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2.
Medicine (Baltimore) ; 99(10): e19301, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150064

RESUMO

We treated skin sclerosis with triple therapy consisting of a glucocorticoid, intravenous cyclophosphamide, and double-filtration plasmapheresis. The objective of this study was to analyze its effectiveness in a case series of patients who received triple therapy.We enrolled 8 patients with diffuse cutaneous systemic sclerosis (dcSSc) who received triple therapy at our hospital from 2008 to 2016. We analyzed the mean change in the modified Rodnan skin score (mRSS), percentage of the predicted forced vital capacity (%FVC), percentage of the predicted carbon monoxide diffusing capacity (%DLCO), and serum KL-6 levels from baseline to follow-up.All patients were treated with an intermediate dose of oral prednisolone (30.6 ±â€Š2.1 mg/day) initially. The mean cumulative dose of intravenous cyclophosphamide was 1.4 ±â€Š0.2 g. The mean mRSS decreased significantly at follow-up compared with that at baseline (27.0 ±â€Š3.3 vs 15.8 ±â€Š3.5; P = .03). At the end of the treatment, the mean %FVC and %DLCO were improved moderately, although the differences were not significant. The serum KL-6 levels decreased from 578.9 ±â€Š146.5 to 205.3 ±â€Š43.1 U/ml (P = .02). No significant correlation was found between the change in mRSS or disease duration and the initial skin score severity.Triple therapy may improve skin sclerosis, with effectiveness equal or superior to other reported treatments. This preliminary case series demonstrates the potential of triple therapy for treating dcSSc. However, prospective studies with long-term follow-up should be performed to assess its role.


Assuntos
Ciclofosfamida/uso terapêutico , Glucocorticoides/uso terapêutico , Imunossupressores/uso terapêutico , Plasmaferese , Prednisolona/uso terapêutico , Esclerodermia Difusa/terapia , Administração Oral , Idoso , Terapia Combinada , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Mucina-1/sangue , Capacidade de Difusão Pulmonar , Estudos Retrospectivos , Esclerodermia Difusa/tratamento farmacológico , Esclerodermia Difusa/fisiopatologia , Resultado do Tratamento , Capacidade Vital
3.
Medicine (Baltimore) ; 99(5): e19036, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000451

RESUMO

RATIONALE: Monoclonal gammopathy of undetermined significance (MGUS) is a plasma cell proliferative disorder that consistently precedes multiple myeloma. Peripheral neuropathy in patients with IgG-MGUS tends to vary in clinical phenotype. We report a rare case of a patient with IgG-MGUS who had nonsystemic vasculitic neuropathy (NSVN). PATIENT CONCERNS: A 56-year-old Japanese woman presented with progressive sensory ataxia with episodic paresthesia. Her clinical and laboratory values were compatible with IgG-MGUS. A nerve conduction study suggested possible chronic inflammatory demyelinating polyneuropathy. However, intravenous immunoglobulin therapy was not effective. A sural nerve biopsy specimen revealed mildly reduced myelinated fiber density and myelin ovoid formation, with epineural arterioles infiltrated by inflammatory cells. DIAGNOSES: We accordingly diagnosed her condition as NSVN. INTERVENTIONS: She was accordingly started on oral prednisolone (40 mg/d) at 3 months after the onset of her neurological symptoms. OUTCOMES: At 1 year after the oral prednisolone treatment was begun, the patient's neurological symptoms showed no worsening. LESSONS: These findings indicate NSVN as a possible cause of peripheral neuropathy in patients with IgG-MGUS. Cumulatively, our findings highlight the need for a nerve biopsy for peripheral neuropathy in patients with IgG-MGUS as a possible cause of NSVN. The early diagnosis of NSVN is expected to be beneficial for such patients.


