Tear replacement therapy for newly diagnosed glaucoma

GlaucomaNews ◽  
2020 ◽  
pp. 35-36
Author(s):  
L.S. Ramazanova ◽  
◽  
E.Y. Yazykova ◽  
O.A. Napylova ◽  
R.Z. Shamratov ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Newly Diagnosed

Цель. Оценка эффективности слезозаместительной терапии у пациентов с впервые выявленной первичной глаукомой. Материал и методы. В исследование было включено 20 пациентов с впервые выявленной ПОУГ I-II стадии, которым в качестве монотерапии были назначены простагландины или неселективные β-адреноблокаторы. Из них 12 мужчин и 8 женщин в возрасте от 60 до 70 лет. 30% пациентов имели сопутствующую глазную патологию (катаракта, хронические заболевания век и глазной поверхности), 50% – патологию системного характера (эндокринные заболевания, артериальная гипертензия, менопауза) с постоянной заместительной терапией, у 20% в анамнезе различного рода хирургические и лазерные операции глаз (ФЭК с ИОЛ, фокальная лазеркоагуляция сетчатки). После первичного обследования пациенты были разделены на 2 группы. Первой группе пациентов на ряду с гипотензивным препаратом был назначен лубрикант, восстанавливающий недостаток липидного и муцинового слоя по 1 капле 3 раза в день. Вторая группа пациентов не использовала слезозаменители. Результаты. Стандартное офтальмологическое обследование, позволило выявить синдром «сухого глаза» (ССГ) легкой степени. У 27% (5 чел.) ССГ был обусловлен хроническими заболеваниями придаточного аппарата глаза, дисфункцией мейбомиевых желез и у 73% (15 чел.) смешанного генеза (эндокринная патология, артериальная гипертензия , системный прием β-адреноблокаторов, гормональная заместительная терапия). Через 1 месяц на контрольном осмотре у всех пациентов 1-й группы, получавших слезозаменитель, уменьшились жалобы на чувство дискомфорта, жжения, затуманивания зрения в сравнении с группой, не получавшей слезозаменитель. Через 3 месяца субъективные жалобы у пациентов 1 группы практически отсутствовали, в то время как у пациентов 2-й группы отмечалось повышение степени выраженности жалоб. Выводы. Слезозаместительная терапия улучшает качество жизни пациентов, способствует приверженности лечению глаукомы, так как купирует жалобы и предотвращает осложнения, связанные с синдромом ССГ. Синдромом сухого глаза у пациентов с глаукомой индуцирован как входящими в состав гипотензивных капель консервантами, обладающими токсическим действием [4], так и наличием сопутствующей патологии глазного и системного характера. Ранее перенесенные хирургические операции переднего отрезка глаза предполагают нарушение стабильности слезной пленки.

scholarly journals Management of Severe Hyponatremia With a Custom Continuous Renal Replacement Therapy in an Infant With Newly Diagnosed Chronic Kidney Disease

2017 ◽  
Vol 2 (6) ◽  
pp. 1254-1258
Author(s):  
Marie-Michèle Gaudreault-Tremblay ◽  
Hassan Faqeehi ◽  
Valérie Langlois ◽  
Diane Hébert ◽  
Dimitri A. Parra ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Newly Diagnosed ◽  
Severe Hyponatremia

scholarly journals Cerebrospinal fluid neurofilament light chain levels in CLN2 disease patients treated with enzyme replacement therapy normalise after two years on treatment

F1000Research ◽  
2022 ◽  
Vol 10 ◽  
pp. 614
Author(s):  
Katharina Iwan ◽  
Nina Patel ◽  
Amanda Heslegrave ◽  
Mina Borisova ◽  
Laura Lee ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Light Chain ◽  
Post Treatment ◽  
Response To Therapy ◽  
Newly Diagnosed ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Enzyme Replacement

