scholarly journals Effectiveness of UVB-therapy with 311 nm wave-length and tacrolimus in treatment of psoriasis in children

2019 ◽  
Vol 2 (26) ◽  
pp. 22-25
Author(s):  
S. N. Turovskaya ◽  
E. V. Matushevskaya
Keyword(s):  
Adverse Reactions ◽  
Pediatric Patients ◽  
Wave Length ◽  
Severe Psoriasis ◽  
Therapeutic Interventions ◽  
Number Of Patients ◽  
High Incidence ◽  
Traditional Drug ◽  
Uvb Phototherapy

Relevance. Of particular relevance in recent years has become the problem of psoriasis in children, it is noted an increase in cases of severe psoriasis refractory to traditional drug therapy, which together with a high incidence raises the questions of optimization of therapeutic interventions in this category of patients in the category of social.The purpose of the study. To study the efficacy and safety of UVB-phototherapy 311 nm, tacrolimus from pediatric patients with psoriasis.Material and methods. Under supervision there were 26 patients from 5 to 16 years old. All patients received UVB 311 nm phototherapy. The effectiveness evaluated in accordance with the dynamics of the indexes PASI, BSA, Quality of Life.Results. As a result of the course of UVB-therapy with 311 nm wave-length the number of patients with PASI 100 was 69 %, PASI 90 was 23 %, PASI 75 was 8 %. Index BSA were thus reduced to 81.5 %, DIKE improved by 65.3 %. The tolerance to UVB 311 nm was evaluated as very good. Adverse reactions such as transient erythema was observed in 11.5 % of patients, xerosis in 19.2 %.Conclusion. UVB 311 nm phototherapy is a highly effective and safe method of therapy of medium-severe psoriasis in children.

Analysis of oral complications related to cancer therapy

2013 ◽  
Vol 9 (2) ◽  
Author(s):  
Antonio Eugenio Magnabosco Neto ◽  
Fernando Henrique Westphalen
Keyword(s):  
Oral Cavity ◽  
Cancer Treatment ◽  
Medical Records ◽  
Adverse Reactions ◽  
The Body ◽  
Cancer Therapies ◽  
Oral Complications ◽  
Dose Limitation ◽  
Number Of Patients

Introduction: The side effects and adverse reactions related to cancer therapies may cause significant alterations in the oral cavity, discomfort or even severe pain in parts of the body, patient’s nutritional deficiency, delay in the administration of oncologic drugs or dose limitation, an increase of hospitalization time and of the related expenses, as well as a decrease in the patient’s quality of life. Objective: The purpose of this study was to determine the deleterious effects of cancer therapies in the oral cavity. Material and methods: Data was gathered from medical records of the treatment of 643 cancer patients at the São José Hospital, in Joinville, state of Santa Catarina, from January to September 2012. Among the records selected for this study, 59.41% were female patients, with a mean age of 51 to 60 years. Results: Oral complications were reported in 72.47% of the patients, and the complication with the highest prevalence was mucositis (14.62%) followed by dry mouth (10.58%). Most of the patients had not received dental care prior to the cancer treatment, and no dental record was found. Conclusions: Several different oral disorders were reported as a result of cancer treatment, and a significant number of patients needed dental evaluation prior to the treatment.

Levetiracetam (Keppra) efficacy and safety in the prevention of early-onset seizures following traumatic brain injuries in pediatric patients

2015 ◽  
Vol 5 (4) ◽  
pp. 144-148
Author(s):  
Young Shin ◽  
Sandra Benavides ◽  
Joanie Wurster ◽  
Neil Patel
Keyword(s):  
Early Onset ◽  
Adverse Reactions ◽  
Brain Injuries ◽  
Pediatric Patients ◽  
Emergency Department Visits ◽  
Efficacy And Safety ◽  
Onset Seizure ◽  
Number Of Children ◽  
Seizure Prophylaxis ◽  
Number Of Patients

