scholarly journals Patients with osteoarthritis of the knee: management in the outpatient setting

2021 ◽  
pp. 86-93
Author(s):  
Yu. S. Filatova ◽  
I. N. Solovyov
Keyword(s):  
Side Effects ◽  
Clinical Studies ◽  
Personal Experience ◽  
Systemic Exposure ◽  
Outpatient Setting ◽  
Osteoarthritis Of The Knee ◽  
Systemic Delivery ◽  
Functional Changes ◽  
Correct Placement

The article discusses the treatment of osteoarthritis. To prevent serious structural and functional changes, it is extremely important to start therapy in the early stages of the disease. Symptomatic slow-acting drugs for the treatment of osteoarthritis (SYSADOA) are an important class in the pharmacological arsenal of OA treatment. The results of the use of this group of drugs in numerous clinical studies have demonstrated good effectiveness in the long-term achievement of the goal. The SYSADOA class (chondroprotectors) includes many different drugs, including glucosamine, chondroitin, diacerein, and soy unsaponifiable avocado substances. Particular attention is paid to the injectable forms of chondroprotective drugs, data from experimental and clinical studies confirming their effectiveness. The authors discuss the issue of intra-articular administration of drugs for knee osteoarthritis and the choice of optimal access. Intra-articular drug delivery has a number of advantages over systemic delivery, including increased local bioavailability, reduced systemic exposure, fewer side effects, and reduced cost. To minimize side effects, it is important to determine the injection site and to have some preparation in the correct placement of the needle during these procedures. To improve the accuracy of intraarticular injections, various imaging methods can be used, but ultrasound of the musculoskeletal system is the most practical. The article presents the data of personal experience of choosing access under the control of ultrasound. Taking into account the anatomy of the knee joint, performing an intra-articular injection from the inside into the upper inversion is the most affordable and optimal. The article presents the data of a clinical example of the introduction of chondroprotectors through the selected access.

Aspects of Long-Term Treatment with Neuroleptics Historical and Literature Review—Personal Experience with Fluspirilene and Penfluridol

1975 ◽  
Vol 3 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Lucian Floru
Keyword(s):  
Side Effects ◽  
Literature Review ◽  
Personal Experience ◽  
Term Treatment ◽  
Term Therapy ◽  
Tabular Form ◽  
Long Term Effects ◽  
Long Term Treatment ◽  
Long Term Therapy

The literature on neuroleptics with substance-specific long-term effects (fluspirilene, penfluridol) is reviewed in tabular form. This is followed by a report of personal investigations on 76 schizophrenics who were treated with fluspirilene initially within the hospital and later on an out-patient basis, on 86 patients who were treated with it exclusively at the out-patients' department, as well as on 123 schizophrenic psychoses treated with penfluridol in the out-patients' department. The side-effects caused by the two substances are compared. Pre-requisites for effective long-term therapy with a few complications are discussed.

scholarly journals Convection-Enhanced Delivery for Targeted Delivery of Antiglioma Agents: The Translational Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jonathan Yun ◽  
Robert J. Rothrock ◽  
Peter Canoll ◽  
Jeffrey N. Bruce
Keyword(s):  
Side Effects ◽  
Targeted Delivery ◽  
Systemic Exposure ◽  
Systemic Delivery ◽  
Convection Enhanced Delivery ◽  
Widespread Application ◽  
Wide Range ◽  
Systemic Side Effects ◽  
Human Gbm ◽  
The Ideal

Recent improvements in the understanding of glioblastoma (GBM) have allowed for increased ability to develop specific, targeted therapies. In parallel, however, there is a need for effective methods of delivery to circumvent the therapeutic obstacles presented by the blood-brain barrier and systemic side effects. The ideal delivery system should allow for adequate targeting of the tumor while minimizing systemic exposure, applicability across a wide range of potential therapies, and have existing safe and efficacious systems that allow for widespread application. Though many alternatives to systemic delivery have been developed, this paper will focus on our experience with convection-enhanced delivery (CED) and our focus on translating this technology from pre-clinical studies to the treatment of human GBM.

