scholarly journals Double anticholinergic therapy for refractory neurogenic and non-neurogenic detrusor overactivity in children: Long-term results of a prospective open-label study

2014 ◽  
Vol 8 (5-6) ◽  
pp. 175 ◽  
Author(s):  
Geneviève Nadeau ◽  
Annette Schröeder ◽  
Katherine Moore ◽  
Lucie Genois ◽  
Pascale Lamontagne ◽  
...  
Keyword(s):  
Side Effects ◽  
Detrusor Overactivity ◽  
Long Term Results ◽  
Open Label ◽  
Open Label Study ◽  
Insufficient Response ◽  
Maximal Pressure ◽  
Bladder Condition

Introduction: In this study, we optimize pharmacotherapy in children who failed anticholinergic monotherapy by simultaneous administration of 2 anticholinergics (oxybutynin and/or tolterodine and/or solifenacin).Methods: This report is an update of our previously published study on double anticholinergic regimen in children with refractory incontinence due to neurogenic (NDO) and non-neurogenic (DO) detrusor overactivity. Patients with an insufficient response (clinically/urodynamically) to an optimized dose of a single anticholinergic (oxybutynin or tolterodine) received a second anticholinergic (tolterodine or solifenacin), in addition to the pre-existing medication. The primary end-point was efficacy (continence) and the secondary end-points were tolerability and safety. The Patient Perception of Bladder Condition (PPBC) scale was used to rate subjective improvement of patients.Results: In total, 56 patients with DO (n = 31) or NDO (n = 25) were enrolled at a mean age of 11.4 ± 3.5 years and were followed for a minimum of 3 months. The duration of double treatment was 36 ± 23 months. Our results found that 23 patients became dry, 18 improved significantly and 15 improved moderately. Urodynamic capacity improved from 158 ± 87 mL to 359 ± 148 mL and maximal pressure of contractions decreased from 76 ± 24 to 22 ± 22 cmH2O (p < 0.0001). The overall success rate was 82%, since 10 patients discontinued treatment for unsatisfactory clinical response or bothersome side effects. No side effects were reported by 28 patients, mild side effects by 20, moderate side effects by 8; 2 patients withdrew from the study due to their side effects. Of the 35 patients who voided spontaneously, 8 developed post-void residuals (>20%).Conclusions: With a larger cohort and prospective follow-up, we reiterated that double anticholinergic regimen in children with DO or NDO refractory to anticholinergic monotherapy is a feasible and efficient approach. 

scholarly journals Long-term use of solifenacin in pediatric patients with overactive bladder: Extension of a prospective open-label study

2014 ◽  
Vol 8 (3-4) ◽  
pp. 118 ◽  
Author(s):  
Geneviève Nadeau ◽  
Annette Schröeder ◽  
Katherine Moore ◽  
Lucie Genois ◽  
Pascale Lamontagne ◽  
...  
Keyword(s):  
Side Effects ◽  
Success Rates ◽  
Duration Of Treatment ◽  
Open Label ◽  
Open Label Study ◽  
The Mean ◽  
Adjusted Dose ◽  
Bladder Condition

Introduction: We evaluate the efficacy and safety of solifenacin to treat incontinence in children with non-neurogenic (DO) or neurogenic detrusor overactivity (NDO) refractory to oxybutininor tolterodine.Methods: We updated and extended our previously published non-randomized uncontrolled study on open-label use of adjusted-dose regimens of solifenacin (1.25-10 mg) in children with refractory incontinence. The follow-up included voiding diaries, post-void residuals, urine cultures, ultrasounds and urodynamic studies. Clinical data were updated as of September 2012. Subjective improvement was assessed with the Patient Perception of Bladder Condition (PPBC) scale. The primary end point was efficacy toward continence and secondary end points were tolerability and safety.Results: Overall, 244 patients (112 girls, 132 boys) were enrolled; 53 with NDO and 191 with DO. Minimal follow-up was 5 months, the mean duration of treatment was 21.0 months and the mean age at initiation was 9.2 years. Urodynamic capacity improved from 145 ± 76 mL to 339 ± 152 mL and the amplitude of uninhibited contractions decreased from 66 ± 26 to 20 ± 20 cmH2O (p < 0.0001). The overall success rate is 91%, and more specifically 94% for non-neurogenic and 79% for neurogenic, which is significantly different (p = 0.013). Twenty-three patients discontinued treatment for unsatisfactory clinical response or bothersome side effects. No side effects were reported by 175 patients, mild by 46, moderate by 9, and 14 withdrew due to their side effects. Ten patients developed post-void residuals of ≥20 mL.Conclusion: Although higher in the non-neurogenic group, high subjective and objective success rates were maintained over a longer follow-up with an adjusted-dose regimen of solifenacin to treat pediatric NDO or DO refractory to oxybutynin or tolterodine. Moreover, we found acceptable tolerability and safety profiles. 

