Laser management for congenital dermal melanocytosis

Congenital dermal melanocytosis (CDM) is a malformation of the dermis caused by antenatal impairment of melanogenesis. There are considered data on the epidemiology, history of the study, the characteristics of the pathogenesis and clinical picture of CDM. Data on the efficacy and side effects of treatment of CDM with ruby, alexandrite and neodymium laser in children and adults are compared. The effectiveness of laser treatment for CDM is closely related to the value of the integral absorption of radiation by targeted photothermophores of the epidermis and dermis: melanin, oxyhemoglobin and reduced hemoglobin. The safety of laser exposure is determined by its selectivity, which directly depends on the ratio between the absorption of radiation by the main target photothermophores and water. For the first time, integral indices of the absorption of laser radiation in the pathological focus area by the main photothermophores of the epidermis and dermis (oxyhemoglobin, reduced hemoglobin, as well as the melanin content and localization of ectopic melanocytes in the reticular layer of the dermis) and water are presented. In the CDM involved area, the integrated coefficients of absorption by the main target photothermophores of radiation with a wavelength of 511 nm and 578 nm were shown to be much higher, and the absorption by water is much lower than for radiation with a wavelength of more than 600 nm generated by a ruby, alexandrite or neodymium laser. The described pathogenetic features of laser skin biophotonics upon exposure of the CDM region to the radiation with a wavelength of more than 600 nm increases the risk of the development of such characteristic side effects as hyperpigmentation, deterioration of the collagen structure of the dermis with subsequent formation of scars in the postradiated area. To ensure the complete elimination of ectopic melanocytes and minimize the risk of side effects during laser surgical treatment of CMD area, it is advisable to use the two-wavelengths radiation generated by the copper vapor laser: with a wavelength that is maximally absorbed by melanin (511 nm) and with a wavelength with high absorption of both oxyhemoglobin and hemoglobin (578 nm), but with negligible absorption by water.

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Probiotics in gastroenterology – from a different angle

Orvosi Hetilap ◽

10.1556/oh.2013.29547 ◽

2013 ◽

Vol 154 (8) ◽

pp. 294-304 ◽

Cited By ~ 2

Author(s):

György Miklós Buzás

Keyword(s):

Side Effects ◽

Beneficial Effect ◽

Analytical Data ◽

Well Being ◽

Gastrointestinal Diseases ◽

Convincing Evidence ◽

Probiotic Treatment ◽

History Of ◽

Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

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Tuning Down the Pain – An Overview of Allosteric Modulation of Opioid Receptors: Mechanisms of Modulation, Allosteric Sites, Modulator Syntheses

Current Topics in Medicinal Chemistry ◽

10.2174/1568026620666200601155451 ◽

2020 ◽

Vol 20 (31) ◽

pp. 2852-2865 ◽

Cited By ~ 1

Author(s):

Damian Bartuzi ◽

Tomasz M. Wróbel ◽

Agnieszka A. Kaczor ◽

Dariusz Matosiuk

Keyword(s):

Side Effects ◽

Opioid Receptors ◽

Pain Perception ◽

Allosteric Modulation ◽

Allosteric Modulators ◽

Signaling Mechanisms ◽

Main Target ◽

Allosteric Sites ◽

Biased Signaling ◽

Opioid Signaling

Opioid signaling plays a central role in pain perception. As such, it remains the main target in the development of antinociceptive agents, despite serious side effects involved. In recent years, hopes for improved opioid painkillers are rising, together with our understanding of allosterism and biased signaling mechanisms. In this review, we focus on recently discovered allosteric modulators of opioid receptors, insights into phenomena underlying their action, as well as on how they extend our understanding of mechanisms of previously known compounds. A brief overlook of their synthesis is also presented.

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Adenoid cystic carcinoma of the labium oris with rare metastasis to the pleural cavity

BMJ Case Reports ◽

10.1136/bcr-2020-237622 ◽

2021 ◽

Vol 14 (1) ◽

pp. e237622

Author(s):

Osama Mosalem ◽

Anas Alsara ◽

Fawzi Abu Rous ◽

Borys Hrinczenko

Keyword(s):

Side Effects ◽

Adenoid Cystic Carcinoma ◽

Pleural Cavity ◽

Epigastric Pain ◽

Asian Woman ◽

Upper Lip ◽

Adenoid Cystic ◽

History Of ◽

The Right

A 57-year-old Southeast Asian woman with a remote history of adenoid cystic carcinoma (ACC) of the right labium superius oris (upper lip) presented to the hospital with vague epigastric pain. On workup, she was found to have multiple pleural nodules. Histopathology confirmed the diagnosis of metastatic ACC. After 8 months of active surveillance, evidence of disease progression was found and the patient was started on pembrolizumab. Follow-up after starting pembrolizumab showed stable disease with no significant side effects.

