New Therapeutic Options for the Management of Diabetes

2007 ◽  
Vol 22 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Brigitte Sicat ◽  
Laura Morgan
Keyword(s):  
Adverse Effects ◽  
English Language ◽  
Background Information ◽  
Management Options ◽  
Incretin Mimetics ◽  
Inhaled Insulin ◽  
Antihyperglycemic Agents ◽  
Pertinent Data ◽  
Treatment Of Diabetes

Objective: To review new hypoglycemic and antihyperglycemic agents recently approved for the treatment of type 1 and type 2 diabetes mellitus.Data Sources: A MEDLINE search of articles published from 1966 to March 2006 was conducted to identify English-language literature available on the newer therapies approved for the treatment of diabetes. Search terms used were: Byetta, exenatide, insulin detemir, NN304, Exubera inhaled insulin, Levemir, pramlintide, Symlin, AC137, AC0137, and Tripro-Amylin. These articles, abstracts, and data provided by the pharmaceutical manufacturers were reviewed to identify pertinent data. Additional references were obtained from the bibliographies of these publications.Study Selection: Randomized, English-language studies investigating safety or efficacy data on these newer agents with a focus on human studies.Data Extraction: These hypoglycemic and antihyperglycemic agents were reviewed with regard to background information, pharmacokinetic and pharmacodynamic data, relevant clinical studies, U.S. Food and Drug Administration-approved indications, dosing and administration, contraindications, drug interactions, adverse effects, storage, cost, availability, and role in therapy.Data Synthesis: Over the last decade, management options for the treatment of diabetes have exploded. Among these are the incretin mimetics, amylin analogs, insulin analogs, and inhaled insulin. Short-term studies demonstrate that each of these therapies may offer specific advantages such as improved glycemia, convenience, and/or weight loss. Continued study of the incretin mimetics, amylin analogs, and inhaled insulin will be needed to verify long-term safety and efficacy of these agents.Conclusions: These agents with novel mechanisms of action and a new insulin-delivery device offer patients and clinicians additional options that improve glycemic and nonglycemic factors while addressing some of the concerns of older agents. Longerterm studies will help providers weigh the benefits, adverse effects, cost, and unknown long-term risks of these medications.

Brexanolone: A Novel Drug for the Treatment of Postpartum Depression

2020 ◽  
pp. 089719002097962
Author(s):  
Edna Patatanian ◽  
David R. Nguyen
Keyword(s):  
Adverse Effects ◽  
Postpartum Depression ◽  
English Language ◽  
Neuronal Excitability ◽  
Data Extraction ◽  
Background Information ◽  
Pharmacologic Therapy ◽  
Loss Of Consciousness ◽  
Efficacy And Safety ◽  
Pubmed Search

Objectives: To review the pharmacology, efficacy, and safety of Brexanolone and define its role in the treatment of postpartum depression. Date Sources: A MEDLINE/PubMed search was conducted (1980-May 2020) using the following keywords: postpartum depression, antidepressants, pharmacologic therapy, drug therapy, and brexanolone to identify relevant articles. Study Selection/Data Extraction: Literature search was limited to human studies published in the English language. Phase I, II, and III studies evaluating the pharmacology, efficacy, safety of brexanolone for postpartum depression were included. Bibliographies of relevant articles evaluating postpartum depression and treatment were reviewed for additional citations and background information. Data Synthesis: Brexanolone is a soluble, proprietary, injectable formulation of allopregnanolone, a neuroactive steroid that modulates neuronal excitability. Allopregnanolone levels increase during pregnancy and decrease substantially after birth. These fluctuations have profound effects on anxiety and depression. Three clinical trials established the efficacy and safety of brexanolone in the treatment of postpartum depression. In all 3 trials, brexanolone had an acceptable safety profile and was well tolerated. The most common adverse effects were loss of consciousness, sedation, dry mouth, headache, dizziness, and flushing. Due to sudden loss of consciousness and excessive sedation, continuous pulse oximetry is recommended. Conclusion: Brexanolone has a novel mechanism of action and appears to be safe and effective for the treatment of moderate to severe postpartum depression. At present, high cost, serious adverse effects, and restricted access may limit its use in clinical practice.

