scholarly journals Coadministration of Cyclosporin a with Prednisolone in Acute Interstitial Pneumonia Complicating Polymyositis/Dermatomyositis

2012 ◽  
Vol 5 ◽  
pp. CMAMD.S9398 ◽  
Author(s):  
Yasuhiro Shimojima ◽  
Wataru Ishii ◽  
Masayuki Matsuda ◽  
Nagaaki Katoh ◽  
Ko-ichi Tazawa ◽  
...  
Keyword(s):  
Cyclosporin A ◽  
Interstitial Pneumonia ◽  
Intravenous Administration ◽  
Therapeutic Option ◽  
Clinical Effectiveness ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Acute Interstitial Pneumonia ◽  
Therapeutic Outcomes ◽  
Death Group

Objective To investigate clinical effectiveness of prednisolone (PSL) and cyclosporin A (CyA), particularly continuous intravenous administration of the latter, in patients with interstitial pneumonia (IP) associated with polymyositis/dermatomyositis (PM/DM). Methods We reviewed the clinical findings and therapeutic outcomes of patients with PM/DM who had received PSL and CyA (PSL + CyA, n = 21 for DM and 2 for PM) or the former alone (n = 12 for DM and 7 for PM). All patients receiving PSL + CyA had active IP. Results Fifteen of the 21 DM patients receiving PSL + CyA showed favorable therapeutic outcomes of IP (recovery group), while the remaining 6 died of respiratory failure (death group). Before treatment PaO2 in room air and %VC were significantly lower, and the total CT score was significantly higher in the death group than in the recovery one. Continuous intravenous administration of CyA was performed in 6 patients for severe IP requiring oxygen therapy, and of these 2 showed complete recovery from it. Conclusions Coadministration of PSL and CyA, particularly continuous intravenous infusion of the latter, from the early phase of illness may be a potent therapeutic option for PM/DM patients with decreases in PaO2 and %VC and/or a high total CT score suggestive of a poor prognosis.

Hybrid Endovascular Repair of Thoracoabdominal Aorta: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 146
Author(s):  
Osman Tansel Darcin ◽  
Mehmet Kalender ◽  
Ayse Gul Kunt ◽  
Okay Guven Karaca ◽  
Ata Niyazi Ecevit ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Therapeutic Option ◽  
Complete Recovery ◽  
Aortic Aneurysms ◽  
Thoracoabdominal Aorta ◽  
Mortality And Morbidity ◽  
Early Results ◽  
The Mean ◽  
Procedural Success

<p><b>Background:</b> Thoracoabdominal aortic aneurysms (TAAA) present a significant clinical challenge, as they are complex and require invasive surgery. In an attempt to prevent considerably high mortality and morbidity in open repair, hybrid endovascular repair has been developed by many authors. In this study, we evaluated the early-term results obtained from this procedure.</p><p><b>Methods:</b> From November 2010 to February 2013, we performed thoracoabdominal hybrid aortic repair in 18 patients. The mean age was 68 years (12 men, 6 women). All of the patients had significant comorbidities. Follow-up computed tomography (CT) scans were performed at 1 week, 3 months, 6 months, and annually thereafter.</p><p><b>Results:</b> All patients were operated on in a staged procedure and stent graft deployment was achieved. Procedural success was achieved in all cases. All patients were discharged with complete recovery. No endoleaks weres detected in further CT examination.</p><p><b>Conclusion:</b> Our results suggests that hybrid debranching and endovascular repair of extensive thoracoabdominal aneurysms represents a suitable therapeutic option to reduce the morbidity and mortality of TAAA repair, particularly in those typically considered at high risk for standard repair.</p>

A Rare Case of Acute Interstitial Pneumonia Diagnosed at Autopsy

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S153-S154
Author(s):  
E Conner ◽  
D Troxclair ◽  
H Khokhar ◽  
W Beversdorf
Keyword(s):  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Diffuse Alveolar Damage ◽  
Ventilatory Support ◽  
Respiratory Illness ◽  
High Dose ◽  
Atypical Pneumonia ◽  
Acute Interstitial Pneumonia ◽  
Diagnostic Role ◽  
History Of

