scholarly journals Propranolol for extensive hemangiomas of infancy: two case reports

2011 ◽  
Vol 10 (2) ◽  
pp. 173-176
Author(s):  
Luíza Helena dos Santos Cavaleiro ◽  
Fernanda de Oliveira Viana ◽  
Deborah Aben Athar Unger ◽  
Maraya de Jesus Semblano Bittencourt
Keyword(s):  
Side Effects ◽  
Large Volume ◽  
Rapid Growth ◽  
Case Reports ◽  
Therapeutic Option ◽  
Functional Limitation ◽  
Infantile Hemangioma ◽  
Benign Tumors ◽  
Systemic Glucocorticoids ◽  
Total Disappearance

Hemangiomas are the most common benign tumors of childhood. They show rapid growth, followed by a regression phase that culminates in the partial or total disappearance of the lesion. Therapeutic options should be evaluated for extensive cases. Systemic glucocorticoids are the therapy of choice; however, there are reports that propranolol offers better and faster results. We report two cases of large volume infantile hemangioma associated with functional limitation and aesthetic disfigurement, treated successfully with propranolol, a drug that comes as a therapeutic option providing satisfactory and maintained results, with few side effects.

scholarly journals Efficacy of propranolol in infantile hemangioma

2015 ◽  
Vol 47 (1-2) ◽  
pp. 32-35
Author(s):  
Mizanur Rahman ◽  
Md Tarikul Islam ◽  
Ratan Lal Dutta Banik ◽  
Choudhury Habibur Rasul
Keyword(s):  
Side Effects ◽  
Cosmetic Surgery ◽  
Low Dose ◽  
Relevant Literature ◽  
Infantile Hemangioma ◽  
Benign Tumors ◽  
Dose Oral ◽  
Oral Propranolol ◽  
Intralesional Steroids ◽  
Surgery Resection

Hemangiomas, are the most common benign tumors of infancy. Despite their selflimited course, infantile capillary hemangiomas can cause local complications e.g. pain, ulceration, bleeding etc. The usual treatments include oral/intralesional steroids, alpha interferon, cytotoxins, pulsed dye laser and cosmetic surgery resection. These treatments are not free of multiple complications and toxic side effects. We report our experience with the use of propranolol in 2 children with haemangiomas along with review of relevant literature. Both the hemangioma cases promptly responded to low-dose oral propranolol. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22561 Bang Med J (Khulna) 2014; 47 : 32-35

scholarly journals OnabotulinumtoxinA for trigeminal neuralgia: a review of the available data

2015 ◽  
Vol 73 (10) ◽  
pp. 877-884 ◽  
Author(s):  
Pedro A. Kowacs ◽  
Marco A. T. Utiumi ◽  
Fábio A. Nascimento ◽  
Elcio J. Piovesan ◽  
Helio A. G. Teive
Keyword(s):  
Side Effects ◽  
Trigeminal Neuralgia ◽  
Case Reports ◽  
Therapeutic Option ◽  
Case Series ◽  
Neurosurgical Procedures ◽  
Open Label ◽  
Randomized Controlled ◽  
Pain Syndromes ◽  
Proven Efficacy

Trigeminal neuralgia (TN) patients may develop side effects from centrally acting drugs, have contraindications for neurosurgical procedures, or experience relapse during conventional therapies. OnabotulinumtoxinA (BoNT/A) has been reported to be effective for TN, although this finding has been challenged. An overview of the available evidence based on a narrative/qualitative analysis of the literature is presented. About 90% of patients who receive BoNT/A show an improvement, a higher figure than that reported for the placebo effect of BoNT/A for other headaches. Tolerability of BoNT/A is good, and its few side-effects are transient. The articles reviewed were mainly case reports, case series and open-label trials; however, randomized controlled trials have endorsed the efficacy of BoNT/A for TN. This evidence, together with a better understanding of the analgesic mechanisms of BoNT/A and its proven efficacy in treating other pain syndromes, supports the use of this toxin as a therapeutic option for TN.

Efficacy and safety of oral dapsone in acne vulgaris – experience of a tertiary care teaching hospital in central Lahore

2020 ◽  
Vol 14 (2) ◽  
pp. 87-90
Author(s):  
Sadaf Amin Chaudhry ◽  
Nadia Ali Zafar ◽  
Rabia Hayat ◽  
Ayesha Noreen ◽  
Gulnaz Ali ◽  
...  
Keyword(s):  
Side Effects ◽  
Therapeutic Option ◽  
Acne Vulgaris ◽  
Treatment Options ◽  
Tertiary Care ◽  
Poor Response ◽  
Global Assessment Scale ◽  
Severe Acne ◽  
Hematologic Profile

