scholarly journals Effectiveness and Safety of Additive Therapy and Monotherapy of Glaucoma with Prostamides

2019 ◽  
Vol 16 (3) ◽  
pp. 366-370
Author(s):  
I. R. Gazizova ◽  
S. R. Zainullina ◽  
E. B. Martynova

Increased intraocular pressure (IOP) is the main risk factor for the development of primary open-angle glaucoma (POAG). Nowadays medicine that reduce IOP remain the main method of treating for POAG. The first-line drugs for POAG are prostaglandin analogues. In Russia, for the first time, it appeared not in the form of a fixed combination (Bimoptic). In this regard it is very important to evaluate the clinical efficacy and safety of Bimoptic as a monotherapy and additive component in the treatment of patients with POAG. Patients and methods. Patients were divided into 3 groups depending on the treatment. Group I comprised of 34 patients with newly diagnosed glaucoma on monotherapy with bimatoprost 0.03 %. Group II consisted of 30 patients who started taking bimatoprost 0.03 % as a replacement for latanoprost 0.005 % or travoprost 0.004 %. There were 32 patients in group III, who were prescribed bimatoprost 0.03 % as an adjuvant therapy for B-blockers (BB) 0.5 % or carbonic anhydrase inhibitors (ICA) 2 %. Results. According to the results of the clinical study, it was found that instillation of Bimoptik as a monotherapy for newly diagnosed POAG leads to a decrease in IOP level by an average of 32.1 % of the initial level. With the additive tactics of assigning Bimoptik to the BB and / or IKA, the level of IOP goes down by 10.6 % more. If prostaglandin is changed to Bimoptik, the level of IOP decreases by 12.6 % of the prostaglandin-associated values. Also according to acquired data, Bimoptik has a low percentage of adverse reactions, slight hyperemia and discomfort were observed in 5.2 % of cases in all groups. Conclution. Bimoptik effectively reduces the level of IOP in both monotherapy and additive tactics with the least adverse reactions.

2020 ◽  
pp. 112067212094433 ◽  
Author(s):  
Momen Mahmoud Hamdi ◽  
Islam Mahmoud Hamdi

Purpose: To compare between mitomycin C alone, porcine extracellular matrix alone, and combined low dose mitomycin C with porcine extracellular matrix in term of efficacy and safety in phaco-trabeculectomy surgery. Study design: Prospective comparative. Methods: Sixty eyes of 60 patients complaining of primary open angle glaucoma and cataract, undergoing phaco-trabeculectomy, were distributed into three groups: group I: surgery was augmented with mitomycin C, group II with porcine extracellular matrix, and group III with porcine extracellular matrix combined with low dose mitomycin C. Intraocular pressure was evaluated, postoperatively, at day 1, week 1, and 1, 3, 6, 9, and 12 months. Bleb vascularity, pre- and post-operative intraocular pressure lowering medications, success of IOP control and complications were also evaluated. Results: After 12 months, the mean preoperative intraocular pressure (mm Hg) improved from 30.85 ± 4.7, 33.8 ± 4.2, and 31.05 ± 5.4 mm Hg, in groups I, II, and III respectively, to 13.8 ± 4.7 (55.2%), 15.2 ± 4.8 (55%), and 13 ± 4.9 (58.1%) ( p > 0.05). Success of IOP control, postoperative IOP lowering medications and complications were comparable ( p > 0.05). Bleb vascularity was significantly different ( p < 0.05). Conclusion: Mitomycin C, porcine extracellular matrix and their combination are equally effective in phacotrabeculectomy.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9509-9509 ◽  
Author(s):  
David Walterhouse ◽  
Alberto S. Pappo ◽  
Jane L Meza ◽  
John C. Breneman ◽  
Andrea Anita Hayes-Jordan ◽  
...  

