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Sustained Remission

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https://www.readbyqxmd.com/read/29667099/analysis-of-relapse-rates-and-risk-factors-of-tapering-or-stopping-pharmacologic-therapies-in-axial-spondyloarthritis-patients-with-sustained-remission
#1
Xiaochan Chen, Ting Zhang, Wenwen Wang, Jing Xue
The objectives of this study are to evaluate whether tapering or stopping strategies of pharmacologic therapies are efficacious for maintaining remission in patients with axial spondyloarthritis (axSPA) and to analyze the risk factors of disease relapse. Patients diagnosed as axSPA with ankylosing spondylitis disease activity score based on C reactive protein (ASDAS-CRP) ≤2.0 for at least 3 months were randomized into three groups: continuing non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) (group 1), tapering NSAIDs and DMARDs by 50% (group 2), or discontinuing NSAIDs and DMARDs (group3) after 6 months of tapering...
April 18, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29662934/bevacizumab-for-refractory-gastrointestinal-bleeding-in-rendu-osler-weber-disease
#2
Carlos Bernardes, Sara Santos, Rafaela Loureiro, Verónica Borges, Gonçalo Ramos
Rendu-Osler-Weber disease, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant disorder which is often characterized by recurrent epistaxis, mucocutaneous and gastrointestinal telangiectasias, and visceral arteriovenous malformations. Patients with gastrointestinal involvement can present with a wide spectrum of severity, which may vary from uncomplicated iron deficiency anemia to continuous and refractory bleeding. We present the case of a 62-year-old female, who was admitted with anemia following several episodes of melena, and whose endoscopic examination revealed multiple angiodysplasias in the stomach and small bowel...
March 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29661469/successful-7-year-eculizumab-treatment-of-plasmapheresis-resistant-recurrent-atypical-hemolytic-uremic-syndrome-due-to-complement-factor-h-hybrid-gene-a-case-report
#3
K Vondrák, T Seeman
Atypical hemolytic-uremic syndrome (aHUS) is an extremely rare disease, and up to 70% of the patients have a genetic mutation in the encoding components of complement activation or anti-complement factor H autoantibodies. The risk of recurrence after kidney transplantation is 10% to 80%. Eculizumab, a monoclonal antibody that binds complement protein C5, has shown to be highly effective in patients with aHUS; however, there are only few reports on the efficacy and safety of long-term eculizumab treatment in children with recurrent aHUS...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29657830/conversion-to-seronegative-status-after-abatacept-treatment-in-patients-with-early-and-poor-prognostic-rheumatoid-arthritis-is-associated-with-better-radiographic-outcomes-and-sustained-remission-post-hoc-analysis-of-the-agree-study
#4
Diahann T S L Jansen, Paul Emery, Josef S Smolen, Rene Westhovens, Manuela Le Bars, Sean E Connolly, June Ye, René E M Toes, Tom W J Huizinga
Objective: To evaluate the effects of the T-cell costimulation blocker abatacept on anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF) in early rheumatoid arthritis (RA), and associations between changes in serological status and clinical response. Methods: Post hoc analysis of the phase III AGREE study in methotrexate (MTX)-naïve patients with early RA and poor prognostic factors. Patients were randomised to abatacept (~10 mg/kg intravenously according to weight range) or placebo, plus MTX over 12 months followed by open-label abatacept plus MTX for 12 months...
2018: RMD Open
https://www.readbyqxmd.com/read/29649264/age-at-antiretroviral-therapy-initiation-and-cell-associated-hiv-1-dna-levels-in-hiv-1-infected-children
#5
Louise Kuhn, Maria Paximadis, Bianca Da Costa Dias, Shayne Loubser, Renate Strehlau, Faeezah Patel, Stephanie Shiau, Ashraf Coovadia, Elaine J Abrams, Caroline T Tiemessen
BACKGROUND: The latent viral reservoir is the major obstacle to achieving HIV remission and necessitates life-long antiretroviral therapy (ART) for HIV-infected individuals. Studies in adults and children have found that initiating ART soon after infection is associated with a reduction in the size of the HIV-1 reservoir. Here we quantified cell-associated HIV-1 DNA in early-treated but currently older HIV-infected children suppressed on ART. METHODS: The study participants comprised of a cohort of 146 early-treated children with HIV-1 RNA <50 copies/ml enrolled as part of a clinical trial in Johannesburg, South Africa...
