ABSTRACT
We aimed to evaluate the efficacy and safety of mepolizumab (MEP) in the management of hypereosinophilic syndrome (HES). A systematic search was performed, and articles published until March 2021 were analyzed. The primary efficacy results evaluated were hospitalization rate related to HES, morbidity (new or worsening), relapses/failure, treatment-related adverse effects, prednisone dosage ≤10 mg/day for ≥8 weeks, and eosinophil count <600/µL for ≥8 weeks. A meta-analysis was conducted, when appropriate. Three randomized controlled trials (RCTs), with a total of 255 patients, were included. The studies contemplated the use of MEP 300 mg/SC or 750 mg/IV. According to the evaluation of the proposed outcomes, when relapse rates/therapeutic failures were assessed, there was a 26% reduction with MEP 300 mg/SC (RD=-0.26; 95% CI: -0.44 to -0.08; p=0.04) and 48% reduction with MEP 750 mg/IV (RD=-0.48; 95% CI: -0.67, -0.30; p<0.00001). For the outcomes, prednisone dosage ≤10 mg/day for ≥8 weeks was 48% (RD=0.48; 95% CI: 0.35 to 0.62; p<0.00001), and the eosinophil count <600/µL for ≥8 weeks was 51% (RD=0.51; 95% CI: 0.38 to 0.63; p<0.00001), both showed a reduction with MEP 300 mg/IV and 750 mg/IV. No statistically significant differences in treatment-related adverse effects outcomes were observed for either dosage (RD=0.09; 95% CI: -0.05 to 0.24; p=0.20; RD=0.09; 95% CI: -0.11 to 0.29; p=0.39). Despite the positive effects observed for the studied outcomes, the exact significance remains unclear.
Subject(s)
Antibodies, Monoclonal, Humanized , Hypereosinophilic Syndrome , Antibodies, Monoclonal, Humanized/therapeutic use , Humans , Hypereosinophilic Syndrome/drug therapy , Leukocyte Count , Prednisone/therapeutic useABSTRACT
We aimed to evaluate the efficacy and safety of mepolizumab (MEP) in the management of hypereosinophilic syndrome (HES). A systematic search was performed, and articles published until March 2021 were analyzed. The primary efficacy results evaluated were hospitalization rate related to HES, morbidity (new or worsening), relapses/failure, treatment-related adverse effects, prednisone dosage ≤10 mg/day for ≥8 weeks, and eosinophil count <600/μL for ≥8 weeks. A meta-analysis was conducted, when appropriate. Three randomized controlled trials (RCTs), with a total of 255 patients, were included. The studies contemplated the use of MEP 300 mg/SC or 750 mg/IV. According to the evaluation of the proposed outcomes, when relapse rates/therapeutic failures were assessed, there was a 26% reduction with MEP 300 mg/SC (RD=-0.26; 95% CI: -0.44 to -0.08; p=0.04) and 48% reduction with MEP 750 mg/IV (RD=-0.48; 95% CI: -0.67, -0.30; p<0.00001). For the outcomes, prednisone dosage ≤10 mg/day for ≥8 weeks was 48% (RD=0.48; 95% CI: 0.35 to 0.62; p<0.00001), and the eosinophil count <600/μL for ≥8 weeks was 51% (RD=0.51; 95% CI: 0.38 to 0.63; p<0.00001), both showed a reduction with MEP 300 mg/IV and 750 mg/IV. No statistically significant differences in treatment-related adverse effects outcomes were observed for either dosage (RD=0.09; 95% CI: -0.05 to 0.24; p=0.20; RD=0.09; 95% CI: -0.11 to 0.29; p=0.39). Despite the positive effects observed for the studied outcomes, the exact significance remains unclear.
Subject(s)
Humans , Hypereosinophilic Syndrome/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Prednisone/therapeutic use , Leukocyte CountABSTRACT
BACKGROUND: Although acceptability of combined oral contraceptives (COCs) is widespread, patients are often unaware of the noncontraceptive benefits. STUDY DESIGN: An opinion survey through telephone interview was conducted to evaluate the knowledge of 500 Brazilian women 15-45 years of age who were current users or had recently used COCs. Data were obtained on their knowledge of adverse events, the effects of COCs on health- and menstrual-related symptoms, noncontraceptive benefits and aspects related to sexual response. RESULTS: Most of the women interviewed learned about the pill from doctors or the Internet. Other than the pill, the best-known contraceptive methods were the condom and intrauterine device. The majority of women believe that COCs do not change the risk of gynecological cancers. Most believed that they had no significant effect on sexual response. CONCLUSIONS: COCs users in Brazil lack precise information on aspects related to general health, particularly menstrual-related symptoms and noncontraceptive health benefits.
Subject(s)
Contraceptives, Oral, Combined , Patient Medication Knowledge , Urban Health , Adolescent , Adolescent Behavior , Adult , Brazil , Condoms/adverse effects , Contraception Behavior , Contraceptives, Oral, Combined/adverse effects , Contraceptives, Oral, Combined/therapeutic use , Female , Humans , Internet , Intrauterine Devices/adverse effects , Menstruation Disturbances/prevention & control , Middle Aged , Patient Education as Topic , Physician's Role , Young AdultABSTRACT
A case of recurrent gestational herpes in the first trimester of gestation is presented by the authors. Her history pointed similar infection in the third trimester of her first pregnancy, resistant to the treatment. This time an abortion was indicated in view of the great risk of an hospitalar infection. Out of pregnancy, the patient had a slight infection during her first menstrual period, with rapid remission.
Subject(s)
Humans , Female , Pregnancy , Adult , Herpes Simplex , Pemphigoid Gestationis , Amikacin/therapeutic use , Azathioprine/therapeutic use , Cephalosporins/therapeutic use , Clindamycin/therapeutic use , Herpes Simplex/diagnosis , Herpes Simplex/drug therapy , Pemphigoid Gestationis/diagnosis , Pemphigoid Gestationis/drug therapy , Prednisone/therapeutic use , Pregnancy Trimester, FirstABSTRACT
A case of Sertoli cells ovarian tumor in a 55 year old patient is reported. Some comments are made on this type of tumor. The tumor reported was very differentiated and non functional. The surgical indication was made on the clinical data, and a bilateral ooforectomy was performed.
