EXPERIENCE OF USING TOCILIZUMAB IN THERAPY OF TAKAYASU ARTERITIS IN CHILDREN

2021 ◽  
Vol 100 (5) ◽  
pp. 145-151
Author(s):  
V.A. Podzolkova ◽  
◽  
G.A. Lyskina ◽  
Yu.O. Kostina ◽  
V.A. Seraya ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Standard Therapy ◽  
Adverse Reactions ◽  
Activity Index ◽  
Active Form ◽  
P Value ◽  
Efficacy And Safety ◽  
Reactive Protein ◽  
Maintenance Of Remission ◽  
The Right

The prognosis of Takayasu arteritis (TA) depends on timely and adequate therapy, but in about half of patients, the disease is refractory to standard therapy or recurs against the background of a decrease in the dose of glucocorticoids (GCs). The use of biological disease-modifying antirheumatic drugs (bDMARDs) in the treatment of TA looks promising, however, the experience of their use in TA in children is presented by isolated observations. Objective of the study: to evaluate the efficacy and safety of tocilizumab (TCZ) in the treatment of refractory and recurrent forms of TA in children. Materials and methods of research: the study retrospectively included 9 children who were prescribed TCZ when standard therapy was ineffective. Before starting TCZ therapy, all patients were diagnosed with an active form of the disease. The median duration of TCZ therapy was 24 months. Results: against the background of TCZ therapy, the median ESR decreased from 22 to 5 mm/h (p value <0,01), the level of C-reactive protein from 6 to 0 mg/l (p value <0,025). All patients achieved remission. No relapses were observed. The median GCs dose decreased from 0,377 to 0,15 mg/kg/day for prednisolone, 2 patients with GCs were completely canceled. The ITAS.A activity index decreased from 3–12 (median 7) to 0 in 7 and to 1 in 2 more patients. The drug was well tolerated. Adverse reactions included one case of pityriasis versicolor and one case of postoperative phlegmon of the neck and subclavian region on the right. Conclusion: TCZ has shown efficacy and safety for the induction and maintenance of remission in children with TA. The presented results of the study indicate the prospects for further study of the use of TCZ for TA in pediatric practice.

scholarly journals Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Espen Benjaminsen ◽  
Anne Reigstad ◽  
Vanja Cengija ◽  
Vibke Lilleby ◽  
Maria Carlsson
Keyword(s):  
Carotid Artery ◽  
Takayasu Arteritis ◽  
Common Carotid Artery ◽  
Right Hemisphere ◽  
Latent Tuberculosis ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Case Presentation ◽  
Reactive Protein ◽  
The Right

Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear.Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein.Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

scholarly journals Efficacy and Safety of Qinghao Biejia Decoction in the Treatment of Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaobo Li ◽  
Zhouqing He ◽  
Li Ru ◽  
Yueming Yuan ◽  
Zheng Yuan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Adverse Reactions ◽  
Activity Index ◽  
Meta Analysis ◽  
Disease Activity Index ◽  
Efficacy And Safety ◽  
Systemic Lupus ◽  
Symptom Scores ◽  
Ifn Γ

Objective: This meta-analysis aimed to systematically assess the therapeutic efficacy and safety of Qinghao Biejia decoction combined with conventional chemical medicine in patients with systemic lupus erythematosus (SLE), and to provide reference for clinical medication.Methods: Multiple databases were retrieved by computer for randomized controlled trials (RCTs) of treating SLE with Qinghao Biejia decoction combining chemical medicine, from the establishment of the database to January 2021. Study screening, data collection, and quality assessment were performed independently by two reviewers. RevMan 5.4 and Stata 15.1 software were used for Meta-analysis.Results: Nine eligible studies, involving 655 SLE participants, were included. Meta-analysis showed that the additional use of Qinghao Biejia decoction superior to chemical medicine alone in people with SLE in improving the overall response rate (RR = 1.30, 95% CI [1.19, 1.41], p &lt; 0.00001, heterogeneity p = 0.61, I2 = 0%), and can decrease SLE Disease Activity Index (SLEDAI) and TCM symptom scores, improve immunological indexes (C3, C4, IgG, IgA, IFN-γ, IL-4, Th1/Th2), reduce the occurrence of adverse events in treatment (P ≤ 0.05).Conclusion: Based on this meta-analysis, the additional use of Qinghao Biejia decoction has more advantages in the treatment of SLE than conventional chemical medication alone, which could enhance the efficacy and reduce adverse reactions, and is worthy of clinical promotion. However, more and higher quality RCTs are still need to confirm our findings.

