scholarly journals Keratoconus: Clinical Associations and Treatment Options

2008 ◽  
Vol 70 (5) ◽  
Author(s):  
Patrick Simard ◽  
Claude Giasson
Keyword(s):  
Visual Acuity ◽  
Treatment Options ◽  
Therapeutic Options ◽  
Present Review ◽  
Review Of Literature ◽  
Longitudinal Evaluation ◽  
Clinical Associations ◽  
Patients Experience ◽  
Irregular Astigmatism

The focus of the present review of literature is keratoconus, a progressive thinning of the cornea. Because keratoconus usually induces irregular astigmatism, the most affected patients experience a decreased visual acuity that limits the correction using ophthalmic lenses. The CLEK (Collaborative Longitudinal Evaluation of Keratoconus) is a study carried out in several centers with the aim of describing the evolution and associations between the visual and physiological manifestations of keratoconus. Since the treatment of keratoconus varies according to its severity, this paper proposes a summary of the results of the CLEK and a review of the therapeutic options.

scholarly journals Robotic Radiosurgery for Persistent Postoperative Acromegaly in Patients with Cavernous Sinus-Invading Pituitary Adenomas—A Multicenter Experience

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 537
Author(s):  
Felix Ehret ◽  
Markus Kufeld ◽  
Christoph Fürweger ◽  
Alfred Haidenberger ◽  
Paul Windisch ◽  
...  
Keyword(s):  
Disease Control ◽  
Effective Treatment ◽  
Cavernous Sinus ◽  
Treatment Options ◽  
Cavernous Sinus Invasion ◽  
Robotic Radiosurgery ◽  
Patient Morbidity ◽  
Biochemical Remission ◽  
Patients Experience

Background: The rates of incomplete surgical resection for pituitary macroadenomas with cavernous sinus invasion are high. In growth hormone-producing adenomas, there is a considerable risk for persistent acromegaly. Thus, effective treatment options are needed to limit patient morbidity and mortality. This multicenter study assesses the efficacy and safety of robotic radiosurgery (RRS) for patients with cavernous sinus-invading adenomas with persistent acromegaly. Methods: Patients who underwent RRS with CyberKnife for postoperative acromegaly were eligible. Results: Fifty patients were included. At a median follow-up of 57 months, the local control was 100%. The pretreatment insulin-like growth factor 1 (IGF-1) levels and indexes were 381 ng/mL and 1.49, respectively. The median dose and prescription isodose were 18 Gy and 70%, respectively. Six months after RRS, and at the last follow-up, the IGF-1 levels and indexes were 277 ng/mL and 1.14, as well as 196 ng/mL and 0.83, respectively (p = 0.0001 and p = 0.0002). The IGF-1 index was a predictor for biochemical remission (p = 0.04). Nine patients achieved biochemical remission and 24 patients showed biochemical disease control. Three patients developed a new hypopituitarism. Conclusions: RRS is an effective treatment for this challenging patient population. IGF-1 levels are decreasing after treatment and most patients experience biochemical disease control or remission.

scholarly journals Comparison of an oncology clinical decision-support system’s recommendations with actual treatment decisions

2021 ◽  
Author(s):  
Suthida Suwanvecho ◽  
Harit Suwanrusme ◽  
Tanawat Jirakulaporn ◽  
Surasit Issarachai ◽  
Nimit Taechakraichana ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Treatment Options ◽  
Stage Iv ◽  
Clinical Decision ◽  
Treatment Decisions ◽  
Therapeutic Options ◽  
Cancer Type ◽  
The Us ◽  
Rectal Cancers

Abstract Objective IBM(R) Watson for Oncology (WfO) is a clinical decision-support system (CDSS) that provides evidence-informed therapeutic options to cancer-treating clinicians. A panel of experienced oncologists compared CDSS treatment options to treatment decisions made by clinicians to characterize the quality of CDSS therapeutic options and decisions made in practice. Methods This study included patients treated between 1/2017 and 7/2018 for breast, colon, lung, and rectal cancers at Bumrungrad International Hospital (BIH), Thailand. Treatments selected by clinicians were paired with therapeutic options presented by the CDSS and coded to mask the origin of options presented. The panel rated the acceptability of each treatment in the pair by consensus, with acceptability defined as compliant with BIH’s institutional practices. Descriptive statistics characterized the study population and treatment-decision evaluations by cancer type and stage. Results Nearly 60% (187) of 313 treatment pairs for breast, lung, colon, and rectal cancers were identical or equally acceptable, with 70% (219) of WfO therapeutic options identical to, or acceptable alternatives to, BIH therapy. In 30% of cases (94), 1 or both treatment options were rated as unacceptable. Of 32 cases where both WfO and BIH options were acceptable, WfO was preferred in 18 cases and BIH in 14 cases. Colorectal cancers exhibited the highest proportion of identical or equally acceptable treatments; stage IV cancers demonstrated the lowest. Conclusion This study demonstrates that a system designed in the US to support, rather than replace, cancer-treating clinicians provides therapeutic options which are generally consistent with recommendations from oncologists outside the US.

