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thrombocytopenia treatmente

Fibi Ninan, Ajay Kumar Mishra, Ajoy Oommen John, Ramya Iyadurai
Melioidosis well known as a 'great mimicker' is caused by Burkholderia pseudomallei. Even though majority of the patients present with acute infection, around 18 % can present as chronic infection. These latent foci of infection may reactivate to cause fulminant infection at a later date. Due to lack of clinical suspicion and good laboratory facility latent infections are often misdiagnosed and treated as tuberculosis. Chronic splenic granuloma is a rare manifestation of Melioidosis . Deep seated abscess requires atleast 4 weeks of intensive treatment with intravenous antibiotics...
January 2018: Journal of Family Medicine and Primary Care
Stephen W Reddel, Michael H Barnett, Sean Riminton, Tej Dugal, Katherine Buzzard, Chenu Tim Wang, Fiona Fitzgerald, Heidi N Beadnall, Diane Erickson, David Gahan, Daniel Wang, Toby Ackland, Richard Thompson
BACKGROUND: Alemtuzumab is a highly effective treatment for relapsing-remitting multiple sclerosis (MS) but requires ongoing pathology monitoring for autoimmune adverse effects. The Alemtuzumab in MS Safety Systems (AMS3) study evaluated the implementation of an automated pathology-monitoring system. OBJECTIVES: To develop an efficient automated clinical decision support system (CDSS) to electronically prompt and track pathology collection and to provide prescribers and patients with customised alerts of abnormal results for identified risks...
June 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Zhao Wang, Xiaojie Fang, He Huang, Huangming Hong, Xueying Li, Chengcheng Guo, Xiaohong Fu, Mengping Zhang, Sio Teng Lam, Shanshan Li, Fangfang Li, Chen Peng, Ying Tian, Tongyu Lin
The aim of this randomized phase II study was to investigate the optimal timing of the administration of thrombopoietin to prevent cytarabine-induced thrombocytopenia. Fifty-two patients who were scheduled for high-dose cytarabine treatment were randomly assigned to receive either the standard prophylactic mode (starting thrombopoietin, 15,000 units/day on days 2-11) or the pre-chemo mode (starting thrombopoietin, 15,000 units/day on days -4, -2, and 2-9) during the first cycle of chemotherapy with a switch to the other mode in the second cycle...
June 18, 2018: Leukemia & Lymphoma
Maiko Nomoto, Jim Ferry, Ziad Hussein
Avatrombopag, a c-Mpl agonist, has been developed to provide an alternative therapy to standard platelet transfusion care for the treatment of thrombocytopenia. The main objectives of this article were to describe the pharmacokinetics (PK) of avatrombopag, to characterize the pharmacokinetic/pharmacodynamic (PK/PD) relationship between plasma avatrombopag concentrations and platelet count, and to identify potential intrinsic and extrinsic factors affecting PK or PK/PD in patients with chronic liver disease (CLD)...
June 15, 2018: Journal of Clinical Pharmacology
Nicole F Laslett, SuJung Park, Gregory A Masters, David D Biggs, Charles J Schneider, Jamal G Misleh, Kathir Suppiah, Pamela S Simpson, Stephen Grubbs, Timothy F Wozniak, Michael Guarino
Lung cancer remains the leading cause of cancer death throughout the world. Despite new chemotherapeutic, immunomodulating and molecularly targeted agents, patients with locally advanced or metastatic disease still have a poor prognosis. This trial looked to combine antiangiogenic therapy with a first-line cytotoxic chemotherapy doublet, hoping to extend median progression-free survival (PFS) while minimizing toxicity in patients with advanced nonsquamous non-small-cell lung cancer (NSCLC). In this single institution, single-arm study, 51 patients (age >18 yo) were followed from 2007 to 2012...