scholarly journals A REVIEW ON THE USE OF REMDESIVIR IN THE CURRENT VIROSIS COVID-19.

2020 ◽  
Vol 8 (2) ◽  
pp. 272-280
Author(s):  
Ana Maria Marinho Andrade de Moura ◽  
Anaís Concepción Marinho Andrade de Moura ◽  
DANY GERALDO Kramer
Keyword(s):  
Clinical Trials ◽  
Adverse Reactions ◽  
Scientific Information ◽  
Active Form ◽  
Cellular Level ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Treatment Protocols ◽  
Randomized Controlled ◽  
Potential Use

Remdesivir (GS-5734) is a drug designed for application in patients with Ebola, being used in patients in the coronavirus outbreak in the Middle East. After internalization of the drug, at the cellular level, it is converted into its active form GS-441524, and binds viral RNA polymerase (RdRp) blocking viral replication. Thus, the present study aimed to discuss the potential use of Remdesivir in coronovavirus infections. Some observed studies report promising results in the recovery of critically ill patients with COVID 19, however, there are reports of serious adverse reactions, which led to the discontinuation of therapy with this drug. Thus, measuring the efficacy and safety of Remdesivir in the treatment of COVID 19 will require broader randomized, controlled and double-blind clinical trials, so that the data and scientific information generated can guide treatment protocols for this drug.

scholarly journals Comparison of iron carboxy maltose and iron sucrose in pregnant females

2019 ◽  
Vol 8 (2) ◽  
pp. 697
Author(s):  
Isha Sunil ◽  
Prabhjit Kour ◽  
Mitali Sharma
Keyword(s):  
Iron Deficiency ◽  
Adverse Reactions ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Iron Sucrose ◽  
P Value ◽  
Efficacy And Safety ◽  
Pregnant Females ◽  
Group A ◽  
Group B

Background: Maternal anaemia is a common problem worldwide. The aim of this study is to compare the efficacy and safety of FCM vs iron sucrose for correction of iron deficiency during pregnancy.Methods: This study was conducted in Swasthya healthcare, Jammu for a period of ten months from Sep 2017 to June 2018. A total of 100 women with Hb 7-9.9g% enrolled. They were divided into two groups of 50 each. Group A were given Iron Carboxy maltose and Group B were given Iron Sucrose. These were compared for their efficacy and safety.Results: In the present study, the rise in mean hemoglobin at 4 weeks in Group A was 1.79±0.47 and 1.06±0.11 in Group B which was highly significant (p-value<0.0001). Rise in mean serum ferritin level at 4 weeks in Group A was 123.80±16.03 and in Group B was 84.78±10.53. Statistically, this rise was also highly significant (p<0.0001). In present study, adverse reactions were observed in 34% patients in Group A, while in Group B it was observed in 52% patients.Conclusions: Iron carboxy maltose shows higher rise in hemoglobin and ferritin levels as compared to Iron Sucrose and incidence of adverse effects is also comparatively lower in the former.

scholarly journals Effectiveness of Convalescent Plasma Therapy for COVID-19 Patients in Hunan, China

