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Sample records for oral antidiabetic therapy

  1. Racial differences in long-term adherence to oral antidiabetic drug therapy: a longitudinal cohort study

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    Meigs James B

    2009-02-01

    Full Text Available Abstract Background Adherence to oral antidiabetic medications is often suboptimal. Adherence differences may contribute to health disparities for black diabetes patients, including higher microvascular event rates, greater complication-related disability, and earlier mortality. Methods In this longitudinal retrospective cohort study, we used 10 years of patient-level claims and electronic medical record data (1/1/1992–12/31/2001 to assess differences in short- and long-term adherence to oral antidiabetic medication among 1906 newly diagnosed adults with diabetes (26% black, 74% white in a managed care setting in which all members have prescription drug coverage. Four main outcome measures included: (1 time from diabetes diagnosis until first prescription of oral antidiabetic medication; (2 primary adherence (time from first prescription to prescription fill; (3 time until discontinuation of oral antidiabetic medication from first prescription; and (4 long-term adherence (amount dispensed versus amount prescribed over a 24-month follow-up from first oral antidiabetic medication prescription. Results Black patients were as likely as whites to initiate oral therapy and fill their first prescription, but experienced higher rates of medication discontinuation (HR: 1.8, 95% CI: 1.2, 2.7 and were less adherent over time. These black-white differences increased over the first six months of therapy but stabilized thereafter for patients who initiated on sulfonylureas. Significant black-white differences in adherence levels were constant throughout follow-up for patients initiated on metformin therapy. Conclusion Racial differences in adherence to oral antidiabetic drug therapy persist even with equal access to medication. Early and continued emphasis on adherence from initiation of therapy may reduce persistent racial differences in medication use and clinical outcomes.

  2. Change of initial oral antidiabetic therapy in type 2 diabetic patients

    NARCIS (Netherlands)

    A. Plat (Arian); F.J.A. Penning-Van Beest (Fernie); S. Kessabi (Sophia); M.T. Groot (Martijn); R.M.C. Herings (Ron)

    2009-01-01

    textabstractObjective To explore the 'real-life' therapy of type 2 diabetes mellitus with oral antidiabetic drugs (OADs). Methods From the PHARMO Record Linkage System comprising linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, among

  3. Oral antidiabetic therapy in a large Italian sample: drug supply and compliance for different therapeutic regimens

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    Vittorino Gaddi, A; Capello, F; Di Pietro, C; Cinconze, E; Rossi, E; De Sando, V; Cevenini, M; D'Alò, G

    2014-01-01

    Objectives: To define the main features of patients treated with oral antidiabetics, evaluating monotherapy (MT), loose-dose combination therapy (LDCT) and fixed-dose combination therapy (FDCT); to describe medication adherence to the different therapies; and to evaluate the differences in compliance with the prescribed therapy regimen among prevalent and incident patient cohorts. Study design: This study was a retrospective cohort analysis based on the ARNO database, a national record that tracks reimbursable prescription claims submitted from selected pharmacies to the Italian national health system. In total, 169,375 subjects, from an overall population of 4,040,624 were included in this study. The patients represented 12 different local health units. Each patient had at least one oral antidiabetic prescription claim (A10B ATC code). Methods: Patients were divided into four groups according to their treatment regimen during the recruitment period (1 January 2008-31 December 2008): MT, FDCT, LDCT and swi...

  4. Insulin versus an oral antidiabetic agent as add-on therapy in type 2 diabetes after failure of an oral antidiabetic regimen: a meta-analysis

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    Gamble, JM; Simpson, Scot H.; Brown, Lauren C.; Johnson, Jeffrey A

    2008-01-01

    Background Although evidence-based guidelines for the treatment of type 2 diabetes mellitus provide clear recommendations for initial therapy, evidence on an optimal treatment strategy after secondary failure is unclear. Purpose To compare the efficacy of add-on therapy using basal insulin versus an additional oral antidiabetic agent in patients with type 2 diabetes and secondary failure. Data sources We searched the following electronic databases from inception until June 2007: MEDLINE; EMBA...

  5. [Oral antidiabetics of the sulfonylurea group and their problems in therapy].

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    Füsgen, I; Summa, J D

    1980-01-01

    By the abolition of biguanids as oral antidiabetics the importance of derivatives of sulfonylcarbamids became prominent in the treatment of diabetic elderly patients. Because of the properties of that group, there are a number of problems by the therapy with these derivatives. There is the mostly existing multimorbidity in geriatric patients with the risk of incompatibilities of drugs in cause of multitherapy and there is the influence of morbid states on the pharmacokinetics. Some of the various questions will be shortly described in this article. There are then given also practical advices for the relations with the derivatives of sulfonylcarbamids in treating diabetic patients.

  6. Adding liraglutide to oral antidiabetic drug therapy: onset of treatment effects over time

    DEFF Research Database (Denmark)

    Gallwitz, B; Vaag, A; Falahati, A;

    2010-01-01

    AIM: To investigate the onset of treatment effects over time observed for liraglutide in combination with oral antidiabetic drugs (OADs). METHODS: This analysis included patients from three phase 3, 26-week, randomised, double-blind, parallel-group trials. Prior to randomisation, patients underwent...

