scholarly journals Delayed immune mediated adverse effects to hyaluronic acid fillers: report of five cases and review of the literature

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Ora Bitterman-Deutsch ◽  
Leonid Kogan ◽  
Faris Nasser
Keyword(s):  
Hyaluronic Acid ◽  
Adverse Effects ◽  
Treatment Options ◽  
General Medicine ◽  
Treatment Modalities ◽  
Medical Specialties ◽  
Immune Mediated ◽  
Wide Range ◽  
Delayed Reactions ◽  
The Individual

Hyaluronic acid (HA) fillers in cosmetic medicine have been considered relatively safe, though fillers used in European countries and throughout the world are not necessarily approved by the Food and Drug Administration. As their use continues to expand worldwide, physicians in a wide range of medical specialties are authorized to perform HA injections, including general medicine practitioners and even dentists. An increasing number of reports have appeared regarding side effects to these products. It is now known that reactions to Hyaluronic acid are related not only to technical faults of the injections, but also to immune responses, including delayed hypersensitivity and granulomatous reactions. Herein, we describe five cases treated by a variety of treatment modalities, all with delayed reactions to different brands of hyaluronic acid fillers. As there is currently no standardization of treatment options of adverse effects, these cases accentuate the debate regarding the approach to the individual patient and the possible need for pre-testing in patients with an atopic tendency.

scholarly journals History of the Development of the Treatment of Keratoconus

2013 ◽  
Vol 2 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Ramez Barbara ◽  
Lamis Abdelaziz
Keyword(s):  
Visual Acuity ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Gradual Decline ◽  
Conical Shape ◽  
Wide Range ◽  
History Of ◽  
Corneal Thinning

ABSTRACT Keratoconus (from Greek meaning horn-shaped cornea) is a degenerative, ectatic disease of the cornea, causing corneal thinning and remodelling into a more conical shape.1 Symptoms include blurring of vision, and a gradual decline in visual acuity.1 It is usually bilateral, but can affect each eye at different severities.1 There are various treatment modalities, both surgical and nonsurgical, both simple and more invasive. Here, we review the history of the development and advances of the wide range of treatment options, since it was first recognized in 1748 up until now. How to cite this article Abdelaziz L, Barbara R. History of the Development of the Treatment of Keratoconus. Int J Kerat Ect Cor Dis 2013;2(1):31-33.

Treatment of cancer

2018 ◽  
Author(s):  
David Cutter ◽  
Martin Scott-Brown
Keyword(s):  
Management Strategies ◽  
Colon Adenocarcinoma ◽  
Management Plan ◽  
Treatment Modalities ◽  
Management Approach ◽  
Best Management ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Specialist Nurses ◽  
The Individual

The variety of conditions that are considered to be ‘cancer’ is extremely wide, with marked variation in the management approach from disease to disease. A common feature in the management of malignant conditions, however, is the involvement of a wide range of medical professionals at different stages of the patient pathway. This commonly includes physicians, surgeons, radiologists, pathologists, medical oncologists, radiation oncologists, and specialist nurses, as well as a plethora of other allied disciplines. As such, a practice that has been widely adopted is to work as a multidisciplinary team (MDT), with regular meetings to decide the appropriate treatment for each patient with a cancer diagnosis, on an individual and case-by-case basis. The main treatment modalities for the treatment of cancer are surgery, radiotherapy, and chemotherapy. While these are often combined to form a multimodality therapy, they are all, in isolation, potentially radical (curative) therapies for certain conditions. For example, surgery (in the case of a Stage I colon adenocarcinoma), radiotherapy (in the case of early laryngeal squamous cell carcinoma), and chemotherapy (in the case of acute lymphoblastic leukaemia) are all curative as single-modality treatments. It is commonly the case, however, for a patient to require more than one mode of therapy to achieve the best outcome, for example a combination of surgery, chemotherapy, and radiotherapy for early breast cancer. It can also be the case that two or more different management strategies are thought to give equivalent oncological results, for example surgery or radiotherapy for early prostate cancer. In this situation, the MDT and the patient need to decide on the ‘best’ management plan for the individual, based on their personal and professional opinions and on the differing toxicity profiles of the alternate treatments.