scholarly journals Successful long-term remission through tapering tocilizumab infusions: a single center prospective study

2019 ◽  
Author(s):  
Chayma Ladhari ◽  
Pierre Le Blay ◽  
Thierry Vincent ◽  
Ahmed Larbi ◽  
Emma Rubenstein ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Sustained Remission ◽  
Single Center ◽  
Open Label ◽  
Open Label Study ◽  
Treatment Interval ◽  
Secondary Failure ◽  
Term Maintenance

Abstract Background Strategic drug therapy for rheumatoid arthritis (RA) patients with prolonged remission is not well defined. According to recent guidelines, tapering biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) may be considered. We aimed to evaluate the long-term maintenance of tocilizumab (TCZ) treatment after the progressive tapering of infusions. Methods We conducted an exploratory, prospective, single-center, open label study, on RA patients with sustained remission for at least 3 months and treated with TCZ infusions every 4 weeks. The initial re-treatment interval was 6 weeks for the first 3 months. Thereafter, the spacing between infusions was determined by the clinician. Successful long-term maintenance following the tapering of TCZ infusions was defined by patients still treated after two years by TCZ with a minimum dosing interval of 5 weeks. Results Thirteen patients were enrolled in the study. Eight out of thirteen were still treated by TCZ after two years. Successful long-term maintenance was possible in six patients, with four patients maintaining a re-treatment interval of 8-weeks or more. We observed 5 patients with TCZ withdrawal: one for adverse drug reaction (neutropenia) and four with secondary failure. Patients achieving successful long-term maintenance with TCZ were significantly younger than those with secondary failure (p<0.05). In addition, RA patients with positive rheumatoid factor and anti-citrullinated peptide antibodies, experienced a significantly greater number of flares during our 2-year follow-up (p<0.01). Conclusions A progressive tapering of TCZ infusions seems possible in most of the patients. However, larger studies, including more patients, are needed to confirm this therapeutic option.

Long Term Results of Stereotactic Thalamotomy for Cerebral Palsy

Neurosurgery ◽  
1983 ◽  
Vol 12 (2) ◽  
pp. 195-202 ◽  
Author(s):  
G. Broggi ◽  
L. Angelini ◽  
R. Bono ◽  
C. Giorgi ◽  
N. Nardocci ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Side Effects ◽  
Clinical Picture ◽  
Clinical Results ◽  
Long Term Results ◽  
Abnormal Movements ◽  
Average Intelligence ◽  
Stereotactic Thalamotomy

Abstract A group of 33 patients (between 10 and 30 years old and with average intelligence) underwent stereotactic surgery for abnormal movements due to cerebral palsy. Neurological, neurofunctional, and neuropsychological examinations were performed pre- and postoperatively. The length of follow-up ranged between 1 and 4 years. The clinical results are reported and discussed in relation to the targets, the side of the lesion, and the clinical picture. Our data show that better results are obtained in patients with tremor and hyperkinesias; dystonia is improved to a lesser extent, whereas spasticity tends to recur. Operation is more effective for patients with unilateral signs than for patients with bilateral symptoms. The clinical results are stable in time, and the side effects fade away after a few months.