Safety and tolerability of lapatinib in combination with taxanes (T) in patients with breast cancer (BC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1027-1027 ◽  
Author(s):  
J. P. Crown ◽  
H. A. Burris ◽  
S. Jones ◽  
K. M. Koch ◽  
A. Fittipaldo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Adverse Events ◽  
Safety Profile ◽  
Clinical Studies ◽  
Kinase Inhibitor ◽  
Safety Data ◽  
Systemic Exposure ◽  
Clinical Activity ◽  
Grade 3

1027 Background: Lapatinib (L) is an oral, dual ErbB1/B2 tyrosine kinase inhibitor. T are mainstay of BC treatment. The side-effects seen with T in combination with gefitinib and erlotinib include neutropenia, diarrhea and rash. Based on preclinical synergy, early clinical studies with L and paclitaxel (P) or docetaxel (D) were studied. Methods: We summarize pharmacokinetics (PK) and preliminary safety data from 192 patients. Results: PK analysis for EGF10009 (q3w), show systemic exposure was increased for both L (21%) and P (23%) at doses of 1500mg daily and 175mg/m2/q3w, respectively. PK analysis in EGF10021 , (L 1250 mg & D 75 mg/m2 with prophylactic pegfilgrastim) indicated no significant effect on systemic exposure of either agent. Toxicities across all studies include i.e., for all patients = grade 3, neutropenia (7.3%), diarrhea (18.2%), rash (3.6%). The rate of adverse events for neutropenia and rash were similar to each agent alone, however diarrhea was more common. The frequency and severity of diarrhea was increased in studies EGF10009 and EGF102580 where no proactive treatment of diarrhea was introduced, whereas in EGF105764, with proactive treatment, currently no =grade 3 diarrhea has been reported. The data show that the combination of L and P has clinical activity (>70% RR reported in EGF102580). Conclusions: T plus L combinations have a predictable and manageable safety profile and clinical activity of P plus L combination was observed. Proactive diarrhea management is essential for these combinations. Based on the PK data, no dose adjustments are required, and any dose adjustments should be toxicity-based. Ongoing clinical studies investigating the combinations of L with T, and combinations of L with T plus trastuzumab will be reported in the future. [Table: see text] No significant financial relationships to disclose.

Outpatient penile aspiration and epinephrine irrigation for young patients with sickle cell anemia and prolonged priapism

Blood ◽  
2000 ◽  
Vol 95 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Elpis Mantadakis ◽  
David H. Ewalt ◽  
Joe Don Cavender ◽  
Zora R. Rogers ◽  
George R. Buchanan
Keyword(s):  
Side Effects ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Young Patients ◽  
Initial Therapy ◽  
Outpatient Setting ◽  
Optimal Management ◽  
Efficacy And Safety ◽  
Corpora Cavernosa

Abstract The optimal management of prolonged priapism for patients with sickle cell anemia (SCA) has not been established. We prospectively studied in an outpatient setting the efficacy and safety of a procedure that employs aspiration of blood from the corpora cavernosa and irrigation with a dilute epinephrine solution under local anesthesia to relieve priapism in young patients with SCA. If hydration and analgesics failed to produce detumescence or if priapism had lasted >4 hours, the protocol was activated in the emergency room or clinic. Fifteen patients with homozygous SCA (Hb SS) were treated on 39 occasions; 10 patients were treated once, 1 patient twice, 2 patients 3 times, 1 patient 6 times, and 1 patient 15 times. Median age of patients at first treatment was 14.3 years (range, 3.9-18.3 years). The procedure was successful in producing immediate detumescence on 37 of 39 occasions (95% efficacy, 95% confidence intervals (CI): 81%-99%). No serious immediate or long-term side effects were observed. None of the patients who demonstrated detumescence required hospitalization. The 2 patients whose priapism persisted after aspiration and irrigation presented with episodes lasting >24 hours. All evaluable patients whose priapism resolved after aspiration and irrigation self-reported normal erectile function at a median of 40 months (range, 3-58 months) after the last procedure. Thus, aspiration of the corpora cavernosa followed by irrigation with dilute epinephrine is effective in producing immediate and sustained detumescence and should be the initial therapy employed for patients with SCA and prolonged priapism. (Blood, 2000; 95:78-82)

scholarly journals Bilastine as a modern antihistamine for the treatment of allergic rhinitis and urticaria

2020 ◽  
Vol 17 (1) ◽  
pp. 93-100
Author(s):  
Igor S Gushchin ◽  
Ekaterina N Medunitsyn
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Safety Profile ◽  
Clinical Studies ◽  
Second Generation ◽  
High Efficiency ◽  
Fold Increase ◽  
Term Therapy ◽  
H1 Antihistamines