Abstract Introduction Approximately half a million emergency department visits for traumatic brain injury (TBI) by children and adolescents occur each year. One of the complications of TBI is early-onset seizure. Current guidelines recommend the use of phenytoin for prevention of seizures following a TBI; however, several drug interactions and adverse reactions are associated with its use. Despite studies demonstrating efficacy of levetiracetam in adult patients, the efficacy and safety of levetiracetam in children with TBI is unknown. The purpose of this study was to determine the efficacy and safety of levetiracetam for the prevention of early-onset seizures in pediatric patients following TBI. Methods A retrospective evaluation was conducted, which included children, ages 0 to 17 years, admitted secondary to a nonpenetrating TBI and who received levetiracetam for seizure prophylaxis for up to 7 days. The primary outcome was the number of children who had a seizure within the first 7 days following a TBI, and secondary outcomes included the number of adverse drug reactions. Results A total of 89 pediatrics patients with nonpenetrating TBI were identified and included in the study. Forty-seven patients received a mean dose of 10 mg/kg (SD ± 4.22) of levetiracetam twice a day, and 42 patients received 500 mg 2 times per day (based on adult dosing). Seizure activity was observed in only two patients (2.2%) within the first 7 days following TBI. A total of 13 patients (14.6%) experienced anemia, agitation, and elevation of liver enzymes during levetiracetam therapy. Discussion The study suggests that levetiracetam appears to be an effective and safe agent for early-onset seizure prophylaxis in pediatric patients with TBI as indicated by the low number of patients with seizures. The reported adverse reactions may have resulted from the trauma rather than the use of levetiracetam.

scholarly journals ANALISIS PENGGUNAAN ANTIBIOTIK PADA PASIEN ANAK DI RUANG THERESIA RUMAH SAKIT ST. ELISABETH SEMARANG DENGAN METODE ATC/DDD

2021 ◽  
Vol 3 (1) ◽  
pp. 26-34
Author(s):  
Fef Rukminingsih ◽  
Apriliyani Apriliyani
Keyword(s):  
Infectious Diseases ◽  
Pediatric Patients ◽  
Anatomical Therapeutic Chemical ◽  
Antibiotic Use ◽  
Defined Daily Dose ◽  
Inappropriate Use ◽  
Number Of Patients ◽  
High Incidence ◽  
Daily Dose ◽  
Record Data

The high incidence of infectious diseases causes the use of antibiotics to increase. Inappropriate use of antibiotics will lead to resistance. Infectious diseases are included in the top 10 diseases in pediatric patients at St. Elisabeth Hospital.Semarang. This study aims to evaluate the use of antibiotics in pediatric patients in the Theresia ward of St. Elisabeth Hospital Semarang. This research is a descriptive observational study using retrospective data. Data were taken from medical records of pediatric patients in the Theresia ward at St. Elisabeth Hospital Semarang, aged 6 months - 14 years, the use of antibiotic therapy during the period October - December 2019. The data obtained were analyzed by calculating the quantity of antibiotic use using the Anatomical Therapeutic Chemical (ATC) and Defined Daily Dose (DDD)) / 100 patient-days methods. Based on the results of tracing medical record data, it was found that the number of pediatric patients in the Theresia room at St. Elisabeth Semarang for the period October - December 2019 is 385. The number of patients who received a single antibiotic was 162. The total value of DDD / 100 patient-days in the Theresia ward of St. Elisabeth Hospital Semarang for the period October - December 2019 is 18.17 with a total length of stay of 1117 days. The antibiotic with the highest DDD / 100 patient-days was ceftriaxone, namely 15.10. While the antibiotics that enter the DU 90% segment are ceftriaxone and cefotaxime.

scholarly journals Treatment strategy in patients with noninsulin-dependent diabetes mellitus: Analysis of current approaches, basic problems, and approaches to solution thereof

1994 ◽  
Vol 40 (4) ◽  
pp. 8-10
Author(s):  
M. B. Antsiferov ◽  
Ye. V. Surkova ◽  
A. Yu. Mayorov
Keyword(s):  
Diabetes Mellitus ◽  
Health Centers ◽  
Dependent Diabetes Mellitus ◽  
First Year ◽  
Practical Training ◽  
District Health ◽  
Number Of Patients ◽  
High Incidence ◽  
Poor Efficacy

