Beyond immune thrombocytopenia: the evolving role of thrombopoietin receptor agonists
AbstractSince its discovery, the thrombopoietin (TPO) pathway has been an important pharmaceutical target for the treatment of thrombocytopenia. The first generation of TPO mimetics included peptide agents sharing homology with endogenous TPO, but these introduced a risk of antibody formation to endogenous TPO and were not successful. However, second-generation TPO mimetics or TPO receptor agonists (RAs) are currently being used to treat thrombocytopenia associated with a number of conditions, such as immune thrombocytopenia (ITP), severe aplastic anaemia (SAA), and hepatitis C virus-associated chronic liver disease. Accumulating efficacy and safety data suggest that the role of TPO-RAs in the treatment of thrombocytopenia may evolve in the near future with broader use of these agents in ITP and SAA, as well as approval in other indications, potentially including myelodysplastic syndromes, chemotherapy-associated thrombocytopenia, and post-transplant thrombocytopenia. This review provides an overview of clinical data on the efficacy and safety of TPO-RAs, emphasising recent findings that may expand their clinical utility.
Aneurysms of the renal arteries are rare, probably under-diagnosed, with an incidence estimated at 0.01%. A size exceeding 20mm and the presence of symptoms such as hypertension represent a therapeutic indication for most authors. Endovascular techniques are used more and more to treat proximal lesions and auto-transplantation is the technique of reference for intra-parenchymatous lesions. However, most hilar, non-intra-parenchymatous lesions can be treated in situ without cooling and with a reasonable clamping time.
The objective of this work was to study the mid-term results of the angioplast y of the renal artery on transplanted kidneys.
Postmastectomy radiation therapy (PMRT) generally improves locoregional control and overall survival in patients with pathologic lymph node-positive breast cancer, as evidenced by meta-analyses of randomized trials (1). Nevertheless, controversy persists regarding whether PMRT is indicated for all such patients, especially those with clinical T1-T3N1 who receive neoadjuvant chemotherapy (NAC) with a complete pathologic response in the involved axillary lymph nodes (ypN0). For such patients, the current standard recommendation is to offer entry into clinical trials comparing regional nodal irradiation (RNI) versus no RNI (2...
This report presents a randomised controlled trial of a mindfulness-based intervention during chemotherapy and suggests that care is needed in employing mindfulness-based interventions in acute health treatment contexts.
We describe a 61-year-old African American diabetic gentleman who presented with nodules in a linear distribution on the flank. Histopathologic examination of a biopsied nodule revealed a pandermal sheet-like infiltrate of plasma cells and histiocytes, some demonstrating elastophagocytosis and emperipolesis. The lesional histiocytes were S100 and CD68 positive and CD1a negative—findings consistent with a diagnosis of CRDD. Additional laboratory work-up performed 12 weeks after the biopsy was taken revealed an elevated serum κ light chain concentration of 37.26 mg/L (reference range: 3.30–19.40 mg/L), whic...
Conclusion: This case may illustrate a resemblance in the renal glomerulus basement membrane and retinal pigment epithelium–Bruch membrane complex, because the authors observed deposits of excess monoclonal kappa chains manifesting as extracellular, proteinaceous aggregates on the basement membrane of the glomerulus, and striking, globular subretinal deposits that overlay a thickened retinal pigment epithelium–Bruch membrane complex. The ocular lesions' refractoriness to intravitreal treatments could be attributed to the fact that they represent proteinaceous aggregates similar to those documented in the glomer...
Conclusion: Pembrolizumab may induce a uveitic reaction. There is mounting evidence that patients using prembrolizumab should be educated and monitored for signs of uveitis.
Objectives: We aimed to explore the sexual and reproductive health attitudes, beliefs and behaviors of African Americans with sickle cell disease and understand the interplay of the various factors that influence their attitudes, beliefs and behavior.
Abstract: Screening for iron deficiency anemia (IDA) in all pregnant women is recommended. IDA is a prevalent cause of nutritional deficiency anemia, and oral iron is the first line of treatment. Other treatments include parenteral iron or blood transfusion(s). Untreated IDA in pregnancy can result in complications for the mother and fetus.