Long-Term Phenothiazine Treatment does not Cause Pituitary Tumours

1984 ◽  
Vol 144 (4) ◽  
pp. 421-424 ◽  
Author(s):  
Victoria A. Lilford ◽  
R. J. Lilford ◽  
Janet E. Dacie ◽  
Lesley A. Rees ◽  
T. Chard
Keyword(s):  
Prolonged Exposure ◽  
Average Duration ◽  
Serum Prolactin ◽  
X Rays ◽  
Pituitary Tumours ◽  
Duration Of Treatment ◽  
Pituitary Fossa

SummaryIn order to explore the possibility that prolactinomas may be caused by prolonged under-inhibition of prolactin-secreting cells we examined the pituitary fossa in 69 patients on long-term phenothiazine treatment. The average duration of treatment was 12.5 years and 55 (80 per cent) of the patients had persistently raised serum prolactin levels. The incidence of radiologically detectable pituitary fossa abnormalities was not significantly different to that in control populations. In 62 per cent of patients the skull x-rays from an earlier admission were available. Comparison of these with earlier films did not show a higher incidence of pituitary fossa abnormalities after prolonged exposure to phenothiazines.

Effects of bromocriptine-induced pregnancy on prolactin-secreting pituitary tumours

1981 ◽  
Vol 98 (3) ◽  
pp. 333-338 ◽  
Author(s):  
T. Bergh ◽  
S. J. Nillius ◽  
S.-G. Larsson ◽  
L. Wide
Keyword(s):  
Post Partum ◽  
Pituitary Tumour ◽  
X Rays ◽  
Pituitary Tumours ◽  
Pituitary Fossa ◽  
X Ray ◽  
Pregnancy And Lactation ◽  
Radiological Changes ◽  
The Mean

Abstract. Twenty-eight women with hyperprolactinaemia and amenorrhoea received bromocriptine treatment which resulted in 31 term pregnancies. Bromocriptine treatment was stopped as soon as pregnancy was established. Nineteen of the women had radiological signs of a pituitary tumour. The pregnancies were clinically un-eventful in all cases except one who developed headache. Post-partum sellar X-ray showed pregnancy-induced enlargement of the pituitary fossa in 4 of the 28 women. Regression of the radiological changes occurred in 3 of the 4 women within 2 years after the delivery. The women with abnormal sellar X-rays had no difference in the mean prolactin levels before treatment and after pregnancy and lactation while all the women with normal sellae had lower prolactin levels after pregnancy than before. Three women resumed regular spontaneous menstruations after pregnancy and lactation but only one conceived again. Thus, serious pituitary tumour complications are rare in hyperprolactinaemic women with bromocriptine-induced pregnancies. The pregnancy does not worsen the condition. Resolution of hyperprolactinaemia after bromocriptine-induced pregnancy is an unfrequent finding.

Photosensitivity Reactions Caused by Lomefloxacin Hydrochloride: A Multicenter Survey

1998 ◽  
Vol 42 (12) ◽  
pp. 3141-3145 ◽  
Author(s):  
Jirô Arata ◽  
Takeshi Horio ◽  
Rinzo Soejima ◽  
Kenji Ohara
Keyword(s):  
Prolonged Exposure ◽  
Previous Treatment ◽  
Underlying Disease ◽  
Duration Of Treatment ◽  
Photosensitivity Reaction ◽  
Multicenter Survey ◽  
Previous Medication ◽  
History Of ◽  
Clinical Records

ABSTRACT The photosensitivity effect of lomefloxacin hydrochloride (LFLX) was investigated in terms of patient background factors (sex, age, underlying disease, complications, history, occupation, and residential condition, etc.), treatment factors (daily dosage of LFLX, duration of treatment, total dose, concomitant drugs, and previous medication, etc.), and correlations among them. In 100 institutions throughout Japan, 4,284 patients were enrolled over a period of 2 years, beginning in October 1991, avoiding the accumulation of patients in any specific season. Since 8 patients did not visit again after enrollment, the clinical records of 4,276 patients were analyzed. Photosensitivity in 44 patients was found (1.03%), but the symptoms in most patients were not severe and improved after discontinuation of LFLX treatment. The photosensitivity reaction was more prevalent in patients who were 60 years of age and older with concomitant diseases and complications, in patients treated with a total amount of 20 g and more of LFLX for 30 days or longer, and in patients with a history of previous treatment with quinolone drugs. Although the incidence and degree of the photosensitivity reaction vary significantly among new quinolone drugs, every quinolone drug is potentially phototoxic. In particular, long-term use of LFLX should be avoided, and patients taking LFLX should be advised to abstain from prolonged exposure to sunlight.

