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Side effect management

Rafael L Batista, Nina R C Musolino, Valter A S Cescato, Gilberto O da Silva, Raphael S S Medeiros, Clarissa G B Herkenhoff, Ericka B Trarbach, Malebranche B Cunha-Neto
BACKGROUND: Complete tumor removal by transsphenoidal surgery is usually difficult for large nonfunctioning pituitary adenomas (NFPAs). A validated medical treatment may be useful for their management. This study evaluates the clinical efficacy of the dopaminergic agonist cabergoline for residual NFPA. DESIGN, SETTING, AND PARTICIPANTS: We conducted a randomized, parallel, open-label clinical trial that compared cabergoline with nonintervention in patients with residual NFPA after transsphenoidal surgery over 2 years...
December 11, 2018: American Journal of Clinical Oncology
Qiujun Guo, Xinyao Xu, Shulin He, Yuan Yuan, Shuntai Chen, Baojin Hua
Objective: To evaluate Xi huang pill combined with chemotherapy for tumor treatment in a meta-analysis. Materials and Methods: We searched PubMed, Excerpta Medica Database, the Cochrane Library, the China National Knowledge Infrastructure, and the Weipu database and Wanfang Databases for eligible studies. We manually searched for printed journals and relevant textbooks. Statistical analyses were performed with Review Manager 5.3 (Cochrane Community, London, United Kingdom) and STATA 12...
December 2018: Journal of Cancer Research and Therapeutics
Jean-Lionel Bagot, Clara Delègue
BACKGROUND: Nearly half of patients discontinue tamoxifen hormone therapy early because of side effects, thus increasing the risk of breast cancer recurrence. Could a homeopathic treatment improve compliance? METHODS: A patient suffering from side effects of tamoxifen was seen in consultation every 2 months for 10 months by a senior homeopathic doctor and a registrar. RESULTS: Case analysis and repertorisation led to the identification of Pulsatilla as the simillimum drug and tamoxifen 7c as the etiological treatment...
December 11, 2018: Wiener Medizinische Wochenschrift
Aung S Myint, Brandon Rieders, Mohammed Tashkandi, Marie L Borum, Joyce M Koh, Sindu Stephen, David B Doman
Gastroparesis is a complex, debilitating dysmotility disorder with challenging symptom management. A diagnosis of gastroparesis is based on objectively delayed gastric emptying in the absence of mechanical obstruction. Given the limited efficacy of treatment options and serious side effects, significant research continues for therapeutic options for gastroparesis. Promising investigational pharmacologic therapies include relamorelin, prucalopride, and aprepitant. A novel endoscopic therapy is gastric peroral endoscopic pyloromyotomy, which is associated with improved gastric emptying...
November 2018: Gastroenterology & Hepatology
Nguyen Truong Giang, Nguyen Van Nam, Nguyen Ngoc Trung, Le Viet Anh, Nguyen Manh Cuong, Ngo Van Dinh, Dinh Cong Pho, Phillip Geiger, Nguyen Trung Kien
Background: Paravertebral block has been proven to be an efficient method to provide post-thoracotomy pain management. This study aimed to compare patient-controlled paravertebral analgesia (PCPA) and intravenous patient-controlled analgesia (IVPCA) in terms of analgesic efficiency, respiratory function, and adverse effects after video-assisted thoracoscopic surgery (VATS) lobectomy. Patients and methods: The prospective randomized trial study was carried out on 60 patients who underwent VATS lobectomy (randomly allocated 30 patients in each group)...
2018: Local and Regional Anesthesia
Nicole Remaliah Samantha Sibuyi, Mervin Meyer, Martin Opiyo Onani, Amanda Skepu, Abram Madimabe Madiehe
Obesity is a global epidemic that poses a serious health concern due to it being a risk factor for life-threatening chronic diseases, such as type 2 diabetes, cancer, and cardiovascular diseases. Pharmacotherapy remains the mainstay for the management of obesity; however, its usefulness is limited due to poor drug efficacy, non-specificity and toxic side effects. Therefore, novel approaches that could provide insights into obesity and obesity-associated diseases as well as development of novel anti-obesity treatment modalities or improvement on the existing drugs are necessary...
