scholarly journals Cutis Tuberculosis

2021 ◽  
Vol 1 (2) ◽  
pp. 158-170
Author(s):  
Yudika Ilhami Rusdi ◽  
Rahmi Hijriani Hardianti ◽  
Lalu Wahyu Alfian ◽  
Cahya Nabila ◽  
Uni Nurul Milenia
Keyword(s):  
Drug Therapy ◽  
Public Awareness ◽  
Current Treatment ◽  
Immunocompromised Patients ◽  
Scientific Journals ◽  
Cutaneous Tuberculosis ◽  
The Public ◽  
Long Term Studies

Background: Tuberculosis (TB) is spreading globally, and more than two billion people (about 30% of the world's population) are thought to be infected with M. tuberculosis.  Tuberculosis cutis is an extrapulmonary Mycoterium tuberculosis infection that attacks the skin. Research Methods: The writing of this article includes various sources originating from scientific journals and government guidelines and related agencies. Source searches were conducted on the online portals of journal publications such as MedScape, Google Scholar and NCBI (ncbi.nlm.nih.gov). Results: Cutaneous TB can be transmitted through exposure to the lungs or infected aerosols entering the lungs. Cutaneous TB is divided into True Cutaneous TB which consists of primary and secondary TB, and Tuberculid Overall, the treatment of cutaneous TB is similar to that of systemic TB, which tends towards multi-drug therapy. Several anti-tuberculosis drugs such as isoniazid, rifampin, and pyrazinamide have been recommended as drugs for the treatment of cutaneous tuberculosis. It was reported that in a five-year follow-up approximately 12.5% ??of cutaneous TB patients showed relapse after standard anti-TB therapy. Conclusion: To reduce the mortality rate, the public needs to be given education regarding the dangers and ways to prevent TB disease to increase public awareness. More long-term studies are needed to understand the recurrence rate of various cutaneous tuberculosis under current treatment recommendations, especially in immunocompromised patients. 

Toxoplasma Appendicitis: A Once-in-a-Lifetime Diagnosis!

2017 ◽  
Vol 26 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Anisha M. Fernandes ◽  
Maheshkumar M. Lakhe ◽  
Sanjay A. Pai
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Muscularis Propria ◽  
Immunocompromised Patients ◽  
Lymphoid Follicles ◽  
Negative Results ◽  
Immunosuppressed Patients ◽  
Life Threatening

Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but it can be life-threatening in immunocompromised patients. We present a case of a 62-year-old man with clinical features of acute appendicitis. Histology showed a transmural infiltrate of eosinophils. In addition, there were reactive lymphoid follicles with histiocytes in the submucosa and tachyzoites in the muscularis propria. Immunohistochemistry confirmed the diagnosis of toxoplasma appendicitis. Serological evaluation yielded negative results. Retrospective review of the history revealed that the patient was on long-term immunosuppressive therapy with methotrexate. The patient was treated with sulfamethoxazole-trimethoprim and is asymptomatic at 7-month follow-up. Toxoplasma appendicitis must be considered in the differential diagnosis of appendicitis in immunosuppressed patients.

MICROSURGICAL TREATMENT OF SYMPTOMATIC SACRAL PERINEURIAL CYSTS

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 1059-1066 ◽  
Author(s):  
Dongsheng Guo ◽  
Kai Shu ◽  
Rudong Chen ◽  
Changshu Ke ◽  
Yanchang Zhu ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Treatment Options ◽  
Current Treatment ◽  
Cerebrospinal Fluid Leakage ◽  
Local Defect ◽  
Microsurgical Treatment ◽  
The Past ◽  
Return Visits

Abstract OBJECTIVE The aim of this study was to investigate the microsurgical results of symptomatic sacral perineurial cysts of 11 patients and to discuss the treatment options of the past 10 years. METHODS We retrospectively reviewed the records of 11 patients with symptomatic sacral perineurial cysts who underwent microsurgical treatment at Tongji Hospital, Huazhong University of Science and Technology from 1993 through 2006. The philosophy was to perform total or partial cyst wall removal, to imbricate the remaining nerve sheath if possible, and to repair local defect with muscle, Gelfoam (Pharmacia & Upjohn, Kalamazoo, MI), and fibrin glue. Patient outcomes were assessed by comparing the preoperative and postoperative examination results. The average follow-up time obtained from return visits to the neurosurgery clinic or by telephone questionnaires ranged from 2 months to 13 years. A literature search and analysis of current treatment options were performed. RESULTS Nine of the 11 patients (82%) experienced complete or substantial relief of their preoperative symptoms. One patient (Patient 4) experienced worsening of bladder dysfunction after surgery and recovered slowly to subnormal function during the subsequent 2 months. The symptoms of Patient 9 did not resolve, and magnetic resonance imaging showed that the cyst had reoccurred. The patient underwent reoperation 3 months later without any improvement. One patient (Patient 11) experience a cerebrospinal fluid leakage complication. Neither new postoperative neurological defects nor infection were observed in our series. In the literature, there are six different treatment options under debate and controversially discussed. CONCLUSION Microsurgical treatment yielded the best long-term resolution of patient symptoms to date and should be recommended to appropriately selected patients.