2018: PloS One
https://www.readbyqxmd.com/read/29629485/has-the-time-come-to-be-more-aggressive-with-bariatric-surgery-in-obese-patients-with-chronic-systolic-heart-failure
#6
REVIEW
Amanda R Vest
PURPOSE OF REVIEW: Obesity is a strong risk factor for the development of heart failure (HF). Diet, exercise, and weight-loss pharmacotherapies have limited potential to achieve significant and sustainable weight loss, especially in patients with symptomatic systolic HF. This review seeks to determine the role of bariatric surgery for patients with systolic HF and obesity. RECENT FINDINGS: Bariatric surgeries such as the laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) represent the most successful long-term strategy for achieving weight loss and diabetes and hypertension remission in the general obese population...
April 8, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29621765/nrf2-activation-induced-by-sirt1-ameliorates-acute-lung-injury-after-intestinal-ischemia-reperfusion-through-nox4-mediated-gene-regulation
#7
DongDong Chai, Lei Zhang, SiWei Xi, YanYong Cheng, Hong Jiang, Rong Hu
BACKGROUND/AIMS: Nuclear erythroid 2-related factor-2 (Nrf2) is a major stress-response transcription factor that has been implicated in regulating ischemic angiogenesis. We investigated the effects of Nrf2 in regulating revascularization and modulating acute lung injury. METHODS: The expression of Nrf2 and sirtuin1 (Sirt1) was assessed in lung tissue by western blotting and immunofluorescence staining after intestinal ischemia/reperfusion (IIR) in Nrf2-/- and wild-type (WT) mice...
March 29, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29610029/final-3-year-results-of-the-dasatinib-discontinuation-trial-in-patients-with-chronic-myeloid-leukemia-who-received-dasatinib-as-a-second-line-treatment
#8
Masaya Okada, Jun Imagawa, Hideo Tanaka, Hirohisa Nakamae, Masayuki Hino, Kazunori Murai, Yoji Ishida, Takashi Kumagai, Seiichi Sato, Kazuteru Ohashi, Hisashi Sakamaki, Hisashi Wakita, Nobuhiko Uoshima, Yasunori Nakagawa, Yosuke Minami, Masahiro Ogasawara, Tomoharu Takeoka, Hiroshi Akasaka, Takahiko Utsumi, Naokuni Uike, Tsutomu Sato, Sachiko Ando, Kensuke Usuki, Syuichi Mizuta, Satoshi Hashino, Tetsuhiko Nomura, Masato Shikami, Hisashi Fukutani, Yokiko Ohe, Hiroshi Kosugi, Hirohiko Shibayama, Yasuhiro Maeda, Toshihiro Fukushima, Hirohito Yamazaki, Kazuo Tsubaki, Toshimasa Kukita, Yoko Adachi, Toshiki Nataduka, Hiroto Sakoda, Hisayuki Yokoyama, Takahiro Okamoto, Yukari Shirasugi, Yasushi Onishi, Masaharu Nohgawa, Satoshi Yoshihara, Satoshi Morita, Junichi Sakamoto, Shinya Kimura
INTRODUCTION: We previously reported an interim analysis of the DADI (dasatinib discontinuation) trial. The results showed that 48% of patients with chronic myeloid leukemia in the chronic phase who maintained a deep molecular response (DMR) for ≥ 1 year could discontinue second- or subsequent-line dasatinib treatment safely at a median follow-up of 20 months. However, the results from longer follow-up periods would be much more useful from a clinical perspective. PATIENTS AND METHODS: The DADI trial was a prospective, multicenter trial conducted in Japan...
March 15, 2018: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29607225/breast-implant-associated-anaplastic-large-cell-lymphoma-case-report-and-review-of-the-literature
#9
Eva Berlin, Kunwar Singh, Christopher Mills, Ilan Shapira, Richard L Bakst, Manjeet Chadha
We are reporting the case of a 58-year-old woman with history of bilateral silicone breast implants for cosmetic augmentation. At 2-year interval from receiving the breast implants, she presented with swelling of the right breast with associated chest wall mass, effusion around the implant, and axillary lymphadenopathy. Pathology confirmed breast implant-associated anaplastic large cell lymphoma (stage III, T4N2M0, using BIA-ALCL TNM staging and stage IIAE, using Ann-Arbor staging). The patient underwent bilateral capsulectomy and right partial mastectomy with excision of the right breast mass and received adjuvant CHOP chemotherapy and radiation to the right breast and regional nodes...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29602164/the-impact-of-patient-global-assessment-in-the-definition-of-remission-as-a-predictor-of-long-term-radiographic-damage-in-patients-with-rheumatoid-arthritis-protocol-for-an-individual-patient-data-meta-analysis
#10
Ricardo J O Ferreira, Paco M J Welsing, Laure Gossec, Johannes W G Jacobs, Pedro M Machado, Mwidimi Ndosi, Désirée van der Heijde, José A P da Silva
BACKGROUND: Remission is the target for management of rheumatoid arthritis (RA) and intensification of immunosuppressive therapy is recommended for those that do not achieve this status. Patient global assessment (PGA) is the single patient reported outcome considered in the American College of Rheumatology/European League Against Rheumatism remission criteria, but its use as target has been questioned. The primary aim of this study is to assess whether excluding PGA from the definition of disease remission changes the association of disease remission with long-term radiographic damage and physical function in patients with RA...
