Home About us Contact
|
Home About us Contact | ||
|
|
||
Side-effects
Kinds of Side-effects Terms modified by Side-effects Selected AbstractsOnychomadesis: A Rare Side-Effect of Valproic Acid Medication?PEDIATRIC DERMATOLOGY, Issue 6 2009ANDREA PORETTI M.D. Several side effects are known. We report on a child with onychomadesis as a possible side-effect of treatment with VPA. Normal nail growth was observed after stopping VPA. The pathomechanism of onychomadesis due to VPA treatment remains unclear. [source] Placebo-controlled evaluation of the irritant potential of tacalcitol (1,, 24-dihydroxyvitamin D3) in healthy volunteersCONTACT DERMATITIS, Issue 5 2000K. Schlotmann In the treatment of psoriasis with topical vitamin D3 analogues, lesional and perilesional irritation is the main side-effect. The aim of this study was to investigate whether local side-effects generated by tacalcitol, a vitamin D3 analogue, show concentration dependence. 3 different concentrations of tacalcitol (0.4; 4; 40 ,g/g ointment) and the vehicle were applied on normal skin of the back of 25 healthy volunteers under occlusive conditions for 5 days. Assessment of erythema, infiltration and scaling as well as measurement of transepidermal water loss (TEWL) was performed on days 1 to 5. On day 5, additional skin barrier tests (DMSO test, alkali resistance test) were performed. Erythema and slight infiltration, but no scaling, were observed in a number of subjects without significant differences. TEWL also did not show significant differences for the test formulations, though there was a tendency towards lower values in the untreated areas. In the skin barrier tests, a tendency towards higher alkali resistance in the test areas treated with 40 ,g tacalcitol/g ointment was detected. Thus, under occlusive conditions, the irritant potential of tacalcitol is very low. There is no convincing evidence of concentration dependence in irritation generated by tacalcitol when applied under occlusive conditions. [source] How hypoglycaemia can affect the life of a person with diabetesDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2008Brian M. Frier Abstract Hypoglycaemia is the commonest side-effect of insulin treatment for diabetes, and is the single greatest barrier to achieving and maintaining good glycaemic control. Severe hypoglycaemia (requiring assistance for recovery) is associated with significant morbidity and is feared by most people with type 1 diabetes and their families. It causes stress and anxiety and may influence self-management and glycaemic control. The annual prevalence of severe hypoglycaemia is around 30% in people with type 1 diabetes, and is higher in those with risk factors such as strict glycaemic control, impaired awareness of hypoglycaemia and increasing duration of diabetes. It is also common during sleep (nocturnal hypoglycaemia). Neurological manifestations include coma, convulsions, transient hemiparesis and stroke, while reduced consciousness and cognitive dysfunction may cause accidents and injuries. Cardiac events may be precipitated such as arrhythmias, myocardial ischaemia and cardiac failure. Hypoglycaemia can affect all aspects of life, including employment, driving, recreational activities involving exercise, and travel, and measures should be taken in all of these situations to avoid this potentially dangerous side-effect of insulin therapy. Copyright © 2007 John Wiley & Sons, Ltd. [source] Sertraline-induced hypomania: a genuine side-effectACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2003D. N. Mendhekar Objective: Antidepressants including selective serotonin reuptake inhibitor (SSRI)-associated mania or hypomania has been well documented in the literature but these patients with switch have either mood disorders or various risk factors for bipolar disorder. This case report examines SSRI-induced hypomania in a patient with dissociative disorder and highlights hypomania as a genuine side-effect of sertraline rather than a switch. Method: A 23-year-old female patient with dissociative disorder has been described. Results: Hypomanic symptoms emerged during treatment with sertraline at the dose of 50 mg/day after 3,4 days of initiation of therapy and had complete recovery within 7 days after stopping sertraline. Conclusion: In the absence of risk factors for manic switch, sertraline-induced hypomania may be a true side-effect of drug. [source] The mechanisms that underlie glucose sensing during hypoglycaemia in diabetesDIABETIC MEDICINE, Issue 5 2008R. McCrimmon Abstract Hypoglycaemia is a frequent and greatly feared side-effect of insulin therapy, and a major obstacle to achieving near-normal glucose control. This review will focus on the more recent developments in our understanding of the mechanisms that underlie the sensing of hypoglycaemia in both non-diabetic and diabetic individuals, and how this mechanism becomes impaired over time. The research focus of my own laboratory and many others is directed by three principal questions. Where does the body sense a falling glucose? How does the body detect a falling glucose? And why does this mechanism fail in Type 1 diabetes? Hypoglycaemia is sensed by specialized neurons found in the brain and periphery, and of these the ventromedial hypothalamus appears to play a major role. Neurons that react to fluctuations in glucose use mechanisms very similar to those that operate in pancreatic B- and A-cells, in particular in their use of glucokinase and the KATP channel as key steps through which the metabolic signal is translated into altered neuronal firing rates. During hypoglycaemia, glucose-inhibited (GI) neurons may be regulated by the