HDR afterloading therapy: Patient acceptability and side effects

Abstract Background Budesonide MMX is indicated for the induction of remission in mild to moderate Ulcerative Colitis (UC) patients when 5-ASA treatment is not sufficient. Unlike traditional first-generation glucocorticoid steroids such as prednisolone, budesonide MMX has demonstrated a robust safety profile, comparable to placebo in several randomised controlled trials1,2,3. There is however limited real-world evidence to substantiate this safety claim in clinical practice. The aim of this observational analysis is to evaluate the tolerability and ease of administration of budesonide MMX in the real-world setting using prednisolone as a benchmark. Methods Patients receiving treatment for mild to moderate UC were identified in 3 treatment centres between April and October 2019. After providing privacy and data consent, patients completed a detailed nurse-led questionnaire regarding their experiences with prednisolone treatment. Following 6 weeks of therapy with budesonide MMX, patients were sent a follow-up questionnaire. Data from both the initial and subsequent questionnaires were entered by the nurse into a database for assimilation and analysis. Results Twenty-eight patients completed initial and follow-up questionnaires. Of these, 78.6% (n = 22) had experienced ≥1 prednisolone-related side effects. In comparison, following treatment with budesonide MMX, 21.4% (n = 6) reported ≥1 side effects. Instances of these side effects are shown in Figure 1. 46.4% of patients (n = 13) reported the impact of prednisolone-related side effects on daily life as moderate or severe vs. 7.1% (n = 2) following treatment with budesonide MMX. By week 2 of treatment with budesonide MMX, rectal bleeding was resolved in 32.1% of patients (n = 9) and stool frequency in 35.7% (n = 10). 93.1% (n = 27) found the instructions to take budesonide MMX given by the health care professional very easy to understand and of those expressing a preference, 71.1% of patients (n = 19) would take budesonide MMX again if prescribed. Additional data will be presented. Conclusion Data from this ‘real-world’ observational study appear to support the safely profile of budesonide MMX reported in clinical trials. The incidence of patients who experienced > 1 side-effect was nearly 4 times lower for budesonide vs. prednisolone. In addition, budesonide MMX therapy was acceptable to the majority of patients and accompanying instructions easy to understand. Additional data will be presented. References

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Safety, Efficacy, and Patient Acceptability of Montelukast in Exercise-Induced Asthma

Clinical Medicine Insights Therapeutics ◽

10.4137/cmt.s7389 ◽

2012 ◽

Vol 4 ◽

pp. CMT.S7389

Author(s):

S. Kansra ◽

A. Mazzei ◽

J. Bhatt

Keyword(s):

Abdominal Pain ◽

Individual Differences ◽

Side Effects ◽

Safety Profile ◽

Leukotriene Receptor Antagonist ◽

Patient Acceptability ◽

Asthmatic Children ◽

Leukotriene Receptor ◽

Exercise Induced

Exercise-induced bronchoconstriction (EIB) can be a troublesome problem in asthmatic children and in some children without asthma. Self-reported exercise related symptoms should be verified formally. EIB is mediated by changes in temperature and humidity in the airway and is secondary to release of several mediators of the bronchoconstriction including leukotrienes. Montelukast as a leukotriene receptor antagonist offers protection against but does not completely ameliorate EIB. Regular use does not appear to lead to tolerance. Nightmares, abdominal pain, fever, nausea and aggressiveness are commonly described side effects; however, the overall safety profile of montelukast is good and does not change with long term use. There are individual differences in response to montelukast for protection against EIB. Bronchoconstriction triggered by exercise responds to cessation of exercise in its natural course. Due to its pharamacokinetic profile, montelukast may be more useful as a prophylaxis than to relieve symptoms.

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Side effects and patient acceptability of transrectal biopsy of the prostate

Clinical Radiology ◽

10.1016/s0009-9260(05)81188-2 ◽

1993 ◽

Vol 47 (2) ◽

pp. 125-126 ◽

Cited By ~ 132

Author(s):

R. Clements ◽

O.U. Aideyan ◽

G.J. Griffiths ◽

W.B. Peeling

Keyword(s):

Side Effects ◽

Patient Acceptability ◽

Transrectal Biopsy

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Acupuncture and the Treatment of Irritative Bladder Symptoms

Acupuncture in Medicine ◽

10.1136/aim.12.1.9 ◽

1994 ◽

Vol 12 (1) ◽

pp. 9-12 ◽

Cited By ~ 31

Author(s):

CJ Kelleher ◽

J Filshie ◽

G Burton ◽

V Khullar ◽

LD Cardozo

Keyword(s):

Side Effects ◽

Urge Incontinence ◽

Anticholinergic Medication ◽

Patient Acceptability ◽

Anticholinergic Therapy ◽

Conventional Management ◽

Bladder Symptoms ◽

High Degree

The conventional management of irritative bladder symptoms, namely urgency, urge incontinence, frequency and nocturia, with anticholinergic medication is limited by the side effects of treatment. Acupuncture is shown to be as effective in the management of irritative bladder symptoms as conventional anticholinergic therapy, with few side effects and a high degree of patient acceptability and compliance.