Topical Formulations and Intradermal Injections of Tranexamic Acid in the Treatment of Hyperpigmentation - A Review

2018 ◽  
Vol 15 (2) ◽  
pp. 212-218
Author(s):  
Mirella Batory ◽  
Helena Rotsztejn
Keyword(s):  
Side Effects ◽  
Tranexamic Acid ◽  
Average Duration ◽  
Skin Irritation ◽  
Therapeutic Effects ◽  
Plasmin Activity ◽  
Duration Of Treatment ◽  
Low Concentrations ◽  
Formulation Stability

Background: The anti-plasmin activity of Tranexamic Acid (TA) is considered to be the main mechanism of hypopigmentation. Several studies have found TA to be effective for both oral and topical application. When used to lighten stains, TA is effective even at low concentrations, ideally in the range of 2 to 5%. Increasing the duration of treatment is more effective than increasing the concentration of TA: Higher concentrations of TA (> 5%) do not improve the effect but rather cause irritation. The TA formulations were applied once or twice a day, and the average duration was eight to twelve weeks: advantageous therapeutic effects were observed after this period. Other studies gave intradermal injections once weekly for 12 weeks, also with an acceptable efficiency. The compound may be administered topically to the skin in the form of emulsions, creams and solutions, and formulations containing liposomes. Encapsulation of TA in liposomes may reduce potential skin irritation, and it ensure high formulation stability, decrease the risk of leakage and allow long-term sustained release. Intradermal injections of TA produce relatively quick bleaching results without significant side effects. Conclusion: In conclusion it should be stated that the lightening effect of tranexamic acid in topical and intradermal applications has been most extensively studied in the case of melasma, and most studies have been performed in Asia. Therefore, the final evaluation of TA, in the cases other than melasma and hyperpigmentation, requires further studies. However, further studies are needed in order to optimize the frequency of application of TA and to determine the long-term benefits from its use, especially concerning stains other than chloasma.

Prophylaxis in people with haemophilia

2009 ◽  
Vol 101 (04) ◽  
pp. 674-681 ◽  
Author(s):  
Massimo Franchini ◽  
Annarita Tagliaferri ◽  
Antonio Coppola
Keyword(s):  
Quality Of Life ◽  
Cost Benefit ◽  
Primary Prophylaxis ◽  
Secondary Prophylaxis ◽  
Severe Haemophilia ◽  
Duration Of Treatment ◽  
First Choice ◽  
Long Term Treatment

SummaryA four-decade clinical experience and recent evidence from randomised controlled studies definitively recognised primary prophylaxis, i.e. the regular infusion of factor concentrates started after the first haemarthrosis and/or before the age of two years, as the first-choice treatment in children with severe haemophilia. The available data clearly show that preventing bleeding since an early age enables to avoid or reduce the clinical impact of muscle-skeletal impairment from haemophilic arthropathy and the related consequences in psycho-social development and quality of life of these patients. In this respect, the aim of secondary prophylaxis, defined as regular long-term treatment started after the age of two years or after two or more joint bleeds, is to avoid (or delay) the progression of arthropathy. The clinical benefits of secondary prophylaxis have been less extensively studied, especially in adolescents and adults; also in the latter better outcomes and quality of life for earlier treatment have been reported. This review summarises evidence from literature and current clinical strategies for prophylactic treatment in patients with severe haemophilia, also focusing on challenges and open issues (optimal regimen and implementation, duration of treatment, long-term adherence and outcomes, cost-benefit ratios) in this setting.

scholarly journals Impact of Prolonged Exposure of Eleven Years to Hot Seawater on the Degradation of a Thermoset Composite

Polymers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 2154
Author(s):  
Amir Hussain Idrisi ◽  
Abdel-Hamid I. Mourad ◽  
Muhammad M. Sherif
Keyword(s):  
Exposure Time ◽  
Prolonged Exposure ◽  
Mechanical Performance ◽  
Matrix Cracking ◽  
Pull Out ◽  
Strength Based ◽  
Different Temperatures ◽  
River Line ◽  
Composite Samples

