Long Term and Low Dose Mifepristone in The Treatment of Uterine Leiomyoma

2021 ◽  
Vol 7 (5) ◽  
pp. 1681-1685
Author(s):  
Panpan Liu ◽  
Meifang Dou ◽  
Li’an Yi ◽  
Kemei Li ◽  
Fenghua Yan
Keyword(s):  
Uterine Leiomyoma ◽  
Adverse Reactions ◽  
Low Dose ◽  
Hot Flashes ◽  
Control Group ◽  
Observation Group ◽  
Conventional Dose ◽  
Long Term Effect ◽  
Significant Difference

To explore the long-term effect of low-dose mifepristone in the treatment of uterine leiomyoma. Methods: 90 cases of hysteromyoma treated in our hospital from December 2018 to May 2019 were randomly divided into control group and observation group, 45 cases in each group. The control group was treated with conventional dose (25mg / D) of mifepristone, and the observation group with low dose (12.5mg / D) of mifepristone. The uterine volume, uterine fibroid volume, hormone level, therapeutic effect and adverse reactions were compared between the two groups. Results: After treatment, the volume of uterus and hysteromyoma in the two groups decreased significantly, but there was no significant difference between the observation group and the control group (P > 0.05); the level of E2, P, FSH in the two groups decreased, but there was no significant difference between the observation group and the control group (P > 0.05); the treatment effect of the observation group and the control group was no significant difference (P > 0.05); the adverse reactions of nausea, anorexia, hot flashes and fatigue in the observation group The birth rate was significantly lower than that of the control group (P < 0.05). Conclusion: Low dose mifepristone can also effectively reduce the level of estrogen and progesterone in patients with uterine leiomyoma, reduce the volume of leiomyoma, reduce the incidence of adverse reactions, with high safety, which is worthy of clinical application.

scholarly journals Sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of acute cerebral infarction

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Xuewen Wo ◽  
Jinyan Han ◽  
Jiajia Wang ◽  
Xinmin Wang ◽  
Xiaoying Liu ◽  
...  
Keyword(s):  
Plasma Level ◽  
Cerebral Infarction ◽  
Antiplatelet Therapy ◽  
Adverse Reactions ◽  
Dual Antiplatelet Therapy ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference ◽  
Better Than

Objective: To observe the clinical efficacy of sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of elderly patients with acute cerebral infarction (ACI). Methods: One hundred and twenty-two elderly patients with ACI who were admitted to the department of neurology of our hospital at May 2016-August 2018 were selected grouped into a control group and an observation group by random number table method, 61 in each group. On the basis of conventional treatment, the patients in the control group were given dual antiplatelet therapy (aspirin enteric-coated tablets + clopidogrel bisulfate tablets), while the patients in the observation group were given sequential butylphthalide therapy on the basis of the control group. The clinical effects of the two groups were compared after four weeks of treatment, and the changes of National Institutes of Health Stroke Scale (NIHSS), ADL score, plasma 3-mercaptopyruvate sulphurtransferase (3-MST) and Amyloid β42 (Aβ42) levels and the occurrence of adverse reactions during treatment were recorded. Results: The clinical efficacy of the observation group was better than that of the control group (P<0.05). There was no significant difference in NIHSS and ADL scores between the two groups before treatment (P>0.05). After treatment, the NIHSS and ADL scores of the observation group were better than those of the control group (P<0.05). There was no significant difference in plasma levels of 3-MST and AB42 between the two groups before treatment (P>0.05). The level of plasma 3-MST in the observation group was higher than that in the control group, and the level of plasma Aβ42 was lower than that in the control group (P<0.05). No serious adverse reactions occurred during the treatment period in both groups. Conclusion: Butylphthalide sequential therapy combined with dual antiplatelet therapy is effective in the treatment of elderly ACI. It can effectively improve the plasma level of 3-MST and decrease the plasma level of Aβ42, which is conducive to improving the living ability and neurological function of patients and has high safety. doi: https://doi.org/10.12669/pjms.36.4.1831 How to cite this:Wo X, Han J, Wang J, Wang X, Liu X, Wang Z. Sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of acute cerebral infarction. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1831 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Docetaxel HIPEC Combined with Endostar versus Docetaxel HIPEC Alone in Treatment of Malignant Ascites：A Retrospective Study