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Assessment of the efficacy of glyceryl trinitrate patch as a tocolytic

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205228 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4953

Author(s):

Sushma Mogri ◽

Lata Choudhary ◽

Anjana Verma

Keyword(s):

Preterm Birth ◽

Side Effects ◽

Glyceryl Trinitrate ◽

Gestational Age ◽

Preterm Labor ◽

Preterm Labour ◽

Low Cost ◽

Patient Acceptability ◽

Good Patient ◽

Lung Maturity

Background: Preterm labor is defined as onset of delivery after the age of gestational viability (20-28 weeks) and prior to 37 weeks. Preterm birth complicated 5-10% of all births and accounts for 75% of perinatal deaths. Several drugs are now available to delay delivery in spontaneous preterm labour. Delaying the delivery for at least 24-48 hr for lung maturity of fetus is the primary goal. Glyceryl trinitrate has less maternal side effects.Methods: The study included 100 women who were admitted in view of preterm labour with gestational age between 28-36 weeks and were given trans dermal nitroglycerin therapy for arrest of preterm labour.Results: The efficacy of nitroglycerine patch to arrest preterm labour was studied. 88 patients were successfully progressed for more than 48 hours with minimum prolongation of 3 days and maximum prolongation of 65 days and average prolongation of 26 days of pregnancy.Conclusions: Glyceryl trinitrate patch as a tocolytic is very effective. This drug has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule.

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A Study of Ormeloxifene in Case of Dysfunctional Uterine Bleeding

International Journal of Medical and Dental Sciences ◽

10.19056/ijmdsjssmes/2013/v2i2/86775 ◽

2013 ◽

Vol 2 (2) ◽

pp. 162

Author(s):

S. Grover ◽

A. Chhabra ◽

S. Bindu

Keyword(s):

Side Effects ◽

Endometrial Thickness ◽

Low Cost ◽

Treatment Options ◽

Tertiary Care ◽

Uterine Bleeding ◽

Care Hospital ◽

Dysfunctional Uterine Bleeding ◽

Patient Acceptability ◽

Blood Haemoglobin

Background:Menorrhagia accounts for 12% of all gynaecology consultations and is one of the most common causes of iron deficiency anaemia in females after nutritional anaemia.Objectives: To evaluate the efficacy and side effects of ormeloxifene in cases of dysfunctional uterine bleeding.Material and Methods: 30 women aged 28-46 years who attended the outpatient gynaecology department in a tertiary care hospital with complaint of heavy menstrual flow were recruited for the study. Two pretreatment baseline cycles were compared to the treatment cycles of ormeloxifene. The main outcomes measured were menstrual blood, blood haemoglobin levels and endometrial thickness in proliferative phase as studied by TVS. Data thus collected was compared and analysed statistically.Results: Total number of bleeding days per year decreased by 76%. Total no. of pads soiled per cycle decreased by 76.3%. All the patients reported disappearance of clots, 66.66% within 1 month of the treatment only. Dysmenorrhoea was relieved in 62.5% patients. Mean increase in Hb was 0.42g%.Conclusion: Ormeloxifene is very effective in improving all the parameters of blood loss in DUB including the no. of days of bleeding, no. of pads soiled and the passage of clots. Ormeloxifene has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule. In the peri-menopausal age group, drug is protective against breast malignancy and osteoporosis. Ormeloxifene has the potential to be an effective treatment for DUB and should always be considered amongst the treatment options.

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A prospective Comparison of Porta-Sonic and Fisoneb Ultrasonic Nebulizers for Administering Aerosol Pentamidine

Canadian Journal of Infectious Diseases ◽

10.1155/1994/202153 ◽

1994 ◽

Vol 5 (2) ◽

pp. 62-66 ◽

Cited By ~ 1

Author(s):

Andrew McIvor ◽

Diane Flood ◽

Leslie Lee-Pack ◽

Anita Rachlis ◽

Philip Berger ◽

...

