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https://www.readbyqxmd.com/read/27913512/walking-a-tightrope-clinical-use-of-ibrutinib-in-mantle-cell-lymphoma-in-the-elderly
#1
Marco Ruella, Pierre Soubeyran
Representative clinical case. A 74-year-old male patient was diagnosed with stage 3 mantle cell lymphoma in 2012. Because he was ineligible for intensive treatment (age, previous myocardial infarction [MI]), he received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemoimmunotherapy for 6 cycles (reaching complete response) and then rituximab maintenance (RM) for 2 years. One year after the end of RM, he relapsed with disseminated disease. He was started on ibrutinib 560 mg/day...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913503/diffuse-large-b-cell-lymphoma-r-chop-failure-what-to-do
#2
Bertrand Coiffier, Clémentine Sarkozy
Although rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the standard treatment for patients with diffuse large B-cell lymphoma (DLBCL), ∼30% to 50% of patients are not cured by this treatment, depending on disease stage or prognostic index. Among patients for whom R-CHOP therapy fails, 20% suffer from primary refractory disease (progress during or right after treatment) whereas 30% relapse after achieving complete remission (CR). Currently, there is no good definition enabling us to identify these 2 groups upon diagnosis...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913497/response-adapted-frontline-therapy-for-hodgkin-lymphoma-are-we-there-yet
#3
Peter W M Johnson
Treating Hodgkin lymphoma by using chemotherapy with or without radiotherapy is highly successful, with substantially fewer deaths from lymphoma than from other causes in recent studies of both early-stage and advanced-stage disease. Long-term toxicity is a major consideration in this context, and recent trials have used functional imaging with [(18)F]fluorodeoxyglucose (FDG) positron emission tomography early in the course of treatment (interim PET) to assess response and modulate subsequent therapy. In early-stage disease, this has allowed omission of consolidation radiotherapy after a good response to doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy, and trials have shown that this can be done without detriment to overall survival, despite a small increase in rates of recurrence of ∼5%...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27905899/a-case-of-extragastrointestinal-stromal-tumor-complicated-by-severe-hypoglycemia-a-unique-presentation-of-a-rare-tumor
#4
Zeb Saeed, Solaema Taleb, Carmella Evans-Molina
BACKGROUND: Non-Islet Cell Tumor Hypoglycemia (NICTH) is a rare paraneoplastic cause of hypoglycemia arising from excess tumor production of insulin-like growth factor. The objective of this report is to describe an unusual case of Extragastrointestinal Stromal Tumor (EGIST) associated NICTH. CASE PRESENTATION: A 64 year-old African female was brought to the emergency room with a 1-month history of recurrent syncope, weight loss, and abdominal bloating. Serum blood glucose was discovered to 39 mg/dL, when insulin, proinsulin, and C-peptide were suppressed...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27900974/disseminated-mycobacteria-chelonae-infection-in-a-kidney-pancreas-transplant-recipient-a-case-report-and-review-of-the-literature
#5
Shafi Malik, Ananda Ghosh, Shahid Husain
A 40-year-old male with a long-standing history of type 1 diabetes with end-stage renal failure underwent combined kidney-pancreas (KP) transplant from a standard criteria donor. Post-operative course was uncomplicated with good primary function of both transplant grafts. Induction was with thymoglobulin and maintenance immunosuppression was with tacrolimus, mycophenolate mofetil and prednisolone. Nine weeks post-transplant, the patient developed dysfunction of both grafts. Panel reactive antibody testing revealed that the patient had developed a de novo donor-specific antibody and considering an antibody-mediated rejection the patient was treated with intravenous pulse methyl prednisone 500 mg ×3 doses, IV immunoglobulin 2 mg/kg in two divided doses, and ATG 7 mg/kg (total dose of 700 mg)...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27895780/curcumin-potentiates-the-effect-of-chemotherapy-against-acute-lymphoblastic-leukemia-cells-via-downregulation-of-nf-%C3%AE%C2%BAb
#6
Helia Judith Pimentel-Gutiérrez, Lucina Bobadilla-Morales, César Cenobio Barba-Barba, Citlalli Ortega-De-La-Torre, Fernando Antonio Sánchez-Zubieta, Jorge Román Corona-Rivera, Betsy Annel González-Quezada, Juan S Armendáriz-Borunda, Rocío Silva-Cruz, Alfredo Corona-Rivera
Acute lymphoblastic leukemia (ALL) accounts for 30% of all pediatric cancers. Currently available treatments exhibit toxicity and certain patients may develop resistance. Thus, less toxic and chemoresistance-reversal agents are required. In the present study, the potential effect of curcumin, a component of Curcuma longa, as a pharmacological co-adjuvant of several chemotherapeutic agents against ALL, including prednisone, 6-mercaptopurine, dexamethasone, cyclophosphamide, l-asparaginase, vincristine, daunorubicin, doxorubicin, methotrexate and cytarabine, was investigated in the REH ALL cell line cultures treated in combination with chemotherapeutic agents and curcumin...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27893685/acute-liver-failure-caused-by-hemophagocytic-lymphohistiocytosis-in-adults-a-case-report-and-review-of-the-literature
