Choice Treatment (choice + treatment)

Distribution by Scientific Domains
Medical Sciences60%

Kinds of Choice Treatment

  • first choice treatment
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    Selected Abstracts

    Critical review of oral drug treatments for diabetic neuropathic pain,clinical outcomes based on efficacy and safety data from placebo-controlled and direct comparative studies

    DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 3 2005
    Hugo Adriaensen
    Abstract The present review aims to evaluate the efficacy and safety of a selection of oral treatments for the management of painful diabetic neuropathy. A literature review was conducted retrieving placebo-controlled and direct comparative studies with a selection of oral treatments for painful diabetic neuropathy. All studies were analyzed with regard to efficacy and tolerability. Efficacy was evaluated as the percentage improvement in pain intensity between baseline and endpoint. Tolerability was evaluated by means of study discontinuations due to adverse events and by incidence of drug-related adverse events. The analyzed trials enrolled different patient populations with mostly small numbers of patients. The great variability in dosages and dose titration schemes, cross-over designs with variable wash-out periods, and other design schemes made comparison between the different studies difficult. Gabapentin, lamotrigine, tramadol, oxycodone, mexiletine, and acetyl-L-carnitine were the only treatments studied in large (at least 100 patients), placebo-controlled parallel group trials. It is concluded that standardization in design and reporting for comparison of treatments is needed. Validated questionnaires for evaluation of the efficacy and safety should be further developed. Based on the reviewed randomised controlled trials, gabapentin shows good efficacy, a favourable side-effect profile with lack of drug interactions and therefore it may be a first choice treatment in painful diabetic neuropathy, especially in the elderly. However, head to head trials of current treatments are lacking and therefore randomized controlled trials are required to address this issue. Copyright © 2005 John Wiley & Sons, Ltd. [source]

    Pharmacokinetics of intravenous immunoglobulin and outcome in Guillain-Barré syndrome,

    ANNALS OF NEUROLOGY, Issue 5 2009
    Krista Kuitwaard MD
    Objective Intravenous immunoglobulin (IVIg) is the first choice treatment for Guillain-Barré syndrome (GBS). All patients initially receive the same arbitrary dose of 2g per kg body weight. Not all patients, however, show a good recovery after this standard dose. IVIg clearance may depend on disease severity and vary between individuals, implying that this dose is suboptimal for some patients. In this study, we determined whether the pharmacokinetics of IVIg is related to outcome in GBS. Methods We included 174 GBS patients who had previously participated in 2 randomized clinical trials. At entry, all patients were unable to walk unaided and received a standard dose of IVIg. Total IgG levels in serum samples obtained immediately before and 2 weeks after the start of IVIg administration were determined by turbidimetry and related to clinical outcome at 6 months. Results The increase in serum IgG (,IgG) 2 weeks after IVIg treatment varied considerably between patients (mean, 7.8g/L; standard deviation, 5.6g/L). Patients with a low ,IgG recovered significantly more slowly, and fewer reached the ability to walk unaided at 6 months (log-rank p < 0.001). In multivariate analysis adjusted for other known prognostic factors, a low ,IgG was independently associated with poor outcome (p = 0.022). Interpretation After a standard dose of IVIg treatment, GBS patients show a large variation in pharmacokinetics, which is related to clinical outcome. This may indicate that patients with a small increase in serum IgG level may benefit from a higher dosage or second course of IVIg. Ann Neurol 2009;66:597,603 [source]

