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1.
BMJ Case Rep ; 14(7)2021 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-34244201

RESUMEN

An 85-year-old ex-smoker being managed conservatively over 2 years for a small right apical pneumothorax presented to the respiratory clinic with suddenly worsening shortness of breath and chest pain. A chest radiograph demonstrated sudden deterioration in the size of his pneumothorax. Previous CT scans had found emphysematous cystic changes within the lungs, and his new presentation warranted definitive surgical intervention with a right bullectomy and talc pleurodesis through a video-assisted thoracoscopic surgery procedure. The patient made a good recovery and was discharged from clinic a year later. This case demonstrates the importance of follow-up in patients with unresolved pneumothoraces due to the potential for sudden deterioration, and highlights the significance of respecting patient involvement and autonomy in the decision-making process.


Asunto(s)
Neumotórax , Anciano de 80 o más Años , Dolor en el Pecho , Humanos , Pleurodesia , Neumotórax/diagnóstico por imagen , Neumotórax/terapia , Recurrencia , Talco , Cirugía Torácica Asistida por Video
2.
Medicina (Kaunas) ; 57(7)2021 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-34198991

RESUMEN

The cognitive-evaluative (C-E) dimension of pain is commonly observed in patients with a relatively long duration of pain. However, little is known about the effects of pain relapse on the C-E dimension of pain. Moreover, the improvement process of the C-E dimension of pain following treatment is unknown. The objective of this case report was to (a) demonstrate that the C-E dimension was affected in the acute phase of neuropathic pain in cases of pain relapse, and (b) demonstrate the improvement process of the C-E dimension of pain. A woman was diagnosed with low back pain (LBP) and sciatica. The patient had previously experienced symptoms of LBP and sciatica; thus, this episode was a case of pain relapse. At the beginning of rehabilitation, the C-E dimension of pain was present in addition to the sensory-discriminative (S-D) dimension of pain. It was observed that improvement of the C-E dimension of pain was delayed in comparison with that of the S-D dimension of pain. The C-E dimension of pain was observed with pain relapse even though it was in the acute phase of pain. This case provides a novel insight into the C-E dimension of pain. Moreover, the delay in improving the C-E dimension of pain indicates a difference in the improvement process for each pain dimension.


Asunto(s)
Dolor de la Región Lumbar , Neuralgia , Ciática , Cognición , Femenino , Humanos , Recurrencia
3.
Bratisl Lek Listy ; 122(8): 559-566, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34282621

RESUMEN

INTRODUCTION: Arthroscopic Latarjet surgery is a technique developed to minimize invasive surgical treatment of anterior shoulder instability. However, compared to an open Latarjet operation, it is considered more technically demanding. The aim of our study was to assess its mid-term success rate in the hands of a surgeon with sufficient experience. PATIENTS AND METHODS: We included 32 patients with recurrent anterior shoulder instability in the analysed cohort who had undergone arthroscopic intervention according to Latarjet as a revision after a previous failed Bankart operation or in the case of the significant bone loss of the glenoid. Patients were followed-up according to a defined protocol for an average of 30.2 months (range 12‒60 months). In this study, we present clinical and radiological results of a long-term follow-up evaluated using Rowe, UCLA, and SST scoring systems, comparing ranges of motion, and thorough analysis of CT examinations performed no earlier than 6 months after surgery. Rowe, UCLA and SST scores were determined pre- and postoperatively; the range of motion was compared to the contralateral side. RESULTS: The postoperative score was significantly improved in accordance with the clinical finding in the followed-up group (Rowe: preOP 22.1 points ‒ postOP 97.6 points, UCLA: preOP 19.50 points ‒ postOP 33.30 points, SST: preOP 8.2 points ‒ postOP 11.5). However, the postoperative external rotation remains significantly smaller as compared to the contralateral side. The feared neurovascular damage did not occur in our cohort; one patient (3 %) had an infection in the access portal, which was managed conservatively; one patient (3 %) required revision surgery. CONCLUSION: Our results demonstrated that when in the hands of experienced surgeon, the arthroscopic Latarjet surgery is an effective surgical method with a low incidence of complications and excellent mid-term clinical outcomes (Fig. 17, Ref. 25).