  7. Pharmacogenetics of oral antidiabetic drugs

    NARCIS (Netherlands)

    M.L. Becker (Matthijs); E. Pearson (Ewan); I. Tkáč (Ivan)

    2013-01-01

    textabstractOral antidiabetic drugs (OADs) are used for more than a half-century in the treatment of type 2 diabetes. Only in the last five years, intensive research has been conducted in the pharmacogenetics of these drugs based mainly on the retrospective register studies, but only a handful of as

  8. Pharmacogenetics of Oral Antidiabetic Drugs

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    Matthijs L. Becker

    2013-01-01

    Full Text Available Oral antidiabetic drugs (OADs are used for more than a half-century in the treatment of type 2 diabetes. Only in the last five years, intensive research has been conducted in the pharmacogenetics of these drugs based mainly on the retrospective register studies, but only a handful of associations detected in these studies were replicated. The gene variants in CYP2C9, ABCC8/KCNJ11, and TCF7L2 were associated with the effect of sulfonylureas. CYP2C9 encodes sulfonylurea metabolizing cytochrome P450 isoenzyme 2C9, ABCC8 and KCNJ11 genes encode proteins constituting ATP-sensitive K+ channel which is a therapeutic target for sulfonylureas, and TCF7L2 is a gene with the strongest association with type 2 diabetes. SLC22A1, SLC47A1, and ATM gene variants were repeatedly associated with the response to metformin. SLC22A1 and SLC47A1 encode metformin transporters OCT1 and MATE1, respectively. The function of a gene variant near ATM gene identified by a genome-wide association study is not elucidated so far. The first variant associated with the response to gliptins is a polymorphism in the proximity of CTRB1/2 gene which encodes chymotrypsinogen. Establishment of diabetes pharmacogenetics consortia and reduction in costs of genomics might lead to some significant clinical breakthroughs in this field in a near future.

  9. Nuevas terapias en diabetes: más allá de la insulina inyectable y de los antidiabéticos orales New therapies for diabetes: beyond injectable insulin and oral antidiabetics

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    John Edwin Feliciano Alfonso

    2008-10-01

    Full Text Available Novos medicamentos para o tratamento do diabetes tipo 1 e tipo 2 foram incorporados à lista de fármacos tradicionais: antidiabéticos orais e insulinas injetáveis. Estas alternativas de tratamento têm novos mecanismos de ação que aproveitam as propriedades antidiabéticas de certos peptídeos como é o caso da amilina ou do peptídeo similar ao glucagon (GLP-1, cujos níveis são deficientes ou insuficientes no diabetes. Isto acontece pelos análogos da amilina ou do GLP-1, embora também possa ser obtido inibindo a enzima que degrada este último. Além disso, encontra-se disponível no mercado um novo sistema para administrar insulina de maneira não-invasiva por meio de inalação. Este artigo resume os resultados mais importantes e atualizados com relação ao mecanismo de ação, eficácia, efeitos adversos e indicações destes fármacos inovadores.New medicines for the therapy of the type 1 and type 2 diabetes have been incorporated in the list of traditional drugs: oral agents and injectable insulin. These treatment alternatives have a new mechanism of action that takes advantage of the antidiabetic properties of certain peptides such as amylin and glucagon like peptide-1 (GLP-1, whose levels are wanting or insufficient in diabetes. This is attained through amylin and GLP-1 analogues, although it can also be achieved by inhibiting the enzyme that degrades the latter. Furthermore, a new system to administer insulin in a noninvasive way through inhalation has become available in the market. This paper summarizes the most important and updated findings on the action mechanism, efficacy, adverse effects and indications of these innovative drugs.

  10. Adherence to treatment for diabetes mellitus: validation of instruments for oral antidiabetics and insulin

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    Lilian Cristiane Gomes-Villas Boas

    2014-01-01

    Full Text Available OBJECTIVES: to verify the face validity, criterion-related validity and the reliability of two distinct forms of presentation of the instrument Measurement of Adherence to Treatment, one being for ascertaining the adherence to the use of oral antidiabetics and the other for adherence to the use of insulin, as well as to assess differences in adherence between these two modes of drug therapy. METHOD: a methodological study undertaken with 90 adults with Type 2 Diabetes Mellitus. The criterion-related validity was verified using the Receiver Operating Characteristic curves; and for the reliability, the researchers calculated the Cronbach alpha coefficient, the item-total correlation, and the Pearson correlation coefficient. RESULTS: the oral antidiabetics and the other showed sensitivity of 0.84, specificity of 0.35 and a Cronbach correlation coefficient of 0.84. For the adherence to the use of insulin, the values found were, respectively, 0.60, 0.21 and 0.68. A statistically significant difference was found between the final scores of the two forms of the instrument, indicating greater adherence to the use of insulin than to oral antidiabetics. CONCLUSION: it is concluded that the two forms of the Measurement of Adherence to Treatment instrument are reliable and should be used to evaluate adherence to drug treatment among people with diabetes mellitus.

  11. COST-EFFECTIVENESS ANALYSIS OF ANTI-DIABETIC THERAPY IN A UNIVERSITY TEACHING HOSPITAL

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    Giwa Abdulganiyu; Tayo Fola

    2014-01-01

    Purpose: To conduct cost-effectiveness analysis of anti-diabetic therapy in a University Teaching Hospital in 2010. Methods: A retrospective review of selected case-notes was conducted. World Health Organization Defined Daily Dose Method of evaluating drug use and probability method for potential effectiveness of antidiabetic therapeutic options from literature analysis was employed in determining cost-effectiveness of each anti-diabetic therapeutic option identified from anti-diabetic dru...

