Pyopneumothorax is a rare but troubling complication of bevacizumab. We herein report a case of pyopneumothorax in a patient with metastatic breast cancer during bevacizumab treatment. A 60-year-old ...female who was diagnosed with metastatic breast cancer (ER+ , PgR+ , HER2-, Ki67 <14 %, metastasized to lung, pleural, brain, subcutaneous tissue, and bone) was started on bevacizumab plus paclitaxel chemotherapy. Although the disease was well-controlled, pyopneumothorax was noted after 3 months of treatment and the chemotherapy was therefore stopped immediately. The pyopneumothorax was so intractable that no conservative treatment could successfully manage it. The patient underwent a radical operation using the technique of latissimus dorsi muscle transfer. The operation improved her general condition and lead to hormonal therapy. Our case indicates the successful management of a severe side effect of bevacizumab for a breast cancer patient.
The aim of this retrospective multicenter study was to clarify efficacy and safety of Elbasvir/Grazoprevir for chronic hepatitis C patients with chronic kidney disease (CKD). Forty-five patients with ...CKD were administered Elbasvir/Grazoprevir and subjected to this analysis. Overall sustained virologic response 12 rates in CKD patients were 95.6%. The sustained virologic response 4 and 12 rates were 92.9% and 92.9% in CKD G3 patients, 100% and 100% in G4 patients and 100% and 100% in G5 patients including 10 dialysis patients, respectively. The frequency of adverse event did not increase in the patients with CKD. This study suggests that Elbasvir/Grazoprevir therapy is effective and safe for genotype 1b chronic hepatitis C patients with CKD.
Aim
Previous studies have suggested that patients with chronic hepatitis
C
with a low pretreatment hepatitis
C
virus (
HCV
) level have a high sustained virological response (
SVR
) rate, and that ...there would be a subpopulation of patients in which
HCV
can be eradicated with pegylated interferon (
PEG IFN
) alone without a decrease in
SVR
. However, the efficacy of
PEG IFN
monotherapy in patients with low
HCV RNA
levels is unclear. Several studies have reported that interferon sensitivity‐determining region (
ISDR
) and the single‐nucleotide polymorphism (
SNP
) of interleukin‐28
B
(
IL‐28B
) contribute to
IFN
response, but these relationships are controversial. The aim of this study was to determine whether the
SNP
of
IL‐28B
(rs8099917) and amino acid substitutions in the
ISDR
among patients with low
HCV
levels affect the response to
PEG IFN
monotherapy.
Methods
One hundred and four patients with low‐level
HCV
infection were studied. Low
HCV
level was defined as 100
KIU
/m
L
or less.
Results
SVR
was achieved in 94 patients (92.2%).
HCV
levels (≤50
KIU
/m
L
) and
ISDR
(≥2 mutations) were associated with
SVR
on univariate analysis. The rates of
SVR
in the patients with
IL‐28B
genotypes
TT
,
TG
and
GG
were 94.5%, 77.8% and 100%, respectively. The
G
allele tended to be associated with poor response to
IFN
therapy (
P
= 0.0623). On multivariate analysis, the
ISDR
was the factor predictive of
SVR
(
P
= 0.004).
Conclusion
The
ISDR
is significantly associated with a good response to
PEG IFN
monotherapy in patients with low
HCV
levels.
In view of the findings and concomitant disease, it is also necessary to perform other imaging modalities as needed, such as CT (computed tomography) or MRI (magnetic resonance imaging), to confirm ...the diagnosis. B-mode Findings Major type Subtype Shape Border/contour Tumor margin Intra-tumor Posterior echo Additional findings Hepatocellular carcinoma Nodular type (≤2 cm) Round, roundish Moderately well-defined, smooth Hypoechoic peripheral zone (infrequent) Various echo levels (mosaic pattern is sometimes observed) Unchanged–sometimes enhanced Bright loop Nodular type (>2 cm) Round, roundish Well-defined, smooth Thin hypoechoic peripheral zone (halo) Mosaic pattern, nodule in nodule. Tumor size is an indirect finding in the characterization that is closely related to the internal structure. ...the typical findings, extracted from different size categories, are stated in the nodular type of HCC. Doppler findings (Table 2; Fig. 7) In Doppler
Background: It remains unclear how we can shorten the treatment duration of antiviral combination therapy with peginterferon and ribavirin for patients with chronic hepatitis C virus (HCV) genotype 2 ...infection who achieved a rapid virological response (RVR).
Aim: We compared the efficacy of antiviral combination therapy with peginterferon and ribavirin for 8 vs. 24 weeks for the treatment of patients with HCV genotype 2 infection and with RVR.
Methods: Sixty‐one patients were enrolled. Serum HCV RNA was not detected at 4 weeks after the start of treatment in 32 patients with an RVR. These 32 patients were randomly assigned to 8‐week (n=15) or 24‐week (n=17) treatment regimens. Patients in the 8‐week group who relapsed underwent a 24‐week retreatment.
Results: No significant difference in patient characteristics was observed between the 8‐ and the 24‐week treatment groups. A sustained virological response (SVR) was seen in five of 15 patients (33.3%) in the 8‐week treatment group and 14 of 17 (82.4%) in the 24‐week treatment group; the rate was significantly higher in the 24‐week treatment group (P=0.0140). Nine of 10 relapsed patients in the 8‐week treatment group underwent a 24‐week retreatment, and seven achieved an SVR.
Conclusion: An 8‐week regimen of combination antiviral therapy with peginterferon and ribavirin yielded an increase in the relapse rate, indicating the limitation of a reduction of treatment below 12 weeks in patients with genotype 2, after RVR.
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