activity of AMP-activated protein kinase. This sensing mechanism is disturbed by recurrent hypoglycaemia, such that counter-regulatory defence responses are triggered at a lower glucose level. Why this should occur is not yet known, but it may involve increased metabolism or fuel delivery to glucose-sensing neurons or alterations in the mechanisms that regulate the stress response. [source] The effect of spironolactone, cilazapril and their combination on albuminuria in patients with hypertension and diabetic nephropathy is independent of blood pressure reduction: a randomized controlled studyDIABETIC MEDICINE, Issue 5 2004R. Rachmani Abstract Objective The effect of spironolactone, cilazapril and their combination on albuminuria was examined in a randomized prospective study in female patients with diabetes and hypertension. Patients and methods Sixty female diabetic patients aged 45,70 years with blood pressure (BP) 140,180/90,110 mmHg, serum creatinine (sCr) , 160 µmol/l, HbA1c , 10%, and albuminuria were treated by atenolol 12.5,75 mg/d and hydrochlorothiazide 6.25,25 mg/d. Titration-to-target helped to reach BP values , 135/85 mmHg in 46 patients after 12 weeks. These patients were randomized to spironolactone 100 mg/d or cilazapril 5 mg/d for 24 weeks. Then both groups received spironolactone 50 mg/d and cilazapril 2.5 mg/d for 24 weeks. BP was stabilized by tapering the dose of the initial agents. Urinary albumin/creatinine ratio (ACR), BP, K+. sCr and HbA1c were assessed at baseline and at weeks 12, 16, 36 and 60. Results The average BP at week 12 was 128 ± 4/81 ± 3 mmHg and remained constant, in both groups, throughout the study. ACR declined on spironolactone from a median value (range) of 452 (124,1571) to 216 (64,875) mg/g (P = 0.001), and on cilazapril to 302 (90,975) mg/g (P = 0.001). The difference between spironolactone and cilazapril was significant (P = 0.002). Combined treatment resulted in a further modest decline in ACR. Serum creatinine was unaltered by spironolactone and rose slightly (121 to 126 µmol/l, P = 0.02) on cilazapril. Conclusion At the doses tested, spironolactone was superior to cilazapril in reducing albuminuria. Combined administration was more effective than either drug alone. These effects were independent of BP values. Hyperkalaemia was the main side-effect. [source] Symptoms of hypoglycaemia in people with diabetesDIABETIC MEDICINE, Issue 9 2001V. McAulay Abstract The symptoms of hypoglycaemia are fundamental to the early detection and treatment of this side-effect of insulin and oral hypoglycaemic therapy in people with diabetes. The physiology of normal responses to hypoglycaemia is described and the importance of symptoms of hypoglycaemia is discussed in relation to the treatment of diabetes. The symptoms of hypoglycaemia are described in detail. The classification of symptoms is considered and the usefulness of autonomic and neuroglycopenic symptoms for detecting hypoglycaemia is discussed. The many external and internal factors involved in the perception of symptoms are reviewed, and symptoms of hypoglycaemia experienced by people with Type 2 diabetes are addressed. Age-specific differences in the symptoms of hypoglycaemia have been identified, and are important for clinical and research practice, particularly with respect to the development of acquired hypoglycaemia syndromes in people with Type 1 diabetes that can result in impaired awareness of hypoglycaemia. In addition, the routine assessment of hypoglycaemia symptoms in the diabetic clinic is emphasized as an important part of the regular review of people with diabetes who are treated with insulin. Diabet. Med. 18, 690,705 (2001) [source] Corticosteroid side-effects and risk for bleeding in immune thrombocytopenic purpura: patient and hematologist perspectivesEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2009Jacqueline A. Guidry Abstract Objectives:, The purpose of this study was to examine hematologist and patient perspectives about the side-effects of the corticosteroid treatment of immune thrombocytopenic purpura (ITP) and their perspectives about the patient's risk for bleeding. The specific aim was to compare patient and hematologist perspectives and, if a difference was documented, the implications of that difference. We hypothesized that patients with ITP may have more concern about corticosteroid side-effects and less concern about serious bleeding than hematologists. Methods:, We surveyed 80 patients in the Oklahoma ITP Registry and all 83 hematologists in Oklahoma about the occurrence and severity of 18 corticosteroid side-effects and risks for serious bleeding. Results:, Response rates were 80% (patients) and 71% (hematologists). Responses of patients and hematologists were significantly different from each other regarding both the frequency of severe corticosteroid side-effects and the risk of serious bleeding. For 13 of the 18 corticosteroid side-effects, patients reported more frequent occurrence of severe symptoms than hematologists (P < 0.05); physicians reported more frequent occurrence for one side-effect (P < 0.05). Conversely, 69% and 93% of hematologists reported being very worried about serious bleeding when responding to two case scenarios describing patients with platelet counts of 10 000/,L and 5000/,L (P < 0.05), compared with only 16 (31%) of 51 patients whose lowest platelet count had been <10 000/,L. Conclusion:, Awareness of the different opinions about corticosteroid side-effects and risk for bleeding between ITP patients and hematologists may improve management decisions. [source] Should levodopa dose be reduced when switched to