Keyword(s):

Side Effects ◽

Subjective Evaluation ◽

Objective Evaluation ◽

Patient Acceptability ◽

Entire Cohort ◽

Prospective Comparison ◽

Significant Difference ◽

Treatment Centre ◽

Prospective Assessment

Objective: To report patient acceptability and overall therapeutic effectiveness of two different ultrasonic nebulizers, Fisoneb and Porta-sonic, for the administration of aerosol pentamidine forPneumocysitis cariniiprophylaxis in human immunodeficiency virus (hiv)-infected individuals.Design: Prospective assessment of a random subgroup of 174 individuals from an inception cohort of 1093 patients attending a central aerosol pentamidine treatment centre in Toronto, Ontario.Methods: One hundred and seventy-four patients who had been receiving aerosolized pentamidine for more than 10 weeks using Fisoneb at 60 mg every two weeks were switched to Porta-sonic. Subjective evaluation included three standard 10 cm visual analogue scales rating cough/wheeze, aftertaste and overall preference. The individuals were also asked to compare the duration of time spent on the aerosol treatments. Objective evaluation included spirometry performed immediately before and 15 mins after pentamidine administration. Prospective surveillance of the entire cohort was preformed to record and document episodes of breakthroughP cariniipneumonia.Results: Porta-sonic was the overall preferred nebulizer in 82% of patients. Less time was spent on aerosol treatment using the Porta-sonic nebulizer compared with the Fisoneb in 66% of patients. The Porta-sonic nebulizer system produced less aftertaste compared with Fisoneb. Both nebulizers produced significant but modest reduction in flow rates. During the study period there was no statistically significant difference in the rates of breakthroughP cariniipneumonia between the two groups. A total of 91 episodes occurred, at a rate of 0.5 episodes per patient-month on Porta-sonic compared with 0.7 episodes per patient-month on Fisoneb (P=0.2536).Discussion: Aerosol pentamidine remains the proven second-line prophylaxis againstP cariniipneumonia inhiv/aidsfor those intolerant to trimethoprim-sulphamethoxazole. Cough, bronchospasm and poor taste are side effects that may limit patient tolerance and acceptability. The results of this study show that the Porta-sonic nebulizer system significantly reduces some of these side effects and increases patient preference.Conclusion: This study suggests that Porta-sonic, the newer nebulizer system, with more ideal in vitro characteristics may become a favoured device in clinical practice.

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Gastric Ulcers Produced by Cisplatin

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100099337 ◽

1981 ◽

Vol 39 ◽

pp. 582-583

Author(s):

S.K. Aggarwal ◽

J. San Antonio

Keyword(s):

Electron Microscopy ◽

Single Dose ◽

Side Effects ◽

Antitumor Agent ◽

Gastric Ulcers ◽

Enzyme Cytochemistry ◽

Intestinal Toxicity ◽

Ovarian Cancers ◽

Inner Surface

Cisplatin (cis-dichlorodiammineplatinum(II)) a potent antitumor agent is now available for the treatment of testicular and ovarian cancers. It is however, not free from its serious side effects including nephrotoxicity, gastro intestinal toxicity, myelosuppression, and ototoxicity. Here we now report that the drug produces peculiar bloating of the stomach in rats and induces acute ulceration.Wistar-derived rats weighing 200-250 g were administered cisplatin(9 mg/kg) ip as a single dose in 0.15 M NaCl. After 3 days the animals were sacrificed by decapitation. The stomachs were removed, the contents analyzed for pepsin and acidity. The inner surface was examined with a dissecting microscope after a moderate stretching for ulcers. Affected areas were fixed and processed for routine electron microscopy and enzyme cytochemistry.The drug treated animals kept on food and water consistently showed bloating and lesions (Fig. 1) with a frequency of 6-70 ulcers in the rumen section of the stomachs.

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Effects of cisplatin treatment on the rat neurohypophysis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100142256 ◽

1986 ◽

Vol 44 ◽

pp. 122-123

Author(s):

J.M. Fadool ◽

P.J. Boyer ◽

S.K. Aggarwal

Keyword(s):

Side Effects ◽

Urine Output ◽

Morphological Changes ◽

Limiting Factor ◽

Antineoplastic Drugs

Cisplatin (CDDP) is currently one of the most valuable antineoplastic drugs available. However, it has severe toxic side effects of which nephrotoxicity is the major dose limiting factor in its use. It induces morphological changes in the kidney with hampered urine output. The present study is an effort to determine the influence of the drug on the neurohypophysis for any antidiuretic effects on the kidney.

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Severe Drooling and Treatment With Botulinum Toxin

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.1.15 ◽

2012 ◽

Vol 21 (1) ◽

pp. 15-21

Author(s):

Merete Bakke ◽

Allan Bardow ◽

Eigild Møller

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Health Risk ◽

Flow Rate ◽

Clinical Evidence ◽

Acetylcholine Release ◽

Psychosocial Problems ◽

Rate Reduction ◽

Local Inhibition ◽

Surgical Treatments

Severe drooling is associated with discomfort and psychosocial problems and may constitute a health risk. A variety of different surgical and non-surgical treatments have been used to diminish drooling, some of them with little or uncertain effect and others more effective but irreversible or with side effects. Based on clinical evidence, injection with botulinum toxin (BTX) into the parotid and submandibular glands is a useful treatment option, because it is local, reversible, and with few side effects, although it has to be repeated. The mechanism of BTX is a local inhibition of acetylcholine release, which diminishes receptor-coupled secretion and results in a flow rate reduction of 25–50% for 2–7 months.

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