Abstract Introduction/Objective Acute interstitial pneumonia (AIP) is a rare disease clinically characterized by rapidly progressing respiratory failure in individuals with no history of respiratory illness or other inciting factors. While most often diagnosed in middle-aged adults, it may present in any age group. Initial presentation is described as influenza- like, and respiratory failure requiring ventilatory support often progresses within weeks to months. Prognosis is poor, with an estimated mortality rate approaching 80% without treatment. Methods We present the case of a 44-year-old male nonsmoker with no significant medical history, who presented in 2018 with 1.5 months of dyspnea and headache initially diagnosed as atypical pneumonia. Chest imaging revealed bilateral opacities; however, microbial workup revealed no evidence of infectious etiology. Autoimmune serology studies were likewise unrevealing. Despite aggressive supportive and medical management, he deteriorated to respiratory failure and succumbed. Results At autopsy, the lungs were symmetrically congested and edematous (combined weight 2,340 g) but free of evident consolidation or discrete lesions. Microscopic examination revealed diffuse alveolar damage with extensive hyaline membrane formation, interstitial edema, and fibroblastic proliferation. The vasculature was severely congested, and the alveoli contained hemorrhage and scattered macrophages. No fungal or mycobacterial elements were identified by staining. Based on the histologic features and clinical context, the diagnosis of AIP was made. Conclusion AIP is a rare, aggressive, and diagnostically challenging disease that includes a broad range of both clinical and histologic differentials. Timely recognition and intervention with aggressive respiratory support and high- dose glucocorticoids are the mainstays of clinical management. The diagnostic role of histology is significant, but hinges on early clinical consideration of AIP as disease progression may later preclude the biopsy procedure. We share this case to raise awareness of this rapidly progressive and diagnostically troubling interstitial lung disease while emphasizing the importance of clinicopathologic correlation.

scholarly journals Typical and atypical CT chest imaging findings of novel coronavirus 19 (COVID-19) in correlation with clinical data: impact on the need to ICU admission, ventilation and mortality

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doaa M. Emara ◽  
Nagy N. Naguib ◽  
M. A. Moustafa ◽  
Salma M. Ali ◽  
Amr Magdi El Abd
Keyword(s):  
Pleural Effusion ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Mediastinal Lymphadenopathy ◽  
Imaging Features ◽  
Imaging Findings ◽  
Icu Admission ◽  
Mortality Outcome ◽  
Novel Coronavirus ◽  
Contrast Ct

Abstract Background The aim of this study was to highlight the typical and atypical chest CT imaging features at first presentation in 120 patients who were proved to be COVID-19 by PCR and to correlate these findings with the need for ICU admission, ventilation, and mortality. We retrospectively included 120 patients 71 males (59.2%) and 49 females (40.8%) with a mean age of 47.2 ± 14.4 years. Patients subjected to clinical assessment, CBC, PCR for COVID-19, and non-contrast CT chest at first presentation. Typical and atypical imaging findings were reported and correlated with the clinical findings of the patients, the need for ICU admission, ventilation, and mortality. Results Clinically, fever was seen in 112 patients followed by dry cough in 108 patients and malaise in 35 patients. The final outcome was complete recovery in 113 cases and death in 7 cases. Typical CT findings included bilateral peripheral ground-glass opacities (GGO) in 74.7%, multilobar affection in 92.5% while atypical findings such as homogeneous consolidation, pleural effusion, mediastinal lymphadenopathy, and single lobar affection were found in 13.4, 5, 6.7, and 7.5% respectively. A statistically significant association between the presence of white lung, pleural effusion, peripheral GGO, and the need for ICU admission as well as mechanical ventilation was noted. The death was significantly higher among elderly patients; however, no significance was found between the imaging features and mortality. Conclusion CT features at first presentation can predict the need for ICU admission and the need for ventilation but cannot predict the mortality outcome of the patients.

scholarly journals Anti-neoplastic Potential of Flavonoids and Polysaccharide Phytochemicals in Glioblastoma

Molecules ◽  
2020 ◽  
Vol 25 (21) ◽  
pp. 4895
Author(s):  
Ayesha Atiq ◽  
Ishwar Parhar
Keyword(s):  
Cancer Progression ◽  
Therapeutic Option ◽  
Normal Brain ◽  
Current Standard ◽  
Pharmacological Agents ◽  
Initiation Phase ◽  
Therapeutic Outcomes ◽  
Effective Therapeutic Option ◽  
Patient Prognosis

Clinically, gliomas are classified into four grades, with grade IV glioblastoma multiforme being the most malignant and deadly, which accounts for 50% of all gliomas. Characteristically, glioblastoma involves the aggressive proliferation of cells and invasion of normal brain tissue, outcomes as poor patient prognosis. With the current standard therapy of glioblastoma; surgical resection and radiotherapy followed by adjuvant chemotherapy with temozolomide, it remains fatal, because of the development of drug resistance, tumor recurrence, and metastasis. Therefore, the need for the effective therapeutic option for glioblastoma remains elusive. Previous studies have demonstrated the chemopreventive role of naturally occurring pharmacological agents through preventing or reversing the initiation phase of carcinogenesis or arresting the cancer progression phase. In this review, we discuss the role of natural phytochemicals in the amelioration of glioblastoma, with the aim to improve therapeutic outcomes, and minimize the adverse side effects to improve patient’s prognosis and enhancing their quality of life.

Acute Interstitial Pneumonia

1986 ◽  
Vol 10 (4) ◽  
pp. 256-267 ◽  
Author(s):  
Anna-Luise A. Katzenstein ◽  
Jeffrey L. Myers ◽  
Michael T. Mazur
Keyword(s):  
Interstitial Pneumonia ◽  
Acute Interstitial Pneumonia
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