Long‐term efficacy and adverse effects of outpatient procedural analgesia with nitrous oxide for a child with Epidermolysis Bullosa

2021 ◽

Vol 42 (2) ◽

pp. e47-e54

Author(s):

Jie Zhou ◽

Shuguang Chen ◽

Zhiqiang Song

Keyword(s):

Atopic Dermatitis ◽

Adverse Effects ◽

Immunoglobulin E ◽

Subcutaneous Immunotherapy ◽

Efficacy And Safety ◽

Long Term Effects ◽

Term Efficacy ◽

Laboratory Test Results ◽

Vas Scores

Introduction: Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease characterized by severe pruritus and eczematous skin lesions. Subcutaneous immunotherapy (SCIT) refers to repeated contact with gradually increasing doses of allergen extracts, which improve patient tolerance to such allergens and controls, or reduces allergic symptoms. This study aimed to explore the long-term efficacy and safety of SCIT for patients with AD sensitized to house-dust mite (HDM). Methods: We conducted a retrospective analysis of 378 patients with HDM-sensitized AD. Among these patients, 164 received SCIT plus pharmacotherapy for 3 years (SCIT group) and the other 214 patients received only pharmacotherapy (non-SCIT group). The scoring atopic dermatitis (SCORAD) and pruritus visual analog scale (VAS) scores, laboratory test results, and adverse effects were recorded. Results: The SCORAD and pruritus VAS scores significantly decreased in the SCIT group. Also, the SCIT group showed higher reduction ratios of SCORAD and pruritus VAS scores than those observed in the non-SCIT group at 3 years after treatment initiation. The risk of development of new sensitization was higher in the non-SCIT group than in the SCIT group (relative risk 1.92 [95% confidence interval {CI}, 1.30‐2.85]; p < 0.05). The eosinophil count of the participants significantly differed in the complete response (CR) group (p < 0.05) but not in the non‐CR group (p = 0.098). However, the serum total immunoglobulin E value was not significantly reduced (p = 0.204). Of 8421 injections given to the patients, 231 injections (2.74%) showed adverse effects during the treatment period. Conclusion: Three years of SCIT can significantly reduce the severity and pruritus of moderate-to-severe AD with HDM sensitization. Patients who are multisensitized can also benefit from HDM SCIT. Patients can achieve long-term effects, such as prevention of neoallergen sensitization and inhibition of the allergy march.

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Long-term efficacy of extracorporeal photochemotherapy in a patient with refractory epidermolysis bullosa acquisita

European Journal of Dermatology ◽

10.1684/ejd.2012.1840 ◽

2012 ◽

Vol 22 (6) ◽

pp. 795-797 ◽

Cited By ~ 5

Author(s):

Barouyr Baroudjian ◽

Christelle Le Roux-Villet ◽

Sabine Bréchignac ◽

Marina Alexandre ◽

Frederic Caux ◽

...

Keyword(s):

Epidermolysis Bullosa ◽

Epidermolysis Bullosa Acquisita ◽

Extracorporeal Photochemotherapy ◽

Term Efficacy

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Opioids in Spine Pain: Indications, Challenges, and Controversies

10.1093/med/9780199350940.003.0029 ◽

2018 ◽

Author(s):

Puneet Sayal ◽

Jianren Mao

Keyword(s):

Adverse Effects ◽

Risk Stratification ◽

Close Monitoring ◽

Efficacy And Safety ◽

Term Efficacy ◽

Spine Pain ◽

Term Basis ◽

Opioid Medications ◽

Chronic Use

Opioid medications are commonly used in the treatment of spine-mediated pain. They are used on a chronic, long-term basis, and their use is on the rise. The available evidence supports their use for short periods if much effort is put into patient and opioid selection, and with close monitoring. Challenges include numerous adverse effects, aberrant behaviors, and the comfort and skill set of providers. Controversies surrounding the chronic use of opioids center on the inconclusive evidence regarding long-term efficacy and safety. More research is necessary to determine whether these medications are appropriate, efficacious, and safe over the long term, and also to aid providers in managing patients on chronic opioids in terms of patient and opioid selection, risk stratification, monitoring, and discontinuation/weaning.

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Long-term effects of antipsychotics

BJPsych Advances ◽

10.1192/apt.bp.114.012591 ◽

2015 ◽

Vol 21 (2) ◽

pp. 78-79 ◽

Cited By ~ 2

Author(s):

Joanna Moncrieff

Keyword(s):

Adverse Effects ◽

Long Term Effects ◽

Term Efficacy ◽

The Brain

SummaryAntipsychotics are useful at reducing acute symptoms, but recent evidence calls into question their long-term efficacy and raises concern about adverse effects on the brain.

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