January 2018: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/29601825/identification-of-endpoints-for-development-of-anti-fibrosis-drugs-for-treatment-of-crohn-s-disease
#11
Silvio Danese, Stefanos Bonovas, Anthony Lopez, Gionata Fiorino, William J Sandborn, David T Rubin, Michael A Kamm, Jean-Frederic Colombel, Bruce E Sands, Severine Vermeire, Julian Panes, Gerhard Rogler, Geert D'Haens, Laurent Peyrin-Biroulet
BACKGROUND & AIMS: Intestinal fibrosis is a challenge to management of patients with Crohn's disease (CD); there is an urgent need to expedite development of anti-fibrosis drugs for this disease. The International Organization for the Study of Inflammatory Bowel Disease (IOIBD) aimed to identify a set of endpoints that can be used to determine efficacy of anti-fibrosis agents tested in clinical trials of patients with CD. METHODS: We conducted a systematic review to identify clinical, radiologic, biochemical, endoscopic, and composite endpoints used in assessing activity of fibrostenosing CD and response to treatment, and determined their operational properties...
March 27, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29600935/rheumatoid-arthritis-patients-achieved-better-quality-of-life-than-systemic-lupus-erythematosus-patients-at-sustained-remission
#12
Virginia Pascual-Ramos, Irazú Contreras-Yáñez, Katya R Valencia-Quiñones, Juanita Romero-Díaz
OBJECTIVES: In 2004 and 1999, respectively, recent-onset rheumatoid arthritis (RA) and systemic lupus erythematous (SLE) cohorts were initiated; the 36 item Medical Outcome Study Short-Form survey (SF-36) was applied beginning from enrolment. The objectives were to compare the SF-36v2 scores between patients from both cohorts who achieved sustained remission and to define the role of disease diagnosis as associated to SF-36v2 normative data in remission patients. METHODS: Sustained remission was considered when RA and SLE patients achieved at least 12 months of continuous follow-up with either SLE disease activity index 2000 update =0 or Disease Activity Score (28 joints) ≤2...
March 21, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29593048/effect-of-short-term-art-interruption-on-levels-of-integrated-hiv-dna
#13
Zachary Strongin, Radwa Sharaf, D Jake VanBelzen, Jeffrey M Jacobson, Elizabeth Connick, Paul Volberding, Daniel J Skiest, Rajesh T Gandhi, Daniel R Kuritzkes, Una O'Doherty, Jonathan Z Li
Analytic treatment interruption (ATI) studies are required to evaluate strategies aimed at achieving ART-free HIV remission, but the impact of ATI on the viral reservoir remains unclear. We validated a DNA size selection-based assay for measuring levels of integrated HIV DNA and applied it to assess the effects of short-term ATI on the HIV reservoir. Samples from participants from four AIDS Clinical Trials Group (ACTG) ATI studies were assayed for integrated HIV DNA levels. Cryopreserved PBMCs were obtained for 12 participants with available samples pre-ATI and approximately 6 months after ART resumption...
March 28, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29587851/clinical-and-mri-remission-in-patients-with-nonradiographic-axial-spondyloarthritis-who-received-long-term-open-label-adalimumab-treatment-3-year-results-of-the-ability-1-trial
#14
Désirée van der Heijde, Joachim Sieper, Walter P Maksymowych, Robert G Lambert, Su Chen, Maja Hojnik, Jaclyn K Anderson, Aileen L Pangan
BACKGROUND: Adalimumab was effective in treating patients with nonradiographic axial spondyloarthritis (nr-axSpA) in the 12-week ABILITY-1 trial. We present long-term efficacy and safety results of adalimumab from the open-label ABILITY-1 extension, including the relationship between clinical and magnetic resonance imaging (MRI) remission and impact of sustained clinical remission on physical function. METHODS: Patients received adalimumab 40 mg every other week or placebo for 12 weeks, then open-label adalimumab for up to 144 weeks...
