scholarly journals Efficacy of Skin Microneedling in Combination with Narrow Band - Ultraviolet B Phototherapy in Vitiligo

2021 ◽  
pp. 68-75
Author(s):  
Sarah Sanad Lotfy ◽  
Yomna Mazid El-Hamd Neinaa ◽  
Nahla El-Sayed Ramzy Ghaly ◽  
Noha Nabil Doghaim
Keyword(s):  
Side Effects ◽  
Narrow Band ◽  
Psychological Impact ◽  
Significant Degree ◽  
Ultraviolet B ◽  
Treatment Modalities ◽  
Duration Of Treatment ◽  
Mild Improvement ◽  
New Treatment

Background: Vitiligo is a chronic cutaneous disease characterized by milky white depigmented patches that leave psychological impact on the patient's quality of life. New treatment modalities have been developed to shorten the duration of treatment of vitiligo with the least side effects. Objective: To evaluate the safety & efficacy of microneedling in combination with narrow band-UVB in the treatment of vitiligo. Patients and Methods: This study included 20 patients with stable vitiligo. They were treated by microneedling (one session every 2 weeks) in combination with narrow band-UVB (3 sessions weekly) for 3 months. Results: The studied patients reported statistically significant degree of clinical improvements as follow;10%reportedgoodimprovement, 25% showe dmoderate improvement, 45% showed mild improvement and 20% showed noimprovement,after3months therapy. The reported side effects were minimal and transient in the form of minor pain, burning sensation and erythema at site of microneedling that disappeared spontaneously within few hours. Conclusion: Microneedling in combination with narrow band-UVB phototherapy could be considered as effective treatment of vitiligo. Microneedling is a tolerable technique, harmless with negligible side effects.

scholarly journals Evaluation of Intralesional Injection of 5-fluorouracil in Treatment of Vitiligo

2021 ◽  
pp. 11-16
Author(s):  
D. M. Abo Anber ◽  
D. A. Mohammed Ali ◽  
R. A. El-Tatawy ◽  
L. H. Elgarhy
Keyword(s):  
Side Effects ◽  
Narrow Band ◽  
Psychological Impact ◽  
Treatment Modalities ◽  
P Value ◽  
Intralesional Injection ◽  
Cutaneous Disease ◽  
Before And After ◽  
New Treatment

Background: Vitiligo is a chronic cutaneous disease characterized by depigmented patches that leave psychological impact on the patients. New treatment modalities have been developed to improve the results vitiligo with less side effects. Objective: To evaluate intralesional injection of 5-fluorouracil in treatment of vitiligo. Patients and Methods: The study included 20 localized stable vitiligo patients. Each patient was treated with intralesional injection of 5-fluorouracil every 2 weeks for 3 sessions followed by narrow band sessions twice weekly for 3 months. Results: There was statistically significant repigmentation after treatment with intralesional 5-FU (mean of 50.30 ± 34.60, P value =0.001 Wilcoxon signed ranks test between before and after). 55% of patients showed >50% repigmentation. after 3 months therapy. Side effects were minimal and transient. Conclusion: Intralesional injection of 5-FU is safe and effective in the treatment of vitiligo.

Systematic literature review of clinical outcomes in adults with metastatic or advanced synovial sarcoma

2020 ◽  
Vol 16 (35) ◽  
pp. 2997-3013
Author(s):  
Kentaro Kogushi ◽  
Michael LoPresti ◽  
Shunya Ikeda
Keyword(s):  
Synovial Sarcoma ◽  
High Frequency ◽  
Clinical Evidence ◽  
Systemic Treatment ◽  
Progression Free Survival ◽  
Treatment Modalities ◽  
Free Survival ◽  
New Treatment ◽  
Poor Outcomes

Background: Synovial sarcoma (SS) is a rare, aggressive soft tissue sarcoma with a poor prognosis after metastasis. The objective of this study was to conduct a systematic review of the clinical evidence for therapeutic options for adults with metastatic or advanced SS. Materials & methods: Relevant databases were searched with predefined keywords. Results: Thirty-nine publications reported clinical data for systemic treatment and other interventions. Data on survival outcomes varied but were generally poor (progression-free survival: 1.0–7.7 months; overall survival: 6.7–29.2 months) for adults with metastatic and advanced SS. A high frequency of neutropenia with systemic treatment and low quality of life post-progression were reported. Conclusion: Reported evidence suggests poor outcomes in adults with metastatic and advanced SS and the need for the development of new treatment modalities.

scholarly journals Correlation of Disease Activity and Quality of Life of Patients with Psoriasis after Narrow-band Ultraviolet B Therapy