Asunto(s)
Inestabilidad de la Articulación , Luxación del Hombro , Articulación del Hombro , Artroscopía , Humanos , Inestabilidad de la Articulación/cirugía , Rango del Movimiento Articular , Recurrencia , Estudios Retrospectivos , Hombro , Luxación del Hombro/diagnóstico por imagen , Luxación del Hombro/cirugía , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/cirugía
4.
Int J Mol Sci ; 22(11)2021 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-34204090

RESUMEN

The intravenous cocaine self-administration model is widely used to characterize the neurobiology of cocaine seeking. When studies are aimed at understanding relapse to cocaine-seeking, a post-cocaine abstinence period is imposed, followed by "relapse" tests to assess the ability of drug-related stimuli ("primes") to evoke the resumption of the instrumental response previously made to obtain cocaine. Here, we review the literature on the impact of post-cocaine abstinence procedures on neurobiology, finding that the prelimbic and infralimbic regions of the prefrontal cortex are recruited by extinction training, and are not part of the relapse circuitry when extinction training does not occur. Pairing cocaine infusions with discrete cues recruits the involvement of the NA, which together with the dorsal striatum, is a key part of the relapse circuit regardless of abstinence procedures. Differences in molecular adaptations in the NA core include increased expression of GluN1 and glutamate receptor signaling partners after extinction training. AMPA receptors and glutamate transporters are similarly affected by abstinence and extinction. Glutamate receptor antagonists show efficacy at reducing relapse following extinction and abstinence, with a modest increase in efficacy of compounds that restore glutamate homeostasis after extinction training. Imaging studies in humans reveal cocaine-induced adaptations that are similar to those produced after extinction training. Thus, while instrumental extinction training does not have face validity, its use does not produce adaptations distinct from human cocaine users.


Asunto(s)
Trastornos Relacionados con Cocaína/genética , Trastornos Relacionados con Cocaína/psicología , Cocaína/efectos adversos , Extinción Psicológica/fisiología , Animales , Humanos , Red Nerviosa/patología , Recurrencia
5.
Int J Mol Sci ; 22(12)2021 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-34208020

RESUMEN

Herpes simplex virus 1 (HSV-1) is a widespread neurotropic virus establishing a life-long latent infection in neurons with periodic reactivations. Recent studies linked HSV-1 to neurodegenerative processes related to age-related disorders such as Alzheimer's disease. Here, we explored whether recurrent HSV-1 infection might accelerate aging in neurons, focusing on peculiar marks of aged cells, such as the increase in histone H4 lysine (K) 16 acetylation (ac) (H4K16ac); the decrease of H3K56ac, and the modified expression of Sin3/HDAC1 and HIRA proteins. By exploiting both in vitro and in vivo models of recurrent HSV-1 infection, we found a significant increase in H4K16ac, Sin3, and HDAC1 levels, suggesting that the neuronal response to virus latency and reactivation includes the upregulation of these aging markers. On the contrary, we found a significant decrease in H3K56ac that was specifically linked to viral reactivation and apparently not related to aging-related markers. A complex modulation of HIRA expression and localization was found in the brain from HSV-1 infected mice suggesting a specific role of this protein in viral latency and reactivation. Overall, our results pointed out novel molecular mechanisms through which recurrent HSV-1 infection may affect neuronal aging, likely contributing to neurodegeneration.


Asunto(s)
Senescencia Celular , Herpes Simple/patología , Herpes Simple/virología , Herpesvirus Humano 1/fisiología , Modelos Biológicos , Neuronas/patología , Neuronas/virología , Acetilación , Animales , Proteínas de Ciclo Celular/metabolismo , Modelos Animales de Enfermedad , Chaperonas de Histonas/metabolismo , Histona Desacetilasa 1/metabolismo , Histonas/metabolismo , Lisina/metabolismo , Ratas Wistar , Recurrencia , Complejo Correpresor Histona Desacetilasa y Sin3/metabolismo , Factores de Transcripción/metabolismo , Latencia del Virus
6.
Artículo en Inglés | MEDLINE | ID: mdl-34205106

