scholarly journals Interprofessional Management of Allergic Conjunctivitis

2018 ◽  
Vol 80 (3) ◽  
pp. 11-27 ◽  
Author(s):  
C. Lisa Prokopich ◽  
Michael Lee-Poyb ◽  
Harold Kimc
Keyword(s):  
Daily Living ◽  
Allergic Conjunctivitis ◽  
Treatment Options ◽  
Management Strategies ◽  
Treatment Algorithm ◽  
Current Treatment ◽  
Inflammatory Drugs ◽  
Patient Presentation ◽  
Symptoms And Signs

Ocular allergies affect a large and increasing number of people in North America. Canada’s statistics are likely to mirror those of the U.S., where up to 40% of the population is affected by ocular allergies. The symptoms and signs of ocular allergies can greatly affect productivity and have a dramatic effect on overall quality of life (QoL). Over the years, many effective treatments have been developed for the management of ocular allergies. For allergic conjunctivitis, topical ophthalmic agents include antihistamines, mast-cell stabilizers, dual-activity agents, steroids, nonsteroidal anti-inflammatory drugs, and other immune-modulating drugs. Oral antihistamines are commonly chosen by patients for all forms of allergy, including allergic conjunctivitis. This review provides a summary of the forms of ocular allergy, with a particular focus on the symptoms and signs, diagnosis, current treatment options, and impact on QoL. More importantly, through multidisciplinary collaboration, a simplified treatment algorithm is proposed for Canadian clinical practice. This algorithm provides practitioners the best possible management strategies based on an individual patient presentation, thereby maximizing treatment efficacy and minimizing the effects on tasks of daily living and QoL.

Integrating Biologic Agents into Management of Moderate-to-Severe Psoriasis: A Consensus of the Canadian Psoriasis Expert Panel

2004 ◽  
Vol 8 (5) ◽  
pp. 321-337 ◽  
Author(s):  
Lyn Guenther ◽  
Richard G Langley ◽  
Neil H. Shear ◽  
Robert Bissonnette ◽  
Vincent Ho ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Expert Panel ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Current Treatment ◽  
Biologic Agents ◽  
Severe Psoriasis ◽  
Appropriate Treatment ◽  
Current Therapies

Background: Approximately 2% of people worldwide have psoriasis, with as many as 1 million people with psoriasis in Canada alone.1,2 The severity of psoriasis ranges from mild to severe. It can lead to substantial morbidity and psychological stress and have a profound negative impact on patient quality of life.3,4 Although available therapies reduce therapies reduce the extent and severity of the disease and improve quality of life,3 reports have indicated a patient preference for more aggressive therapy and a dissatisfaction with the effectiveness of current treatment options.5 Objective: A Canadian Expert Panel, comprising Canadian dermatologists, convened in Toronto on 27 February 2004 to reach a consensus on unmet needs of patients treated with current therapies and how to include the pending biologic agents in and improve the current treatment algorithm for moderate-to-severe psoriasis. Current treatment recommendations suggest a stepwise strategy starting with topical agents followed by phototherapy and then systemic agents.3,6,7 The Panel evaluated the appropriate positioning of the biologic agents, once approved by Health Canada, for the treatment of moderate-to-severe psoriasis. Methods: The Panel reviewed available evidence and quality of these data on current therapies and from randomized, controlled clinical trials.8–14 Subsequently, consensus was achieved by small-group workshops followed by plenary discussion. Results: The Panel determined that biologic agents are an important addition to therapies currently available for moderate-to-severe psoriasis and proposed an alternative treatment algorithm to the current step wise paradigm. Conclusion: The Panel recommended a new treatment algorithm for moderate-to-severe psoriasis whereby all appropriate treatment options, including biologic agents, are considered together and patients' specific characteristics and needs are taken into account when selecting the most appropriate treatment option.

scholarly journals Expert Opinion on the Management of Non-Alcoholic Fatty Liver Disease (NAFLD) in the Middle East with a Focus on the Use of Silymarin

