scholarly journals Intravitreal Clindamycin as First-Line Therapy for Toxoplasmic Retinochoroiditis: A Case Series

2020 ◽  
Vol Volume 14 ◽  
pp. 4279-4285
Author(s):  
Lalit Verma ◽  
Mithun Thulasidas ◽  
Avnindra Gupta
Keyword(s):  
Case Series ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Toxoplasmic Retinochoroiditis

scholarly journals Nintedanib Treatment for Idiopathic Pulmonary Fibrosis Patients Who Have Been Switched from Pirfenidone Therapy: A Retrospective Case Series Study

2020 ◽  
Vol 9 (2) ◽  
pp. 422 ◽  
Author(s):  
Andrea Vianello ◽  
Francesco Salton ◽  
Beatrice Molena ◽  
Cristian Turato ◽  
Maria Laura Graziani ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Disease Progression ◽  
Safety Profile ◽  
Real Life ◽  
Case Series ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Case Series Study

Background: The efficacy and effectiveness of nintedanib as a first-line therapy in idiopathic pulmonary fibrosis (IPF) patients have been demonstrated by clinical trials and real-life studies. Our aim was to examine the safety profile and effectiveness of nintedanib when it is utilized as a second-line treatment in subjects who have discontinued pirfenidone. Methods: The medical charts of 12 patients who were switched from pirfenidone to nintedanib were examined retrospectively. The drug’s safety was defined by the number of adverse events (AEs) that were reported; disease progression was evaluated based on the patient’s vital status and changes in forced vital capacity (FVC) at 12-month follow-up. Results: The numbers of patients experiencing AEs and of the AEs per patient in our study group didn’t significantly differ with respect to a group of 56 individuals who were taking nintedanib as a first-line therapy during the study period (5/12 vs. 22/56; p = 0.9999, and 0.00 (0.00–1.00) vs. 0.00 (0.00–3.00); p = 0.517, respectively). Two out of the 3 patients who had been switched to nintedanib due to a rapid disease progression showed stabilized FVC values. Conclusions: Nintedanib was found to have an acceptable safety profile in the majority of the IPF patients switched from pirfenidone. Prospective studies are warranted to determine if the drug can effectively delay disease progression in these patients.

ST-Segment Resolution on ECG after Streptokinase with Stemi in Diabetics

2021 ◽  
Vol 15 (7) ◽  
pp. 1767-1768
Author(s):  
Saira Fayyaz ◽  
Azher Mehmood Kiani ◽  
Qazi Abdul Saboor ◽  
Husnain Bashir ◽  
Rakesh Bahadur Adhikari ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Case Series ◽  
First Line ◽  
Exclusion Criteria ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
First Line Therapy ◽  
Line Therapy ◽  
St Segment

Objective: observe effectiveness of streptokinase in diabetic cases presenting with ST-segment elevation myocardial infarction Methodology: In this descriptive case series we enrolled 200 cases fulfilling inclusion/exclusion criteria from the emergency department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi. The inj. Streptokinase 1.5 million units diluted in 100 ml of normal saline administered over 1 hour and efficacy was observed. Results: Of 200 diabetic STEMI cases, the effectiveness in terms of ST segment resolution by streptokinase in diabetics presenting with ST-segment elevation myocardial infarction (STEMI) was recorded as 38.5%(n=77). Conclusion: The frequency of effectiveness of streptokinase in diabetic cases for resolution of STEMI is encouraging and it can be used as first line therapy. Keywords: STEMI, Diabetics, Streptokinase, efficacy

scholarly journals Clinico-Pathological Profile and Outcomes of 45 Cases of Plasma Cell Gingivitis

2021 ◽  
Vol 10 (4) ◽  
pp. 830
Author(s):  
Stefania Leuci ◽  
Noemi Coppola ◽  
Nicola Adamo ◽  
Maria Eleonora Bizzoca ◽  
Daniela Russo ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Clinical Phenotype ◽  
Case Series ◽  
Unknown Etiology ◽  
Cell Infiltrate ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Plasma cell gingivitis (PCG) is an infrequent inflammatory disease of the gingiva of unknown etiology, characterized by a dense polyclonal proliferation of plasma cells in the connective tissue. The aim of this study was to present a case series of patients affected by PCG, analyzing demographic, clinical, histopathological, and therapeutic data. A group of 36 females and 9 males with a mean age of 60.3 years was evaluated. Clinically, 25 cases were bullous, a clinical phenotype never reported to date, 4 erythematous, 4 keratotic, 4 verruciform, and 3 ulcerative. On histological examination, pure polyclonal plasma cell infiltrate was detected in 20 specimens, while in 25 specimens it was associated with a mixed infiltrate. The first-line therapy consisted of oral hygiene and topical corticosteroids in all patients. In 25 patients, doxycycline and sulfasalazine were added; in 10 of these patients, the disease persisted, and it was necessary to resort to systemic steroids. This study presented the clinico-pathological profile and outcomes of a case series of PCG. This could be an aid for clinicians to be aware of the heterogeneous clinical phenotype and of the possible pure bullous phenotype of PCG. Further studies are needed to improve the knowledge about this disorder.

scholarly journals EGFR or PD-L1 decision for first line therapy in a case series of EGFR positive and PD-L1 >50%

2017 ◽  
Vol 22 ◽  
pp. 7-10 ◽  
Author(s):  
Paul Zarogoulidis ◽  
Panos Chinelis ◽  
Christofors Efthymiou ◽  
Anastasia Athanasiadou ◽  
Vasilis Mpikos ◽  
...  
Keyword(s):  
Case Series ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

scholarly journals Comprehensive approaches for diagnosis, monitoring and treatment of chronic inflammatory demyelinating polyneuropathy

