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Therapy Options (therapy + option)
Selected AbstractsMolecular Neuropathology of Temporal Lobe Epilepsy: Complementary Approaches in Animal Models and Human Disease TissueEPILEPSIA, Issue 2007Michael Majores Summary:, Patients with temporal lobe epilepsies (TLE) frequently develop pharmacoresistance to antiepileptic treatment. In individuals with drug-refractory TLE, neurosurgical removal of the epileptogenic focus provides a therapy option with high potential for seizure control. Biopsy specimens from TLE patients constitute unique tissue resources to gain insights in neuropathological and molecular alterations involved in human TLE. Compared to human tissue specimens in most neurological diseases, where only autopsy material is available, the bioptic tissue samples from pharmacoresistant TLE patients open rather exceptional preconditions for molecular biological, electrophysiological as well as biochemical experimental approaches in human brain tissue, which cannot be carried out in postmortem material. Pathological changes in human TLE tissue are multiple and relate to structural and cellular reorganization of the hippocampal formation, selective neurodegeneration, and acquired changes of expression and distribution of neurotransmitter receptors and ion channels, underlying modified neuronal excitability. Nevertheless, human TLE tissue specimens have some limitations. For obvious reasons, human TLE tissue samples are only available from advanced, drug-resistant stages of the disease. However, in many patients, a transient episode of status epilepticus (SE) or febrile seizures in childhood can induce multiple structural and functional alterations that after a latency period result in a chronic epileptic condition. This latency period, also referred to as epileptogenesis, cannot be studied in human TLE specimens. TLE animal models may be particularly helpful in order to shed characterize new molecular pathomechanisms related to epileptogenesis and open novel therapeutic strategies for TLE. Here, we will discuss experimental approaches to unravel molecular,neuropathological aspects of TLE and highlight characteristics and potential of molecular studies in human and/or experimental TLE. [source] Adjuvant topical therapy with a cannabinoid receptor agonist in facial postherpetic neuralgiaJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 2 2010Ngoc Quan Phan Summary Background: Postherpetic neuralgia is a frequent adverse event in herpes zoster patients and difficult to treat. Conventional analgetic therapy often fails to reduce the burning pain transmitted by unmyelinated nerve fibers. These nerves express cannabinoid receptors which exert a role in modulation of nociceptive symptoms. Therefore, topical therapy with cannabinoid receptor agonist seems likely to suppress local burning pain. Patients and methods: In an open-labeled trial, 8 patients with facial postherpetic neuralgia received a cream containing the cannabinoid receptor agonist N-palmitoylethanolamine. The course of symptoms was scored with the visual analog scale. Results: 5 of 8 patients (62.5 %) experienced a mean pain reduction of 87.8 %. Therapy was tolerated by all patients. No unpleasant sensations or adverse events occurred. Conclusions: Topical cannabinoid receptor agonists are an effective and well-tolerated adjuvant therapy option in postherpetic neuralgia. [source] Imiquimod in the treatment of eyelid basal cell carcinomaACTA OPHTHALMOLOGICA, Issue 5 2007Jari Leppälä ABSTRACT. Purpose:, To assess the efficacy and safety of topical imiquimod 5% cream in the treatment of eyelid basal cell carcinoma. Methods:, Four patients with eyelid basal cell carcinoma were treated with imiquimod once daily, 5 days per week, for 6 weeks. Tissue biopsy was taken and clinical examination with slit-lamp microscopy was performed at the beginning of the study and after a follow-up of 12 weeks. Photographic follow-up was performed from the baseline visit to 6, 12 and 26 weeks. Results:, In the 12-week follow-up after imiquimod treatment, histopathological tissue sample analysis showed no signs of basal cell carcinoma in any of the patients. Conclusions:, The results indicate that 5% imiquimod cream with topical administration may represent a new therapy option for eyelid basal cell carcinoma. [source] COPD management: new and existing therapy optionsFUTURE PRESCRIBER, Issue 1 2010DRCOG Professor of Primary Care, David Price MA, MRCGP Early detection and appropriate management of chronic obstructive pulmonary disease (COPD) may help to reduce the high mortality and morbidity associated with this disease. New pharmacological treatments for COPD, along with the implementation of recommendations of the National Strategy for COPD due for publication later this year, will help to raise the standard of care and improve outcomes for COPD patients. In this article, Professor Price and Rhonda Siddall consider current COPD therapy and look at future treatment options for COPD. Copyright © 2010 John Wiley & Sons, Ltd. [source] Obesity: the science behind the managementINTERNAL MEDICINE JOURNAL, Issue 5-6 2002K. Steinbeck Abstract The prevalence of obesity is increasing in Western and Westernizing countries. The changing environment plays a major role in this increase, particularly the reduction in physical activity. There is also a strong genetic contribution to the development of obesity, although single-gene defect obesity