2021 ◽  
Vol 12 (2) ◽  
pp. 155-165
Author(s):  
Ahmed Hashem ◽  
Yogesh Shastri ◽  
Malfi Al Otaibi ◽  
Elwin Buchel ◽  
Hussam Saleh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Middle East ◽  
Fatty Liver Disease ◽  
Expert Panel ◽  
Treatment Options ◽  
Current Treatment ◽  
Alcoholic Fatty Liver ◽  
Liver Disease Progression ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty disease (NAFLD) is amongst the leading causes of chronic liver disease worldwide. The prevalence of NAFLD in the Middle East is 32%, similar to that observed worldwide. The clinicians in this region face several challenges in diagnosing and treating patients with NAFLD. Additionally, there are no national or regional guidelines to address the concerns faced with current treatment options. Silymarin, derived from milk thistle, provides a rational and clinically proven approach to hepatoprotection. This article focuses on addressing regional diagnostic challenges and provides clear guidance and potential solutions for the use of Silymarin in the treatment of NAFLD in the Middle East. Both clinical and preclinical studies have highlighted the efficiency of Silymarin in managing NAFLD by reducing liver disease progression and improving patient symptoms and quality of life, alongside being safe and well tolerated. An expert panel of professionals from the Middle East convened to establish a set of regional-specific diagnostics. A consensus was established to aid general physicians to address the diagnostic challenges in the region. In conclusion, Silymarin can be considered beneficial in treating NAFLD and should be initiated as early as possible and continued as long as necessary.

Symptomatic Treatment in Multiple Sclerosis

US Neurology ◽  
2013 ◽  
Vol 09 (01) ◽  
pp. 35
Author(s):  
Sandra Bigi ◽  
E Ann Yeh ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Young Adults ◽  
Sexual Dysfunction ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Negative Impact ◽  
Treatment Options ◽  
Symptomatic Treatment

Multiple sclerosis (MS) is a progressive and disabling neurodegenerative disease that primarily affects young adults. Despite significant therapeutic advances in the prevention of relapses, individuals with MS experience a variety of symptoms, most notably fatigue, spasticity, depression, gait and balance difficulties, and sexual dysfunction. These symptoms may interfere with activities of daily living and have a negative impact on quality of life. This review discusses treatment options for these symptoms.

scholarly journals Pressure ulcers: Current understanding and newer modalities of treatment

2015 ◽  
Vol 48 (01) ◽  
pp. 004-016 ◽  
Author(s):  
Surajit Bhattacharya ◽  
R. K. Mishra
Keyword(s):  
Pressure Ulcers ◽  
Treatment Options ◽  
Healing Process ◽  
Treatment Algorithm ◽  
Wound Debridement ◽  
Advantages And Disadvantages ◽  
Prone Area ◽  
Long Time

ABSTRACTThis article reviews the mechanism, symptoms, causes, severity, diagnosis, prevention and present recommendations for surgical as well as non-surgical management of pressure ulcers. Particular focus has been placed on the current understandings and the newer modalities for the treatment of pressure ulcers. The paper also covers the role of nutrition and pressure-release devices such as cushions and mattresses as a part of the treatment algorithm for preventing and quick healing process of these wounds. Pressure ulcers develop primarily from pressure and shear; are progressive in nature and most frequently found in bedridden, chair bound or immobile people. They often develop in people who have been hospitalised for a long time generally for a different problem and increase the overall time as well as cost of hospitalisation that have detrimental effects on patient’s quality of life. Loss of sensation compounds the problem manifold, and failure of reactive hyperaemia cycle of the pressure prone area remains the most important aetiopathology. Pressure ulcers are largely preventable in nature, and their management depends on their severity. The available literature about severity of pressure ulcers, their classification and medical care protocols have been described in this paper. The present treatment options include various approaches of cleaning the wound, debridement, optimised dressings, role of antibiotics and reconstructive surgery. The newer treatment options such as negative pressure wound therapy, hyperbaric oxygen therapy, cell therapy have been discussed, and the advantages and disadvantages of current and newer methods have also been described.

Current Treatment Options for Vulvovaginal Candidiasis

2005 ◽  
Vol 1 (2) ◽  
pp. 253-261 ◽  
Author(s):  
Jack Sobel
Keyword(s):  
Antifungal Agents ◽  
Topical Therapy ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Management Strategies ◽  
Current Treatment ◽  
Vulvovaginal Candidiasis ◽  
Short Term ◽  
Appropriate Therapy ◽  
Antimycotic Agent

For practitioners, selecting successful therapy for vulvovaginal candidiasis is anything but trivial. The dominant problem; however, lies not with selecting the correct antimycotic agent, but with making the correct diagnosis and not treating non-yeast infections and noninfections as yeast-induced. Moreover, not all cases of vulvovaginal candidiasis are equal and practitioners owe patients the obligation of selecting appropriate therapy based upon the specific type and severity of vulvovaginal candidiasis. Uncomplicated candidiasis is readily treated with short-term oral or topical therapy, whereas complicated candidiasis needs additional strategies using the plethora of therapies available. Problematic refractory cases still abound and the pipeline for new, more potent antifungal agents is largely empty. Management strategies for complicated Candida vaginitis are discussed.

