scholarly journals Oxymetazoline, Mupirocin, Clotrimazole—Safe, Effective, Off-Label Agents for Tympanostomy Tube Care

2020 ◽  
Vol 99 (1_suppl) ◽  
pp. 30S-34S
Author(s):  
Glenn Isaacson
Keyword(s):  
Nasal Spray ◽  
Tympanostomy Tube ◽  
Off Label ◽  
Highly Active ◽  
Tympanostomy Tubes ◽  
United States Food ◽  
States Food ◽  
The Common ◽  
Mupirocin Ointment

Objectives: Only a few medications have a United States Food and Drug Administration indications for prevention and/or treatment of infections in patients with tympanic perforations or tympanostomy tubes. We examined 3 off-label agents that have become important in tympanostomy tube care hoping to demonstrate the effectiveness and safety of each in experimental assays and human application. Methods: Computerized literature review. Results: (1) Oxymetazoline nasal spray applied at the time of surgery is equivalent to fluoroquinolone ear drops in the prevention of early postsurgical otorrhea and tympanostomy tube occlusion at the first postoperative visit. (2) Topical mupirocin 2% ointment is effective alone or in combination with culture-directed systemic therapy for the treatment of tympanostomy tube otorrhea caused by community-acquired, methicillin-resistant Staphylococcus aureus. (3) Topical clotrimazole 1% cream is highly active against the common yeast and fungi that cause otomycosis. A single application after microscopic debridement will cure fungal tympanostomy tube otorrhea in most cases. None of these 3 agents is ototoxic in animal histological or physiological studies, and each has proved safe in long-term clinical use. Conclusions: Oxymetazoline nasal spray, mupirocin ointment, and clotrimazole cream are safe and effective as off-label medications for tympanostomy tube care in children.

Helping Children with Special Needs: Who Receives Tympanostomy Tubes?

2021 ◽  
pp. 000348942098742
Author(s):  
David W. Wassef ◽  
Nehal Dhaduk ◽  
Savannah C. Roy ◽  
Gregory L. Barinsky ◽  
Evelyne Kalyoussef
Keyword(s):  
Developmental Disorders ◽  
Developmental Disorder ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Tube Placement ◽  
Hospital Charges ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Tympanostomy Tubes

Objectives: Tympanostomy tubes can prevent sequelae of otitis media that adversely affect long term hearing and language development in children. These negative outcomes compound the existing difficulties faced by children who are already diagnosed with developmental disorders. This study aims to characterize this subset of children with developmental disorders undergoing myringotomy and tympanostomy tube insertion. Methods: A retrospective review using the Kids’ Inpatient Database (KID) was conducted, with codes from International Classification of Diseases, Ninth Revision used to query data from the years 2003 to 2012 to determine a study group of children with a diagnosis of a developmental disorder undergoing myringotomy and tympanostomy insertion. This group was compared statistically to patients undergoing these procedures who did not have a diagnosed developmental disorder. Results: In total, 21 945 cases of patients with myringotomy with or without tympanostomy tube insertion were identified, of which 1200 (5.5%) had a diagnosis of a developmental disorder. Children with developmental disorders had a higher mean age (3.3 years vs 2.9 years, P = .002) and higher mean hospital charges ($43 704.77 vs $32 764.22, P = .003). This cohort also had higher proportions of black (17.6% vs 12.3%, P < .001) and Hispanic (23.9% vs 20.6%, P = .014) patients, and had lower rates of private insurance coverage (39.6% vs 49%, P < .001). Conclusion: The population of children with developmental disorders undergoing myringotomy or tympanostomy tube placement has a different demographic composition than the general population and faces distinct financial and insurance coverage burdens. Further study should be done to assess if these differences impact long term outcomes.

scholarly journals Albumin-based nanosystems in medicine

2018 ◽  
Vol 72 ◽  
pp. 1004-1017
Author(s):  
Bogusława Konopska ◽  
Krzysztof Gołąb ◽  
Katarzyna Juszczyńska ◽  
Jakub Gburek
Keyword(s):  
Drug Delivery ◽  
The United States ◽  
Delivery Systems ◽  
Anti Cancer ◽  
United States Food ◽  
Poorly Soluble ◽  
States Food ◽  
The Common ◽  
Low Cytotoxicity ◽  
Delivery Efficiency