#7
Shide Lin, Ying Li, Jun Long, Qichuan Liu, Fangwan Yang, Yihuai He
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare condition that can be caused by a primary or acquired disorder of uncontrolled immune response. Liver injury is a common complication of HLH; however, HLH presenting as acute liver failure (ALF) has rarely been reported in adults. CASE SUMMARY: A 34-year-old man was admitted to our hospital with nausea and fatigue persisting for 2 weeks and jaundice for 1 week. He had hyperthermia at the onset of disease...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27891588/whole-body-mri-reveals-high-incidence-of-osteonecrosis-in-children-treated-for-hodgkin-lymphoma
#8
Annemieke S Littooij, Thomas C Kwee, Goya Enríquez, Jonathan I M L Verbeke, Claudio Granata, Auke Beishuizen, Charlotte de Lange, Floriana Zennaro, Marrie C A Bruin, Rutger A J Nievelstein
Osteonecrosis is a well-recognized complication in patients treated with corticosteroids. The incidence of osteonecrosis in children treated for Hodgkin lymphoma is unknown because prospective whole-body magnetic resonance imaging (MRI) studies are lacking in this patient population. Paediatric patients with newly diagnosed Hodgkin lymphoma who were treated according to a uniform paediatric Hodgkin protocol were eligible for inclusion in this prospective study. Whole-body MRI was performed in all 24 included patients (mean age 15·1 years, 12 girls) both before treatment and after 2 cycles of chemotherapy, and in 16 patients after completion of chemotherapy...
November 28, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27891382/a-case-of-immune-thrombocytopenic-purpura-secondary-to-pulmonary-tuberculosis
#9
Sameer Panda, Lalit Kumar Meher, Siba Prasad Dalai, Sachidananda Nayak, Sujit Kumar Tripathy
The haematological abnormalities associated with active pulmonary tuberculosis were known to human beings since decades but Immune Thrombocytopenic Purpura (ITP) secondary to pulmonary tuberculosis have been reported only in a couple of instances. We report a 27 year-old male patient who was admitted to our hospital with fever, shortness of breath, haematuria, epistaxis and generalized petechiae. The sputum positivity for Acid Fast Bacilli (AFB) and chest X-ray reports were suggestive of active pulmonary tuberculosis in our patient...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27891268/a-case-report-describing-a-rare-presentation-of-simultaneous-occurrence-of-mpo-anca-associated-vasculitis-and-rheumatoid-arthritis
#10
Nathalie Foray, Tamer Hudali, Muralidhar Papireddy, John Gao
Background. Renal-limited myeloperoxidase vasculitis with simultaneous rheumatoid arthritis is reported as a rare occurrence. Review of literature suggests that most patients had a diagnosis of rheumatoid arthritis for several years prior to presenting with renal failure from myeloperoxidase vasculitis. Case Presentation. A 58-year-old Caucasian male presented to the hospital experiencing malaise, fevers, decreased oral intake, nausea, and vomiting for one week duration. His past medical history consisted of newly diagnosed but untreated rheumatoid arthritis, hypertension, and non-insulin-dependent diabetes mellitus...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27891149/corynebacterium-propinquum-a-rare-cause-of-prosthetic-valve-endocarditis
#11
Umair Jangda, Ankit Upadhyay, Farshad Bagheri, Nilesh R Patel, Robert I Mendelson
Nondiphtheria Corynebacterium species are often dismissed as culture contaminants, but they have recently become increasingly recognized as pathologic organisms. We present the case of a 48-year-old male patient on chronic prednisone therapy for rheumatoid arthritis with a history of mitral valve replacement with prosthetic valve. He presented with fever, dizziness, dyspnea on exertion, intermittent chest pain, and palpitations. Transesophageal echocardiography revealed two medium-sized densities along the inner aspect of the sewing ring and one larger density along the atrial surface of the sewing ring consistent with vegetation...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27888478/examining-the-quality-of-medicines-at-kenyan-healthcare-facilities-a-validation-of-an-alternative-post-market-surveillance-model-that-uses-standardized-patients
#12
Francis Wafula, Amy Dolinger, Benjamin Daniels, Njeri Mwaura, Guadalupe Bedoya, Khama Rogo, Ana Goicoechea, Jishnu Das, Bernard Olayo
BACKGROUND: Promoting access to medicines requires concurrent efforts to strengthen quality assurance for sustained impact. Although problems of substandard and falsified medicines have been documented in low- and middle-income countries, reliable information on quality is rarely available. OBJECTIVE: The aim of this study was to validate an alternative post-market surveillance model to complement existing models. METHODS: The study used standardized patients or mystery clients (people recruited from the local community and trained to pose as real patients) to collect medicine samples after presenting a pre-specified condition...