stalevo?EUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2008G. Linazasoro The addition of entacapone to levodopa-carbidopa (LC) or the switch from LC to a tablet containing levodopa,carbidopa,entacapone (LCE) improves the wearing-off phenomenon, increases the ,on' time and decreases the ,off' time, but the appearance or exacerbation of dyskinesias is the more frequent side-effect. Thus, a reduction of the total levodopa dosage would be recommended. However, this could result in a lack of efficacy against the wearing-off. We report on the results of a clinical trial conducted to determine the best way in terms of efficacy, tolerability and safety of switching from LC to LCE in patients with Parkinson's disease (PD) and end of dose wearing-off. 39 patients with PD and wearing-off without or with mild dyskinesias were randomly assigned to either a group receiving the same LC dosage or to a group in which the total LC amount was reduced by 15,25%. Four weeks after the change, both groups showed an increase in daily ,on' time and a reduction in the daily time spent in ,off'. Two patients in each group experienced an increase in basal dyskinesias. No differences in clinical assessment between groups were found. Tolerance was excellent. This study suggests that switching from LC to LCE in patients with mild-to-moderate wearing-off can be done safely with or without reducing the total LD amount, but in the clinical setting it would be more practical to keep the dosage of LC unchanged unless severe dyskinesias are present. [source] Putting value of information theory into practice: a methodology for building sequential decision support systemsEXPERT SYSTEMS, Issue 2 2004Silvano MussiArticle first published online: 7 MAY 200 Abstract: The paper presents a methodology for building sequential decision support systems based on decision theory using value of information (for short, DT-VOI based SDSSs). DT-VOI based SDSSs support decision-makers in difficult problems of sequential decision-making. In particular we consider the problem of building DT-VOI based SDSSs which are capable of supporting decisions in critical situations where (1) making a decision entails knowing the states of some critical hypotheses, and such knowledge is acquired by performing suitable tests; (2) test outcomes are uncertain; (3) performing a test entails, in general, some drawbacks, so that a trade-off exists between such drawbacks and the value of the information provided by the test; (4) performing a test has the side-effect that it changes the expected benefit from performing other tests; (5) exceptional situations alter probability and utility default values. [source] Induction of endogenous pathways by antiepileptics and clinical implicationsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2005M. Strolin Benedetti Abstract The aim of this study was to review modifications of the endogenous pathways (e.g. enzyme elevations, normal body constituent depletion or higher formation/excretion of endogenous metabolites) which could be ascribed to enzyme induction by antiepileptic drugs (AEDs). Information on older (e.g. phenobarbital, phenytoin and carbamazepine) and newer drugs (where information is available) is discussed together with clinical implications. The enzymes involved in the endogenous pathways and induced by the AEDs will not be limited to the hepatic microsomal enzymes; extrahepatic enzymes and/or enzymes present in other subcellular fractions will also be discussed, if pertinent. The induction of endogenous pathways by AEDs has been taken into account in the past, but much less emphasis has been given compared with the extensive literature on induction by AEDs of the metabolism of concomitantly administered drugs, either of the same or of different classes. Not all of the endogenous pathways examined and induced by AEDs appear to result in serious clinical consequences (e.g. induction of hepatic ALP, increased excretion of d -glucaric acid or of 6, -hydroxycortisol). In some cases, induction of some pathways (e.g. increase of high-density lipoprotein cholesterol or of conjugated bilirubin) might even be a beneficial side-effect, however enzyme induction is considered rather a detrimental aspect for an AED, as induction is generally a broad and a non-specific phenomenon. The new AEDs have generally less induction potential than the older agents. Yet some (felbamate, topiramate, oxcarbazepine and lamotrigine) have the potential for inducing enzymes, whereas others (levetiracetam, gabapentin and vigabatrin) appear to be completely devoid of enzyme inducing characteristics, at least as far as the enzymes investigated are concerned. [source] Cough after inhalation of corticosteroids delivered from spacer devices in children with asthmaFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2003Jean-Christophe Dubus Abstract Children using a spacer device rather than another device for delivering inhaled corticosteroids (ICS) has been identified as a risk factor for cough immediately after inhalation. The aim of this study was to point out the different factors influencing the occurrence of such lateral side-effects. We studied this local side-effect in 402 asthmatic children (55.6 ± 34.9 months; 65.6% boys) treated for at least 1 month with beclomethasone dipropionate (n = 331), budesonide (n = 47) or fluticasone propionate (n = 24) delivered from pressurized metered-dose inhalers and small (75.1%) or large volume (24.8%) spacer devices mainly used with face mask (90.7%). A total of 219 patients (54.5%), treated with either high doses of ICS or ICS and long-acting ,2-agonist, were considered as having severe asthma. Cough was reported after each inhalation