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Managing Disaster and Understanding Disease and the Environment in the Early Eighteenth Century
Published in Lori Jones, Disease and the Environment in the Medieval and Early Modern Worlds, 2022
In humoural theory, then, the cause of disease was not understood as external to the body, like a virus or a bacterium, but rather as a state of humoural imbalance. Dyscrasia could result from a number of different causes or disturbances, either internal (tied, for example, to menstruation or the onset of puberty) or external. Exposure to cold air, for instance, could cause an overabundance of black bile or phlegm, which could lead to respiratory illness (Brunton 2014, 105). Perhaps most notably, disease could result from the inhalation or absorption of miasmas through the pores.14 These were disease-causing foul odours or noxious vapours in the air that could be released from a variety of sources, including corpses, stagnant water or swamps, astrological events like the position of the stars or the arrival of a comet, or even God’s desire to punish a human population for its sins.15 Because people believed that many illnesses resulted from exposure to miasmas, treatments or regimens often emphasized the elimination of these corrupt vapours and the rebalancing of humours through practices such as bloodletting, purging via emesis (vomiting) or with laxatives or enemas, as well as the practice of prayer and/or the use of stones, talismans, minerals, and brews or concoctions. Such understandings and practices persisted in Europe, largely unchanged, for centuries.
Chancroid and chancre
Published in Dinesh Kumar Jain, Homeopathy, 2022
Hahnemann also said at various places that allopathic drugs modify acute diseases into chronic diseases (Hahnemann, 1921/1996, p. 98) and chronic diseases that are produced by allopathy are very troublesome to people (Hahnemann, 1921/1996, p. 100). “Chronic medical dyscrasia so often produced by allopathic bungling along with the natural disease left uncured by it require a much longer time for their recovery often indeed, are they incurable” (Hahnemann, 1921/1993, p. 216). Hahnemann also mentioned that allopathic drugs when removed external manifestations or discharge, disease redirected internally from the surface and creates various systemic symptoms. Hahnemann repeatedly mentioned that allopathic drugs are very dangerous. Hahnemann was right because, during his time, antibiotics had not been discovered. Metals and their compounds were used in various diseases and these compounds were very toxic; that's why they are not used today.
Ethosuximide
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Non-dose related adverse effects forcing discontinuation of therapy include skin rashes mostly nonspecific in nature but erythema multiforme, the Stevens-Johnson syndrome, and scleroderma (13). Hematologic problems usually occurred within the first 6 months. Reported blood dyscrasias include transient eosinophilia, leukopenia, thrombocytopenia, and pancytopenia. Clinical signs which may indicate a blood dyscrasia include fever, sore throat, petichiae, or intestinal bleeding. Complete blood counts should be performed monthly and periodically thereafter. Any granulopenia observed is likely to recover on reduction of the dose or discontinuation of the drug. A lupus-like syndrome has been reported in patients receiving ESM alone or in combination. Three types of reactions have been recognized: (1) development of antinuclear antibodies; (2) classic lupus-like illness with malar rash, arthritis, lymphadenopathy, pleural effusion, myocarditis, and pericarditis; autoimmune thyroiditis; and (3) a systemic immunologic disorder which includes the nephrotic syndrome (12). The lupus-like syndromes usually resolve on discontinuation of the medication. Hepatic toxicity is uncommon, though elevation of “liver” enzymes has been reported which resolved on discontinuing the medication. The relatively reduced risk of hepatic toxicity is an important positive feature of ESM therapy.
Guidelines for high dose chemotherapy and stem cell transplantation for systemic AL amyloidosis: EHA-ISA working group guidelines
Published in Amyloid, 2022
Vaishali Sanchorawala, Mario Boccadoro, Morie Gertz, Ute Hegenbart, Efstathios Kastritis, Heather Landau, Peter Mollee, Ashutosh Wechalekar, Giovanni Palladini
Deep and durable haematologic responses can be achieved after SCT in AL amyloidosis. Haematologic response assessment should be performed at 3–6 months after SCT, preferably at 3 months. Bone marrow aspiration and biopsy are not needed to assess for validated haematologic response but are required for assessment of minimal residual disease. Deep haematologic responses indicated by normalisation of serum free light chain levels along with absence of monoclonal protein in serum and urine by immunofixation electrophoresis are desirable [32]. The goal should be to achieve a complete haematologic response or very good partial haematologic response with an organ response. It is imperative to note that the organ responses can lag behind the haematologic response by 6–12 months and can continue to occur gradually over many years after SCT. Haematologic and organ responses predict for overall survival in AL amyloidosis. Institution of additional therapy directed towards the plasma cell dyscrasia should weigh the risks and benefits and follow complete recovery from the toxicities of SCT. It should not be instituted solely for organ progression in the setting of adequate haematologic response (≥VGPR), unless indicated by other measures and individualised.
Detection of monoclonal free light chains by immunofixation electrophoresis and isoelectric focusing – comparison with the quantitative method of determination
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2020
Pavlína Kušnierová, David Zeman, Kamila Revendová, Ondřej Dlouhý
Cross-reactivity of light chain-linked antibodies may be another problem in the determination of FLC, potentially leading to significant overvaluation of FLC in biological material. [13]. At the same time, some antibodies used in FLC tests detect FLC dimers better than monomers, while the degree of FLC dimerisation may change under pathological conditions [14]. Moreover, all FLC tests were primarily developed to assist in the diagnosis and monitoring of plasma cell dyscrasia, while their determination in other indications was not sufficiently validated. Thus the different diagnostic kits to determine FLCs, not surprisingly, provide different results. In our study, we tried to interpret the laboratory data according to the reference intervals given to a particular diagnostic kit manufacturer and then compare the results with each other according to the Kappa statistics. However, even in this case we did not arrive at the same clinical interpretation of the finding. That is why we have resorted to the intention of subjecting all samples with pathological FLC ratio to immunofixation electrophoresis and even more sensitive detection of monoclonal bands by the isoelectric focusing method followed by affinity immunoblotting. We concluded that most of these positive FLC ratios obtained using the method from The Binding Site, as well as from Sebia, are false positive.
Fluorescence in situ hybridisation combined with CD138 immunomagnetic sorting is effective to identify cytogenetic abnormalities which play significant prognostic roles in Chinese AL amyloidosis patients
Published in Amyloid, 2020
Yang Liu, Yueyun Lai, Ling Ma, Lei Wen, Wenbing Duan, Fengrong Wang, Ying Kang, Huan Chen, Yao Chen, Lu Gao, Xiaojun Huang, Jin Lu
Cytogenetic abnormalities play key prognostic roles in plasma cell dyscrasia, and their significance continues to be refined. FISH cytogenetics has been used to address chromosomal aberrations in plasma cells in AL amyloidosis and has been of great significance for obtaining outcomes that may guide therapeutic choices. Our results show that MACS can enrich sufficient plasma cells and improve the detection efficiency of cytogenetic abnormalities. For AL amyloidosis with a low proliferative index and a low bone marrow plasma cell proportion, MACS-FISH is superior to the c-FISH test. The overall abnormality rate by MACS-FISH in a Germany group was 82.9%, with t(11;14) the most prevalent aberration (59%), followed by deletion of 13q14 (29%) and amplification of 1q21 (22%) [2]. The proportion of patients with t(11;14) FISH aberration was lower in our group; however, the percentages of deletion of 13q14 and amplification of 1q21 were similar between these studies. Whether there are racial differences in the cytogenetic features of AL amyloidosis needs to be addressed in future studies. Our findings enrich what is known about the cytogenetic characteristics of this rare plasma cell disease.