We present our experience with a patient with effusive pericarditis and recurrent pleural effusion that first developed 23 yr after radiation treatment for the nodular sclerosis type of Hodgkin's disease. Extensive diagnostic work up including pericardial and pleural biopsy, excluded any other cause (than radiation) of the recurrent pleural effusion. Pericarditis and pleural effusion were not controlled with regimens including steroid and non-steroid anti-inflammatory agents. The fluid collections improved only with per os doxycycline (100 mg twice a day). Four episodes of recurrent pleural effusions were also controlled with per os doxycycline. Although the concentration of doxycycline in the pericardial and pleural fluid when given orally is smaller compared with that achieved by direct installation of the agent, the fact that all episodes of pleural effusion improved with an agent commonly used for pleurodesis is intriguing.
Targeted therapies are on the market for the past five years and recently pembrolizumab was approved as first line treatment for patients with PD-L1 >50%. We present three cases of patients which had epidermal growth factor receptor positive expression and programmed death-ligand 1 (PD-L1), PD-L1 >50% overexpression.
The aim of this study is to determine the prevalence of osteoporosis and osteopenia in a female urban population. Dual energy X-ray absorptiometry measurements were done at the lumbar spine (6920 females) and at the femur (3222 females) Bone mineral density (BMD) and corresponding T-scores were analysed using multivariate regression models. In females, the prevalence rate of osteoporosis was 15.3% at the lumbar spine and of osteopenia 36.5%. In females osteoporosis rate at the femur was 17.7% for the neck, 30.65% for the ward’s triangle and 1.86% for the tronchater, whereas the osteopenic rates were 53.3%, 44.7% and 32.09% respectively. A polynominal cubic model performed for age showed the steepest decline at the age of 55 years for the spine BMD (-0.973% change, 95% CI -1.031/-0.915) and at the age of 64 years for the femur BMD (-0.726% change, 95% CI - 0.793/-0.658). Actually sensitive interventions for prevention of osteoporosis in urban population need serious concern
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