of corticosteroids in 216 patients (53.7%). Among them, about 30% also complained of cough with ,2-agonists. Despite different propellants and dispersants, all corticosteroids induced cough similarly. Cough was not linked with asthma severity, but was significantly related to therapy duration and use of long-acting ,2-agonist. Type and volume of the spacer device, use of a face mask or mouthpiece were not influencing factors. Cough after inhalation of corticosteroids delivered from spacer devices is a frequent local side-effect in children with asthma. This side effect can greatly alter compliance. A practitioner must be sought at each visit. [source] Prolonged-release oxycodone/naloxone for chronic painFUTURE PRESCRIBER, Issue 1 2009Nicola O'Connell Medical Writer Chronic pain is common, and opioid therapy is often required for pain management. Unfortunately, opioid-induced bowel dysfunction (OIBD) is a frequent and debilitating side-effect of opioid use. A new prolonged-release (PR) preparation of oxycodone/naloxone has been developed for moderate-to-severe pain that reduces OIBD in patients. In this article, we consider the mode of action and efficacy of this combination opioid therapy for chronic pain. Copyright © 2009 John Wiley & Sons, Ltd. [source] Alzheimer's disease: Mechanisms and development of therapeutic strategiesGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2003Takeshi Tabira Senile plaques are the most characteristic change in Alzheimer's disease (AD). In senile plaques, , amyloid is deposited, which is composed of aggregated amyloid , protein (A,) derived from amyloid precursor protein (APP). Therefore, it is suggested that there exists a mechanism of increase of A, production or a decrease of A, degradation and/or clearance of , amyloid in AD. Mutations in familial Alzheimer's disease (FAD) genes such as APP, presenilin 1 (PS1) and presenilin 2 (PS2) result in an increase of A, production. Apolipoprotein E (ApoE), a genetic risk factor for AD, is involved in A, production and/or its clearance. Thus, it is suggested that an inhibition of A, production and a facilitation of , amyloid degradation and clearance delay the clinical onset and progression of AD, and it is possible to cure AD even after an onset of the disease, if it is still at an early phase. Researchers studied the fine mechanisms of A, production and identified enzymes that cleave-out A, from APP. Inhibitors of the cleaving enzymes are proven to be effective in ameliorating AD-like conditions in its animal models and are now being applied to humans. Researchers also found an efficient way of clearing , amyloid deposits using the immune system, which was effective in animal models. When it was applied to humans, some patients developed meningoencephalitis as a side-effect. Therefore, safer vaccines are now being developed. It did not require 20 years for researchers to develop therapeutic strategies since the discovery of A, in 1984. Now that AD is becoming a treatable disease, early diagnosis and early treatment will soon become the rule. Notably, AD may not be a psychiatric disorder any more, and mainly neurologists and geriatricians will see patients. Thus, neurogeriatrics will become more and more important. [source] Bell's palsy during interferon therapy for chronic hepatitis C infection in patients with haemorrhagic disordersHAEMOPHILIA, Issue 2 2000Ogundipe Two adult patients with life-long severe haemorrhagic disorders commenced on interferon-,2b therapy for chronic hepatitis C infection. Both developed Bell's palsy several weeks after commencing therapy, They were started on steroids and, in addition, the first patient discontinued interferon-,2b therapy while the second patient elected to continue with therapy. In both cases facial paralysis improved over the ensuing weeks. Bell's palsy is often idiopathic but has been reported. in association with herpesviruses. It is not a recognised complication of chronic hepatitis B or C infection, or interferon-,2b therapy. However, the interferons are associated with numerous adverse reactions including various neuropsychiatric manifestations and neurological syndromes. There are several reports of nerve palsies, including optic tract neuropathy, occurring during interferon therapy, and immune-based mechanisms are thought to play a role in the aetiopathogenesis. No reports of Bell's palsy in association with interferon therapy were identified in our literature search, although one possible case has been reported to the Committee of Safety in Medicine. Although Bell's palsy in our patients may have occurred by chance, a neuropathic effect of interferon-,2b on the facial nerve cannot be excluded and we urge physicians using interferons to be aware of this potential side-effect. [source] Peginterferon-alpha-2b plus ribavirin therapy in patients with chronic hepatitis C as assessed by a multi-institutional questionnaire in JapanHEPATOLOGY RESEARCH, Issue 6 2010Tatsuya Ide Background and aim:, There has so far been no questionnaire report on patients who were treated with peginterferon plus ribavirin (PEG IFN+RBV) therapy. The purpose of this study was to investigate the problems of this therapy by a questionnaire survey. Patients and methods:, A survey of 681 patients with chronic hepatitis C who received treatment with PEG IFN+RBV was conducted in the Kyushu region of Japan. Using an original questionnaire, the survey was conducted prior to the treatment, during the third month of treatment, at the completion of treatment or the discontinuation of treatment, and at 6 months after the completion of treatment. Results:, It was indicated that the patients had a high