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Topical Medications (topical + medication)
Selected AbstractsChronic open angle glaucoma: patient awareness of the nature of the disease, topical medication, compliance and the prevalence of systemic symptomsOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2004Sunil Deokule Abstract Purpose:, To study the awareness of the nature of the disease, compliance with treatment, and prevalence of systemic symptoms in a group of patients with chronic open angle glaucoma (COAG). Method:, A structured questionnaire was designed and given to 260 consecutive COAG patients attending a general ophthalmology clinic. Questions related to the increased risk of COAG amongst family members, screening of family members, nature of field defects, variation in IOP, topical treatment and availability of a free eye test for a COAG patient in the UK were asked. Compliance and systemic symptoms were also assessed. Results:, Forty-one per cent (107 of 260) of patients in the study group were aware of the increased risk of COAG in family members and 45.5% (118 of 260) of patient's family members had undergone screening for COAG. Seventy-three per cent (191 of 260) of the patients were aware of their own and their family members' entitlement to a free eye test. Seventy-seven per cent of patients claimed full compliance. Thirty per cent of patients were noted to have systemic symptoms. Conclusions:, The awareness of the nature of COAG in this population was low and incidence of perceived drug related systemic symptoms very high. Both of these may contribute to poor compliance. [source] "Unknown Risks" of non-steroid topical medications for atopic dermatitisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2007Anne Marie McNeill PhD Introduction, Tacrolimus ointment is a nonsteroid treatment for atopic dermatitis which is both effective and has a minimal side-effect profile. However, some clinicians may be reluctant to use tacrolimus ointment due to the "unknown risks", meaning those that have not been uncovered in human studies conducted thus far. Therefore, the available animal data regarding the "unknown risks" of topical tacrolimus therapy are reviewed, and a discussion of the interpretation of this available but limited data is presented. Animal studies, Some of the fear on the part of clinicians regarding the use of topical tacrolimus may come from the results of animal studies which showed an increase in lymphoma and UV-induced skin cancer after treatment with topical tacrolimus in animal models of carcinogenesis. However, rigorous assessment of these studies suggest that it is somewhat likely that these represent a species-specific response to tacrolimus in an animal already predisposed to tumor formation, and therefore may not be relevant in assessing the possibility of an increased human health risk. Conclusions, Animal and human studies suggest that topical tacrolimus is a safe alternative to topical steroids, with the major known adverse effect being a transient burning sensation, compared with the known adverse effects of topical steroids, including long-lasting ones. Therefore, in the opinion of the authors, currently available data, including animal studies, does not suggest that "unknown risks" of topical tacrolimus need be any more concerning than the known side-effects of the topical steroids. [source] Vitiligo Treatment in Childhood: A State of the Art ReviewPEDIATRIC DERMATOLOGY, Issue 5 2010Marion Eunice B. Tamesis M.D. Approximately half of the affected individuals develop the disease before adulthood. Etiologic hypotheses for vitiligo include biochemical, neural and autoimmune mechanisms. The most compelling of these suggests a combination of genetic and immunologic factors that result in an autoimmune melanocyte destruction. We reviewed studies carried out on various treatment modalities used in childhood vitiligo. Topical corticosteroids were found to have excellent repigmentation rates, whereas calcineurin inhibitors have comparable efficacy and a better safety profile compared with topical corticosteroids. These two groups of topical medications are good first-line treatment modalities for localized vitiligo. For the treatment of generalized vitiligo, phototherapy has excellent efficacy. Narrow-band ultraviolet B (UVB) has better overall repigmentation rates and safety profile than either topical or oral psoralens and ultraviolet A (PUVA). Other treatment modalities may be considered depending on a patient's specific condition, such as surgical options and depigmentation. With adequate sun protection, the option of no treatment with or without corrective camouflage, is an innocuous alternative to any of these treatment modalities. [source] Herpetic Infection in Epidermolysis BullosaPEDIATRIC DERMATOLOGY, Issue 4 2006Adam I. Rubin M.D. Standard wound care practices advocate the use of special dressings on open erosions as well as antibiotic topical medications to treat and prevent cutaneous infections. We report a child with recessive dystrophic epidermolysis bullosa admitted to our institution because of fevers at home. She was treated with multiple antibiotics for a cutaneous infection of the right hand. During her hospital