June 14, 2018: Cancer Medicine
Yi Yuan, Ling Zhao, Ning Ma, Zhuang Ye, Zhenyu Jiang, Congqiu Chu
Objectives: This study aims to assess the complement 3 (C3) expressions in whole blood cells and verify a pathway toll-like receptor 9 (TLR9)/ transforming growth factor-beta 1 (TGF-β1)/C3 for C3 regulation in mediating thrombocytopenia (TCP) in patients with systemic lupus erythematosus (SLE). Patients and methods: The study included 63 newly diagnosed SLE patients (2 males, 61 females; mean age 39.5 years; range 15 to 67 years). Whole blood messenger ribonucleic acid expression for C3, TLR9 and TGF-β1 were measured by quantitative reverse transcription real-time polymerase chain reaction in SLE patients with TCP (n=38) and age- and sex-matched SLE patients without TCP (n=25) at baseline and in 10 SLE patients with TCP after four weeks of treatment...
December 2017: Archives of Rheumatology
Ariel I Loredo, Jenny E Bauman, Raegan J Wells
  A case report of a domesticated ferret ( Mustela furo) envenomated by a presumptive rattlesnake ( Crotalus sp.) treated successfully and safely with the novel Fab (2') North American Snake Antivenom (Veteria Labs). The ferret presented with clinical signs of depressed mentation and facial edema following a rattlesnake ( Crotalus sp.) bite. It developed hypotension, thrombocytopenia, and ecchymosis following the envenomation. It was treated with Fab (2') antivenom and given supportive care including crystalloid fluids and analgesia to resolution of clinical signs...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
David G Li, Katherine M Krajewski, Arash Mostaghimi
Cellulitis is a common skin and soft tissue infection with substantial misdiagnosis rates due to its nonspecific clinical characteristics. In this report, we present a patient with recurrent metastatic diffuse large B-cell lymphoma (DLBCL) masquerading as a unilateral lower extremity cellulitis. A 62-year-old man with a history of DLBCL, in remission for two years, presented with a two-week history of swelling and erythema of the right thigh and leg. Despite treatment with clindamycin and cephalexin, the redness and swelling continued to progress...
April 12, 2018: Curēus
Changhoon Yoo, Jihoon Kang, Ho Yeong Lim, Jee Hyun Kim, Myung-Ah Lee, Kyung-Hun Lee, Tae-You Kim, Baek-Yeol Ryoo
Purpose: The signal transducer and activator of transcription 3 (STAT3) signaling pathway might be a promising therapeutic target for hepatocellular carcinoma (HCC). Materials and Methods: This study was a multicenter, open-label, non-comparative, dose escalating phase I study of OPB-111077, an oral STAT3 inhibitor, in patients with advanced HCC who failed on sorafenib. Continuous dosing (daily administration: 50 mg to 400 mg) and intermittent dosing (4-days on/3-days off administration: 300 mg to 900 mg) regimens were evaluated and the dose-limiting toxicities (DLTs), maximum tolerated dose (MTD), and recommended dose (RD) were the primary endpoints...
June 13, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Florentina Paraschiv, Gabriel Adrian Popescu, Alina Maria Borcan
Introduction: Klebsiella pneumoniae liver abscess syndrome (KLAS) is characterized by bacteraemia, liver abscesses and metastatic infection caused by a hypervirulent strain of Klebsiella pneumoniae , usually belonging to the capsular serotype K1 or K2. Initially, KLAS was described in Eastern Asia; recently isolated cases have been reported from different parts of the world. Case presentation: We describe the case of a woman with KLAS including meningeal, ocular and cutaneous metastatic infection and organ dysfunctions (coagulation abnormalities, thrombocytopenia and increased creatinine level)...
May 2018: JMM Case Reports
Matthew S Davids, Michael Hallek, William Wierda, Andrew W Roberts, Stephan Stilgenbauer, Jeffrey A Jones, John F Gerecitano, Su Young Kim, Jalaja Potluri, Todd Busman, Andrea Best, Maria E Verdugo, Elisa Cerri, Monali Desai, Peter Hillmen, John F Seymour
PURPOSE: The oral BCL-2 inhibitor venetoclax is an effective therapy for patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL), including disease with high-risk genomic features such as chromosome 17p deletion (del[17p]) or progressive disease following B-cell receptor pathway inhibitors. EXPERIMENTAL DESIGN: We conducted a comprehensive analysis of the safety of 400mg daily venetoclax monotherapy in 350 patients with CLL using an integrated dataset from three phase-I/II studies...