level of comprehension and understanding of chronic hepatitis C and PEG IFN+RBV treatment. However, the results also indicated that patients had a high level of anxiety. Side effects were adequately dealt with by physicians. However, dermatological symptoms were not adequately explained to the patients, although they were the second most severe side-effect. It was also revealed that side-effects were most distressing during the first and second months after the start of treatment. Conclusion:, The questionnaire survey provided new information that has never been reported. It is believed that understanding this information is important for future treatment. [source] Cardiotoxicity with 5-fluorouracil and capecitabine: more than just vasospastic anginaINTERNAL MEDICINE JOURNAL, Issue 4 2010T. Stewart Abstract In this case series we present a variety of different cardiac toxicities with 5-fluorouracil and its pro-drug capecitabine, including myocardial infarction, cardiomyopathy, sinoatrial and atrioventricular node dysfunction, tako-tsubo cardiomyopathy and QT prolongation with torsade-de pointes ventricular tachycardia. We stress the fact that while vasospasm is a well-recognized side-effect of this class of chemotherapeutic agent, broader cardiotoxicity is commonly seen and an increased awareness of the range of toxicity is necessary if repeat toxicity is to be avoided. [source] Efficacy of 10% silver nitrate solution in the treatment of common warts: a placebo-controlled, randomized, clinical trialINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2007Sedigheh Ebrahimi MD Background, Warts are a common skin lesion, especially in children and young adults, caused by human papillomaviruses. So far, there is no definitive therapy for warts and the treatment is modified regularly to obtain the best result with the least discomfort to the patient. The aim of this placebo-controlled clinical trial was to evaluate the clinical efficacy, tolerability, and safety of 10% silver nitrate solution for the treatment of common warts. Methods, Sixty individuals attending pediatrics and dermatology clinics and health centers in Yasuj, south-west of Iran, were recruited. The patients were divided into two groups: 30 patients received 10% silver nitrate solution (case group) and 30 control patients received black ink (placebo group). Silver nitrate solution was used every other day for 3 weeks. After 3 weeks, the patients were evaluated for healing, and treatment was continued for another 3 weeks if the lesions were still present. Results, Complete regression of lesions was achieved in 19 of the 30 (63.33%) case patients. No significant side-effect was noted in the treated patients apart from temporary brownish discoloration of the skin which resolved 1 week after treatment. Conclusion, This study demonstrated that 10% silver nitrate solution can be used effectively for the treatment of warts with no serious complications. [source] Side-effects and treatment with clozapine: A comparison between the views of consumers and their cliniciansINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2008Kay Hodge ABSTRACT:, This study sought to clarify the prevalence of various side-effects experienced by consumers taking clozapine (n = 27) and to elucidate the impact of clozapine on their quality of life. Responses of consumers were contrasted with those of clinicians to highlight any discrepancies between the two groups, thus providing a focus for the improvement of clinical practice. Consumers completed a demographic questionnaire, the Liverpool University Neuroleptic Side-Effect Rating Scale. They next took part in a semistructured interview, which explored their attitudes to clozapine treatment. File searches provided historical data for antipsychotic use before the prescription of clozapine. Clinicians completed the same instruments and submitted them by mail. Most clinicians overestimated the prevalence and severity of clozapine side-effects. Consumers reported drooling mouth as the most prevalent and severe side-effect, whereas clinicians estimated that difficulty staying awake was the most prevalent side-effect, and the most severe side-effect was sleeping too much. Clinicians and consumers agreed that clozapine lifts mood. Only 19% of consumers were unhappy about blood tests, whereas 52% of clinicians estimated that consumers were unhappy about blood tests. This study suggests that despite significant side-effects and regular blood tests, most stable consumers taking clozapine were happier and more satisfied with their treatment than many of their clinicians believed they were. The study also highlights the need for clinicians to ask consumers about the different side-effects they may be experiencing, so they can provide clinical support to improve their quality of life. [source] Chemotherapy: the effect of oral cryotherapy on the development of mucositisJOURNAL OF CLINICAL NURSING, Issue 6 2005erife Karagözo, lu MSc Aims and objective., The aim of this study is to investigate the effect of oral cryotherapy on the development of chemotherapy-induced mucositis in patients administered combined chemotherapy. Background., Mucositis has been of interest to scientists for more than 20 years. Unfortunately, this has not resulted in the development of standard procedures for prevention and management. To cope with this side-effect and to prevent opportunistic infections that may emerge during treatment, attempts are taken to provide preventative and comfort measures. In this context, cryotherapy (oral cooling) has become popular as a cheap and readily applicable method in preventing the developing due the rapid infusion