This paper presents a long-term experimental investigation of E-glass/epoxy composites’ durability exposed to seawater at different temperatures. The thermoset composite samples were exposed to 23 °C, 45 °C and 65 °C seawater for a prolonged exposure time of 11 years. The mechanical performance as a function of exposure time was evaluated and a strength-based technique was used to assess the durability of the composites. The experimental results revealed that the tensile strength of E-glass/epoxy composite was reduced by 8.2%, 29.7%, and 54.4% after immersion in seawater for 11 years at 23 °C, 45 °C, and 65 °C, respectively. The prolonged immersion in seawater resulted in the plasticization and swelling in the composite. This accelerated the rate of debonding between the fibers and matrix. The failure analysis was conducted to investigate the failure mode of the samples. SEM micrographs illustrated a correlation between the fiber/matrix debonding, potholing, fiber pull-out, river line marks and matrix cracking with deterioration in the tensile characteristics of the thermoset composite.

scholarly journals Onset and Resolution of Key Adverse Events in Valbenazine-Treated Patients with Tardive Dyskinesia: Pooled Analyses from Two Long-Term Clinical Trials

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 151-151
Author(s):  
Stephen R. Marder ◽  
Jean-Pierre Lindenmayer ◽  
Chirag Shah ◽  
Tara Carmack ◽  
Angel S. Angelov ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Adverse Events ◽  
Tardive Dyskinesia ◽  
Suicidal Behavior ◽  
Prolonged Exposure ◽  
First Occurrence ◽  
Balance Disorder ◽  
Clinical Interest ◽  
Post Hoc

AbstractObjectiveTardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine receptor blocking agents. Long-term safety of the approved TD medication, valbenazine, was demonstrated in 2 clinical trials (KINECT 3 [NCT02274558], KINECT 4 [NCT02405091]). Data from these trials were analyzed post hoc to evaluate the onset and resolution of adverse events (AEs).MethodsParticipants in KINECT 3 and KINECT 4 received up to 48 weeks of once-daily valbenazine (40 or 80 mg). Data from these studies were pooled and analyzed to assess the incidence, time to first occurrence, and resolution for the following AEs of potential clinical interest: akathisia, balance disorder, dizziness, parkinsonism, somnolence/sedation, suicidal behavior/ideation, and tremor.ResultsIn the pooled population (N=314), all AEs of potential clinical interest occurred in <10% of participants, with somnolence (9.6%), suicidal behavior/ideation (6.4%), and dizziness (5.7%) being the most common AEs. Mean time to first occurrence ranged from 36 days (akathisia [n=9]) to 224 days (parkinsonism [n=2]). By end of study (or last study visit), resolution of AEs was as follows: 100% (suicidal ideation/behavior, parkinsonism); >85% (somnolence/sedation, dizziness); >70% (akathisia, balance disorder, tremor).ConclusionsIn long-term clinical trials, the incidence of AEs of potential clinical interest was low (<10%) and most were resolved by end of treatment (>70–100%). All patients taking valbenazine should be routinely monitored for AEs, particularly those that may exacerbate the motor symptoms associated with TD.FundingNeurocrine Biosciences, Inc.

scholarly journals Cerebrospinal Fluid Rhinorrhoea in Pituitary Tumours

1980 ◽  
Vol 73 (4) ◽  
pp. 244-254 ◽  
Author(s):  
I E Cole ◽  
Malcolm Keene
Keyword(s):  
Cerebrospinal Fluid ◽  
Pituitary Tumours ◽  
Pituitary Fossa ◽  
Muscle Graft ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea

Three cases of CSF rhinorrhoea due to pituitary tumours are reported and the literature reviewed. The treatment of choice appears to be trans-sphenoidal exploration of the pituitary fossa with insertion of a free muscle graft followed by radiotherapy. The probability of the tumour being a prolactin-secreting adenoma is discussed.

scholarly journals Implications for health services

1997 ◽  
Vol 352 (1363) ◽  
pp. 1887-1893 ◽  
Author(s):  
John Grimley Evans
Keyword(s):  
Health Services ◽  
Political Thought ◽  
Elderly Population ◽  
Average Duration ◽  
Later Life ◽  
The Elderly ◽  
Services Research ◽  
Extrinsic Factors ◽  
Progressive Loss