is rare. Neither the environment nor genes is simple to modify. Obesity is an energy-balance disorder, and the human body has evolved to resist any loss of body fat. This biological drive to maintain weight is coordinated through central pathways, with the involvement of many neuropeptides. Thus, dietary restriction will induce changes designed to counter weight loss, including a fall in resting metabolic rate. The management of obesity demands reasonable goals, which focus on metabolic, rather than cosmetic, improvement. As obesity is a complex condition, multiple therapeutic strategies are required. Dietary modification, an increase in physical activity, a reduction in sedentary activity and behaviour modification all form the basis of obesity therapy. Drug therapy options at present are limited and may have a stronger role in weight maintenance. Currently, surgical management of obesity has the best long-term outcomes. Long-term maintenance of weight loss is achieved by few individuals. Those individuals who are successful are able to maintain long-term restrictive eating habits and high levels of physical activity. (Intern Med J 2002; 32: 237,241) [source] Current topical and systemic approaches to treatment of rosaceaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2009HC Korting Abstract Rosacea is a common, often overlooked, chronic facial dermatosis characterized by intermittent periods of exacerbation and remission. Clinical subtypes and grading of the disease have been defined in the literature. On the basis of a genetic predisposition, there are several intrinsic and extrinsic factors possibly correlating with the phenotypic expression of the disease. Although rosacea cannot be cured, there are several recommended treatment strategies appropriate to control the corresponding symptoms/signs. In addition to adequate skin care, these include topical and systemic medications particularly suitable for the papulopustular subtype of rosacea with moderate to severe intensity. The most commonly used and most established therapeutic regimens are topical metronidazole and topical azelaic acid as well as oral doxycycline. Conventionally, 100,200 mg per day have been used. Today also a controlled release formulation is available, delivering 40 mg per day using non-antibiotic, anti-inflammatory activities of the drug. Anti-inflammatory dose doxycycline in particular allows for a safe and effective short- and long-term therapy of rosacea. Topical metronidazole and topical azelaic acid also appear to be safe and effective for short-term use. There are indications that a combined therapy of anti-inflammatory dose doxycycline and topical metronidazole could possibly have synergy effects. Further interesting therapy options for the short- and long-term therapy of rosacea could be low-dose minocycline and isotretinoin; however, too little data are available with regard to the effectiveness, safety, optimal dosage and appropriate length of treatment for these medications to draw final conclusions. Conflicts of interest None declared. [source] Scalp psoriasis: a review of current topical treatment optionsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 9 2007K Papp Abstract The scalp is the most common site of disease involvement at the onset and throughout the course of psoriasis. For many patients, psoriasis of the scalp is the most difficult aspect of their disease; yet, despite a wide range of therapy options and an extensive literature base, scalp psoriasis remains difficult to treat, highlighting a long-standing unmet need for the effective treatment of scalp psoriasis. A review of past and current medical literature reveals that a number of interesting therapeutic approaches have been used in the treatment of scalp psoriasis. The diverse and sometimes extreme therapeutic approaches, the marginal benefit of many topical agents, the paucity of controlled studies evaluating the efficacy of topical agents in the treatment of scalp psoriasis and the high level of patient dissatisfaction with currently available treatments for psoriasis all support the need for new, effective and well-tolerated treatment options for scalp psoriasis. [source] Pulsed dye laser: what's new in non-vascular lesions?JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2007S Karsai Abstract Background and objective, In dermatology, the pulsed dye laser (PDL) is the therapeutic instrument of choice for treating most superficial cutaneous vascular lesions. In addition, clinical experience over the last decade allowed us to treat patients with an ever increasing number of non-vascular indications. The purpose of this report is to summarize and critically appraise the scientific evidence that support the role of PDL in treating non-vascular skin lesions. Methods, A literature-based study has been conducted, including the review of publications over the period January 1995 to December 2006, using the Medline Database. We also included our own experience in managing non-vascular lesions with the PDL. Four sets of preoperative and postoperative photos are presented. Results, For viral skin lesions, PDL proved to be an alternative to other therapy options. This applies particularly to periungual warts and mollusca contagiosa. The mechanism of PDL with inflammatory dermatoses has not yet been elucidated. The effect seems to be better if there is a vascular component to the disease. With most of these indications (such as psoriasis and acne), PDL currently