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Lung adenocarcinoma concomitant with xeroderma pigmentosum: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02754-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Masataka Matsumoto ◽

Kazumi Kaneshiro ◽

Kiyonobu Takatsuki

Keyword(s):

Epidermal Growth Factor Receptor ◽

Growth Factor ◽

Side Effects ◽

Epidermal Growth Factor ◽

Lung Adenocarcinoma ◽

Xeroderma Pigmentosum ◽

Growth Factor Receptor ◽

Consanguineous Marriage ◽

History Of ◽

Epidermal Growth

Abstract Background Xeroderma pigmentosum is a rare, autosomal-recessive photosensitive dermatosis. Patients with xeroderma pigmentosum have an impaired ability to repair deoxyribonucleic acid damage caused by ultraviolet rays, resulting in skin cancer. Patients with xeroderma pigmentosum are more susceptible to some cancers. We herein report a case of xeroderma pigmentosum accompanied by lung cancer. Case presentation The patient was a Japanese woman in her 70s with a family history of consanguineous marriage. Her medical history included squamous cell carcinoma and basal cell carcinoma, in addition to xeroderma pigmentosum. She presented with dry skin with small, pigmented spots, which were particularly focused around the areas exposed to sunlight. Chest computed tomography was conducted to assess for any evidence of metastatic skin carcinoma, and revealed a tumor in the left upper subpleural lobe of the lung. Consequently, she was referred to our department. Finally, we diagnosed lung adenocarcinoma (pT2aN0M1b: stage IVA). She had an epidermal growth factor receptor (EGFR) mutation (p.L858R). Treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (gefitinib) was initiated, and the tumor gradually regressed. No side effects were observed. However, she later died from aspiration pneumonia. Conclusions Although xeroderma pigmentosum is rare, a history of consanguineous marriage should be verified. Because of the severe side effects of cisplatin and radiotherapy in xeroderma pigmentosum patients, the risks and benefits of treatment should be considered thoroughly.

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Dermal Discoloration Secondary to Triamcinolone Acetonide Injection Observed in Patients with Autoimmune Disorders

Journal of the American Podiatric Medical Association ◽

10.7547/20-210 ◽

2021 ◽

Vol 111 (4) ◽

Author(s):

James A. Wright ◽

Jessica A. Wenz ◽

Gabrielle Jackson Madrigal

Keyword(s):

Psoriatic Arthritis ◽

Side Effects ◽

Autoimmune Disease ◽

Triamcinolone Acetonide ◽

Current Literature ◽

Side Effect ◽

Inflammatory Conditions ◽

Rare Side Effect ◽

History Of ◽

Synthetic Glucocorticoid

Triamcinolone acetonide is a synthetic glucocorticoid used to treat numerous acute and chronic inflammatory conditions. The various side effects of this drug from parenteral administration are well documented in the literature. In this study, three patients present with a rare side effect of violaceous dermal pigmentation. To the best of the authors' knowledge, this finding is rarely presented in the current literature. The purpose of this study is to provide awareness of a less-documented, delayed side effect from triamcinolone acetonide administration. Although all patients presenting in this study had a known history of autoimmune disease (eg, lupus, psoriatic arthritis) further research is needed to suggest a possible association between dermal violaceous change and the use of triamcinolone.

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Complications after Intrathecal Drug Delivery Due to the Underlying Malignancy in Two Patients with Intractable Cancer Pain

January 2018 - Pain Physician ◽

10.36076/ppj.2013/16/e107 ◽

2013 ◽

Vol 2;16 (2;3) ◽

pp. E107-E111

Author(s):

Thomas Chai

Keyword(s):