Treatment Options for Rheumatoid Arthritis: Celecoxib, Leflunomide, Etanercept, and Infliximab

2000 ◽  
Vol 34 (6) ◽  
pp. 743-760 ◽  
Author(s):  
Brigitte T Luong ◽  
Barbara S Chong ◽  
Dionne M Lowder
Keyword(s):  
Rheumatoid Arthritis ◽  
English Language ◽  
Data Extraction ◽  
Treatment Options ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Pertinent Data

OBJECTIVE: To review new pharmacologic agents approved for use in the management of rheumatoid arthritis (RA). DATA SOURCES: A MEDLINE search (1966–January 2000) was conducted to identify English-language literature available on the pharmacotherapy of RA, focusing on celecoxib, leflunomide, etanercept, and infliximab. These articles, relevant abstracts, and data provided by the manufacturers were used to collect pertinent data. STUDY SELECTION: All controlled and uncontrolled trials were reviewed. DATA EXTRACTION: Agents were reviewed with regard to mechanism of action, efficacy, drug interactions, pharmacokinetics, dosing, precautions/contraindications, adverse effects, and cost. DATA SYNTHESIS: Traditional pharmacologic treatments for RA have been limited by toxicity, loss of efficacy, or both. Increasing discoveries into the mechanisms of inflammation in RA have led to the development of new agents in hopes of addressing these limitations. With the development of celecoxib, a selective cyclooxygenase-2 inhibitor, the potential exists to minimize the gastrotoxicity associated with nonsteroidal antiinflammatory drugs. Leflunomide has been shown to be equal to or less efficacious than methotrexate, and may be beneficial as a second-line disease-modifying antirheumatic drug (DMARD). The biologic response modifiers, etanercept and infliximab, are alternatives that have shown benefit alone or in combination with methotrexate. However, they should be reserved for patients who fail to respond to DMARD therapy. Further studies should be conducted to evaluate the long-term safety and efficacy of these agents as well as their role in combination therapy. CONCLUSIONS: Celecoxib, leflunomide, etanercept, and infliximab are the newest agents approved for RA. Clinical trials have shown that these agents are beneficial in the treatment of RA; however, long-term safety and efficacy data are lacking.

Propofol for the long-term sedation of a critically ill patient

1998 ◽  
Vol 7 (1) ◽  
pp. 73-76 ◽  
Author(s):  
LJ Miller ◽  
R Wiles-Pfeifler
Keyword(s):  
Adverse Effects ◽  
English Language ◽  
Case Reports ◽  
Critically Ill Patient ◽  
Limited Data ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Cardiovascular Depression ◽  
Language Literature

OBJECTIVE: To report a case in which propofol was used successfully in an intubated patient on a prolonged basis and to review the literature that discusses long-term infusions (> 7 days) of propofol. METHODS: Information was retrieved from a MEDLINE search of the English-language literature. Reports of clinical trials and case reports that compared the safety and efficacy of long-term propofol and midazolam were included in this review. Information about the study design and the efficacy and adverse effects of the drugs was collected, and the data were synthesized. RESULTS: Clinical reports indicate that a long-term infusion of propofol is comparable in safety and efficacy to a long-term infusion of midazolam. The distinct adverse-effect profile of long-term use of propofol, including hypertriglyceridemia, was evaluated and reported as significant. CONCLUSION: The limited data available suggest that long-term infusion of propofol is a practical alternative to use of standard agents for sedation of intubated patients. Adverse effects such as cardiovascular depression, respiratory depression, and hypertriglyceridemia may limit the routine use of propofol.