RESUMEN

Background and Objectives: Stroke is a strong risk factor for recurrent cardiovascular disease (CVD) incidents. The risk of post-stroke CVD incidents can be reduced by eliminating the most relevant risk factors. The aim of the study was to compare the incidence of recurrent CVD events and to determine the quantitative and qualitative differences in CVD risk factors over the 5-year follow-up period in patients with ischemic stroke (IS) and haemorrhagic stroke (ICH) with the use of ICF classification categories to present these differences. Materials and Methods: The study was retrospective. The study groups included 55 post-IS patients and 47 post-ICH patients. The results were translated into the categories from the International Classification of Functioning, Disability and Health (ICF) classification. Results: As compared to post-ICH patients, post-IS patients were significantly more frequently observed to have recurrent CVD incidents (p < 0.001), including fatal CVD incidents (p = 0.003). More risk factors in total were identified in both post-IS patients (p = 0.031) and post-ICH patients (p = 0.002) who had a recurrent CVD incident. Post-IS patients were more often found to have arterial blood pressure higher than 140/90 mmHg (p = 0.045). On the other hand, post-ICH patients were more frequently observed to have carotid artery stenosis in the range of 50-69% (p = 0.028) and an eGFR of <15 mL/min/1.73 m2 (p = 0.001). Conclusions: The type of primary stroke determines the type and incidence of risk factors as well as the recurrence rate of CVD incidents over a 5-year follow-up period. Patients after IS have a higher risk of recurrence of CVD events, including fatal ones in the 5-year follow-up compared to patients after ICH. In addition, post-IS patients who have a recurrent CVD event over a 5-year follow-up have more risk factors for a CVD event than ICH. The ICF classification can be useful for assessing and analysing risk factors for recurrent CVD incidents, which can help to improve the effectiveness of secondary prevention.


Asunto(s)
Accidente Cerebrovascular , Estudios de Seguimiento , Humanos , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/epidemiología
7.
Brain Nerve ; 73(7): 819-828, 2021 Jul.
Artículo en Japonés | MEDLINE | ID: mdl-34234040

RESUMEN

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune peripheral neuropathy with chronic progression over 2 months or more. In this review, we provide an overview of key clinical studies involved in the development of CIDP therapy, as well as a discussion of changes in the concept of treatment. Although a definitive therapy has not yet been established, international and Japanese clinical guidelines recommend three first-line treatment options for symptom improvement, namely corticosteroids, intravenous immunoglobulin (IVIg), and plasmapheresis, based on the results of clinical studies conducted before the early 2000s. Since 2010, several treatments for the prevention of CIDP relapse (maintenance therapy) have been developed and more recently, studies have focused on the optimization of each treatment. On the other hand, CIDP treatment is associated with several limitations, including a lack of biomarkers for prediction of disease progression, differences in response to treatment between CIDP subtypes, and difficulties in the selection of appropriate maintenance therapy. Several studies aimed at resolving these issues are currently being conducted. (Received 22 May, 2020; Accepted 12 January, 2021; Published 1 July, 2021).


Asunto(s)
Polirradiculoneuropatía Crónica Inflamatoria Desmielinizante , Corticoesteroides , Humanos , Inmunoglobulinas Intravenosas , Plasmaféresis , Polirradiculoneuropatía Crónica Inflamatoria Desmielinizante/tratamiento farmacológico , Recurrencia , Resultado del Tratamiento
9.
Blood Adv ; 5(13): 2794-2798, 2021 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-34255033

RESUMEN

A variety of autoimmune disorders have been reported after viral illnesses and specific vaccinations. Cases of de novo immune thrombocytopenia (ITP) have been reported after SARS-CoV-2 vaccination, although its effect on preexisting ITP has not been well characterized. In addition, although COVID-19 has been associated with complement dysregulation, the effect of SARS-CoV-2 vaccination on preexisting complementopathies is poorly understood. We sought to better understand SARS-CoV-2 vaccine-induced recurrence of autoimmune- and complement-mediated hematologic conditions. Three illustrative cases were identified at the University of Washington Medical Center and the Seattle Cancer Care Alliance from January through March 2021. We describe the recrudescence of 2 autoimmune conditions (ITP and acquired von Willebrand Disease [AvWD]/acquired hemophilia A) and 1 complementopathy (paroxysmal nocturnal hemoglobinuria [PNH]). We report the first known case of AvWD/acquired hemophilia A, and describe the first PNH exacerbation in the absence of complement inhibition after SARS-CoV-2 vaccination. Although SARS-CoV-2 vaccine-induced ITP is a known concern, our case clearly depicts how thrombocytopenia in the setting of preexisting ITP can sequentially worsen with each vaccine dose. Based on our experiences and these examples, we provide considerations for how to monitor and assess risk in patients with underlying autoimmune- and complement-mediated hematologic conditions.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Humanos , Recurrencia , SARS-CoV-2 , Vacunación/efectos adversos
10.
J Coll Physicians Surg Pak ; 30(7): 825-828, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34271784

