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BACKGROUND: Inflammatory mediators are an important component in the pathophysiology of the coronavirus disease 2019 (COVID-19). This study aimed to assess the effects of reducing inflammatory mediators using hemoperfusion (HP) and continuous renal replacement therapy (CRRT) on the mortality of patients with COVID-19. MATERIALS AND METHODS: Twelve patients with confirmed diagnosis of COVID-19 were included. All patients had acute respiratory distress syndrome (ARDS). Patients were divided into three groups, namely, HP, CRRT and HP+CRRT. The primary outcome was mortality and the secondary outcomes were oxygenation and reduction in inflammatory mediators at the end of the study. RESULTS: Patients were not different at baseline in demographics, inflammatory cytokine levels, and the level of acute phase reactants. Half of the patients (3 out of 6) in the HP+CRRT group survived along with the survival of one patient (1 out of 2) in the HP group. All four patients in the CRRT group died. Serum creatinine (SCr), Interleukin-1 (IL1), Interleukin-6 (IL6), Interleukin-8 (IL8), partial pressure of oxygen (PaO2), O2 saturation (O2 sat), and hemodynamic parameters improved over time in HP+CRRT and CRRT groups, but no significant difference was observed in the HP group (All Ps > 0.05). CONCLUSION: Combined HP and CRRT demonstrated the best result in terms of mortality, reduction of inflammatory mediators and oxygenation. Further investigations are needed to explore the role of HP+CRRT in COVID-19 patients.
RESUMO
We report a 45 year-old woman who had bilateral breast masses with extradural involvement. Pathologic report revealed malignant high-grade lymphoblastic lymphoma. Systemic chemotherapy was performed but 3 months later, lesions indicating relapse in bone and breast re-appeared. She received salvage chemotherapy, but 4 months after that she was expired.
RESUMO
BACKGROUND: The efficacy of second line chemotherapy for relapsed non small cell lung cancer has been established. In this study, we evaluated the efficacy and toxicity of maintenance therapy with docetaxel in patients with non-small cell lung cancer who were stabilized with first line chemotherapy and had good performance status before relapse. The primary objective was to determine one-year survival and the other objectives were evaluation of adverse effects and time to progression. MATERIALS AND METHODS: Eighteen patients with lung cancer were included in this study. All patients were at stage III and IV, without distant metastasis or neuropathy. All patients had been treated with platinum based regimen initially and were responsive or stable with no progression. The patients were treated with docetaxel 75 mg/m(2) for a total of 4 cycles repeated every 3 weeks. RESULTS: All patients accomplished 4 chemotherapy cycles and a total of 72 cycles were administered. The mean time of progression free survival (PFS) was 9-10 months and one- year survival (OS) was 94.4% without any significant adverse effect necessitating medical intervention. The mean survival time of patients was 18 (12-20) months. CONCLUSION: Using docetaxel as consolidation chemotherapy in patients with non small cell lung cancer can prolong time to progression of disease and probably patients' survival without significant adverse effects or negative impact on the quality of life.