March 27, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29572374/case-of-a-fractured-human-bone-fragment-as-an-endobronchial-foreign-body-following-a-traffic-incident
#15
Kouko Hidaka, Tetsushi Takeda, Masamichi Nakayama, Hirohisa Yano
Endobronchial foreign bodies (EFBs) are present in various settings, such as eating or dental procedure. Accidental aspiration of foreign bodies is more common in children; however, cases of adult foreign body aspiration exist. Traumatic incidents can precipitate endobronchial aspiration of foreign bodies. Loss of consciousness, such as in coma, can result in foreign bodies being easily inhaled into the airways. Teeth or vehicle parts have been reported as EFBs following traumatic incidents. We report on a patient with chronic, sustained cough following maxillofacial trauma...
March 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29570475/tocilizumab-in-giant-cell-arteritis
#16
Vincent J Mariano, William H Frishman
Giant cell arteritis is a granulomatous immune-mediated vasculitis of medium and large vessels. It most commonly affects Caucasian females over the age of 50 and is the most common primary vasculitis in the United States. Treatment of this disease has classically been with high-dose corticosteroids, but this therapy has been associated with severe morbidity and mortality. Tocilizumab, a humanized monoclonal antibody targeting the interleukin-6 receptor, has been used with great efficacy and safety in rheumatoid arthritis and systemic-onset juvenile idiopathic arthritis...
March 22, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29562271/vedolizumab-as-induction-and-maintenance-for-inflammatory-bowel-disease-12-month-effectiveness-and-safety
#17
Britt Christensen, Ruben J Colman, Dejan Micic, Peter R Gibson, Sarah R Goeppinger, Andres Yarur, Christopher R Weber, Russell D Cohen, David T Rubin
Background: Vedolizumab is approved for moderate to severe Crohn's disease (CD) and ulcerative colitis (UC). We present prospective, 1-year data of the real-world effectiveness and safety of vedolizumab in inflammatory bowel disease. Methods: Consecutive patients receiving vedolizumab for treatment of UC or CD with at least 14 weeks of follow-up, regardless of outcome, were included. Patients had clinical activity scores (Harvey-Bradshaw Index [HBI] or Simple Clinical Colitis Activity Index [SCCAI]) and inflammatory markers prospectively measured at baseline and weeks 14, 30, and 52...
March 19, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29548010/stopping-biologics-in-ibd-what-is-the-evidence
#18
Edouard Louis
Biologic treatments have revolutionized the way we treat inflammatory bowel disease patients (IBD). Anti-tumor necrosis factor (anti-TNF) antibodies are superior to conventional therapies to achieve sustained remission without steroids and mucosal healing. The objective of IBD treatment has evolved from symptom alleviation to a combination of absence of symptoms and intestinal healing. Nevertheless, biologics are expensive and are associated with an increased risk of infections and possibly skin cancers. Therefore, the duration of these treatments may be questioned, and stopping them may be contemplated by some patients and clinicians, while it is sometimes even imposed by some jurisdictions across the world...
March 14, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29547411/novel-therapies-hopes-for-hiv-cure-in-perinatally-acquired-hiv-positive-adolescents
#19
Thomas Joshua Pasvol, Caroline Foster, Sarah Fidler
PURPOSE OF REVIEW: Successful roll-out of paediatric antiretroviral therapy (ART) has led to a significant increase in survival of adolescents and young people growing up with HIV. Those on suppressive ART since childhood represent a unique group particularly well positioned to interrupt ART and achieve post-treatment control (PTC), or HIV remission. This maybe a consequence of early and sustained treatment since infancy, the small size of the HIV reservoir, the presence of a functioning thymus and a more 'flexible' immune system better able to respond to novel immune therapeutic interventions when compared with adults who acquired HIV at a time of immunological maturity and thymic involution...
March 14, 2018: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/29541474/early-diagnosis-of-idiopathic-pulmonary-haemosiderosis-increased-haemosiderin-laden-macrophages-in-repeat-bronchoscopy
#20
Yuichi Mukai, Toshihiko Agatsuma, Gen Ideura
Idiopathic pulmonary haemosiderosis (IPH) is a diagnosis of exclusion, which is characterized by persistent or recurrent episodes of alveolar haemorrhage. Early diagnosis of IPH, especially in the case of first-time manifestation, is challenging because previous episodes of alveolar haemorrhage are often difficult to prove. Repeated episodes of alveolar haemorrhage can result in chronic iron-deficient anaemia and irreversible interstitial fibrosis; thus, early recognition and intervention are desirable in terms of clinical outcome...
April 2018: Respirology Case Reports
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