RESUMEN

OBJECTIVE: To describe the outcome of modified transabdominal laparoscopic preperitoneal (TAPP) hernioplasty repair with plug-patch of polypropylene mesh. STUDY DESIGN:  A descriptive study. PLACE AND DURATION OF STUDY: Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey from December 2017 to December 2019. METHODOLOGY: Patients aged 18-70 years, who underwent TAPP hernioplasty at this clinic between December 2017 and 2019 were evaluated retrospectively. Those with a defect diameter of 3 cm and above, which were measured intraoperatively, were considered as large inguinal hernias. A modified TAPP procedure that includes the plug-patch technique, using polyester mesh, similar to that of open inguinal hernia repair, was performed on these patients. Complications and recurrences frequency was noted. RESULTS: This modified TAPP procedure was applied to 35 patients (24 men, 11 women). The defect size was 3-4 cm in 24 patients, and 4 cm in 11 patients. None of the patients developed chronic pain. Five patients had a feeling of fullness in the inguinal region where the repair was performed, and their complaints subsided at the first month of follow-up. Seroma developed in 2 patients, but resolved spontaneously. During the follow-up period, no chronic complications or recurrences were observed. CONCLUSION: This technique is simple and does not create a serious cost burden on TAPP technique. Furthermore, it can be applied routinely with the advantages of low pain, rapid recovery and acceptable complication rates as well as the reduction of pseudo-recurrence rates. Key Words: Hernia, Laparoscopic repair, Plug-patch technique, Modified TAPP, Mesh.


Asunto(s)
Hernia Inguinal , Laparoscopía , Femenino , Hernia Inguinal/cirugía , Herniorrafia , Humanos , Masculino , Polipropilenos , Recurrencia , Estudios Retrospectivos , Mallas Quirúrgicas , Resultado del Tratamiento , Turquia
11.
Am J Case Rep ; 22: e931321, 2021 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-34272354

RESUMEN

BACKGROUND Uveitis is a clinical condition characterized by acute blurry vision related to an inflammation of the uvea. Gut microbiome dysbiosis can influence the prognosis of uveitis by inducing a loss of intestinal immune homeostasis leading to a lower activation threshold of the immune cells. This promotes a pro-inflammatory response resulting in reactivation of the disease. This is the case report of a 21-year-old woman with a 3-year history of acute anterior uveitis (AAU) of the right eye, who responded favorably to probiotic dietary supplementation. CASE REPORT A 21-year-old woman, previously unknown to our Ophthalmology Unit, presented with ocular pain and redness. Three years ago, she had been diagnosed with monolateral AAU in the right eye. Her medical and family histories were unremarkable. After a complete clinical evaluation, we decided to start a combination treatment protocol with continuous use of probiotics and the use of ocular steroids only during an exacerbation of the condition. To monitor the trend of the disease, she underwent a monthly clinical examination for the following year. During this period, we observed a decrease in ocular inflammation with a gain in the primary outcome (best-corrected visual acuity), and the steroids and atropine were discontinued for the following months. CONCLUSIONS This case report describes a patient with a 3-year history of AAU, who responded well to a combination treatment of dietary probiotic supplementation and steroids, demonstrating that probiotics can reduce recurrences of AAU.


Asunto(s)
Probióticos , Uveítis Anterior , Uveítis , Enfermedad Aguda , Adulto , Femenino , Humanos , Probióticos/uso terapéutico , Pronóstico , Recurrencia , Uveítis Anterior/tratamiento farmacológico , Adulto Joven
12.
Cesk Patol ; 57(2): 109-112, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34275321

RESUMEN

Inflammatory bowel disease (IBD) is a group of chronic relapsing intestinal inflammatory processes primarily represented by ulcerative colitis (UC) and Crohn´s disease (CD). Nearly half of IBD cases are followed by extraintestinal complications and renal involvement can occur independatly or along with other complications and are described with the patients sufferring from UC or CD. Most frequent renal involvement is nephrolithiasis, tubulointerstinal nephritis, different kinds of glomerulonephritis and AA amyloidosis. We are presenting an unusal form of renal involvement of a young female patient with a severe form of Crohn´s disease treated with recombinant monoclonal antibodies.


