scholarly journals Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

2018 ◽  
Vol 90 (2) ◽  
pp. 127 ◽  
Author(s):  
Pietro Ferrara ◽  
Ester Del Vescovo ◽  
Francesca Ianniello ◽  
Giulia Franceschini ◽  
Luciana Romaniello ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Nocturnal Enuresis ◽  
Bladder Function ◽  
Efficacy And Safety ◽  
Nocturnal Polyuria ◽  
First Line ◽  
Normal Bladder ◽  
Increased Risk ◽  
The Right ◽  
Line Drug

Background: The first-line drug therapy for patients with nocturnal enuresis (NE) associated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP). Objective: To evaluate if increasing dose of oral desmopressin lyophilisate (MELT) can improve response rates to dDAVP and is useful in enuretic children. Materials and methods: We enrolled a total of 260 children all diagnosed with NE. Enuretic children were treated with increasing MELT at a dose of 120, 180 and 240 mcg a day.Results. We included in our study a total of 237 children, 164 males (69.2%) and 73 females (30.8%) aged between 5 and 18 years (mean age 10.32 ± 2.52 years). Of the 237 patients enrolled in the study and treated with MELT 120 mcg, a full response was achieved in 135 (56.9%). A partial response was achieved in 21 (8.9%) patients, therefore the dose was increased up to 180 mcg, with further improving symptoms (14.3%) or full response (9.5%), and up to 240 mcg, without usefulness. Conclusions: MELT at the dose of 120 mcg resulted efficacy and safety; the increased dose up to 180 mcg resulted poorly efficacy; finally, the further increase up to 240 mcg did not improve the symptoms with the increased risk of side effects.

An overview of some drugs: Lopinavir, Ritonavir, Chloroquine, Hydroxy chloroquine and Interferon as a effective treatment against COVID-19

2020 ◽  
Vol 10 (1) ◽  
pp. 20-24
Author(s):  
Sujaritha J ◽  
Deepa sankar N ◽  
Mathivathani K ◽  
Aravindh G ◽  
Gnanasekaran G
Keyword(s):  
Rheumatoid Arthritis ◽  
Plasmodium Falciparum ◽  
Drug Therapy ◽  
Hiv Infection ◽  
Effective Treatment ◽  
Protease Inhibitors ◽  
First Line ◽  
Duration Of Illness ◽  
Line Drug

Lopinavir, Ritonovir and Interferon (IFN) are anti-viral drugs mainly used in the treatment of HIV infection by protease inhibitors. Chloroquine and Hydroxychloroquine are used in the treatment of malarial causing infection such as Plasmodium falciparum and also auto immune condition such as rheumatoid arthritis. Chloroquine makes toxic for the parasite to digest its host hemoglobin and disrupting the virus ability to enter the cell. The anti-viral and anti-malarial drugs are used in the first line drug therapy for the treatment of COVID-19. The aim of this therapy is to minimize the symptoms and shortens the duration of illness.

Clinical Outcomes of Three or More Courses of First-line Chemotherapy for Metastatic Urothelial Carcinoma

2021 ◽  
Vol 1 (5) ◽  
pp. 459-461
Author(s):  
SHOHEI KAWAGUCHI ◽  
KOUJI IZUMI ◽  
RENATO NAITO ◽  
SUGURU KADOMOTO ◽  
HIROAKI IWAMOTO ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Urothelial Carcinoma ◽  
Focal Therapy ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Metastatic Urothelial Carcinoma ◽  
Line Drug ◽  
Line Chemotherapy ◽  
First Line Treatment

Background/Aim: The current standard of care for first-line treatment of locally advanced or metastatic urothelial carcinoma (UC) is platinum-based combination chemotherapy. Recently, immune checkpoint inhibitors have been reported to be effective for UC. Knowing whether immunotherapy or chemotherapy is suitable as first-line treatment is beneficial for patients. A retrospective study was conducted on the clinical outcomes of Japanese patients who received three or more courses of first-line chemotherapy for metastatic UC to assess the outcome of conventional treatments in real clinical situation. Patients and Methods: Patients who received first-line chemotherapy between August 2009 and December 2019 were included. Progression-free survival (PFS) and overall survival (OS) were assessed. Results: The median PFS and OS were 7.1 and 27.1 months, respectively, for patients with no disease progression at the end of three courses. Of 28 patients, 25 (89.3%) received second-line drug therapy and 10 (35.7%) received focal therapy for disease control. Patients with focal therapy had significantly longer OS than those without focal therapy (p=0.019, log-rank test). Conclusion: OS of metastatic UC at our Institution is relatively long, suggesting that aggressive second-line drug therapy and focal therapy may have contributed to such result.