of chemotherapy agents, or decreasing its severity. Design and method., Study involved 60 patients, 30 of whom were in the study group and 30 in the control group. Ice cubes at a size that can be moved easily in the mouth and whose corners have been smoothed in order that they will not cause irritation in the mouth has been used in oral cryotherapy in the study group. Oral chemotherapy was initiated five minutes before chemotherapy and maintained during venous infusions of etoposide (Vepesid®), platinol (Cisplatin®), mitomycin (Mitomycin-C®) and vinblastin (Velbe®) depending on the chemotherapy course. Results., According to Patient-Judged Mucositis Grading, the rate of mucositis is 36.7% in study group and 90.0% in control group, the difference between two groups being statistically significant (P < 0.05). According to Physician-Judged Mucositis Grading, the rate of mucositis is 10.0% in the study group and 50.0% in the control group, the difference between two groups being statistically significant (P < 0.05). Oral pH values decreased in 90% of the subjects in study group, i.e. mucositis risk was reduced whereas oral pH values remained unchanged or decreased in 86.7% of the subjects in the control group, namely mucositis risk increased. The difference between study and control groups in terms of the change in pH values after chemotherapy was found to be statistically significant (P < 0.05). Conclusion., Our findings have demonstrated that oral cryotherapy makes an important contribution to the protection of oral health by reducing the mucositis score according to patient- and physician-judged mucositis score and by increasing oral pH values. Relevance to clinical practice., Aggressive cancer therapy places patients at greater risk for oral complications and treatment-related consequences. Unfortunately, prevention and/or treatment of such oral sequelae have often become overlooked as priorities of the treatment team. Effective approaches for the prevention or treatment of oral mucositis have not been standardized, and vary considerably among institutions. Prophylactic measures begin with an increased emphasis on improved oral status. Oral cryotherapy, the therapeutic administration of cold, is a prophylactic measure for oral inflammation. The relevance for clinical practice will be to understand the content of mucositis; comprehensive care should focus on the prevention of this complication in the clinical practice. [source] Photographic scoring of gingival overgrowthJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2001J. S. Ellis Abstract Background: A wide range of methods have been employed to determine the severity of gingival overgrowth resulting in uncertainty regarding the prevalence of the side-effect. There is no simple, non-invasive, objective, blind method for assessing gingival overgrowth. Aim: This article aims to describe a method which is suitable for use in large-scale population studies. Materials and Methods: Photographs were taken of the anterior, buccal gingivae and teeth of 925 patients medicated with calcium channel blockers. In addition, each patient was ascribed a clinical gingival overgrowth score. 100 patients had repeat photographs, and a further 10 patients had alginate impressions taken. The models were scored for severity of gingival overgrowth using a described technique. The slides were scored using a modification of this technique. Results: When photographic and study model scores were compared, photographic scores were consistently higher, and as a result, a photographic score of 38.6% was considered to represent a significant overgrowth. There was good agreement between clinically determined scores and photographic scores (,=0.71). Conclusions: The results indicate that this method is suitable for large-scale population studies where it also has the advantage of providing a continuous scale of gingival changes for subsequent statistical analysis. [source] Hyperprolactinemia and amenorrhea associated with olanzapine normalized after addition of aripiprazoleJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2007J. Wolf MD Summary Hyperprolactinemia is a frequent side-effect in the use of atypical antipsychotics. The propensity to induce hyperprolactinemia is highly substance dependent and hyperprolactinemia is not always associated with clinical side-effects. We report a case in which hyperprolactinemia and amenorrhea under the treatment with olanzapine gets normalized after the addition of aripiprazole. [source] Patients' knowledge and perceptions of the side-effects of OTC medicationJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 4 2002L. Hughes BPharm PhD MRPharmS Summary Objective:, To investigate the knowledge of patients with regard to the side-effects of over-the-counter medicines. Method:, This took the form of ethnographic interviews and focus groups. Results:, Patients generally had poor knowledge of the potential side-effects of their medication. However, this appeared not to affect their ability to identify adverse drug reactions (ADRs). A number of the patients had experienced ADRs, and they identified a medicine as the cause because of the timing or unexpected nature of the symptom. The patients obtained information about medicines from many sources, including health care professionals, friends and family. Despite wide availability, patient information leaflets were rarely used by the patients. The leaflets were usually only read if the medicine was new or if a side-effect was experienced. Negative views of the leaflets included poor design and long lists of side-effects. Conclusion:, Accurate information and advice from health care