upper respiratory tract infection
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2021 ◽  
Vol 23 (11) ◽  
pp. 263-272
Author(s):  
Dr.Raed jabbar Hussain ◽  
◽  
Dr. Rahan Assim Mohammed Al-Qazzaz ◽  
Kahtan Adnan Abdullah ◽  
◽  
...  

Background Guillain Barre syndrome (GBS) is most common cause of acute flaccid paralysis, affect peripheral nerves with distinctive features clinical, pathological and prognosis. Patient and methods this study is prospective of 60 patients admitted at al-kadymia teaching hospital from first January 2004 to end April 2009. Age includes 1 to ≤11 years. Diagnosis was by clinical examination and confirmed by CSF tests and nerve conduction velocity study. Results It was found that 32 patients were male and 28 were female. Cranial nerves involved in 30% of patients. Sensory symptoms found in 16%. CSF changes was seen in 85.5% patients. Antecedent events were found in 27 patients out of 60, 14 had history of upper respiratory tract infection 45%, 7 had gastroenteritis 11%, 6 patients had history of fever 3 weeks earlier 10% and 15 patients had complicated by respiratory failure managed by mechanical ventilators, During this study 4 patients had been died. Conclusions: Current study conclude about 45% of patients had history antecedent events in as upper respiratory tract infection , gastroenteritis and fever, so cerebrospinal fluid CSF cell in the majority of cases within normal range and mostly lymphocytes, Cranial nerves were affected in most patients without serious sequels so Steroid was not given to most of patients in our study without any significant effect on the course of disease , Hospitalization was range from 2 week to 4 week, Recovery was range from 4 to 12 week and Death rate was 6% .


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3536-3536
Author(s):  
Zhong Zheng ◽  
Huilai Zhang ◽  
Jingwen Wang ◽  
Keshu Zhou ◽  
Li Zhang ◽  
...  

Abstract Background: Follicular lymphoma (FL) is a common subtype of indolent lymphomas, and accounts for about 10% of all non-Hodgkin lymphoma(NHL) cases. FL patients generally respond well to the 1 st line therapy, but most patients would then relapse, and duration of response gradually decreases as treatment line escalates. For FL patients of 3 rd line and beyond, treatment options are limited, and recurrent chemotherapy also greatly impact their quality of life. Four PI3Kδ inhibitors have been approved in the US for adult patients with relapsed or refractory FL. Currently, multiple trials investigating PI3K inhibitors in R/R FL are on-going in China, yet none has been approved. Parsaclisib, a potent, highly-selective, next-generation PI3Kδ inhibitor, has shown promising efficacy and tolerance in patients with previously treated B-cell malignancies. Here, we report interim result of CIBI376A201 (NCT04298879), a multicenter, open-label phase 2 study of parsaclisib in 3 rd line FL patients in China. Methods: Key eligibility included, age ≥18 years, histologically confirmed FL grade 1, 2, or 3a, ≥2 prior systemic therapies, Eastern Cooperative Oncology Group performance status (ECOG PS) ≤2, and ineligible for hematopoietic stem cell transplantation (HSCT). Patients were allocated to receive parsaclisib 20 mg once daily (QD) for 8 weeks followed by 2.5 mg QD, till disease progression, intolerable AE or withdrawal from study due to other reasons. Prophylaxis for Pneumocystis jirovecii pneumonia (PJP) was required. Primary end point was objective response rate (ORR) evaluated by independent review committee (IRC), secondary end points included: ORR by investigator, duration of response (DOR), progression-free survival (PFS), overall survival (OS), pharmacokinetic characteristics and safety and tolerability. Results: From April, 2020 to 11 th, April 2021 (data cut-off), 36 patients were treated. Enrollment is ongoing. At cut-off date, 5 (13.9%) patients had discontinued treatment due to PD (progressive disease)/PMD (progressive metabolic disease). The median exposure (range) was 104 days (5-354 days). The median age was 51 years, and 52.8% of the patients were male. The median time since initial diagnosis was 3.3 years. At enrollment, most patients (88.9%) had an ECOG PS ≤1, and 55.6% had a Follicular Lymphoma International Prognostic Index score ≥3 (high risk). All patients had ≥2 lines of prior systemic therapy, in which 22.2% had 3 or more prior lines. At the data cut-off date, 24 patients were evaluable for response. According to the investigator's evaluation, the ORR and CRR were 91.7% (95% confidence interval [CI]: 73%−99%) and 16.7% (95% confidence interval [CI]: 4.7%-37.4%) respectively, in all evaluable patients. The median DOR was not reached among responders overall. Among the 36 patients evaluable for safety, the most common treatment-emergent adverse events (TEAE) were neutrophil count decrease (36.1%), white blood cell count decrease (16.7%), platelet count decrease (16.7%), anemia (13.9%), upper respiratory tract infection (11.1%), ALT elevation (11.1%) and diarrhea (11.1%). The most common grade ≥3 TEAEs were neutrophil count decrease (8.3%), platelet count decrease (2.8%), upper respiratory tract infection (2.8%) and anemia (2.8%). 22.2% of patients had dose interruption due to TEAE, no dose reduction occurred due to TEAE. No treatment discontinuation occurred due to TEAE. Serious TEAEs included upper respiratory tract infection (2.8%), organ dysfunction (2.8%), dizziness (2.8%) and nasal cavity mass (2.8%), all unrelated to the study drug. One patient (2.2%) died during the trial, considered unrelated to studied drug by investigator. Conclusion: Parsaclisib demonstrated promising efficacy, and was generally well tolerated. These results demonstrate parsaclisib could bring substantial benefit for 3 rd line FL patient. Updated data will be presented in the future. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S801-S802
Author(s):  
Jilan M Shah ◽  
Olga Badem ◽  
Zeyar Thet ◽  
Thinzar Wai ◽  
Karthik Seetharam ◽  
...  