Proteins are natural and safe substitutes of the synthetic polymers for the development of drug delivery systems (DDS). Few of proteins have been approved for drug delivery purposes by the United States Food and Drug Administration (FDA). Among them, albumin is the most explored carrier for synthesis of therapeutic nanoparticles. Its usefulness was determined by the common accessibility, biocompatibility and the feasibility of accumulation in tissues with increased metabolism. Albumin with its properties is particularly attractive carrier for anti-arthritis and anti-cancer drugs. It is mainly used to design delivery systems for poorly soluble substances with low permeability through biological membranes. The albumin nanoparticles are characterized by favourable pharmacokinetics, high drug delivery efficiency and low cytotoxicity. In addition, they are biodegradable, relatively easy to prepare and non-immunogenic. Interest in the exploration of clinical applications of albumin-based drug delivery carriers, especially for those at the nanoscale, has increased in recent years. A lot of research have been done to design multifunctional theranostic nanosystems that could be used for both imaging and cancer therapy. This article aims at providing an overview of already commercialized and just emerging applications of albumin-based nanosystems as drug delivery carriers.

scholarly journals Off-label use of rituximab in dermatology: pemphigus treatment

2013 ◽  
Vol 88 (4) ◽  
pp. 676-678 ◽  
Author(s):  
Lislaine Bomm ◽  
Tainá Scalfoni Fracaroli ◽  
João Luz Sodré ◽  
Aline Bressan ◽  
Alexandre Carlos Gripp
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Reports ◽  
Pemphigus Vulgaris ◽  
Off Label Use ◽  
Treatment Resistant ◽  
Off Label ◽  
The Past ◽  
Inflammatory Conditions ◽  
United States Food ◽  
States Food

Since its approval in 1997 by the FDA (United States Food and Drug Administration), rituximab has been used for certain B-cell lymphomas and treatment-resistant rheumatoid arthritis. Nevertheless, over the past 14 years, many case reports have demonstrated the efficacy of off-label rituximab in several dermatological inflammatory conditions. This study describes two cases of pemphigus vulgaris and two cases of pemphigus foliaceous that were treated with rituximab at 375 mg/m2 once a week for 4 weeks, and that responded well to treatment.

scholarly journals Strategies to prevent anthracycline-induced cardiotoxicity in cancer survivors

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Neha Bansal ◽  
M. Jacob Adams ◽  
Sarju Ganatra ◽  
Steven D. Colan ◽  
Sanjeev Aggarwal ◽  
...  
Keyword(s):  
The Elderly ◽  
Cancer Diagnostics ◽  
European Medicines Agency ◽  
Cardiovascular Comorbidities ◽  
Thoracic Radiation ◽  
United States Food ◽  
Short And Long Term ◽  
States Food ◽  
Anthracycline Chemotherapy

AbstractCancer diagnostics and therapies have improved steadily over the last few decades, markedly increasing life expectancy for patients at all ages. However, conventional and newer anti-neoplastic therapies can cause short- and long-term cardiotoxicity. The clinical implications of this cardiotoxicity become more important with the increasing use of cardiotoxic drugs. The implications are especially serious among patients predisposed to adverse cardiac effects, such as youth, the elderly, those with cardiovascular comorbidities, and those receiving additional chemotherapies or thoracic radiation. However, the optimal strategy for preventing and managing chemotherapy-induced cardiotoxicity remains unknown. The routine use of neurohormonal antagonists for cardioprotection is not currently justified, given the marginal benefits and associated adverse events, particularly with long-term use. The only United States Food and Drug Administration and European Medicines Agency approved treatment for preventing anthracycline-related cardiomyopathy is dexrazoxane. We advocate administering dexrazoxane during cancer treatment to limit the cardiotoxic effects of anthracycline chemotherapy.

scholarly journals Tympanostomy Tubes—A Visual Guide for the Young Otolaryngologist

2020 ◽  
Vol 99 (1_suppl) ◽  
pp. 8S-14S
Author(s):  
Glenn Isaacson
Keyword(s):  
Clinical Practice ◽  
Correct Diagnosis ◽  
Acute Otitis Media ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Shared Experience ◽  
Tube Removal ◽  
Recurrent Acute Otitis Media ◽  
Tympanostomy Tubes ◽  
The Common

Objectives: To illustrate some of the common dilemmas in tympanostomy tube care and describe time-tested ways to address them. Methods: Computerized literature review. Results: Issues including the correct diagnosis of recurrent acute otitis media, tympanostomy tube types and techniques for tube placement, management of tube clogging and otorrhea, and methods for tube removal and patching are illustrated. Conclusions: Tympanostomy tube placement is the most common surgery performed in children requiring general anesthesia. While some elements of tympanostomy tube care have been addressed in clinical studies, much of clinical practice is guided by shared experience.