Dose-Response ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 155932582097992
Author(s):  
Xingsheng Hu ◽  
Chunhong Hu ◽  
Dixuan Jiang ◽  
Qian Zuo ◽  
Ya Li ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Albumin Level ◽  
Outcome Data ◽  
Efficacy And Safety ◽  
C Reactive Protein ◽  
Plasma Therapy ◽  
Reactive Protein ◽  
Critical Patients ◽  
D Dimer

Objective: To investigate clinical efficacy and safety of convalescent plasma (CP) therapy in coronavirus disease 2019 (COVID-19) patients. Methods: We included 4 severe patients and 3 critical patients. The date of admission to hospital ranged from January 30 to February 19, 2020. We retrospectively collected clinical and outcome data. Relative parameters were compared. Results: After CP therapy, the symptoms and respiratory functions were improved. Median PaO2/FIO2 increased from 254 (142-331) to 326 (163–364), and dependence of oxygen supply decreased. Median time to lesion’s first absorption was 5 (2–7) days, undetectable viral RNA was 11 (3.5–15.7) days. Median lymphocyte count (0.77 × 109/L vs 0.85 × 109/L) and albumin level (31g/L vs 36 g/L) were elevated, C-reactive protein (44 mg/L vs 18 mg/L), D-dimer (5.9 mg/L vs 4 mg/L) and lactate dehydrogenase (263 U/L vs 245 U/L) decreased. No obvious adverse reactions were observed. At the follow-up on June 14, 2020, 6 patients had completely recovered and one died from terminal disease. Conclusion: CP therapy for COVID-19 was effective and safe. Three patients who did not combine with antiviral therapy after CP also obtained viral clearance and clinical improvement. However, CP therapy failed to save the life of a terminally ill patient.

scholarly journals The Efficacy of Probiotics, Prebiotic Inulin-Type Fructans, and Synbiotics in Human Ulcerative Colitis: A Systematic Review and Meta-Analysis

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 293 ◽  
Author(s):  
Erola Astó ◽  
Iago Méndez ◽  
Sergi Audivert ◽  
Andreu Farran-Codina ◽  
Jordi Espadaler
Keyword(s):  
Ulcerative Colitis ◽  
Disease Activity ◽  
Activity Index ◽  
Meta Analysis ◽  
Disease Activity Index ◽  
P Value ◽  
Significant Heterogeneity ◽  
Jadad Score ◽  
The Us ◽  
Maintenance Of Remission

Studies of probiotics, fructan-type prebiotics, and synbiotics in patients with ulcerative colitis (UC) show significant heterogeneity in methodology and results. Here, we study the efficacy of such interventions and the reasons for the heterogeneity of their results. Eligible random controlled trials were collected from the PUBMED and SCOPUS databases. A total of 18 placebo-controlled and active treatment-controlled (i.e., mesalazine) studies were selected with a Jadad score ≥ 3, including 1491 patients with UC. Data for prebiotics and synbiotics were sparse and consequently these studies were excluded from the meta-analysis. The UC remission efficacy of probiotics was measured in terms of relative risk (RR) and odds ratio (OR). Significant effects were observed in patients with active UC whenever probiotics containing bifidobacteria were used, or when adopting the US Food and Drug Administration (FDA)-recommended scales (UC Disease Activity Index and Disease Activity Index). By the FDA recommended scales, the RR was 1.55 (CI95%: 1.13–2.15, p-value = 0.007, I2 = 29%); for bifidobacteria-containing probiotics, the RR was 1.73 (CI95%: 1.23–2.43, p-value = 0.002, I2 = 35%). No significant effects were observed on the maintenance of remission for placebo-controlled or mesalazine-controlled studies. We conclude that a validated scale is necessary to determine the state of patients with UC. However, probiotics containing bifidobacteria are promising for the treatment of active UC.

scholarly journals Effectiveness and safety of methotrexate versus leflunomide in 12-month treatment for Takayasu arteritis