2018: International Journal of Nanomedicine
Amir Nejati, Mohammad Jalili, Saeed Abbasi, Farhad Talebi Sarwari, Ali Bidari, Mahsa Ghajarzadeh, Atousa Akhgar
BACKGROUND: Low dose ketamine can be used as analgesic in acute pain management in the emergency department (ED). OBJECTIVE: Efficacy of IN ketamine in acute pain management in the ED. METHOD: This is a double blind randomized clinical trial on patients older than 15 years who needed digital nerve block (DNB). Participants randomly received IN Ketamine (1 ml = 50 mg) or placebo (normal saline, 1 ml) 5 min before DNB. In both groups, patients' pain score was recorded by visual analogue score (VAS) at baseline, after DNB and 45 min after completion of DNB...
November 17, 2018: American Journal of Emergency Medicine
Hiroshi Komamura, Takaaki Nakamura, Junpei Kobayashi, Ryuhei Harada, Kaoru Endo, Masaki Ogura, Jun Higuchi
Early neurosyphilis commonly appears in basilar meninges, and its meningeal inflammation can spread to neighboring cranial nerves, resulting in some cranial nerve palsies. Herein, we report a case of a 51-year-old man who presented with right peripheral facial nerve palsy. His symptoms completely disappeared with prednisolone monotherapy without antibiotics use and were not exacerbated during clinical treatment. However, 2 months after remission of seventh cranial neuropathy, fifth and eighth cranial neuropathies appeared on the right side...
December 8, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Catherine N Marti, Gregg C Fonarow, Stefan D Anker, Clyde Yancy, Muthiah Vaduganathan, Stephen J Greene, Ali Ahmed, James L Januzzi, Mihai Gheorghiade, Gerasimos Filippatos, Javed Butler
Multiple drug classes have shown incremental benefits in heart failure with reduced ejection fraction. Most of these trials were designed to achieve specific doses of the investigational agent. Clinical practice guidelines recommend using the same target dosing of therapies, as tolerated. However, with the increasing number of available therapies, clinicians face the challenge of simultaneously using several drugs, achieving target doses, and managing side effects that are often overlapping. Blood pressure, renal function, hyperkalaemia, and other factors may impede achieving target doses of all medications, leaving clinicians with dilemmas as to how to sequence and dose these various classes of drugs...
December 10, 2018: European Journal of Heart Failure
Payahoo Laleh, Khajebishak Yaser, Ostadrahimi Alireza
Obesity as a multifactorial disorder has been shown a dramatically growing trend recently. Besides genetic and environmental factors, dysregulation of the endocannabinoid system tone is involved in the pathogenesis of obesity. This study reviewed the potential efficacy of Oleoylethanolamide (OEA) as an endocannabinoid-like compound in the energy homeostasis and appetite control in people with obesity. OEA as a lipid mediator and bioactive endogenous ethanolamide fatty acid is structurally similar to the endocannabinoid system compounds; nevertheless, it is unable to induce to the cannabinoid receptors...
December 7, 2018: Journal of Cellular Physiology
Alex Solderer, Manuela Kaufmann, Deborah Hofer, Daniel Wiedemeier, Thomas Attin, Patrick R Schmidlin
BACKGROUND: Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is-surprisingly-still missing. OBJECTIVES: To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential...
December 7, 2018: Clinical Oral Investigations
Shao-Cheng Liu, Ming-Chang Kao, Yun-Chen Huang, Wan-Fu Su
BACKGROUND: Management of chronic cluster headache (CCH) remains a challenging endeavor, and the optimal surgical approach for medically refractory CCH remains controversial. OBJECTIVE: To conduct a preliminary evaluation of the efficacy and safety of vidian neurectomy (VN) in patients with medically refractory CCH. METHODS: Between March 2013 and December 2015, 9 CCH patients, all of whom had failed to respond to conservative therapy, underwent VN with a precise nerve cut and maximal preservation of the sphenopalatine ganglion...
December 10, 2018: Neurosurgery
Kyle R Eberlin, Ivica Ducic
Successful treatment of the painful neuroma is a particular challenge to the nerve surgeon. Historically, symptomatic neuromas have primarily been treated with excision and implantation techniques, which are inherently passive and do not address the terminal end of the nerve. Over the past decade, the surgical management of neuromas has undergone a paradigm shift synchronous with the development of contemporary techniques aiming to satisfy the nerve end. In this article, we describe the important features of surgical treatment, including the approach to diagnosis with consideration of neuroma type and the decision of partial versus complete neuroma excision...
October 2018: Plastic and Reconstructive Surgery. Global Open
Lei Zhang, Wei-Qiang Tan, Qing-Qing Fang, Wan-Yi Zhao, Qi-Ming Zhao, Jie Gao, Xiao-Wei Wang
Objective: Melasma is a highly prevalent, chronic, and pigmentary disorder. This systematic review aims to evaluate the efficacy and safety of tranexamic acid (TA) for the treatment of adults with melasma. Methods: We independently searched 3 databases from beginning to 26 April, 2018. The study included 21 eligible trials. Two writers extracted data at the same time independently. Study outcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (CIs)...
