Uveitis associated with Systemic Diseases: Clinical, Diagnosis, and Treatment

2020 ◽  
pp. 267-276
Keyword(s):  
Visual Loss ◽  
Treatment Options ◽  
Systemic Diseases ◽  
Immunomodulatory Drugs ◽  
Immune Mediator ◽  
First Choice ◽  
Choice Of Treatment ◽  
Life Threatening ◽  
Eye Involvement

Uveitis is a frequently seen entity with systemic immune mediator related diseases. Among these diseases, Behçet's disease, sarcoidosis, spondyloarthropathies, and juvenile idiopathic arthritis are relatively common. In this group of patients, uveitis may result in visual loss. Additionally, eye involvement may also be the presenting sign of these life-threatening systemic diseases. Therefore, early diagnosis and proper treatment of these diseases are important. Corticosteroids are the first choice of treatment in this group of patients. However, their use is limited due to potential side effects in the long-term. In recent years, an increasing number of immunomodulatory drugs and biological agents are being used more effectively to reduce complications related to these diseases. In this review, clinical features, diagnostic dilemmas, and treatment options of uveitis associated with noninfective systemic diseases were evaluated.

scholarly journals Skin directed treatment of cutaneous T-cell lymphomas, case report

2020 ◽  
Vol 96 (5) ◽  
pp. 212-218
Author(s):  
Melánia Pozsgai ◽  
◽  
Rolland Gyulai ◽  
Csaba Gyömörei ◽  
Zsuzsanna Lengyel
Keyword(s):  
T Cell ◽  
Mycosis Fungoides ◽  
Treatment Options ◽  
Disease Stage ◽  
Treatment Modalities ◽  
T Cell Lymphomas ◽  
Choice Of Treatment ◽  
Puva Treatment ◽  
Show Lymph Node

Cutaneous T-cell lymphomas are rare diseases with significant differences in their clinical course and prognosis. The choice of treatment basically depends on the stage, in the early stages of the disease only skin directed treatment is recommended. With most of the treatment modalities, complete cure is not possible, only long-term remission can be achieved. The authors report the case of a 52-year-old female patient who developed extensive annular, erythematous, infiltrated plaques in the spring of 2019. Histological examination confirmed mycosis fungoides, imaging did not show lymph node or other organ involvement. Given the disease (stage IB), PUVA treatment was initiated. After a total of 21 sessions of phototherapy from September 2019, the patient underwent complete remission. The authors provide a detailed review of skin directed treatment options for mycosis fungoides based on current international recommendations.

X-linked thrombocytopenia (XLT) due to WAS mutations: clinical characteristics, long-term outcome, and treatment options

Blood ◽  
2010 ◽  
Vol 115 (16) ◽  
pp. 3231-3238 ◽  
Author(s):  
Michael H. Albert ◽  
Tanja C. Bittner ◽  
Shigeaki Nonoyama ◽  
Lucia Dora Notarangelo ◽  
Siobhan Burns ◽  
...  
Keyword(s):  
Severe Disease ◽  
Treatment Options ◽  
Gene Mutations ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Increased Risk ◽  
Life Threatening ◽  
Severe Infections

Abstract A large proportion of patients with mutations in the Wiskott-Aldrich syndrome (WAS) protein gene exhibit the milder phenotype termed X-linked thrombocytopenia (XLT). Whereas stem cell transplantation at an early age is the treatment of choice for patients with WAS, therapeutic options for patients with XLT are controversial. In a retrospective multicenter study we defined the clinical phenotype of XLT and determined the probability of severe disease-related complications in patients older than 2 years with documented WAS gene mutations and mild-to-moderate eczema or mild, infrequent infections. Enrolled were 173 patients (median age, 11.5 years) from 12 countries spanning 2830 patient-years. Serious bleeding episodes occurred in 13.9%, life-threatening infections in 6.9%, autoimmunity in 12.1%, and malignancy in 5.2% of patients. Overall and event-free survival probabilities were not significantly influenced by the type of mutation or intravenous immunoglobulin or antibiotic prophylaxis. Splenectomy resulted in increased risk of severe infections. This analysis of the clinical outcome and molecular basis of patients with XLT shows excellent long-term survival but also a high probability of severe disease-related complications. These observations will allow better decision making when considering treatment options for individual patients with XLT.