Heel Pain in Youth: A Guide to Potential Management Strategies

2014 ◽  
Vol 19 (5) ◽  
pp. 44-52
Author(s):  
Michelle L. Weber ◽  
Kelsey J. Picha ◽  
Tamara C. Valovich McLeod
Keyword(s):  
Treatment Options ◽  
Management Strategies ◽  
Group Analysis ◽  
Control Group ◽  
Physically Active ◽  
Effective Interventions ◽  
Reduction Of Pain ◽  
Inflammatory Drugs ◽  
Disease Understanding ◽  
Calcaneal Apophysitis

Calcaneal apophysitis, or Sever's disease, is common among physically active youth between the ages of 8-15. This condition is related to skeletal growth during maturation and relief often comes once growth is complete. However, it is not feasible to limit participation in physical activity until growth ceases; therefore, it is important to determine effective interventions to regulate pain while continuing participation. A search of the literature yielded nine studies that met the inclusion criteria and were included for data analysis. Within these publications, many treatment methods were suggested, including nonsteroidal anti-inflammatory drugs (NSAIDs), taping, orthoses, heel lifts, stretching, activity modification, and ice. However, few of the treatment options were compared with a control group. Analysis revealed that clinicians should provide treatments with caution when treating patients suffering from Sever's disease, understanding that strong evidence is not supportive of one treatment option alone. Data are limited for individual treatments related to calcaneal apophysitis and more research in this area is warranted. Clinicians should work with patients on an individual basis to determine if one form of treatment provides a reduction of pain and allows that patient to continue with activity.

scholarly journals Dysmenorrhea and related disorders

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1645 ◽  
Author(s):  
Mariagiulia Bernardi ◽  
Lucia Lazzeri ◽  
Federica Perelli ◽  
Fernando M. Reis ◽  
Felice Petraglia
Keyword(s):  
Treatment Options ◽  
Clinical History ◽  
Good Prognosis ◽  
Common Symptom ◽  
Primary Dysmenorrhea ◽  
Uterine Contractility ◽  
Gynecological Disorders ◽  
Inflammatory Drugs ◽  
Primary Form

Dysmenorrhea is a common symptom secondary to various gynecological disorders, but it is also represented in most women as a primary form of disease. Pain associated with dysmenorrhea is caused by hypersecretion of prostaglandins and an increased uterine contractility. The primary dysmenorrhea is quite frequent in young women and remains with a good prognosis, even though it is associated with low quality of life. The secondary forms of dysmenorrhea are associated with endometriosis and adenomyosis and may represent the key symptom. The diagnosis is suspected on the basis of the clinical history and the physical examination and can be confirmed by ultrasound, which is very useful to exclude some secondary causes of dysmenorrhea, such as endometriosis and adenomyosis. The treatment options include non-steroidal anti-inflammatory drugs alone or combined with oral contraceptives or progestins.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: The burden of Cushing's disease: clinical and health-related quality of life aspects

2012 ◽  
Vol 167 (3) ◽  
pp. 311-326 ◽  
Author(s):  
R A Feelders ◽  
S J Pulgar ◽  
A Kempel ◽  
A M Pereira
Keyword(s):  
Quality Of Life ◽  
Cushing’S Disease ◽  
Treatment Options ◽  
Current Treatment ◽  
Cushing's Disease ◽  
Health Related Quality ◽  
Time To Diagnosis ◽  
Related Quality ◽  
Health Related

ObjectiveCushing's disease (CD) is a rare endocrine disorder characterized by excess secretion of ACTH due to a pituitary adenoma. Current treatment options are limited and may pose additional risks. A literature review was conducted to assess the holistic burden of CD.DesignStudies published in English were evaluated to address questions regarding the epidemiology of CD, time to diagnosis, health-related quality of life (HRQoL), treatment outcomes, mortality, prevalence of comorbidities at diagnosis, and reversibility of comorbidities following the treatment.MethodsA two-stage literature search was performed in Medline, EMBASE, and Science Citation Index, using keywords related to the epidemiology, treatment, and outcomes of CD: i) articles published from 2000 to 2012 were identified and ii) an additional hand search (all years) was conducted on the basis of bibliography of identified articles.ResultsAt the time of diagnosis, 58–85% of patients have hypertension, 32–41% are obese, 20–47% have diabetes mellitus, 50–81% have major depression, 31–50% have osteoporosis, and 38–71% have dyslipidemia. Remission rates following transsphenoidal surgery (TSS) are high when performed by expert pituitary surgeons (rates of 65–90%), but the potential for relapse remains (rates of 5–36%). Although some complications can be partially reversed, time to reversal can take years. The HRQoL of patients with CD also remains severely compromised after remission.ConclusionsThese findings highlight the significant burden associated with CD. As current treatment options may not fully reverse the burden of chronic hypercortisolism, there is a need for both improved diagnostic tools to reduce the time to diagnosis and effective therapy, particularly a targeted medical therapy.

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