scholarly journals Long-term follow-up of DYT1 dystonia patients treated by deep brain stimulation: An open-label study

2010 ◽  
Vol 25 (3) ◽  
pp. 289-299 ◽  
Author(s):  
Laura Cif ◽  
Xavier Vasques ◽  
Victoria Gonzalez ◽  
Patrice Ravel ◽  
Brigitte Biolsi ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
Dyt1 Dystonia ◽  
Long Term Follow Up ◽  
Deep Brain

scholarly journals Percutaneous Microcompression for Idiopathic Trigeminal Neuralgia: curative effects and complications

2020 ◽  
Author(s):  
yi ma ◽  
Yan-feng Li ◽  
Hai-tao Huang ◽  
Bin Wang ◽  
Quan-cai Wang
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Intracranial Hemorrhage ◽  
Long Term Results ◽  
Base Line ◽  
Intracranial Infection ◽  
Idiopathic Trigeminal Neuralgia

Abstract Background. We aimed to present the immediate and long term effect of percutaneous balloon compression (PBC) for idiopathic trigeminal neuralgia (ITN). Methods. ITN patients who underwent PBC for the first time in the past seven years were enrolled. Base line data and immediate postoperative outcomes were collected by reviewing the medical records and long term results. Kaplan-Meier curve, life-table analysis proportional-hazards analysis were utilized to assess the long term results and the likelihood of tic recurrence. Results. 12,797 patients were enrolled. Immediate after the PBC procedure, complete and partial pain relief were achieved in 95.6% and 1.1% patients respectively, with no relief in 1.7 % patients; the common side effects on the affected side of face included the sense loss in 98.9% patients, with 3.8% of them experienced sense loss combined abnormal sense; masseter weakness in 90.6%, herpes eruption in 51.4%, corneal reflex weakness or loss in 12.7% patients. The fewer perioperative complications covered diplopia in 139 patients (1.1%), partial hearing loss in 190 patients (1.5%), vascular complications in 5 patients (0.05%), brainstem hematoma in one patient (0.01%), ischemic stroke in two patients (0.02%), intracranial hemorrhage in 11 patents (0.09%), and intracranial infection in one patient (0.01%) patients. Of three deaths happened in the perioperative period, two died of intracranial hemorrhage, and the other one died of intracranial infection. 5794 (49.2%) patients, who were followed than one year after the procedure, were included in the follow-up study, with the median follow-up period of 7.2 years. Complete and partial pain relief were obtained in 82.9% and 6.8% patients respectively, while the pain recurrence occurred in 8.5% patients. Side effects included sense loss without abnormal sense in 54.3%, with acceptable abnormal sense in 6.0%, and with severe abnormal sense in 2.0% patients. Masseter weakness was reported by 7.5% patients. 96.4% patients were satisfied with the procedure. Conclusion. Our study shows PBC is a safe, simple and effective procedure, with both immediate and long-term success rates, acceptable side effects and fewer deadly complications, should be considered as one of the best choice for the treatment of ITN patients.

scholarly journals A comparision of efficacy of risperidone and olanzapine in schizophrenia patients

2012 ◽  
Vol 7 (3) ◽  
pp. 29-35
Author(s):  
SK Shah ◽  
SP Ojha ◽  
NR Koirala ◽  
VD Sharma ◽  
B Yengkokpam
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Drop Out ◽  
Medical Sciences ◽  
Open Label ◽  
General Psychopathology ◽  
Sexual Side Effects ◽  
Significant Difference

