scholarly journals Minirin for the sublingual application to manage diabetes insipidus in the patients treated for brain tumours

2012 ◽  
Vol 58 (5) ◽  
pp. 46-49 ◽  
Author(s):  
N A Mazerkina
Keyword(s):  
Single Dose ◽  
Surgical Treatment ◽  
Pituitary Adenoma ◽  
Diabetes Insipidus ◽  
Patient Compliance ◽  
Brain Tumours ◽  
Adverse Reactions ◽  
Therapeutic Modality ◽  
Sublingual Tablet ◽  
Therapeutic Modalities

The objective of the present study was to compare the effectiveness of desmopressin (standard oral and sublingual minirin tablets) and patient compliance with these two therapeutic modalities. The study included 51 patients at the age from 1 to 23 years presenting with diabetes insipidus (DI) at least 6 months in duration who had undergone the surgical treatment of craniopharyngioma (n=25), germinoma (n=21, glioma (n=3), and pituitary adenoma (n=2). The patients were transferred from the oral minirin formulation to the sublingual one (the dose of 100 mcg of oral minirin is equivalent to a 60 mcg sublingual tablet). The patients were interviewed to estimate their preference as regards either therapeutic modality within one week after the onset of the treatment. It turned out after the completion of the study that 30 of the 51 patients (59%) adhered to the new sublingual formulation of minirin. Their preferences were unrelated to the age of the patients, diagnosis, and duration of the disease but significantly correlated with a single dose of the preparation. Specifically, the single dose was lower than 1 tablet in 71% of the patients who chose to use oral minirin. No adverse reactions in response to the treatment with sublingual minirin were documented.

scholarly journals The technologies integrated into the phototherapy for the treatment the children suffering from the severe forms of psoriasis

2016 ◽  
Vol 15 (4) ◽  
pp. 191-194
Author(s):  
Svetlana Nikolaevna Turbovskaya ◽  
K. V Kotenko ◽  
L. S Kruglova
Keyword(s):  
Adverse Reaction ◽  
Side Effects ◽  
Topical Application ◽  
Adverse Reactions ◽  
Clinical Course ◽  
Combined Treatment ◽  
Therapeutic Modality ◽  
Reliable Control ◽  
Frequency Range ◽  
Therapeutic Modalities

The last decades have witnessed the increased frequency of the cases of the severe clinical course of psoriasis in the children. The application of systemic immunosuppressive therapy for the treatment of such patients is limited due to the serious adverse reactions especially pronounced when such medicines as methotrexate, acitretin, and cyclosporine are prescribed. For this reason, the investigations aimed at the evaluation of the effectiveness and safety of the non-pharmacological therapeutic modalities including phototherapeutic technologies appear to be highly promising. In this context, the treatment of psoriasis with the use of ultraviolet radiation may find the wide application for the management of many dermatological problems provided it is performed under reliable control. The present study included 25 patients at the age below 18 years presenting with the severe forms of psoriasis and resistance to traditional pharmacotherapy. All of them were prescribed the combined treatment that consisted of EHF-therapy in the 311 nm frequency range together with the topical application of calcipotriol. This treatment was shown to be highly efficient and safe enough as far as the predictable early side effects are concerned. In the case of the torpid response of the disease to the standard therapy, it is recommended to prescribe the combined treatment with the use of 311 nm UVB-irradiation and the topical application of calcipotriol. The effectiveness of this therapeutic modality may be higher than 90%. None of the children treated in this way developed an early adverse reaction. The results of the present study give reason to recommend this approach as the method of choice for the treatment of the widespread forms of psoriasis affecting the children.

Update on the Treatment of Bacterial Urinary Tract Infections

1981 ◽  
Vol 15 (10) ◽  
pp. 738-750 ◽  
Author(s):  
Neil Massoud
Keyword(s):  
Biological Activity ◽  
Single Dose ◽  
Urinary Tract ◽  
Patient Compliance ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
Complex Problem ◽  
Tract Infections

The treatment of urinary tract infections (UTIs) has become a complex problem for the clinical practitioner. An understanding of the pharmacology, pharmacokinetics, and in vivo biological activity of antimicrobial agents is needed, as is an understanding of the variables that may influence patient compliance with medication regimens. Although UTIs are usually treated for 10 to 14 days, shorter treatment schedules of seven to ten days or even single-dose regimens are possible. Guidelines for the treatment of UTIs are presented along with suggestions for increased patient compliance.

