and laboratory features and mortality were performed. Results A total of 160 patients were included. Most of them, 128 (78.8%), were women and the mean (SD) age at diagnosis was 39.1 (14.0) years. The majority of them, 104 (65.0%), had primary APS, 36 (22.5%) had APS associated with systemic lupus erythematous, and 20 (12.5%) had APS associated with other autoimmune disease. During the study period, thrombotic events occurred in 27 (16.9%) patients, the most common being strokes, nonbacterial thrombotic endocarditis and deep venous thrombosis. Regarding obstetric morbidity, 18 women (14.3%) became pregnant and 90% of pregnancies succeeded in having live births. The most common obstetric complication was early pregnancy loss (15% of pregnancies). Prematurity (11.1% of live births) and intrauterine growth restriction (5.6% of live births) were the most frequent fetal morbidities. Ten (6.3%) patients died and the most frequent causes of death were severe thrombosis, hemorrhage, and cancer. Three (0.9%) cases of catastrophic APS occurred. The survival probability at 10 years was 93.8%. Conclusions Patients with APS develop significant morbidity and mortality despite current treatment. It is imperative to identify prognostic factors and therapeutic measures to prevent these complications.

Methicillin-Resistant Staphylococcus aureus in Two Tertiary-Care Centers in Jeddah, Saudi Arabia

2001 ◽  
Vol 22 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Tariq A. Madani ◽  
Nabeela A. Al-Abdullah ◽  
Ali A. Al-Sanousi ◽  
Tawfik M. Ghabrah ◽  
Shadia Z. Afandi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Saudi Arabia ◽  
Tertiary Care ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Total Mortality ◽  
Control Measures ◽  
Methicillin Resistant ◽  
Mrsa Infection ◽  
Tertiary Care Hospitals

AbstractObjective:To review clinical experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia.Design:Retrospective review for the year 1998.Setting:Two tertiary-care hospitals.Methods:Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the microbiology laboratories' records. Charts of patients were reviewed, with standardized data collection.Results:Of 673 S aureus isolates identified, 222 (33%, or 6.8 isolates/1,000 admissions) were MRSA Overall MRSA prevalence was 2% in 1988. Nosocomial acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of all isolates), the medical wards (24.8%), and the surgical wards (19.8%). Seventy-three percent of isolates caused infection; the rest represented colonization. Surgical wounds (35.2%), the chest (29%), and central venous catheters (13%) were the most common sites of infection. Bacteremia occurred in 15.4% of patients. Local signs (84%) and fever (75.9%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 30.2% and 13.6% of cases, respectively. Of 162 patients with MRSA infection and 60 patients with MRSA colonization, 95.7% and 70% received antibiotics in the preceding 6 weeks, respectively (P<.0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other causes.Conclusions:The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent die spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.

scholarly journals Criteria for referral of pediatric SARS-CoV-2 infection: a real-life experience in the pandemic era

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Carlotta Montagnani ◽  
Elisabetta Venturini ◽  
Manuela L’Erario ◽  
Chiara Tersigni ◽  
Barbara Bortone ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Experience ◽  
Tertiary Care ◽  
Real Life ◽  
Pediatric Intensive Care ◽  
University Hospital ◽  
Children At Risk ◽  
Referral Criteria ◽  
Practical Guidance

AbstractA practical guidance on the management of children with COVID-19 to insure homogeneous criteria for referral to a higher-level facility, according to the disease severity, is pivotal in the pandemic era. A panel of experts in pediatric infectious diseases and intensive care at the tertiary-care Meyer Children’s University Hospital, Florence, Italy, issued a practical document shared with Tuscany hospitals. The rationale was to target the referral for those children at risk of requiring an intensive support, since the above mentioned hospital has the pediatric intensive care unit. Overall, 378 patients between 0 and 19 years of age were diagnosed with COVID-19 infection in the Tuscany region with 24 (6.3%) hospitalizations. Only three children were centralized to Meyer Children’s University Hospital according to reported criteria. Considering that appropriate referral criteria have been associated with reduced mortality in other conditions, our document might be useful to improve outcomes of children with COVID-19.

Prucalopride for Constipation in a Tertiary Care Setting: Real Life Experience

2011 ◽  
Vol 140 (5) ◽  
pp. S-612
Author(s):  
Phaedra M. Tachtatzis ◽  
Usman Khan ◽  
Anne Kelly ◽  
Deborah J. Rowley-Conwy ◽  
Yan Yiannakou
Keyword(s):  
Care Setting ◽  
Life Experience ◽  
Tertiary Care ◽  
Real Life ◽  
Tertiary Care Setting

scholarly journals ACECLOFENAC-INDUCED STEVENS-JOHNSON SYNDROME AFTER ONE SINGLE DOSE: A MAIDEN CASE REPORT

2018 ◽  
Vol 11 (9) ◽  
pp. 1 ◽  
Author(s):  
Saurabh Agarwal ◽  
Balaji O ◽  
Navin Patil
Keyword(s):  
Case Reports ◽  
Tertiary Care ◽  
Stevens Johnson Syndrome ◽  
Care Hospital ◽  
Skin Reactions ◽  
Johnson Syndrome ◽  
Organ Systems ◽  
Major Organ ◽  
Threatening Condition ◽  
Life Threatening

