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Thalidomide


Presentation

  • The aim of this article is to present an alternative therapy for refractory pyoderma gangrenosum, along with a literature review.[ncbi.nlm.nih.gov]
  • RESULTS: Six out of seven patients with leprosy were treated with prednisone and/or thalidomide during TBE and presented at least one positive aPL. All patients presented ß2GPI polymorphism, and one showed prothrombin mutation.[ncbi.nlm.nih.gov]
  • This is the first case of a patient presenting with acute severe UC who was treated with thalidomide, with favorable evolution.[ncbi.nlm.nih.gov]
  • Thalidomide, mainly used for the treatment of leprosy, is a current teratogen in South America, and it is reasonable to assume that at present this situation is affecting many births in underdeveloped countries.[ncbi.nlm.nih.gov]
  • One month later, our patient presented with fever and an important inflammatory syndrome (CRP 150 mg/dL and 16.8 10(9)/L leukocytes), while no infection was found despite a thorough review.[ncbi.nlm.nih.gov]
Plethora
  • Since 1965 there has been a plethora of clinical trial-related guidelines and regulations which has culminated in the adoption of the ICH Guideline for Good Clinical Practice ( ICH E6 ) in 1996 and the publication of the Clinical Trials Directive ( 2001[web.archive.org]
Melena
  • In this report, we presented a Chinese patient with recurrent melena due to gastric angiodysplasia in HHT treated successfully with thalidomide.[ncbi.nlm.nih.gov]
  • Obscure Gastrointestinal Bleeding / Thalidomide 1 2 Completed Treatment Ankylosing Spondylitis (AS) 1 2 Completed Treatment Arachnoiditis 1 2 Completed Treatment Arteriovenous Malformations / Hematochezia / Hereditary Haemorrhagic Telangiectasia (HHT) / Melena[drugbank.ca]
Left Flank Pain
  • Abstract A 54-year-old male presented with a sudden burning sensation during urination and left flank pain.[ncbi.nlm.nih.gov]
Papule
  • It occurs in patients with chronic itch and is characterized by multiple hyperkeratotic papules and nodules. The pathogenesis of PN is unclear, but involves a complex interplay of numerous pathways including neurogenic and inflammatory factors.[ncbi.nlm.nih.gov]
Flank Pain
  • Abstract A 54-year-old male presented with a sudden burning sensation during urination and left flank pain.[ncbi.nlm.nih.gov]
Urinary Incontinence
  • At 6 months' follow-up his PSA is unrecordable and he is voiding well with minimal urinary incontinence, requiring 1 pad/day. We aim to outline our approach and highlight the technical modifications in this rare physically disabling condition.[ncbi.nlm.nih.gov]
Peripheral Neuropathy
  • Compared with thalidomide initiators, lenalidomide initiators had a reduced risk of peripheral neuropathy (HR 0.71, 95% CI: 0.56-0.92). We found no difference in rates of death (HR 1.00, 95% CI: 0.71-1.41).[ncbi.nlm.nih.gov]
  • Peripheral neuropathy did not increase after thalidomide addition. Adding low-dose thalidomide may safely improve the responses for multiple myeloma refractory to bortezomib and dexamethasone.[ncbi.nlm.nih.gov]
  • Peripheral neuropathy is observed in both idiosyncratic and dose-dependent relationships; children older than 12 years may be more susceptible to developing this adverse effect than younger patients.[ncbi.nlm.nih.gov]
  • If you get symptoms of peripheral neuropathy, tell your doctor promptly. Ongoing use of thalidomide may result in severe peripheral neuropathy, which can be irreversible.[leiomyosarcoma.info]
  • Conversely, the pooled rate of thalidomide withdrawal related to adverse events was 24% (95% CI, 14-35) including confirmed peripheral neuropathy in 16% (95% CI, 9-25) and thromboembolic events in 2% (95% CI, 1-3).[ncbi.nlm.nih.gov]
Responsiveness Decreasing
  • (decreased concentrations of monoclonal immunoglobulins [e.g., myeloma or Bence-Jones proteins] in serum or urine) in patients with newly diagnosed multiple myeloma. 1 242 243 Effect of combination therapy on survival in such patients not established[drugs.com]

Workup

Karyotype Abnormal
  • Bone marrow aspirates were obtained and biopsies were performed to determine the percentage of plasma cells in bone marrow, to identify karyotypic abnormalities (Giemsa-banded cells in metaphase), and to assess the proliferative activity in plasma cells[doi.org]
Multiple Ulcerations
  • A follow-up endoscopy performed 10 weeks after the treatment showed significant improvement and the patient's multiple ulcers had healed well.[ncbi.nlm.nih.gov]