November 25, 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27887650/the-anti-inflammatory-effect-of-andrographis-paniculata-burm-f-nees-on-pelvic-inflammatory-disease-in-rats-through-down-regulation-of-the-nf-%C3%AE%C2%BAb-pathway
#13
Wei Zou, Zuoqi Xiao, Xiaoke Wen, Jieying Luo, Shuqiong Chen, Zeneng Cheng, Daxiong Xiang, Jian Hu, Jingyu He
BACKGROUND: Andrographis paniculata (Burm. f.) Nees (APN), a principal constituent of a famous traditional Chinese medicine Fukeqianjin tablet which is used for the treatment of pelvic inflammatory disease (PID), has been reported to have anti-inflammatory effect in vitro. However, whether it has pharmacological effect on PID in vivo is unclear. Therefore, the aim of this study is to test the anti-inflammatory effect of APN and illuminate a potential mechanism. METHODS: Thirty-six female specific pathogen-free SD rats were randomly divided into control group, PID group, APN1 group, APN2 group, APN3 group and prednisone group...
November 25, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27884822/a-framework-for-remission-in-sle-consensus-findings-from-a-large-international-task-force-on-definitions-of-remission-in-sle-doris
#14
Ronald van Vollenhoven, Alexandre Voskuyl, George Bertsias, Cynthia Aranow, Martin Aringer, Laurent Arnaud, Anca Askanase, Petra Balážová, Eloisa Bonfa, Hendrika Bootsma, Dimitrios Boumpas, Ian Bruce, Ricard Cervera, Ann Clarke, Cindy Coney, Nathalie Costedoat-Chalumeau, László Czirják, Ronald Derksen, Andrea Doria, Thomas Dörner, Rebecca Fischer-Betz, Ruth Fritsch-Stork, Caroline Gordon, Winfried Graninger, Noémi Györi, Frédéric Houssiau, David Isenberg, Soren Jacobsen, David Jayne, Annegret Kuhn, Veronique Le Guern, Kirsten Lerstrøm, Roger Levy, Francinne Machado-Ribeiro, Xavier Mariette, Jamil Missaykeh, Eric Morand, Marta Mosca, Murat Inanc, Sandra Navarra, Irmgard Neumann, Marzena Olesinska, Michelle Petri, Anisur Rahman, Ole Petter Rekvig, Jozef Rovensky, Yehuda Shoenfeld, Josef Smolen, Angela Tincani, Murray Urowitz, Bernadette van Leeuw, Carlos Vasconcelos, Anne Voss, Victoria P Werth, Helena Zakharova, Asad Zoma, Matthias Schneider, Michael Ward
OBJECTIVES: Treat-to-target recommendations have identified 'remission' as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE. METHODS: An international task force of 60 specialists and patient representatives participated in preparatory exercises, a face-to-face meeting and follow-up electronic voting...
November 24, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27884821/the-effect-of-different-durations-of-remission-on-damage-accrual-results-from-a-prospective-monocentric-cohort-of-caucasian-patients
#15
Margherita Zen, Luca Iaccarino, Mariele Gatto, Silvano Bettio, Francesca Saccon, Anna Ghirardello, Leonardo Punzi, Andrea Doria
AIM: To identify the shortest duration of remission associated with improved outcomes in systemic lupus erythematosus (SLE). METHODS: We studied 293 Caucasian patients with SLE during 7-year follow-up. Disease activity was assessed by SLE Disease Activity Index 2000 and damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). We defined three remission levels: complete, clinical off-corticosteroids, clinical on-corticosteroids (prednisone 1-5 mg/day)...