9509 Background: Intergroup Rhabdomyosarcoma Study (IRS) trials showed improved survival with VAC compared with VA for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II ERMS (see table). In COG ARST0331, we hypothesized that VA in combination with lower doses of C (total cumulative dose=4.8 g/m2) would produce the benefit of IRS-IV VAC with less toxicity for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II low-risk ERMS. Methods: This single arm, non-inferiority, phase III study enrolled newly diagnosed patients with Stage 1 Group III (non-orbit) ERMS or Stage 3 Group I/II ERMS onto Subset 2. Therapy was 4 cycles of VAC followed by 12 cycles of VA over 46 weeks (total cumulative doses: V=54 mg/m2, A=21.6 mg/m2, C=4.8 g/m2). The radiation therapy dose was 36 Gy for Group IIA patients, 41.4 Gy for Group IIB/C patients, and 50.4 Gy for Group III patients. From 2004–2008 girls with Group III vaginal RMS did not receive radiotherapy if a complete response was achieved with chemotherapy with or without delayed resection. The primary endpoint was failure-free survival (FFS), and results were compared with a fixed expected outcome. Results: With a median follow-up of 3.0 yrs, we observed 16 failures vs. 7.8 expected failures. Estimated 3-yr FFS was 63% (95% CI: 46%, 75%) (n=60), and overall survival (OS) was 84% (95% CI: 68%, 93%). Estimated 3-yr FFS was 46% (95% CI: 23%, 67%) for girls with non-bladder genitourinary tract ERMS (n=21) and 75% (95% CI: 53%, 88%) for all other Subset 2 patients (n=39). Conclusions: We observed suboptimal FFS of patients with Subset 2 low-risk RMS using reduced total cyclophosphamide (4.8 g/m2). Results were complicated by the choice of no radiation therapy for girls with vaginal tumors. Future studies for low-risk RMS Subset 2 patients could investigate a dose of C between 4.8 and 26.4 g/m2 with VA and local radiotherapy. [Table: see text]


2020 ◽  
Vol 7 (1) ◽  
pp. 38-47
Author(s):  
R. V. Royuk ◽  
S. K. Yarovoy ◽  
N. A. Guseva ◽  
Sh. L. Voskanyan ◽  
V. V. Royuk ◽  
...  

Purpose of the study. To analyze prevalence and characteristics of the cardiovascular diseases (CVD) in patients with urolithiasis, revealed for the first timeMaterials and methods. In a period between 2009 and 2018, was made a retrospective analysis of medical histories of 2311 patients with urolithiasis, which were treated in in the urology departments of the branch No. 1 of the MCHG named after N.N. Burdenko (n=1487) and GBUZ MO Krasnogorsk City Hospital No. 1 (n=824). In 67,6% of the cases (1562 patients) the diagnosis of urolithiasis was diagnosed for the first time on admission. Isolated urolithiasis was recorded in 676 cases (43,3%), in other 154 cases (9,8%) nephrolithiasis was combined with different variants of cardiovascular diseases (CVD) and diabetes. From 732 respondents with urolithiasis and associated cardiovascular diseases (CVD), were formed 3 groups, in the first group (I) were included patients (n=363) with hypertension and arterial hypertension: the second group (II; n=79) was formed from patients with isolated coronary heart disease. In the third group (III) were included 290 patients which had urolithiasis combined with hypertension, arterial hypertension and coronary heart disease. The stages of hypertension and degree of expression of arterial hypertension were given according to the recommendations of Russian science society of cardiology (2004). Stages of congestive heart failure were defined according to c NYHA (New York Heart Association) classification. Functional class of stable angina was defined according to Canadian Cardiovascular Society classification (1970,1976). The obtained data was analyzed using descriptive statistics methods.Results. Average age of patients was 65,4 +– 3,27; 78% of the patients were men. On an emergency basis were hospitalized 30,9% from group I, 27,6% from group 2, and 31,3% from group III. In group I more often were recorded hypertension I + arterial hypertension I (32,5%) and hypertension II + arterial hypertension II (40,2%). In group II effort angina was recorded in 30 cases (38%). Congestive heart failure occurred among 153 patients (20,9%); most often it occurred among patients from III – in 102 cases (35,2%). In the whole sample, congestive heart failure of I and II degrees prevailed – in 88 (12%) and 57 (7,9%) patients. Kidney stones were found in 59,4% of patients, in the ureters – in 30,9% of patients, in kidneys and in the ureters – in 9,9% of patients. Share of the patients with kidney stones in the shape of corals is 3,4% of the whole sample. Average sizes of kidney stones of the patients with congestive heart failure are 9,2–11,8 mm which is different from the sizes in whole sample – 6,9–9,5 mm.Conclusion. During the observation period, share of the patients with first time revealed urolithiasis, complicated with the cardiovascular diseases (CVD) increased in 1,9 times (16,7 versus 31,7%). Congestive heart failure, which was registered in 20,9% of patients, was charged with I and II degrees. The presence chronic cardiovascular diseases (CVD), especially complicated by congestive heart failure in patients with first time revealed nephrolithiasis, implies changes in the algorithms of metaphylactic of nephrolithiasis (regime of water loads, selection of diuretics and anticoagulants).