Surgical Treatment of Pituitary Adenoma in Young versus Elderly Patients: A Population-Based Analysis

2021 ◽  
Author(s):  
Brandon M. Lehrich ◽  
Khodayar Goshtasbi ◽  
Frank P. K. Hsu ◽  
Edward C. Kuan
Keyword(s):  
Surgical Treatment ◽  
Pituitary Adenoma ◽  
Elderly Patients ◽  
Population Based

scholarly journals Efficacy and safety of non-steroidal anti-inflammatory drugs for acute attack of gout

2021 ◽  
Vol 5 (2) ◽  
pp. 96-101
Author(s):  
V.B. Vasilyuk ◽  
◽  
G.I. Syraeva ◽  
M.V. Faraponova ◽  
◽  
...  
Keyword(s):  
Inflammatory Arthritis ◽  
Adverse Reactions ◽  
Acute Attack ◽  
Therapeutic Modality ◽  
Efficacy And Safety ◽  
Nsaid Treatment ◽  
Depth Analysis ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Russian Medical

Gout is one of the most common forms of inflammatory arthritis. Medical care for gout includes non-steroidal anti-inflammatory drugs (NSAIDs). This paper reviews the efficacy and safety of NSAIDs prescribed for the acute attack of gout, in particular, AMBENIUM® parenteral. It was demonstrated that phenylbutazone is a powerful NSAID that provides significant analgesic and anti-inflammatory effects. Considering a broad spectrum of adverse reactions of NSAIDs, these agents should be prescribed and used under in-depth analysis of patient’s condition, comorbidities and the level of their decompensation, and potential drug interactions. In addition, optimal dosages and duration of NSAID treatment are of particular importance. The authors conclude that AMBENIUM® parenteral is an effective and safe therapeutic modality for gout. Its profile and risk/benefit ratio are regarded as “favorable” compared to other NSAIDs. KEYWORDS: gout, arthritis, pain, non-steroidal anti-inflammatory drugs, parenteral, efficacy, safety. FOR CITATION: Vasilyuk V.B., Syraeva G.I., Faraponova M.V. Efficacy and safety of non-steroidal anti-inflammatory drugs for acute attack of gout. Russian Medical Inquiry. 2021;5(2):96–101. DOI: 10.32364/2587-6821-2021-5-2-96-101.

scholarly journals Clinical syndromes of compression and surgical transection of the pituitary stalk

2018 ◽  
Vol 64 (1) ◽  
pp. 4-13
Author(s):  
Ludmila I. Astafyeva ◽  
Boris A. Kadashev ◽  
Pavel L. Kalinin ◽  
Maxim A. Kutin ◽  
Irina S. Klochkova ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Diabetes Insipidus ◽  
Tumor Resection ◽  
Pituitary Stalk ◽  
Endocrine Disorders ◽  
Free T4 ◽  
Clinical Syndromes ◽  
Hypothalamic Nuclei ◽  
Dopamine Transport ◽  
The Difference

Background. The pituitary stalk (PS) is an anatomical structure consisting of the portal vessel system and axons of the hypothalamic nuclei terminating in the posterior pituitary lobe. Surgical injury or compression (by a tumor or another space-occupying process) of the PS can lead to hypopituitarism, diabetes insipidus, and hyperprolactinemia. However, the literature lacks studies on the extent of these disorders depending on PS injury or compression in clinical practice. Aim. The study aim was to investigate pre- and postoperative endocrine disorders in patients with chiasmo-sellar region (CSR) tumors and the PS compressed and preserved or involuntarily transected during neurosurgery. Material and methods. The PS compressed before surgery was preserved in 82 patients (41 patients with non-functioning endosuprasellar adenoma and 41 — with suprasellar meningioma). The PS was transected during transcranial surgery in 57 patients (46 patients with pituitary stalk craniopharyngioma and 11 patients with non-functioning endosupresellar pituitary adenoma). All patients underwent blood tests for prolactin (PRL), TSH, LH, FSH, free T4, cortisol, testosterone, or estradiol levels before and 6 months after surgery. Results. Hyperprolactinemia was detected in 37.4% of patients with CSR tumors compressing the PS. Elimination of PS compression led to normalization of the PRL level in most patients and was not accompanied by worsening of hypopituitarism symptoms. Transection of the PS resulted in panhypopituitarism in 100% of patients and diabetes insipidus in 93% of cases. There was no evidence of hyperprolactinemia in 58.7% of patients with craniopharyngiomas and 81.9% of patients with non-functioning pituitary adenomas. Conclusion. Given the difference in symptoms, we distinguished two syndromes: PS compression syndrome and PS transection syndrome. Syndrome of PS compression by a CSR tumor was characterized mainly by hyperprolactinemia (37.4% of cases); elimination of PS compression due to tumor resection led to normalization of the PRL level in most patients and was not accompanied by worsening of hypopituitarism symptoms. Syndrome of surgical PS transection in patients with craniopharyngioma (CP) and non-functioning pituitary adenoma (NFPA) manifested as panhypopituitarism in all patients and as permanent diabetes insipidus in most of them. The causes for the absence of hyperprolactinemia in many patients with the transected PS require further research. We can not exclude both adenohypophysis ischemia (due to its impaired blood supply) with partial or complete atrophy of lactotrophic cells and pituitary revascularization with restoration of dopamine transport.