scholarly journals Immunotherapy, immunochemotherapy and chemotherapy for American cutaneous leishmaniasis treatment

2006 ◽  
Vol 39 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Wilson Mayrink ◽  
Ana Cristina de Carvalho Botelho ◽  
Paulo Araújo Magalhães ◽  
Sebastião Mariano Batista ◽  
Antonio de Oliveira Lima ◽  
...  
Keyword(s):  
Side Effects ◽  
Cutaneous Leishmaniasis ◽  
Term Treatment ◽  
Prevention Measures ◽  
Prophylactic Measure ◽  
American Cutaneous Leishmaniasis ◽  
First Choice ◽  
Long Term Treatment ◽  
Choice Of Treatment

The first choice of treatment for American cutaneous leishmaniasis is the pentavalent antimonial drug. Although it has been shown that this treatment is mostly effective and indicated, some disadvantages should be taken into account such as side effects, long term treatment inconveniences and counter-indication for patients suffering from cardiopathy, nephropathy; yet, aging, pregnancy and other conditions. With the advent of the vaccine anti-American cutaneous leishmaniasis as a prophylactic measure, studies on therapy using the vaccine associated or not with other drugs have been performed by many investigators and it is currently among the alternative treatments and prevention measures for American cutaneous leishmaniasis. In conclusion, the association between antimony and vaccine (immunochemotherapy) showed the same cure rate when compared with the standard treatment (100%) and it was also able to reduce the salt volume in 17.9% and treatment length from 87 to 62 days, decreasing side effects.

scholarly journals A Case of Intractable Hiccup Treated by Acupuncture and Moxibustion

2021 ◽  
Vol 5 (6) ◽  
pp. 22-24
Author(s):  
Hui Sun ◽  
Yufeng Bi ◽  
Changchun Ji ◽  
Qinlang Liu
Keyword(s):  
Quality Of Life ◽  
Western Medicine ◽  
Treatment Method ◽  
Systemic Diseases ◽  
Curative Effect ◽  
Acupuncture And Moxibustion ◽  
Intractable Hiccup ◽  
Life Threatening

Hiccup is a syndrome characterized by continuous sound in the throat, short and frequent sound, and difficult to stop [1]. Although the disease is not life-threatening, it seriously affects the quality of life of patients. Long term intractable hiccup will also have an impact on the psychology of patients and bring great trouble to patients. Hiccup is equivalent to diaphragmatic spasm in western medicine and involves a variety of systemic diseases [2]. At present, the treatment of this disease includes drugs and nerve block, but the curative effect and prognosis are not ideal. Acupuncture and moxibustion, as a green and simple treatment method, has unique curative effect in the treatment of hiccup. Now the test of one case of intractable hiccup caused by ineffective treatment is as follows.

Treatment of non-ST elevation acute coronary syndromes

ESC CardioMed ◽  
2018 ◽  
pp. 1241-1255
Author(s):  
Marco Valgimigli ◽  
Andreas Mitsis ◽  
Marco Angelillis
Keyword(s):  
Coronary Revascularization ◽  
Artery Bypass ◽  
Treatment Options ◽  
Bleeding Risk ◽  
Risk Scores ◽  
Single Individual ◽  
Serious Adverse Events ◽  
Life Threatening ◽  
St Elevation

Treatment of patients presenting with a non-ST elevation acute coronary syndrome (NSTE-ACS) aims at immediate relief of ischaemia and the prevention of serious adverse events, including death, myocardial (re)infarction, and life-threatening arrhythmias. In NSTE-ACS, patient management is guided by risk stratification (troponin, electrocardiogram, risk scores, etc.). Treatment options include anti-ischaemic and antithrombotic drugs and coronary revascularization including percutaneous coronary interventions, or coronary artery bypass grafting. While long-term secondary prevention with aspirin monotherapy is currently the gold standard approach for all NSTE-ACS patients who tolerate the drug, additional medications on top of aspirin such as oral P2Y12 inhibitors or oral anticoagulation have been investigated across clinical trials and their long-term use should be guided by the ischaemic versus bleeding risk status of each single individual patient.