Drug Delivery ◽

Side Effects ◽

Cancer Pain ◽

Systemic Absorption ◽

Pain Patient ◽

Drug Side Effects ◽

Intrathecal Drug Delivery ◽

Underlying Malignancy ◽

History Of ◽

Intractable Cancer Pain

Intrathecal drug delivery is a mode of analgesic delivery that can be considered in those experiencing both refractory pain and excessive side effects from opioid and adjuvant analgesic use. Delivery of analgesic agents directly to the cerebral spinal fluid allows binding of the drug to receptors at the spinal level. Therefore, a reduced analgesic dosage can be afforded, resulting in reduction of drug side effects due to decreased systemic absorption. Drug delivery into the intrathecal space provides this benefit, yet it does not eliminate the possibility of drug side effects or risks of complications. Complications from this route of administration may be seen in the perioperative period or beyond, including infection, inflammatory mass, bleeding, and catheter or pump dysfunction, among others. This may manifest as new/worsening pain or as a neurologic deficit, such as a sensorimotor change and bladder/bowel dysfunction. Urgent evaluation with a detailed physical examination, device interrogation, and other workup including imaging is called for if symptoms suspicious for device-related problems arise. For the cancer pain patient, the underlying malignancy should also be considered as a potential cause for these new symptoms after intrathecal system implantation. We present 2 such cases of complications in the cancer pain patient after intrathecal drug delivery due to progression of the underlying malignant process rather than to surgical or device-related problems. The first patient had a history of metastatic osteosarcoma who, shortly after undergoing an intrathecal drug delivery trial with external pump, presented with new symptoms of both pain and neurologic changes. The second patient with a history of chondrosarcoma developed new symptoms of pain and sensorimotor change several days after intrathecal drug delivery system implantation. Key words: Intrathecal analgesia, intrathecal drug delivery, perioperative complications, cancer pain, malignant pain, pain pump

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Utilization of modern contraceptives and associated factors among street women in Dire Dawa, Eastern Ethiopia: a mixed study

Reproductive Health ◽

10.1186/s12978-021-01263-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Alemu Guta ◽

Bezhabh Amsalu ◽

Tadesse Weldamanuel ◽

Alekaw Sema ◽

Legesse Abera ◽

...

Keyword(s):

Side Effects ◽

Health Facility ◽

Health Professionals ◽

Associated Factors ◽

Qualitative Data ◽

Sexual Partners ◽

Modern Contraceptive ◽

Eastern Ethiopia ◽

Modern Contraceptives ◽

History Of

Abstract Introduction Unwanted pregnancy and sexually transmitted diseases are the major problems in street women because of the non-utilization of modern contraceptives. To the best of our knowledge, no studies have assessed the utilization of modern contraceptives and associated factors among street women in the study area. Therefore, this study aimed to determine the utilization of modern contraceptives and its associated factors among street women. Methods A community-based cross-sectional study using mixed methods was conducted from February 16th to April 10, 2021, among all censuses and 615 reproductive-aged street women. Face-to-face and in-depth interviews were employed to generate quantitative and qualitative data, respectively. Binary logistic regression was used to analyze the association between modern contraceptive utilization and independent variables with statistical significance set at p < 0.05. Qualitative data were analyzed using a thematic approach. Results Approximately half 279 (50.3%) (95% CI: 46.3%, 54.4%) street women currently used modern contraceptives. Factors significantly associated were women aged 25–34 years [AOR = 5.5, 95% CI: 1.2–24], distance from a nearby health facility within 30 min [AOR = 9.2, 95% CI: 1.6–51], getting advice from health professionals [AOR = 14.3; 95% CI = 5.3–38.4], discussed with their sexual partners about the utilization of modern contraceptives [AOR = 6.2, 95% CI: 2.4–16.5], a history of pregnancy [AOR = 2.7, 95% CI: 1.2–6], the desire to have a child after two years [AOR = 2.2, 95% CI: 1.1–4.7], and women who faced rape in street life [AOR = 5.4; 95% CI = 1.9–15.3]. Fear of side effects, misperceptions, and the desire to have a child are the main identified themes for the key barriers to using modern contraceptives. Conclusion The proportion of street women currently using modern contraceptives was low. Age, distance from the health facility, discussion with health professionals, discussion with sexual partners, history of pregnancy, desire time to have a child in the future, and history of rape were factors significantly associated with the use of modern contraceptives. Most of the participants’ reasons for the lack of use of modern contraceptives were fear of its side effects.

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Lithium Clinics in Berlin and Dresden: a 50-Year Experience

Pharmacopsychiatry ◽

10.1055/a-0633-3450 ◽

2018 ◽

Vol 51 (05) ◽

pp. 166-171 ◽

Cited By ~ 7

Author(s):

Werner Felber ◽

Michael Bauer ◽

Ute Lewitzka ◽

Bruno Müller-Oerlinghausen

Keyword(s):