Background: Acne is the eighth most prevalent disease affecting 9.4% of the population worldwide and its prevalence in our country is estimated to be around 5%. Severe inflammatory acne is most likely to leave scars and in order to prevent facial disfigurement due to acne scarring, early treatment is desirable. Various treatment options have been formulated for acne, and are tailored according to the severity of the disease. Numerous clinical trials have been conducted till now, to determine the usefulness and side effect profile of such therapies, making acne treatment a highly studied area in dermatology. Objective of this study is to highlight the fact that oral Dapsone could be used as a cheaper alternate to isotretinoin in recalcitrant severe acne, especially in females where retinoids are sometimes contraindicated. Patients and methods: 51 patients, suffering from severe nodulocystic acne, fulfilling the criteria, were enrolled from the Department of Dermatology, Sir Ganga Ram Hospital, Lahore. All the study patients were given oral Dapsone 50mg for initial two weeks and then 100mg daily for the next 10 weeks along with oral cimetidine and topical clindamycin application twice daily. Investigator Global Assessment Scale (IGAS) was employed to measure effectiveness. The treatment was considered ʽeffectiveʹ if the patient achieves 2 or more than 2-grade improvement or almost clear or clear skin at the end of 12 weeks according to IGAS scale. The lesion counts were also done before the start of therapy (day 1) and at every two weeks follow up for 12 weeks. The change in lesion count observed between the baseline number and that seen at follow up visits was also used to evaluate the effectiveness of oral Dapsone. Safety was analyzed by fortnightly visits of the patients to look for any undesirable side effects and monitoring of the hematologic profile of the patients. Final follow up was done at the end of 16 weeks. Results: The study was conducted on 51 patients, with a ratio of 1:3 for males and females and a mean age of 25.2 years (SD ±5.81). At 12th week, patients had significant reduction in their acne lesions; with 7 patients (13.7%) showing completely clear skin, 17 patients (33.3%) had almost clear skin, 5 patients (9.8%) had 3-grade improvement. Twelve patients (23.5%) had 2-grade improvement from baseline score and only 2 patients (3.9%) had 1-grade improvement from baseline. Based on percentage reduction of lesions, excellent response was seen in 32 patients (62.7%), good response in 9 patients (17.6%), moderate response in 2 patients (3.9%), while no patient showed poor response. Dapsone was discontinued in 8 patients due to derangement of hematologic profile. Conclusion: Oral Dapsone, when given carefully, is a very effective therapeutic option in severe recalcitrant acne, with limited side effects.

scholarly journals Early anti IL-1 treatment replaces steroids in refractory Kawasaki disease: clinical experience from two case reports

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110025
Author(s):  
Maria Vincenza Mastrolia ◽  
Giulia Abbati ◽  
Claudia Signorino ◽  
Ilaria Maccora ◽  
Edoardo Marrani ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Evidence ◽  
Case Reports ◽  
Therapeutic Option ◽  
Intravenous Immunoglobulins ◽  
Second Line Therapy ◽  
Coronary Artery Aneurysms ◽  
Coronary Arteritis ◽  
Line Therapy ◽  
Prior Use

Refractory Kawasaki disease (KD) is related to a major risk of coronary arteries abnormalities and its treatment is not standardized. In this regard, anakinra (ANA), an interleukin (IL)-1 receptor antagonist, represents an emerging therapeutic option. We report two cases of children, diagnosed with KD, nonresponsive to two doses of intravenous immunoglobulins, successfully treated with ANA, without a prior use of steroids. Patient 2 developed a coronary dilatation, that improved significantly after ANA therapy. Our experience highlights IL-1 blockade effectiveness in reducing KD inflammation and suggests ANA adoption as second-line therapy, with a timesaving and steroid-sparing strategy. Our results, combined with the evidence of the IL-1 key role in KD and coronary arteritis pathogenesis and to the recent clinical evidence reported by the KAWAKINRA trial, encourage an earlier recourse to ANA in patients with refractory KD, in order to fight inflammation, and to treat and prevent the development of coronary artery aneurysms. Further studies are needed to better define the place of IL-1 blockade in KD step-up treatment.

scholarly journals Oral and Palmitate Paliperidone Long-Acting Injectable Formulations use in Schizophrenia Spectrum Disorders: a retrospective cohort study from the CRUPEP First Episode Psychosis Intervention Program

2021 ◽  
Author(s):  
R Segarra ◽  
M Recio-Barbero ◽  
M Sáenz-Herrero ◽  
O Mentxaka ◽  
J Cabezas-Garduño ◽  
...  
Keyword(s):  
Side Effects ◽  
Retrospective Cohort ◽  
Intervention Program ◽  
Therapeutic Option ◽  
Cohort Analysis ◽  
Clinical Information ◽  
First Episode ◽  
Psychotic Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Long Acting