The shortcomings of current approaches to therapy of patients with noninsulin-dependent diabetes mellitus are discussed. A tendency to early prescription of oral sugar-reducing drugs which are prescribed to 71 % of patients during the first year of the disease was noted, as well as underevaluation of nondrug therapy. Poor efficacy of therapeutic and prophylactic care of patients with this condition is demonstrated as exemplified by quite a number of district health centers of Moscow, resulting in inadequate level of compensation, a high incidence of diabetes complications, and increase in the number of patients administered insulin therapy. The authors emphasize the importance of introducing practical training of patients as a means to improve the quality of specialized diabetological care.

scholarly journals High incidence of stroke and mortality in pediatric critical care patients with COVID-19 in Peru

2020 ◽  
Author(s):  
Alvaro Coronado Munoz ◽  
Jaime Tasayco ◽  
Willy Morales ◽  
Luis Moreno ◽  
David Zorrilla ◽  
...  
Keyword(s):  
Critical Care ◽  
Pediatric Patients ◽  
Pediatric Critical Care ◽  
Exact Test ◽  
Cerebrovascular Events ◽  
Number Of Patients ◽  
High Incidence ◽  
Neurological Presentation ◽  
Pediatric Providers ◽  
Critical Care Patients

Abstract Introduction: Pediatric critical care patients with COVID-19 treated in Peru have higher mortality than those previously reported from other countries. Pediatric providers have reported a high number of patients without comorbidities presenting with hemorrhagic strokes associated with COVID-19. We present a study analyzing the factors associated with mortality in this setting.Methods: Prospective case-control study that included patients < 17 years old admitted to a pediatric critical care unit with a positive test confirming COVID-19. The primary outcome was mortality, and secondary outcomes were laboratory results and length of stay. Fisher’s exact test and the Mann-Whitney U test were used for the analysis.Results: Forty-seven patients were admitted to critical care. The mortality of our study is 21.3%. The mortality of patients with neurological presentation was 45.5%, which was significantly higher than the mortality of acute COVID-19 (26.7%) and MIS-C (4.8%), p 0.18. Other risk factors for mortality in our cohort were strokes and comorbidities. Only one patient presenting with hemorrhagic stroke had an undiagnosed comorbidity.Conclusion: Cerebrovascular events associated with COVID-19 in pediatric patients, including infants, must be recognized as one of the more severe presentations of this infection in pediatric patients.

scholarly journals Continuous subcutaneous infusion of somatostatin analogues in the treatment of congenital hyperinsulinism

2020 ◽  
Vol 66 (3) ◽  
pp. 81-87
Author(s):  
Maria A. Melikyan ◽  
Diliara N. Gubaeva ◽  
Maria A. Kareva
Keyword(s):  
Quality Of Life ◽  
Pediatric Patients ◽  
Research Centre ◽  
Infusion Therapy ◽  
Congenital Hyperinsulinism ◽  
Intravenous Glucose ◽  
Subcutaneous Infusion ◽  
Number Of Patients ◽  
Continuous Subcutaneous Infusion