  12. Pharmacogenomics in type 2 diabetes: oral antidiabetic drugs.

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    Daniels, M A; Kan, C; Willmes, D M; Ismail, K; Pistrosch, F; Hopkins, D; Mingrone, G; Bornstein, S R; Birkenfeld, A L

    2016-10-01

    Type 2 diabetes mellitus (T2DM) is a fast progressing disease reaching pandemic proportions. T2DM is specifically harmful because of its severe secondary complications. In the course of the disease, most patients require treatment with oral antidiabetic drugs (OADs), for which a relatively large number of different options are available. The growing number of individuals affected by T2DM as well as marked interindividual differences in the response to treatment call for individualized therapeutic regimens that can maximize treatment efficacy and thus reduce side effects and costs. A large number of genetic polymorphisms have been described affecting the response to treatment with OADs; in this review, we summarize the most recent advances in this area of research. Extensive evidence exists for polymorphisms affecting pharmacokinetics and pharmacodynamics of biguanides and sulfonylureas. Data on incretin-based medications as well as the new class of sodium/glucose cotransporter 2 (SGLT2) inhibitors are just starting to emerge. With diabetes being a known comorbidity of several psychiatric disorders, we also review genetic polymorphisms possibly responsible for a common treatment response in both conditions. For all drug classes reviewed here, large prospective trials are necessary in order to consolidate the existing evidence and derive treatment schemes based on individual genetic traits.

  13. Impact of rosiglitazone safety alerts on oral antidiabetic sales trends: a countrywide study in Portugal.

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    Herdeiro, Maria T; Soares, Sara; Silva, Tânia; Roque, Fátima; Figueiras, Adolfo

    2016-10-01

    Pharmacovigilance systems are important to monitor the safety of on-market drugs after approval. The aim of this study was to assess the impact of rosiglitazone safety alerts on trends in the sale of rosiglitazone and other oral antidiabetic drugs. An ecological study was conducted, using temporally aggregated data and linking safety alerts to countrywide sales of all oral antidiabetic drugs in Portugal from January 2002 to December 2012. Sales figures for oral antidiabetic drugs marketed in Portugal were supplied by IMS Health Portugal with a breakdown by active substance and fixed combinations. The number of defined daily doses per 1000 inhabitants per day (DIDs) of each oral antidiabetic drug sold to the estimated diabetic population using oral antidiabetic drugs in Portugal was calculated. Particular attention was paid to the case of rosiglitazone, with the results being adjusted for changes in rosiglitazone reimbursement policies. A total of four safety alerts were issued about rosiglitazone. Rosiglitazone sales registered an increase of 32.9% (0.202 DIDs; P sales fell. Following the January 2006 and January 2008 safety alerts, rosiglitazone sales described a long-term downward trend, with decreases of 3.75% (-0023 DIDs; P > 0.05) and 0.24% (-0.001 DIDs; P > 0.05), respectively. It is important to promote the dissemination and publication of drug safety alerts. © 2016 Société Française de Pharmacologie et de Thérapeutique.

  14. Combining insulins with oral antidiabetic agents: effect on hyperglycemic control, markers of cardiovascular risk and disease

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    Kjeld Hermansen

    2008-06-01

    Full Text Available Kjeld Hermansen, Lene Sundahl Mortensen, Marie-Louise HermansenDepartment of Endocrinology and Metabolism C, Aarhus University Hospital, DK-8000 Aarhus, DenmarkAbstract: Patients with type 2 diabetes mellitus (T2DM have an increased risk of cardiovascular disease (CVD. Unfortunately, several potential barriers exist for CVD risk management in diabetes, including the need for significant lifestyle changes, potential problems with hypoglycemia, weight gain, injection tolerability, treatment complexity with current diabetes therapies and other, unmodifiable factors. Improving glycemic control may impact CVD risk. Treatment of T2DM usually starts with lifestyle changes such as diet and exercise. When these become insufficient, pharmacotherapy is required. Various oral antidiabetic drugs (OADs are available that reduce hyperglycemia. The first line of therapy is usually metformin, since it does not increase weight and seems to have a beneficial effect on CVD mortality and risk factors. As T2DM progresses, insulin treatment becomes necessary for the majority of patients. The last few years have seen the development of long-acting, rapid-acting, and premixed insulin analog formulations. The treat-to-target algorithms of recent studies combining OADs plus insulin analogs have demonstrated that patients can reach glycemic treatment targets with low risk of hypoglycemia, greater convenience, and – with some analogs – limited weight gain vs conventional insulins. These factors may possibly have a positive influence on CVD risk. Future studies will hopefully elucidate the benefits of this approach.Keywords: diabetes mellitus, type 2 diabetes, cardiovascular disease, hyperglycemia, insulin, oral antidiabetic drugs

  15. Cost analysis study of oral antidiabetic drugs available in Indian market

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    Nisharani B Jadhav, Manisha S Bhosale, Charles V Adhav