Asunto(s)
Colitis Ulcerosa , Enfermedad de Crohn , Glomerulonefritis , Enfermedades Inflamatorias del Intestino , Enfermedad de Crohn/complicaciones , Femenino , Humanos , Recurrencia
13.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(7): 724-729, 2021 Jul.
Artículo en Chino | MEDLINE | ID: mdl-34266531

RESUMEN

OBJECTIVE: To study the clinical features and recurrence factors of myelin oligodendrocyte glycoprotein (MOG) antibody disease in children and the effect of recurrence prevention regimens. METHODS: A retrospective analysis was performed on the medical data of 41 children with MOG antibody disease who were hospitalized in the Department of Pediatric Neurology, Xiangya Hospital of Central South University, from December 2014 to September 2020. According to the presence or absence of recurrence, they were divided into a monophasic course group (n=19) and a recurrence group (n=22). According to whether preventive treatment for recurrence was given, the children with recurrence were further divided into a preventive treatment group and a non-preventive treatment group. The clinical features were analyzed for all groups, and the annualized relapse rate (ARR) was compared before and after treatment with prevention regimens. RESULTS: For these 41 children, acute disseminated encephalomyelitis was the most common initial manifestation and was observed in 23 children (56%). Of the 41 children, 22 (54%) experienced recurrence, with 57 recurrence events in total, among which optic neuritis was the most common event (17/57, 30%). The proportion of children in the recurrence group who were treated with corticosteroids for less than 3 months in the acute phase was higher than that in the monophasic course group (64% vs 32%; P < 0.05). There was no significant difference in the ARR between the preventive treatment and non-preventive treatment groups (P > 0.05). The assessment of preventive treatment regimens for 32 cases showed that the children treated with rituximab or azathioprine had a significant reduction in the ARR during treatment (P < 0.05). CONCLUSIONS: More than half of the children with MOG antibody disease may experience recurrence. Most children with recurrence are treated with corticosteroids for less than 3 months in the acute phase. Rituximab and azathioprine may reduce the risk of recurrence.


Asunto(s)
Autoanticuerpos , Neuritis Óptica , Niño , Humanos , Glicoproteína Mielina-Oligodendrócito , Recurrencia , Estudios Retrospectivos
14.
JSLS ; 25(2)2021.
Artículo en Inglés | MEDLINE | ID: mdl-34248345

RESUMEN

Background and Objectives: Although several large studies regarding patients undergoing minimally invasive repair of incisional hernia are currently available, the results are not particularly reliable as they are based on heterogeneous groups, different surgical techniques, different mesh types, or with a too short follow period. Methods: We conducted a retrospective observational trial, collecting data from patients who underwent laparoscopic repair of a primary abdominal wall or an incisional hernia using the laparoscopic Intraperitoneal Onlay Mesh technique and a single mesh type, i.e., a composite polyester mesh with a hydrophilic film (Parietex CompositeTM mesh - Medtronic, Minneapolis, MN - USA). All patients signed an informed consent. Results: One thousand seven hundred seventy-seven patients were enrolled. The median surgery time was 50 minutes and the median length of hospital stay was 2 days. Intraoperative complications occurred in 12 patients (0.7%), while early postoperative surgical complications occurred in 115 (6.5%); during follow-up, bulging mesh was diagnosed in 4.5% of cases and hernia recurred in 4.3% of patients. An overlap equal or greater than 4 cm resulted as a significant protective factor, while the use of absorbable fixing devices was a risk factor for recurrence (odds ration: 9.06, p < 0.001, 95% confidence interval: 4.19 - 19.57). Conclusions: Minimally invasive treatment of primary and postincisional abdominal wall hernias is a safe, effective, and reproducible procedure. An overlap equal or greater than 4 cm, the use of nonabsorbable fixing devices and a postoperative care and follow-up regime are crucial in order to obtain good results and low recurrence rates.