Abstract Background Long-acting injectable antipsychotics (LAIs) may be a suitable therapeutic option for those patients in earlier stages of psychosis to avoid relapses and disease progression. Despite that, there is a lack of evidence in the literature regarding the use of LAIs in this profile of patients. Methods This is a retrospective cohort analysis to assess the efficacy, tolerability, and pattern of use of palmitate paliperidone long-acting injectable (PPLAI) formulations (1-monthly and 3-monthly) compared to oral paliperidone/risperidone in patients with a non-affective First Psychotic Episode(FEP) over a 12-month follow-up. Relevant sociodemographic and clinical information were assessed as well as main clinical scales: Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP), and Clinical Global Impression Scale (CGI-I and CGI-S). Results Forty-eight patients, 16 per arm, 20-50 year aged with a FEP were included. Significant improvements were registered for all treatment groups. Despite that, patients receiving PPLAI 1-monthly and PPLAI 3-monthly formulations obtained greater improvements than the oral group in the main domains assessed (p<0.001). We found no statistically significant differences in hospitalizations between groups. Side effects were presented in 24% of patients. A trend towards reducing antipsychotic doses was observed in 43.8% of patients to achieve the minimum effective dose and avoid the occurrence of side effects. Conclusions To our knowledge, this is the first study assessing the use of palmitate paliperidone long-acting formulations versus oral risperidone or paliperidone in FEP. Treatment with PPLAI formulations seems to be an effective therapeutic choice at earlier stages of the disease.

Endoscopic, assisted, modified turbinoplasty with mucosal flap

2012 ◽  
Vol 126 (5) ◽  
pp. 525-528 ◽  
Author(s):  
M M Puterman ◽  
N Segal ◽  
B-Z Joshua
Keyword(s):  
Side Effects ◽  
Large Volume ◽  
Inferior Turbinate ◽  
Nasal Airway ◽  
Mucosal Flap ◽  
Surgical Methods ◽  
Endoscopic Assistance

AbstractA variety of surgical methods have been developed to reduce the volume of the inferior turbinates, in order to create a more patent nasal airway. We describe a technique used in our department since February 2002 for all patients undergoing inferior turbinectomy. We resect with endoscopic assistance the lateral mucosa and bony inferior turbinate. This technique can reduce a large volume of the turbinate while preserving the mucosal continuity and the submucosa by covering the raw surface with a mucosal flap. We believe our method minimises post-operative side effects and complications such as dryness, infection, bleeding and pain.

scholarly journals Cutaneous Side Effects of BRAF Inhibitors in Advanced Melanoma: Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Bilgen Gençler ◽  
Müzeyyen Gönül
Keyword(s):  
Side Effects ◽  
Metastatic Melanoma ◽  
Mapk Pathway ◽  
Case Reports ◽  
Mitogen Activated Protein Kinase ◽  
Braf V600e ◽  
Braf Inhibitors ◽  
Braf Mutations ◽  
Cutaneous Side Effects ◽  
Downstream Signaling

The incidence of melanoma has recently been increasing. BRAF mutations have been found in 40–60% of melanomas. The increased activity of BRAF V600E leads to the activation of downstream signaling through the mitogen-activated protein kinase (MAPK) pathway, which plays a key role as a regulator of cell growth, differentiation, and survival. The use of BRAF inhibitors in metastatic melanoma with BRAF mutation ensures clinical improvement of the disease. Vemurafenib and dabrafenib are two selective BRAF inhibitors approved by the Food and Drug Administration (FDA). Both drugs are well tolerated and successfully used in clinical practice. However, some adverse reactions have been reported in patients in the course of treatment. Cutaneous side effects are the most common adverse events among them with a broad spectrum. Both the case reports and several original clinical trials reported cutaneous reactions during the treatment with BRAF inhibitors. In this review, the common cutaneous side effects of BRAF inhibitors in the treatment of metastatic melanoma with BRAF V600E mutation were reviewed.

Methylene blue is not contraindicated to treat hemodynamic instability in pediatric and neonate patient

2021 ◽  
Vol 17 ◽  
Author(s):  
Walusa A. Gonçalves-Ferri ◽  
Agnes A.S. Albuquerque ◽  
Patricia Martinez Evora ◽  
Paulo R.B. Evora
Keyword(s):  
Methylene Blue ◽  
Side Effects ◽  
Infusion Rate ◽  
Case Reports ◽  
Hemodynamic Instability ◽  
Exclusion Criteria ◽  
Old Patients ◽  
Randomized Clinical Study ◽  
Dose Infusion ◽  
Administration Timing

