Alternative Management Of Cushing's Syndrome During Covid-19 Pandemic

Coronaviruses ◽  
2021 ◽  
Vol 02 ◽  
Author(s):  
Serghei Covantev ◽  
Stanislav I. Volkov ◽  
Kristina I. Samsonova
Keyword(s):  
Cushing’S Syndrome ◽  
Prolonged Exposure ◽  
Cushing's Syndrome ◽  
Current Treatment ◽  
Endovascular Embolization ◽  
Risk Of Infection ◽  
First Line ◽  
First Line Therapy ◽  
Current Review ◽  
Line Therapy

: Cushing's syndrome results from prolonged exposure to glucocorticoids. Surgery is often the first-line treatment for this condition, regardless of etiology. However, COVID-19 pandemic caused a decrease in surgical procedures due to the risk of infection transmission. There are still emergency cases of Cushing’s syndrome that are admitted to the hospital and require urgent management. The current treatment should be focused at medical management and endovascular embolization in selective cases. Embolization can be performed in facilities where there is trained personal with experience in adrenal embolization. Surgery, which traditionally is a first-line therapy can increase the risk of infection and, therefore should be avoided. The current review provides a brief description of the possible options for management of adrenal Cushing’s syndrome during COVID-19 pandemic.

scholarly journals Treatment of post-menopausal acne with tretinoin lotion 0.05% delivers rapid results and concomitant benefits

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092979
Author(s):  
Archana M Sangha
Keyword(s):  
Prolonged Exposure ◽  
First Line ◽  
Topical Tretinoin ◽  
Sustained Improvement ◽  
Actinic Keratoses ◽  
First Line Therapy ◽  
Line Therapy ◽  
Topical Retinoids ◽  
Photodamaged Skin ◽  
Post Menopausal

We describe a case of comedonal acne in a post-menopausal female treated with a novel tretinoin lotion 0.05%. The patient also had some actinic keratoses, which are hyperkeratotic, scaly lesions caused by prolonged exposure to ultraviolet radiation. These lesions have the ability to progress into squamous cell carcinoma. Actinic keratoses can occur in patients as young as 20 years, but are more common in patients aged 50 years and older. Topical retinoids are recommended as monotherapy in comedonal acne but despite their documented clinical efficacy are underutilized due to concerns about cutaneous tolerability. Topical tretinoin is currently not recommended as first-line therapy in the treatment of actinic keratosis as its efficacy is not comparable to that of other modalities. In this patient, a novel tretinoin lotion 0.05% resulted in rapid in and sustained improvement of acne. The investigator also observed improvement in actinic keratoses and photodamage. If these results can be confirmed in a larger patient population this may be an attractive area of investigation for the treatment of patients with adult acne and photodamaged skin.

Toenail Onychomycosis—A Canadian Approach With a New Transungual Treatment

2015 ◽  
Vol 19 (5) ◽  
pp. 440-449 ◽  
Author(s):  
Aditya K. Gupta ◽  
R. Gary Sibbald ◽  
Anneke Andriessen ◽  
Richard Belley ◽  
Alan Boroditsky ◽  
...  
Keyword(s):  
Treatment Strategy ◽  
Expert Panel ◽  
Healthcare Providers ◽  
Nail Plate ◽  
Current Treatment ◽  
Review Of The Literature ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Treatment Paradigm

Background: Onychomycosis is a difficult-to-treat infection whose current treatment paradigm relies primarily on oral antifungals. The emergence of new topical drugs broadens the therapeutic options and prompts a re-evaluation of the current Canadian treatment strategy. Objective: To define a patient-centred Canadian treatment strategy for onychomycosis. Methods: An expert panel of doctors who treat onychomycosis was convened. A systematic review of the literature on treatments for onychomycosis was conducted. Based on the results, a survey was designed to determine a consensus treatment system. Results: First-line therapy should be selected based on nail plate involvement, with terbinafine for severe onychomycosis (>60% involvement), terbinafine or efinaconazole for moderate onychomycosis (20%-60% involvement), and efinaconazole for mild onychomycosis (<20% involvement). Comorbidities, patient preference and adherence, or nail thickness may result in the use of alternative oral or topical antifungals. Conclusion: These guidelines allow healthcare providers and patients to make informed choices about preventing and treating onychomycosis.

scholarly journals Efficacy of Anlotinib for the Treatment of Angiosarcoma of the Face and Neck: A Case Report