Asunto(s)
Pared Abdominal/cirugía , Hernia Ventral/cirugía , Herniorrafia/métodos , Hernia Incisional/cirugía , Laparoscopía/métodos , Adulto , Anciano , Herniorrafia/efectos adversos , Humanos , Laparoscopía/efectos adversos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Tempo Operativo , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Periodo Posoperatorio , Recurrencia , Estudios Retrospectivos , Mallas Quirúrgicas
16.
Niger J Clin Pract ; 24(7): 1082-1085, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34290187

RESUMEN

Background: Inguinal hernia is a common pathology seen by the general surgeon in the outpatient clinic. Its spectrum of clinical features on presentation significantly varies from the asymptomatic to the complicated. Objective: To identify and audit the common clinical presentation and presence of known risk factors for inguinal hernia among adult patients with inguinal hernias presenting to an outpatient clinic. Methods: The study involved adults presenting over 1 year at a surgical clinic with a clinical diagnosis of inguinal hernia. Data on age, sex, family history, abdominal pain, constipation, chronic cough, previous hernia surgery as well as features of bladder outlet obstruction and intra-abdominal mass were recorded into a format. Analysis into a simple percentage, mean, and standard deviation was done with SPSS version 17 (SPSS Inc. Chicago, IL, USA). Results: Sixty-five patients were enrolled in the study, comprising 49 males (75.4%) and 16 females (24.6%), M:F = 3:1. The mean age was 45.6 years (SD ± 16.9). The 16-40-year age group had the highest incidence of 29 cases (44.6%) of inguinal hernia. A family history of inguinal hernia (31 cases [47.7%]) and history of previous inguinal hernia surgery (15 cases [23.1%])) was observed. Ten patients with previous surgery presented with a contralateral hernia and 5 with a recurrence. Other factors were chronic constipation 10 cases, smoking 9 cases, chronic cough 8 cases, dysuria 7 cases, enlarged prostate 6 cases, abdominal mass 4 cases, and urethral stricture 1 case. Conclusion: Inguinal hernia is common among young and middle-aged adults in our series. Many patients have features suggestive of complications at presentation. Family history and past inguinal hernia surgery were important risk factors.


Asunto(s)
Hernia Inguinal , Adulto , Femenino , Hernia Inguinal/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Recurrencia , Factores de Riesgo , Fumar
17.
Rinsho Ketsueki ; 62(5): 505-511, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-34248128

RESUMEN

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell lymphoma with a dismal prognosis. Its most effective treatment is allogeneic hematopoietic stem cell transplantation (allo-HSCT), which provides a chance of long-term remission through a graft-versus-ATLL (GvATLL) effect. However, the incidence of relapse after allo-HSCT remains high at approximately 40%, and treatment options for patients with ATLL who have relapsed disease after allo-HSCT are limited. Accumulating evidence shows that mogamulizumab or lenalidomide use for relapsed disease even after allo-HSCT might have advantages with effects similar to that of GvATLL. Recent genomic and transcriptomic studies have shown that ATLL cells evade immune surveillance. Further investigations of incorporating immune-based approaches with new molecular target drugs as therapeutic options of patients with ATLL after transplantation are warranted.


Asunto(s)
Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Leucemia-Linfoma de Células T del Adulto , Linfoma , Adulto , Humanos , Leucemia-Linfoma de Células T del Adulto/terapia , Recurrencia , Trasplante Homólogo
18.
Urologiia ; (3): 5-12, 2021 Jun.
Artículo en Ruso | MEDLINE | ID: mdl-34251095