scholarly journals Alcohol-Induced Neuropathy in Chronic Alcoholism: Causes, Pathophysiology, Diagnosis, and Treatment Options

2020 ◽  
Vol 8 (4) ◽  
pp. 87-97
Author(s):  
Iga Dudek ◽  
Danuta Hajduga ◽  
Cezary Sieńko ◽  
Amr Maani ◽  
Elżbieta Sitarz ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Peripheral Neuropathy ◽  
Alcohol Abuse ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Chronic Alcoholism ◽  
Treatment Modalities ◽  
Excessive Alcohol Consumption ◽  
Chronic Alcohol Abuse ◽  
Wide Range

Abstract Purpose of the Review Alcohol abuse causes a wide range of disorders that affect the nervous system. These include confusion, cerebellar ataxia, peripheral neuropathy, and cognitive impairment. Chronic and excessive alcohol consumption is the primary cause of peripheral neuropathy. It is worth noting that peripheral neuropathy has no reliable treatment due to the poor understanding of its pathology. Recent Findings Coasting is a major feature of alcoholic neuropathy, largely due to chronic alcohol abuse. Its major features are hyperalgesia, allodynia, and burning pain. Even though much research was done in this area, still we do not have a full understanding of the mechanism of alcoholic neuropathy. However, some theories have been proposed. These include direct or indirect effects of alcohol metabolites, impaired axonal transport, suppressed excitatory nerve pathway activity, or imbalance in neurotransmitters. Activation of spinal cord microglia, mGlu5 spinal cord receptors, and hypothalamic-pituitary-adrenal axis also seem to be implicated in the pathophysiology of this alcoholic neuropathy. The goal of treatment is to impede further damage to the peripheral nerves while also restoring their normal physiology. Alcohol abstinence, intake of balanced diets, and treatment with medications are suggested including benfotiamine, alpha-lipoic acid, acetyl-l-carnitine, vitamin E, methylcobalamin, myo-inositol, N-acetylcysteine, capsaicin, tricyclic antidepressants, or antiepileptic drugs. Summary This review focuses on the many pathways that play a role in the onset and development of alcohol-induced neuropathy, as well as present the possible treatment strategies of this disorder, providing insights into a further search of new treatment modalities.

Hypergonadotropic Hypogonadism: Management Of Infertility

2020 ◽  
Vol 26 ◽  
Author(s):  
Arif Kalkanli ◽  
Hakan Akdere ◽  
Gökhan Cevik ◽  
Emre Salabas ◽  
Nusret Can Cilesiz ◽  
...  
Keyword(s):  
Treatment Options ◽  
Sperm Concentration ◽  
Treatment Modalities ◽  
Hypergonadotropic Hypogonadism ◽  
Level Of Evidence ◽  
Medical Treatments ◽  
Estrogen Receptor Modulators ◽  
Wide Range ◽  
Reproductive Techniques ◽  
Receptor Modulators

Background: Medical treatments are used either alone or in combination with assisted reproductive techniques for treatment of infertile patients with hypergonadotropic hypogonadism. A wide range of treatment options such as gonadotropins, aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and their combination are available as options. Objective: The aim of this review was to evaluate treatment options for the infertile men with hypergonadotropic hypogonadism. Methods: A literature search of MEDLINE (1980-2019) was conducted using the terms ‘hypogonadism’, ‘male infertility’, ‘gonadotropins’, ‘SERMs’ and ‘AIs’. Pathologies leading to hypergonadotropic hypogonadism and treatment modalities such as gonadotropins, SERMs, AIs and surgical treatment were discussed. Results: FSH increases spontaneous pregnancy rates but level of evidence was proven to be low for live birth rates. AIs are valid treatment options for patients with low T/E2 ratio as they significantly increase sperm concentrations. SERMs are recommended for infertile males with a sperm concentration between 10-20 millions. Varicocele was reported to increase testosterone levels of hypogonadic infertile males. Conclusion: Medical treatment modalities such as gonadotropins, SERMs, AIs and combination of these therapies has been showed to have some effect in improvement of fertility but is not mainstream of the treatment.