2020 ◽  
pp. 491-496
Author(s):  
Rei Ogawa

AbstractIn Japan, corticosteroid tapes and plasters have long served as a first-line therapy for keloids and hypertrophic scars. Pediatric patients are particularly responsive to this type of treatment. This may reflect the fact children have thinner skin than adults and the steroids are therefore more easily absorbed. The postoperative application of corticosteroid tapes/plasters also significantly prevents the development of keloids and hypertrophic scars after surgery. Steroid tape is available in the following three countries in different preparations. In the UK, the commercially available formulation comprises a fludroxycortide-impregnated tape (4 μg/cm2). Fludroxycortide tape is a Group III preparation. The USA has a steroid tape preparation that contains 4 μg/cm2 flurandrenolide, which is also a Group III preparation. In Japan, two steroid tape formulations are available, namely, the Group III preparation found in the UK (4 μg/cm2 fludroxycortide tape) and a 20 μg/cm2 deprodone propionate tape. Deprodone propionate tape is considered to be a Group I or II preparation. In our experience, deprodone propionate tape (Eclar® plaster) is the most effective tape for the treatment and prevention of keloids.


2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Ghulam Sabir

Aim: To recognize and draw a line between glaucomatous and non glaucomatous patients at very early stage. Objects: Such silent dangerous ocular problem must be recognized and treated at very initial stage to avoid subsequent complications. Diagnosis: History and all the parameters including intraocular pressure, vision, visual fields and fundus examination were evaluated for diagnosis. Method of study: The study was done at General Hospital and Services Hospital Lahore from 1987 to early 1991. All the patients over the age of 40 year whether coming for first time or already on antiglaucoma treatment were evaluated thoroughly. Patients were examined by senior colleagues also. Results: Total 180 patients were included in study, 120 males 60 females. They were divided into four groups. Group I and II were diagnosed early and included 120 patients with no complications. Group-III and IV were misdiagnosed and included 60 patients. Discussion Until and unless, special care is taken to focus on the diagnosis, it is usually missed with many complications. It is only the casual behaviour of treating physician who considers the patient`s complaint lightly and examines them superficially. Conclusion: Although misdiagnosed cases are relatively less than truly misdiagnosed cases of glaucoma yet they form an important fraction of patients who may go blind within coming years. It is therefore necessary to diagnose such patients at very early stage. The surgeon should take special interest to diagnose such patients. One should not hesitate to consult senior colleagues in doubtful cases. Proper counseling for non cooperative patients is very necessary.


2003 ◽  
Vol 69 (5) ◽  
pp. 2595-2602 ◽  
Author(s):  
Yali Cheng ◽  
David J. McNally ◽  
Caroline Labbé ◽  
Normand Voyer ◽  
François Belzile ◽  
...  

ABSTRACT Insertional mutagenesis was applied for the first time to a fungal biocontrol agent, Pseudozyma flocculosa, in an attempt to obtain mutants with altered antagonistic properties. Transformants were obtained via DNA-mediated transformation. Molecular analyses of the transformants revealed that multiple copies of the plasmid were integrated in tandem at one to many chromosomal loci. The transformants were screened for their biocontrol properties using standard bioassays, and the 160 tested transformants were classified into four groups: group I mutants (22 transformants) showed a stronger antagonistic effect than the wild type (WT) while those of group II (107 transformants) had a comparable antagonistic effect; group III mutants (17 transformants) had a decreased antagonistic effect relative to WT and group IV mutants (14 transformants) had lost their biocontrol properties. Culture extracts of the mutants (group IV) and WT were analyzed and compared for the presence of active metabolites which were then separated by solid-phase extraction and purified using conventional methods. Nuclear magnetic resonance experiments and analytical studies on a metabolite specifically produced by the WT revealed the presence of 2-(2′,4′-diacetoxy-5′-carboxy-pentanoyl) octadecyl cellobioside (flocculosin), a novel glycolipid with strong antifungal properties; the production of this compound would account for the biocontrol activity of P. flocculosa.