scholarly journals Long-term efficacy assessment of current treatment options for epistaxis in HHT

2021 ◽  
Author(s):  
Cilgia Dür ◽  
L. Anschuetz ◽  
S. Negoias ◽  
O. C. Bulut ◽  
A. Angelillo-Scherrer ◽  
...  
Keyword(s):  
Laser Photocoagulation ◽  
Treatment Options ◽  
Current Treatment ◽  
Endovascular Embolization ◽  
Vascular Disorder ◽  
Comprehensive Management ◽  
Life Threatening ◽  
Efficacy Assessment ◽  
Treatment Procedures

Abstract Purpose Hereditary hemorrhagic telangiectasia (HHT) is a vascular disorder that presents with recurrent, intractable epistaxis. The aim of this study was to retrospectively analyze the efficacy of various treatment options for epistaxis in patients with HHT, over a period of 18 years, and to correlate these findings with available evidence in the literature. Methods Records of patients with HHT, treated for epistaxis between 2000 and 2018 were analyzed. Treatment procedures carried out and their efficacy were extracted and analyzed. Results Forty-three records were evaluated. All patients were given nasal humidifying ointments, 93% required acute treatment with bipolar electrocautery, and 60% underwent atraumatic nasal packing. Recurrent cases were treated medically with tranexamic acid (26%), oestrogen (19%), and bevacizumab (2%). Laser photocoagulation was done in selected cases (40%) and if unsuccessful, septal dermoplasty was performed (2.3%). Endovascular embolization was reserved for life-threatening emergencies (7%). Conclusion Epistaxis in HHT is not curable, but can be managed by employing a comprehensive stepwise approach. An algorithm for effective and comprehensive management has been presented.

scholarly journals Diagnosis and treatment of hereditary angioedema with normal C1-inhibitor level

2020 ◽  
Vol 92 (12) ◽  
pp. 86-90
Author(s):  
A. V. Emelyanov ◽  
E. V. Leshenkova ◽  
G. A. Kameneva
Keyword(s):  
Hereditary Angioedema ◽  
Autosomal Dominant ◽  
Clinical Presentation ◽  
Treatment Options ◽  
Genetic Mutation ◽  
C1 Inhibitor ◽  
Short Term ◽  
Inhibitor Level ◽  
Life Threatening

Hereditary angioedema (HAE) with normal C1-inhibitor level is a rare potentially life-threatening disorder with autosomal dominant inheritance which was first described in 2000. Its clinical presentation is similar to HAE with C1-deficiency. The review is summarized data about its prevalence, mechanisms, genetics and diagnostic criteria. Different subtypes and treatment options (on demand, short term and long-term prophylaxis) are discussed. We describe family clinical cases of 2 female patients with normal C1-inhibitor and plasminogen gene mutation. Their features were late diagnosis (in 10 and 25 years after the onset of symptoms), family history (similar genetic mutation in 3 female members of the same family, including 1-asymtomatic) and combination of face, tongue, larynx and abdominal angioedema in patient and her sibling.

scholarly journals Hyperuricaemia and gout

2020 ◽  
pp. 95-100
Author(s):  
A Kopke ◽  
OBW Greeff
Keyword(s):  
Uric Acid ◽  
Side Effects ◽  
Treatment Options ◽  
The Body ◽  
Acute Gout ◽  
Tophaceous Gout ◽  
Life Threatening ◽  
Inflammatory Drugs ◽  
Urate Crystals

