scholarly journals Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports

2020 ◽  
Author(s):  
Guiomar Pinheiro ◽  
Ana Rita Costa ◽  
Ana Campar ◽  
Teresa Mendonça
Keyword(s):  
Side Effects ◽  
Partial Response ◽  
Adverse Effects ◽  
Large Scale ◽  
Case Reports ◽  
Immunosuppressive Drugs ◽  
Systemic Corticosteroids ◽  
First Case ◽  
Symptom Relapse

Fasciitis with eosinophilia (FE) is a rare connective tissue disease. Due to its rarity, large-scale studies are lacking, which makes its treatment challenging. Systemic corticosteroids (SCSs) are the cornerstone of treatment; however, additional immunosuppressive drugs (ISDs) are frequently necessary (usually methotrexate). We report 2 patients, for whom an SCS and methotrexate were not a viable long-term option. In the first case, we were unable to taper the SCS dose without symptom relapse, the patient showed only a partial response to methotrexate and presented side effects. The second case never fully responded to the SCS and methotrexate and demonstrated serious SCS adverse effects. Both patients were started on tocilizumab with extremely favourable results, making this drug a potential therapeutic weapon for these patients.

scholarly journals Long-term macrolides in diffuse interstitial lung diseases

2017 ◽  
Vol 26 (146) ◽  
pp. 170082 ◽  
Author(s):  
Paola Faverio ◽  
Francesco Bini ◽  
Adriano Vaghi ◽  
Alberto Pesci
Keyword(s):  
Lung Diseases ◽  
Large Scale ◽  
Case Reports ◽  
Interstitial Lung Diseases ◽  
Intracellular Protein ◽  
First Line ◽  
Cellular Models ◽  
Systemic Corticosteroids

In the present review we provide currently available evidence for the use of macrolides in the treatment of diffuse interstitial lung diseases (ILDs). Up to now, research on macrolides has mainly focused on three areas. First, macrolides have shown some promising results in cellular models and case reports as antifibrotic agents, by promoting autophagy and clearance of intracellular protein aggregates and acting as regulators of surfactant homeostasis. Secondly, macrolides have an immunomodulatory effect, which has been applied in some organising pneumonia cases. In particular, macrolides have been tested in association with systemic corticosteroids as steroid-sparing agents and alone as either first-line agents in mild cases or second-line agents where steroids were poorly tolerated or had failed. Thirdly, a recent area of research concerns the possible role of macrolides as modulators of lung microbiota and the host–microbiota interaction. This function has been particularly studied in idiopathic pulmonary fibrosis patients, in whom changes in microbiota have been proved to be associated with disease progression. However, the lack of high-quality studies makes the application of macrolide therapy in ILDs a field in which research should be conducted on a large scale.

scholarly journals Systematic Review of Adverse Effects: A Further Step towards Modernization of Acupuncture in China

2015 ◽  
Vol 2015 ◽  
pp. 1-19 ◽  
Author(s):  
Junyi Wu ◽  
Yanmei Hu ◽  
Yin Zhu ◽  
Ping Yin ◽  
Gerhard Litscher ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Systematic Review ◽  
Central Nervous System ◽  
Adverse Effects ◽  
Scientific Literature ◽  
Acupuncture Treatment ◽  
Case Reports ◽  
The World ◽  
Organ Tissue

As a further step towards the modernization of acupuncture, the objective of this review was to figure out the frequency and severity of adverse complications and events in acupuncture treatment reported from 1980 to 2013 in China. All first-hand case reports of acupuncture-related complications and adverse events that could be identified in the scientific literature were reviewed and classified according to the type of complication and adverse event, circumstance of the event, and long-term patient outcome. The selected case reports were published between 1980 and 2013 in 3 databases. Relevant papers were collected and analyzed by 2 reviewers. Over the 33 years, 182 incidents were identified in 133 relevant papers. Internal organ, tissue, or nerve injury is the main complications of acupuncture especially for pneumothorax and central nervous system injury. Adverse effects also included syncope, infections, hemorrhage, allergy, burn, aphonia, hysteria, cough, thirst, fever, somnolence, and broken needles. Qualifying training of acupuncturists should be systemized and the clinical acupuncture operations should be standardized in order to effectively prevent the occurrence of acupuncture accidents, enhance the influence of acupuncture, and further popularize acupuncture to the rest of the world.

scholarly journals Secondary Adrenal Insufficiency after Treatment with Budesonide for Autoimmune Hepatitis

