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Present Treatment (present + treatment)
Selected AbstractsRecent clinical findings with memantine should not mean that the idea of neuroprotection in glaucoma is abandonedACTA OPHTHALMOLOGICA, Issue 4 2009Neville N. Osborne Abstract. Loss of vision in primary open-angle glaucoma (glaucoma) is caused by retinal ganglion cells dying at a seemingly steady and variable rate in different patients. Present treatments for all glaucoma patients are inadequate and a goal to rectify this is to discover appropriate drugs or chemicals (neuroprotectants) that can be taken orally to slow down retinal ganglion cell death and have negligible side-effects. It was therefore of great disappointment to learn earlier this year that the one clinical trial conducted to test the efficacy of memantine as a neuroprotectant for glaucoma was unsuccessful. In this article, I consider the mechanisms by which retinal ganglion cells may die in glaucoma and suggest that memantine may have benefited patients taking it but to a level that was difficult to detect with present methodologies. Ganglion cells are induced to die by different triggers in glaucoma, suggesting that neuroprotectants with multiple modes of actions are likely to reveal clearer results than was found for memantine. Therefore, the idea of neuroprotection in glaucoma must not be abandoned. [source] Complex bile duct injuries: managementHPB, Issue 1 2008E. DE SANTIBÁÑES Abstract Background. Laparoscopic cholecystectomy is the present treatment of choice for patients with gallbladder stones, despite its being associated with a higher incidence of biliary injuries compared with the open procedure. Injuries occurring during the laparoscopic approach seem to be more complex. A complex biliary injury is a disease that is difficult to diagnose and treat. We considered complex injuries: 1) injuries that involve the confluence; 2) injuries in which repair attempts have failed; 3) any bile duct injury associated with a vascular injury; 4) or any biliary injury in association with portal hypertension or secondary biliary cirrhosis. The present review is an evaluation of our experience in the treatment of these complex biliary injuries and an analysis of the international literature on the management of patients. [source] Axisymmetric interaction of a rigid disc with a transversely isotropic half-spaceINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 12 2010Amir Aabbas Katebi Abstract A theoretical formulation is presented for the determination of the interaction of a vertically loaded disc embedded in a transversely isotropic half-space. By means of a complete representation using a displacement potential, it is shown that the governing equations of motion for this class of problems can be uncoupled into a fourth-order partial differential equation. With the aid of Hankel transforms, a relaxed treatment of the mixed-boundary value problem is formulated as dual integral equations, which, in turn, are reduced to a Fredholm equation of the second kind. In addition to furnishing a unified view of existing solutions for zero and infinite embedments, the present treatment reveals a severe boundary-layer phenomenon, which is apt to be of interest to this class of problems in general. The present solutions are analytically in exact agreement with the existing solutions for a half-space with isotropic material properties. To confirm the accuracy of the numerical evaluation of the integrals involved, numerical results are included for cases of different degrees of the material anisotropy and compared with existing solutions. Further numerical examples are also presented to elucidate the influence of the degree of the material anisotropy on the response. Copyright © 2009 John Wiley & Sons, Ltd. [source] A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patientsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2009Abstract Background, Treatment options remain unsatisfactory for patients with palmoplantar psoriasis (PP) and palmoplantar pustular psoriasis (PPP). Aim, To evaluate the therapeutic responses of PP and PPP patients that were treated in our psoriasis polyclinic between 2003 and 2007. Methods, This retrospective study comprised PP (n = 62) and PPP (n = 52) patients. Treatments were individualized according to patient compliance and associating systemic diseases. The effect of systemic treatments was grouped as follows: ,no improvement': patients unresponsive for the present treatment; ,partial improvement': < 50% decrease in severity or affected area; ,moderate improvement': 50,75% decrease in severity or affected area, and ,marked improvement': > 75% decrease of the disease compared to baseline. Results, In the PP group, 17 of 62 patients showed marked improvement to topical agents, while the remaining patients required systemic agents including oral retinoids (n = 24), local psoralen plus ultraviolet A (PUVA; n = 12), methotrexate (n = 9) and cyclosporine (n = 2). Marked improvement was achieved in 53%, 45%, 47% and 100%, respectively. In these patients, two (n = 10), three (n = 5), or four (n = 5) systemic agents were used alternately. In the PPP group, 18 of 52 patients achieved marked improvement by topical agents. Patients that required systemic agents were treated with colchicum (n = 19), local PUVA (n = 8), methotrexate (n = 4), oral retinoids (n = 3) and cyclosporine (n = 2). These treatments achieved a marked improvement in 60%, 33%, 57%, 83%, and 50% of the patients, respectively. In the course of the disease, 18 patients required two and 3 patients required three systemic agents alternately. Conclusions, Although the success rates appeared to be high, the high number of patients who required multiple systemic agents emphasized the fact that localized forms of psoriasis were resistant to therapy. Conflicts of interest None declared [source] | ||||||||||