Schizophrenia is a leading worldwide mental health problem. It is also one of the common and challenging problems in Nepal. Risperidone and olanzapine is one of the major antipsychotic drug used for schizophrenia patients, however their efficacy is not compared in Nepal.To assess the efficacy of risperidone and olanzapine in schizophrenia patients in Nepalese context. An open-label, randomized, comparative, prospective study was done for 6 weeks. Total of 63 patients attending Psychiatry OPD in Jan to July 2008 at TUTH who could be available for close follow up were enrolled with consent. Risperidone was given in dose of 3-6 mg and Olanzapine in the dose of 15-20 mg per day. Efficacy and tolerability was assessed using PANSS, CGI, and UKU side-effect checklist. Both groups showed improvement in the entire positive, negative and general psychopathology subscales without significant difference in the two groups. Regarding tolerability, olanzapine was found to have significant sedation, weight gain while with risperidone extrapyramidal side-effects, palpitations, sexual side-effects were significant. Risperidone and olanzapine both are efficacious in the treatment of schizophrenia. Both the drugs have their own side-effects. Long-term efficacy and tolerability needs to be studied. As it has been seen in the ongoing studies, long-term use and side-effect profile, drop-out rates and the increase in metabolic syndromes need more consideration.DOI: http://dx.doi.org/10.3126/jcmsn.v7i3.6706 Journal of College of Medical Sciences-Nepal, 2011, Vol-7, No-3, 29-35

scholarly journals Rituximab in refractory myasthenia gravis: a prospective, open‐label study with long‐term follow‐up

2016 ◽  
Vol 3 (7) ◽  
pp. 552-555 ◽  
Author(s):  
Dustin Anderson ◽  
Cecile Phan ◽  
Wendy S. Johnston ◽  
Zaeem A. Siddiqi
Keyword(s):  
Myasthenia Gravis ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
Long Term Follow Up

scholarly journals Long-term outcome of the humoral and cellular immune response of an H5N1 adjuvanted influenza vaccine in elderly persons: 2-year follow-up of a randomised open-label study

Trials ◽  
2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Paul Gillard ◽  
Didier Giet ◽  
Stéphane Heijmans ◽  
Mamadou Dramé ◽  
Karl Walravens ◽  
...  
Keyword(s):  
Immune Response ◽  
Elderly Persons ◽  
Open Label ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Open Label Study ◽  
Label Study ◽  
Cellular Immune

scholarly journals Long-term outcomes of antibiotic combination therapy for ulcerative colitis

2021 ◽  
Vol 12 ◽  
pp. 204062232110287
Author(s):  
Yuriko Nishikawa ◽  
Nobuhiro Sato ◽  
Shintaro Tsukinaga ◽  
Kan Uchiyama ◽  
Shigeo Koido ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Side Effects ◽  
Adverse Events ◽  
Medical Information ◽  
Compliance Rate ◽  
University Hospital ◽  
Open Label ◽  
Antibiotic Combination

Aims: An antibiotic combination of amoxicillin, tetracycline and metronidazole (ATM) is effective for ulcerative colitis (UC), but this regimen is discontinued in some cases due to adverse events. This study aimed to assess a revised combination, namely, amoxicillin, fosfomycin and metronidazole (AFM), in UC patients with the goal of reducing side effects while maintaining therapeutic efficacy. Methods: A prospective open-label trial was undertaken in 104 adult UC patients. A combination of oral amoxicillin (1500 mg), fosfomycin (3000 mg) and metronidazole (750 mg) was administered to patients daily for 2–4 weeks in addition to their conventional medication. Clinical assessment was performed using the Lichtiger index before treatment and at 0, 3, 6, 9 and 12 months and 2 and 3 years. Endoscopic evaluation was performed using the Mayo score before treatment and at 3 and 12 months. Results: The compliance rate was 99.2%. Response and remission rates were 80.8% and 63.5% at completion, 73.1% and 64.4% at 3 months, and 39.4% for both at 12 months, respectively. Of the 41 patients who were in remission at 12 months, 63.4% maintained that status until the 2-year follow-up. Similarly, 69.2% of those in remission at 2 years remained relapse free at the 3-year follow-up. Side effects were observed in 44.2% of the participants. Fever occurred in one patient (1.0%), which was lower than the rate observed with ATM therapy. Conclusion: These results indicate that AFM therapy induces remission and is appropriate for long-term maintenance of UC while producing fewer and milder adverse events than ATM therapy. Clinical trials: This study was registered in the University Hospital Medical Information Network (No. R000046546).

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