November 24, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27884537/-nephrotic-syndrome-complicated-by-chylous-ascites-in-a-girl-of-2%C3%A2-years-and-8%C3%A2-months-old
#16
J R Mabiala Babela, L C Ollandzobo Ikobo, R Loumingou, E R Nika, A Mouko
We report on a case of nephrotic syndrome with focal and segmental hyalinosis complicated by chylous ascites in a girl of 2 years and 8 months old. This pure nephrotic syndrome in its early stage was initially treated with intensive steroid treatment at 2mg/kg/day orally for 2 months, followed by a bolus of methylprednisolone. The persistence of proteinuria meant corticosteroid resistance. Renal biopsy then revealed focal and segmental hyalinosis. A recurrence of the edema-ascites syndrome was associated with macroscopic hematuria...
November 21, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27882163/insulin-induced-autoimmune-syndrome-a-case-report
#17
Jian-Ping Chu, Xiao-Wei Zheng, Jie Lu, Jin-Yan Zhong, Jia-Lin Li, Miao Xu, Fang Lin
Insulin autoimmune syndrome (IAS) is a disease characterized by hyperinsulinemic hypoglycemia associated with autoantibodies against endogenous insulin. A 56-year-old man was admitted to Ningbo First Hospital for the treatment of spontaneous hypoglycemia. He was found to have elevated fasting insulin level (>1,000 mIU/l) and presence of insulin autoantibodies, and after appropriate workup, was diagnosed with IAS. After treating with prednisone for 2 months, his insulin level started decreasing. In patients with repeated hypoglycemia, IAS should be considered in the differential diagnosis...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27881910/low-dose-modified-release-prednisone-in-axial-spondyloarthritis-3-month-efficacy-and-tolerability
#18
Francesca Bandinelli, Francesco Scazzariello, Emanuela Pimenta da Fonseca, Mittermayer Barreto Santiago, Claudio Marcassa, Francesca Nacci, Marco Matucci Cerinic
BACKGROUND: Oral glucocorticoids (GCs) have been shown to be effective in reducing the inflammatory symptoms of rheumatoid arthritis, but their use is not supported by evidence in spondyloarthritis (SpA). Modified-release (MR) oral prednisone taken at bedtime has been shown to be more effective than immediate-release prednisone taken in the morning. The efficacy of low-dose MR prednisolone in patients with SpA is unknown. PATIENTS AND METHODS: This single-center cohort study retrospectively assessed the effectiveness and safety of 12-week low-dose MR prednisone (5 mg daily, bedtime administration) in GC-naïve adult patients with symptomatic axial SpA...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27879427/abnormality-in-hippocampal-signal-intensity-predicts-atrophy-in-patients-with-systemic-lupus-erythematosus
#19
A T Lapa, T Pedro, J Francischinelli, A C Coan, L T Lavras Costallat, F Cendes, S Appenzeller
OBJECTIVES: To quantify signal abnormalities in the hippocampus (Hsig) of patients with systemic lupus erythematosus (SLE) and to determine if Hsig predict hippocampal atrophy (HA) in SLE. METHODS: We included all SLE patients and healthy age- and sex-matched individuals with two magnetic resonance imaging (MRI) scans performed with a minimum of 1 year interval. All individuals underwent a standardized neuropsychological evaluation. Individual results were converted into standard scores and compared to normative data...
November 22, 2016: Lupus
https://www.readbyqxmd.com/read/27878318/-corticosteroids-in-the-management-of-advanced-prostate-cancer
#20
H Kübler
Corticosteroids have been widely used for decades in cancer therapy, predominantly due to their anti-inflammatory activity. In the treatment of metastatic castration-resistant prostate cancer (mCRPC), corticosteroids play an important role both in the management of tumor-related symptoms, especially bone metastasis-related pain, and as concomitant treatment to counteract side effects associated with approved active prostatic anticancer agents such as docetaxel, cabazitaxel, and abiraterone acetate. In association with abiraterone acetate, low-dose corticosteroids (prednisone or prednisolone) reduce the mineralocorticoid side effects of abiraterone...
November 22, 2016: Der Urologe. Ausg. A
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