scholarly journals Successful treatment of extensive recurrent keloid scar

Author(s):  
V. I. Lomakin ◽  
A. S. Kuzmichev ◽  
A. L. Akinchev

The treatment of scars and impact by them their deformations, as well as the formation of pathological scars, remain one of the most difficult and insufficiently explored problems of plastic and reconstructive surgery. The most severe type of pathological scars is keloid a tumor-like growth of immature connective tissue due to uncontrolled proliferative fibroblast activity. The simple removal of keloids even within healthy tissue was often accompanied by their recurrence. Here presented clinical observation of the patient with benign fibroma of 1 finger of the right foot, who had after excision of formation, keloid scar has developed. Repeated operations with keloid excision and the use of free skin plastic have proved ineffective. Only long-term therapy with diprospan injections for 1.5 years allowed to achieve cure of the patient.

2020 ◽  
Author(s):  
Johannes Krämer

Abstract Introduction Pegvaliase is a novel enzyme substitution therapy approved by the European Drug Administration (EDA) in May 2019 for the treatment of Phenylketonuria (PKU) in adults and children ≥16 years of age. The pegylated phenylalanine ammonia lyase is isolated from bacteria and therefore provokes multifarious immunogenic reactions. Thus, the selection of the right patient for a potential harmful treatment is essential for patient’s contentedness and long-term therapy compliance.Methods and Results 101 patients with PKU were screened for eligibility for an additional treatment with Pegvaliase. 51 patients were included in the study, 26 received a structural information about the new treatment for in mean 43±12 minutes and clinical data and plasma Phe-levels were assessed. After 4 weeks of consideration the willing of treatment initiation as well as reasons for denial are registered. 7 patients (27%) concluded in beginning of treatment. Phe-level in this (acceptance) group were higher (1180±231µmol/l) compared to the denial group (930±278µmol/l, p=0.01). After 4 weeks Phe-levels in the acceptance group remained stable (1264±311µmol/l, p=26) while Phe-levels in the denial group decreased (779±226µmol/l, p<0.01). Main reasons for denial of therapy were fear of adverse effects (47%), no need for additional treatment (26%) and the subcutaneous way of application (21%).Conclusion PKU patients have reservations against an invasive subcutaneous treatment for their disease. This is mainly caused by the form of application by syringe and the potential harmful side effects. Only less than one-third of the patients in our cohort are willing to start treatment. Besides that, most PKU patients seem to have untapped potential for self-contained reduction of Phe-levels only by being focused on their diet.


1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.


2007 ◽  
Vol 40 (05) ◽  
Author(s):  
M Kungel ◽  
A Engelhardt ◽  
T Spevakné-Göröcs ◽  
M Ebrecht ◽  
C Werner ◽  
...  

2021 ◽  
Vol 12 ◽  
pp. 204201882110011
Author(s):  
Sarah Montenez ◽  
Stéphane Moniotte ◽  
Annie Robert ◽  
Lieven Desmet ◽  
Philippe A. Lysy

Background: Amiodarone treatment is effective against various types of arrhythmias but is associated with adverse effects affecting, among other organs, thyroid function. Amiodarone-induced thyroid dysfunction was not thoroughly evaluated in children as it was in adults, yet this affection may lead to irreversible neurodevelopmental complications. Our study aimed to define the incidence and risk factors of amiodarone-induced thyroid dysfunction in children. Methods: The study was designed as an observational study with a retrospective clinical series of 152 children treated by amiodarone in the Pediatric Cardiology Unit of our center from 1990 to 2019. All patients were divided into three groups according to their thyroid status: euthyroid, AIH (amiodarone-induced hypothyroidism) or AIT (amiodarone-induced thyrotoxicosis). Patients from these three groups were compared in terms of key clinical and therapeutic features. Results: Amiodarone-induced thyroid dysfunction was present in 23% of patients. AIT (5.3%) was three times less common than AIH (17.7%), and its occurrence increased with older age ( p < 0.05), treatment dosage ( p < 0.05), treatment duration ( p < 0.05) and the number of loading doses administered ( p < 0.05). There were no distinctive clinical features between euthyroid and AIH groups. A multivariable prediction model of AIT was built, with a yield of 66.7% as positive predictive value and 96.7% as negative predictive value. Conclusion: We observed that one in five children developed amiodarone-induced thyroid dysfunction. Special attention is required for older children with a high dosage and long-term therapy and who received a large number of loading doses, since these children are at risk to develop AIT, which is more delicate to manage than AIH.


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