Efficacy of Electronic Cigarettes for Smoking Cessation

2014 ◽  
Vol 48 (11) ◽  
pp. 1502-1506 ◽  
Author(s):  
Katherine Kelly Orr ◽  
Nicole J. Asal
Keyword(s):  
Smoking Cessation ◽  
Adverse Effects ◽  
Clinical Studies ◽  
English Language ◽  
Electronic Cigarettes ◽  
Data Extraction ◽  
Withdrawal Symptoms ◽  
Smoking Reduction ◽  
Study Selection

Objective: To review data demonstrating effective smoking cessation with electronic cigarettes (e-cigarettes). Data Sources: A literature search of MEDLINE/PubMed (1946-March 2014) was performed using the search terms e-cigarettes, electronic cigarettes, and smoking cessation. Additional references were identified from a review of literature citations. Study Selection and Data Extraction: All English-language clinical studies assessing efficacy of e-cigarettes compared with baseline, placebo, or other pharmacological methods to aid in withdrawal symptoms, smoking reduction, or cessation were evaluated. Data Synthesis: A total of 6 clinical studies were included in the review. In small studies, e-cigarettes significantly decreased desire to smoke, number of cigarettes smoked per day, and exhaled carbon monoxide levels. Symptoms of nicotine withdrawal and adverse effects were variable. The most common adverse effects were nausea, headache, cough, and mouth/throat irritation. Compared with nicotine patches, e-cigarettes were associated with fewer adverse effects and higher adherence. Most studies showed a significant decrease in cigarette use acutely; however, long-term cessation was not sustained at 6 months. Conclusions: There is limited evidence for the effectiveness of e-cigarettes in smoking cessation; however, there may be a place in therapy to help modify smoking habits or reduce the number of cigarettes smoked. Studies available provided different administration patterns such as use while smoking, instead of smoking, or as needed. Short-term studies reviewed were small and did not necessarily evaluate cessation with a focus on parameters associated with cessation withdrawal symptoms. Though long-term safety is unknown, concerns regarding increased poisoning exposures among adults in comparison with cigarettes are alarming.

Topical Aminophylline: Is it Safe and Effective in Causing Regional Fat Loss?

1997 ◽  
Vol 13 (2) ◽  
pp. 80-83
Author(s):  
Lisa M Tong ◽  
Kristin R Gericke
Keyword(s):  
Adverse Effects ◽  
English Language ◽  
Data Extraction ◽  
Treatment Options ◽  
Local Concentration ◽  
Drug Induced ◽  
Fat Loss ◽  
Study Selection ◽  
Data Source

Objective: To provide a better understanding of the efficacy and possible adverse effects of topical aminophylline in causing regional fat loss. Data Source: Pertinent English-language literature (1958–1995). Study Selection: Representative articles documenting mechanisms of action and types of drug-induced reactions, as well as treatment options. Data Extraction: Data were extracted only from articles that documented relevant and substantive information backed by clinical studies. Data Synthesis: Topical aminophylline 2% thigh cream has been introduced as a method of treating cellulite, or dimpled thighs and buttocks. The proposed method of action is by increasing local concentration, thereby stimulating lipolysis. Data from two small clinical trials showed that the cream reduced thigh girth and had no known adverse effects. However, adverse dermatologic effects caused by aminophylline have been reported in the past. Conclusions: Topical aminophylline cream appears to be a reasonable option for regional reduction of thigh girth for some people and has not shown any adverse effects. Nevertheless, larger, long-term studies need to be done.

scholarly journals Management of ureteric avulsion during ureteroscopy: a systematic review and our experience

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
P. Ashwin Shekar ◽  
Gaurav Kochhar ◽  
Dinesh Reddy ◽  
Anuj Dumra
Keyword(s):  
English Language ◽  
Literature Search ◽  
Long Term Results ◽  
Cochrane Library ◽  
Management Options ◽  
Intraoperative Complication ◽  
Distal Ureter ◽  
The Common ◽  
Meta Analyses