BACKGROUND: Congenital hyperinsulinism (CHI) is a severe disease with a high risk of development of neurological complications due to persistent hypoglycemia. The use of an analog of somatostatin (octreotide) in patients with the resistance to the first-line drug allows to avoid surgical intervention. However, the octreotide is currently used in the form of frequent fractional injections due to the short duration of its effect. We present in this article our own experience of using octreotide in continuous subcutaneous infusion in pediatric patients in order to improve the quality of life. AIM To evaluate the efficiency and safety of the regime of continuous subcutaneous infusion of octreotide with the use of micro-dispensers (pumps) in children with diazoxide-resistant course of CHI. MATERIALS AND METHODS: An observational single-centre dynamic research was carried out on the basis of the Federal State Budgetary Institution Endocrinology Research Centre of the Ministry of Health of the Russian Federation. The study included pediatric patients with CHI and proven diazoxide-resistant course who were initially treated with octreotide in the form of intermittent subcutaneous injections. The researches compared the indicants of efficiency and safety of therapy on treatment of intermittent injections and after transfer to continuous subcutaneous infusion of the drug. The duration of each method of administration was at least 2 weeks. RESULTS: 16 patients took part in the research. The median for the total duration of octreotide usage in the examined patients was 3 months. According to the results of the work, the use of micro-dispensers for continuous subcutaneous administration of octreotide allowed to reduce the number of patients with episodes of hypoglycemia for more than 4 times (13/16 vs. 3/16); p=0,001). Also, there was a significant decrease in the number of patients with hyperglycemic episodes (4/16 vs. 0/16); p=0.000) and reduced dose of intravenous glucose (6.8 vs 5.2 mg/kg/min; p=0.042) as a result of continuous therapy, which indicates the advantages of smooth continuous administration comparing to single injections. We have not detected any significant side effects of the treatment. Elevated liver enzyme levels, dyspeptic symptoms and gallstone formation in some patients did not require cancellation of therapy. There were no hormonal disorders in the form of hypothyroidism and somatotropic hormone deficiency against the background of continuous octreotide infusion. CONCLUSIONS: Thus, the use of octreotide in patients with diazoxide-resistant course of СHI in continuous subcutaneous infusion using pumps has a number of advantages over the standard method of intermittent subcutaneous injection. This method of administration allows to achieve better glycemic control and reduce the risks from infusion therapy with highly concentrated glucose solutions, which undoubtedly improves the quality of life of patients.

Prevalence of Inhibitors in a Population of 3435 Hemophilia Patients in France

1992 ◽  
Vol 67 (06) ◽  
pp. 600-602 ◽  
Author(s):  
Y Sultan ◽  
Keyword(s):  
Hemophilia A ◽  
Hemophilia B ◽  
Study Group ◽  
Cooperative Study ◽  
Population Prevalence ◽  
French Study ◽  
Number Of Patients ◽  
High Incidence ◽  
Recombinant Fviii ◽  
High Responders

SummaryA cooperative study between the 37 centers of the French Hemophilia Study Group was undertaken to establish the prevalence of inhibitor patients in the French hemophilia population. The prevalence reported in the literature varies widely from 3.6% to 17.5%. Some of the studies are dealing with a small number of patients and inhibitor patients are reported either to the total number of hemophiliacs or to the severely affected ones. The French study provided information concerning 3,435 hemophiliacs and showed a prevalence of 6.2% for the overall population. Prevalence of inhibitors was found to be 7% in the population of hemophilia A patients and 12.8% in the population of severely affected ones. The prevalence of inhibitors in the population of hemophilia B patients was 2% and 4% in the population of severely affected hemophilia B patients. The cooperative study also showed that 47.5% of inhibitors are detected before 10 years of age and that 82% of inhibitor patients are high responders. Analysis of inhibitor detection in patients under the age often showed that there was a peak in the population of 2 years old children. Although not comparable to the present study the high incidence of inhibitors with ultrapurified and recombinant FVIII reported in previously untransfused patient may be borne in mind.

Malignant Gastrointestinal Obstruction: Options for Decompression and Nutrition

2020 ◽  
Vol 04 (03) ◽  
pp. 311-322
Author(s):  
Robert J. Litwin ◽  
Johanna L. Chan ◽  
Steven Y. Huang
Keyword(s):  
Clinical Presentation ◽  
Practice Patterns ◽  
Patient Care Team ◽  
Therapeutic Interventions ◽  
Collaborative Approach ◽  
Malignant Bowel Obstruction ◽  
Advanced Malignancy ◽  
Gastrointestinal Obstruction ◽  
Malignant Gastrointestinal Obstruction

AbstractMalignant bowel obstruction (MBO) is a relatively common condition affecting patients with advanced malignancy. Therapeutic interventions should be aimed at maintaining quality of life. Given the lack of prospective controlled studies in this patient population, patient management is often based on local practice patterns and anecdotal experience. To foster a collaborative approach among the members of the patient care team involving internal medicine, oncology, palliative care, clinical nutrition, surgery, gastroenterology, and interventional radiology physicians, it is important to improve our understanding of MBO. The purpose of this article is to describe the clinical presentation, pathophysiology, as well as medical, surgical, and nonsurgical palliative options available to patients with MBO for purposes of decompression and nutrition.

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

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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