Treatment

  • Myeloma de Novo Treatment 1 3 Completed Treatment Myelodysplastic Syndromes 1 3 Completed Treatment Prostate Cancer 1 3 Completed Treatment Renal Cancers 1 3 Completed Treatment Sarcoidosis 1 3 Completed Treatment Tumors Metastatic to Brain 1 3 Recruiting[drugbank.ca]
  • Aim to study the recurrence rate of GIVM bleeding after thalidomide treatment, the response to treatment, and the adverse effects.This was a retrospective study of 80 patients with GIVM treated with thalidomide between November 2003 and November 2013.[ncbi.nlm.nih.gov]
  • The median haemoglobin levels of these patients increased from 5.13 2.15 g/dL before treatment to 10.38 1.19 g/dL after treatment.[ncbi.nlm.nih.gov]
  • Treatment for wasting in patients with the Acquired Immunodeficiency Syndrome. N Engl J Med. 1999; 340:1740-50. 225. Kaplan G, Thomas S, Fierer DS et al. Thalidomide for the treatment of AIDS-associated wasting.[drugs.com]

Prognosis

  • Although the prognosis of mucormycosis is generally poor, in the reported case the patient recovered successfully. This case should alert dermatologists to possible opportunistic infections in immunosuppressed patients.[ncbi.nlm.nih.gov]
  • Extramedullary plasmacytomas and those that revert to an immature state are associated with a poor prognosis, so further treatment improvements are needed in the future.[ncbi.nlm.nih.gov]
  • Since increased bone marrow vascularity imparts a poor prognosis in myeloma, we evaluated the efficacy of thalidomide, which has antiangiogenic properties, in patients with refractory disease.[ncbi.nlm.nih.gov]
  • The presence of hormone responsive disease also implies a better prognosis than those who fail to respond to androgen ablation. Therefore, it is in this setting that we proposed to evaluate the clinical efficacy of thalidomide.[ncbi.nlm.nih.gov]

Etiology

  • The etiology of these lesions is poorly understood, and no definitive standard of care has been established for patients with these diagnoses.[ncbi.nlm.nih.gov]
  • The role of nitric oxide and β-catenin must be further evaluated, regarding thalidomide teratogenesis complex etiology. Copyright 2017 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • Abstract: Despite the fact that sickle cell anemia was one of the first diseases to have a demonstrated genetic etiology, to date there is still only one approved therapy for this disease.[doi.org]
  • Dai, Etiology and Pathogenesis of Hemifacial Microsomia, Journal of Dental Research, 10.1177/0022034518795609, 97, 12, (1297-1305), (2018). R. L. Smith and S. C.[doi.org]
  • The authors commented that idiopathic and “drug induced” gynecomastia tended to be more commonly unilateral whereas in those with a presumed hormonal etiology it was bilateral.[doi.org]

Epidemiology

  • The epidemiological method is described. Of the 115 children, 74 were alive at the time of reporting, 41 of these being severely handicapped; 8 had been stillborn; 33 had died.[ncbi.nlm.nih.gov]
  • Genetics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 3 Post-Graduate program in Genetics and Molecular Biology, Genetics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Post-graduate program in Epidemiology[ncbi.nlm.nih.gov]
  • He conducted a thorough epidemiological investigation, pinpointing the period of pregnancy associated with the greatest risk, and comparing the frequency of the birth defect for mothers who used the drug with the expected frequency in the general population[jameslindlibrary.org]
  • Allen Mitchell, director of the Slone Epidemiology Unit at the Boston University School of Public Health, which will run the thalidomide monitoring system.[nytimes.com]
  • Ardinger, Genetic epidemiology of cardiovascular malformations, Progress in Pediatric Cardiology, 10.1016/j.ppedcard.2005.04.003, 20, 2, (113-126), (2005).[oadoi.org]
Sex distribution
Age distribution

Pathophysiology

  • Tumor necrosis factor alpha (TNF-α) appears to play a central role in the pathophysiology of the disease. Standard therapies for inflammatory bowel disease fail to induce remission in about 30% of patients.[ncbi.nlm.nih.gov]
  • Recent increases in our understanding of the pathophysiology of the disease should translate into improved and more rapid development of newer therapies.[doi.org]
  • Was he contemplating the role of angiogenesis in the pathophysiology of the disease? Figure 2 Sarah Newbury, the first reported patient with multiple myeloma. (A) Bone destruction in the sternum.[doi.org]
  • Rose LI, Underwood RH, Newmark SR et al (1977) Pathophysiology of spironolactone-induced gynecomastia. Ann Intern Med 87:398–403 PubMed Google Scholar 95.[doi.org]

Prevention

  • […] seizures or reduce their severity. antiemetic A drug used to prevent nausea or vomiting.[ebi.ac.uk]
  • Thalidomide prevents blood vessel formation and causes stabilisation of the vessels to prevent bleeding.[independent.co.uk]
  • The decreased level of TNFα alters the mechanisms of intracellular transduction by preventing the activation of NF-kB and by decreasing the synthesis of proteins, in particular IL-6, involved in cell proliferation, inflammation, angiogenesis and protection[ncbi.nlm.nih.gov]
  • The most common symptom of thalidomide teratogenicity is limb abnormality, which led us to hypothesize that thalidomide prevents early mesodermal differentiation. Therefore, mesodermal differentiation of hiPSCs was induced over a 6-d period.[ncbi.nlm.nih.gov]

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