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📃Scientific paper: Teprotumumab in advanced reactivated thyroid eye disease Abstract: PURPOSE: To report the case of a patient with reactivated, refractory thyroid eye disease (TED) treated with teprotumumab. OBSERVATIONS: A 51-year-old female with a 16-year history of thyroid eye disease previously treated with orbital decompression and multiple eyelid surgeries presented in a recurrent flare of the disease. The disease recurrence was refractory to intravenous steroid therapy and only partially responsive to oral steroid therapy, and the patient developed dysthyroid optic neuropathy in the right eye with decreased visual acuity and color vision. Clinical activity score was 8/10 and proptosis measurements were 27 mm OD and 26 mm OS. The patient underwent treatment with eight infusions of teprotumumab coinciding with a low taper of oral prednisone and experienced resolution of dysthyroid optic neuropathy, decrease of clinical activity score to 1, and dramatic improvement in proptosis (17 mm OD, 17 mm OS) and extraocular muscle size on imaging. Thirty weeks after completion of teprotumumab and 2 weeks after the second dose of the COVID vaccine, she experienced another flare and subsequently underwent bilateral orbital decompressions. CONCLUSION: This case report suggests teprotumumab may be used in patients with reactivation of longstanding thyroid eye disease. Reduction of extraocular muscle size and improvement in proptosis suggest teprotumumab may be disease-modifying even in advanced cases. Continued on ES/IODE ➡️ https://etcse.fr/kf7i ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

🔷 𝐌𝐚𝐫𝐜𝐡 𝐢𝐬 𝐂𝐨𝐥𝐨𝐫𝐞𝐜𝐭𝐚𝐥 𝐂𝐚𝐧𝐜𝐞𝐫 𝐀𝐰𝐚𝐫𝐞𝐧𝐞𝐬𝐬 𝐌𝐨𝐧𝐭𝐡 🔷 #Colorectalcancer is a cancer that starts in the colon or rectum, which are parts of the #digestive system. Unlike most cancers, colorectal cancer is often preventable with screening and highly treatable when detected early. 𝐖𝐡𝐚𝐭 𝐲𝐨𝐮 𝐒𝐇𝐎𝐔𝐋𝐃 𝐤𝐧𝐨𝐰 𝐚𝐛𝐨𝐮𝐭 𝐂𝐨𝐥𝐨𝐫𝐞𝐜𝐭𝐚𝐥 𝐂𝐚𝐧𝐜𝐞𝐫: 🔍 𝐈𝐧𝐜𝐫𝐞𝐚𝐬𝐞𝐝 𝐈𝐧𝐜𝐢𝐝𝐞𝐧𝐜𝐞: #CRC ranks as the 3rd leading cause of cancer-related death in the USA. It is estimated that in the USA alone over 13,500 CRC cases could be prevented with better detection. 𝐑𝐢𝐬𝐤 𝐅𝐚𝐜𝐭𝐨𝐫𝐬: Possible contributing factors include lifestyle changes, diet, and environmental exposures. 𝐒𝐜𝐫𝐞𝐞𝐧𝐢𝐧𝐠 𝐑𝐞𝐜𝐨𝐦𝐦𝐞𝐧𝐝𝐚𝐭𝐢𝐨𝐧𝐬: The American College of Gastroenterology (#ACG) has revised its guidelines, now recommending #colorectal cancer screening to start at age 45 for average-risk patients. 𝐁𝐥𝐨𝐨𝐝-𝐁𝐚𝐬𝐞𝐝 𝐒𝐜𝐫𝐞𝐞𝐧𝐢𝐧𝐠: The ACG does not currently recommend blood-based screening tests for colorectal cancer. 𝐒𝐮𝐫𝐯𝐞𝐢𝐥𝐥𝐚𝐧𝐜𝐞 𝐂𝐨𝐥𝐨𝐧𝐨𝐬𝐜𝐨𝐩𝐢𝐞𝐬: A letter from 45 members of Congress urges federal agencies to expand access to colorectal cancer screenings by ensuring that surveillance #colonoscopies are covered as preventive services. 𝐄𝐧𝐝𝐨𝐬𝐜𝐨𝐩𝐲 𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞𝐬: The volume of #endoscopic procedures performed at ambulatory surgery centers (#ASCs) continues to increase, ranging from screening colonoscopies to #upperGI endoscopies. 𝐑𝐨𝐛𝐨𝐭𝐢𝐜 𝐒𝐮𝐫𝐠𝐞𝐫𝐲: #Roboticsurgery is associated with improved outcomes over #laparoscopic procedures for #coloncancer patients undergoing #colectomies. 𝐂𝐡𝐫𝐨𝐧𝐢𝐜 𝐂𝐚𝐫𝐞 𝐌𝐚𝐧𝐚𝐠𝐞𝐦𝐞𝐧𝐭: Investing in the future of #chroniccare management is crucial, as chronic diseases are prevalent and costly health conditions. #colorectalcancerawareness #colorectalcancer #crc #gi #gastrointestinal #gastroenterology #ddw #ddw2024 #medicaldevices #medtech #executivesearch #recruitment #endoscopy #cancerscreening #cancerawareness