Abstract Background Ureteric avulsion is a disastrous intraoperative complication that can happen to any urologist during a common endoscopic procedure like ureteroscopy. The aim of this study is to evaluate the various management options of ureteric avulsion during ureteroscopy and also report our relevant experience in this topic. Results The Preferred Reporting Items for Systematic Reviews and Meta-Analyses of existing literature in English language was used in the period 1967–2019 with a literature search in PubMed, Cochrane Library and Google Scholar. Forty-three patients in twenty-three articles who had undergone management of ureteric avulsion during ureteroscopy were identified for review. There were 15 proximal, 19 two-point (“scabbard”) and 9 distal avulsions. All distal avulsions were managed successfully with ureteroneocystostomies or Boari flaps. Boari flaps and ureteropyelostomy with ureterovesicostomy were the common procedures used for proximal avulsions. Proximal avulsions had more varied outcomes with salvage rates of 86.9%. Procedures which incorporated the avulsed distal ureter for reconstruction had poor results. Conclusion Management of ureteric avulsion during ureteroscopy is a surgical challenge. While management of distal avulsions is straightforward in the form of ureteroneocystostomies and has uniformly good results in most hands, proximal avulsions need expertise in management and choosing ideal reconstruction, with variable results following reconstruction. Extended Boari flaps, ileal ureter and autotransplantation are good options for proximal avulsions. Reconstruction using the distal avascular ureter should be avoided for better long-term results.

Interactions Between Antipsychotic and Antihypertensive Drugs

1995 ◽  
Vol 29 (6) ◽  
pp. 603-609 ◽  
Author(s):  
John S Markowitz ◽  
Barbara G Wells ◽  
William H Carson
Keyword(s):  
English Language ◽  
Antihypertensive Drugs ◽  
Case Reports ◽  
Data Extraction ◽  
Plasma Concentrations ◽  
Antihypertensive Agents ◽  
Background Information ◽  
Antipsychotic Therapy ◽  
Medline Search ◽  
Pertinent Data

Objective: To provide a comprehensive review of the pharmacokinetic and pharmacodynamic interactions between antipsychotics and antihypertensives and to provide recommendations for the selection of antihypertensives in patients receiving antipsychotic therapy. Data Sources: A MEDLINE search of the English-language literature was used to identify pertinent human and animal studies, reviews, and case reports. Study Selection: All available sources were reviewed. Data Extraction: Background information was obtained from comprehensive reviews. Individual case reports were assimilated, and pertinent data were extracted. Data Synthesis: Because hypertension is common in patients with psychiatric illness and antihypertensive agents are used for a multiplicity of indications, significant numbers of patients receive concurrent therapy with antihypertensives and antipsychotics. Many antipsychotics may block the antihypertensive efficacy of guanethidine and related drugs. The interaction between Clonidine and antipsychotics is defined less clearly. Limited data suggest possible additive hypotensive effects when chlorpromazine and methyldopa are given in combination. Increased plasma concentrations of thioridazine with a resultant increase in adverse effects have been reported when propranolol or pindolol are added to the regimen. A similar increase in chlorpromazine concentrations has been reported when propranolol was added. Although there are no reports documenting an interaction between a calcium-channel antagonist and an antipsychotic, the possible inhibition of oxidative metabolism of antipsychotics, additive calcium-blocking activity, and additive pharmacodynamic effects are theorized. Hypotension and postural syncope were reported in a patient given therapeutic dosages of chlorpromazine and Captopril, and in 2 patients when clozapine was added to enalapril therapy. Conclusions: No antipsychotic-antihypertensive combination is absolutely contraindicated, but no combination should be considered to be completely without risk. Antihypertensives with no centrally acting activity, such as diuretics, may be the least likely to result in adverse reactions. The combination of the beta-antagonists propranolol or pindolol with thioridazine or chlorpromazine should be avoided if possible. Scrupulous patient monitoring for attenuated or enhanced activity of either agent is essential whenever antipsychotics and antihypertensives are given concurrently.