    2013-01-01

    Full Text Available There exists a wide range of variation in the prices of drugs marketed in India and other countries of the world. Very few studies have been conducted to reveal such price variations in the open market. Aim & Objectives: To evaluate the cost of oral anti-diabetics of different generic classes and different brand names of one compound, To evaluate the difference in cost of different brands for the same active drug by calculating percentage variation of cost. Methods: Cost of a particular drug being manufactured by different companies, in the same strength, number and dosage form was compared. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and the percentage variation in price was calculated. Results: In Single drug therapy, among sulfonylurea group of drugs, Glimepiride (1 mg shows maximum price variation of 655.38%, while Glipizide (10mg shows variation of 38.88%. In Biguanides & Thizolidinediones groups of drugs, Metformin (500 mg & Pioglitazone (15 mg show maximum price variation of 308.33% & 542% respectively. In α-glucosidases inhibitor group of drugs, Miglitol shows maximum price variation of 135.50 %. In combination therapies, Glipizide & Metformin combination shows the maximum variation up to 399.04 %. Conclusion: The average percentage price variation of different brands of the same drug manufactured in India is very wide and the appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences

  16. Antidiabetic therapy in real practice: indicators for adherence and treatment cost

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    Colombo GL

    2012-09-01

    Full Text Available Giorgio L Colombo,1,2 Elisa Rossi,4 Marisa De Rosa,4 Danilo Benedetto,3 Antonio V Gaddi31School of Pharmacy, Department of Drug Sciences, University of Pavia, Pavia, 2S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, 3CINECA – Bologna; 4Centro Aterosclerosi GC Descovich, Dipartimento di Medicina Interna e dell'Invecchiamento, University of Bologna, Bologna, ItalyBackground: Type 2 diabetes has become a disease with a high economic and social impact. The ARNO Observatory is a clinical data warehouse consisting of a network of local health care units (ASL scattered throughout the Italian territory which collects data on health care consumption for about 10.5 million people. The purpose of this study was to evaluate the use of antidiabetic drugs with particular reference to type of treatment. The analyses were carried out on a sample of 169,375 patients treated with oral blood glucose-lowering drugs in 2008 from a total population of 4,040,624 health care beneficiaries at 12 local health care units in the ARNO Observatory.Methods: Patients were considered “on treatment with oral blood glucose-lowering drugs” if they had received at least one prescription of an antidiabetic drug (Anatomical Therapeutic Chemical code A10B during 2008. The patients were divided into three treatment groups, ie, monotherapy, fixed-combination drugs, and dual therapy. The following indicators were assessed: number of patients treated with an oral antidiabetic drug, mean number of hospitalizations, mean number of specialist examinations, and mean expenditure per treated patient. Adherence was assessed using the medication possession ratio indicator (MPR.Results: Patients treated with oral blood glucose-lowering drugs comprised 4.2% of the investigated population, and had an average age of 68.9 years. The mean annual number of hospitalizations was lower in the dual therapy group (298 versus 328 per 1000 patients in the sample, while the average number of

  17. Transporter-Mediated Drug–Drug Interactions with Oral Antidiabetic Drugs

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    Jörg König

    2011-10-01

    Full Text Available Uptake transporters (e.g., members of the SLC superfamily of solute carriers and export proteins (e.g., members of the ABC transporter superfamily are important determinants for the pharmacokinetics of drugs. Alterations of drug transport due to concomitantly administered drugs that interfere with drug transport may alter the kinetics of drug substrates. In vitro and in vivo studies indicate that many drugs used for the treatment of metabolic disorders and cardiovascular diseases (e.g., oral antidiabetic drugs, statins are substrates for uptake transporters and export proteins expressed in the intestine, the liver and the kidney. Since most patients with type 2 diabetes receive more than one drug, transporter-mediated drug-drug interactions are important molecular mechanisms leading to alterations in oral antidiabetic drug pharmacokinetics with the risk of adverse drug reactions. This review focuses on uptake transporters of the SLCO/SLC21 (OATP and SLC22 (OCT/OAT family of solute carriers and export pumps of the ABC (ATP-binding cassette transporter superfamily (especially P-glycoprotein as well as the export proteins of the SLC47 (MATE family and their role for transporter-mediated drug-drug interactions with oral antidiabetic drugs.

  18. Beliefs related to adherence to oral antidiabetic treatment according to the Theory of Planned Behavior

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    Fernanda Freire Jannuzzi

    2014-08-01

    Full Text Available OBJECTIVE: to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior.METHOD: cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories.RESULTS: behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents.CONCLUSION: medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.

  19. Inadequate glycaemic control and antidiabetic therapy among inpatients with type 2 diabetes in Guangdong Province of China

    Institute of Scientific and Technical Information of China (English)

    BI Yan; CAI De-hong; WU Ge; ZHANG Fan; LIN Shao-da; XIAO Zheng-hua; ZHU Da-long; WENG Jian-ping; YAN Jin-hua; LIAO Zhi-hong; LI Yan-bing; ZENG Long-yi; TANG Kuan-xiao; XUE Yao-ming; YANG Hua-zhang; LI Lu

    2008-01-01

    Background Diabetes mellitus has become epidemic in recent years in China.We investigated the prevalence of hyperglycaemia and inadequate glycaemic control among type 2 diabetic inpatients from ten university teaching hospitals in Guangdong Province,China. Methods Inadequate glycaemic control in diabetic patients was defined as HbA1c(≥)6.5%.Therapeutic regimens included no-intervention,lifestyle only,oral antiglycemic agents(OA),insulin plus OA(insulin+OA),or insulin only. Antidiabetic managements included monotherapy,double therapy,triple or quadruple therapy. Results Among 493 diabetic inpatients with known history,75%had HbA1c≥6.5%.Inadequate glucose control rates were more frequently seen in patients on insulin+OA regimen(97%) than on OA regimen(71%)(P<O.001),and more frequent in patients on combination therapy(81%-96%)than monotherapy(75%)(P<0.05).Patients on insulin differed significantly from patients on OA by mean HbA1c,glycemic control rate,diabetes duration,microvascular complications,and BMI(P<0.01). Conclusions This study showed that glycaemic control of type 2 diabetic patients deteriorated for patients who received insulin and initiation time of insulin was usually delayed.It is up to clinicians to move from the traditional stepwise therapy to a more active and early combination antidiabetic therapy to provide better glucose control.