Possibilities of scleral lenses for visual rehabilitation of patients with corneal scars

2021 ◽  
pp. 157-161
Author(s):  
O.I. Ryabenko ◽  
◽  
O.M. Selina ◽  
E.M. Tananakina ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Efficacy And Safety ◽  
Visual Rehabilitation ◽  
Optical Correction ◽  
Vision Correction ◽  
Post Traumatic ◽  
Key Words Cornea ◽  
Irregular Astigmatism ◽  
Spectacle Correction

Purpose. To analyze the efficacy and safety of SCL in patients with corneal cicatricial changes and other concomitant conditions. Material and мethods. The study included 19 patients (20 eyes) with cicatricial deformity of the cornea of various etiology, who were fitted with scleral contact lenses. Results and discussions. The use of SCL is possible in post-traumatic pathology, such as corneoscleral scars with or without aphakia, as well as after keratitis with an outcome in cicatricial deformity, cicatricial changes after a burn. A significant increase in visual acuity compared with spectacle correction has been proven. Depending on the topography of the scar, it is possible to select scleral lenses such as Oblate and Prolate, as well as with different versions of the support zone: both toric and quadratic. Conclusion. Scleral lenses can be successfully used for optical correction in patients with cicatricial changes in the cornea and other concomitant post-traumatic conditions of ineffectiveness of other methods of visual rehabilitation. Key words: cornea, lenses, vision correction, contact lenses, visual rehabilitation, scleral lenses, corneal scars, post-traumatic astigmatism, aphakia, keratitis, toric lenses, quadratic lenses, astigmatism, irregular cornea, regular cornea, regular astigmatism, irregular cornea, irregular astigmatism, prolate, oblate.

Novel treatment options in advanced adenoid cystic carcinoma of the breast.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13071-e13071
Author(s):  
Evan Wenig ◽  
Reumu E. Birhiray
Keyword(s):  
Disease Control ◽  
Adenoid Cystic Carcinoma ◽  
Metastatic Disease ◽  
Triple Negative ◽  
Treatment Options ◽  
Locally Advanced ◽  
Therapeutic Options ◽  
Breast Mass ◽  
Ongoing Research ◽  
Adenoid Cystic

e13071 Background: Adenoid cystic carcinoma (ACC) accounts for less than 0.1% of all breast cancer cases. The disease typically remains localized and indolent, and frequently occurs with triple negative status. Methods: In patients with locally advanced or metastatic disease, chemotherapy for triple negative breast carcinoma is seldom effective. Thus new treatment paradigms are desired. Drug targeted analysis derived from next generation sequencing and identification of driver mutations may offer a bright future in treatment options in chemo-resistant malignancy. Results: A 53 year old woman presented with breast mass and mastectomy with stage pT3N0M0 triple negative ACC of the breast resulting in observation. She later relapsed with chest wall disease, resulting in resection and radiation therapy. Shortly thereafter, she relapsed with pulmonary metastatic disease. She was treated with carboplatin and doxorubicin which were discontinued due to disease progression. Liquid assay revealed an IDH2 mutation, prompting treatment with enasidenib with ongoing evidence of disease control at 4 months. Patient tolerated treatment well without grade 3 or 4 adverse reactions. A 48 year old woman presented with an increasing 9.5 cm unresectable breast mass without distant metastasis. Pathology showed triple negative ACC of the breast, resulting in chemotherapy with doxorubicin, cyclophosphamide, and paclitaxel with clinically progressive disease. She represented with necrotic and ulcerating changes of the breast. Foundational genomic testing showed an FGFR2 mutation. After four months of treatment with erdafitinib, she had resolution of pain and cessation of pain medication. Her therapy led to a grade 2 adverse event related to hyperphosphatemia. She underwent surgical resection with negative margins. Conclusions: These examples illustrate a potential treatment paradigm for a rare malignancy for which there is no standard of care. Here we present two desperate cases, one of which had a driver mutation of IDH2, and the other FGFR2 for which there are targeted therapies approved in other disease states. The use of these two agents resulted in clinical benefit. A patient with metastatic disease treated with enasidenib has ongoing disease control for over 4 months with minimal adverse reaction. A patient with advanced local disease requiring narcotics and gabapentin for pain control treated with erdafitinib had significant symptomatic control with successful cessation of pain medications and ability to undergo potentially curable mastectomy with negative margins despite progression on prior chemotherapy. In summary, ongoing research of ACC of the breast will be required. Alternative therapeutic options related to targeted treatment may offer promise to clinical outcomes in the future. For cases of locally advanced or metastatic disease, the use of targeted therapy may offer new therapeutic options.

scholarly journals Recent advances in managing systemic sclerosis

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 88
Author(s):  
Martin Aringer ◽  
Anne Erler
Keyword(s):  
Systemic Sclerosis ◽  
Treatment Options ◽  
The Body ◽  
Therapeutic Options ◽  
Recent Advances ◽  
Main Components ◽  
Near Future