Assuntos
Gamopatia Monoclonal de Significância Indeterminada/diagnóstico , Doenças do Sistema Nervoso Periférico/diagnóstico , Vasculite/diagnóstico , Idoso , Biópsia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunoglobulina G , Gamopatia Monoclonal de Significância Indeterminada/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Prednisolona/uso terapêutico , Vasculite/tratamento farmacológico
4.
Internist (Berl) ; 61(3): 313-320, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-31965234

RESUMO

A 78-year-old woman with rheumatoid arthritis on TNF-α inhibitor, methotrexate and prednisolone presented with severe but unspecific symptoms such as leg weakness, shivering, bifrontal headache, nausea and staggering. The broad range of differential diagnoses lead to intricate and time-consuming diagnostic procedures. Serology, magnetic resonance imaging and microbiological investigations represent important steps to make the final diagnosis of cerebral toxoplasmosis. Both diagnostic approach and therapy require close cooperation of different disciplines. Therapies of rheumatoid arthritis as well as of toxoplasmosis are based on a long-term treatment and could be associated with numerous harmful side effects. Continuous monitoring and permanent adjustment of therapy regimes are therefore mandatory.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Encéfalo/diagnóstico por imagem , Imunossupressores/uso terapêutico , Metotrexato/uso terapêutico , Infecções Oportunistas/diagnóstico , Prednisolona/uso terapêutico , Toxoplasmose Cerebral/diagnóstico , Fator de Necrose Tumoral alfa/uso terapêutico , Idoso , Antirreumáticos/efeitos adversos , Encéfalo/fisiopatologia , Diagnóstico Diferencial , Quimioterapia Combinada , Feminino , Humanos , Imunossupressores/efeitos adversos , Imagem por Ressonância Magnética/métodos , Metotrexato/efeitos adversos , Prednisolona/efeitos adversos , Toxoplasmose Cerebral/diagnóstico por imagem , Toxoplasmose Cerebral/imunologia , Toxoplasmose Cerebral/patologia , Resultado do Tratamento , Fator de Necrose Tumoral alfa/efeitos adversos
5.
Nihon Shokakibyo Gakkai Zasshi ; 117(1): 64-71, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-31941858

RESUMO

A 45-year-old Japanese man presenting with leg purpura, abdominal pain, and arthralgia was diagnosed with IgA vasculitis. His symptoms resolved after the intravenous administration of prednisolone. However, on day 20 of admission, he experienced bloody discharge and hypovolemic shock. The bleeding point was not identified on contrast-enhanced computed tomography scanning. The blood loss was approximately 10800ml and the patient received transfusions of 48 units of concentrated red blood cells, 18 units of fresh frozen plasma, and 30 units of concentrated platelets. Laparotomy and enteroscopy were performed through the incision of the jejunum to detect the bleeding source. Spurting bleeding was observed during the enteroscopy and partial resection of the jejunum was performed. Histopathological examination of the resected specimen revealed large vessels beneath the jejunal ulcer scar, suggesting bleeding from a Dieulafoy's lesion. Leukocytoclastic vasculitis or cytomegalovirus infection was not observed in the resected specimen. Gastrointestinal symptoms in patients with IgA vasculitis usually improve with bowel rest and conservative treatment. Administration of steroids or factor XIII is recommended for patients with severe abdominal pain refractory to conservative management. Rarely, massive bleeding, perforation, intussusception, and/or intestinal obstruction occur in the gastrointestinal tract and these complications affect patients' prognoses. The clinical course in the present patient indicated that severe bleeding from the gastrointestinal tract can occur even after symptom remission in patients with IgA vasculitis. In such cases, prompt treatment, including laparotomy and/or enteroscopy, is essential.


Assuntos
Imunoglobulina A/metabolismo , Jejuno , Vasculite/diagnóstico , Anti-Inflamatórios/uso terapêutico , Hemorragia Gastrointestinal , Humanos , Masculino , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Vasculite Leucocitoclástica Cutânea
6.
J Cancer Res Clin Oncol ; 146(3): 749-759, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31788741