  20. [Dapagliflozin, a novel oral antidiabetic with an uncertain future].

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    Escudero Vilaplana, Belén; Almodóvar Carretón, María José; Herrero Hernández, Silvia

    2014-11-03

    Objetivo: La diabetes mellitus tipo 2 (DM2) es uno de los principales problemas sociosanitarios a nivel mundial, para la que existen multitud de tratamientos. Recientemente, se ha aprobado el primer farmaco de una nueva familia de antidiabeticos orales (ADO): la dapagliflozina. Nuestro objetivo es revisar la evidencia cientifica disponible sobre la dapagliflozina, con el fin de analizar su eficacia, seguridad y coste y poder estimar su papel en la farmacoterapia actual de la DM2. Métodos: La eficacia y seguridad de la dapagliflozina se analizaron mediante una evaluacion de la evidencia cientifica. El coste de los diferentes ADO se calculo en base a sus dosis diarias definidas (DDD) y al precio de venta del laboratorio. Resultados: Se identificaron 7 ensayos clinicos aleatorizados: 2 en monoterapia (840 pacientes) y 5 en terapia combinada con otros antidiabeticos (3184 pacientes). En los 7 ensayos, la dapagliflozina redujo la concentracion de HbA1c; en todos se comparo con placebo, salvo en un estudio en terapia combinada que se comparo frente a farmaco activo (glipizida). Entre los efectos adversos mas frecuentes se detectaron infecciones genitourinarias e hipotension, aunque se debe prestar especial atencion al incremento del cancer de vejiga. Junto con los inhibidores de la DPP-4, la dapagliflozina es uno de los ADO de mayor coste (coste anual de DDD=729,3 euros). Conclusiones: La dapagliflozina no aporta ventajas respecto a la farmacoterapia de la DM2 ya existente. Su falta de experiencia de uso, la ausencia de importantes beneficios clinicos y su elevado coste hacen necesario restringir su utilizacion.

  1. Comparative genotoxic and cytotoxic effects of the oral antidiabetic drugs sitagliptin, rosiglitazone, and pioglitazone in patients with type-2 diabetes: a cross-sectional, observational pilot study.

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    Oz Gul, Ozen; Cinkilic, Nilufer; Gul, Cuma Bulent; Cander, Soner; Vatan, Ozgur; Ersoy, Canan; Yılmaz, Dilek; Tuncel, Ercan

    2013-09-18

    This cross-sectional, observational pilot study was designed to investigate the frequency of different endpoints of genotoxicity (sister-chromatid exchange, total chromosome aberrations, and micronucleus formation) and cytotoxicity (mitotic index, replication index, and nuclear division index) in the peripheral lymphocytes of patients with type-2 diabetes treated with different oral anti-diabetic agents for 6 months. A total of 104 patients who met the American Diabetes Association criteria for type-2 diabetes were enrolled in the study. Of the 104 patients, 33 were being treated with sitagliptin (100mg/day), 25 with pioglitazone (30mg/day), 22 with rosiglitazone (4mg/day), and 24 with medical nutrition therapy (control group). The results for all the genotoxicity endpoints were significantly different across the four study groups. Post hoc analysis revealed that the genotoxicity observed in the sitagliptin group was significantly higher than that observed in the medical nutrition therapy group, but lower than that occurring in subjects who received thiazolidinediones. All of the three cytotoxicity endpoints were significantly lower in patients treated by oral anti-diabetic agents compared with those who received medical nutrition therapy. However, the three indexes did not differ significantly in the sitagliptin, rosiglitazone, and pioglitazone groups. Taken together, these pilot data indicate that sitagliptin and thiazolidinediones may exert genotoxic and cytotoxic effects in patients with type-2 diabetes. Further investigations are necessary to clarify the possible long-term differences between oral anti-diabetic drugs in terms of genotoxicity and cytotoxicity, and how these can modulate the risk of developing diabetic complications in general and cancer in particular.