🚨 Skin patches could be used to provide an early warning of lung transplant rejection, in a new trial being funded by NIHR and the Medical Research Council . 🚨 Transplanted organs such as lungs, hearts, kidneys and pancreases are subject to attack by the immune system causing rejection. 🚨 Lung transplant rejection rates are high and limit lives. Around 55% of patients are alive after 5 years following the transplant. 🚨 Rejection is currently monitored through tests of lung function, blood tests, X-rays and biopsies. But it’s difficult to identify until it is already quite advanced. 🚨 However skin seems to reject earlier than other transplanted organs and is easily visible at all times. 🚨 Organ rejection may show as a rash on the donated skin patch, often before the body has started to reject the lungs. 🚨 Identifying the signs early allows quicker and more personalised treatment. This helps the organ to function for longer and the patient to live longer. 🚨 If the trial is successful, the researchers estimate that lung transplant rejection rates could be reduced by half. 🚨 A team from Oxford University is leading the study together with 5 UK lung transplant centres and NHS Blood and Transplant . 🚨 Read the full story at: https://lnkd.in/e8_CsPB8

Exciting news about the potential of GLP-1 RAs in reducing obesity-related cancer risks! As someone with multiple family members affected by cancer, this area of research is deeply personal. However, it's important to approach these findings with a "dose" of caution. While the study offers signals that are positive, we must recognize the limitations and avoid prematurely signaling these results as definitive to prevent a further rush on the drugs when there is already a shortage. The reliance on data from the TriNetX database, the exclusion of certain patient populations, and the inherent limitations of propensity score matching all point to areas where further review is needed. Also, the paradoxical finding that GLP-1 RAs offer superior mortality benefits despite less weight loss compared to bariatric surgery raises an area for further discussion. It's essential that to balance enthusiasm with a criticism and not fall into an area of confirmation bias one way or the other! https://buff.ly/45vQJWE #GLP1RA #Healthcare #EvidenceBasedMedicine #AOMs #WeightLoss

📃Scientific paper: Teprotumumab in advanced reactivated thyroid eye disease Abstract: PURPOSE: To report the case of a patient with reactivated, refractory thyroid eye disease (TED) treated with teprotumumab. OBSERVATIONS: A 51-year-old female with a 16-year history of thyroid eye disease previously treated with orbital decompression and multiple eyelid surgeries presented in a recurrent flare of the disease. The disease recurrence was refractory to intravenous steroid therapy and only partially responsive to oral steroid therapy, and the patient developed dysthyroid optic neuropathy in the right eye with decreased visual acuity and color vision. Clinical activity score was 8/10 and proptosis measurements were 27 mm OD and 26 mm OS. The patient underwent treatment with eight infusions of teprotumumab coinciding with a low taper of oral prednisone and experienced resolution of dysthyroid optic neuropathy, decrease of clinical activity score to 1, and dramatic improvement in proptosis (17 mm OD, 17 mm OS) and extraocular muscle size on imaging. Thirty weeks after completion of teprotumumab and 2 weeks after the second dose of the COVID vaccine, she experienced another flare and subsequently underwent bilateral orbital decompressions. CONCLUSION: This case report suggests teprotumumab may be used in patients with reactivation of longstanding thyroid eye disease. Reduction of extraocular muscle size and improvement in proptosis suggest teprotumumab may be disease-modifying even in advanced cases. Continued on ES/IODE ➡️ https://etcse.fr/kf7i ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

