Systemic Bevacizumab for the Treatment of Chronic Bleeding in Hereditary Hemorrhagic Telangiectasia

Introduction: Hereditary hemorrhagic telangiectasia (HHT) is a rare hereditary multisystem vascular disorder causing visceral arteriovenous malformations (AVMs) and mucocutaneous bleeding. Chronic gastrointestinal bleeding and epistaxis frequently produce profound iron deficiency anemia refractory to conventional treatment. Patients with HHT have elevations in vascular endothelial growth factor (VEGF), so the anti-VEGF agent bevacizumab, a recombinant, humanized monoclonal IgG1 antibody that binds to and neutralizes circulating VEGF, is a promising systemic HHT therapy. Currently, data pertaining to the efficacy of bevacizumab for the treatment of HHT is limited to case reports and retrospective studies that do not describe the effect of bevacizumab on objective hematologic parameters (Guilhem et al 2017, Iyer et al 2018). As our institution is an HHT center that has developed a pathway for the use of bevacizumab in HHT patients, we performed a retrospective analysis assessing the efficacy of bevacizumab to alleviate chronic bleeding as measured by improvement in hemoglobin concentration, need for red cell transfusions and iron infusions, and epistaxis control. Management of bleeding in HHT patients is an off-label use of bevacizumab.Methods: All HHT patients treated with systemic bevacizumab for chronic bleeding were selected for retrospective analysis. Data was collected for each patient over a 14-month course, divided into a pretreatment period (six months), induction peri...
Source: Blood - Category: Hematology Authors: Tags: 102. Regulation of Iron Metabolism: Translating Iron Biology to the Clinic Source Type: research

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Publication date: Available online 16 August 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Andrew Sharp, Richard Jackson, Christine Cornforth, Jane Harrold, Mark A. Turner, Louise Kenny, Philip N. Baker, Edward D. Johnstone, Asma Khalil, Peter von Dadelszen, Aris T. Papageorghiou, Zarko AlfirevicAbstractBackgroundSevere early-onset fetal growth restriction (FGR) predisposes to fetal death, neonatal death, neonatal morbidity and neurodisability. The use of placental biomarkers has been proposed for risk stratification in pre-eclampsia, but they could be equally useful in fetal...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
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Source: American Heart Journal - Category: Cardiology Source Type: research
Publication date: Available online 16 August 2019Source: Tribology InternationalAuthor(s): L.E. Buckley-Johnstone, G. Trummer, P. Voltr, K. Six, R. LewisAbstractLow adhesion in the wheel/rail contact can be caused by small amounts of water combining with iron oxides. This happens in light rain or at dew point. In small-scale tests, ultra-low adhesion (≤0.05) has not been maintained. The aim here was to see if the mechanism could be realized at a larger scale. Sustained ultra-low adhesion was achieved when water was applied constantly to the wheel/rail contact at a rate of 25μL/s. In these conditions wear debris and o...
Source: Tribology International - Category: Materials Science Source Type: research
In conclusion, our results demonstrated that compression induced apoptosis in primary cultured cortical neurons, which was associated with ROS mediated ER stress and mitochondrial dysfunction. Pharmacological compounds or agents targeting mitochondrial dysfunction and ER stress associated oxidative stress might be ideal candidates for the treatment of IH-related neurological diseases.
Source: Neuroscience - Category: Neuroscience Source Type: research
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Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Publication date: Available online 16 August 2019Source: Journal of Food Composition and AnalysisAuthor(s): Gloria Ifeoma Davidson, Henrietta Nkechi Ene-ObongAbstractDocumentation of commonly consumed dishes and their contribution to the energy and nutrient intake of adults in southeast Nigeria were the aims of the study. Twenty communities were selected from the study area using a stratified sampling technique. Twenty-four-hour dietary recall, focus group discussion (FGD) and a 3-day weighed food intake conducted in each of the selected communities were used to collect the data, which were analyzed using percentages, mean...
Source: Journal of Food Composition and Analysis - Category: Food Science Source Type: research
Publication date: December 2019Source: Food Packaging and Shelf Life, Volume 22Author(s): Jin-Feng He, Xin-Guang Lv, Qin-Bao Lin, Zhong Li, Jia Liao, Cai-Yun Xu, Wen-Jun ZhongAbstractThe metal elements in polylactic acid (PLA) dinner plate were determined by inductively coupled plasma optical emission spectrometer (ICP-OES); migration of these metal elements from PLA dinner plate into 3% acetic acid food simulant at 40, 60 and 70 °C was investigated; three subsequent migration experiments under 40 °C for 10 days and 70 °C for 2 h to simulate migration under multiple-use conditions were conducted. The re...
Source: Food Packaging and Shelf Life - Category: Food Science Source Type: research
We report a novel anode electrocatalyst, iron carbide nanoparticles dispersed in porous graphitized carbon (Nano-Fe3C@PGC), which is synthesized by facile approach involving a direct pyrolysis of ferrous gluconate and a following removal of free iron, but provides microbial fuel cells with superior performances. The physical characterizations confirm the unique configuration of iron carbide nanoparticles with porous graphitized carbon. Electrochemical measurements demonstrate that the as-synthesized Nano-Fe3C@PGC exhibits an outstanding electrocatalytic activity toward the charge transfer between bacteria and anode. Equipp...
Source: Biosensors and Bioelectronics - Category: Biotechnology Source Type: research
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Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Hereditary hemorrhagic telangiectasia (HHT) is an inherited disease characterized by mucocutaneous telangiectatic lesions, arteriovenous malformations and recurrent spontaneous epistaxis. A 61-year-old white male patient sought dental service because of a recurrent gingival bleeding. He had previously been diagnosed with HHT. His medical history included pulmonary hypertension, brain abscess, arterial hypertension, iron deficiency anemia, recurrent episodes of epistaxis and oral bleeding. Physical examination revealed numerous telangiectatic lesions on the face, tongue, buccal mucosa, palate, gums and a vascular malformati...
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Tags: CPP - Clinical Poster Presentation Source Type: research
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