Different Therapeutic Approaches and Outcome in the Treatment of Pterygium

1998 ◽  
Vol 8 (3) ◽  
pp. 148-152 ◽  
Author(s):  
C. H. Karabatsas ◽  
G. W. Marsh ◽  
A. M. Cook ◽  
S. D. Cook
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Surgical Excision ◽  
Lamellar Keratoplasty ◽  
Therapeutic Approaches ◽  
Therapeutic Modalities ◽  
Results Of Treatment ◽  
One Year

Purpose This study was initiated to investigate the role of different therapeutic modalities in the outcome of the surgical treatment of pterygium. Methods The results of treatment of pterygia with a variety of surgical techniques were studied in 56 eyes (49 patients) operated on at Bristol Eye Hospital during a period of five years. The surgical techniques included simple excision; bare sclera; conjunctival autograft; sliding conjunctival flap; lamellar keratoplasty and penetrating keratoplasty. Twelve eyes received additional beta irradiation in a fractionated total dose of 40 Gys. Results The incidence of recurrence was 23.2% for the 43 treated primary pterygia, and 23% for the 13 recurrent pterygia. All recurrences occurred between 2.5 and 11 months postoperatively. None of the 11 cases where additional beta irradiation was used showed any recurrence or other complication within the study period. In the recurrent pterygia group, the cases treated with a combination of surgical excision and beta irradiation, showed significantly lower recurrence rate (p<0.001) compared to those cases treated with surgical excision alone. Conclusions Beta irradiation as a complement to surgical treatment of pterygium, is successful in treating high risk cases such as reoperations, whereas for the majority of primary pterygia surgical excision alone is adequate. Additionally, follow up of one year will reveal any recurrences.

Radiosurgical Management of Benign Cavernous Sinus Tumors: Dose Profiles and Acute Complications

Neurosurgery ◽  
2001 ◽  
Vol 48 (5) ◽  
pp. 1022-1032 ◽  
Author(s):  
Joseph C.T. Chen ◽  
Steven L. Giannotta ◽  
Cheng Yu ◽  
Zbigniew Petrovich ◽  
Michael L. Levy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pituitary Adenoma ◽  
Radiation Dose ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Tumor Volume ◽  
Grade Iii

Abstract OBJECTIVE Radiosurgery has emerged as an alternative treatment modality for cranial base tumors in patients deemed not suited for primary surgical extirpation, patients with recurrent or residual tumor after open surgery, or patients who refuse surgical treatment. We review our short-term experience with radiosurgical management of cavernous sinus region tumors with the Leksell gamma knife. METHODS From August 1994 to February 1999, 69 patients with cavernous sinus lesions were treated in 72 separate treatment sessions. The tumor type distribution was 29 pituitary adenomas, 35 meningiomas, 4 schwannomas, and 1 paraganglioma. The median follow-up was 122 weeks. Lesions were stratified according to a five-level surgical grade. The grade distribution of the tumors was as follows: Grade I, 13; Grade II, 21; Grade III, 19; Grade IV, 12; Grade V, 4. Median tumor volume was 4.7 cm3. The median radiation dose was 15 Gy to the 50% isodose line. Median maximal radiation dose was 30 Gy. RESULTS Analysis of tumor characteristics and radiation dose to optic nerve and pontine structures revealed a significant correlation between distance and dose. Much lower correlation coefficients were found between tumor volume and dose. One lesion in this series had evidence of transient progression and later regression on follow-up radiographic studies. No other lesions in this series were demonstrated to have exhibited progression. Complications after radiosurgical treatment were uncommon. Two patients had cranial nerve deficits after treatment. One patient with a surgical Grade III pituitary adenoma had VIth cranial nerve palsy 25 months after radiosurgical treatment that spontaneously resolved 10 months later. A patient with a bilateral pituitary adenoma experienced bilateral VIth cranial nerve palsy 3 months after treatment that had not resolved at 35 months after treatment. Six patients with preoperative cranial nerve deficits experienced resolution or improvement of their deficits after treatment. One patient with a prolactin-secreting adenoma experienced normalization of endocrine function with return of menses. CONCLUSION Radiosurgical treatment represents an important advance in the management of cavernous sinus tumors, with low risk of neurological deficit in comparison with open surgical treatment, even in patients with high surgical grades.

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