scholarly journals Update on the role of copanlisib in hematologic malignancies

2021 ◽  
Vol 12 ◽  
pp. 204062072110060
Author(s):  
Thuy Le ◽  
David Jerel ◽  
Locke J. Bryan
Keyword(s):  
Hematologic Malignancies ◽  
Pi3k Pathway ◽  
Pi3k Inhibitors ◽  
Fda Approval ◽  
Solid Malignancies ◽  
Valuable Treatment ◽  
United States Food ◽  
States Food

Clinical research in hematologic malignancies is continually advancing with emerging concepts in therapy and evolving results from clinical protocols. Targeting of the PI3K pathway remains a valuable treatment across both hematologic and solid malignancies. There are currently four United States Food and Drug Administration (FDA)-approved PI3K inhibitors, with several others in development. Copanlisib is a pan-PI3K inhibitor currently FDA-approved for the treatment of relapsed/refractory follicular lymphoma (FL) following two lines of therapy. Since FDA approval, there have been further investigations into the long-term safety profile of copanlisib, as well as treatment of FL and other lymphoma subtypes, both indolent and aggressive. Here, we review the most recent available data from clinical trials, describe the management of the most common side effects, and explore future concepts. The use of copanlisib as part of a combination therapy for various hematologic malignancies will also be discussed. Copanlisib is a unique drug compared with other PI3K inhibitors, with remarkable potential to improve our armamentarium in cancer treatment.

scholarly journals Rituximab therapy in pemphigus and other autoantibody-mediated diseases

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 83 ◽  
Author(s):  
Nina A. Ran ◽  
Aimee S. Payne
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Microscopic Polyangiitis ◽  
The United States ◽  
Cell Marker ◽  
Off Label Use ◽  
Off Label ◽  
Non Hodgkin Lymphoma ◽  
United States Food ◽  
Blistering Disease ◽  
States Food

Rituximab, a monoclonal antibody targeting the B cell marker CD20, was initially approved in 1997 by the United States Food and Drug Administration (FDA) for the treatment of non-Hodgkin lymphoma. Since that time, rituximab has been FDA-approved for rheumatoid arthritis and vasculitides such as granulomatosis with polyangiitis and microscopic polyangiitis. Additionally, rituximab has been used off-label in the treatment of numerous other autoimmune diseases, with notable success in pemphigus, an autoantibody-mediated skin blistering disease. The efficacy of rituximab therapy in pemphigus has spurred interest in its potential to treat other autoantibody-mediated diseases. This review summarizes the efficacy of rituximab in pemphigus and examines its off-label use in other select autoantibody-mediated diseases.

scholarly journals A comparison of mutagenic potential of Aji-no-Moto with a traditional chemical mutagen on microsporogenesis in barley (Hordeum vulagre L.)

2021 ◽  
Vol 13 (4) ◽  
pp. 1378-1382
Author(s):  
Vivek Singh
Keyword(s):  
The United States ◽  
Chemical Mutagen ◽  
Hordeum Vulgare L ◽  
Mutagenic Potential ◽  
Long Term Effect ◽  
Methane Sulphonate ◽  
United States Food ◽  
States Food ◽  
Higher Doses

Aji-no-Moto or Mono Sodium Glutamate (MSG) is a flavour enhancer being used extensively in South East Asian cuisine. The Federation of American Societies for Experimental Biology for the United States Food and Drug Administration (FDA) has concluded that MSG is safe when "eaten at customary levels" but there is still great confusion regarding its toxicity at higher concentrations. Therefore, it was decided to assess the mutagenic efficacy of MSG on a plant system and present the findings as a model for probably similar effects in the animal model. For this, a traditionally popular genus for genetic studies, Hordeum vulgare L. or winter barley, was used as the model system. The studies of microsporogenesis were done in order to see the long term effect. The sets were compared with experimental sets of plants grown from seeds treated with a traditional chemical mutagen Ethyl Methane Sulphonate (EMS). The study revealed that MSG does not induce much genotoxic effects at lower doses and the chromosomal damages induced were very few. However, at higher doses, it almost equals the effects of EMS in terms of heritable genetic damage. The work is significant as MSG continues to be one of the most popular flavouring agents and does not face any challenge to its biosafe status. However, the clastogenic and chromotoxic effects of higher doses of MSG as observed in the study are in total contradiction to the popular belief.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

Sign in / Sign up

Export Citation Format

Share Document