Side Effects ◽

Lithium Treatment ◽

Scientific Evidence ◽

Bipolar Disorders ◽

Lithium Therapy ◽

Psychopharmacological Treatment ◽

Academic Settings ◽

History Of ◽

The 1960S

AbstractAlthough lithium’s serendipitous discovery as a medication for depression dates back more than 200 years, the first scientific evidence that it prevents mania and depression arose only in the 1960s. However, at that time there was a lack of knowledge about how to administer and monitor lithium therapy safely and properly. The lithium clinics in Dresden and Berlin were remarkably similar in their beginnings in the late 1960s regarding patient numbers and scientific expertise without being aware of one another due to the Iron Curtain separating Germany into a western and eastern part until 1990. In what were initially lithium-care programs run independently from one another, the lithium clinics embedded in academic settings in Dresden and Berlin represent a milestone in the history of psychopharmacological treatment of affective disorders in Germany and trailblazers for today’s lithium therapy. Nowadays, lithium’s clinical applications are unquestioned, such as its use in strategies to prevent mood episodes and suicide, and to treat depression. The extensively documented knowledge of lithium treatment is the fruit of more than 50 years of observing disease courses and of studying side effects and influencing factors of lithium prophylaxis. Its safe and proper administration—in determining the correct indication, baseline and follow-up examinations, recommended dosages, monitoring, or the management of side effects—is well established. Subsequently, both national and international guidelines continue recommending lithium as the gold standard in treating patients with unipolar and bipolar disorders.

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The Rationality of Using Diclofenac in Outpatient Cases of Osteoarthritis of RSUP MH Palembang Period January-March 2018

Archives of The Medicine and Case Reports ◽

10.37275/amcr.v2i1.8 ◽

2021 ◽

Vol 2 (1) ◽

pp. 43-50

Author(s):

Dara Prameswari ◽

Nita Parisa ◽

Muhammad Totong Kamaluddin

Keyword(s):

Side Effects ◽

Medical Records ◽

Daily Activity ◽

Sampling Technique ◽

Synergistic Interaction ◽

Inclusion Criteria ◽

Cross Sectional ◽

Correct Dose ◽

History Of ◽

Lowback Pain

Rationality of Diclofenac Use in Osteoarthritis Outpatient Case at RSUP MHPalembang in January-March 2018. Osteoarthritis (OA) is the most common diseasein joints that affects people in their middle until late years. In Indonesia the prevalenceof OA is relatively high and disturbs their daily activity. Diclofenac is one of the drug ofchoice in treating OA. To avoid multiple side effects from Diclofenac use, the usagemust be in accordance to rationality indicators which are correct dose, correctfrequency, and correct length of use. This study is aimed to know the rationality ofDiclofenac use in Osteoarthritis outpatient cases at RSUP Mohammad HoesinPalembang. This study is a descriptive observational with a cross-sectional approachto know the rationality of Diclofenac use in outpatient cases of osteoarthritis at RSUPMohammad Hoesin Palembang. Samples were medical records of OA patients inoutpatient setting from January to March 2018 which fulfilled the inclusion andexclusion criteria. Sampling technique used was total sampling. The amount ofsamples fulfilling the inclusion criteria were 201 patients, with the most were aged 46-65 years (60.2%), female (55.7%), and has a history of comorbidity which includes lowback pain (22.8%). The result of this study shows pattern of Diclofenac use with dosageof 2 x 25mg (73.6%), length of use about <7 days (57.2%). In combination with otherdrugs there were no interaction to be found (84.4%), or synergistic interaction (8.5%)and antagonistic interaction (7.1%). The use of diclofenac in osteoarthritis cases atoutpatient setting in RSUP Dr Mohammad Hoesin Palembang is rational and needs tobe maintained.

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Oxybutynin Efficacy in the Treatment of Primary Enuresis

PEDIATRICS ◽

10.1542/peds.82.1.104 ◽

1988 ◽

Vol 82 (1) ◽

pp. 104-106

Author(s):

John S. Lovering ◽

Susan E. Tallett ◽

James B. J. McKendry

Keyword(s):

Urinary Tract ◽

Side Effects ◽

Treatment Period ◽

Nocturnal Enuresis ◽

Drug Regimen ◽

Double Blind Study ◽

Double Blind ◽

History Of ◽

Clinic Population ◽

Or History

The effectiveness of oxybutynin in the treatment of primary enuresis was evaluated in a double-blind study. A total of 30 children (25 boys, five girls), at least 6 years of age, with primary enuresis and no daytime incontinence or history of other urinary tract problems were selected at random from an enuresis clinic population. The study was explained to the families and they were told how to keep records of nocturnal bed-wetting episodes and side effects. The patients were treated with a 10 mg of oxybutynin at suppertime for 28 days. Before or after the treatment period, all children received an identical placebo for 4 weeks. Two-sided paired t tests were used to compare frequency of nocturnal enuresis. Frequency during the drug regimen did not differ significantly from that during the placebo study. There were no differences in findings between boys and girls or between children who had previously taken imipramine and those who had not. The study showed no evidence that oxybutynin is effective in treating primary enuresis.

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