Searching Online for Methods of Suicide

Crisis ◽  
2020 ◽  
pp. 1-8
Author(s):  
Christian Ulrich Eriksen ◽  
Flemming Konradsen ◽  
Thilde Vildekilde
Keyword(s):  
Content Analysis ◽  
English Language ◽  
Significant Proportion ◽  
Background Information ◽  
Access To Information ◽  
Online Content ◽  
Negative Effects ◽  
Search Terms ◽  
Methods Of Suicide

Abstract. Background: Information on methods of suicide is available online, and access to information on methods of suicide appears to contribute to a small but significant proportion of suicides. There is limited documentation of how methods of suicide are being profiled, as well as what content exists in other languages than English. Aim: We aimed to analyze and compare how methods of suicide are profiled on Danish and English-language websites. Method: We applied a categorization and content analysis of websites describing methods of suicide. Sites were retrieved by applying widely used Danish and English-language search terms. Results: A total of 136 English-language websites and 106 Danish-language websites were included for analysis. Websites were more often categorized as prevention or support sites, academic or policy sites, and against suicide sites than dedicated suicide sites (i.e., pro-suicide sites), or information sites. However, information on methods of suicide was available, and 20.1% and 8.9% of the English and Danish-language sites, respectively, suggested that a particular method of suicide was quick, easy, painless, or certain to result in death. Limitations: Only one author coded and analyzed all websites. A further operationalization of the content analysis checklist is warranted to increase reliability. Conclusion: The websites primarily had a prevention or anti-suicide focus, but information on methods of suicide was available, requiring an increased focus on how to diminish the negative effects of harmful online content.

English Students’ Attitudes towards English Language Teaching and Learning at IAIN Padangsidimpuan

2016 ◽  
Vol 13 (2) ◽  
Author(s):  
Ida Royani ◽  
T. Silvana Sinar
Keyword(s):  
Language Learning ◽  
Role Models ◽  
English Language ◽  
Language Teaching ◽  
English Language Teaching ◽  
English Learning ◽  
Learner Centered ◽  
Students Attitudes ◽  
English Students

This study investigated the English students’ attitudes of IAIN Padangsidimpuan towards both English language teaching in terms of (a) language-centered, (b) learner-centered, and (c) learning-centered method; and learning English in terms of scales (a) attitudes toward long-term English learning, (b) interest in culture and communication, (c) perception about studying in school context, (d) images associated with English, (e) English learning activities, (f) exposure to English outside school, (g) self-rated four English skills, (h) self-reported academic English grade, and (i) identification of English role models. The data were obtained by questionnaire and interview from 10 selected students in which 4 male and 6 female students in 7th semester and were analyzed by steps provided by Gay, L.R and Airasian (1996). The result showed:  first, English students’ attitudes towards English language teaching had been found highly onlearning-centered method, followed by learner-centered method in second range, and almost negative view in language-centered method.Second, English students’ attitudes towards English language learningwere positivein scales; long-term English learning, interest in communication, and images associated with English.  Third, role of students’ gender on English language learning were not found. Reasons for this statement are (i) status of English as international language and (ii) equalization of getting education for male and female. Keywords: attitude, language teaching, language learning, and gender

Oil pollution and fisheries

1982 ◽  
Vol 297 (1087) ◽  
pp. 401-411 ◽  
Keyword(s):  
Water Quality ◽  
Adverse Effects ◽  
Oil Pollution ◽  
Coastal Areas ◽  
Short Term ◽  
Fish Stocks ◽  
Local Impacts ◽  
Reduced Water ◽  
Long Term Adverse Effects

The term ‘pollution’ is taken in its broadest sense and effects are recognized to be due to interference, tainting and toxicity. Each of these types of impact is discussed and assessed. It is concluded that no long-term adverse effects on fish stocks can be attributed to oil but that local impacts can be extremely damaging in the short term and that produce from specific localities can be tainted and unmarketable for long periods. In some coastal areas oil can be one among several contributors to reduced water quality, and the implications of this are discussed.

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