2018: BioMed Research International
Dita Aditianingsih, Chaidir Arif Mochtar, Susilo Chandra, Raden Besthadi Sukmono, Ilham Wahyudi Soamole
Background: Postoperative pain management is important for the early recovery of the living donor patient. Patient-controlled opioid analgesia, epidural analgesia, or a combination of both is the preferred pain management after abdominal surgery although these approaches have serious side effects. The transversus abdominis plane (TAP) block has been increasingly used for postoperative pain management and the addition of dexamethasone to local anesthetic can prolong the duration of action...
October 2018: Anesthesiology and Pain Medicine
Barbara Atzori, Rosapia Lauro Grotto, Andrea Giugni, Massimo Calabrò, Wadee Alhalabi, Hunter G Hoffman
Background: Dental procedures often elicit pain and fear in pediatric dental patients. Aim: To evaluate the feasibility and effectiveness of immersive virtual reality as an attention distraction analgesia technique for pain management in children and adolescents undergoing painful dental procedures. Design: Using a within-subjects design, five patients (mean age 13.20 years old, SD 2.39) participated. Patients received tethered immersive interactive virtual reality distraction in an Oculus Rift VR helmet (experimental condition) during one dental procedure (a single dental filling or tooth extraction)...
2018: Frontiers in Psychology
Mohamadreza Amin, Mahsa Bagheri, Mercedeh Mansourian, Mahmoud Reza Jaafari, Timo Lm Ten Hagen
Introduction: PEGylated liposomes are widely used and studied as carriers for chemotherapeutics. While pharmacokinetics of the encapsulated drug is drastically altered resulting in favorable circulation time, improved tumor accumulation, and better manageable or reduced side effects, therapeutic efficacy has been disappointing. Major drawbacks are a failure to reach the tumor cell, limited penetration depth, and impaired uptake by tumor cells. Materials and methods: Here, we study the implication of HIV-1 transactivator of transcription (TAT)-derived peptides inserted on PEGylated liposomal doxorubicin (PLD) and followed in vitro and in vivo fate...
2018: International Journal of Nanomedicine
Liselotte E M van Kempen, Augustinus S van Teeffelen, Annemijn A de Ruigh, Dick Oepkes, Monique C Haak, Elisabeth van Leeuwen, Mallory Woiski, Martina M Porath, Caroline J Bax, Aleid G van Wassenaer-Leemhuis, Antonius L Mulder, David P van der Ham, Christine Willekes, Maureen T Franssen, Jan B Derks, Ewoud Schuit, Ben W Mol, Eva Pajkrt
OBJECTIVE: To assess the effectiveness of amnioinfusion in women with second-trimester preterm prelabor rupture of membranes. METHODS: We performed a nationwide, multicenter, open-label, randomized controlled trial, the PPROM: Expectant Management versus Induction of Labor-III (PPROMEXIL-III) trial, in women with singleton pregnancies and preterm prelabor rupture of membranes at 16 0/7 to 24 0/7 weeks of gestation with oligohydramnios (single deepest pocket less than 20 mm)...
December 4, 2018: Obstetrics and Gynecology
Huiqi Yang, Yiting Liu, Jie Chen, Yingmo Shen
We present our experience in managing mesh infection after laparoscopic inguinal hernia repair. We analyzed 19 patients with extensive mesh infection treated between 2012 and 2017 via laparoscopic mesh excision after preoperative workup. After mesh removal and insertion of a drain into the preperitoneal space, the peritoneal flap was closed with 3/0 absorbable consecutive suture. The operative course in all patients was uneventful. Sigmoidectomy for a fistula was required in 1 patient. Two patients required a second laparoscopic surgery for infection on the contralateral side and residual mesh around the pubic bone...
December 10, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Nicola Warren, Vanessa Grote, Cullen O'Gorman, Dan Siskind
BACKGROUND: Anti-NMDA receptor encephalitis most commonly presents with psychiatric symptoms such as behavioural disturbance, catatonia and psychosis. Although the primary treatment is with immunomodulatory therapy, psychiatric symptoms often require adjuvant management. Side effects and treatment resistance limits the use of psychotropics, but the role of ECT has been minimally reviewed. OBJECTIVE: To review the safety and effectiveness of ECT for treatment of psychiatric symptoms in anti-NMDA receptor encephalitis...
December 4, 2018: Brain Stimulation
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