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Anna Lena Fisse ◽  
Jeremias Motte ◽  
Thomas Grüter ◽  
Melissa Sgodzai ◽  
Kalliopi Pitarokoili ◽  
...  
Keyword(s):  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Imaging Techniques ◽  
Case Series ◽  
Diagnostic Techniques ◽  
European Federation ◽  
First Line ◽  
Comprehensive Overview ◽  
Molecular Approaches ◽  
First Line Therapy ◽  
Line Therapy

AbstractChronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most common chronic inflammatory neuropathy. CIDP is diagnosed according to the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) criteria, which combine clinical features with the electrophysiological evidence of demyelination. However, firstly, diagnosis is challenging, as some patients e.g. with severe early axonal damage do not fulfil the criteria. Secondly, objective and reliable tools to monitor the disease course are lacking. Thirdly, about 25% of CIDP patients do not respond to evidence-based first-line therapy. Recognition of these patients is difficult and treatment beyond first-line therapy is based on observational studies and case series only. Individualized immunomodulatory treatment does not exist due to the lack of understanding of essential aspects of the underlying pathophysiology.Novel diagnostic imaging techniques and molecular approaches can help to solve these problems but do not find enough implementation. This review gives a comprehensive overview of novel diagnostic techniques and monitoring approaches for CIDP and how these can lead to individualized treatment and better understanding of pathophysiology.

Triple Immunosuppressive Therapy in Patients with Chronic Resistant Immune Thrombocytopenic Purpura; a Case Series of 11 Patients.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2059-2059
Author(s):  
Howard H.W. Chan ◽  
Nancy M. Heddle ◽  
John G. Kelton
Keyword(s):  
Side Effects ◽  
Immunosuppressive Therapy ◽  
Case Series ◽  
Adult Patients ◽  
First Line ◽  
Thrombocytopenic Purpura ◽  
First Line Therapy ◽  
Line Therapy ◽  
Impaired Liver

Introduction: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by destruction of opsonized platelets. The first-line therapy for adult patients with chronic ITP includes steroid, IVIG and anti-D. Splenectomy is reserved for patients not responding to the first-line therapy. However, approximately 20–30% of patients are resistant or relapsed after splenectomy. In this subgroup of patients, more aggressive immunosuppressive therapy is indicated. Methods: This is a case series of patients with chronic resistant ITP receiving multiple immunosuppressive treatments in a tertiary medical referral center. The diagnosis of ITP was established by excluding other thrombocytopenic diseases. Adult patients with chronic resistant ITP presenting with life threatening thrombocytopenia were selected for a therapeutic trial of immunosuppressive therapy. The therapy included azathioprine 100–200 mg daily; cyclosporine 100–200 mg daily; and mycophenolate 1–2 gm daily (triple immunosuppressive therapy). All of these patients failed 1st line therapy; splenectomy; and other immunosuppressive treatments. Patients with uncontrolled hypertension; impaired liver functions; impaired renal functions; and those who have not completed family were excluded from triple immunosuppressive therapy. A response to the therapy was defined as persistent platelet count above 30 without other concurrent treatments. When patients responded to the triple immunosuppressive therapy, the doses of the medications were gradually tapered to minimize the long-term side effects. Results: Since July of 2000, 11 patients with chronic resistant ITP have received triple immunosuppressive therapy for a variable duration (table 1). Five out of these 11 patients (45.5%) achieved a response within 4 to 6 weeks after the initiation of the treatments. One of the five patients eventually had a break-through during the tapering of triple immunosuppressive therapy. This patient was stabilized by further doses of IVIG and prednisone. The treatments were well tolerated. The most common side effects were mildly elevated blood pressure; and mildly impaired liver function tests. None of the patients suffered from serious side effects that resulted in termination of the treatments. Conclusion: Combining low-dose azathioprine, cyclosporin and mycophenolate can induce long-term remission in patients with chronic ITP resistant to steroid, IVIG, splenectomy and other immunosuppressive agents. This combination regimen is safe and well-tolerated. In adult patients with chronic resistant ITP, the immune dysfunction may need multiple immune blockades. Summary of Treatments ID Rx Prior to Triple Rx Concurrent Rx with Triple Rx Mean (mg OD) Mean (mg OD) Mean (gm OD) Response Duration of Triple Rx Triple Rx:Triple Immunosuppressive Therapy; PRD:Prednisone; DAN:Danazol; AnD:Anti-D; SPN:Splenectomy; VCR:Vincristine; CTX:Cyclophosphamide; LUF:Luflunomide 1 PRD, IVIG, DAN, SPN PRD, IVIG 66.7 63.8 1 No 77 2 PRD, IVIG, DAN, SPN, VCR 75 25 0.8 No 20 3 PRD, AnD, SPN, CTX PRD (taper) 75 50 0.9 Yes 91 4 PRD, SPN, DAN, CTX, LUF 100 100 2 No 106 5 PRD, IVIG, SPN, DAN PRD, IVIG 144.2 236.1 1.9 No 217 6 PRD, IVIG, SPN, DAN, VCR IVIG 91.7 120.5 1.4 No 406 7 PRD, IVIG, DAN, SPN, VCR PRD (taper) 140.9 156.6 1.6 Yes 296 8 PRD, IVIG, SPN, DAN, VCR DAN (taper) 150 100 2 Yes 1351 9 PRD, DAN, SPN, AnD, CTX IVIG 100 150 2 No 130 10 PRD, IVIG, SPN, VCR, CTX PRD (taper) 85.6 121.1 1.4 Yes 1456 11 PRD, DAN, IVIG, SPN, AnD IVIG, PRD (taper) 125.6 225 1.9 Yes 875

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