June 12, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Kg Sajeeth Kumar, Santhosh Narayanan, V Udayabhaskaran, N K Thulaseedharan
Background: Snake bites are a neglected public health problem in all tropical countries, and particularly in Malabar region of Kerala, India. Demographic characteristics and clinical parameters vary in this part of the world, and studies based on them are scarce. Increased incidence of capillary leak syndrome (CLS) in hemotoxic snake bites and emergence of cases of hump-nosed pit viper (HNPV, Hypnale hypnale ) envenomation are some notable features seen here. Objectives: The study was conducted to assess the epidemiological profile and clinical features to identify factors contributing to outcome in patients with venomous snakebites...
2018: International Journal of General Medicine
Chow Yee Lai, Tristan Pettit
In this report, we present a young infant with multisystem Langerhans cell histiocytosis, who after cladribine and cytarabine salvage treatment developed immune thrombocytopenia (IT). On review of the literature, there were no previous reports of Langerhans cell histiocytosis-associated IT. Treatment of the IT with intravenous immunoglobulin and oral corticosteroids was unsuccessful. Eltrombopag, in combination with a 4-day course of dexamethasone was commenced as second-line therapy. Platelet recovery occurred 10 days after initiation of eltrombopag...
June 8, 2018: Journal of Pediatric Hematology/oncology
Bérangère S Joly, Paul Coppo, Agnès Veyradier
Child-onset thrombotic thrombocytopenic purpura (TTP) is a rare entity of thrombotic microangiopathy (TMA). The pathophysiology of the disease is based on a severe functional deficiency of ADAMTS13 (activity <10%), the specific von Willebrand factor (VWF)-cleavage protease. This deficiency may be either acquired (associated anti-ADAMTS13 autoantibodies) or congenital (resulting from biallelic mutations of ADAMTS13 gene). ADAMTS13 deficiency is responsible for the accumulation of high molecular weight multimers of VWF and the formation of platelet thrombi in the microcirculation...
June 11, 2018: European Journal of Haematology
Hong-Hu Zhu, De-Pei Wu, Xin Du, Xi Zhang, Lin Liu, Jun Ma, Zong-Hong Shao, Han-Yun Ren, Jian-Da Hu, Kai-Lin Xu, Jing-Wen Wang, Yong-Ping Song, Mei-Yun Fang, Juan Li, Xiao-Yan Yan, Xiao-Jun Huang
BACKGROUND: Intravenous arsenic trioxide plus all-trans retinoic acid (ATRA) without chemotherapy is the standard of care for non-high-risk acute promyelocytic leukaemia (white blood cell count ≤10 × 109 per L), resulting in cure in more than 95% of cases. However, a pilot study of treatment with oral arsenic realgar-Indigo naturalis formula (RIF) plus ATRA without chemotherapy, which has a more convenient route of administration than the standard intravenous regimen, showed high efficacy...
June 5, 2018: Lancet Oncology
Grzegorz Charlinski, Norbert Grzasko, Artur Jurczyszyn, Mariusz Janczarski, Agnieszka Szeremet, Anna Waszczuk-Gajda, Paweł Bernatowicz, Alina Swiderska, Renata Guzicka-Kazimierczak, Ewa Lech-Maranda, Andrzej Szczepaniak, Ryszard Wichary, Anna Dmoszynska
BACKGROUND: Patients with relapsed/refractory multiple myeloma (RRMM) have poor prognosis. Pomalidomide is an immunomodulatory compound that has demonstrated activity in MM patients with disease refractory to lanlidomide and bortezomib. OBJECTIVES: Participants of clinical trials are highly selected populations; therefore, the aim of this study was to present observations from real practice that might provide important information for practitioners. PATIENTS AND METHODS: We analyzed retrospectively 50 patients treated with pomalidomide in 12 Polish sites between 2014 and 2017...