RESUMO

PURPOSE: The German Maintenance Study (GERMAIN) was designed to evaluate the impact of lenalidomide maintenance after induction therapy with bortezomib, melphalan and prednisolone (VMP) in transplant-ineligible newly diagnosed multiple myeloma (MM) patients. METHODS: Due to poor accrual and high dropout rate, only 85 patients (planned 286) entered the trial and 40 (planned 200) were randomized to lenalidomide maintenance (n = 19) vs. observation (n = 21). RESULTS: The primary endpoint, improved progression-free survival, was not met (p = 0.3572). After a median follow-up of 12.9 months, median progression-free survival in the lenalidomide arm was 14.4 months and 11.4 months with placebo. The hazard ratio 0.621 (95% confidence interval: [0.224, 1.725]) was about the same as expected (0.625). However, with only 40 patients randomized, the actual power to detect a difference was 11%. Of patients receiving at least one dose of induction, 54% were frail according to a modified International Myeloma Working Group frailty score. Discontinuations were high during induction (47%), and affected mainly frail patients (54%). Despite a higher rate of adverse events in the lenalidomide arm (p = 0.0061), only 2 patients discontinued lenalidomide due to toxicity. CONCLUSION: A frailty assessment with appropriate dose modification for induction therapy should be mandatory for all elderly non-transplant-eligible myeloma patients.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fragilidade , Quimioterapia de Indução/métodos , Lenalidomida/uso terapêutico , Quimioterapia de Manutenção/métodos , Mieloma Múltiplo/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Bortezomib/uso terapêutico , Método Duplo-Cego , Feminino , Idoso Fragilizado , Humanos , Quimioterapia de Indução/efeitos adversos , Masculino , Melfalan/uso terapêutico , Mieloma Múltiplo/mortalidade , Prednisolona/uso terapêutico , Intervalo Livre de Progressão
8.
Muscle Nerve ; 61(1): 26-35, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31599456

RESUMO

INTRODUCTION: In this study we characterized disease progression over 48 weeks among boys receiving deflazacort vs prednisone/prednisolone placebo arm treatment in two recent Duchenne muscular dystrophy (DMD) clinical trials. METHODS: Ambulatory boys with DMD receiving placebo in the phase 3 ataluren (N = 115) and tadalafil (N = 116) trials were included. The trials required at least 6 months of prior corticosteroid use and stable baseline dosing. Associations between corticosteroid use and 48-week changes in ambulatory function were estimated using mixed models. Adjusted differences between corticosteroid groups were pooled in a meta-analysis. RESULTS: In the meta-analysis, deflazacort-treated patients vs prednisone/prednisolone-treated patients experienced, on average, lower declines of 28.3 meters on 6-minute walk distance (95% confidence interval [CI], 5.7, 50.9; 2.9 seconds on rise from supine [95% CI, 0.9, 4.9 seconds]; 2.3 seconds on 4-stair climb [95% CI, 0.5, 4.1 seconds]; and 2.9 [95% CI, 0.1, 5.8] points on the North Star Ambulatory Assessment linearized score). DISCUSSION: Deflazacort-treated patients experienced significantly lower functional decline over 48 weeks.


Assuntos
Anti-Inflamatórios/uso terapêutico , Distrofia Muscular de Duchenne/tratamento farmacológico , Prednisona/uso terapêutico , Pregnenodionas/uso terapêutico , Criança , Progressão da Doença , Humanos , Masculino , Estudos Multicêntricos como Assunto , Prednisolona/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Caminhada
9.
An Bras Dermatol ; 94(6): 713-716, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31789267

RESUMO

Hyperzincemia and hypercalprotectinemia is a rare inflammatory disease caused by a mutation in the PSTPIP1 gene, with a dysregulation of calprotectin metabolism. Calprotectin is a zinc-binding protein with antimicrobial properties and pro-inflammatory action. The authors report the case of a 20 year-old girl with cutaneous ulcers comparable with pyoderma gangrenosum, growth failure and chronic anemia, who was given the diagnosis of hyperzincemia and hypercalprotectinemia. Measurement of serum zinc and calprotectin concentrations are indicated in these cases.


Assuntos
Erros Inatos do Metabolismo dos Metais/patologia , Pioderma Gangrenoso/patologia , Ciclosporina/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Complexo Antígeno L1 Leucocitário/sangue , Erros Inatos do Metabolismo dos Metais/tratamento farmacológico , Prednisolona/uso terapêutico , Resultado do Tratamento , Adulto Jovem , Zinco/sangue
10.
Int J Nanomedicine ; 14: 9113-9125, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31819422

