scholarly journals Morbidnoe ozhirenie - vozmozhnostikonservativnoy terapii

2010 ◽  
Vol 7 (4) ◽  
pp. 40-43 ◽  
Author(s):  
E V Ershova ◽  
E A Troshina ◽  
O S Fedorova ◽  
S A Butrova
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Conservative Therapy ◽  
Adult Population ◽  
Line Treatment ◽  
Social Significance ◽  
First Line ◽  
Associated Diseases ◽  
Overall Effectiveness ◽  
First Line Treatment

Medico-social significance of morbid obesity, occurring in 2-4% of the adult population in Russia, results from the severity of obesity- associated diseases. Conservative therapy of morbid obesity is the first line treatment and is mostly a preparation for bariatric surgery, because the overall effectiveness of conservative measures for morbid obesity does not exceed 5-10%.

scholarly journals Drugs and future candidates

2013 ◽  
Vol 5 (5-S2) ◽  
pp. 131
Author(s):  
Karl-Erik Andersson
Keyword(s):  
Overactive Bladder ◽  
Adverse Effects ◽  
Line Treatment ◽  
First Line ◽  
Bladder Filling ◽  
Antimuscarinic Drugs ◽  
Overall Effectiveness ◽  
First Line Treatment

Antimuscarinic drugs are still first-line treatment for the symptomsof overactive bladder (OAB) and are associated with good initialresponse rates. Adverse effects and decreasing efficacy overthe longer term do, however, limit their overall effectiveness. Assuch, alternatives to antimuscarinics are needed. The recognitionof the functional contribution of the urothelium, the spontaneousmyocyte activity during bladder filling, and the diversity of nervetransmitters involved in the symptoms of the OAB has sparkedinterest in pharmacologic manipulation of both peripheral andcentral pathophysiology. Some of the treatments currently underinvestigation are discussed in this review.

Analysis of first-line treatment in older patients with metastasic colorectal cancer

2021 ◽  
pp. 107815522098422
Author(s):  
Arantxa Magallón Martínez ◽  
Maria J Agustín Ferrández ◽  
Andrea Pinilla Rello ◽  
Vicente Gimeno-Ballester ◽  
Angel Escolano Pueyo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trials ◽  
Older Patients ◽  
Adult Population ◽  
Real Life ◽  
Line Treatment ◽  
First Line ◽  
Palmoplantar Erythrodysesthesia ◽  
Dose Reductions ◽  
First Line Treatment

Objective The purpose of this study was to analyse the effectiveness and safety of first-line treatment of metastatic colorectal cancer (CRCm) in older patients treated in a tertiary hospital. Material and methods This was an observational and retrospective study, including patients aged 75 years or older, with CRCm, who received chemotherapy treatment in 2017. The main variables studied were type of treatment, Progression-Free Survival (PFS), Overall Survival (OS), dose reductions, and treatment delays due to adverse events. Results A total of 59 patients (71.2% men) with a median age of 76 years were enrolled in this study. About 70% presented colon cancer, with the left colon being the most frequent location. They were treated with 9 different schemes, in most cases using polychemotherapy and biological agents. The median PFS and OS was 12 and 30 months, respectively. A total of 23/59 of patients started treatment at doses lower than recommended in the clinical practice guidelines. In terms of safety, 34/59 of patients had at least one dose reduction, and 30/59 suffered one treatment delay. The most frequent adverse reactions were asthenia, peripheral neuropathy, diarrhoea, and palmoplantar erythrodysesthesia. Conclusion Our patients presented baseline clinical characteristics similar to the general adult population, with no tumour characteristics associated with advanced age. The efficacy and toxicity were similar to those in the clinical trials, although our patients had more dose reductions. Considering the heterogeneity of patients and in the absence of clinical trials in the older population, real-life studies can be very useful.

scholarly journals Endoscopic Double-Pigtail Catheter (EDPC) Internal Drainage as First-Line Treatment of Gastric Leak: A Case Series during Laparoscopic Sleeve Gastrectomy Learning Curve for Morbid Obesity

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Gianni Lazzarin ◽  
Marino Di Furia ◽  
Lucia Romano ◽  
Alessandra Di Sibio ◽  
Carla Di Giacomo ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Gastric Leak ◽  
Pigtail Catheter ◽  
Line Treatment ◽  
Internal Drainage ◽  
First Line ◽  
Clinical Visit ◽  
First Line Treatment

Objectives. The prevalence of morbid obesity has dramatically increased over the last several decades worldwide, currently reaching epidemic proportions. Gastric leak (GL) remains the potentially fatal main complication after sleeve gastrectomy (SG) for morbid obesity. To our knowledge, there are no standardized guidelines for GL treatment after laparoscopic sleeve gastrectomy (LSG) yet. The aim of this study was to represent our institutional preliminary experience using the endoscopic double-pigtail catheter (EDPC) as the method of internal drainage and propose it as first-line treatment in case of GL after LSG. Methods. One hundred and seventeen patients were admitted to our surgical department and underwent laparoscopic sleeve gastrectomy (LSG) for morbid obesity from March 2014 to June 2019. In 5 patients (4.3%) of our series, GL occurred as a complication of LSG. EPDC was the stand-alone procedure of internal drainage and GL first-line treatment. The internal pig tail was endoscopically removed from 30th to 40th POD in all cases. Results. Present data (clinical, biochemical, and instrumental tests) showed a complete resolution of GL, with promotion of a pseudodiverticula and complete re-epithelialization of leak. Follow-up was more strict than usual (clinical visit and biochemical test on 7th, 14th, and 21st day after discharge; a CT scan with gastrografin on 30th day from discharge if clinical visit and exams were normal). Conclusion. This was a preliminary retrospective observational study, conducted on 5 patients affected by GL as a complication of LSG for morbid obesity. EDPC maintains the safety, efficacy, and nonexpensive characteristic and may be proposed as better first-line treatment in case of GL after bariatric surgery.

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