June 8, 2018: European Journal of Haematology
Marina Osawa, Hideki Akiyama, Sunao Mae, Yuko Fujiwara, Michio Yamane
We report here a new adverse event of romiplostim which is a protein analog of thrombopoietin. Leukemic mature B-cell neoplasm was observed during the treatment of thrombocytopenia in a patient with liver cirrhosis. Their relationship was suggested clinically but the mechanism of leukemic expansion of lymphoma cells was not clarified.
June 2018: Clinical Case Reports
Anthony R Mato, Meghan Thompson, John N Allan, Danielle M Brander, John M Pagel, Chaitra S Ujjani, Brian T Hill, Nicole Lamanna, Frederick Lansigan, Ryan Jacobs, Mazyar Shadman, Alan P Skarbnik, Jeffrey J Pu, Paul M Barr, Alison R Sehgal, Bruce D Cheson, Clive S Zent, Hande H Tuncer, Stephen J Schuster, Peter V Pickens, Nirav N Shah, Andre Goy, Allison M Winter, Christine Garcia, Kaitlin Kennard, Krista Isaac, Colleen Dorsey, Lisa M Gashonia, Arun K Singavi, Lindsey E Roeker, Andrew Zelenetz, Annalynn Williams, Christina Howlett, Hanna Weissbrot, Naveed Ali, Sirin Khajavian, Andrea Sitlinger, Eve Tranchito, Joanna Rhodes, Joshua Felsenfeld, Neil Bailey, Bhavisha Patel, Timothy F Burns, Melissa Yacur, Mansi Malhotra, Jakub Svoboda, Richard R Furman, Chadi Nabhan
Venetoclax is a BCL2 inhibitor approved for 17p-deleted relapsed/refractory chronic lymphocytic leukemia with activity following kinase inhibitors. We conducted a multicenter retrospective cohort analysis of patients with CLL treated with venetoclax to describe outcomes, toxicities, and treatment selection following venetoclax discontinuation. A total of 141 chronic lymphocytic leukemia patients were included (98% relapsed/refractory). Median age at venetoclax initiation was 67 years (range 37-91), median prior therapies was 3 (0-11), 81% unmutated IGHV, 45% del(17p), and 26...
June 7, 2018: Haematologica
Constance C F M J Baaten, Floor C J I Moenen, Yvonne M C Henskens, Frauke Swieringa, Rick J H Wetzels, René van Oerle, Harry F G Heijnen, Hugo Ten Cate, Graham P Holloway, Erik A M Beckers, Johan W M Heemskerk, Paola E J van der Meijden
Severe thrombocytopenia (≤50x109 platelets/L) due to hematological malignancy and intensive chemotherapy is associated with an increased risk of clinically significant bleeding. Since the bleeding risk is not linked to the platelet count only, other hemostatic factors must be involved. In 77 patients with acute leukemia, multiple myeloma or malignant lymphoma, who experienced chemotherapy-induced thrombocytopenia, we studied platelet function. Platelets from all patients - independent of disease or treatment type - were to a variable extent compromised in Ca2+ flux, integrin αIIbβ3 activation and P-selectin expression, when stimulated with a panel of agonists...
June 7, 2018: Haematologica
Taiichiro Shirai, Akira Onishi, Daisuke Waki, Jun Saegusa, Akio Morinobu
RATIONALE: TAFRO syndrome is a systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly. In contrast to that in multicentric Castleman disease, interleukin-6 targeting strategies seem ineffective in some TAFRO syndrome cases; however, the optimal treatment remains unclear. Here, we report 2 cases of TAFRO syndrome, where 1 with cardiomyopathy, successfully treated with tacrolimus. This is the first case report of successful treatment with tacrolimus in TAFRO syndrome...
June 2018: Medicine (Baltimore)
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