2021 ◽  
Author(s):  
Jing Wu ◽  
Hao Jiang ◽  
Liting Chen ◽  
Bingqi Yu ◽  
Zhibing Wu
Keyword(s):  
Qualitative Data ◽  
Adverse Reactions ◽  
Clinical Effect ◽  
Objective Response ◽  
Malignant Ascites ◽  
Control Group ◽  
Observation Group ◽  
Improvement Rate ◽  
Significant Difference

Abstract Objective：The purpose of this study is to retrospectively observe the clinical efficacy and adverse reactions of docetaxel hyperthermic intraperitoneal chemotherapy (HIPEC) combined with endostar in treatment of malignant ascites. Methods：56 cases of malignant ascites admitted to Zhejiang Hospital from July 2019 and October 2020 had received no less than second-line chemotherapy. The observation group (n = 29) was treated with endostar 60mg d1,4,7 Q3W intraperitoneal injection combined with docetaxel 60mg/m2 d4 HIPEC Q3W for 2 cycles. The control group (n = 27) was just treated with docetaxel 60mg/m2 d1 HIPEC Q3W for 2 cycles. The general clinical data and qualitative data of the treatment results were processed by SPSS26.0 using χ2 test, and quantitative data were processed by t test. When P < 0.05, statistical data can be considered statistically significant.Results：There were significant differences between the observation group and the control group in objective response rate (ORR) (65.5% vs 37.0%，P=0.033)，in the improvement rate of KPS (48.3% vs 22.2%, P=0.042)，also in the median control time (57dvs 45d，P=0.027). The incidence of III to IV adverse reactions was low, and no treatment-related death was observed. There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion：Endostar combined with docetaxel HIPEC has good clinical effect on malignant ascites and can improve patients’ quality of life, and the adverse reactions can be tolerated.

scholarly journals Efficacy of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Management of Malignant Ascites

2020 ◽  
Author(s):  
Jie Jiao ◽  
Chengzhen Li ◽  
Guanying Yu ◽  
Lei Zhang ◽  
Xiaoyan Shi ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Adverse Reactions ◽  
Total Effective Rate ◽  
Malignant Ascites ◽  
Effective Rate ◽  
Control Group ◽  
Observation Group ◽  
Short Term ◽  
Significant Difference ◽  
The Difference

Abstract Objective: The purpose of this study is to compare the difference of clinical efficacy between conventional intraperitoneal chemotherapy and HIPEC, so as to explore the clinical application value and advantages of HIPEC.Design: A retrospective analysis was conducted on 80 patients with malignant ascites admitted to our hospital from June 2017 to June 2019. The general clinical data and qualitative data of the treatment results of 80 patients with malignant ascites were processed by SPSS19.0 using χ2 test and quantitative data were processed by t test. P <0.05, statistical data can be considered statistically significant.Results: 1. There was no significant change in vital signs and temperature in the observation group during the treatment, and the difference was not statistically significant 2. The short-term total effective rate of patients in the observation group was 91.11%, and the short-term total effective rate of the patients in the control group was 40%.3. There was no significant difference in the incidence of adverse reactions between the two groups of patients.Conclusion: Intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy can significantly control malignant ascites, and has small adverse reactions, which is worthy of clinical promotion and application.

scholarly journals Clinical effect of Zoledronic Acid in the treatment of Senile Osteoporosis

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Li Kong ◽  
Kai Zuo ◽  
Long Ma
Keyword(s):  
Bone Mineral Density ◽  
Zoledronic Acid ◽  
Bone Mineral ◽  
Adverse Reactions ◽  
Clinical Effect ◽  
Control Group ◽  
Observation Group ◽  
Mineral Density ◽  
Senile Osteoporosis ◽  
Significant Difference

Objective: To investigate the clinical efficacy of zoledronic acid in the treatment of senile osteoporosis. Methods: One hundred and six cases of senile osteoporosis who visited to our hospital from August 2017 to December 2018 for treatment were selected and randomly divided into a control group and an observation group. The control group was treated with conventional therapy, while the observation group was treated with zoledronic acid in addition to the treatment of the control group. Bone mineral density, pain degree, therapeutic effect and adverse reactions of the two groups were compared. Results: The total effective rate of the observation group was 96.67%, higher than 80.00% of the control group (P<0.05); the bone mineral density of lumbar vertebrae, femoral neck and Ward’ area in the two groups increased after 6 months of treatment, and the bone mineral density of the observation group increased more than that of the control group (P<0.05); the pain degree of the observation group was lower than that of the control group after 6 months of treatment, and the difference was significant (P<0.05). There was no significant difference in the occurrence of adverse reactions between the two groups (P>0.05). Conclusion: Zoledronic acid is helpful to alleviate clinical symptoms, reduce the degree of bone pain, and promote the increase of bone mass, and has high safety in the treatment of senile osteoporosis, which is worth promotion. doi: https://doi.org/10.12669/pjms.36.7.1964 How to cite this:Kong L, Zuo K, Ma L. Clinical effect of Zoledronic Acid in the treatment of Senile Osteoporosis. Pak J Med Sci. 2020;36(7):1703-1707.   doi: https://doi.org/10.12669/pjms.36.7.1964 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effect of Metoprolol on Cardiac Function and Prognosis in Patients with Dilated Cardiomyopathy

