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Treatment Armamentarium (treatment + armamentarium)

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Medical Sciences100%

Selected Abstracts

Treatment of Surgical Scars with Nonablative Fractional Laser Versus Pulsed Dye Laser: A Randomized Controlled Trial

DERMATOLOGIC SURGERY, Issue 8 2009
EMILY TIERNEY MD
OBJECTIVE Comparison of the efficacy of nonablative fractional laser (NAFL) and the V-beam pulsed dye laser (PDL) for improvement of surgical scars. METHODS A randomized blinded split-scar study. Fifteen scars in 12 patients were treated a minimum of 2 months after Mohs surgery. Patients were treated on half of the scar with a 1,550-nm NAFL and on the contralateral half with the 595 nm PDL. MAIN OUTCOME MEASURE(S) A nontreating physician investigator evaluated the outcome of the scar in terms of scar dyspigmentation, thickness, texture, and overall cosmetic appearance (5-point grading scale). RESULTS After a series of four treatments at 2-week intervals, greater improvements were noted in the portion of surgical scars treated with NAFL (overall mean improvement 75.6%, range 60,100%, vs. PDL, 53.9%, range 20,80%; p<.001). CONCLUSION These data support the use of NAFL as a highly effective treatment modality for surgical scars, with greater improvement in scar appearance than with PDL. It is likely that the greater depth of penetration and focal microthermal zones of injury with NAFL, inducing neocollagenesis and collagenolysis, account for its greater improvement in scar remodeling. These encouraging results lead us to recommend that NAFL be added to the current treatment armamentarium for surgical scars. [source]

Current treatment strategies for pulmonary arterial hypertension

JOURNAL OF INTERNAL MEDICINE, Issue 3 2005
S. H. LEE
Abstract., Lee SH, Rubin LJ (University of California, San Diego, La Jolla, CA, USA). Current treatment strategies for pulmonary arterial hypertension (Review). J Intern Med 2005; 258: 199,215. Pulmonary arterial hypertension (PAH) is a disease characterized by an elevation in pulmonary artery pressure that can lead to right ventricular failure and death. Although there is no cure for PAH, newer medical therapies have been shown to improve a variety of clinically relevant end-points including survival, exercise tolerance, functional class, haemodynamics, echocardiographic parameters and quality of life measures. Since the introduction of continuous intravenous prostacyclin, the treatment armamentarium of approved drugs for PAH has expanded to include prostacyclin analogues with differing routes of administration, a dual endothelin receptor antagonist, and a phosphodiesterase-5 inhibitor. Selective endothelin-A receptor antagonists have shown promise in clinical trials and are likely to be added to the list of options. As the number of medications available for PAH continues to increase, treatment decisions regarding first-line therapy, combination treatments, and add-on strategies are becoming more complex. This article reviews the current treatments strategies for PAH and provides guidelines for its management. [source]

Improving patient outlook in rheumatoid arthritis: Experience with abatacept

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2008
MA (Nurse Manager), Mary Coughlin RN
Abstract Purpose: To examine the importance of improving patient outlook in rheumatoid arthritis (RA) and to discuss the role of the nurse practitioner (NP) who, through the assessment of patient-reported outcomes and in acting as an advocate for the patient with the wider healthcare team, has a crucial part to play in managing the overall well-being of the patient. This article will draw on the clinical experience to date with abatacept, a first-in-class therapy that has been approved for the treatment of RA in patients with an inadequate response to either traditional disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, or biological DMARDs, such as tumor necrosis factor-, antagonists. Data sources: A comprehensive literature search was performed using the National Library of Medicine (MEDLINE), EMBASE, and BIOSIS databases (restricted to articles posted between January 2000 and February 2007) with the search terms CTLA-4Ig, abatacept, and primary clinical trial publications in patients with RA. The clinical data are summarized in this review along with safety data presented in the prescribing information. Conclusions: Recent changes in the approach to RA treatment, particularly the advent of biological therapies, have impacted the role of the NP. The role of the NP is integral to the management of RA and in maximizing patient outcomes, through educating patients to make informed choices regarding their treatment, ensuring the safe administration of therapies and monitoring response to therapy, and in acting as an advocate for the patient within the wider healthcare team. Implications for practice: The use of more patient-centered measures of response are gaining increasing importance both in clinical trials and in clinical practice, and as such the NP has an important role in ensuring that both the physical and the psychological needs of patients are met. Clinical trials to date have shown that abatacept provides significant and clinically meaningful improvements in patient-reported outcomes, as well as demonstrating significant clinical benefits and a consistent safety profile, thus representing a valuable treatment option within the RA treatment armamentarium. [source]

Circadin: a new option in sleep disorders

PROGRESS IN NEUROLOGY AND PSYCHIATRY, Issue 8 2008
Mark Greener
Circadin - a prolonged-release formulation containing 2mg melatonin - offers a promising short-term treatment for primary insomnia that is characterised by poor sleep quality in patients aged 55 years or over. Medical writer, Mark Greener, reviews this new addition to the sleep treatment armamentarium. Copyright © 2008 Wiley Interface Ltd [source]

Treatment adherence with antipsychotic medications in bipolar disorder

BIPOLAR DISORDERS, Issue 3 2006
Martha Sajatovic
Objectives:, Atypical antipsychotic medications are a relatively new, increasingly prominent component of the treatment armamentarium for bipolar disorder. Information on adherence with antipsychotics among individuals with bipolar disorder in general, and atypical antipsychotics in particular, is currently quite limited. Using data from the VA National Psychosis Registry, we examined adherence with antipsychotic medications among patients with bipolar disorder (n = 73,964). Methods:, Antipsychotic medication adherence among veterans with bipolar disorder was evaluated using the medication possession ratio and categorizing patients into three groups: fully adherent, partially adherent and non-adherent. We compared characteristics of bipolar patients who received versus those who did not receive antipsychotic medication, and also identified predictors of poor adherence with antipsychotic medications. Results:, Approximately 45% (n = 32,993) of all individuals with bipolar disorder were prescribed antipsychotic medication. Individuals who were prescribed antipsychotic medications were younger and more often had comorbid substance abuse or post-traumatic stress disorder compared to individuals with bipolar disorder who were not prescribed antipsychotic medication. Just over half (51.9%) of individuals appear to be fully adherent with antipsychotic medications, while 48.1% of individuals are either partially adherent or non-adherent with antipsychotic medications. Factors associated with treatment non-adherence were younger age, minority ethnicity, comorbid substance abuse and homelessness. Conclusions:, Treatment non-adherence is a major issue for close to half of individuals with bipolar disorder prescribed antipsychotic medication. Additional studies are needed to better understand treatment adherence within the full range of pharmacologic therapies among individuals with bipolar disorder. [source]