2018 ◽  
Vol 12 (3) ◽  
pp. 597-601 ◽  
Author(s):  
Filip De Maeyer ◽  
Bruno Lapauw ◽  
Anne Hoorens ◽  
Anja Geerts ◽  
Hans Van Vlierberghe ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Adrenal Insufficiency ◽  
Attractive Alternative ◽  
Secondary Adrenal Insufficiency ◽  
Systemic Activity ◽  
Immunosuppressive Medication ◽  
Systemic Corticosteroids ◽  
First Case ◽  
First Pass

Autoimmune hepatitis (AIH) is a rare cause of chronic liver disease. The backbone of treatment is immunosuppressive medication, typically prednisolone as induction therapy and azathioprine as a maintenance therapy. Side effects of the long-term use of systemic corticosteroids are well known and have led to the use of alternative induction regimens. An attractive alternative is budesonide, a nonhalogenated glucocorticosteroid characterized by a high first-pass effect in the liver (90%), resulting in a high topical anti-inflammatory activity and a low systemic activity. It should be stressed that budesonide is contraindicated in patients with established cirrhosis with portal hypertension and portocaval shunting. In this case report, we present the first case of adrenal insufficiency following treatment with budesonide for AIH.

scholarly journals Alternative Leprosy Treatment Using Rifampicin Ofloxacin Minocycline (ROM) Regimen – Two Case Reports

2019 ◽  
Vol 11 (3) ◽  
pp. 89-93
Author(s):  
Yohanes Widjaja ◽  
Khairuddin Djawad ◽  
Saffruddin Amin ◽  
Widyawati Djamaluddin ◽  
Dirmawati Kadir ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Alternative Treatment ◽  
Histopathological Examination ◽  
Case Reports ◽  
Erythematous Plaque ◽  
First Case ◽  
Satisfactory Outcome ◽  
Significant Clinical Improvement ◽  
The Right

Abstract Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.

scholarly journals The vulnerability of tidal flats and multi-channel estuaries to dredging and disposal

2021 ◽  
Vol 4 (1) ◽  
pp. 36-60
Author(s):  
Wout M. van Dijk ◽  
Jana R. Cox ◽  
Jasper R.F.W. Leuven ◽  
Jelmer Cleveringa ◽  
Marcel Taal ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tidal Flats ◽  
Main Channel ◽  
Channel System ◽  
Adverse Side Effects ◽  
Limited Effectiveness ◽  
Physical Scale ◽  
Large Vessels

Shipping fairways in estuaries are continuously dredged to maintain access for large vessels to major ports. However, several estuaries worldwide show adverse side effects to dredging activities, in particular affecting morphology and ecologically valuable habitats. We used physical scale experiments, field assessments of the Western Scheldt estuary (the Netherlands), and morphodynamic model runs to analyse the effects of dredging and future stresses (climate and sediment management) on a multi-channel system and its ecologically valuable intertidal flats. All methods indicate that dredging and disposal strategies are unfavourable to long-term morphology because dredging creates and propagates the imbalance between shallow and deeper parts of the estuary, causing a loss of valuable connecting channels and fixation of the tidal flats and main channel positions, while countering adverse effects by disposal strategy has limited effectiveness. Changing the disposal strategy towards main channel scour disposal can be economically and ecologically beneficial for the preservation of the multi-channel system. Further channel deepening will accelerate the adverse side effects, whereas future sea-level rise may revive the multi-channel system.

Galeazzi-equivalent Fractures: Report of Two Cases and Literature Review

2017 ◽  
Vol 22 (02) ◽  
pp. 232-235
Author(s):  
Seigo Suganuma ◽  
Kaoru Tada ◽  
Daiki Yamamoto ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Emergency Surgery ◽  
Case Reports ◽  
Growth Arrest ◽  
Short Term ◽  
Rare Injury ◽  
First Case ◽  
Long Term Follow Up ◽  
Epiphyseal Injury

The Galeazzi-equivalent fracture is a rare injury that occurs in children. The most important issue is the distal ulnar epiphyseal injury. Although there have been some case reports, most of them performed only short term follow-up. This article describes two cases of this fracture with long term follow-up until epiphyseal closure. First case is a 12-year-old girl who sustained a Galeazziequivalent fracture of her right forearm and underwent emergency surgery. At follow-up of 5 years and 10 months postsurgery, radiographs show ulnar growth arrest of one mm and she has mild pain. Second case is a 15-year-old boy who sustained an open Galeazzi-equivalent fracture of his left forearm and underwent emergency surgery. At follow-up of 3 years and 3 months postsurgery, radiographs show no growth arrest of the distal ulna. He has no residual complaint. Long term follow-up is absolutely necessary to monitor ulnar growth.

