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Diabetic Nephropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The prognosis of nephrotic syndrome is varied because of the different causes. Total remission can occur with or without treatment. Prognosis is usually good when the patient responds well to corticosteroids. Worsened prognosis is given if there is hematuria, hypertension, infection, severe azotemia, or thromboses of the cerebral, peripheral, pulmonary, or renal veins. Recurrence of nephrotic syndrome is high after a kidney transplant if the patient has focal segmental glomerulosclerosis, IgA nephropathy, or membranoproliferative glomerulonephritis.
Emerging Oral Treatments: Oral JAK Inhibitors for Alopecia Areata
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Jared Marc John, Rodney Sinclair
Long-term JAK inhibitor therapy is likely required to achieve and maintain therapeutic response. The mean time to initial hair regrowth on JAK inhibitor therapy was 2.2 months and the time to complete hair regrowth in the cases that did was 6.7 months [1]. As such, initial response assessments are recommended at about 3 months of therapy. The high relapse rates following treatment withdrawal suggest that maintenance therapy is required to sustain remission. Further work involving larger patient cohorts and longer follow-up duration are necessary to support the present findings and determine optimal regimens that minimize the probability of relapse after treatment discontinuation.
Design and Analysis of Cancer Clinical Trials
Published in Yingwei Peng, Binbing Yu, Cure Models, 2021
Cancer is a heterogeneous disease and differs greatly among different patients and even within the same type of tumor. Survival rates may vary greatly between different cancer types and remain poor for some cancers, while some treatments can have serious side effects (ICR, 2014). Exciting advances are paving the way to better treatments and possibly more cures. Although it is difficult to achieve cure for most advanced solid tumors, many types of cancer, e.g., leukemia, lymphoma, testicular cancers, may have long-lasting durable remission. Because of the progress of early diagnosis and cancer treatment, many cancer patients become long-term survivors, even though one cannot be sure that cancer eventually goes away after treatment. In this chapter, we refer the “cure” as long-term remission, meaning there is still a slight chance that disease may come back. But, in general, a person who stays cancer free five years after a diagnosis has better odds of recovery.
Therapeutic apheresis in kidney diseases: an updated review
Published in Renal Failure, 2022
Yi-Yuan Chen, Xin Sun, Wei Huang, Fang-Fang He, Chun Zhang
To some extent, FSGS is a set of clinical-pathological syndromes, rather than a single disease. Circulatory permeability factors in plasma have been suggested as the pathogenic factors of FSGS, which target podocytes and damage the glomerular filtration barrier [9]. Typically, for the treatment of primary FSGS, corticosteroid is considered as the first-line therapy, and immunosuppressive agents such as cyclophosphamide (CYC), calcineurin inhibitors (CNI), rituximab (RTX), or mycophenolate mofetil (MMF) are recommended in patients with steroid-dependent or steroid-resistant conditions [10–13]. However, partial remission is still more common than complete remission, and these drugs can cause severe complications [14]. Currently, extracorporeal therapies, such as PE, IAS, and LDL-A, are reserved for patients with drug-resistant or drug-based treatment failure [15–17].
Sarcoidosis: epidemiology, characteristics, and outcomes over 10 years - a single-center study in Pakistan
Published in Expert Review of Respiratory Medicine, 2022
Muhammad Junaid Akram, Usman Khalid, Muhammad Abu Bakar, Faheem Mahmood Butt, Mohammad Bilal Ashraf
Following diagnosis, treatment was instituted with oral steroids with or without immunosuppressive medications (azathioprine, methotrexate, or mycophenolate mofetil) and outpatient follow-up was maintained (2 weeks, monthly, or 6 monthly) to evaluate treatment response and disease status (remission or relapse). Remission was defined as significant clinical or radiological improvement, resulting in either a) de-escalation of high-dose steroids to a minimum maintenance dose or b) complete cessation of treatment. Disease relapse was defined as i) Worsening of pulmonary or extra-pulmonary symptoms leading to deterioration in the quality of life after initial remission. ii) Significant worsening of radiological imaging. iii) Significant re-escalation of systemic medication. As our hospital has a central electronic medical record system (MIS) with complete patient follow-up, after IRB approval, death information has been recorded from the hospital MIS.
Predictors of poor 6-week outcome in a cohort of major depressive disorder patients treated with antidepressant medication: the role of entrapment
Published in Nordic Journal of Psychiatry, 2021
Serafim Carvalho, Filipa Caetano, José Pinto-Gouveia, Jorge Mota-Pereira, Dulce Maia, Paulo Pimentel, Cátia Priscila, Paul Gilbert
The available treatments for Major Depressive Disorder (MDD) are based on pharmacological and psychological approaches. However, their effectiveness is still relatively poor. According to the STAR*D study, only one-third of patients achieved remission with first-line treatments, and one third showed little response [1]. Failure to achieve complete remission can lead to adverse consequences, including treatment resistance, social disability, physical health problems and increased risk of relapse and recurrence [2]. Predicting treatment factors that facilitate or inhibit therapeutic response could help prevent or reduce those consequences [3,4]. Currently, there are few replicable predictors of treatment response, although stress plays an important role [5]. Depressed patients who are under severe stress do not respond as well to antidepressants as do patients with less stress [5]. Nonetheless, more research is needed to address the form and role of stressful life events and severe difficulties in depressed patients undergoing pharmacological treatment [6].