Investigation of the presence of pregnancy rhinitis in the third trimester with rhinomanometry

Aim: Pregnancy rhinitis (PR) is characterized with nasal symptoms during pregnancy without any signs of respiratory infection and it usually disappears within 2 weeks after delivery. We aimed to investigate the relationship between pregnancy rhinitis and findings derived from anterior rhinoscopy (AnR), anterior rhinomanometry (ARM) and subjective nasal obstruction score (SNOS). Methods: This prospective, controlled study was performed in otorhinolaryngology and obstetrics and gynecology departments of our tertiary care center. A total of 30 pregnant women in the third trimester and 30 non-pregnant women were involved. All participants underwent otorhinolaryngology examination, as well as clinical evaluation for AnR, ARM and SNOS. Results: Pregnancy rhinitis was detected in 66.7% of the pregnant women. The mean AnR was 3.60 ± 1.35 in pregnant women and 0.77 ± 0.73 in the control group. Total nasal inspiratory resistance (TNID) was 0.46±0.23 in pregnant women and 0.27±0.06 in the control group. The mean SNOS was 1.37±0.72 in pregnant women and 0.57±0.63 in the control group. AnR, ARM and SNOS findings were significantly higher in pregnant women (p<0.05). There is a low positive and significant correlation between AnR, ARM, and SNOS values in pregnant women (p<0.05). Conclusion: Our data yielded that nasal obstruction and pregnancy rhinitis were common in pregnant women.  Nasal symptoms and complaints must be carefully examined during pregnancy. Further prospective, controlled, randomized trials on larger series are warranted to elucidate the clinical and pathophysiological features of pregnancy rhinitis

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Characterization of an emerging isolate of watermelon mosaic virus in Turkey

International audienceA watermelon mosaic virus isolate (WMV-Tr) was obtained from a naturally infected watermelon (Citrullus lanatus (Thunb.) Matsum. and Nakai) plant with mosaic, mottle and leaf deformation symptoms collected in the major cucurbit-growing area in Adana province of Turkey during a survey conducted in May 2009. DAS-ELISA and RT-PCR showed the presence of watermelon mosaic virus (WMV, Potyvirus) in the sample. WMV-Tr was characterized biologically and its partial coat protein genome sequence was established. WMV-Tr had biological properties similar to those reported for the WMV isolates from different parts of the world. WMV-Tr belonged to molecular group 3, containing Asian isolates of WMV as well as isolates currently emerging in different parts of the world including Europe. This suggests recent emergence of Group 3 isolates in Turkey

Characterization of an emerging isolate of watermelon mosaic virus in Turkey

International audienceA watermelon mosaic virus isolate (WMV-Tr) was obtained from a naturally infected watermelon (Citrullus lanatus (Thunb.) Matsum. and Nakai) plant with mosaic, mottle and leaf deformation symptoms collected in the major cucurbit-growing area in Adana province of Turkey during a survey conducted in May 2009. DAS-ELISA and RT-PCR showed the presence of watermelon mosaic virus (WMV, Potyvirus) in the sample. WMV-Tr was characterized biologically and its partial coat protein genome sequence was established. WMV-Tr had biological properties similar to those reported for the WMV isolates from different parts of the world. WMV-Tr belonged to molecular group 3, containing Asian isolates of WMV as well as isolates currently emerging in different parts of the world including Europe. This suggests recent emergence of Group 3 isolates in Turkey

Consensus Report on Patient Blood Management in Cardiac Surgery by Turkish Society of Cardiovascular Surgery (TSCVS), Turkish Society of Cardiology (TSC), and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care (SCTAIC)

Anemia, transfusion and bleeding independently increase the risk of complications and mortality in cardiac surgery. The main goals of patient blood management are to treat anemia, prevent bleeding, and optimize the use of blood products during the perioperative period. The benefit of this program has been confirmed in many studies and its utilization is strongly recommended by professional organizations. This consensus report has been prepared by the authors who are the task members appointed by the Turkish Society of Cardiovascular Surgery, Turkish Society of Cardiology (TSC), and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care to raise the awareness of patient blood management. This report aims to summarize recommendations for all perioperative blood-conserving strategies in cardiac surgery

Long-term efficacy and safety of eculizumab in Japanese patients with generalized myasthenia gravis: A subgroup analysis of the REGAIN open-label extension study

The terminal complement inhibitor eculizumab was shown to improve myasthenia gravis-related symptoms in the 26-week, phase 3, randomized, double-blind, placebo-controlled REGAIN study (NCT01997229). In this 52-week sub-analysis of the open-label extension of REGAIN (NCT02301624), eculizumab's efficacy and safety were assessed in 11 Japanese and 88 Caucasian patients with anti-acetylcholine receptor antibody-positive refractory generalized myasthenia gravis. For patients who had received placebo during REGAIN, treatment with open-label eculizumab resulted in generally similar outcomes in the Japanese and Caucasian populations. Rapid improvements were maintained for 52 weeks, assessed by change in score from open-label extension baseline to week 52 (mean [standard error]) using the following scales (in Japanese and Caucasian patients, respectively): Myasthenia Gravis Activities of Daily Living (−2.4 [1.34] and − 3.3 [0.65]); Quantitative Myasthenia Gravis (−2.9 [1.98] and − 4.3 [0.79]); Myasthenia Gravis Composite (−4.5 [2.63] and − 4.9 [1.19]); and Myasthenia Gravis Quality of Life 15-item questionnaire (−8.6 [5.68] and − 6.5 [1.93]). Overall, the safety of eculizumab was consistent with its known safety profile. In this interim sub-analysis, the efficacy and safety of eculizumab in Japanese and Caucasian patients were generally similar, and consistent with the overall REGAIN population

Consistent improvement with eculizumab across muscle groups in myasthenia gravis

Objective: To assess whether eculizumab, a terminal complement inhibitor, improves patient- and physician-reported outcomes (evaluated using the myasthenia gravis activities of daily living profile and the quantitative myasthenia gravis scale, respectively) in patients with refractory anti-acetylcholine receptor antibody-positive generalized myasthenia gravis across four domains, representing ocular, bulbar, respiratory, and limb/gross motor muscle groups. Methods: Patients with refractory anti-acetylcholine receptor antibody-positive generalized myasthenia gravis were randomized 1:1 to receive either placebo or eculizumab during the REGAIN study (NCT01997229). Patients who completed REGAIN were eligible to continue into the open-label extension trial (NCT02301624) for up to 4 years. The four domain scores of each of the myasthenia gravis activities of daily living profile and the quantitative myasthenia gravis scale recorded throughout REGAIN and through 130 weeks of the open-label extension were analyzed. Results: Of the 125 patients who participated in REGAIN, 117 enrolled in the open-label extension; 61 had received placebo and 56 had received eculizumab during REGAIN. Patients experienced rapid improvements in total scores and all four domain scores of both the myasthenia gravis activities of daily living profile and the quantitative myasthenia gravis scale with eculizumab treatment. These improvements were sustained through 130 weeks of the open-label extension. Interpretation: Eculizumab treatment elicits rapid and sustained improvements in muscle strength across ocular, bulbar, respiratory, and limb/gross motor muscle groups and in associated daily activities in patients with refractory anti-acetylcholine receptor antibody-positive generalized myasthenia gravis