Drugs are known to cause various adverse drug reactions involving major organ systems. Skin-related adverse reactions are very common and range from a simple rash to life-threatening condition like Stevens-Johnson syndrome. Various drugs are known to cause skin reactions which include antiepileptics, analgesics, antibiotics, and proton-pump inhibitors. Nonsteroidal anti-inflammatory drugs causing life-threatening conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis are very rare and only few case reports are published. Hence, we report a case of Aceclofenac-induced Stevens-Johnson syndrome after single time administration in a tertiary care hospital in India.

scholarly journals A clinico-epidemiological study of acute encephalitis syndrome with multi organ dysfunction

2017 ◽  
Vol 4 (3) ◽  
pp. 745
Author(s):  
Mahima Mittal ◽  
Komal P. Kushwaha ◽  
Ashok K. Pandey ◽  
Milind M. Gore
Keyword(s):  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
The Body ◽  
Organ Involvement ◽  
Care Hospital ◽  
Viral Etiology ◽  
Biochemical Tests ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Background: Acute Encephalitis Syndrome (AES) is a pressing public health problem in Eastern Uttar Pradesh, India. Japanese Encephalitis (JE), which has been endemic in this region, has shown a declining trend. AES not due to JE (Non JE) constitutes more than 75% of all cases and is associated with non-neurological clinical manifestations also. The etiology of Non JE AES is still unknown. We studied the clinic-epidemiological profile of AES, and compared Non JE AES to JE.Methods: This study was done in a tertiary care hospital in children 1-15 years. Clinical features, CSF analysis, biochemical tests, radiological features and outcome were studied in AES cases.Results: Out of 505 patients, 27 had an identifiable non-viral etiology. JE was a cause in 31/478(6.48%) patients. The remaining 447 patients were labeled as Non JE AES. Headache at presentation (25.8% vs. 10.7%) and hypertonia (22.6% vs. 9.8%) were significantly higher in JE patients. Swelling over the body (21.25%vs 3.2%) and hypotonia (25.7% vs. 3.2%) were significantly more common in Non JE AES. Although cardiac involvement and multi-organ involvement was more in Non JE AES, the difference was not statistically significant. Overall mortality was 32.42%.Conclusions: JE is no longer an important cause of AES in this region. Swelling over the body, floppiness and multi organ involvement are predominant features of Non JE AES. Although many infectious diseases can present with similar features, a viral etiology seems most likely. Further efforts are needed to identify etiology.

scholarly journals Daratumumab Monotherapy in Severe Patients with AL Amyloidosis and Biopsy-Proven Renal Involvement: A Real Life Experience

2020 ◽  
Vol 9 (10) ◽  
pp. 3232 ◽  
Author(s):  
Dario Roccatello ◽  
Roberta Fenoglio ◽  
Carla Naretto ◽  
Simone Baldovino ◽  
Savino Sciascia ◽  
...  
Keyword(s):  
Life Experience ◽  
Cell Clone ◽  
Renal Involvement ◽  
Single Agent ◽  
Real Life ◽  
Clinical Results ◽  
Current Treatment ◽  
Clinical Activity ◽  
Al Amyloidosis ◽  
M Proteins

Objectives: This paper aims to describe the clinical experience with Daratumumab (DARA), a first-in-class anti-CD38 human monoclonal IgG1κ antibody monotherapy, in severe patients with AL and biopsy-proven renal involvement. Immunoglobulin light chain (AL) amyloidosis with multi-organ involvement is characterized by short survival. Novel powerful drugs are expanding the therapeutic options. Current treatment of AL amyloidosis, which has been adopted from multiple myeloma (MM), is based on chemotherapy targeting the underlying plasma cell clone. DARA is effective in treating MM. The clinical activity and toxicity profile of DARA as a single agent in the treatment of AL amyloidosis is currently under evaluation. Patients and Methods: DARA was administered in a series of patients with severe AL amyloidosis and biopsy-proven renal involvement. Five patients(mean age 64.2 years) were treated. One patient was refractory and one intolerant to conventional bortezomib-based therapy, two were treated with DARA for relapsing disease, and one was treated front-line. Results: Data showed that DARA monotherapy resulted in good clinical results, with the disappearance of M-proteins in four out of five patients and with serum free light chains (sFLC) ratio normalization in three out of four and a remarkable amelioration in the remaining patient. The four patients with still preserved renal function at baseline also showed serum creatinine stabilization or improvement and a decrease in proteinuria. These data were paralleled by the reduction of the N-terminal prohormone of brain natriuretic peptide (NT pro-BNP)values. Conclusions: Our data show that monotherapy with DARA had significant clinical efficacy in pretreated/naïve patients with severe AL amyloidosis and biopsy-proven renal involvement.

scholarly journals Very elderly patients and lung cancer in a tertiary care center: a real life experience

2017 ◽  
Vol 28 ◽  
pp. vi64
Author(s):  
A. Ponzetti ◽  
C. Crsitiano ◽  
E. Milanesi ◽  
G. Ritorto ◽  
S. Bustreo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Life Experience ◽  
Care Center ◽  
Tertiary Care ◽  
Real Life ◽  
Tertiary Care Center ◽  
Very Elderly
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