    Inflammation assessment after selective laser trabeculoplasty (SLT) treatment

    ACTA OPHTHALMOLOGICA, Issue 2009
    M AYALA
    Purpose Glaucoma is a progressive neuropathy, reducing intraocular pressure (IOP) seems to be the only treatment to stop progression in glaucoma. There are several methods to reduce IOP: medical treatment, laser and surgery. Selective Laser Trabeculoplasty (SLT) is a new treatment alternative. SLT selectively targets the pigmented cells of the trabecular meshwork without causing thermal or collateral damage to the surroundings structures. The aim of the present study was to assess inflammation after SLT treatment. Methods 40 patients (80 eyes) were included in the study. Inclusion criteria: Glaucoma (POAG, pigmentary and pseudoexfoliative glaucoma)/ OHT patients that will be treated with SLT in just one eye, both with and without eye-drops. Exclusion criteria: patients suffering from ocular or systemic inflammatory diseases or treated with cortisone or immunosuppressive drugs. Inflammation was measured in 2 different ways: 1) clinically with a slit lamp and classified 0-4; 2) with a "Laser flare meter (Kowa FM 500)". Measurements were done before, 2 hours after, 1 week and 1 month after SLT treatement, both eyes were evaluated. IOP was also checked in the same way. SLT treatment was performed in 90° with the SLT Solo Ellex laser. Results inflammation before and after SLT showed no significant difference measured both clinically with slit lamp and objectively with the laser flare meter. No inflammation was found in the untreated eyes. No IOP peaks after SLT treatment were found. Conclusion SLT treatment seems not to induce inflammation in the anterior chamber when 90° were treated. SLT treatment might be considered as a first choice treatment against high intraocular pressure. [source]

    Attention deficit hyperactivity disorder in pre-school children: current findings, recommended interventions and future directions

    CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2009
    D. Daley
    Abstract This paper outlines the presentation, aetiology and treatment of attention deficit hyperactivity disorder (ADHD) in pre-school children. A review of current parenting training interventions demonstrates that there is good evidence for their efficacy in reducing symptoms of ADHD in pre-school children, and three interventions are evaluated: The new forest parent training programme (NFPP); the triple P , positive parenting programme and the incredible years parent training programme (IY). The evaluation of the NFPP provides strong evidence demonstrating its effectiveness for pre-school children with ADHD, while the efficacy of the Triple , P and the IY programme have, to date, only been demonstrated on children with conduct problems and co-morbid ADHD. It is suggested that parent training should be the first choice treatment for pre-school children presenting signs of ADHD, and medication introduced only for those children where parent training is not effective. Few moderators of outcome have been identified for these interventions, with the exception of parental ADHD. Barriers to intervention and implementation fidelity will need to be addressed to achieve high levels of attendance, completion and efficacy. The IY programme is a good model for addressing fidelity issues and for overcoming barriers to intervention. The future directions for parent training are also discussed. [source]

    Nutrients, not caloric restriction, extend lifespan in Queensland fruit flies (Bactrocera tryoni)

    AGING CELL, Issue 5 2009
    Benjamin G. Fanson
    Summary Caloric restriction (CR) has been widely accepted as a mechanism explaining increased lifespan (LS) in organisms subjected to dietary restriction (DR), but recent studies investigating the role of nutrients have challenged the role of CR in extending longevity. Fuelling this debate is the difficulty in experimentally disentangling CR and nutrient effects due to compensatory feeding (CF) behaviour. We quantified CF by measuring the volume of solution imbibed and determined how calories and nutrients influenced LS and fecundity in unmated females of the Queensland fruit fly, Bactocera tryoni (Diptera: Tephritidae). We restricted flies to one of 28 diets varying in carbohydrate:protein (C:P) ratios and concentrations. On imbalanced diets, flies overcame dietary dilutions, consuming similar caloric intakes for most dilutions. The response surface for LS revealed that increasing C:P ratio while keeping calories constant extended LS, with the maximum LS along C:P ratio of 21:1. In general, LS was reduced as caloric intake decreased. Lifetime egg production was maximized at a C:P ratio of 3:1. When given a choice of separate sucrose and yeast solutions, each at one of five concentrations (yielding 25 choice treatments), flies regulated their nutrient intake to match C:P ratio of 3:1. Our results (i) demonstrate that CF can overcome dietary dilutions; (ii) reveal difficulties with methods presenting fixed amounts of liquid diet; (iii) illustrate the need to measure intake to account for CF in DR studies and (iv) highlight nutrients rather than CR as a dominant influence on LS. [source]