scholarly journals Does immunological remission, defined as disappearance of autoantibodies, occur with current treatment strategies? A long-term follow-up study in rheumatoid arthritis patients who achieved sustained DMARD-free status

2019 ◽  
Vol 78 (11) ◽  
pp. 1497-1504 ◽  
Author(s):  
Debbie M Boeters ◽  
Leonie E Burgers ◽  
René EM Toes ◽  
Annette van der Helm-van Mil
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Dmard Therapy ◽  
Before And After ◽  
Long Term Follow Up ◽  
Free Status

ObjectivesSustained disease-modifying antirheumatic drug (DMARD)-free status, the sustained absence of synovitis after cessation of DMARD therapy, is infrequent in autoantibody-positive rheumatoid arthritis (RA), but approximates cure (ie, disappearance of signs and symptoms). It was recently suggested that immunological remission, defined as disappearance of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF), underlies this outcome. Therefore, this long-term observational study determined if autoantibodies disappear in RA patients who achieved sustained DMARD-free remission.MethodsWe studied 95 ACPA-positive and/or RF-positive RA patients who achieved DMARD-free remission after median 4.8 years and kept this status for the remaining follow-up (median 4.2 years). Additionally, 21 autoantibody-positive RA patients with a late flare, defined as recurrence of clinical synovitis after a DMARD-free status of ≥1 year, and 45 autoantibody-positive RA patients who were unable to stop DMARD therapy (during median 10 years) were studied. Anti-cyclic citrullinated peptide 2 (anti-CCP2) IgG, IgM and RF IgM levels were measured in 587 samples obtained at diagnosis, before and after achieving DMARD-free remission.Results13% of anti-CCP2 IgG-positive RA patients had seroreverted when achieving remission. In RA patients with a flare and persistent disease this was 8% and 6%, respectively (p=0.63). For anti-CCP2 IgM and RF IgM, similar results were observed. Evaluating the estimated slope of serially measured levels revealed that RF levels decreased more in patients with than without remission (p<0.001); the course of anti-CCP2 levels was not different (p=0.66).ConclusionsSustained DMARD-free status in autoantibody-positive RA was not paralleled by an increased frequency of reversion to autoantibody negativity. This form of immunological remission may therefore not be a treatment target in patients with classified RA.

scholarly journals Public priorities for osteoporosis and fracture research: results from a focus group study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Ashley Hawarden ◽  
Clare Jinks ◽  
Waheed Mahmood ◽  
Laurna Bullock ◽  
Steven Blackburn ◽  
...  
Keyword(s):  
Focus Groups ◽  
National Survey ◽  
Public Awareness ◽  
Research Priorities ◽  
Fragility Fractures ◽  
Healthcare Services ◽  
Future Research ◽  
The Public ◽  
Delays In Diagnosis

Abstract Summary Four focus groups were conducted with members of the public to identify important areas for future osteoporosis research. Participants identified priorities to increase public awareness of osteoporosis, reduce delays in diagnosis, improve communication between healthcare providers and to improve follow-up and information provision about causes of osteoporosis, medication harms and prognosis. Purpose Patients and the public must be involved in setting research agendas to ensure relevant and impactful questions are prioritised. This study aimed to understand what people living with osteoporosis and fragility fractures felt was important to research, to inform the content of a national survey on research priorities in this area. Methods Focus groups were conducted with members of the public with experience of osteoporosis or fragility fractures. The topic guide was co-developed with a patient and public involvement research user group, and explored participants’ experiences of osteoporosis including diagnosis, management and effect upon their lives, what aspects of their ongoing care was most important to them and what about their care or condition could be improved. Focus groups were audio-recorded, transcribed and analysed thematically. Results A total of twenty-three participants were recruited to four focus groups. Analysis identified two main themes: challenges in living with osteoporosis and healthcare services for osteoporosis. Information needs was a further cross-cutting theme. Participants called for increased public awareness of osteoporosis and wanted healthcare services to address conflicting messages about diet, exercise and medication. Participants described long delays in diagnosis, poor communication between primary and secondary care and the need for structured follow-up as important areas for future research to address. Conclusion The findings from this study provide an understanding of research priorities from the perspective of patients and the public, have informed the content of a national survey and have implications for patient education, health services research and policy.