Health services for older people in the NHS have developed pragmatically, and reflect the nature of disease in later life and the need to agree objectives of care with patients. Although services are likely to be able to cope with the immediate future, the growth of the elderly population anticipated from 2030 calls for long–term planning and research. The issue of funding requires immediate political thought and action. Scientifically the focus needs to be on maximizing the efficiency of services by health services research and reducing the incidence of disability in later life through research on its biological and social determinants. Senescence is a progressive loss of adaptability due to an interaction between intrinsic (genetic) processes with extrinsic factors in environment and lifestyle. There are grounds for postulating that a policy of postponement of the onset of disability, by modifications of lifestyle and environment, could reduce the average duration of disability before death. The new political structures of Europe offer underexploited–unexploited opportunities for the necessary research.

621 PL02.05 LONG-TERM TREATMENT OF PATIENTS WITH EOSINOPHILIC GASTRITIS AND/OR EOSINOPHILIC DUODENITIS WITH LIRENTELIMAB, A MONOCLONAL ANTIBODY AGAINST SIGLEC-8

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kathryn Peterson ◽  
Mirna Chehade ◽  
Joseph Murray ◽  
Gary Falk ◽  
Nirmala Gonsalves ◽  
...  
Keyword(s):  
Mast Cells ◽  
Common Adverse Event ◽  
Symptom Improvement ◽  
Duration Of Treatment ◽  
Open Label ◽  
Double Blind ◽  
Long Term Treatment ◽  
Patient Reported ◽  
Symptom Scores

Abstract   Eosinophilic esophagitis (EoE), gastritis (EG), and/or duodenitis (EoD) are associated with accumulation and activation of eosinophils and mast cells in the esophagus, stomach, and/or duodenum, respectively. Lirentelimab (AK002), an antibody against siglec-8, depletes eosinophils and inhibits mast cells. We performed an open-label extension (OLE) study of subjects who completed ENIGMA (a randomized, double-blind, placebo-controlled phase 2 study of lirentelimab in adults with symptomatic, biopsy-confirmed EG and/or EoD, with or without EoE) to evaluate long-term responses. Methods Subjects who received 4 monthly infusions of lirentelimab or placebo during ENIGMA (n = 59) were eligible for the OLE; they received monthly, escalating doses of lirentelimab (0.3 or 1 mg/kg escalating to 3 mg/kg). Symptoms were assessed weekly using an electronic daily patient-reported outcome questionnaire and total symptom scores (TSS) were calculated. Patients underwent upper endoscopy with biopsy at screening and at the end of ENIGMA (day 99, week 16, blinded); in the OLE, endoscopies were performed on day 323 (30 weeks after the first dose in the OLE). Histopathology was assessed by a single pathologist. Results Fifty-eight subjects entered the OLE; 45 completed ≥52 weeks lirentelimab (including exposure during ENIGMA) and 29 completed 70 weeks. Mean TSS improved through week 70 (Figure 1). Subjects receiving 70 weeks lirentelimab (ENIGMA+OLE) had further improvements in TSS from baseline (mean reductions: 68% at weeks 29–30, 70% at weeks 51–52, 75% at weeks 69–70). Symptom scores (abdominal pain, nausea, vomiting, early satiety, appetite loss, abdominal cramping, bloating, diarrhea) decreased significantly from baseline. Treatment response was not associated with concomitant EoE. The most common adverse event was mild to moderate infusion-related reactions, usually with the first infusion. Conclusion In the OLE of the ENIGMA study, patients with EG and or EoD (with or without concomitant EoE) who received lirentelimab had sustained tissue eosinophil depletion and significant long-term symptom improvement. Symptoms continued to improve with duration of treatment. Lirentelimab appears to be a promising targeted treatment for EG and/or EoD.

Classification of Fresh Fractures of the Lunate

1988 ◽  
Vol 13 (4) ◽  
pp. 458-462
Author(s):  
H. TEISEN ◽  
J. HJARBAEK
Keyword(s):  
Vascular Anatomy ◽  
X Rays ◽  
Lunate Bone ◽  
X Ray

The X-rays of 17 patients with fresh fractures of the lunate bone have been reviewed. The fractures were classified according to their radiological appearances and according to the vascular anatomy of the lunate. A long term X-ray follow-up examination was performed.

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