: The present review was carried out to describe publications on the use of methylene blue (MB) in pediatrics and neonatology, discussing dose, infusion rate, action characteristics and possible benefits for a pediatric patient group. The research was performed on the data sources PubMed, BioMed Central, and Embase (updated on Aug 31, 2020) by two independent investigators. The selected articles included human studies that evaluated MB use in pediatric or neonatal patients with vasoplegia due to any cause, regardless of the applied methodology. The MB use and 0 to18-years-old patients with vasodilatory shock were the adopted criteria. Exclusion criteria were the use of MB in patients without vasoplegia and patients ≥ 18-years-old. The primary endpoint was the increase in mean arterial pressure (MAP). Side effects and dose were also evaluated. Eleven studies were found of which 10 were case reports and 1 was a randomized clinical study. Only two of these studies were with neonatal patients (less than 28 days-old), reporting a small number of cases (1 and 6). All studies described positive action of MB on MAP, allowing the decrease of vasoactive amines in several of them. No severe side effects or death related to the use of the medication was reported. The maximum dose used was 2 mg/kg, but there was no consensus on the infusion rate and drug administration timing. Finally, no theoretical or experimental basis sustains the decision to avoid MB in children claiming it can cause pulmonary hypertension. The same goes for the concern of a possible deleterious effect on inflammatory distress syndrome.

Mineralocorticoid receptors and the heart, multiple cell types and multiple mechanisms: a focus on the cardiomyocyte

2013 ◽  
Vol 125 (9) ◽  
pp. 409-421 ◽  
Author(s):  
Laura A. Bienvenu ◽  
Melissa E. Reichelt ◽  
Lea M. D. Delbridge ◽  
Morag J. Young
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Sex Differences ◽  
Side Effects ◽  
Therapeutic Option ◽  
Cell Types ◽  
Receptor Activation ◽  
Cardiac Events ◽  
Cardiac Tissues ◽  
Targeted Interventions

MR (mineralocorticoid receptor) activation in the heart plays a central role in the development of cardiovascular disease, including heart failure. The MR is present in many cell types within the myocardium, including cardiomyocytes, macrophages and the coronary vasculature. The specific role of the MR in each of these cell types in the initiation and progression of cardiac pathophysiology is not fully understood. Cardiomyocyte MRs are increasingly recognized to play a role in regulating cardiac function, electrical conduction and fibrosis, through direct signal mediation and through paracrine MR-dependent activity. Although MR blockade in the heart is an attractive therapeutic option for the treatment of heart failure and other forms of heart disease, current antagonists are limited by side effects owing to MR inactivation in other tissues (including renal targets). This has led to increased efforts to develop therapeutics that are more selective for cardiac MRs and which may have reduced the occurrence of side effects in non-cardiac tissues. A major clinical consideration in the treatment of cardiovascular disease is of the differences between males and females in the incidence and outcomes of cardiac events. There is clinical evidence that female sensitivity to endogenous MRs is more pronounced, and experimentally that MR-targeted interventions may be more efficacious in females. Given that sex differences have been described in MR signalling in a range of experimental settings and that the MR and oestrogen receptor pathways share some common signalling intermediates, it is becoming increasingly apparent that the mechanisms of MRs need to be evaluated in a sex-selective manner. Further research targeted to identify sex differences in cardiomyocyte MR activation and signalling processes has the potential to provide the basis for the development of cardiac-specific MR therapies that may also be sex-specific.

Pallor Sign: An Indicator of Hemangioma in Evolution

2012 ◽  
Vol 16 (6) ◽  
pp. 451-452
Author(s):  
Muzamil Chisti ◽  
Nusrat Banka ◽  
Abdullah Alfadley
Keyword(s):  
Case Reports ◽  
Infantile Hemangioma ◽  
Clinical Implications ◽  
Atypical Presentations

Background: The typical presentation of infantile hemangioma is well known and is easily recognizable. However, it may have many atypical presentations, as reported in the literature. Most of the hemangiomas are not visible at birth and become apparent at about 3 to 4 weeks of age. There are very few case reports of hemangioma presenting as a pale patch in the dermatology literature, and none of them describe the etiopathogenesis of this presentation and its clinical implications. Objective and Conclusion: We report a case of an infantile hemangioma with a trichrome presentation: an erythematous oval patch with a dark red macule at the periphery enclosed by a hypopigmented halo. A brief description of the etiopathogenesis of the pallor sign is also given. Renseignements de base: La présentation typique d'un hémangiome infantile est bien connue et facilement reconnaissable. Toutefois, comme l'indique la documentation, il peut avoir de nombreuses présentations atypiques. La plupart des hémangiomes ne sont pas visibles à la naissance et deviennent apparents à environ 3 à 4 semaines. La documentation dermatologique ne compte que très peu d'observations d'hémangiome se présentant sous forme de plaque pâle, et aucune d'entre elles ne décrit l'étiopathogénie de cette présentation et ses conséquences cliniques. Objectif et conclusion: Nous signalons un cas d'hémangiome infantile avec présentation trichrome: plaque érythémateuse ovale avec une macule rouge foncée en périphérie, entourée d'un halo hypopigmenté. Une brève description de l'étiopathogénie de la pâleur est également donnée.

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