scholarly journals Drug-Induced Autoimmune Hepatitis following Treatment with Zoledronic Acid

2017 ◽  
Vol 11 (2) ◽  
pp. 440-445 ◽  
Author(s):  
Jenny Sarah Schneider ◽  
Matteo Montani ◽  
Felix Stickel
Keyword(s):  
Liver Disease ◽  
Zoledronic Acid ◽  
Side Effects ◽  
Liver Injury ◽  
Drug Reactions ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
First Case ◽  
Alternative Drugs

Adverse drug reactions are among the most frequent side effects of synthetic and complementary alternative drugs and represent the premier causes of license revocations and acute liver failure. Drug-induced liver injury can resemble literally any other genuine liver disease and usually responds well to drug dechallenge. However, in some cases autoimmune-like hepatitis can evolve, requiring short- and sometimes long-term immunosuppression. Here, we present the hitherto first case of autoimmune-like hepatitis following treatment with zoledronic acid.

Propofol for the long-term sedation of a critically ill patient

1998 ◽  
Vol 7 (1) ◽  
pp. 73-76 ◽  
Author(s):  
LJ Miller ◽  
R Wiles-Pfeifler
Keyword(s):  
Adverse Effects ◽  
English Language ◽  
Case Reports ◽  
Critically Ill Patient ◽  
Limited Data ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Cardiovascular Depression ◽  
Language Literature

OBJECTIVE: To report a case in which propofol was used successfully in an intubated patient on a prolonged basis and to review the literature that discusses long-term infusions (> 7 days) of propofol. METHODS: Information was retrieved from a MEDLINE search of the English-language literature. Reports of clinical trials and case reports that compared the safety and efficacy of long-term propofol and midazolam were included in this review. Information about the study design and the efficacy and adverse effects of the drugs was collected, and the data were synthesized. RESULTS: Clinical reports indicate that a long-term infusion of propofol is comparable in safety and efficacy to a long-term infusion of midazolam. The distinct adverse-effect profile of long-term use of propofol, including hypertriglyceridemia, was evaluated and reported as significant. CONCLUSION: The limited data available suggest that long-term infusion of propofol is a practical alternative to use of standard agents for sedation of intubated patients. Adverse effects such as cardiovascular depression, respiratory depression, and hypertriglyceridemia may limit the routine use of propofol.

scholarly journals Tamoxifen-associated eye disease. A review.

1996 ◽  
Vol 14 (3) ◽  
pp. 1018-1026 ◽  
Author(s):  
S G Nayfield ◽  
M B Gorin
Keyword(s):  
Breast Cancer ◽  
Adverse Effects ◽  
Macular Edema ◽  
Case Reports ◽  
Eye Disease ◽  
High Dose ◽  
Ocular Toxicity ◽  
Early Stage Disease ◽  
Clinical Series

PURPOSE The oral antiestrogen tamoxifen has demonstrated efficacy in the treatment of metastatic breast cancer and as adjuvant therapy in early-stage disease. Clinical trials of tamoxifen in chemoprevention of breast cancer among high-risk women have focused attention on potential adverse effects of long-term tamoxifen use, including the possibility of ocular toxicity. This review evaluates the published case reports, clinical series, and clinical trial data on ocular toxicities attributed to tamoxifen. Clinical issues of surveillance, differential diagnosis, and management of tamoxifen-related eye disease are discussed. DESIGN National Library of Medicine online bibliographic services were used to identify case reports and clinical studies of ocular adverse effects that occurred in patients receiving tamoxifen published through the fall of 1994. The medical literature relevant to issues raised by the reports and studies was similarly identified and reviewed. RESULTS Case reports and case series identify crystalline retinal deposits, macular edema, and corneal changes as potential tamoxifen ocular toxicities. Extensive retinal lesions and macular edema with visual impairment have been reported in a few patients receiving high-dose tamoxifen. Less extensive retinal changes may occur in patients receiving low doses for long periods, and isolated retinal crystals may be observed in patients without visual symptoms. CONCLUSION Ocular toxicity is uncommon in the current clinical setting of long-term, low-dose tamoxifen use. Physicians should be aware of the potential for ocular toxicity among patients receiving the drug and should assure appropriate surveillance and prompt evaluation of visual complaints.

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