Transcript of The Dory Derby Accident

This story is an excerpt from a longer interview that was collected as part of the Launching through the Surf: The Dory Fleet of Pacific City project. In this story, Don Grotjohn recounts an accident that occurred during a Dory Derby competition

Frequency and time to relapse after discontinuing 6-month therapy with IVIg or pulsed methylprednisolone in CIDP

Background: We reported that 6-month therapy with intravenous immunoglobulin (IVIg) was more frequently effective or tolerated than intravenous methylprednisolone (IVMP) in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We now retrospectively compared the proportion of patients who eventually worsened after discontinuing therapy and the median time to clinical worsening. Methods: By March 2013, data were available from 41 of the 45 patients completing the trial with a median follow-up after therapy discontinuation of 42 months (range 1-60). Three patients withdrew during the original study and one failed to respond to either of the therapies. No patient received a diagnosis alternative to CIDP during the follow-up. Results: Twenty-eight of the 32 patients treated with IVIg (as primary or secondary therapy after failing to respond to IVMP) improved after therapy (87.5%) as compared with 13 of the 24 patients treated with IVMP as primary or secondary therapy (54.2%). After a median follow-up of 42 months (range 1-57), 24 out of 28 patients responsive to IVIg (85.7%) worsened after therapy discontinuation. The same occurred in 10 out of 13 patients (76.9%) responsive to IVMP (p=0.659) after a median follow-up of 43 months (range 7-60). Worsening occurred 1-24 months (median 4.5) after IVIg discontinuation and 1-31 months (median 14) after IVMP discontinuation (p=0.0126). Conclusions: A similarly high proportion of patients treated with IVIg or IVMP eventually relapse after therapy discontinuation but the median time to relapse was significantly longer after IVMP than IVIg. This difference may help to balance the more frequent response to IVIg than to IVMP in patients with CIDP

Dronedarone in high-risk permanent atrial fibrillation

BACKGROUND: Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events in high-risk permanent atrial fibrillation. METHODS: We assigned patients who were at least 65 years of age with at least a 6-month history of permanent atrial fibrillation and risk factors for major vascular events to receive dronedarone or placebo. The first coprimary outcome was stroke, myocardial infarction, systemic embolism, or death from cardiovascular causes. The second coprimary outcome was unplanned hospitalization for a cardiovascular cause or death. RESULTS: After the enrollment of 3236 patients, the study was stopped for safety reasons. The first coprimary outcome occurred in 43 patients receiving dronedarone and 19 receiving placebo (hazard ratio, 2.29; 95% confidence interval [CI], 1.34 to 3.94; P = 0.002). There were 21 deaths from cardiovascular causes in the dronedarone group and 10 in the placebo group (hazard ratio, 2.11; 95% CI, 1.00 to 4.49; P = 0.046), including death from arrhythmia in 13 patients and 4 patients, respectively (hazard ratio, 3.26; 95% CI, 1.06 to 10.00; P = 0.03). Stroke occurred in 23 patients in the dronedarone group and 10 in the placebo group (hazard ratio, 2.32; 95% CI, 1.11 to 4.88; P = 0.02). Hospitalization for heart failure occurred in 43 patients in the dronedarone group and 24 in the placebo group (hazard ratio, 1.81; 95% CI, 1.10 to 2.99; P = 0.02). CONCLUSIONS: Dronedarone increased rates of heart failure, stroke, and death from cardiovascular causes in patients with permanent atrial fibrillation who were at risk for major vascular events. Our data show that this drug should not be used in such patients. (Funded by Sanofi-Aventis; PALLAS ClinicalTrials.gov number, NCT01151137.) Copyright © 2011 Massachusetts Medical Society. All rights reserved.published_or_final_versio

Throat infections by beta-hemolytic streptococcus A group. Bacteriology and clinical response

Fil: Armelini, Pedro Alberto. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Paolasso, R. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Gómez, E. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentin

CAN ELECTROPHYSIOLOGY PREDICT CLINICAL OUTCOMES IN CIDP?

This report examined data from a multicentre, randomised, double-blind, placebo controlled, parallel-group study in patients with CIDP: 45 patients, 24 intravenous immunoglobulin (IVIg), 21 intravenous methylprednisolone (IMP) completed the study. The study is registered under the EUDRACT number 2005-001136-76 and was approved by the ethics committees of all the participating centres. At present, few data are available on correlations between changes in nerve motor and sensory conduction study and clinical outcomes; particularly, can electrophysiology predict treatment response? Before enrollment and six months after, the nerve-conduction measurement on a minimum of eight motor and six sensory nerves were performed. The analysis of the variations in the two most relevant motor nerves for the diagnosis of CIDP showed a marginal non-significant improvement in both groups in distal and proximal amplitude of compound muscle action potentials, in motor conduction velocities, but not in the number of nerves with conduction block. The only significant difference was in the reduction in the distal latency in the IVIg group. The analysis of the per-protocol population showed a significant improvement in motor nerve conduction velocity and reduction in distal latency in the IVIg group but also an increase in the number of nerves with conduction block; there was no significant difference compared with the IMP group. In addition, the analysis of our data documented that: 1) there is no difference in the clinical response to IMP in patients with a pattern of focal demyelination, and 2) the amplitude or conduction velocity of the most affected motor nerves and the other electrophysiological parameters evaluated before therapy were not predictive of responder status. These findings are partially in accordance with those made by Bril et al. (2010) and recommend to treat with IVIg or IMP also the patients presenting serious electrophysiological alterations before therapy. S2

Rituximab treated CIDP: a retrospective study

Journée de doctorants Centre d’études et de recherches sur l’espace germanophone (CEREG) Université Paris 3 – Sorbonne Nouvelle / Université Paris Ouest-Nanterre-La Défense Atelier de réflexion méthodologique et de formation à la recherche en Études germaniques (ED 514) Vendredi 27 mai 2016 Université Sorbonne Nouvelle-Paris 3 Institut du Monde anglophone, 5 rue de l’Ecole de Médecine, 75006 Paris, Salle 33 9h30-10h30 Elisabeth Hamm, Animal et animalité au théâtre dans l’espace germanophone..