Abstract Background As part of our outpatient Antimicrobial Stewardship Program, we do surveillance of diagnoses and antibiotic use for common upper respiratory tract infections such as acute upper respiratory tract infection, acute bronchitis, sinusitis, and pharyngitis. We sought to evaluate the impact of the Covid-19 pandemic on the incidence rate of upper respiratory tract infection diagnoses per clinic visit during October 2020 to March 2021 season compared to the three prior respiratory seasons. We also sought to reflect of impact of increase in televisits and overlapping symptoms of COVID 19 and upper respiratory tract infections. Methods Our cohort study extending from October 2017 to March 2021. We collected number of diagnoses of upper respiratory infections and number of unique clinic visits during four consecutive respiratory seasons at our primary care sites via electronic health records. Results During the recent October 2020 to March 2021 respiratory season which coincided with the second NYC Covid-19 wave, we had 11569 unique clinic visits and 39 diagnoses of an upper respiratory tract infection - incident rate of 1.29. In the three prior respiratory seasons combined, we had 40939 unique clinic visits and 833 diagnoses of an upper respiratory tract infection – incident rate of 1.49. The incident rates showed a dramatic decline using the test based method and the chi square-statistic p< 0.0001 with an incident rate ratio using a poisson exact method of 6.0359. Statistical comparisons of the current season to each prior individual season yielded similar results. The percentage of Tele-visits during the current season was 19% compared to 0% in the 3 prior seasons. Conclusion During the first respiratory season from October 2020 to March 2021 in midst of the Covid-19 pandemic which also coincided with the second Covid-19 wave in New York, we saw a statistically significant decrease in incidence of common upper respiratory tract infection diagnoses per clinic visit compared to the three prior respiratory seasons. Overlapping signs and symptoms of upper respiratory tract infections and Covid-19 with the added percentage in Tele-visits did not cause an increase in incidence rates of upper respiratory tract infection diagnoses. Covid-19 related mitigation efforts may have played a role. Disclosures All Authors: No reported disclosures


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