scholarly journals Lymphocutaneous Sporotrichosis Refractory to First-Line Treatment

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Walter Belda ◽  
Luiz Felipe Domingues Passero ◽  
Ana Thereza Stradioto Casolato
Keyword(s):  
Amphotericin B ◽  
Potassium Iodide ◽  
Traumatic Injury ◽  
Complete Recovery ◽  
Skin Lesions ◽  
First Line ◽  
Amphotericin B Deoxycholate ◽  
The Right ◽  
Line Drug ◽  
Control Skin

Sporotrichosis is a fungal infection endemic in Latin America and has been attributed to the thermodimorphic fungus of the genus Sporothrix. Transmission to humans occurs during a traumatic injury with soil or organic material; additionally, lesions caused by infected cats play an important role in the epidemiology of the disease. The classic treatment of sporotrichosis is performed with itraconazole or potassium iodide; second-line medications, such as amphotericin B and terbinafine, can alternatively be used in cases of first-line drug failure. In the present study, a patient with lymphocutaneous sporotrichosis in the right upper limb exhibited intolerance to itraconazole and potassium iodide, additionally during the period of use; these drugs did not control skin lesions. In this patient, amphotericin B deoxycholate and its liposomal version were used in this patient; and complete recovery of the lesions was observed.

Intradural inclusion cysts following in utero closure of myelomeningocele: clinical implications and follow-up findings

2008 ◽  
Vol 2 (6) ◽  
pp. 406-413 ◽  
Author(s):  
Enrico Danzer ◽  
N. Scott Adzick ◽  
Natalie E. Rintoul ◽  
Deborah M. Zarnow ◽  
Erin S. Schwartz ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tethered Cord ◽  
Bladder Function ◽  
Clinical Implications ◽  
Clean Intermittent Catheterization ◽  
Lower Extremity Function ◽  
Normal Bladder ◽  
Increased Risk ◽  
Clinical Consequences

Object The goal in this study was to evaluate the incidence and clinical implications of the development of cutaneously derived intradural inclusion cysts (ICs) following fetal myelomeningocele (fMMC) closure. Methods Retrospective databases and responses to a parental questionnaire were reviewed to determine the incidence, clinical presentation, and outcomes of fMMCs in children in whom ICs developed at follow-up. Results Prior to the National Institutes of Health (NIH)-sponsored Management of Myelomeningocele Study (MOMS), 54 patients underwent fMMC closure at the authors' institution. Sixteen (30%) presented with symptomatic tethered cord syndrome (TCS) at a median age of 27 months (range 4–93 months). Ten (63%) of the 16 (19% of the total) developed TCS in association with an intradural IC. In 9 (90%) of 10 patients, the IC was seen on preoperative MR imaging, and in 1 it was found during surgery. Four additional children (7% of the total) with evidence of an IC on surveillance MR imaging are currently asymptomatic at 94, 84, 60, and 60 months of age, respectively. All but 1 (an L-3 level lesion) IC developed in infants with L-4 and L-5 defects. After cyst removal, 6 children are asymptomatic at a median follow-up of 36 months (range 12–63 months). Following IC removal, 4 children lost normal bladder function and now require clean intermittent catheterization, and 1 lost normal leg function and now requires a walking aid for ambulation. Histologically, 8 lesions were dermoid, 1 was an epidermoid, and 1 was a mixed dermoid-epidermoid IC. Three patients developed another IC and required its removal at 24, 39, and 51 months, respectively. One required another tethered cord release within 57 months after IC removal. Conclusions Cutaneously derived intradural ICs can develop following fMMC surgery. Deterioration of bladder function, risk of recurrence, and loss of lower-extremity function appear to be the most important long-term complications of IC in children with fMMCs. The ongoing NIH-sponsored MOMS may help determine whether children with fMMC are at increased risk of IC development compared with children treated with postnatal MMC closure. Parents seeking fMMC closure should be informed about the possibility of IC formation and the potential clinical consequences.

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