RESUMO

Background: Prednisolone (PD) is extremely effective for treating rheumatoid arthritis (RA). However, it distributes nonspecifically throughout the body and its use is associated with serious side effects, which promoted us to compound it into a phytomedicine for greater efficacy and safety. Methods: We combined PD with curcumin (CU), an effective monomer from traditional Chinese medicine, and human serum albumin (HSA) in a nanoparticulate system (N-PD/CU) to compensate for the poor bioavailability of PD and CU. N-PD/CU was prepared by high-pressure homogenization, and its characteristics were evaluated in vitro. Next, we investigated its toxicity and mechanism of anti-inflammatory to macrophages. Finally, its pharmacokinetics, biodistribution and therapeutic efficacy were assessed in rats with adjuvant-induced arthritis (AIA). Results: N-PD/CU showed a narrow size distribution around 150.4 ± 2.4 nm, a polydispersity index of 0.22 ± 0.02 and drug loading efficiency (DLE) of 88.75 ± 1.82% for PD and 85.79 ± 1.43% for CU. N-PD/CU showed sustained release of both drugs in vitro. N-PD/CU had no toxicity to macrophages in vitro on concentrations between 0.1 and 1.2 µmol/mL. In activated macrophages, N-PD decreased levels of pro-inflammatory cytokines, while N-CU increased levels of anti-inflammatory IL-10, and N-PD/CU exhibited best therapeutic effect in vitro, suggesting co-delivery of PD and CU may synergistically control the course of RA. In AIA rats, N-PD/CU accumulated in inflamed joints through the effect of extravasation through leaky vasculature and subsequent inflammatory cell-mediated sequestration (ELVIS effect) in inflammatory lesion and showed higher therapeutic efficacy than single-loaded nanoparticles, either free drug on its own, or a simple mixture of the two drugs. Conclusion: This codelivery system based on HSA is a promising platform for combination chemotherapy in RA.


Assuntos
Artrite Reumatoide/tratamento farmacológico , Curcumina/administração & dosagem , Curcumina/uso terapêutico , Sistemas de Liberação de Medicamentos , Nanopartículas/administração & dosagem , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Albumina Sérica Humana/metabolismo , Animais , Anti-Inflamatórios/uso terapêutico , Artrite Reumatoide/patologia , Disponibilidade Biológica , Citocinas/metabolismo , Liberação Controlada de Fármacos , Humanos , Mediadores da Inflamação/metabolismo , Masculino , Camundongos , Nanopartículas/ultraestrutura , Tamanho da Partícula , Células RAW 264.7 , Ratos Sprague-Dawley , Distribuição Tecidual
11.
Vet J ; 254: 105395, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31836169

RESUMO

Meningoencephalitis of unknown origin (MUO) is a common inflammatory disease of the central nervous system. Several studies investigated finding prognostic factors, but results are contradictory. The aim of this study was to determine the concentrations of blood lactate (Blood-L) and cerebrospinal fluid lactate (CSF-L) in dogs with MUO for prognostic purposes. A total of 45 dogs with MUO (MUO group) and 11 with idiopathic epilepsy (IE group) were included. In the MUO group, 22 dogs were treated with prednisolone + cytosine arabinoside, 17 with prednisolone ± cyclosporine, and six received no treatment. In the MUO group, there was a strong-moderate positive correlation between Blood-L and CSF-L (ρ = 0.63557; P < 0.0001), a strong-moderate negative correlation between survival and CSF-L (ρ= -0.50210; P < 0.0004), and a weak negative correlation between survival and Blood-L (ρ= -0.35685; P < 0.0220). Dogs with a favourable response to treatment at 1 month had lower initial concentrations of Blood-L and CSF-L (P < 0.0010; P < 0.0037), and those with a worse response had higher values (P < 0.0497; P < 0.0004). Dogs that remained stable with treatment showed lower CSF-L concentrations (P < 0.0013). Dogs with Blood-L>4 mmol/L (P < 0.03) and/or CSF-L> 4 mmol/L (P < 0.009) had lower survival rates with the latter also showing more severe signs, probably indicating severe neuronal damage. These findings suggest that concentrations of CSF-L and Blood-L in dogs with MUO could be used as prognostic indicators.