  2. Use of oral anti-diabetic agents in pregnancy: A pragmatic approach

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    Bharti Kalra

    2015-01-01

    Full Text Available Insulin is the gold standard for treatment of hyperglycemia during pregnancy, when lifestyle measures do not maintain glycemic control during pregnancy. However, recent studies have suggested that certain oral hypoglycemic agents (metformin and glyburide may be safe and be acceptable alternatives. There are no serious safety concerns with metformin, despite it crossing the placenta. Neonatal outcomes are also comparable, with benefit of reductions in neonatal hypoglycemia, maternal hypoglycemia and weight gain, and improved treatment satisfaction. Glibenclamide is more effective in lowering blood glucose in women with gestational diabetes, and with a lower treatment failure rate than metformin. Although generally well-tolerated, some studies have reported higher rates of pre-eclampsia, neonatal jaundice, longer stay in the neonatal care unit, macrosomia, and neonatal hypoglycaemia. There is also paucity of long-term follow-up data on children exposed to oral agents in utero. This review aims to provide an evidence-based approach, concordant with basic and clinical pharmacological knowledge, which will help medical practitioners use oral anti-diabetic agents in a rational and pragmatic manner. Pubmed search was made using Medical Subject Headings (MESH terms "Diabetes" and "Pregnancy" and "Glyburide"; "Diabetes" and "Pregnancy" and "Metformin". Limits were randomized controlled trials (RCTs and meta-analysis. The expert reviews on the topic were also used for discussion. Additional information (studies/review pertaining to discussion under sub-headings like safety during breastfeeding; placental transport; long-term safety data were searched (pubmed/cross-references/expert reviews.

  3. COST-EFFECTIVENESS ANALYSIS OF ANTI-DIABETIC THERAPY IN A UNIVERSITY TEACHING HOSPITAL

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    Giwa Abdulganiyu

    2014-03-01

    Full Text Available Purpose: To conduct cost-effectiveness analysis of anti-diabetic therapy in a University Teaching Hospital in 2010. Methods: A retrospective review of selected case-notes was conducted. World Health Organization Defined Daily Dose Method of evaluating drug use and probability method for potential effectiveness of antidiabetic therapeutic options from literature analysis was employed in determining cost-effectiveness of each anti-diabetic therapeutic option identified from anti-diabetic drug utilization studies. Sample Size, n=1200. Subjects’ case-notes were selected by systematic random sampling (Sampling Interval = 1. Results: Glibenclamide (N1.76/unit of effectiveness which was more cost-effective than chlopropamide (N2.97/unit of effectiveness in the management of moderate hyperglycemia in non-obese Type II Diabetes Mellitus was more frequently prescribed (81.5%. Glibenclamide + Metformin (N7.63/unit of effectiveness which was more frequently prescribed (92.5% was not necessarily more cost-effective than Chlopropamide + Metformin (N9.76/unit of effectiveness in the management of moderate hyperglycemia in obese Type II Diabetes- Mellitus. Biphasic Isophane Insulin (N12.65/unit of effectiveness which was more cost-effective than soluble insulin + insulin zinc (N30.37/unit of effectiveness in the management of serve hyperglycemia in non-obese Type II Diabetes Mellitus was less frequently prescribed (42.3%. Biphasic Isophane Insulin + Metformin (N15.91/unit of effectiveness which was more cost-effective than soluble insulin + insulin zinc + metformin (N34.45/ unit of effectiveness in the management of severe hyperglycemia in obese Type II Diabetes Mellitus patients was less frequently prescribed (25%. Conclusions: Prescription of lees cost-effective anti-diabetic drugs was rampant in Hospitals.

  4. EXPERIENCE WITH THE ROSINSULIN C IN COMBINATION WITH ORAL ANTIDIABETIC DRUGS IN PATIENTS WITH TYPE 2 DIABETES IN ROUTINE CLINICAL PRACTICE

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    O. D. Rymar

    2014-01-01

    Full Text Available This study aimed to estimate the efficacy and safety of intermediate-acting insulin Rosinsulin C in patients with type 2 diabetes mellitus inadequately controlled with oral antidiabetic drugs.The present study is a 6-month, prospective, uncontrolled, clinical experience evaluation study using insulin Rosinsulin С for type 2 diabetes patients in daily clinical practice. Episodes of hypoglycaemia, adverse events were recorded. The study included 28 patients with type 2 diabetes, 4 men and 24 women who treated with metformin in combination with sulfonylureas in the highest dose. Indicators of glycosylated hemoglobin (HbA1c of 8 to 14%, the median HbA1c was 11 (10; 13% of patients age 65 (57; 72 years, body mass index – 33 (30; 35 kg/m2, waist circumference – 105 (99; 111 cm, diabetes duration – 7 (2; 11 years. With the introduction of Rosinsulin С cartridges carried pen Autopen. At the start of the study and after 3 and 6 months, determined the level of HbA1c, fasting plasma glucose.After 6 months' treatment with Rosinsulin С in combination with oral antidiabetic drugs HbA1c was significantly lowered (–3% (p = 0,001, fasting plasma glucose level decreased by 5 mmol/L (p = 0,001. There was not severe hypoglycemia during the observation period.This research showed that Rosinsulin C is effective and safe in the treatment of patients with type 2 diabetes who were decompensated with oral antidiabetic drugs and can be recommended for use as the initiation of insulin therapy in routine clinical practice.

  5. Oral Appliances Therapy

    Science.gov (United States)

    ... your sleep doctor may schedule you for a sleep study to verify treatment success. Follow-Up Visits Follow-up visits with your dentist will be needed to ensure the optimal fit of the oral appliance. Effective oral appliances ...

  6. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    OpenAIRE

    Wu P; Liu N

    2016-01-01

    Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB), patients’ beliefs about taking oral antidiabetic drugs (OADs) as prescribed, and to measure the correlations between bel...