Antihistamines have long been an integral part of the treatment of allergic rhinitis and urticaria. Treatment of these diseases is usually long-term, so the drugs of choice are H1-antihistamines of the second generation, which have high efficiency and a good safety profile in the absence of clinically significant side effects. The variety of drugs in this group makes it possible to personalize the therapy, using the drug taking into account the individual sensitivity of the patient. One of the antihistamines used in practical allergy at the present time is bilastine. The article presents the data of clinical studies devoted to the research of the effectiveness, safety and tolerability of Hj-antihistamine of the second generation - bilastine. Short-term and long-term use of bilastine in patients with rhinitis (rhinoconjunctivitis) and chronic urticaria has demonstrated it’s good effectiveness and safety, which are due to the pharmacological properties of the medicine and the peculiarities of its metabolism. A number of sources provide data on the high safety profile of bilastine not only in the standard therapeutic dosage, but also with its four-fold increase. The results of these studies are of particular importance, since the clinical recommendations for the management of urticaria in various countries, including Russia, provide for the possibility of increasing the dose of H1 -antihistamines in case of insufficient effectiveness of therapy. Studies have also shown that bilastine has no clinically pronounced side effects that could significantly limit the use of the medicine, including in patients with concomitant diseases, or negatively affect patient’s compliance. According to the results of clinical studies, bilastine is characterized as an effective, safe, well-tolerated medicine for long-term therapy of allergic rhinitis and urticaria.

Outpatient penile aspiration and epinephrine irrigation for young patients with sickle cell anemia and prolonged priapism

Blood ◽  
2000 ◽  
Vol 95 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Elpis Mantadakis ◽  
David H. Ewalt ◽  
Joe Don Cavender ◽  
Zora R. Rogers ◽  
George R. Buchanan
Keyword(s):  
Side Effects ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Young Patients ◽  
Initial Therapy ◽  
Outpatient Setting ◽  
Optimal Management ◽  
Efficacy And Safety ◽  
Corpora Cavernosa

The optimal management of prolonged priapism for patients with sickle cell anemia (SCA) has not been established. We prospectively studied in an outpatient setting the efficacy and safety of a procedure that employs aspiration of blood from the corpora cavernosa and irrigation with a dilute epinephrine solution under local anesthesia to relieve priapism in young patients with SCA. If hydration and analgesics failed to produce detumescence or if priapism had lasted >4 hours, the protocol was activated in the emergency room or clinic. Fifteen patients with homozygous SCA (Hb SS) were treated on 39 occasions; 10 patients were treated once, 1 patient twice, 2 patients 3 times, 1 patient 6 times, and 1 patient 15 times. Median age of patients at first treatment was 14.3 years (range, 3.9-18.3 years). The procedure was successful in producing immediate detumescence on 37 of 39 occasions (95% efficacy, 95% confidence intervals (CI): 81%-99%). No serious immediate or long-term side effects were observed. None of the patients who demonstrated detumescence required hospitalization. The 2 patients whose priapism persisted after aspiration and irrigation presented with episodes lasting >24 hours. All evaluable patients whose priapism resolved after aspiration and irrigation self-reported normal erectile function at a median of 40 months (range, 3-58 months) after the last procedure. Thus, aspiration of the corpora cavernosa followed by irrigation with dilute epinephrine is effective in producing immediate and sustained detumescence and should be the initial therapy employed for patients with SCA and prolonged priapism. (Blood, 2000; 95:78-82)

Cutaneous ulcers following hydroxyurea therapy

Phlebologie ◽  
2004 ◽  
Vol 33 (06) ◽  
pp. 202-205 ◽  
Author(s):  
K. Hartmann ◽  
S. Nagel ◽  
T. Erichsen ◽  
E. Rabe ◽  
K. H. Grips ◽  
...  
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Antineoplastic Agent ◽  
Limited Time ◽  
Myeloproliferative Diseases ◽  
Dermatological Side Effects ◽  
Chronic Myeloproliferative Diseases ◽  
Hydroxyurea Therapy

SummaryHydroxyurea (HU) is usually a well tolerated antineoplastic agent and is commonly used in the treatment of chronic myeloproliferative diseases. Dermatological side effects are frequently seen in patients receiving longterm HU therapy. Cutaneous ulcers have been reported occasionally.We report on four patients with cutaneous ulcers whilst on long-term hydroxyurea therapy for myeloproliferative diseases. In all patients we were able to reduce the dose, or stop HU altogether and their ulcers markedly improved. Our observations suggest that cutaneous ulcers should be considered as possible side effect of long-term HU therapy and healing of the ulcers can be achieved not only by cessation of the HU treatment, but also by reducing the dose of hydroxyurea for a limited time.

Long-term side effects following pneumonectomy: A case report and review of the literature

2019 ◽  
Author(s):  
BA Högerle ◽  
EL Bulut ◽  
L Klotz ◽  
F Eichhorn ◽  
M Eichhorn ◽  
...  
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Review Of The Literature

Ixekizumab in the Management of Non-Selected Out Patients with Moderate to Severe Psoriasis -New Data and Personal Clinical Experience

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Clinical Experience ◽  
Personal Experience ◽  
Therapeutic Response ◽  
Systemic Disease ◽  
Severe Psoriasis ◽  
Adequate Treatment ◽  
Scalp Psoriasis ◽  
Number Of Patients ◽  
Genital Psoriasis

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.

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