Assuntos
Doenças do Cão/sangue , Doenças do Cão/líquido cefalorraquidiano , Ácido Láctico/sangue , Ácido Láctico/líquido cefalorraquidiano , Meningoencefalite/veterinária , Animais , Anti-Inflamatórios/uso terapêutico , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Citarabina/uso terapêutico , Cães , Feminino , Masculino , Meningoencefalite/sangue , Meningoencefalite/líquido cefalorraquidiano , Meningoencefalite/tratamento farmacológico , Prednisolona/uso terapêutico , Prognóstico , Estudos Prospectivos
12.
Medicine (Baltimore) ; 98(44): e17604, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689765

RESUMO

This study genotyped blood samples from 214 patients with rheumatoid arthritis (RA) and 293 healthy controls for single nucleotide polymorphisms (SNPs) rs2977537, rs2929970, rs2929973, rs2977530, rs1689334 and rs62514004. We want to investigate whether the SNPs in the WNT1-inducible signaling pathway protein 1 (WISP-1) gene may increase the risk of developing RA. We showed that RA disease was more likely with the AA genotype compared with the AG genotype of SNP rs2977537 (adjusted odds ratio [AOR]: 0.54; 95% confidence interval [CI]: 0.34-0.84), and with the TT genotype (AOR: 0.24; 95% CI: 0.13-0.39) or the GG genotype (AOR: 0.05; 95% CI: 0.03-0.10) compared with the GT genotype of rs2929973, and with the AA genotype (AOR: 0.34; 95% CI: 0.22-0.54) or GG genotype (AOR: 0.52; 95% CI: 0.31 to 0.87) vs the AG genotype of rs2977530. Rheumatoid factor positivity was more likely with the AA genotype than with the AG genotype of the rs2977537 polymorphism (AOR: 0.16; 95% CI: 0.16-0.94). High CRP (>8 mg/L) was more likely with the non-AG genotype (AA + GG) than the AG genotype of rs2977537 (AOR: 1.84; 95% CI: 1.05-3.21) and with the AA genotype vs the AG genotype of rs2977530 (AOR: 2.62; 95% CI: 1.35-5.09). Compared with the AG genotype, the AA genotype of rs2929970 was more likely to require prednisolone (AOR: 0.49; 95% CI: 0.27-0.88), while the AG genotype was more likely than the AA genotype of SNP rs2977530 to require TNF-α inhibitors (AOR: 2.07; 95% CI: 1.08 to 3.98). WISP-1 may be a diagnostic marker and therapeutic target for RA therapy.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/genética , Prednisolona/uso terapêutico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Idoso , Alelos , Artrite Reumatoide/etnologia , Grupo com Ancestrais do Continente Asiático , Biomarcadores , Proteínas de Sinalização Intercelular CCN , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica , Razão de Chances , Polimorfismo de Nucleotídeo Único , Proteínas Proto-Oncogênicas , Reação em Cadeia da Polimerase em Tempo Real
13.
Anticancer Res ; 39(11): 6355-6358, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704867

RESUMO

BACKGROUND/AIM: Pneumonitis is a serious complication after radiotherapy of breast cancer. This study aimed to identify its prevalence and potential risk factors. PATIENTS AND METHODS: A total of 606 patients irradiated following breast-conserving surgery or mastectomy were retrospectively analyzed. In patients developing pneumonitis, radiation and clinical parameters were investigated to identify potential risk factors. RESULTS: Eleven patients (1.8%) developed a pneumonitis grade ≥2. Mean doses to the ipsilateral lung were >7 Gy in 5 patients (45%). Of the other patients, 5 had a chronic inflammatory disease. Six patients (55%) had another malignancy (4 previous contralateral breast cancers, 1 previous ovarian and thyroid cancer, 1 synchronous carcinoma-in-situ (pTis) at the contralateral breast). Five patients (45%) received chemotherapy including taxanes and 4 patients (36%) received trastuzumab. CONCLUSION: The prevalence of pneumonitis was 1.8%. Potential risk factors included mean radiation dose to ipsilateral lung >7 Gy, systemic treatment with taxanes or trastuzumab, chronic inflammatory disease and history of another malignancy.