  7. Antidiabetic Effects of Add-On Gynostemma pentaphyllum Extract Therapy with Sulfonylureas in Type 2 Diabetic Patients

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    V. T. T. Huyen

    2012-01-01

    Full Text Available Aims. To investigate the antidiabetic effect of the traditional Vietnamese herb Gynostemma pentaphyllum (GP together with sulfonylurea (SU in 25 drug-naïve type 2 diabetic patients. Methods. After 4-week treatment with gliclazide (SU, 30 mg daily, all patients were randomly assigned into 2 groups to add on GP extract or placebo extract, 6 g daily, during eight weeks. Results. After 4-week SU treatment, fasting plasma glucose (FPG and HbA1C decreased significantly (P<0.001. FPG was further reduced after add-on therapy with 2.9 ± 1.7 and 0.9 ± 0.6 mmol/L in the GP and placebo groups, respectively (P<0.001. Therapy with GP extract also reduced 30- and 120-minute oral glucose tolerance test postload values. HbA1C levels decreased approximately 2% units in the GP group compared to 0.7% unit in the placebo group (P<0.001. Conclusion. GP extract in addition to SU offers an alternative to addition of other oral medication to treat type 2 diabetic patients.

  8. Antidiabetic Effects of Add-On Gynostemma pentaphyllum Extract Therapy with Sulfonylureas in Type 2 Diabetic Patients

    Science.gov (United States)

    Huyen, V. T. T.; Phan, D. V.; Thang, P.; Ky, P. T.; Hoa, N. K.; Ostenson, C. G.

    2012-01-01

    Aims. To investigate the antidiabetic effect of the traditional Vietnamese herb Gynostemma pentaphyllum (GP) together with sulfonylurea (SU) in 25 drug-naïve type 2 diabetic patients. Methods. After 4-week treatment with gliclazide (SU), 30 mg daily, all patients were randomly assigned into 2 groups to add on GP extract or placebo extract, 6 g daily, during eight weeks. Results. After 4-week SU treatment, fasting plasma glucose (FPG) and HbA1C decreased significantly (P < 0.001). FPG was further reduced after add-on therapy with 2.9 ± 1.7 and 0.9 ± 0.6 mmol/L in the GP and placebo groups, respectively (P < 0.001). Therapy with GP extract also reduced 30- and 120-minute oral glucose tolerance test postload values. HbA1C levels decreased approximately 2% units in the GP group compared to 0.7% unit in the placebo group (P < 0.001). Conclusion. GP extract in addition to SU offers an alternative to addition of other oral medication to treat type 2 diabetic patients. PMID:23125867

  9. Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital

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    Bruce SP

    2015-03-01

    Full Text Available Background: The burden of diabetes mellitus, especially Type-2, continues to increase across the world. Medication adherence is considered an integral component in its management. Poor glycemic controls due to medication nonadherence accelerates the development of long-term complications which consequently leads to increased hospitalization and mortality. Objective: This study examined the level of adherence to oral antidiabetic drugs among patients who visited the teaching hospital and explored the probable contributory factors to non-adherence. Methods: A cross-sectional descriptive study using systematic sampling to collect quantitative data was undertaken. Questionnaires were administered to out-patients of the medical department of a teaching hospital in Ghana. Logistic regression was performed with statistical significance determined at p<0.05. Results: A total of 200 diabetic patients participated in the study. Using the Morisky Medication Adherence scale, the level of adherence determined was 38.5%. There were significant correlations between level of adherence and educational level [(OR=1.508; (CI 0.805- 2.825, P=0.019, and mode of payment [(OR=1.631; (CI 0.997- 2.669, P=0.05. Conclusion: Adherence in diabetic patients was low among respondents and this can be improved through education, counseling and reinforcement of self-care. There were several possible factors that contributed to the low adherence rate which could benefit from further studies.

  10. Thrice-daily biphasic insulin aspart 30 may be another therapeutic option for Chinese patients with type 2 diabetes inadequately controlled with oral antidiabetic agents

    Institute of Scientific and Technical Information of China (English)

    YANG Wen-ying; JI Qiu-he; ZHU Da-long; YANG Jin-kui; CHEN Lu-lu; LIU Zhi-min; YU De-min; YAN Li

    2009-01-01

    In subjects with type 2 diabetes inadequately controlled with oral antidiabetic agents (OADs), insulin therapy is usually started to improve glycaemic control after failure of diet, exercise and OADs.1 Although there is no standard way to introduce insulin treatment, premixed formulations are a popular option. They offer an alternative to basal-bolus therapy and provide basal and prandial coverage with a single injection. Indeed, Koivisto et al2 in 1999 reported that 39% of patients with type 2 diabetes worldwide used premixed insulin as part of their therapeutic regimen. The modem premixed insulins, such as biphasic insulin aspart 30 (BIAsp 30) are most frequently prescribed twice-daily (BID) in clinical Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China (Yang WY)

  11. Polypharmacy in elderly patients with type 2 diabetes receiving oral antidiabetic treatment.

    Science.gov (United States)

    Noale, Marianna; Veronese, Nicola; Cavallo Perin, Paolo; Pilotto, Alberto; Tiengo, Antonio; Crepaldi, Gaetano; Maggi, Stefania

