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Article ; Online: Lamivudine-Associated Lactic Acidosis.

Konala, Venu Madhav / Adapa, Sreedhar / Dinesh, Kumar P / Agrawal, Nikhil / Naramala, Srikanth / Dhingra, Hemant / Aronow, Wilbert S

American journal of therapeutics

2022 Volume 29, Issue 4, Page(s) 449–451

MeSH term(s)	Acidosis, Lactic/chemically induced ; Acidosis, Lactic/diagnosis ; Acidosis, Lactic/drug therapy ; Anti-HIV Agents/therapeutic use ; Humans ; Lamivudine/adverse effects ; Reverse Transcriptase Inhibitors
Chemical Substances	Anti-HIV Agents ; Reverse Transcriptase Inhibitors ; Lamivudine (2T8Q726O95)
Language	English
Publishing date	2022-07-01
Publishing country	United States
Document type	Letter
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0000000000000922
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Article ; Online: Acute Interstitial Nephritis Induced by Clozapine.

Vantipalli, Praveena / Roy, Sasmit / Koduri, Narayana M / Konala, Venu Madhav / Garcha, Amarinder Singh / Kunaparaju, Srikanth / Ayala, Raul / Yarram, Samanvitha Sai / Adapa, Sreedhar

Journal of medical cases

2022 Volume 13, Issue 7, Page(s) 322–329

Abstract: Acute interstitial nephritis (AIN) classically presents as acute kidney injury most often induced by offending drugs. Less frequently it is secondary to infections, autoimmune disorders, or idiopathic conditions. Development of drug-related AIN is not ... ...

Abstract	Acute interstitial nephritis (AIN) classically presents as acute kidney injury most often induced by offending drugs. Less frequently it is secondary to infections, autoimmune disorders, or idiopathic conditions. Development of drug-related AIN is not dose dependent and a recurrence can occur with re-exposure to the drug. We present a 50-year-old male with treatment resistant schizoaffective disorder who developed clozapine-induced AIN, confirmed with kidney biopsy within 2 months of taking this medication. His kidney function improved with removal of the drug and treatment with steroids. However, his kidney function was again significantly impaired when rechallenged with even a lower dose of clozapine a year later. Kidney function returned to baseline after stopping clozapine. Monitoring of kidney function during clozapine therapy is essential to therapy. Prompt diagnosis is imperative as discontinuation of offending agent can prevent acute kidney injury.
Language	English
Publishing date	2022-06-16
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2586383-6
ISSN	1923-4163 ; 1923-4163
ISSN (online)	1923-4163
ISSN	1923-4163
DOI	10.14740/jmc3934
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Article ; Online: Multiple morphological phenotypes of monoclonal immunoglobulin disease on renal biopsy: Significance of treatment.

Adapa, Sreedhar / Konala, Venu Madhav / Naramala, Srikanth / Nast, Cynthia C

Clinical nephrology. Case studies

2020 Volume 8, Page(s) 17–24

Abstract: Plasma cell dyscrasias frequently involve the kidney causing renal dysfunction. Multiple morphologic manifestations of κ light chain disease occurring simultaneously in the same kidney biopsy are uncommon and suggest local microenvironment effects in ... ...

Abstract	Plasma cell dyscrasias frequently involve the kidney causing renal dysfunction. Multiple morphologic manifestations of κ light chain disease occurring simultaneously in the same kidney biopsy are uncommon and suggest local microenvironment effects in addition to structural properties of the light chain. A 61-year-old female presented with new onset renal failure and proteinuria. Serological workup revealed monoclonal gammopathy with elevated κ : λ ratio of 1,371. Renal biopsy revealed several paraprotein manifestations including κ light chain deposition disease, monoclonal fibrillary glomerulonephritis, cryocrystalglobulenemia and fibrillar/microtubular cast nephropathy. There was also incidental leukocyte chemotactic factor 2 amyloidosis (ALECT 2), negative for κ light chain and confirmed by immunohistochemistry (IHC). Bone marrow biopsy revealed 10 - 20% κ restricted plasma cells. The patient received 10 cycles of CyBorD (cyclophosphamide, bortezomib, and dexamethasone) chemotherapy. Renal function improved with decreased κ : λ ratio. Repeat bone marrow biopsy showed no evidence of abnormal plasma cells by IHC. The renal recovery demonstrates there may be response to chemotherapy irrespective of the morphologic manifestations of light chain-related injury. Additionally, if amyloid is not demonstrated to be of light chain origin, other amyloid types should be considered.
Language	English
Publishing date	2020-04-17
Publishing country	Germany
Document type	Case Reports
ISSN	2196-5293
ISSN (online)	2196-5293
DOI	10.5414/CNCS110052
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Article ; Online: Immunotherapy in Bladder Cancer.