scholarly journals How Important Is the Etiology in the Treatment of Epiphora?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mahmut Oğuz Ulusoy ◽  
Sertaç Argun Kıvanç ◽  
Mehmet Atakan ◽  
Berna Akova-Budak
Keyword(s):  
Negative Impact ◽  
Treatment Options ◽  
Specific Treatment ◽  
Treatment Modalities ◽  
Common Cause ◽  
Lacrimal System ◽  
System Disease ◽  
Chronic Dacryocystitis ◽  
Wide Range ◽  
Ophthalmologic Examination

Purpose.There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients.Materials and Methods.Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination.Results.This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1–92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p=0.012) and six of these had chronic dacryocystitis and one had ectropion.Conclusion.Epiphora not only has a negative impact on patients’ comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied.

Therapeutic potential of stem cells in lung disease: progress and pitfalls

2007 ◽  
Vol 114 (2) ◽  
pp. 99-108 ◽  
Author(s):  
Michael R. Loebinger ◽  
Susana Aguilar ◽  
Sam M. Janes
Keyword(s):  
Stem Cells ◽  
Lung Disease ◽  
Therapeutic Potential ◽  
Treatment Options ◽  
Lung Parenchyma ◽  
Treatment Modalities ◽  
In Vivo Experiments ◽  
Wide Range

There has been increasing excitement over the last few years with the suggestion that exogenous stem cells may offer new treatment options for a wide range of diseases. Within respiratory medicine, these cells have been shown to have the ability to differentiate and function as both airway and lung parenchyma epithelial cells in both in vitro and increasingly in vivo experiments. The hypothesis is that these cells may actively seek out damaged tissue to assist in the local repair, and the hope is that their use will open up new cellular and genetic treatment modalities. Such is the promise of these cells that they are being rushed from the benchside to the bedside with the commencement of early clinical trials. However, important questions over their use remain and the field is presently littered with controversy and uncertainty. This review evaluates the progress made and the pitfalls encountered to date, and critically assesses the evidence for the use of stem cells in lung disease.

Intravenous pulses of methylprednisolone to treat flares of immune-mediated diseases: how much, how long?

Lupus ◽  
2018 ◽  
Vol 27 (7) ◽  
pp. 1177-1184 ◽  
Author(s):  
A Danza ◽  
I Borgia ◽  
J I Narváez ◽  
A Baccelli ◽  
C Amigo ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Clinical Response ◽  
Complete Response ◽  
Median Dose ◽  
Duration Of Treatment ◽  
Immune Mediated ◽  
Wide Range ◽  
Severe Infections ◽  
Diabetic Population ◽  
The Relationship

Introduction Glucocorticoids are widely used in the treatment of immune-mediated diseases. Despite their widespread use, details on dosing, effectiveness and adverse effects are yet to be determined. Objective To know the current use of methylprednisolone (MTP) in the management of immune-mediated conditions, evaluating the relationship among doses, therapeutic response and adverse effects. Methodology A multicenter retrospective cohort study was designed, including patients who received intravenous pulses of MTP between 1 January 2013 and 12 December 2015 in three different hospitals in Uruguay. The patients included received MTP to treat systemic autoimmune diseases (SADs), hematological, nephrological and neurologic diseases and others. The following variables were analyzed: age, gender, MTP cumulative dose, duration of treatment, clinical response (complete, partial and no response) and adverse effects. Results In total, 164 cases were identified, of which 118 (72%) were female. The median age was 48.4 (SD: 18) years. The indications for MTP included: neuroimmune-mediated 92 (56.1%), SADs 29 (17.5%), hematological 15 (9.1%), nephrological 12 (7.3%) and others 16 (9.9%). The median dose to achieve complete response was 3.2 g (SD: 1.5); the median dose to accomplish a partial response was 3.5 g (SD: 1.25); the median dose for non-responders was 3.3 g (SD 1.2) ( p > 0.05). The median dose in those patients with adverse effects was 3.4 g (SD 1.5) and the median dose for those who did not experience adverse effects was 3.3 g (SD: 1.3) ( p > 0.05). The most frequent adverse effects were infectious (22/164, 13.4%). Diabetics were found to have the highest incidence of adverse effects (13/16, 81%) in comparison to non-diabetics, p < 0.05. Discussion Our study suggests a wide range of doses and duration of treatments with MTP. No major associations were found between clinical response and the use of high MTP doses, but the latter was associated with a large proportion of severe infections. No severe infections were identified with MTP doses lower than 1.5 g. The diabetic population is known to be at risk of experiencing varied adverse effects to MTP. These observations reinforce the need for protocolized use of MTP in order to achieve a better relationship among doses, effectiveness and safety profile.