professionals could serve to reassure patients and to ensure they are well informed about the medicines they take. [source] Adefovir dipivoxil therapy in liver transplant recipients for recurrence of hepatitis B virus infection despite lamivudine plus hepatitis B immunoglobulin prophylaxisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 12 2007Murat Akyildiz Abstract Background:, Treatment of post-transplantation recurrence of hepatitis B virus (HBV) infection despite prophylaxis with hepatitis B immunoglobulin (HBIG) and lamivudine combination therapy is not easy. Because HBV reinfection has a severe course and could result in graft failure in liver transplant recipients, prompt medication is essential. Herein is reported the authors' experience with adefovir dipivoxil (AD) therapy in 11 liver transplant recipients who had HBV reinfection despite the administration of lamivudine and HBIG. Method:, Two-hundred and nine patients underwent liver transplantation (100 deceased donor liver transplantations [DDLT], 109 living donor liver transplantation [LDLT]) due to chronic hepatitis B infection between April 1997 and May 2005 in Ege University Medical School, Liver Transplantation Unit. Patients had prophylaxis with lamivudine and low-dose HBIG combination after liver transplantation. Treatment of recurrence consisted of AD 10 mg once a day and lamivudine 300 mg/daily and HBIG was discontinued in those patients. Results:, In total there were 11 HBV recurrences: five occurred in DDLT recipients and six in LDLT recipients, at a median follow up of 18 months (range, 6,48 months). In one of 11 patients, pretransplant HBV-DNA and HBeAg were positive. Three patients had a severe course and one patient had fibrosing cholestatic hepatitis. After AD treatment, HBV-DNA level decreased in all patients and became negative in seven patients. Two patients died due to hepatocellular carcinoma recurrence after 12 and 14 months of follow up. Serum creatinine level increased mildly in one patient and no other side-effect was observed, and all patients continued therapy. Conclusion:, Adefovir dipivoxil is a safe, effective treatment option for post-transplant HBV recurrence even among patients with fibrosing cholestatic hepatitis caused by lamivudine-resistant HBV. [source] Redeeming the "Character of the Creoles": Whiteness, Gender and Creolization in Pre-Revolutionary Saint DomingueJOURNAL OF HISTORICAL SOCIOLOGY, Issue 1 2010YVONNE FABELLA This article examines the political significance of white creolization in pre-revolutionary French Saint Domingue. Eighteenth-century Europeans tended to view white creoles as having physically, morally, and culturally degenerated due to the tropical climate, the monotony of plantation life, and their interaction with enslaved and free people of color. Yet elite white colonists in Saint Domingue claimed that white creoles possessed certain positive traits due to their new world birth, traits that rendered them physically stronger and potentially more virtuous than the French. Focusing on little-known publications authored by the white creole Moreau de Saint-Méry, this article highlights the deployment of gendered notions of virtue and noble savagery in debates over white creolization. Moreau's claims, when placed in the context of a conflict between local colonial magistrates and the French Colonial Ministry, challenge interpretations of white creolization as an undesirable, subversive side-effect of colonial slavery. Rather, white colonial men claimed that white colonists knew best how to ensure the obedience of the enslaved precisely because of their creolization. [source] Growth factors and proliferation of cultured rat gingival cells in response to cyclosporin AJOURNAL OF PERIODONTAL RESEARCH, Issue 1 2005Takumasa Yoshida Objective:, The prominent side-effect of cyclosporin A, an immunosuppressive drug, in oral tissues is gingival outgrowth, although the exact mechanism underlying this side-effect is unclear. The main purposes of the present study were to determine whether cyclosporin A induced the gingival outgrowth by promoting proliferation of gingival cells and whether growth factors such as transforming growth factor-,s (TGF-,s), fibroblast growth factor-2 (FGF-2), platelet-derived growth factors (PDGFs), and insulin-like growth factors (IGFs) are involved in the possible changes in the proliferation of gingival cells induced by cyclosporin A. Methods:, Cells isolated from rat gingival tissues were cultured with cyclosporin A or IGF-I for 3 days. The effects of cyclosporin A or IGF-I on the proliferation of cultured rat gingival cells were analyzed with a CellTiter 96 proliferation assay kit. The mRNA expression levels for TGF-,s, FGF-2, PDGFs, IGFs, insulin-like growth factor receptors (IGFRs), and insulin-like growth factor binding proteins (IGFBPs) in the rat gingival cells treated with cyclosporin A were measured using competitive reverse transcription,polymerase chain reaction (RT,PCR). Results:, Cyclosporin A induced 23,25% (p < 0.001) increases in the proliferation of rat gingival cells and approximately 130% (p < 0.05) and 60% (p < 0.05) elevations in the mRNA expression levels for TGF-,1 and FGF-2, respectively. On the other hand, exogenous IGF-I induced 8,11% (p < 0.05) increases in the proliferation, but cyclosporin A induced 30,80% (p < 0.05,0.01) reductions in the mRNA expression levels for endogenous IGF-I, IGFR1, IGFBP2, IGFBP3, IGFBP5, and IGFBP6. Conclusions:, Cyclosporin A stimulates the proliferation of rat gingival cells. TGF-,1 and FGF-2 could be involved, but IGFs, IGFRs and IGFBPs could not be directly involved in this cyclosporin A induced-stimulation