Konala, Venu Madhav / Adapa, Sreedhar / Aronow, Wilbert S

American journal of therapeutics

2019 Volume 29, Issue 3, Page(s) e334–e337

Abstract: Background: Bladder cancer is the fifth most common cancer in the United States. Cisplatin-based chemotherapy is the current standard of care in stage IV bladder cancer. It has increased overall survival but rarely results in complete remission, with an ...

Abstract	Background: Bladder cancer is the fifth most common cancer in the United States. Cisplatin-based chemotherapy is the current standard of care in stage IV bladder cancer. It has increased overall survival but rarely results in complete remission, with an overall survival of 14-15 months. The most significant breakthrough in cancer therapy over the last decade was the development of immunotherapy. Data sources: KEYNOTE-045, IMvigor211, CheckMate275, Javelin Solid Tumor, MEDI4736, and KEYNOTE-0528 clinical trials. Areas of uncertainty: There are ongoing clinical trials using combination of immunotherapy and chemotherapy as first line of therapy in the setting of metastatic urothelial cancer and also to determine the duration of treatment. Therapeutic advances: Immunotherapy is approved as a second-line treatment for metastatic urothelial cancer. Their use as a first-line agent is only limited to patients who are ineligible for cisplatin-based treatments. Five drugs are approved by Food and Drug Administration for metastatic urothelial cancer including 3 Programmed cell-death protein 1 (PD-1) inhibitors and 2 programmed cell-death ligand 1 (PD-L1) inhibitors in patients who have progressed during or after platinum-based therapy. Pembrolizumab, nivolumab, and atezolizumab are PD-1 inhibitors. Durvalumab and avelumab are PD-L1 inhibitors. However, only 2 drugs were approved based on phase III clinical trials-pembrolizumab and atezolizumab, of which only KEYNOTE study performed with pembrolizumab showed overall survival difference. Atezolizumab and pembrolizumab are the Food and Drug Administration-approved checkpoint inhibitors in cisplatin-ineligible patients. Conclusion: This review article summarizes the significance of immunotherapy in treatment of bladder cancer, its side effects, and limitations.
MeSH term(s)	B7-H1 Antigen/metabolism ; B7-H1 Antigen/therapeutic use ; Cisplatin/therapeutic use ; Female ; Humans ; Immunologic Factors/therapeutic use ; Immunotherapy/methods ; Male ; Nivolumab/therapeutic use ; United States ; Urinary Bladder Neoplasms/drug therapy
Chemical Substances	B7-H1 Antigen ; Immunologic Factors ; Nivolumab (31YO63LBSN) ; Cisplatin (Q20Q21Q62J)
Language	English
Publishing date	2019-03-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0000000000000934
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Article ; Online: Immune Checkpoint Inhibitors-Related Cardiotoxicity.

Konala, Venu Madhav / Adapa, Sreedhar / Aronow, Wilbert S

American journal of therapeutics

2019 Volume 27, Issue 6, Page(s) e591–e598

Abstract: Background: Immunotherapy is a significant breakthrough in cancer therapy in the last decade. Immunotherapy is better tolerated compared with chemotherapy. However, it does have side effects, and one of the rare and serious side effects of immunotherapy ...

Abstract	Background: Immunotherapy is a significant breakthrough in cancer therapy in the last decade. Immunotherapy is better tolerated compared with chemotherapy. However, it does have side effects, and one of the rare and serious side effects of immunotherapy is cardiotoxicity. Cardiotoxicity has been described with other cancer-related treatments such as chemotherapy and targeted therapy. A high index of suspicion is required, and prompt management with immunosuppression needs to be instituted as soon as possible to prevent fatal outcomes. Areas of uncertainty: Research is still ongoing to identify biomarkers that will help us to choose the patients, who will respond well to immunotherapy. Tumor-infiltrating lymphocytes, tumor PD-L1 expression, and tumor mutational burden explored as potential biomarkers. There are no predictive biomarkers to identify patients who are at higher risk of severe cardiotoxicity. Both cardiologists and oncologists should be aware of cardiac toxicity from immune checkpoint inhibitors. Conclusion: All patients who are starting immune checkpoint inhibitors should undergo baseline cardiac risk factor assessment with referral to a cardiologist in a patient with multiple risk factors or previous history of cardiovascular disease. Cardiac immune-related adverse events are higher in patients taking combination therapy with anti-CTLA-4/anti-PD-1 agents compared with monotherapy. Patients with known cardiac comorbidities require a higher level of vigilance to monitor for cardiac toxicity because nonspecific symptoms can lead to rapid clinical deterioration and a higher rate of mortality when treated with checkpoint inhibitors.
MeSH term(s)	CTLA-4 Antigen/antagonists & inhibitors ; Cardiology/methods ; Cardiology/standards ; Cardiotoxicity/diagnosis ; Cardiotoxicity/epidemiology ; Cardiotoxicity/etiology ; Cardiotoxicity/prevention & control ; Humans ; Immune Checkpoint Inhibitors/adverse effects ; Incidence ; Medical Oncology/methods ; Medical Oncology/standards ; Neoplasms/drug therapy ; Neoplasms/immunology ; Practice Guidelines as Topic ; Programmed Cell Death 1 Receptor/antagonists & inhibitors ; Risk Assessment/methods ; Risk Assessment/standards ; Risk Factors ; Severity of Illness Index
Chemical Substances	CTLA-4 Antigen ; CTLA4 protein, human ; Immune Checkpoint Inhibitors ; PDCD1 protein, human ; Programmed Cell Death 1 Receptor
Language	English
Publishing date	2019-05-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0000000000000988
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Article ; Online: Response to Letter Regarding "A Case Series of Patients Coinfected With Influenza and COVID-19".

