Early treatment of reactive arthritis with etanercept and 2 years follow-up

2017 ◽  
Vol 84 (3) ◽  
pp. 367 ◽  
Author(s):  
Audrey Courcoul ◽  
Olivier Muis Pistor ◽  
Jacques G. Tebib ◽  
Fabienne Coury
Keyword(s):  
Early Treatment ◽  
Reactive Arthritis

scholarly journals Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Sæmundur Rögnvaldsson ◽  
Thorvardur Jon Love ◽  
Sigrun Thorsteinsdottir ◽  
Elín Ruth Reed ◽  
Jón Þórir Óskarsson ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Early Treatment ◽  
Monoclonal Gammopathy ◽  
Controlled Trial ◽  
Participation Rate ◽  
Population Based ◽  
Early Therapy ◽  
Screening Study ◽  
Undetermined Significance

AbstractMonoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Population-based screening for MGUS could identify candidates for early treatment in MM. Here we describe the Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM), the first population-based screening study for MGUS including a randomized trial of follow-up strategies. Icelandic residents born before 1976 were offered participation. Blood samples are collected alongside blood sampling in the Icelandic healthcare system. Participants with MGUS are randomized to three study arms. Arm 1 is not contacted, arm 2 follows current guidelines, and arm 3 follows a more intensive strategy. Participants who progress are offered early treatment. Samples are collected longitudinally from arms 2 and 3 for the study biobank. All participants repeatedly answer questionnaires on various exposures and outcomes including quality of life and psychiatric health. National registries on health are cross-linked to all participants. Of the 148,704 individuals in the target population, 80 759 (54.3%) provided informed consent for participation. With a very high participation rate, the data from the iStopMM study will answer important questions on MGUS, including potentials harms and benefits of screening. The study can lead to a paradigm shift in MM therapy towards screening and early therapy.

scholarly journals Stewart–Treves syndrome: a case report

2013 ◽  
Vol 95 (5) ◽  
pp. e6-e8 ◽  
Author(s):  
DG McKeown ◽  
PJ Boland
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Early Treatment ◽  
Radical Mastectomy ◽  
Node Dissection ◽  
Modified Radical Mastectomy ◽  
Patient Death ◽  
Cutaneous Lesions ◽  
Chemotherapeutic Treatment

We present a case of chronic lymphoedema that progressed to Stewart–Treves syndrome in a 63-year-old woman with a previous modified radical mastectomy, associated lymph node dissection, chemotherapy and radiotherapy. While producing stabilisation of most cutaneous lesions initially, chemotherapeutic treatment of the angiosarcoma did not prevent subsequent metastasis and patient death. We urge vigilance and regular follow-up appointments for patients following a mastectomy with chronic lymphoedema to facilitate prevention or early treatment of this devastating syndrome.

scholarly journals Reactive Arthritis Secondary to Cauda Equina Injury following Spine Fracture: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Xiao Li ◽  
Shaoling Wu ◽  
Chao Ma
Keyword(s):  
Urinary Tract Infection ◽  
Reactive Arthritis ◽  
Early Recognition ◽  
Burst Fracture ◽  
Cauda Equina ◽  
Spine Fracture ◽  
Appropriate Treatment ◽  
Delayed Initiation ◽  
History Of

A 38-year-old man presented with a one-month history of muscle weakness and dysesthesia in the lower extremities, urinary retention, and urinary tract infection after lumbar burst fracture resulted from high fall. During the rehabilitation in our hospital, he had arthritis in both the ankle and knee. However, the patient was treated as gouty arthropathy initially. The arthritis was completely remitted in a few days after the patient was diagnosed as reactive arthritis and started with sulfasalazine therapy and there was no recurrence during 4 months of follow-up. Based on this case, early recognition of reactive arthritis is of major importance to avoid delayed initiation of appropriate treatment in the patients with polyarthritis secondary to neurogenic bladder following cauda equina injury after spine fracture.

scholarly journals Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)

2020 ◽  
Vol 79 (5) ◽  
pp. 605-611
Author(s):  
Riitta Tuompo ◽  
Tinja Lääveri ◽  
Timo Hannu ◽  
Sari H Pakkanen ◽  
Juha Kirveskari ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multivariate Analysis ◽  
Antibiotic Treatment ◽  
Reactive Arthritis ◽  
Musculoskeletal Symptoms ◽  
E Coli ◽  
Increased Risk ◽  
Stool Samples ◽  
Study Participants