plays a rather minor or complementary role. Regarding collagen remodelling (hypertrophic scars, keloids, stretch marks, and skin rejuvenation), the question of whether a therapy makes sense or not has to be decided from case to case. Conclusion, With PDL, it is possible to achieve good results with numerous, partly less well-known indications (i.e. lupus erythematosu). With other diseases, PDL has so far been considered to be a complementary therapy method or to be in an experimental state. [source] Relapse to prior therapy is the most important factor for the retreatment response in patients with chronic hepatitis C virus infectionLIVER INTERNATIONAL, Issue 7 2007Abdurrahman Sagir Abstract Background: Treatment options for hepatitis C have developed rapidly in the past decade. The current treatment of choice is a combination of pegylated-interferon-, (PEG-IFN-,) and ribavirin. With the development of more therapy options, patients who failed in prior therapy hope to clear hepatitis C virus by undergoing a more effective retreatment regime. In this report, we investigated response rates to combination therapy [standard IFN-, or PEG-IFN-, and ribavirin] in patients who relapsed or failed in prior therapy. Methods: Ninety-three patients were included in this retrospective study. All patients failed to previous IFN-, monotherapy (n=55) or to a combination of standard IFN-, and ribavirin (n=38). Fifty-nine patients were nonresponders and 34 were relapsers. Thirty-five patients were retreated with standard IFN-, plus ribavirin and 58 received PEG-IFN-, combination therapy. Results: Sustained virologic response (SVR) was induced in 31% of all patients. The highest SVR rate (58%) was observed in relapsers to standard IFN-, combination therapy who were retreated with PEG-IFN-, combination therapy. The SVR rate in relapsers to standard IFN-, monotherapy who received a standard IFN-, combination therapy was 50%. Relapsers responded in a significantly higher proportion to retreatment than nonresponders (56% vs. 17%, P<0.001). Relapse to previous therapy was identified as an independent predictor for therapy response. The lowest SVR rate was observed in nonresponders to standard IFN-, combination therapy who were retreated with PEG-IFN-, combination therapy (1/26; 4%). Conclusions: In relapsers, retreatment with the most effective therapy regime to date a combination of PEG-IFN-, and ribavirin, is promising. However, retreatment with PEG-IFN-, combination therapy in nonresponders to standard IFN combination therapy is not effective. [source] Radical radiation therapy options for organ-confined prostate cancerBJU INTERNATIONAL, Issue 5 2001P.N. Plowman First page of article [source] Antiangiogenetic therapy with pioglitazone, rofecoxib, and metronomic trofosfamide in patients with advanced malignant vascular tumorsCANCER, Issue 10 2003Thomas Vogt M.D. Abstract BACKGROUND Systemic therapy options for patients with advanced angiosarcomas are limited, and their prognosis is poor. The idea of angiostatic therapy following the paradigm of metronomic dosed chemotherapeutics combined with proapoptotic biomodulators had not been considered previously in these patients. Therefore, in a pilot study, the efficacy of metronomically scheduled, low-dose trofosfamide in combination with the peroxisome proliferator-activated receptor , agonist, pioglitazone, and the selective cyclooxygenase-2 inhibitor, rofecoxib, was evaluated in patients with advanced vascular malignancies. METHODS Six patients with advanced and pretreated but progressive, malignant vascular tumors (5 angiosarcomas and 1 hemangioendothelioma) received a combination of pioglitazone (45 mg per day orally) plus rofecoxib (25 mg per day orally) and, after 14 days, trofosfamide (3 × 50 mg per day orally). The therapy was administered continuously until progression was observed. If necessary, doses were modified according to side effects. RESULTS Two patients responded with complete remission of disease, one patient responded with partial remission, and three patients achieved stabilization of disease (no change). The median progression-free survival was 7.7 months (range, 2,15 months). Side effects generally were mild (World Health Organization Grade 1,2). Hospitalization was not necessary. CONCLUSIONS This new triple combination of low-dose metronomic trofosfamide, pioglitazone, and rofecoxib may represent a feasible new alternative in the palliative treatment of patients with advanced malignant vascular tumors. Cancer 2003. © 2003 American Cancer Society. [source] Therapeutic options for palmoplantar pustulosisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2010E. Adi Summary Palmoplantar pustulosis (PPP) is a common chronic and recurrent pustular dermatosis characterized by multiple sterile pustules and erythematous plaques on the palms and soles. The exact cause and pathogenesis of the disease remain unknown, and there is still debate about whether PPP is a variant of psoriasis or a distinct condition. A review of the medical literature revealed that a wide range of treatments have been used in the treatment of PPP over the years. The literature in PPP is restricted to case reports or small case series, and there is a lack of well-documented clinical studies, which makes it difficult to select an ideal therapy for the condition. The purpose of this review is to discuss the current therapy options for PPP, based on results of randomized controlled trials. [source] | ||||||||||