Classic late infantile neuronal ceroid lipofuscinosis (CLN2 disease) is caused by a deficiency of tripeptidyl-peptidase-1. In 2017, the first CLN2 enzyme replacement therapy (ERT) cerliponase alfa (Brineura) was approved by the FDA and EMA. The CLN2 disease clinical rating scale (CLN2 CRS) was developed to monitor loss of motor function, language and vision as well as frequency of generalised tonic clonic seizures. Using CLN2 CRS in an open label clinical trial it was shown that Brineura slowed down the progression of CLN2 symptoms. Neurofilament light chain (NfL) is a protein highly expressed in myelinated axons. An increase of cerebrospinal fluid (CSF) and blood NfL is found in a variety of neuroinflammatory, neurodegenerative, traumatic, and cerebrovascular diseases. We analysed CSF NfL in CLN2 patients treated with Brineura to establish whether it can be used as a possible biomarker of response to therapy. Newly diagnosed patients had CSF samples collected and analysed at first treatment dose and up to 12 weeks post-treatment to look at acute changes. Patients on a compassionate use programme who were already receiving ERT for approximately 1yr had CSF samples collected and NfL analysed over the following 1.3 years (2.3 years post-initiation of ERT) to look at long-term changes. All newly diagnosed patients we investigated with classical late infantile phenotype had high NfL levels >2000 pg/ml at start of treatment. No significant change was observed in NfL up to 12 weeks post-treatment. After one year of ERT, two out of six patients still had high NfL levels, but all patients showed a continued decrease, and all had low NfL levels after two years on ERT. NfL levels appear to correspond and predict improved clinical status of patients on ERT and could be useful as a biomarker to monitor neurodegeneration and verify disease modification in CLN2 patients on ERT.

scholarly journals Testosterone Replacement Therapy and the Risk of Prostate Cancer in Men With Late-Onset Hypogonadism

2019 ◽  
Vol 188 (9) ◽  
pp. 1666-1673 ◽  
Author(s):  
Christina Santella ◽  
Christel Renoux ◽  
Hui Yin ◽  
Oriana H Y Yu ◽  
Laurent Azoulay
Keyword(s):  
Prostate Cancer ◽  
Replacement Therapy ◽  
Late Onset ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Late Onset Hypogonadism ◽  
The Impact

Abstract The association between the use of testosterone replacement therapy (TRT) and prostate cancer remains uncertain. Thus, we investigated whether TRT is associated with an increased risk of prostate cancer in men with late-onset hypogonadism. We used the UK Clinical Practice Research Datalink to assemble a cohort of 12,779 men who were newly diagnosed with hypogonadism between January 1, 1995, and August 31, 2016, with follow-up until August 31, 2017. Exposure to TRT was treated as a time-varying variable and lagged by 1 year to account for cancer latency, with nonuse as the reference category. During 58,224 person-years of follow-up, a total of 215 patients were newly diagnosed with prostate cancer, generating an incidence rate of 3.7 per 1,000 person-years. In time-dependent Cox proportional hazards models, use of TRT was not associated with an overall increased risk of prostate cancer (hazard ratio = 0.97; 95% confidence interval: 0.71, 1.32) compared with nonuse. Results remained consistent in secondary and sensitivity analyses, as well as in a propensity score–matched cohort analysis that further assessed the impact of residual confounding. Overall, the use of TRT was not associated with an increased risk of prostate cancer in men with late-onset hypogonadism.

Hormone Replacement Therapy and Voice

2019 ◽  
Vol 4 (4) ◽  
pp. 607-614
Author(s):  
Jean Abitbol
Keyword(s):  
Replacement Therapy ◽  
Symptom Severity ◽  
Low Dose ◽  
Hormone Replacement ◽  
Clinical Signs ◽  
Female Voice ◽  
Fat Cells ◽  
High Pitch ◽  
Endocrine Effects ◽  
The Voice

The purpose of this article is to update the management of the treatment of the female voice at perimenopause and menopause. Voice and hormones—these are 2 words that clash, meet, and harmonize. If we are to solve this inquiry, we shall inevitably have to understand the hormones, their impact, and the scars of time. The endocrine effects on laryngeal structures are numerous: The actions of estrogens and progesterone produce modification of glandular secretions. Low dose of androgens are secreted principally by the adrenal cortex, but they are also secreted by the ovaries. Their effect may increase the low pitch and decease the high pitch of the voice at menopause due to important diminution of estrogens and the privation of progesterone. The menopausal voice syndrome presents clinical signs, which we will describe. I consider menopausal patients to fit into 2 broad types: the “Modigliani” types, rather thin and slender with little adipose tissue, and the “Rubens” types, with a rounded figure with more fat cells. Androgen derivatives are transformed to estrogens in fat cells. Hormonal replacement therapy should be carefully considered in the context of premenopausal symptom severity as alternative medicine. Hippocrates: “Your diet is your first medicine.”

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