ObjectivesUsing a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers.MethodsA total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed.ResultsFrom among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers’ diarrhoea did not prevent development of MSK symptoms.ConclusionA total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms.

scholarly journals Myofunctional Treatment of Anterior Crossbite in a Growing Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Marianna Pellegrino ◽  
Maria Laura Cuzzocrea ◽  
Walter Rao ◽  
Gioacchino Pellegrino ◽  
Sergio Paduano
Keyword(s):  
Growth Pattern ◽  
Early Treatment ◽  
Mixed Dentition ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Night Time ◽  
Therapy Strategy ◽  
Aesthetic Results ◽  
Mandibular Protrusion

The purpose of this case report is to add another means of treatment for the anterior crossbite malocclusion in early mixed dentition. The selected functional device is an eruption guidance appliance (EGA). The analysed patient had a functional anterior crossbite, a mandibular protrusion tendency, and a normodivergent growth pattern. The early treatment was suggested to correct the malocclusion and avoid unfavourable occlusal conditions that could end in a class III malocclusion growth pattern. After 18 months of treatment, with night-time use, the malocclusion was completely resolved. This therapy strategy allowed the correction of the sagittal jaws’ relationship and maximum control of the vertical dimension. After 2 years of follow-up, the results were preserved. The peculiarity of this kind of intraoral orthodontic tools is the use of the erupting forces rather than the active forces. This early treatment of anterior crossbites with EGA may be considered an effective treatment approach for achieving good functional and aesthetic results.

Phase II trial of preoperative cisplatin-irinotecan followed by concurrent cisplatin-irinotecan and radiotherapy: PET scan after induction therapy may identify early treatment failure

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4023-4023 ◽  
Author(s):  
D. H. Ilson ◽  
M. Bains ◽  
N. Rizk ◽  
M. Shah ◽  
V. Rusch ◽  
...  
Keyword(s):  
Phase Ii ◽  
Early Treatment ◽  
Phase Ii Trial ◽  
Prognostic Significance ◽  
Feeding Tube ◽  
Pet Scan ◽  
R0 Resection ◽  
The Mean ◽  
C 30

4023 Background: Response on PET scan during preoperative chemotherapy (chemo) for esophageal cancer (EC) has prognostic significance [JCO 19:3058;2001]. Induction chemo with weekly irinotecan(I)/cisplatin(C) relieves dysphagia, and weekly I/C administered with radiotherapy (RT) is well tolerated [ProcASCO 23:Abs 4017;2005]. We completed a Phase II trial of induction I/C followed by I/C/RT followed by surgery. Repeat PET scan was performed after induction chemo and prior to RT. Methods: Patients (pts) with resectable EC/GE junction carcinoma were staged with EUS, PET, and CT scan. Induction chemo consisted of I-65 mg/m2 and C-30 mg/m2 weeks 1,2,4,5, and weeks 7,8,10,11 with RT (180 cGy daily fractions to 5040 cGy). PET scan was repeated at week 6. Esophagectomy was planned 4–8 weeks after RT. Results: 60 pts were enrolled: 6 inevaluable, 54 evaluable, 3 await surgery; 49 male (91%), 5 female (9%), 41 adenocarcinoma (76%), 13 squamous (24%), median age 59, median PS 0, EUS T3N1 35 (65%), N1 40 (74%). Of 41 pts with dysphagia, 31 (76%) had resolution/improvement with induction chemo and 3/54 (6%) required a feeding tube. Of 51 pts, 3 clinical complete responders (CR) deferred surgery (1 refusal, 2 medically inoperable). Of 48 pts, 4 progressed during induction (8%), 9 progressed during RT (19%), and 35 underwent R0 resection (73%). 9/48 (19%) achieved pathologic CR. The median overall survival was 35.4 mos (median follow up 15 mos). In exploratory analysis in 54 pts, response after induction on the week 6 PET scan measured as a decline in SUV, correlated with time to tumor progression (TTP). The mean change in SUV was 43%. A set point of 22% or greater decline in SUV (PET responder) yielded the greatest distinction in TTP (PET responders TTP 18.5 mos, vs nonresponders 5.5 mos, p = 0.03). 4 pts with progression during induction crossed over to RT with paclitaxel: 3 (2 squamous, 1 adenocarcinoma) achieved durable disease control (one pathologic CR, one pathologic PR, one clinical CR). Conclusions: Response on PET scan during induction chemo for EC may identify early treatment failures, and may direct pts to successful salvage with alternative chemo during RT. Supported by a grant from Pfizer. [Table: see text]

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