Pulmonary Sarcoidosis: Diagnosis and Differential Diagnosis

Sarcoidosis is a multisystem disorder of unknown origin and poorly understood pathogenesis that predominantly affects lungs and intrathoracic lymph nodes and is characterized by the presence of noncaseating granulomatous inflammation in involved organs. The disease is highly heterogeneous and can mimic a plethora of other disorders, making diagnosis a challenge even for experienced physicians. The evolution and severity of sarcoidosis are highly variable: many patients are asymptomatic and their disease course is generally benign with spontaneous resolution. However, up to one-third of patients develop chronic or progressive disease mainly due to pulmonary or cardiovascular complications that require long-term therapy. The diagnosis of sarcoidosis requires histopathological evidence of noncaseating granulomatous inflammation in one or more organs coupled with compatible clinical and radiological features and the exclusion of other causes of granulomatous inflammation; however, in the presence of typical disease manifestations such as Löfgren’s syndrome, Heerfordt’s syndrome, lupus pernio and asymptomatic bilateral and symmetrical hilar lymphadenopathy, the diagnosis can be established with high level of certainty on clinical grounds alone. This review critically examines the diagnostic approach to sarcoidosis and emphasizes the importance of a careful exclusion of alternative diagnoses.

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A Randomized Open Clinical Study of the Atherosclerosis Treatment Information Video Effect on Adherence to Long-Term Therapy in Patients with Cardiovascular Diseases

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2021-10-04 ◽

2021 ◽

Vol 17 (5) ◽

pp. 683-687

Author(s):

Yu. V. Bulaeva ◽

E. A. Naumova ◽

O. N. Semenova ◽

T. V. Kanaeva ◽

K. A. Popov ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Patient Adherence ◽

Intervention Group ◽

Cardiovascular Complications ◽

The Body ◽

Term Therapy ◽

Control Group ◽

Treatment Information ◽

Long Term Therapy

Aim. Study the effect of a study video, which was created by researchers and devoted to the atherosclerosis development and the effect of statin therapy on atherosclerotic plaque, on adherence to long-term therapy in patients with high or very high risk of cardiovascular complications.Material and methods. 120 patients admitted to hospital with cardiovascular diseases were included in the study. Patients were randomized into 2 groups: in the main group (n=60), the information video edited by the researchers was shown to patients on the eve of discharge, in addition to a printed brochure on lifestyle and diet modification, and in the control group (n=60), patients were given only a standard brochure. The motivating video shows the damage to the cardiovascular system by the atherosclerotic process and the beneficial effect on the body of constant intake of statins. After 1 and 3 months after discharge from the hospital, telephone calls were made, after which the patients had to visit the center for an objective examination by a researcher and control of laboratory parameters. After 1 month, 110 patients visited the center, after 3 months, 98 respondents visited the center.Results. The group with the information video demonstration noted more frequent adherence to medical recommendations compared to the control: after 1 month, 52 (96%) patients continued treatment versus 48 (86%) patients, 3 months after discharge 48 (96%) patients continued treatment versus 38 (79%) patients (p<0.05). After 1 month, 38 (70%) patients in the intervention group continued taking statins versus 29 (43%) respondents in the control group (p<0.05), 3 months after discharge, 40 (80%) patients in the intervention group continued to take statins versus 33 (69%) control patients (p<0.09).Conclusion. Demonstration of a motivating video about the effect of statins on the atherosclerosis course increases patient adherence to medicinal therapy, including adherence to statins.

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Selective Streptokinase Fibrinolysis in Femoro-Iliac Arterial Obstruction

Acta Radiologica Diagnosis ◽

10.1177/028418518602700305 ◽

1986 ◽

Vol 27 (3) ◽

pp. 279-283 ◽

Cited By ~ 4

Author(s):

K. Sørensen ◽

V. Hegedüs

Keyword(s):

Low Dose ◽

Transluminal Angioplasty ◽

Term Therapy ◽

High Dose ◽

Short Term ◽

Short Term Therapy ◽

One Year ◽

High Level ◽

Long Term Therapy

Percutaneous transluminal angioplasty of iliac and femoral arteries was in 17 patients combined with selective intra-arterial streptokinase treatment. The patients were divided into two groups, one given low dose long-term therapy and the other high dose short-term therapy. The experiences obtained during an observation period of over one year revealed greater benefit from high dose short-term therapy. It seems that the major cause of complications must be attributed to the development of a high level of streptokinase antibodies during low dose long-term therapy. References

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Biochemical evaluation of glycemic levels of long-term tacrolimus therapy in rats

Brazilian Oral Research ◽

10.1590/s1806-83242007000400002 ◽

2007 ◽

Vol 21 (4) ◽

pp. 293-297 ◽

Cited By ~ 3

Author(s):

Carlos Augusto Nassar ◽

Patricia Oehlmeyer Nassar ◽

Denise Carleto Andia ◽

Morgana Rodrigues Guimarães ◽

Maria Teresa Pepato ◽

...