scholarly journals Successful use of Netakimab in the treatment of psoriasis accompanied by the psoriatic onychodystrophy

2020 ◽  
pp. 64-70
Author(s):  
N. N. Potekaev ◽  
O. V. Zhukova ◽  
S. I. Artemyeva
Keyword(s):  
Plaque Psoriasis ◽  
Treatment Options ◽  
Nail Plate ◽  
Current Treatment ◽  
Efficacy And Safety ◽  
High Efficacy ◽  
Results Of Treatment ◽  
Interleukin 17A ◽  
Immune Mediated ◽  
Wide Range

Psoriasis is a chronic immune-mediated disease that is accompanied by a significant number of comorbid pathologies. Damage to the nail plates (psoriatic onychodystrophy) is widespread among patients with psoriasis and is associated with significant functional as well as psychosocial impairments. Despite the fact that nails constitute a small percentage of the surface of the human body, the damage to this particular area can lead to a deterioration in the quality of life and irreversible disability. In addition, studies have shown that nail psoriasis is indicative of a more severe course of the disease and it can also be associated with psoriatic arthritis or it can be a predictor of its development. Current treatment options for psoriasis accompanied by the nail plates damage include many topical and systemic methods, however, patients often report dissatisfaction with the results of treatment due to low efficacy or many side effects. Achieving higher efficiency is possible with the use of biologic therapy. Currently, a wide range of biologics have been developed that modulate key elements in the immunopathogenesis of psoriasis.The pathogenesis of psoriasis is a multifactorial process, however, it is the IL23 / Th17 signaling pathway that is key in this process. Interleukin-17A is the principal effector of this pathway and overexpression of IL-17A leads to epidermal hyperplasia and an excessive inflammatory response seen in psoriasis. Therefore, interleukin-17A is a promising therapeutic target.Considering the critical pathogenetic role as well as the high efficacy and safety of IL-17A inhibitors, the study of their effect on the psoriatic onychodystrophy manifestations is of great clinical importance.Netakimab is the first Russian original IL-17 inhibitor which is a promising modern agent for the treatment of moderate-to-severe plaque psoriasis. The obtained real clinical data indicate the high efficacy and safety of the use of Netakimab in patients with both plaque psoriasis and «severe» psoriasis in difficult to treat localizations, such as damage of the nail plate.

scholarly journals Selection of treatment modalities in children with spastic cerebral palsy

2006 ◽  
Vol 21 (2) ◽  
pp. E4 ◽  
Author(s):  
Paul Steinbok
Keyword(s):  
Cerebral Palsy ◽  
Treatment Options ◽  
Intrathecal Baclofen ◽  
Treatment Modalities ◽  
Orthopedic Procedures ◽  
Spastic Cerebral Palsy ◽  
Neurosurgical Procedures ◽  
Dorsal Rhizotomy ◽  
The Individual ◽  
The Impact

✓ The purpose of this report was to outline the various options currently used for treatment of spastic cerebral palsy (CP) and to discuss factors involved in selecting the appropriate treatment modalities for the individual child. In a review of the literature and his personal observations, the author presents an outline of treatment options and the criteria for using each. Therapeutic options include the following: physiotherapy; occupational therapy; oral spasmolytic and antidystonic drugs; botulinum toxin injections; orthopedic procedures; continuous infusion of intrathecal baclofen (ITB); selective dorsal rhizotomy (SDR); and selective peripheral neurotomy. The most commonly used neurosurgical procedures are ITB pump placement and SDR, and these are discussed in the most detail. The author's personal schema for assessment of the child to determine the nature of the hypertonia, the impact of the hypertonia, and the appropriate therapeutic intervention is presented. There are factors that help guide the optimal treatment modalities for the child with spastic CP. The treatment of these children is optimized in the setting of a multidisciplinary team.

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