Assuntos
Neoplasias da Mama/radioterapia , Pneumonite por Radiação/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/uso terapêutico , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antineoplásicos Imunológicos/administração & dosagem , Antineoplásicos Imunológicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Carcinoma in Situ/radioterapia , Feminino , Humanos , Pulmão/efeitos da radiação , Mastectomia , Mastectomia Segmentar , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas , Prednisolona/uso terapêutico , Prevalência , Pneumonite por Radiação/tratamento farmacológico , Pneumonite por Radiação/etiologia , Estudos Retrospectivos , Fatores de Risco , Trastuzumab/administração & dosagem , Trastuzumab/efeitos adversos
14.
BMC Vet Res ; 15(1): 337, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604435

RESUMO

BACKGROUND: Flea bite is considered to be the main cause of allergic dermatitis in cats. There is a need for treatments able to control clinical signs of allergic dermatitis associated with flea bite in cats. This was an open pre-treatment versus post-treatment clinical field study. All cats included in the study presented pruritus, skin lesions or other evidence compatible with flea infestation. Skin lesions were assessed (using SCORFAD) at days 0, 28, 56 and 84 whereas pruritus severity was assessed (using PVAS) at days 0, 15, 28, 56 and 84. On day 0, The fluralaner (280 mg/ml) product (Bravecto® spot-on for cats) was supplied in pipettes containing 0.4, 0.89 and 1.79 ml for cats of 1.2-2.8 kg, > 2.8-6.25 kg and > 6.25-12.5 kg body weight, respectively. The other animals living in the same household also received fluralaner. Based on cytological examination at day 0, oral amoxicillin and clavulanic acid was prescribed for 21 days if indicated. For cats presenting intense pruritus and discomfort at day 0, oral prednisolone at 0.5 mg/kg was prescribed for 3 days. RESULTS: During the study all cats, except for one (cat number 10), improved significantly. Post-treatment median SCORFAD scores at all evaluations were significantly different from the pre-treatment score on day 0 (P values < 0.002 for all three post treatment examination days) with a score reduction of 49% on day 28, 79% on day 56 and 87% on day 84. The PVAS score decreased significantly over the study period for all cats but one (cat number 10). Post-treatment median PVAS scores at all evaluations were significantly different from the pre-treatment PVAS score on day 0 (P value < 0.002 for all four post-treatment days) with a reduction of 46% on day 15, 67% on day 28, 82% on day 56 and 92% on day 84. No adverse reaction or other health issue was reported during the study. CONCLUSIONS: A single topical treatment with fluralaner results in a significant reduction of flea bite allergic dermatitis clinical signs in cats over the subsequent 12 weeks without any additional environmental treatment.


Assuntos
Doenças do Gato/tratamento farmacológico , Dermatite Atópica/veterinária , Infestações por Pulgas/veterinária , Inseticidas/administração & dosagem , Isoxazóis/administração & dosagem , Administração Tópica , Amoxicilina/uso terapêutico , Animais , Gatos , Ácido Clavulânico/uso terapêutico , Ctenocephalides , Dermatite Atópica/tratamento farmacológico , Feminino , Infestações por Pulgas/complicações , Infestações por Pulgas/tratamento farmacológico , França , Masculino , Prednisolona/uso terapêutico , Prurido/tratamento farmacológico , Prurido/veterinária , Resultado do Tratamento
17.
Pak J Pharm Sci ; 32(3 Special): 1415-1418, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31551223

RESUMO

To evaluate the clinical efficacy of combined therapy of Zushima tablet and western medicine in treatment of rheumatoid arthritis and analyze the MRI test results. A total of 170 patients who had been treated for rheumatoid arthritis at our hospital from August 2016 and June 2018, were enrolled as research objects. They were randomly divided into control group and research group, with 85 patients in each group. The patients in the control group were treated with western medicine, while patients in the research group were treated with combined therapy of Zushima tablet and western medicine. The clinical efficacies of two groups were compared. results showed that the overall effective rate of the research group was higher than that of the control group (p<0.05). Various clinical symptoms including joint swelling, joint tenderness, duration of morning stiffness for both groups before and after treatment were recorded, and results showed that the improvement of the research group was significantly better than that of the control group (p<0.05). Application of combined therapy of Zushima tablet and western medicine in treatment of rheumatoid arthritis could lead to favorable effects and improvement of the patients' clinical symptoms.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Adulto , Artrite Reumatoide/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Naproxeno/uso terapêutico , Prednisolona/uso terapêutico , Sulfassalazina/uso terapêutico , Comprimidos , Resultado do Tratamento , Ocidente
18.
Hinyokika Kiyo ; 65(6): 219-222, 2019 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-31501389