How the main components in systemic sclerosis—namely autoimmunity, vasculopathy, and fibrosis—fit together is still not sufficiently clear. However, vascular treatment options are well established, the body of evidence for the efficacy of immunomodulatory approaches is increasing, and now at least one hopeful substance that may directly interfere with fibrosis is being tested. Although we still wait for important breakthroughs, there is grounds for hope that better therapeutic options will be available in the near future.

scholarly journals Influence of eye diseases on the mortality rate of the population

2018 ◽  
Vol 11 (1) ◽  
pp. 47-53
Author(s):  
Andrey V Zolotarev ◽  
Elena V Karlova ◽  
Elena V Miroshnichenko
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Mortality Rate ◽  
Life Expectancy ◽  
Eye Diseases ◽  
Review Of Literature ◽  
The Impact

Evaluating of the correlation between quality of life, life expectancy and mortality rate is an important problem of modern ophthalmology. Many researchers note that eye pathology, which leads to a visual acuity decrease and blindness, has a significant impact on the mortality rate of the population. This review of literature is dedicated to studies examining the impact of eye diseases on the mortality rate of the population. (For citation: Zolotarev AV, Karlova EV, Miroshnichenko EV. Influence of eye diseases on the mortality rate of the population. ­Oph­thal­mology Journal. 2018;11(1):47-53. doi: 10.17816/OV11147-53).

scholarly journals shinySISPA: A web tool for defining sample groups using gene sets from multiple-omics data

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 213
Author(s):  
Bhakti Dwivedi ◽  
Jeanne Kowalski
Keyword(s):  
Profile Analysis ◽  
Technological Development ◽  
Treatment Options ◽  
Genetic Mutation ◽  
Gene Panel ◽  
Molecular Profile ◽  
Data Types ◽  
Gene Panel Testing ◽  
Clinical Associations ◽  
Gene Panels

As opposed to genome-wide testing of several hundreds of thousands of genes on very few samples, gene panels target as few as tens of genes and enable the simultaneous testing of many samples.  For example, some cancer gene panels test for 50 genes that can affect tumor growth and potentially identify treatment options directed against the genetic mutation.  The increasing popularity of gene panel testing has spurred the technological development of panels that test for diverse data types such as expression and mutation.   Once samples are tested, there is the desire to examine clinical associations based on the panel and for this purpose, one would like to identify, among the samples tested, which show support for a molecular profile (e.g., presence of mutation with increased expression) versus those samples that do not among the genes tested.  With user-specified molecular profile of interest, and gene panel data matrices (e.g., gene expression, variants, etc.) that define the profile, shinySISPA (Sample Integrated Set Profile Analysis) is a web-based shiny tool to define two sample groups with and without profile support based on our previously published method from which clinical associations may be readily examined. The shinySISPA can be accessed from http://shinygispa.winship.emory.edu/shinySISPA/.

scholarly journals CURRENT THERAPEUTIC OPTIONS FOR CORONAVIRUS DISEASE-2019 – A PHARMACOLOGICAL REVIEW

2020 ◽  
pp. 42-50
Author(s):  
SASMI MB ◽  
MARIA JOSE ◽  
PRAVEENLAL KUTTICHIRA
Keyword(s):  
Case Reports ◽  
Treatment Options ◽  
Case Series ◽  
Standard Of Care ◽  
Therapeutic Options ◽  
Cochrane Library ◽  
Global Public Health ◽  
Medical Subject Headings ◽  
Published Evidence

Objectives: Coronavirus pandemic is currently a global public health emergency. With expanding knowledge of the virus and the disease, new therapeutic targets are emerging widely. There is limited evidence about the use of different treatment options in coronavirus disease-2019 (COVID-19). This review aims to summarize the available evidence regarding therapeutic options in treating coronavirus infection. Methods: We searched PubMed, Google Scholar, and Cochrane library using pre-specified Medical Subject Headings terms about the role of therapeutic options in COVID-19 patients. Results: The majority of the published evidence is either case reports or small observational studies. Antimalarial like hydroxychloroquine reported equivocal results with five studies got positive results and five without any added benefit compared with standard of care. Lopinavir/ ritonavir monotherapy does not show any significant role except in combination with other antiviral drugs but encouraging results are emerging with remdesivir. Studies with favipiravir are inconclusive with some exhibit benefit and others not. Limited case series have shown that tocilizumab and convalescent plasma to be useful as adjuvant therapy in critically ill patients. Conclusion: There is currently no strong evidence for the efficacy of different therapeutic agents in the treatment of COVID-19. More data from ongoing and future trials will add more insight into the role of various drugs.

Longitudinal Changes in Corneal Irregular Astigmatism and Visual Acuity in Eyes with Keratoconus

2007 ◽  
Vol 51 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Mariko Suzuki ◽  
Shiro Amano ◽  
Norihiko Honda ◽  
Tomohiko Usui ◽  
Satoru Yamagami ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Longitudinal Changes ◽  
Irregular Astigmatism
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