Parasagittal and Parafalcine MENINGIOMAS : UPFRONT vs ADJUVANT RADIOSURGERY; a systematic review and meta-analysis Fernando De Nigris Vasconcellos et al., Neurosurg Rev, 2024 Mar https://lnkd.in/di5xMha9 8 studies involving 821 patients with 878 parafalcine and parasagittal (PFPS) grade I meningiomas - LOCAL CONTROL (LC) was achieved in >80% of all cases, while in the subgroup of patients that recieved UPFRONT SRS LC was achieved in 97% of such cases - TOXICITY was reported in 7.3% of the SRS treated PFPS meningiomas - RECURRENCE was observed in 17.1% of cases - FURTHER SURGICAL APPROACH was needed in 9.2% of cases - SYMPTOM IMPROVEMENT was noted in 33.2% of patients Conclusions: SRS is a SAFE and EFFECTIVE treatment for PFPS meningiomas, both as an adjuvant therapy and as an upfront treatment for often smaller tumors. The use of single and hypofractionated SRS for larger volume PFPS meningiomas should be more explored to better define the risks and benefits. #SRS #upfront_SRS #adjuvant_SRS #parafalcine #parasagittal #meningiomas

Having a rare disease can mean what feels like an infinitely long journey, in and out of medical centers, dozens of tests, and seeing precious time wasted along both the diagnostic and treatment journey. So, in honor of #rarediseaseday I thought I'd post four exciting wins in the rare disease space from the last quarter of 2023 as a silver lining. 1. Dec 2023: The FDA approved Filsuvez by the Chiesi Group for junctional & dystrophic epidermolysis bullosa, a skin condition that causes severe blistering, tearing, and sores on the skin. In severe cases, life expectancy is severely reduced especially in countries that struggle with sanitary living conditions as the sores may become infected. 2. Oct 2023: A study on the impact of newborn screening on adrenal insufficiency in adrenoleukodystrophy (ALD) showed significant differences (P < .001) in diagnosis but also ACTH and peak cortisol levels after treatment in male populations leading to earlier intervention & better health outcomes. 3. Nov 2023: The FDA approved OGSIEVO, the first ever approved treatment for desmoid tumors. Studies showed an objective response rate of 41% and a hazard ratio of 0.31. 4. Nov 2023: A study characterized the histological changes in sinus tissue of patients with primary ciliary dyskinesia, a disease caused by genetic mutations that affect the cilia in the lungs, nose and ears, impairing their ability to remove pollutants. Patients with this disease have a reduced lifespan and often experience recurring pneumonia. This study demonstrated neurophils as the dominant immune cell which will support R&D for therapeutics to treat this condition. Find information on epidermolysis bullosa via American Academy of Dermatology, information on ALD via the The Stop ALD Foundation, information on desmoid tumors via Mayo Clinic or Memorial Sloan Kettering Cancer Center, and information on primary ciliary dyskinesia via the American Lung Association. #rarediseaseday2024 #rarediseases #genomicmedicine

