Therapeutic Apheresis in Neurology | Author : Rolf Bambauer | Abstract | Full Text | Abstract :Therapeutic plasma exchange (TPE) remove harmful plasma constituents from patient’s blood and replacing the extracted plasma with replacement solutions. The advantages of TPE with hollow fiber membranes are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate higher efficacy. Therapeutic apheresis (TA) is used more and more throughout the world. The development of new, more sophisticated membranes and new adsorption technologies allow the most selective separation of plasma components. TA has been successfully introduced in a variety of autoantibody-mediated diseases. TA is the first- or second-line therapy in the treatment of neurological disorders. The updated information on immunology and molecular biology of different neurological diseases are discussed in relation to the rationale for apheresis therapy and its place in combination with other modern treatments. The different neurological diseases can be treated by various apheresis methods. Pathogenetical aspects are demonstrated in these diseases, in which they are clarified. TA has been shown to effectively remove the autoantibodies, immune complexes, inflammatory moderators, paraproteins, and other toxins from blood and lead to rapid clinical improvement. For the neurological diseases, which can be treated with TA, the guidelines of the Apheresis Application Committee (AAC) of the American Society for Apheresis (ASFA) are cited. |
| Factors Associated with and Reasons for Loss to follow-up Among Glaucoma Patients at a Nigerian Eye Hospital | Author : Stella Ngozi Onwubiko | Abstract | Full Text | Abstract :Background: Glaucoma is an emerging vision-threatening disease requiring a life-long management protocol with regular surveillance.
Aim: To explore the factors associated with and reasons for loss to follow-up among glaucoma patients.
Methods: All adult glaucoma patients who attended Bridget medical Centre (BMC) Eye hospital, Enugu during a two-year period (2016 – 2018) were identified via the medical records. Those who had missed an appointment by at least 12 months were reached via their cellular phones to ascertain their reasons. Information on their socio-demographic and clinical characteristics was retrieved from their records. Data was analyzed using SPSS version 21. Chi-square test was done to identify the factors associated with loss to follow-up. The level of significance was at p< 0.05.
Results: A total of 113 patients had glaucoma. They were mainly males, 67(59.3%), retirees with a mean age of 62.0±2SD years. Ninety-four (83.2%) participants were lost to follow-up. The main reasons were forgetfulness, 33(41.2%), and have not noticed any problem in vision, 20(25.0%).
Male gender, advanced age, tertiary education, retiree, normal visual acuity, moderate/advanced stage, IOP of less than 21mmHg, more than 5 years of diagnosis and using more than one medication were associated with loss to follow-up. However, only Retiree and IOP of less than 21mmHg were statistically significant.
Conclusion: The findings from this study emphasized the need for continual glaucoma education and appointment reminder, especially to Retirees with normal intraocular pressure. |
| Mucocutaneous involvement in Behçets disease | Author : Zeineb Alaya | Abstract | Full Text | Abstract :Behçets disease is a chronic inflammatory disease characterized by its clinical polymorphism associating mucocutaneous involvement to systemic manifestations. The mucocutaneous lesions are considered the hallmark of the disease, being the most common symptoms presenting at the onset of disease. Our objective was to determine the characteristics of this skin involvement during Behçets disease. We conducted a descriptive study over a period of 30 years, having collected all patients with Behçets disease. These were 98 patients. A male predominance was observed in our studied population with a Sex Ratio of 2.5. The mean age at diagnosis was 34 years. Mucocutaneous involvement was observed in all patients. Oral aphthosis was constant and genital ulcers, were observed in 81 cases. The other mucocutaneous manifestations were: pseudofolliculitis (61 cases), erythema nodosum (7 cases), skin ulcers (4 cases), acneiform lesions (2 cases), perianal ulcers (1 case), skin ulceration (1 case) and erythema multiforme. (1 case). All of our patients were treated with colchicine. Corticosteroids and non-steroidal anti-inflammatory drugs were each indicated in one case for resistant forms. |
| Characterization of Cardiovascular Risk factors and Framingham score in an HIV-1 population | Author : R. Correia de Abreu | Abstract | Full Text | Abstract :With the advent of high-potency antiretroviral treatment introduced in 1996, HIV infection ceased to be an acute and deadly disease to become chronic and controllable.However, the early aging of this population, which according to some authors and cohorts, is 10 years less than in the "normal" population, has been studied.Although the realities of these patients comorbidities are well known, the definition of time, when and how or with what to treat still seems to be a matter of debate.The aim of this study is to evaluate the incidence and prevalence according to the state of the art for the non-HIV population of cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus) and apply the adjusted Framingham Risk Score by recording analytical and clinical factors in an HIV-1 population with more than 50 years of age, followed in the Infectious Diseases Service for more than 6 months. |
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