2021 ◽  
Vol 28 (12) ◽  
pp. 1711-1717
Author(s):  
Nazish Waris ◽  
Samina Bano ◽  
Asher Fawwad ◽  
Abdul Basit

Objective: Association between alanine transaminase (ALT) and aspartate transaminase (AST) with newly diagnosed and known type 2 diabetes mellitus (DM) and to estimate association of liver enzymes with lipid profile in type 2 DM subjects. Study Design: Prospective Clinical study. Setting: Karachi University with Collaboration of Baqai Institute of Diabetology and Endocrinology. Period: November 2018 to May 2019. Material & Methods: Total 100 people were divided into four groups; Group I: 25 healthy controls with normal glucose tolerance, Group II: 25 newly diagnosed DM, Group III: 25 known DM type 2 with <5years duration and Group IV: 25 known DM type 2 between 5-10 years duration. Baseline data was collected on predesigned questionnaire. Blood samples for biochemical parameters were analyzed using standardized laboratory techniques. Results: Group I mean age (years) was 50.78±2.34, group II 50.56±1.96, group III 50.37±1.46 and group IV 56±1.36. In Group I, ALT and AST were significantly correlated to each other’s. In group II, ALT was significantly correlated with AST, triglycerides and HDL-C, while AST correlated with ALT and HDL-C. In group III, ALT was significantly correlated with AST, while AST correlated to ALT, triglycerides and HbA1c. However, in group IV, ALT was significantly correlated with AST, LDL-C and HDL-C, and, AST with ALT, total cholesterol, LDL-C and HDL-C. Conclusion: Elevated ALT and AST- the salient markers for disease of non-alcoholic fatty liver with deranged dyslipidemia were found in known type 2 DM as well as in newly diagnosed type 2 DM subjects.


2014 ◽  
Vol 32 (31) ◽  
pp. 3547-3552 ◽  
Author(s):  
David O. Walterhouse ◽  
Alberto S. Pappo ◽  
Jane L. Meza ◽  
John C. Breneman ◽  
Andrea A. Hayes-Jordan ◽  
...  

Purpose Intergroup Rhabdomyosarcoma Study Group (IRSG) studies III and IV showed improved failure-free survival (FFS) rates with vincristine, dactinomycin, and cyclophosphamide (VAC; total cumulative cyclophosphamide dose, 26.4 g/m2) compared with vincristine and dactinomycin (VA) for patients with subset-one low-risk embryonal rhabdomyosarcoma (ERMS; stage 1/2 group I/II ERMS or stage 1 group III orbit ERMS). The objective of Children's Oncology Group ARST0331 was to reduce the length of therapy without compromising FFS for this subset of low-risk patients by using VA in combination with lower-dose cyclophosphamide (total cumulative dose, 4.8 g/m2) plus radiotherapy (RT). Patients and Methods This noninferiority prospective clinical trial enrolled newly diagnosed patients with subset-one clinical features. Therapy included four cycles of VAC followed by four cycles of VA over 22 weeks. Patients with microscopic or gross residual disease at study entry received RT. Results With a median follow-up of 4.3 years, we observed 35 failures among 271 eligible patients versus 48.4 expected failures, calculated using a fixed outcome based on the FFS expected for similar patients treated on the IRSG D9602 protocol. The estimated 3-year FFS rate was 89% (95% CI, 85% to 92%), and the overall survival rate was 98% (95% CI, 95% to 99%). Patients with paratesticular tumors had the most favorable outcome. Three-year cumulative incidence rates for any local, regional, or distant failures were 7.6%, 1.5%, and 3.4%, respectively. Conclusion Shorter-duration therapy that included lower-dose cyclophosphamide and RT did not compromise FFS for patients with subset-one low-risk ERMS.


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