stay, she sustained persistent fevers, and oral erosions developed, with progressive hemorrhagic crusting. Viral culture of the lip grew herpes simplex virus type 1, consistent with a diagnosis of herpetic gingivostomatitis. We present this patient to illustrate the importance of investigating wounds of epidermolysis bullosa patients for viral agents when faced with managing a child with an unclear source of fever. To the best of our knowledge, although this is the first report of herpetic gingivostomatitis in association with epidermolysis bullosa, it is likely to be more prevalent than the literature could suggest. [source] Antibacterial activity of medicinal plant extracts against periodontopathic bacteriaPHYTOTHERAPY RESEARCH, Issue 6 2003L. Iauk Abstract This study was performed to evaluate the antibacterial activity of Althaea of,cinalis L. roots, Arnica montana L. ,owers, Calendula of,cinalis L. ,owers, Hamamelis virginiana L. leaves, Illicium verum Hook. fruits and Melissa of,cinalis L. leaves, against anaerobic and facultative aerobic periodontal bacteria: Porphyromonas gingivalis, Prevotella spp., Fusobacterium nucleatum, Capnocytophaga gingivalis, Veilonella parvula, Eikenella corrodens, Peptostreptococcus micros and Actinomyces odontolyticus. The methanol extracts of H. virginiana and A. montana and, to a lesser extent, A. of,cinalis were shown to possess an inhibiting activity (MIC , 2048 mg/L) against many of the species tested. In comparison, M. of,cinalis and C. of,cinalis extracts had a lower inhibiting activity (MIC , 2048 mg/L) against all the tested species with the exception of Prevotella sp. Illicium verum methanol extract was not very active though it had a particular good activity against E. corrodens. The results suggest the use of the alcohol extracts of H. virginiana, A. montana and A. of,cinalis for topical medications in periodontal prophylactics. Copyright © 2003 John Wiley & Sons, Ltd. [source] Impact of medication on ocular blood flowACTA OPHTHALMOLOGICA, Issue 2009L SCHMETTERER Purpose Reduced ocular blood flow appears to play a role in the pathophysiology of glaucoma. Hence, there is considerable interest in drugs that are capable of improving ocular perfusion. Methods A large numer of clinical trials have been performed investigating the ocular hemodynamic effects of topical and systemic medications. Such trials used a variety of different methods to assess ocular blood flow parameters. Results When adminsitered systemically most vasodilators decrease systemic blood pressure thereby reducing ocular perfusion pressure (OPP). Only few classes of drugs have been reported to increase ocular blood flow with no or minimal effect on OPP. Among these carbonic anhydrase inhibitors and endothelin receptor anatgonists show the most prononced ocular vasodilator effects. The ocular hemodynamoic effects of topical medications is generally considered small. Conclusion When drugs are given systemically the effects on OPP have to be considered. In addition, the potentially positive effects on ocular perfusion need to be carefully weighed against the side effects. With topically administered drugs the ocular hemodynamic effects will be generally small, because the drugs reach the posterior pole of the eye in small concentrations only. [source] In vivo effects of fluoroquinolones on rabbit corneasCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2003Graeme A Pollock PhD Abstract Purpose: The use of topical fluoroquinolones to treat microbial keratitis is associated with an increased incidence of corneal perforation compared to other standard treatments. This study examined the effects of topical fluoroquinolones on corneal collagen and keratocytes in intact rabbit corneas and corneas with an epithelial defect. Methods: Studies consisted of one group of intact corneas and one group of corneas where a 6-mm epithelial defect was created with a surgical scrape. Within each group, eyes were randomly assigned to one of four topical medications (0.3% ciprofloxacin, 0.3% ofloxacin, fortified antibiotics (1.36% tobramycin, 5% cefrazolin) or Tears Naturale (Alcon Laboratories, Frenchs Forest, NSW, Australia). Two drops were instilled hourly for 48 h and then 2-hourly for an additional 48 h. At 96 h the corneas were removed and processed for light microscopy, immunohistology for collagen IV, V and VI, and apoptosis staining. Results: In intact rabbit corneas there was no demonstrable difference between treatment groups. In corneas with an epithelial defect, both fluoroquinolones delayed epithelial healing when compared to fortified antibiotics or tears. Keratocyte loss was seen in all groups and was greatest in the ofloxacin group. Median stromal thickness with keratocyte loss were: ofloxacin 30%; ciprofloxacin 10%; fortified antibiotics 7.5%; and tears 15% (ofloxacin vs tears, Mann,Whitney = 16.0, P = 0.09). Keratocyte loss did not correlate with the amount of demonstrable apoptosis. Collagens IV, V and VI showed no differences between treatments. Conclusions: These results suggest that ofloxacin is potentially cytotoxic to corneal keratocytes. Such an effect could lead to the observed increased incidence of corneal perforation in microbial keratitis. [source] |