RESUMEN

INTRODUCTION: The importance of recurrent lower urinary tract infection (LUTI) is associated with its high frequency, a significant decrease in the quality of life and insufficient efficiency of currently available treatment methods. Due to the high antibiotic resistance of uropathogens, the role of alternative therapeutic strategies increases, including substances with antiadhesive properties. AIM: to evaluate the efficiency of a biologically active additive (BAA) "Ecocystin" containing D-mannose and inulin for the prevention of recurrent LUTI in women. MATERIALS AND METHODS: A total of 74 women aged 21 to 75 years (mean 47.4+/-13.6 years) with recurrent LUTI were included in the study. After the initial treatment of LUTI all the patients were divided into two groups. Patients of the main group (n=44) received BAA "Ecocystin", containing D-mannose with antiadhesive properties and inulin, which is a prebiotic, to prevent recurrence of LUTI. Ecocystin was prescribed 1 sachet packet 2 times a day for the first 3 days, and then 1 sachet packet 1 time a day for 6 months. The Ecocystin sachet contains 1.5 g of D-mannose and 1.5 g of inulin. In the control group (n=30) were not prescribed Ecocystin. Clinical indicators were assessed on the 3rd day, as well as after 3 and 6 months from the beginning of the study. RESULTS: During the first 3 months, recurrent LUTI were diagnosed in 51.7% of patients in the control group and only in 15.9% of patients in the main group (p=0.002). By the 6th month of follow-up, relapses were seen in 75.9% and 29.5% of patients, respectively (p<0.001). In the main group a significant increase in the time interval before the onset of recurrence was found. During the first three months of follow-up, the recurrence of LUTI in the main group developed on average after 43.4+/-14.3 days compared to 28.2+/-13.5 days in the control group (p=0.026). In addition, severity and duration of recurrent LUTI in patients of the main group were less pronounced than in the control group. CONCLUSION: Our results showed that Ecocystin is an effective drug for the prevention of recurrences in patients with recurrent LUTI. Considering antiadhesive properties of D-mannose, which is part of Ecocystin, this drug can be recommended as a pathogenetically justified alternative to the antibacterial drugs.


Asunto(s)
Cistitis , Infecciones Urinarias , Antibacterianos/uso terapéutico , Cistitis/tratamiento farmacológico , Femenino , Humanos , Manosa , Calidad de Vida , Recurrencia , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/prevención & control
19.
Artículo en Chino | MEDLINE | ID: mdl-34256485

RESUMEN

Objective: We conducted a Meta-analysis to investigate the necessity of postural restrictions after manual reduction in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV). Methods: We searched PubMed, EBSCO, Proquest, Web of Science databases, Ovid, and screened eligible studies that investigated the effect of post-maneuver postural restriction in treating patients with PC-BPPV. Outcomes included the efficacy of treatment and recurrence. Meta-analysis was performed using Stata 15.0 software. Results: Studies of the single visit efficiency included 11 references, with a sample size of 1 733 cases. The Meta-analysis results showed that the difference in the efficacy between the postural restricted group and the non-postural restricted group in PC-BPPV patients was statistically significant(RR=1.12, 95%CI=1.07-1.18, P<0.001). There were 12 references included in the study on the total efficiency, with a cumulative sample size of 1763 cases. There was no statistically significant difference between the effect of postural restriction after manipulative reduction and that of simple manipulative reduction (RR=1.03, 95%CI=0.99-1.08, P=0.118). There were 5 references included in the study of recurrence rate, and the cumulative sample size was 659 cases. There was no statistically significant difference in the recurrence rate between the postural restricted group and the non-postural restricted group(RR=0.98, 95%CI=0.62-1.54, P=0.937). Conclusions: In comparison with non-postural restriction group, post-maneuver postural restriction after a single visit can improve the treatment effective rate of PC-BPPV and contribute to the improvement in the symptoms of patients in a short term. However, postural restrictions has no significant effect on the final prognosis of PC-BPPV, and it also has no significant effect on the recurrence.


Asunto(s)
Vértigo Posicional Paroxístico Benigno , Posicionamiento del Paciente , Vértigo Posicional Paroxístico Benigno/terapia , Ambiente , Humanos , Recurrencia , Canales Semicirculares , Resultado del Tratamiento
20.
Harefuah ; 160(7): 429-432, 2021 Jul.
Artículo en Hebreo | MEDLINE | ID: mdl-34263569

RESUMEN

INTRODUCTION: This case report presents a teenage girl hospitalized due to fever, left wrist pain and elevated inflammatory markers. These clinical findings, as well as a lytic lesion seen on plain radiographs and MRI in the distal left radius, led to the working diagnosis of acute osteomyelitis. Following 4 weeks of antibiotic therapy, a bone scan was conducted due to inadequate clinical response. It showed additional skeletal lesions and led to the final diagnosis of chronic recurrent multifocal osteomyelitis (CRMO). Treatment was changed to anti-inflammatory medications with a good response. This article presents key features of CRMO and emphasizes the role of skeletal scintigraphy in establishing the diagnosis.


Asunto(s)
Osteomielitis , Adolescente , Niño , Enfermedad Crónica , Femenino , Humanos , Imagen por Resonancia Magnética , Osteomielitis/diagnóstico por imagen , Cintigrafía , Recurrencia
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