Inadvertent iatrogenic gluing of the eyelids—Learning points for practice

Digitalitzat per Artypla

Cirrhosis of the Liver and Incidence of associated Osteoporosis

Abstract: Objective: The main aim of this study is to find the incidence of osteoporosis (a bone weakening and breaking disease) in cirrhosis of the liver.Place and Duration of the Study: This study was carried out in services hospital Lahore in a period of 8 months form May 2018 to December 2018. Materials and Methods: Patients were selected who presented in the medical department of Services hospital Lahore. Patients were selected randomly and only those patients were selected who were willing to take part in this study. Mean age of the patients was between 40 t0 70 years and all the patients had cirrhosis of the liver either due to Hepatitis B or C. On DEXA scan T score <2.5 was considered to have osteoporosis. Informed consent was taken from all the patients.Results:  A total of 50 cases were seen with cirrhosis of the liver and included 18(36%) and 32(64%) males. Mean age of the patients was 47 years. 14(28%) of the patients had osteoporosis. More males 10 (31.25%) were affected with osteoporosis. In age group 56 to 70 years the incidence was much higher. Duration for which the patient had cirrhosis had no significant effect on the incidence.  Conclusion: Almost every 4th to 5th case of cirrhosis of the liver suffers from osteoporosis which is neglected mostly and not given significance. In people with higher age the complication is more frequent

Novel variants in COL4A4 and COL4A5 are rare causes of FSGS in two unrelated families

We report two female patients with focal segmental glomerulosclerosis and chronic kidney disease. The first patient was found to have a heterozygous, de novo, pathogenic variant in COL4A5 (c.141+1G>A, IVS2+1G>A), which is associated with Alport syndrome. The second patient was found to have a heterozygous, likely pathogenic variant in COL4A4 (c.2842G>T). Both these variants in COL4A5 and COL4A4 are novel, and they were detected using whole exome sequencing and gene panel testing, respectively. Additionally, we discuss the complexities of diagnosis in such cases and the benefits of using the abovementioned diagnostic approaches

Correction: Novel variants in COL4A4 and COL4A5 are rare causes of FSGS in two unrelated families

No abstract available

Rituximab or Cyclosporine in the Treatment of Membranous Nephropathy

Background: B-cell anomalies play a role in the pathogenesis of membranous nephropathy. B-cell depletion with rituximab may therefore be noninferior to treatment with cyclosporine for inducing and maintaining a complete or partial remission of proteinuria in patients with this condition. Methods: We randomly assigned patients who had membranous nephropathy, proteinuria of at least 5 g per 24 hours, and a quantified creatinine clearance of at least 40 ml per minute per 1.73 m(2) of body-surface area and had been receiving angiotensin-system blockade for at least 3 months to receive intravenous rituximab (two infusions, 1000 mg each, administered 14 days apart; repeated at 6 months in case of partial response) or oral cyclosporine (starting at a dose of 3.5 mg per kilogram of body weight per day for 12 months). Patients were followed for 24 months. The primary outcome was a composite of complete or partial remission of proteinuria at 24 months. Laboratory variables and safety were also assessed. Results: A total of 130 patients underwent randomization. At 12 months, 39 of 65 patients (60%) in the rituximab group and 34 of 65 (52%) in the cyclosporine group had a complete or partial remission (risk difference, 8 percentage points; 95% confidence interval [CI], -9 to 25; P=0.004 for noninferiority). At 24 months, 39 patients (60%) in the rituximab group and 13 (20%) in the cyclosporine group had a complete or partial remission (risk difference, 40 percentage points; 95% CI, 25 to 55; P<0.001 for both noninferiority and superiority). Among patients in remission who tested positive for anti-phospholipase A(2) receptor (PLA2R) antibodies, the decline in autoantibodies to anti-PLA2R was faster and of greater magnitude and duration in the rituximab group than in the cyclosporine group. Serious adverse events occurred in 11 patients (17%) in the rituximab group and in 20 (31%) in the cyclosporine group (P=0.06). Conclusions: Rituximab was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission up to 24 months. (Funded by Genentech and the Fulk Family Foundation; MENTOR ClinicalTrials.gov number, .) In a randomized, controlled trial involving patients with membranous nephropathy, rituximab was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission for up to 24 months.Genentech; Fulk Family Foundation6 month embargo; published July 4, 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]