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Huailing Su ◽  
Bin Li ◽  
Zhisheng Jia
Keyword(s):  
Cardiac Function ◽  
Dilated Cardiomyopathy ◽  
Adverse Reactions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference ◽  
Conventional Methods ◽  
The Difference

Objective: To investigate the effect of metoprolol on cardiac function and prognosis in patients with dilated cardiomyopathy. Methods: 100 patients with dilated cardiomyopathy treated in our hospital from January 2018 to December 2019 were randomly divided into control group (n = 50) and observation group (n = 50). The control group was treated with conventional methods, and the observation group was treated with conventional methods and metoprolol for 6 months. The cardiac function [left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO)] and prognosis [Glasgow Outcome Scale (GOS) score] of the two groups before and at the end of 6 months of intervention were compared, and the incidence of adverse reactions of the two groups were compared. Results: After 6 months of treatment, the levels of LVEF, SV and CO in the two groups were higher than before treatment, and the comparison level between the observation group and the control group was higher, the difference was statistically significant (P  < 0.05);After 6 months of treatment, the GOS score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05);There was no significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). Conclusion:  Metoprolol can improve the cardiac function and prognosis of patients with dilated cardiomyopathy, without increasing the incidence of adverse reactions.

The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis

2022 ◽  
pp. 1-8
Author(s):  
Jun Li ◽  
Hui Li ◽  
Wenjiao Deng ◽  
Lixin Meng ◽  
Wenya Gong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Adverse Reactions ◽  
Statistical Significance ◽  
Continuous Treatment ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference

<b><i>Background:</i></b> Patients with maintenance hemodialysis (MHD) generally have a microinflammatory state. The aim of this study was to investigate the effects of hemodialysis (HD) combined with hemoperfusion (HP) on microinflammatory state in elderly patients with MHD. <b><i>Methods:</i></b> One hundred and fifty elderly patients with MHD were randomly divided into the control group and the observation group. The control group received simple HD treatment, and the observation group received combined HD + HP treatment on the basis of the control group. After 6 months of continuous treatment, the patients were evaluated to compare the quality of life, inflammation, adverse reactions, and nutritional indicators in the 2 groups before and after treatment. <b><i>Results:</i></b> There was no significant difference in the quality of life between the 2 groups before treatment. After treatment, the scores of psychological aspects, physiological aspects, social aspects, environmental aspects, and independent ability in the observation group were higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in the level of inflammation between 2 groups before treatment. After treatment, the levels of hs-CRP, Hcy, IL-6, and TNF-α in the observation group were significantly lower than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). The incidence of dry mouth, skin reaction, neuritis, and subcutaneous tissue fibrosis in the observation group was lower than that in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in nutritional level indexes between 2 groups before treatment (<i>p</i><sub>1</sub> &#x3e; 0.05). After treatment, the levels of hemoglobin, total protein, albumin, and transferrin in the observation group were significantly higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> The clinical effect of HD combined with HP in elderly MHD patients is significant, which can effectively reduce the incidence of adverse reactions and inflammation in the patients and improve the quality of life and nutritional indicators of the patients.