RESUMO

We report a case of idiopathic penile pyoderma gangrenosum that was successfully treated with corticosteroid treatment without penectomy. A 67-year-o1d man with induration and tenderness of the penile shaft visited a local hospital. A penile abscess was suspected on magnetic resonance imaging, and needle biopsy did not reveal malignancy. After the tension of the penile shaft had worsened, he was referred to our hospital where surgical drainage and re-biopsy were performed. Microbiological cultures revealed no growth, and pathological examination revealed no evidence of malignancy. Despite drainage, the abscess recurred on postoperative day 18. With a working diagnosis of penile pyoderma gangrenosum, we initiated prednisolone 30 mg once daily followed by taper and performed a second surgical drainage, leaving the wound open to heal by secondary intention. Wound discharge declined gradually, and no recurrence of abscess has yet been observed. Pyoderma gangrenosum is clinically diagnosed when subcutaneous chronic inflammatory findings are present without concurrent bacterial infection. Corpus cavernosum abscess presenting as the initial symptom of pyoderma gangrenosum is rare. Most cases of recurrent corpus cavernosum abscess eventually result in total penectomy. In this case, we successfully avoided penectomy by suspecting pyoderma gangrenous and initiating prednisolone treatment appropriately.


Assuntos
Glucocorticoides , Prednisolona , Pioderma Gangrenoso , Abscesso , Idoso , Drenagem , Glucocorticoides/uso terapêutico , Humanos , Imagem por Ressonância Magnética , Masculino , Prednisolona/uso terapêutico , Pioderma Gangrenoso/tratamento farmacológico
20.
J Pak Med Assoc ; 69(9): 1266-1272, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31511710

RESUMO

Purpose: Hodgkin lymphoma (HL) is one of the most curable paediatric cancers, with long-term survival rates now exceeding 90% after treatment with chemotherapy alone or combined with radiotherapy (RT). Treatment options for Hodgkin's Lymphoma differ among various study groups and there is still no consensus regarding the standard treatment for Hodgkin's lymphoma. Taking into account the impact of treatment-related mortality in low- and middle-income countries we propose to study the the clinical features and treatment outcomes by using different chemotherapy protocols in Hodgk in s' s Lymphoma children's at Shaukat khanam hospital Lahore.. METHODS: Clinical data from a large regional cancer center Pediatrics patients with Hodgkin's Lymphoma from January 2009 till December 2015 was retrospectively collected after Institutional Review Board (IRB) approval. RESULTS: A total of 748 patients were reviewed retrospectively. Mostly (45%) were in 6-10 years age group. Male showed predominance ,male to female ratio was 4:1. B symptoms were present in 51%, bulky disease in 44% and ESR was more than 30mm in 26% of patients. CD 30 was positive in 95%, Bone marrow involved in 13% of patients. Stage I in 8%, stage- II in 27%, stage -III in 39% and stage IV in 26% was seen. COPDAc/ABVD was given in 412 patients, CHLVPP/ABVD in 176 patients, OEPA/COPP in 57 patients, OEPA in 35 patients, OEPA/COPDAC in 33 Patients and remaining 33 received various chemotherapy protocol combination. XRT was given in 17% of patients. Of these 86% of patients were alive ,5% patients died , 3% patients abandoned, 6% patients relapsed ,3% patients progressed while on chemotherapy. Five years Overall survival was 94% and 5 Years Event free survival was 91%. Minimum haematological and other toxicity was seen in patients who had received COPDac/ABVD when compared to other regimen. CONCLUSIONS: Hodgkin's lymphoma patients had good outcome with different chemotherapy regimens, however our experience showed that the COPDac/ABVD regimen wass better tolerated with minimum toxicity.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Adolescente , Bleomicina/uso terapêutico , Criança , Pré-Escolar , Clorambucila/uso terapêutico , Ciclofosfamida/uso terapêutico , Dacarbazina/uso terapêutico , Doxorrubicina/uso terapêutico , Etoposídeo/uso terapêutico , Feminino , Doença de Hodgkin/patologia , Humanos , Lactente , Estimativa de Kaplan-Meier , Masculino , Estadiamento de Neoplasias , Paquistão , Prednisolona/uso terapêutico , Prednisona/uso terapêutico , Procarbazina/uso terapêutico , Prognóstico , Radioterapia Adjuvante , Estudos Retrospectivos , Taxa de Sobrevida , Centros de Atenção Terciária , Resultado do Tratamento , Vimblastina/uso terapêutico , Vincristina/uso terapêutico
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