2021 ◽  
Vol 11 ◽  
Author(s):  
Biyong Ren ◽  
Wei Wang ◽  
Jing Tan ◽  
Bo Yuan ◽  
Guilan Chen ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Current Treatment ◽  
First Line ◽  
Free Survival ◽  
New Approach ◽  
First Line Therapy ◽  
Line Therapy ◽  
The Face ◽  
Degree Of Malignancy ◽  
High Degree

Angiosarcoma of the face and neck is a rare soft tissue sarcoma with a high degree of malignancy. The current treatment methods mainly rely on a combination of surgery and radiotherapy and/or chemotherapy. However, the options for drug treatment are very limited and surgery can be difficult to carry out due to the location of the tumor, so the efficacy of first-line drugs needs to be constantly explored. A case of angiosarcoma of the head and face diagnosed by biopsy is reported here. The patient received an oral anlotinib hydrochloride capsule once a day (12 mg on days 1 - 14/1 week off for a 21-day cycle) due to the difficulty of surgery. Until now (April, 2020), after 10 months of treatment, the patient’s scalp and facial lesions have gradually reduced and the partial response and progression-free survival of this patient were good, with moderate or tolerable adverse events. This approach provides a new approach for the clinical treatment of malignant angiosarcoma of the face and neck with anlotinib as first-line therapy.

1904: Outcomes of Large Renal Calculi (>2-Cm) Treated with ESWL as First Line Therapy

2004 ◽  
Vol 171 (4S) ◽  
pp. 503-503
Author(s):  
Richard Vanlangendock ◽  
Ramakrishna Venkatesh ◽  
Jamil Rehman ◽  
Chandra P. Sundaram ◽  
Jaime Landman
Keyword(s):  
Renal Calculi ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Is digoxin still justifiable as single first-line therapy in fetal SVT associated with fetal hydrops?

2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
DJ Kersten ◽  
J McDougall ◽  
C Schuller ◽  
JP Pfammatter ◽  
L Raio ◽  
...  
Keyword(s):  
First Line ◽  
Fetal Hydrops ◽  
First Line Therapy ◽  
Line Therapy

EFFICACY OF MODIFIED BISMUTH QUADRUPLE THERAPY (RBMA) AS FIRST-LINE THERAPY FOR ERADICATION OF HELICOBACTER PYLORI IN PATIENTS WITH CHRONIC GASTRITIS

2019 ◽  
pp. 28-32
Author(s):  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
High Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Quadruple Therapy ◽  
First Line Therapy ◽  
Line Therapy

Background and aims: Efficacy with substitution of tetracycline with amoxicillin, an antibiotics having a very low resistance rate and a high tolerability, in bismuth quadruple therapy (BQT) have not been studied in Vietnam. Our study aimed to evaluate the efficacy and tolerability of modified BQT vs. standard BQT for first-line Helicobacter pylori eradication. Patients and methods: This is a randomized, prospective study. 120 patients with H.pylori positive-chronic gastritis were randomly divided into two groups. The RBMA group containing rabeprazole 20 mg, bismuth subsalicylic 524mg, metronidazole 500mg, amoxicillin 1000mg, all 2 times a day, for 14 days. The RBMT group received rabeprazole, bismuth subsalicylic, metronidazole and tetracycline. Evaluation for compliance and drug-related side effects were evaluated at the end of two weeks. 4-6 weeks after the end of treatment, the H.pylori eradication rate was determined by the C13urease breath test. Results: Eradication rate was not statistically significative different between the RBMA and the RBMT: 91.2%; 95% confidence interval, 78.2% - 96.7%) vs. 90%; 95% CI, 81.6% - 96.3%) by per-protocol analysis (p = 0.42) and 86.7% (95%CI, 75.84% - 93.09%) vs. 75% (95%CI, 62.1% - 85.3%) by intention-to-treat analysis (ITT, p = 0.06). Adverse effects were significant higher in the RBMT group than in the RBMA group (48.3% vs. 26.7%; p = 0.071) and rate of good compliance was significantly higher in RBMA group than in RBMT group (p < 0.05). Conclusion: The modified BQT including rabeprazole, bismuth, metronidazole and amoxicillin achieved a fairly high rate of H.pylori infection eradication with a higher compliance and lower rate of adverse effects compared to the BQT in patients with chronic gastritis. Further studies need to conduct to confirm this new regimens as a first-line therapy in our country. Key words: Modified bismuth quadruple therapy, BQT, Helicobacter pylori eradication

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