Long-Term Effect of High-Dose Dexamethasone with or without Low-Dose Dexamethasone Maintenance in Untreated Immune Thrombocytopenia

2014 ◽  
Vol 133 (1) ◽  
pp. 124-128 ◽  
Author(s):  
Banhe Din ◽  
Xingwen Wang ◽  
Yuye Shi ◽  
Yufeng Li
Keyword(s):  
Immune Thrombocytopenia ◽  
Low Dose ◽  
Overall Response Rate ◽  
Control Group ◽  
High Dose ◽  
High Dose Dexamethasone ◽  
Group 4 ◽  
Long Term Effect ◽  
Group 2

Background: To tackle the problems associated with high-dose dexamethasone (HD-DXM) in patients with immune thrombocytopenia (ITP). Aim: To compare the efficacy of HD-DXM with or without low-dose dexamethasone maintenance in untreated ITP patients. Results: Dexamethasone (40 mg/day) was given in 4-day pulses every 14 days for 3 cycles in 61 patients with ITP. Among them, 30 cases were given dexamethasone (0.035 mg/kg per day) for maintenance between pulsed HD-DXM and after 3 HD-DXM courses (HD-DXM-M group) and another 31 cases did not receive dexamethasone maintenance (HD-DXM-nM group). The control group comprised the patients who received prednisone (prednisone group). The following results were obtained: (1) at the end of the 3rd cycle, the overall response rate (ORR) was higher in the HD-DXM group than in the prednisone group; (2) the ORR of the HD-DXM group peaked after the 3rd cycle; (3) the ORR after each course was higher in the HD-DXM-M group than in the HD-DXM-nM group; (4) in the 12th month after HD-DXM discontinuation, the relapse rate of the HD-DXM-M group was lower than that of the other groups (prednisone and HD-DXM-nM). Conclusion: Treatment with 3 cycles of HD-DXM pulses with low-dose dexamethasone maintenance is an effective method for untreated ITP.

scholarly journals Long-Term Effect of Left Atrial Appendage Occlusion in Treating Patients with Previous Ischemic Stroke on the Disease Recurrence

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jia Yu ◽  
Yufeng Liu ◽  
Peng Sun ◽  
Xing Guo ◽  
Haiyang Jiang ◽  
...  
Keyword(s):  
Left Atrial Appendage ◽  
Disease Recurrence ◽  
Term Effect ◽  
Control Group ◽  
Observation Group ◽  
Systemic Embolism ◽  
Exact Test ◽  
Left Atrial Appendage Occlusion ◽  
Long Term Effect

Background and Objective. Thrombolytics and anticoagulants are conventional drugs for ischemic stroke (IS) treatment, whereas some patients have unfavorable responses to these drugs. The disease presents a relatively high recurrence rate. This investigation attempted to unveil the long-term effect of left atrial appendage occlusion (LAAO) in treating patients with previous IS on the disease recurrence. Methods. A total of 120 patients with IS admitted to Tangdu Hospital from July 2016 to September 2017 were grouped into the control group ( n = 60 ) and the observation group ( n = 60 ). Patients in the control group were only treated with thrombolytics and anticoagulants while those in the observation group were treated with both drugs and LAAO. Transesophageal echocardiography (TEE) was performed to observe the occlusion of LAA in patients in the observation group after 45 d and 6 months, respectively. Clinical outcomes in two groups were compared from the following aspects: recurrence of IS, incidence of systemic embolism, and the 3-year recurrence-free survival (RFS). The 3-year IS recurrence of patients was compared by Fisher’s exact test. Results. No significant differences were observed at baseline levels (age, sex, etc.) between the observation group and control group ( p > 0.05 ). During follow-up visit of 45 d and 6 months, all occluders met the efficacious occludsion criteria. The results of TEE at 45 d after LAAO showed that 50% of patients (30/60) in the observation group had complete occlusion of LAA. The results of TEE at 6 months after LAAO suggested that 58.3% of patients (35/60) had complete occlusion of LAA. IS recurrence in the observation group (3.33%, 2/60) was significantly lower than that in the control group (18.33%, 11/60), with the difference presenting statistical significance ( p = 0.008 ). Incidence of systemic embolism in the observation group (1.67%, 1/60) was markedly lower than that in the control group (13.33%, 11/60) ( p = 0.014 ). The average RFS in the observation group (31.97 months, 95% CI: 27.50~32.31 months) was notably longer than that in the control group (29.91 months, 95% CI: 29.85~32.92 months) ( p < 0.05 ). The 3-year IS recurrence of patients between two groups compared by Fisher’s exact test showed significant differences (1 year: p = 0.014 , 2 year: p = 0.008 , 3 year: p = 0.008 ). Conclusion. Regarding patients with previous IS who had poor response to thrombolytics and anticoagulants, LAAO could effectively decrease recurrence of IS and incidence of systemic embolism and prolong RFS of patients. LAAO was, therefore, an alternative for patients with high IS recurrence risk.