2020 ◽  
Vol 11 ◽  
pp. 204062232097523
Author(s):  
Chunling Wu ◽  
Ying Sun ◽  
Xiaomeng Cui ◽  
Sifan Wu ◽  
Lili Ma ◽  
...  
Keyword(s):  
Treatment Response ◽  
Takayasu Arteritis ◽  
Activity Index ◽  
Treatment Resistance ◽  
Disease Activity Index ◽  
Disease Relapse ◽  
Protein Levels ◽  
Reactive Protein ◽  
Medical University

Aims: The study investigates the effectiveness and safety of methotrexate (MTX) versus leflunomide (LEF) in 12-month treatment of Takayasu arteritis (TAK). Methods: This was a cohort study. Patients diagnosed with TAK between 1 January 2013 and 1 January 2019 were enrolled from First Hospital of China Medical University and Zhongshan Hospital of Fudan University. Patients had active disease and were treated with glucocorticoid combined with LEF or MTX. Treatment response, imaging assessment and side-effects were evaluated during 12-month follow-up. Results: In total, 68 patients were enrolled (40 cases treated with LEF and 28 treated with MTX). At baseline, age, sex, disease duration and disease activity index showed no significant differences between groups. Prevalence of complete remission (CR) at 6 months was significantly higher in the LEF group than that in the MTX group (LEF versus MTX: 72.50% versus 53.57%, p = 0.04), though the CR prevalence at 9 months and 12 months showed no significant differences between groups. At 9 months, the prevalence of treatment resistance was much lower in the LEF group compared with MTX group (5.41% versus 11.54%, p = 0.03). Furthermore, prevalence of disease relapse in the LEF group was lower than that in MTX group at 12 months (7.24% versus 16.67%, p = 0.03). Patients with high baseline C-reactive protein levels (⩾15 mg/L) carried a higher risk of treatment resistance (OR = 1.36, 95% CI 1.07–13.41, p = 0.06) and disease relapse (HR = 2.51, 95% CI 1.36–12.98, p = 0.04). Conclusion: LEF might provide a quicker treatment response with lower prevalence of disease relapse compared with that elicited in MTX during 12 months follow-up for TAK.

Penanganan Issu Terkait Keselamatan Pasien di Rumah Sakit

2020 ◽  
Author(s):  
Kristin Natal Riang Gea
Keyword(s):  
Patient Safety ◽  
Health Workers ◽  
Sampling Technique ◽  
Good Health ◽  
Bivariate Analysis ◽  
P Value ◽  
Patient Identification ◽  
Cross Sectional ◽  
The Right ◽  
The Relationship

AbstrakKeselamatan pasien merupakan dasar dari pelayanan kesehatan yang baik. Pengetahuan tenaga kesehatan dalam sasaran keselamatan pasien terdiri dari ketepatan identifikasi pasien, peningkatan komunikasi yang efektif, peningkatan keamanan obat yang perlu diwaspadai, kepastian tepat lokasi, prosedur, dan tepat pasien operasi, pengurangan risiko infeksi, pengurangan risiko pasien jatuh. Tujuan penelitian untuk mengetahui hubungan antara pengetahuan dengan penerapan keselamatan pasien pada petugas kesehatan di Puskesmas Kedaung Wetan Kota Tangerang. Metode Penelitian menggunakan deskriptif korelasi menggunakan pendekatan cross sectional. Populasi sebanyak 50 responden. Teknik pengambilan sampel menggunakan total sampling. Instrumen yang digunakan berupa lembar kuesioner. Teknik analisa diatas menggunakan analisa Univariat dan Bivariat. Hasil Penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien pada Petugas Kesehatan, dengan hasil, p value sebesar 0,013 &lt; 0,05 maka dapat disimpulkan bahwa ada Hubungan Pengetahuan dengan Penerapa Keselamatan Pasien pada Petugas Kesehatan. Kesimpulan penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien.. AbstrackPatient safety is the basis of good health services. Knowledge of health personnel in patient safety targets consists of accurate patient identification, increased effective communication, increased safety of the drug that needs to be watched, certainty in the right location, procedure, and precise patient surgery, reduction in risk of infection, reduction in risk of falling patients. The purpose of this study was to determine the relationship between knowledge and the application of patient safety to health workers in the Kedaung Wetan Health Center, Tangerang City. The research method uses descriptive correlation using cross sectional approach. The population is 50 respondents. The sampling technique uses total sampling. The instrument used was a questionnaire sheet. The analysis technique above uses Univariate and Bivariate analysis. The results of the study there is a Relationship of Knowledge with the Implementation of Patient Safety in Health Officers, with the result, p value of 0.013 &lt;0.05, it can be concluded that there is a Relationship between Knowledge and Patient Safety Implementation in Health Officers. The conclusion of the study is the Relationship between Knowledge and the Implementation of Patient Safety.Keywords Knowledge, Patient safety, Health workers