Gout is a painful, inflammatory disease that affects more men than women. The incidence of gout has increased substantially over the past few decades, as evidenced by information from the Rochester project. Some of the risk factors for the development of gout include: increased ethanol intake, high dietary purine consumption, obesity and the use of certain drugs, such as diuretics. Another important risk factor for the development of gout is hyperuricaemia. Hyperuricaemia results from an imbalance between the rate of production and excretion of uric acid in the body. An excess of uric acid thus builds up in the body, supersaturating body fluids and leading to the formation of monosodium urate crystals. These crystals accumulate in tissue and around joints, leading to an acute gout attack. Gout can be divided into four phases, namely asymptomatic hyperuricaemia, acute gout attacks or recurrent gout, intercritical gout and chronic tophaceous gout. Various treatment options are available for gout, and the treatment for each gout patient is determined by the stage of the disease. Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, corticotropin and colchicine are used for the treatment of acute gout attacks. Allopurinol and probenecid are used for long-term hypouricaemic therapy, while NSAIDs and colchicine are prescribed for the prophylaxis of future gout attacks. All of these treatments have side-effects, ranging from mild to life-threatening in nature. There is a need for novel gout therapies that have fewer side-effects but are still as effective.

scholarly journals Invasive Cervical Resorption: Etiology, Diagnosis, Classification and Treatment

2012 ◽  
Vol 13 (5) ◽  
pp. 723-728 ◽  
Author(s):  
José Augusto César Discacciati ◽  
Eduardo Lemos de Souza ◽  
Sérgio Carvalho Costa ◽  
Herbert Haueisen Sander ◽  
Vinícius de Magalhães Barros ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Treatment Options ◽  
Interdisciplinary Treatment ◽  
Osseointegrated Implants ◽  
Inappropriate Treatment ◽  
First Choice ◽  
Choice Of Treatment ◽  
External Trauma ◽  
Diagnosis Classification ◽  
Classification And Treatment

ABSTRACT Background Invasive cervical resorption (ICR) is not well understood by the professional, being misdiagnosed, leading to inappropriate treatment and unnecessary loss of tooth. Introduction ICR is defined as a localized process of resorption, which begins in the cervical area of the tooth, just below the epithelial junction and above the ridge crest in the area of the connective tissue insertion. Possible predisposing factors include external trauma, orthodontic movement, surgical procedures, periodontal disease and its treatments, endogenous bleaching, pressure generated by wind instruments and herpes virus infection. Different approaches have been suggested for the treatment of ICR, depending on the extent of the lesion and its location. However, in some cases due to the severity of the injury, there is no alternative but to tooth extraction, followed by restoration of the edentulous area. Aim and objective Discuss etiology, diagnosis and classification of the ICR, as well as different treatment options. Also is presented a case in which extraction was carried out, installation of the implant and ceramic crown, subsequent to a treatment approach that resulted in failure in the short-term period. Conclusion Early diagnosis of the ICR is critical to proper treatment and favorable prognosis. Interdisciplinary treatment should be instituted as soon as possible, avoiding the loss of the affected tooth. In advanced cases, treatment involving the installation of osseointegrated implants should be considered the first choice of treatment. Clinical significance Early diagnosis of the ICR is critical do prevent unnecessary tooth loss, once the prognosis for advanced cases is doubtful. How to cite this article Discacciati JAC, de Souza EL, Costa SC, Sander HH, Barros VM, Vasconcellos WA. Invasive Cervical Resorption: Etiology, Diagnosis, Classification and Treatment. J Contemp Dent Pract 2012;13(5):723-728.

scholarly journals Use of Over-the-Scope Clip as First Choice to Treat Gastric Dieulafoy Lesions

2021 ◽  
Vol 13 (2) ◽  
pp. 163-165
Author(s):  
Attila Onmez ◽  
Serkan Torun
Keyword(s):  
Vascular Lesion ◽  
Recurrent Bleeding ◽  
Large Artery ◽  
Endoscopic Injection ◽  
Thermal Methods ◽  
First Choice ◽  
Choice Of Treatment ◽  
Life Threatening ◽  
Over The Scope Clip ◽  
Dieulafoy Lesion

Dieulafoy lesion is a rarely seen, superficial vascular lesion of the gastric mucosa that can lead to severe and recurrent bleeding which can be life-threatening. It is characterized by massive hemorrhages that can occur as a result of protrusion of a large artery from a submucosal defect. Endoscopic injection and mechanical and thermal methods are frequently used in traditional treatment. Herein, we presented a 61-year-old women who was admitted with upper gastrointestinal hemorrhage owing to Dieulafoy lesion who was successfully treated with over-the-scope clip as the first choice of treatment.

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