Naramala, Srikanth / Konala, Venu Madhav / Adapa, Sreedhar / Chenna, Avantika / Garlapati, Pavani Reddy / Gayam, Vijay

Journal of investigative medicine high impact case reports

2020 Volume 8, Page(s) 2324709620963611

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coinfection ; Coronavirus Infections ; HIV Infections ; Humans ; Influenza, Human/epidemiology ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-10-06
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2710326-2
ISSN	2324-7096 ; 2324-7096
ISSN (online)	2324-7096
ISSN	2324-7096
DOI	10.1177/2324709620963611
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Article ; Online: Use of Immunotherapy in Extensive-Stage Small Cell Lung Cancer.

Konala, Venu Madhav / Madhira, Bhaskar Reddy / Ashraf, Sara / Graziano, Stephen

Oncology

2020 Volume 98, Issue 11, Page(s) 749–754

Abstract: Lung cancer is a leading cause of cancer death in the United States and around the world. Approximately 13% of lung cancers are small cell lung cancer (SCLC). SCLC is generally classified as a limited-stage and extensive-stage disease depending on the ... ...

Abstract	Lung cancer is a leading cause of cancer death in the United States and around the world. Approximately 13% of lung cancers are small cell lung cancer (SCLC). SCLC is generally classified as a limited-stage and extensive-stage disease depending on the extent of involvement. For patients with the extensive-stage disease, until recently, chemotherapy alone has been the recommended treatment, although radiotherapy could be used in select patients for palliation of symptoms. The standard of care for extensive-stage SCLC is platinum doublet chemotherapy with either cisplatin or carboplatin in combination with etoposide. Even though first-line therapy has an initial response rate of 60-80%, the prognosis is poor, with overall survival of 10-12 months. The only FDA-approved second line of therapy is topotecan, approved both as an intravenous formulation as well as an oral formulation, with response rates of 6-12% in chemorefractory disease and 15-37% in chemosensitive disease. Immunotherapy has recently been approved as a first-line agent in metastatic SCLC in combination with chemotherapy. It is also approved as a third-line agent in metastatic SCLC after the failure of two chemotherapy regimens. The FDA approved four drugs, two of them being PD-1 inhibitors (pembrolizumab, nivolumab), and two of them being PD-L1 inhibitors (atezolizumab and durvalumab) in SCLC. This review article summarizes the significance of immunotherapy in the treatment of extensive-stage SCLC, its side effects, and limitations.
MeSH term(s)	Antineoplastic Agents, Immunological/administration & dosage ; Antineoplastic Agents, Immunological/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; B7-H1 Antigen/antagonists & inhibitors ; B7-H1 Antigen/immunology ; Clinical Trials as Topic ; Humans ; Immunotherapy/methods ; Lung Neoplasms/drug therapy ; Lung Neoplasms/immunology ; Lung Neoplasms/pathology ; Neoplasm Staging ; Programmed Cell Death 1 Receptor/antagonists & inhibitors ; Programmed Cell Death 1 Receptor/immunology ; Randomized Controlled Trials as Topic ; Small Cell Lung Carcinoma/drug therapy ; Small Cell Lung Carcinoma/immunology ; Small Cell Lung Carcinoma/pathology
Chemical Substances	Antineoplastic Agents, Immunological ; B7-H1 Antigen ; CD274 protein, human ; PDCD1 protein, human ; Programmed Cell Death 1 Receptor
Language	English
Publishing date	2020-07-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	250101-6
ISSN	1423-0232 ; 0030-2414
ISSN (online)	1423-0232
ISSN	0030-2414
DOI	10.1159/000508516
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Article ; Online: Golimumab-Associated Glomerulonephritis.