Cornea Update: Direct Immunofluorescence Findings and Factors Affecting Conjunctival Biopsy Positivity in Ocular Mucous Membrane Pemphigoid: Purpose: The aim of this study was to describe the direct immunofluorescence (DIF) findings and factors affecting conjunctival biopsy positivity in patients clinically diagnosed with ocular mucous membrane pemphigoid (OMMP). Methods: This retrospective observational case series included patients with clinical OMMP who underwent conjunctival biopsy for DIF in at least 1 eye between 2018 and 2021 in an institutional setting. The primary outcome measures were association of age and chronic ocular complications with biopsy positivity. Results: Of 61 patients, DIF positivity was seen in 33 (54.1%) clinically suspected cases of OMMP. Of 39 patients who underwent bilateral biopsy, 23 (59%) were positive, of which 12 (52%) were positive in both eyes while 11 (48%) were positive in 1 eye. Of 22 patients who underwent unilateral biopsy, 10 (45%) were positive. Of the 100 biopsied eyes, 45 (45%) were DIF positive. Among the immunoreactants studied, linear deposition of C3 was seen in all 45 positive eyes (100%). Increasing age was significantly associated with higher likelihood of biopsy negativity (P = 0.032), whereas a greater Sotozono chronic ocular complication score, indicative of disease severity, was associated with low likelihood of biopsy positivity (P = 0.0042) and lower overall expression of immunoreactants on DIF (P = 0.0007). Conclusions: Older patients and patients with more severe ocular surface disease sequelae are likely to have negative DIF results. To optimize the chances of confirming the diagnosis of OMMP by DIF, both eyes should be biopsied early in the disease course. If 1 eye is being biopsied, the less affected eye must be chosen. http://dlvr.it/T0sMcR #Cornea #MostPopularArticles #Ophthalmology

Cornea Update: Direct Immunofluorescence Findings and Factors Affecting Conjunctival Biopsy Positivity in Ocular Mucous Membrane Pemphigoid: Purpose: The aim of this study was to describe the direct immunofluorescence (DIF) findings and factors affecting conjunctival biopsy positivity in patients clinically diagnosed with ocular mucous membrane pemphigoid (OMMP). Methods: This retrospective observational case series included patients with clinical OMMP who underwent conjunctival biopsy for DIF in at least 1 eye between 2018 and 2021 in an institutional setting. The primary outcome measures were association of age and chronic ocular complications with biopsy positivity. Results: Of 61 patients, DIF positivity was seen in 33 (54.1%) clinically suspected cases of OMMP. Of 39 patients who underwent bilateral biopsy, 23 (59%) were positive, of which 12 (52%) were positive in both eyes while 11 (48%) were positive in 1 eye. Of 22 patients who underwent unilateral biopsy, 10 (45%) were positive. Of the 100 biopsied eyes, 45 (45%) were DIF positive. Among the immunoreactants studied, linear deposition of C3 was seen in all 45 positive eyes (100%). Increasing age was significantly associated with higher likelihood of biopsy negativity (P = 0.032), whereas a greater Sotozono chronic ocular complication score, indicative of disease severity, was associated with low likelihood of biopsy positivity (P = 0.0042) and lower overall expression of immunoreactants on DIF (P = 0.0007). Conclusions: Older patients and patients with more severe ocular surface disease sequelae are likely to have negative DIF results. To optimize the chances of confirming the diagnosis of OMMP by DIF, both eyes should be biopsied early in the disease course. If 1 eye is being biopsied, the less affected eye must be chosen. http://dlvr.it/T9SQHJ #Cornea #MostPopularArticles #Ophthalmology

Hello connection 🤝 Artical on abdominal paracentesis Paracentesis is a procedure in which a needle or catheter is inserted into the peritoneal cavity to obtain ascitic fluid for diagnostic or therapeutic purposes. [1, 2, 3] Ascitic fluid may be used to help determine the etiology of ascites, as well as to evaluate for infection or presence of cancer. CAUSES injury to the abdomen. infection of the peritoneum (peritonitis) scarring of the liver tissue (cirrhosis) or liver failure. cancer, in particular ovarian, uterine, cervical, colorectal, stomach, pancreatic or liver cancer. POSITION Midline and lateral approaches can be used for paracentesis, with the left-lateral technique more commonly employed. INDICATION Abdominal paracentesis is a safe and effective diagnostic and therapeutic procedure used in the evaluation of a variety of abdominal problems, including ascites, abdominal injury, acute abdomen, and peritonitis. Ascites may be recognized on physical examination as abdominal distention and the presence of a fluid wave CONTRAINDICATED Poor patient cooperation, surgical scarring over the puncture area, large intra-abdominal masses, and severe portal hypertension with abdominal collateral circulation are relative contraindications. CONCLUSION Abdominal paracentesis is a safe and effective diagnostic and therapeutic procedure used in the evaluation of a variety of abdominal problems, including ascites, abdominal injury, acute abdomen, and peritonitis. #snsinstitutions #snsdesignthinkers #snsdesignthinking