of the gingival cell proliferation. [source] Patient satisfaction after removal of skin lesionsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2007Y Rissin Abstract Background, Removal of skin lesions is one of the most common surgical procedures, with the number increasing progressively since the 1980s. Objective, We tried to evaluate the satisfaction level of patients after removal of skin lesions and to identify the factors influencing it. Study design, The study group consisted of 138 patients who had skin lesions removed by shaving or primary excision and closure. They were evaluated 1 year after the procedure. Two questionnaires were completed independently by the patient and the surgeon. Results, The main indication for the procedure was suspicion of malignancy, functional disturbance, or aesthetic reason. The satisfaction level (general and specific areas) for patients who had a malignant tumour removed was similar to those who had a benign tumour removed. Females were less satisfied than males (P = 0.05). Younger people were less satisfied with the aesthetic results (P = 0.007). Patients who had at least one significant side-effect were less satisfied than those who did not mention any side-effects (P = 0.038). The higher the level of patient satisfaction, the higher the level of surgeon satisfaction (P = 0.012). Conclusion, Skin lesions removal, although considered to be a minor procedure, leaves scars that sometimes disturb the patient. According to our study, the most prevalent population for dissatisfaction is females and young males. [source] Pustular acral erythema in a patient with acute graft-versus-host diseaseJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2003DP Ruiz-Genao ABSTRACT Acral erythema is a well-known side-effect of chemotherapy treatment but it is not common in patients undergoing bone marrow transplant. We report a post-transplant patient with clinical and histological acute graft-versus-host disease (GVHD) who concurrently developed acral erythema presenting as painful, well-defined and self-limiting palmar erythema with pustules. A skin biopsy from the palm showed abnormal keratinocyte maturation and eccrine squamous syringometaplasia. This case illustrates the difficulties in establishing the differential diagnosis of cutaneous eruptions in patients undergoing bone marrow transplant. [source] Experience of maintenance infliximab therapy for refractory ulcerative colitis from six centres in EnglandALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009E. A. RUSSO Summary Background, Infliximab is used for treatment of Crohn's disease and, following the Active Ulcerative Colitis Trials (ACT) 1 and 2, it has been used as rescue and maintenance therapy in moderate and severe ulcerative colitis (UC). Aim, To report on English experience with maintenance infliximab in terms of response and colectomy rates and side-effect profile in UC. Methods, A retrospective audit conducted by using a web-based questionnaire filled in by 12 gastroenterologists from six English centres. Results, Of the 38 patients receiving induction with infliximab, 28 (73.6%) maintained an ongoing response (8-weekly infusions 5 mg/kg) for a mean duration of 16.8 months (range 4,59), with 21 (55.3%) being in remission. Three of 38 patients (7.9%) who also responded had a secondary loss of response after an average of 10 months (range 8,13); seven of 38 patients (18.4%) showed no response. The colectomy rate was seven of 38 (18.4%, five non-responders and two with secondary loss of response). Adverse effects occurred in five patients (13.2%). Two discontinued infliximab (alopecia, invasive breast cancer). The three less-severe adverse effects were acute and delayed-type hypersensitivity reactions and one persistent otitis media. Conclusion, Our experience suggests acceptable response rates, colectomy rates and side-effect profile of maintenance therapy with infliximab in moderate and severe UC. [source] A comparison of sirolimus vs. calcineurin inhibitor-based immunosuppressive therapies in liver transplantationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2006H. ZAGHLA Summary Background, Sirolimus is a potent immunosuppressive agent whose role in liver transplantation has not been well-described. Aim, To evaluate the efficacy and side-effects of sirolimus-based immunosuppression in liver transplant patients. Methods, Retrospective analysis of 185 patients who underwent orthotopic liver transplantation. Patients were divided into three groups: group SA, sirolimus alone (n = 28); group SC, sirolimus with calcineurin inhibitors (n =56) and group CNI, calcineurin inhibitors without sirolimus (n = 101). Results, One-year patient and graft survival rates were 86.5% and 82.1% in group SA, 94.6% and 92.9% in group SC, and 83.2% and 75.2% in group CNI (P = N.S.). The rates of acute cellular rejection at 12 months were comparable among the three groups. At the time of transplantation, serum creatinine levels were significantly higher in group SA, but mean creatinine among the three groups at 1 month was similar. More patients in group SA required dialysis before orthotopic liver transplantation (group SA, 25%; group SC, 9%; group CNI, 5%; P = 0.008), but at 1 year, post-orthotopic liver transplantation dialysis rates were similar. Conclusions, Sirolimus given alone or in conjunction with calcineurin inhibitors appears to be an effective primary immunosuppressant regimen for orthotopic liver transplantation patients. Further studies to evaluate the efficacy and side-effect profile of sirolimus in liver transplant patients are warranted. [source] | ||||||||||||||||||||||||||||||||||||||||||||||