Keyword(s):

Serum Levels ◽

Cardiovascular Complications ◽

Term Therapy ◽

Control Group ◽

Post Transplantation ◽

Tacrolimus Therapy ◽

Biochemical Evaluation ◽

Long Term Therapy

One of the more serious complications following transplantation is the development of post-transplantation diabetes mellitus (PTDM), which has a major impact on the quality of life, with effects ranging from the control of glycemia times to increased susceptibility to infections and cardiovascular complications. It has been suggested that immunosuppressive therapy, mainly tacrolimus therapy, may be an important factor in the development of PTDM. There is a lack of studies that explore the effects of long-term tacrolimus on PTDM in animal protocols. The objective of this study was therefore to evaluate the effects of long-term therapy with tacrolimus in rats. One group was treated with tacrolimus, injected subcutaneously, in a daily dose of 1 mg/kg of body weight. The chosen dose was sufficient to achieve therapeutic tacrolimus serum levels. The experimental periods were 60, 120, 180 and 240 days. One group was used as control and received daily subcutaneous injections of saline solution during all periods. A tendency towards increased glycemia levels during the initial periods (60 and 120 days) was observed. However, at 180 and 240 days, the glycemia levels were not statistically different from that of the control group of the same period. It may thus be concluded that the deleterious effects of tacrolimus therapy on glycemia may be a time-related side effect.

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The role of diuretics in the treatment of hypertension: a focus on chlorthalidone (lecture)

HYPERTENSION ◽

10.22141/2224-1485.14.2.2021.231853 ◽

2021 ◽

Vol 14 (2) ◽

pp. 12-29

Author(s):

Yu.M. Sirenko

Keyword(s):

Cardiovascular Complications ◽

Term Therapy ◽

Thiazide Diuretics ◽

Cerebrovascular Complications ◽

Hypertension Therapy ◽

Long Term Therapy ◽

The Impact ◽

Therapy Of Hypertension

The lecture discusses the role of thiazide and thiazide-like diuretics, in particular chlorthalidone, in the modern treatment of arterial hypertension. The modern concepts about the mechanism of action of thiazide diuretics and chlorthalidone are presented. Differences in the degree of antihypertensive effect of hydrochlorothiazide and chlorthalidone are discussed. The results of large randomized trials SHEP, MRFIT, ALLHAT were analyzed, in which chlorthalidone therapy significantly reduced the risk of developing cardiovascular and cerebrovascular complications of hypertension. The effect of thiazide diuretics on glucose metabolism and the impact of carbohydrate metabolism disorders during treatment with chlorthalidone on the risk of cardiovascular complications was considered. The lecture also discusses the effect of chlorthalidone therapy on kidney function, the possibility of its use in chronic kidney disease. The data are presented on the prevention of resistant hypertension and chro-nic heart failure during long-term therapy of hypertension with chlorthalidone. The frequency and terms of the development of side effects of hypertension therapy with thiazide-like diuretics were also analyzed.

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THE RISK FACTORS FOR CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

JOURNAL OF CARDIORESPIRATORY RESEARCH ◽

10.26739/2181-0974-2020-2-10 ◽

2020 ◽

Vol 2 (1) ◽

pp. 62-65

Author(s):

M.R. Rahmetova ◽

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cardiovascular Complications ◽

Term Therapy ◽

Patients With Diabetes ◽

Long Term Therapy

Purpose: to study the influence of risk factors on the development of cardiovascular complications in patients with diabetes mellitus and to evaluate the effectiveness of treatment depending on the effect of certain factors. Materials and methods. Westudied 23 patients with type 2 diabetes mellitus with chronic cardiovascular complications, who were prescribed long-term therapy for diabetes and cardiovascular complications. Patients were offered questionnaires with questions about the prescribed treatment, the actual treatment received and the reasons for the violation of the recommendations.

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Efficacy of Crisis Intervention

Crisis ◽

10.1027//0227-5910.20.2.78 ◽

1999 ◽

Vol 20 (2) ◽

pp. 78-85 ◽

Cited By ~ 6

Author(s):

Thomas Reisch ◽

Petra Schlatter ◽

Wolfgang Tschacher

Keyword(s):

Crisis Intervention ◽

Intervention Program ◽

Suicide Ideation ◽

Indirect Evidence ◽

Well Being ◽

Term Therapy ◽

Contributing Factors ◽

Step Therapy ◽

Long Term Therapy ◽

The Impact

This study assesses the efficacy of the treatment approach implemented in the Bern Crisis Intervention Program, where particular emphasis is placed on the remediation of suicide ideation and suicidal behavior, and depression, fear, and phobia are generally considered to be contributing factors. Four questionnaires addressing psychopathology, emotional well-being, social anxiety, and personality were administered prior to and after the treatment of 51 patients over a period of 2 to 3 weeks. The reduction of symptoms contributing to suicidal ideation and behavior was interpreted as indirect evidence of an antisuicidal effect of the program. Significant improvements were found in the psychopathology ratings, with depression and anxiety showing the largest reductions. The impact on personality and social phobia, however, was only moderate, and on average patients still exhibited symptoms after attending the program. This residual symptomatology points to the necessity of introducing a two-step therapy approach of intensive intervention targeted at the precipitating causes of the crisis, augmented by long-term therapy to treat underlying problems.

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Antithrombotic Therapy for DVT/PE

Hämostaseologie ◽

10.1055/s-0038-1659983 ◽

1997 ◽

Vol 17 (03) ◽

pp. 161-162

Author(s):

Thomas Hyers

Keyword(s):

Molecular Weight ◽

Low Molecular Weight Heparin ◽

Oral Anticoagulants ◽

Cost Effective ◽

Therapeutic Agents ◽

Great Promise ◽

Term Therapy ◽

Low Molecular Weight ◽

Long Term Therapy

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.

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