Folia Medica ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 89-93
Author(s):  
Lyubomir A. Dourmishev ◽  
Karolina Lyubomirova
Keyword(s):  
Quality Of Life ◽  
Narrow Band ◽  
Life Quality ◽  
Clinical Effectiveness ◽  
Symptom Assessment ◽  
Severity Index ◽  
Ultraviolet B ◽  
Effective Treatment Option ◽  
Pasi Score

Introduction: Treatment with ultraviolet light is a well-established and effective treatment option for mild to moderate psoriasis. The aims of the study were to measure the psoriasis area and severity index (PASI) reduction after narrow-band ultraviolet B (NB UVB) therapy, to evaluate the quality of life before and after treatment using the dermatology life quality index (DLQI), and to compare the clinical effectiveness with quality of life improvement.   Material and methods: Twenty two patients (13 male and 9 female patients), aged between 21 to 70 years (mean age 40±14.65 years) were enrolled in the study. NB UVB treatment was performed with 10 to 25 (mean 18.5; SD 3.39) procedures with cumulative doses of 5 to 19.4 J/cm2. The baseline median PASI score was 20.027 which decreased after therapy to 11.11. More than PASI 50% reduction was achieved in 40.91% of the patients after at least 6 weeks of treatment and the results are highly statistically significant. Quality of life (QoL) assessed using DLQI was found moderately affected by disease pretreatment. NB UVB therapy significantly increased DLQI score in spectrum of ‘symptoms and feelings’ and ‘treatment’.   Discussion: The PASI score reduction that we observed after NB-UVB therapy is consistent with the results reported by other authors. Baseline DLQI scores were indicative of moderate QoL impairments associated with disease. At the same time, the reduction of the DLQI index corresponding to improved QoL correlated with the objective clinical symptom assessment.    Conclusion: Our data suggest that DLQI and PASI indexes are important complementary methods for comprehensive health assessment of patients with psoriasis. 

scholarly journals Positive and Negative Effects of Antipsychotic Medication: An International Online Survey of 832 Recipients

2019 ◽  
Vol 14 (3) ◽  
pp. 173-181 ◽  
Author(s):  
John Read ◽  
James Williams
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Antipsychotic Medication ◽  
Online Survey ◽  
Negative Effects ◽  
Duration Of Treatment ◽  
Direct To Consumer ◽  
Poor Outcomes

Background: Antipsychotic medication is currently the treatment of choice for psychosis, but few studies directly survey the first-hand experience of recipients. Objective: To ascertain the experiences and opinions of an international sample of users of antipsychotic drugs, regarding positive and negative effects. Methods: An online direct-to-consumer questionnaire was completed by 832 users of antipsychotics, from 30 countries – predominantly USA, UK and Australia. This is the largest such sample to date. Results: Over half (56%) thought, the drugs reduced the problems they were prescribed for, but 27% thought they made them worse. Slightly less people found the drugs generally ‘helpful’ (41%) than found them ‘unhelpful’ (43%). While 35% reported that their ‘quality of life’ was ‘improved’, 54% reported that it was made ‘worse’. The average number of adverse effects reported was 11, with an average of five at the ‘severe’ level. Fourteen effects were reported by 57% or more participants, most commonly: ‘Drowsiness, feeling tired, sedation’ (92%), ‘Loss of motivation’ (86%), ‘Slowed thoughts’ (86%), and ‘Emotional numbing’ (85%). Suicidality was reported to be a side effect by 58%. Older people reported particularly poor outcomes and high levels of adverse effects. Duration of treatment was unrelated to positive outcomes but significantly related to negative outcomes. Most respondents (70%) had tried to stop taking the drugs. The most common reasons people wanted to stop were the side effects (64%) and worries about long-term physical health (52%). Most (70%) did not recall being told anything at all about side effects. Conclusion: Clinical implications are discussed, with a particular focus on the principles of informed consent, and involving patients in decision making about their own lives.

Combination of Prednisolone and Azathioprine for Steroid-Responsive Meningitis-Arteritis Treatment in Dogs

2020 ◽  
Vol 57 (1) ◽  
pp. 1-7
Author(s):  
Lucile Giraud ◽  
Maud Girod ◽  
Laurent Cauzinille
Keyword(s):  
Side Effects ◽  
Relapse Rate ◽  
Primary Treatment ◽  
Immunosuppressive Drug ◽  
Duration Of Treatment ◽  
Glucocorticoid Treatment ◽  
Immune Mediated