ОЦЕНКА ЭФФЕКТИВНОСТИ И БЕЗОПАСНОСТИ 10% ВНУТРИВЕННОГО ИММУНОГЛОБУЛИНА ПРИВИДЖЕН В РЕАЛЬНОЙ КЛИНИЧЕСКОЙ ПРАКТИКЕ

2019 ◽  
Author(s):  
L.G. Khludova ◽  
I.A. Manto ◽  
E.A. Latysheva ◽  
T.V. Latysheva ◽  
M.R. Khaitov
Keyword(s):  
Replacement Therapy ◽  
Primary Immunodeficiency ◽  
Adverse Reactions ◽  
Efficacy And Safety ◽  
High Efficacy ◽  
Antibody Synthesis ◽  
Human Immunoglobulins ◽  
Severe Adverse Reactions ◽  
Common Variable ◽  
Real Clinical Practice

Актуальность. Заместительная терапия иммуноглобулинами человека является ведущим патогенетическим методом лечения первичных иммунодефицитов с нарушением синтеза антител. В настоящее время в России доступно несколько препаратов иммуноглобулинов человека нормальных для внутривенного введения. Цель. Оценить эффективность и безопасность препарата Привиджен (10 раствор иммуноглобулина для внутривенного введения) в реальной клинической практике в течение 12 клинических месяцев. Материалы и методы. 20 взрослых с диагнозом общая вариабельная иммунная недостаточности и Х-сцепленная агаммаглобулинемия получали внутривенный иммуноглобулин Привиджен к интервалом 243 дня в течение 12 мес. Первичными критериями оценки была частота инфекционных осложнений и нежелательных явлений. Результаты. У большинства пациентов в ходе исследования достигнут удовлетворительный претранс-фузионный уровень IgG. Тяжелых нежелательных явлений, связанных с введением препарата, не зарегистрировано. Заключение. В ходе исследования препарат продемонстрировал высокую эффективность и безопасность у пациентов, нуждающихся в ежемесячной заместительной терапииRelevance. Replacement therapy with human immunoglobulins is the leading pathogenetic method of treatment of primary immunodeficiency with impaired antibody synthesis. Currently, several preparations of human immunoglobulins for intravenous administration are available in Russia. Purposes. Evaluation of the efficacy and safety of Privigen immunoglobulin intravenous 10 liquid in real clinical practice within 12 clinical months. Methods. Twenty adults diagnosed with common variable immunodeficiency or X-linked agammaglobulinemia received intravenous Privigen infusions (0.2-0.4 mg/kg) at 243 intervals over a 12-month period. The primary endpoint was the annual rate of infections and adverse events. Results. Sufficient level of IgG was achieved in most patients during the study. Severe adverse reactions during the treatment were not registered. Conclusions. High efficacy and safety of monthly replacement therapy in patients with primary immunodeficiency with impaired antibody synthesis has been demonstrated.

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