Agrawal, Nikhil / Roy, Neil / Naramala, Srikanth / Konala, Venu Madhav / Adapa, Sreedhar / Dhingra, Hemant / Aronow, Wilbert S

American journal of therapeutics

2021 Volume 28, Issue 1, Page(s) e145–e147

MeSH term(s)	Antibodies, Monoclonal/adverse effects ; Antirheumatic Agents/therapeutic use ; Glomerulonephritis/chemically induced ; Glomerulonephritis/drug therapy ; Humans ; Injections, Subcutaneous ; Methotrexate ; Treatment Outcome ; Tumor Necrosis Factor-alpha
Chemical Substances	Antibodies, Monoclonal ; Antirheumatic Agents ; Tumor Necrosis Factor-alpha ; golimumab (91X1KLU43E) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2021-01-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0000000000000946
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Article ; Online: Paget-Schroetter Syndrome in a Young Female.

Sangani, Vikram / Pokal, Mytri / Balla, Mamtha / Gayam, Vijay / Konala, Venu Madhav

Journal of investigative medicine high impact case reports

2021 Volume 9, Page(s) 23247096211003263

Abstract: Paget-Schroetter syndrome or effort thrombosis is a relatively rare primary spontaneous thrombosis of upper extremity deep veins secondary to entrapment of axillary subclavian veins from an abnormality of the thoracic outlet. It is commonly seen in young ...

Abstract	Paget-Schroetter syndrome or effort thrombosis is a relatively rare primary spontaneous thrombosis of upper extremity deep veins secondary to entrapment of axillary subclavian veins from an abnormality of the thoracic outlet. It is commonly seen in young adults who lift heavy weights or strenuous use of the upper extremities during athletic activities. Repetitive microtrauma to the subclavian vein secondary to narrow costoclavicular space and strenuous activities leads to intimal layer inflammation, hypertrophy, fibrosis, and coagulation cascade activation. Management of Paget-Schroetter syndrome differs from the venous thrombosis of the lower extremity as treatment includes anticoagulation, thrombolysis, and surgical decompression. Early recognition and timely management are required to prevent significant disability from post-thrombotic syndrome and long-term morbidity from recurrent thromboembolism and pulmonary embolism. Internists and emergency physicians should be aware of the disease's presentation, treatment options, and early referral to vascular surgeons since prompt initiation of appropriate treatment will have better outcomes than delayed treatment. We discussed a case of a 31-year-old female who lifts heavyweight at work, presented with right arm swelling and pain for 2 weeks, and diagnosed with axillary subclavian vein thrombosis secondary to thoracic outlet obstruction. She received a high-dose heparin drip followed by catheter-directed thrombolysis and underwent surgical decompression of axillary subclavian vein via resection of the first rib, subclavius muscle resection, partial anterior scalenectomy, and venolysis. In our review of the literature, randomized controlled studies lack the efficacy and safety of surgical decompression. However, the results are promising based on accumulated experience from vascular surgery experts and small case series. Extensive studies are needed further to delineate the protocol for the management of Paget-Schroetter syndrome.
MeSH term(s)	Adult ; Female ; Humans ; Subclavian Vein/diagnostic imaging ; Thoracic Outlet Syndrome/diagnosis ; Thoracic Outlet Syndrome/etiology ; Thoracic Outlet Syndrome/surgery ; Thrombolytic Therapy ; Treatment Outcome ; Upper Extremity Deep Vein Thrombosis/diagnosis ; Upper Extremity Deep Vein Thrombosis/etiology ; Upper Extremity Deep Vein Thrombosis/therapy ; Young Adult
Language	English
Publishing date	2021-03-22
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2710326-2
ISSN	2324-7096 ; 2324-7096
ISSN (online)	2324-7096
ISSN	2324-7096
DOI	10.1177/23247096211003263
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Bacteremia Secondary to Uncommon Gram-Negative Bacilli Transmitted From the Canine in a Patient With Multiple Myeloma.

Konala, Venu Madhav / Naramala, Srikanth / Bose, Subhashish / Gayam, Vijay / Madhira, Bhaskar Reddy / Adapa, Sreedhar

Journal of investigative medicine high impact case reports

2020 Volume 8, Page(s) 2324709620969500

Abstract: Sphingobacterium ... ...

Abstract	Sphingobacterium multivorum
MeSH term(s)	Aged ; Animals ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy ; Bacteremia/microbiology ; Cellulitis/drug therapy ; Cellulitis/microbiology ; Dogs/microbiology ; Female ; Gram-Negative Bacterial Infections/diagnosis ; Gram-Negative Bacterial Infections/drug therapy ; Humans ; Immunocompromised Host ; Multiple Myeloma/complications ; Sphingobacterium/isolation & purification ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2020-11-21
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2710326-2
ISSN	2324-7096 ; 2324-7096
ISSN (online)	2324-7096
ISSN	2324-7096
DOI	10.1177/2324709620969500
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