DID KATRINA RECALIBRATE ATTITUDES TOWARD POVERTY AND INEQUALITY?: A Test of the “Dirty Little Secret” Hypothesis

2006 ◽  
Vol 3 (1) ◽  
pp. 59-82 ◽  
Author(s):  
David B. Grusky ◽  
Emily Ryo
Keyword(s):  
Hurricane Katrina ◽  
Coming Out ◽  
Media Coverage ◽  
Public Awareness ◽  
The United States ◽  
The Public ◽  
Poverty And Inequality ◽  
The Media ◽  
Public Ignorance

We test the popular claim that poverty and inequality were “dirty little secrets” until the media coverage of Hurricane Katrina exposed them to a wider public. If this account were on the mark, it would suggest that the absence of major antipoverty initiatives in the United States is partly attributable to public ignorance and apathy coupled with the narrowly rational decision on the part of policymakers to attend to other issues about which the public evidently cares more. Using the 2004 Maxwell Poll, we find strikingly high levels of awareness and activism on poverty and inequality issues even prior to Katrina, clearly belying the “dirty little secret” account. The follow-up Maxwell Poll, which was administered in 2005 immediately after Katrina, revealed only a slight increase in public awareness of poverty and inequality. The Katrina effect was evidently dampened because (1) the large number of preexisting poverty activists reduced the size of the residual population “at risk” for conversion to antipoverty activism, and (2) the remaining non-activists were ardently opposed to poverty activism and hence unlikely to be receptive to the liberal message coming out of Katrina.

Treatment of Mixed Anxiety-Depression Disorder: Long-Term Outcome

2005 ◽  
Vol 34 (1) ◽  
pp. 95-101 ◽  
Author(s):  
Enrique Echeburúa ◽  
Karmele Salaberría ◽  
Paz de Corral ◽  
Raúl Cenea ◽  
Tomás Berasategui
Keyword(s):  
Drug Therapy ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Control Group ◽  
Standard Drug ◽  
Cognitive Behavioural ◽  
Anxiety Depression ◽  
Depression Disorder

The aim of this paper was to test the long-term contribution of cognitive-behavioural therapy to the treatment of mixed anxiety-depression disorder. Fifty-seven patients, selected according to DSM-IV diagnostic criteria, were assigned to: 1) cognitive-behavioural therapy; 2) combined therapy (drug and cognitive-behavioural therapy); or 3) a standard drug therapy control group. A multigroup experimental design with repeated measures of assessment (pretreatment, posttreatment, and 3-, 6- and 12 month follow-ups) was used. Most patients who were treated (71%) in experimental groups showed significant improvement at the 12-month follow-up, but there were no differences between the two therapeutic modes. No improvement was shown by the control-group participants at the 6-month follow-up. The results of the present trial do not support the beneficial effects of drug therapy by itself for this disorder. Finally, several topics that may contribute to future research in this field are discussed.

Twelve cases of glottic carcinoma in situ treated by radiotheraphy: an observation on clinical course versus response

1993 ◽  
Vol 107 (11) ◽  
pp. 1014-1016 ◽  
Author(s):  
J. P. Brooks ◽  
D. W. Morgan ◽  
J. Glaholm
Keyword(s):  
Carcinoma In Situ ◽  
Clinical Course ◽  
Alternative Methods ◽  
Glottic Carcinoma ◽  
Methods Of Treatment ◽  
Disease Free ◽  
Long Term Studies

AbstractCarcinoma in Situ (CIS) of the glottis is an uncommon and poorly understood condition with few, large, long- term studies. Twelve cases are presented which were treated with radiotherapy. At three-year follow-up all the patients are disease free and in 83 per cent the mucosa has returned to normal. The alternative methods of treatment are discussed.

scholarly journals Long-term antipsychotic use and its association with outcomes in schizophrenia – the Northern Finland Birth Cohort 1966

2016 ◽  
Vol 36 ◽  
pp. 7-14 ◽  
Author(s):  
J.M. Moilanen ◽  
M. Haapea ◽  
E. Jääskeläinen ◽  
J.M. Veijola ◽  
M.K. Isohanni ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Population Sample ◽  
Population Based ◽  
Current Treatment ◽  
Illness Onset ◽  
Mean Lifetime ◽  
Poor Outcomes ◽  
Drug Free

AbstractBackgroundDue to the paucity of previous studies, we wanted to elucidate the pharmacoepidemiology of antipsychotics in schizophrenia in a general population sample, and the association between long-term antipsychotic use and outcomes.MethodsThe sample included 53 schizophrenia subjects from the Northern Finland Birth Cohort 1966 with at least ten years of follow-up (mean 18.6 years since illness onset). Data on lifetime medication and outcomes (remission, Clinical Global Impression [CGI], Social and Occupational Functioning Assessment Scale [SOFAS]) were collected from medical records, interviews, and national registers.ResultsDuring the first two years 22 (42%), between two to five years 17 (32%), and between five to ten years 14 (26%) subjects had used antipsychotics less than half of the time. Drug-free periods became rarer during the follow-up. The mean lifetime daily dose of antipsychotics was 319 mg in chlorpromazine equivalents. A high lifetime average and cumulative dose and antipsychotic polypharmacy were associated with a poorer outcome in all measures, whereas having no drug-free periods was associated with a better SOFAS score and a low proportion of time on antipsychotics with a better CGI score.ConclusionsIn our population-based sample, the use of antipsychotics increased during the first five years of illness and was relatively stable after that. Our results suggest that both low dose and proportion of use, and having no drug-free periods, are associated with better outcomes, which concords with current treatment recommendations and algorithms. High long-term doses and polypharmacy may relate to poor outcomes.

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