scholarly journals 145. the Efficacy and Safety of Low Dose Trimethoprim-sulfamethoxazole for the Treatment of Pneumocystis Pneumonia: A Systematic Review and Meta-analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S203-S203
Author(s):  
Brandon Tritle ◽  
Andre A Hejazi ◽  
Tristan Timbrook
Keyword(s):  
Systematic Review ◽  
Dose Group ◽  
Adverse Reactions ◽  
Low Dose ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Treatment Discontinuation ◽  
Forest Plot ◽  
Conventional Dose ◽  
Significant Difference

Abstract Background Pneumocystis jirovecii pneumonia (PJP) is an opportunistic fungal infection causing significant morbidity and mortality in immunocompromised patients. The conventional treatment of PJP is sulfamethoxazole-trimethoprim (SMX-TMP) dosed at 15–20 mg/kg/day of the trimethoprim component. This high-dose regimen is associated with severe adverse reactions that result in patient harm or treatment discontinuation. Studies have suggested similar mortality and an improved adverse effect profile using lower dose (&lt; 15 mg/kg/day) SMX-TMP. Our objective of this meta-analysis was to evaluate the safety and efficacy of lower dose SMX-TMP for PJP pneumonia. Methods We conducted a systematic review and meta-analysis according to PRISMA guidelines. Pubmed and Embase databases were searched from inception to January 15, 2020, for studies in English evaluating low-dose SMX-TMP (&lt; 15 mg/kg/day) compared with conventional dosing for the treatment of PJP. Additionally, conference proceedings were reviewed to address potential publication bias. Outcomes evaluated in our meta-analysis include survival and adverse reactions. We performed a sensitivity analysis using E-values to determine the robustness of our results. Results After excluding studies that did not meet our inclusion criteria, four studies were analyzed for adverse reaction rates and three for mortality rates. Overall, there was no significant difference in mortality between low-dose and conventional-dose SMX-TMP groups (relative risk [RR]: 0.55, 95% confidence interval [CI], 0.18 -1.70). There was a significant decrease in the rate of adverse reactions for the low-dose group compared with the conventional-dose group (RR: 0.70, 95% CI, 0.53 - 0.91). Sensitivity analyses using E-Values reflect a confounder with RR 2.2 or greater could explain away the estimate on adverse events leading to no difference while mortality would require RR 5.6 to reflect worse outcomes with low dose. Mortality Forest Plot Adverse Effects Forest Plot Conclusion This meta-analysis shows a significant decrease in adverse reactions and similar mortality rates with lower-dose SMX-TMP compared with conventional dosing. A low-dose SMX-TMP regimen in the treatment of PJP should be considered a viable option with the potential to decrease treatment discontinuation and reduce harm. Disclosures All Authors: No reported disclosures

scholarly journals Long-Term Impact of Cyclosporin Reduction with MMF Treatment in Chronic Allograft Dysfunction: REFERENECE Study 3-Year Follow Up

2010 ◽  
Vol 2010 ◽  
pp. 1-11 ◽  
Author(s):  
L. Frimat ◽  
E. Cassuto-Viguier ◽  
F. Provôt ◽  
L. Rostaing ◽  
B. Charpentier ◽  
...  
Keyword(s):  
Kidney Function ◽  
Randomized Study ◽  
Control Group ◽  
Serious Adverse Events ◽  
Transplant Patients ◽  
Long Term Effect ◽  
Significant Difference ◽  
Long Term Impact

Calcineurin inhibitor (CNI) toxicity contributes to chronic allograft nephropathy (CAN). In the 2-year, randomized, study, we showed that 50% cyclosporin (CsA) reduction in combination with mycophenolate mofetil (MMF) treatment improves kidney function without increasing the risk for graft rejection/loss. To investigate the long-term effect of this regimen, we conducted a follow up study in 70 kidney transplant patients until 5 years after REFERENCE initiation. The improvement of kidney function was confirmed in the MMF group but not in the control group (CsA group). Four graft losses occurred, 2 in each group (graft survival in the MMF group 95.8% and 90.9% in control group). One death occurred in the control group. There was no statistically significant difference in the occurrence of serious adverse events or acute graft rejections. A limitation is the weak proportion of patient still remaining within the control group. On the other hand, REFERENCE focuses on the CsA regimen while opinions about the tacrolimus ones are still debated. In conclusion, CsA reduction in the presence of MMF treatment seems to maintain kidney function and is well tolerated in the long term.

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