ABSTRACT Treatment with high corticosteroid dosages for steroid-responsive meningitis-arteritis (SRMA) is correlated with severe adverse effects and worse quality of life. In order to improve immunosuppression and decrease dosage and duration of glucocorticoid treatment, a second immunosuppressive drug is commonly used in most of the immune-mediated diseases. The objective of this retrospective study was to evaluate the efficacy, tolerability, and occurrence of relapse for the combination of prednisolone and azathioprine. All dogs received azathioprine 2 mg/kg q 24 hr for 1 mo and then 2 mg/kg every other day for 2 mo; prednisolone was started at an immunosuppressive dosage and tapered off gradually during a mean of 3 mo. Twenty-six dogs met inclusion criteria. Twenty-one dogs (81%) were in clinical remission with no relapse observed within the 2 yr follow-up period. Treatment was well tolerated in all dogs and side effects were most of the time mild and self-limiting. The relapse rate (19%) was lower than most published rates. A prednisolone and azathioprine combination appeared to be effective for primary treatment of dogs with SRMA and allows a quicker tapering in prednisolone dosage, a decrease in long-term side effects of steroids, a shorter duration of treatment, and a low relapse rate.

Treatment of painful diabetic peripheral neuropathy

2015 ◽  
Vol 39 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Casandra J Rosenberg ◽  
James C Watson
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Side Effects ◽  
Diabetic Peripheral Neuropathy ◽  
Pain Control ◽  
Treatment Options ◽  
Mechanisms Of Action ◽  
Treatment Modalities ◽  
Painful Diabetic Peripheral Neuropathy

Background: Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat. Objective: To discuss current treatment recommendations for painful diabetic peripheral neuropathy. Study design: Literature review. Methods: Systematic review of the literature discussing treatment of painful diabetic peripheral neuropathy. Existing treatment guidelines were studied and compared. Results: Painful diabetic peripheral neuropathy occurs in about one in six people with diabetes. This condition impairs quality of life and increases healthcare costs. Treatment recommendations exist, but individual patient therapy can require a trial-and-error approach. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control. Adequate medication titration and a reasonable trial period should be allowed. Conclusion: The treatment of painful diabetic peripheral neuropathy can be challenging, but effective management can improve patient’s quality of life. Clinical relevance Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control.

scholarly journals A study on awareness on allergic disorders and allergen immunotherapy among medical practitioners

2021 ◽  
Vol 8 (11) ◽  
pp. 5394
Author(s):  
Giriyanna Gowda ◽  
Pruthvi S. ◽  
M. S. Phaneendra ◽  
Chitra Nagaraj
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
School Performance ◽  
Allergen Immunotherapy ◽  
Duration Of Treatment ◽  
Medical Practitioners ◽  
Long Duration ◽  
Allergic Disorders ◽  
Life Work

Background: Allergy is a common ailment affecting more than 20% of the population worldwide. Allergic patients suffer from a debilitating disease with a major impact on their quality of life, work and school performance. Allergic disorders can be debilitating, with a major impact on their quality of life, work and school performance. AIT (Allergen immunotherapy), modify the natural history of allergic disease and prevent the progression of allergic respiratory diseases by maintaining a long-lasting effect. Since the awareness among medical practitioners plays very important role in advising AIT for allergy patients, we attempted to conduct this study.Methods: This was a descriptive study done for a period of three months from December 2016 to February 2017. The 110 study subjects were recruited through purposive sampling. Doctors of various specialties and general practitioners were interviewed using self-administered, semi-structured questionnaire.Results: There were 73 (66.36%) males and 37 (33.64%) females. Mean age of the medical practitioners was 35.73±13.07 (Mean±SD). 98 (89.09%) of the practitioners were aware of skin prick test for the diagnosis of allergy, 70 (63.3%) subjects had heard term AIT, 59 (84.28%) were aware about subcutaneous immunotherapy (SCIT) and 25 (35.71%) of sublingual immunotherapy (SLIT). Forty-four (62.96%) were not advising immunotherapy for their patients in spite of having awareness on immunotherapy. The common reasons for not advising immunotherapy were long duration of treatment, high cost, less effective, not available in India, fear of side effects and others.Conclusions: Though the awareness among medical practitioners on AIT was good, majority are not advising because of long duration of treatment, high cost, less effective, not available in India, fear of side effects and others.

scholarly journals Pediatric Cardio-Oncology Medicine: A New Approach in Cardiovascular Care

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1200
Author(s):  
Hugo R. Martinez ◽  
Gary S. Beasley ◽  
Jason F. Goldberg ◽  
Mohammed Absi ◽  
Kaitlin A. Ryan ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Pediatric Patients ◽  
Rapid Expansion ◽  
Treatment Modalities ◽  
Cancer Therapies ◽  
New Approach ◽  
Children And Young Adults ◽  
New Treatment ◽  
Cardiovascular Care

Survival for pediatric patients diagnosed with cancer has improved significantly. This achievement has been made possible due to new treatment modalities and the incorporation of a systematic multidisciplinary approach for supportive care. Understanding the distinctive cardiovascular characteristics of children undergoing cancer therapies has set the underpinnings to provide comprehensive care before, during, and after the management of cancer. Nonetheless, we acknowledge the challenge to understand the rapid expansion of oncology disciplines. The limited guidelines in pediatric cardio-oncology have motivated us to develop risk-stratification systems to institute surveillance and therapeutic support for this patient population. Here, we describe a collaborative approach to provide wide-ranging cardiovascular care to children and young adults with oncology diseases. Promoting collaboration in pediatric cardio-oncology medicine will ultimately provide excellent quality of care for future generations of patients.

Safe and effective use of phototherapy and photochemotherapy in the treatment of psoriasis

2020 ◽  
Vol 29 (10) ◽  
pp. 547-552
Author(s):  
Joanna Campbell
Keyword(s):  
Side Effects ◽  
Inflammatory Disease ◽  
Narrow Band ◽  
Ultraviolet B ◽  
Second Line ◽  
Skin Involvement ◽  
Ultraviolet A ◽  
History Of ◽  
Effective Use

Psoriasis is a chronic, multisystem inflammatory disease, predominantly affecting the skin and joints, which is present in 2−3% of the world's population. Narrow band ultraviolet B (NB-UVB) and Psoralen + ultraviolet A (PUVA) are recognised, effective and, in the case of UVB, economical second-line treatments for psoriasis where topical therapies fail to control the disease or are an impracticable option due to the extent of skin involvement. This article examines the history of phototherapy and photochemotherapy and looks at current phototherapy treatments used for psoriasis. It discusses side effects of treatment and regimens that can be followed to increase effectiveness of treatment and minimise risks. The role of the nurse phototherapist is also discussed.

scholarly journals Evaluation of rituximab infusion therapy in patients with recalcitrant pemphigus vulgaris

2019 ◽  
Vol 10 (3) ◽  
pp. 1900-1903
Author(s):  
Akeel Hamed Jabur ◽  
Farah Saleh Abdul-reda ◽  
Suhad Jassim abdlkadhim
Keyword(s):  
Side Effects ◽  
Previous Treatment ◽  
Pemphigus Vulgaris ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Infusion Therapy ◽  
Duration Of Treatment ◽  
Weekly Basis ◽  
Duration Of Disease ◽  
Neoplastic Disorders

The usual approach is to treat pemphigus vulgaris by corticosteroids and in some cases, immune suppressive agents may be indicated. The response is often satisfactory to the patient and acceptable clinically; however, the use of such agents is not free of side effects. Adverse effects associating the use of corticosteroids and immune-suppressing agents are numerous, but the principal side effects are those of fatal infections and neoplastic disorders. Therefore, the search for other forms of treatment modalities has been proven necessary, especially in resistant and recalcitrant types of the disorder. A number of studies have shown role Rituximab in the treatment of pemphigus vulgaris; however, results were conflicting. Therefore we planned and conducted the current study to assess the efficacy of this drug in the treatment of recalcitrant cases of pemphigus vulgaris in a sample of Iraqi patients in the Mid-Euphrates region. to assess the efficacy of Rituximab in the treatment of recalcitrant cases of pemphigus vulgaris in a sample of Iraqi patients in the Mid-Euphrates region. The current cohort study included 10 patients with pemphigus vulgaris. Those patients were selected from the pool of patients visiting the dermatology consultation unit at Al-Diwaniyah teaching hospital, Al-Diwaniyah Province, Iraq during the period from January 2017 through June 2019. Age, gender, duration of disease, previous treatment, and maintenance treatment were the main variables included in the study; the outcome was a response to treatment classified as satisfactory, partially satisfactory and unsatisfactory. All patients were given an intravenous infusion of Rituximab in a dose of a 375 mg/m2 in a weekly basis. The patients were followed for a minimum of 6 months. All patients were treated by intravenous rituximab and followed for a period of 6 up to 18 months, mean of 11.30 ±3.83 months. Four (40.0 %) patients developed a satisfactory response, 5 (50.0 %) had partial satisfaction, and a single patient had an unsatisfactory response. Response to treatment was no significantly correlated to patients' age, gender or duration of disease; however, there was a significant positive correlation between duration of treatment and response to it. Good rate of satisfaction can be obtained following the use of weekly based intravenous retuximab in patients with recalcitrant pemphigus vulgaris.

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