    2016-04-01

    Polypharmacy in older diabetics can have detrimental effects linked to poor adherence and the risk of drug interaction or more serious/frequent side effects. The aim of this study was to identify the characteristics associated with polypharmacy in a cohort of elderly diabetic patients being treated with oral hypoglycemic agents. The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers in Italy participating in the METABOLIC Study. Patients meeting the following inclusion criteria were enrolled: diagnosis of type 2 diabetes mellitus, age ≥65 years, and receiving oral antidiabetic treatment. Data concerning diabetes duration and complications, the medications the patients were taking, and the number of hypoglycemic events were registered. Multidimensional impairment was assessed using the Multidimensional Prognostic Index. The mean age of the participants was 73.3 ± 5.5 years. Polypharmacy, defined as being prescribed contemporaneously at least five drugs, was found in 57.1 % of the study population. According to a multivariable logistic model, the female gender was significantly associated with polypharmacy, as were living in Northern Italian regions, diabetes duration longer than 4 years, and having a body mass index ≥30 kg/m(2). Comorbidities, diabetes complications, a better cognitive performance on the Short Portable Mental Status Questionnaire, and being malnourished/at risk of malnourishment according to the mini nutritional assessment were associated with polypharmacy. Polypharmacy, a condition that may lead to many potential detrimental outcomes in older diabetic subjects, was significantly associated with some risk factors that may be useful to identify subjects at risk.

  12. Patients’ beliefs about adherence to oral antidiabetic treatment: a qualitative study

    Directory of Open Access Journals (Sweden)

    Guénette L

    2015-03-01

    Full Text Available Line Guénette,1–3 Sophie Lauzier,1–3 Laurence Guillaumie,2–4 Gabriel Giguère,1 Jean-Pierre Grégoire,1–3 Jocelyne Moisan1–3 1Faculty of Pharmacy, Laval University, Quebec City, QC, Canada; 2Chair on Adherence to Treatments, Laval University, Quebec City, QC, Canada; 3CHU de Québec Research Center, Population Health and Optimal Practices Research Unit, Quebec City, QC, Canada; 4Faculty of Nursing, Laval University, Quebec City, QC, Canada Purpose: The purpose of this study was to elicit patients’ beliefs about taking their oral antidiabetic drugs (OADs as prescribed to inform the development of sound adherence-enhancing interventions.Methods: A qualitative study was performed. Adults with type 2 diabetes who had been taking an OAD for >3 months were solicited to participate in one of six focus groups. Discussions were facilitated using a structured guide designed to gather beliefs related to important constructs of the theory of planned behavior. Four coders using this theory as the theoretical framework analyzed the videotaped discussions.Results: Forty-five adults participated. The most frequently mentioned advantages for OAD-taking as prescribed were to avoid long-term complications and to control glycemia. Family members were perceived as positively influential. Carrying the OAD at all times, having the OAD in sight, and having a routine were important facilitating factors. Being away from home, not accepting the disease, and not having confidence in the physician’s prescription were major barriers to OAD-taking.Conclusion: This study elicited several beliefs regarding OAD-taking behavior. Awareness of these beliefs may help clinicians adjust their interventions in view of their patients’ beliefs. Moreover, this knowledge is crucial to the planning, development, and evaluation of interventions that aim to improve medication adherence. Keywords: type 2 diabetes, medication adherence, theory of planned behavior, focus groups

  13. Efficacy and safety of oral antidiabetic drugs in comparison to insulin in treating gestational diabetes mellitus: a meta-analysis.

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    Nalinee Poolsup

    Full Text Available OBJECTIVE: To assess the efficacy and safety of oral antidiabetic drugs (OADs in gestational diabetes mellitus (GDM in comparison to insulin. METHODS: A meta-analysis of randomized controlled trials was conducted. The efficacy and safety of OADs in comparison to insulin in GDM patients were explored. Studies were identified by conducting a literature search using the electronic databases of Medline, CENTRAL, CINAHL, LILACS, Scopus and Web of Science in addition to conducting hand search of relevant journals from inception until October 2013. RESULTS: Thirteen studies involving 2,151 patients met the inclusion criteria. These studies were randomized controlled trials of metformin and glyburide in comparison to insulin therapy. Our results indicated a significant increase in the risk for preterm births (RR, 1.51; 95% CI, 1.04-2.19, p = 0.03 with metformin compared to insulin. However, a significant decrease in the risk for gestational hypertension (RR, 0.54; 95% CI, 0.31-0.91, p = 0.02 was found. Postprandial glucose levels also decreased significantly in patients receiving metformin (MD, -2.47 mg/dL; 95% CI, -4.00, -0.94, p = 0.002. There was no significant difference between the two groups for the remaining outcomes. There were significant increases in the risks of macrosomia (RR, 2.34; 95% CI, 1.18-4.63, p = 0.03 and neonatal hypoglycemia (RR, 2.06; 95% CI, 1.27-3.34, p = 0.005 in the glyburide group compared to insulin whereas results for the other analyzed outcomes remained non-significant. CONCLUSION: The available evidence suggests favorable effects of metformin in treating GDM patients. Metformin seems to be an efficacious alternative to insulin and a better choice than glyburide especially those with mild form of disease.

  14. Association between Gastroenterological Malignancy and Diabetes Mellitus and Anti-Diabetic Therapy: A Nationwide, Population-Based Cohort Study.

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    Chien-Ming Lin

    Full Text Available The relationship between diabetes mellitus (DM and cancer incidence has been evaluated in limited kinds of cancer. The effect of anti-diabetic therapy (ADT on carcinogenesis among diabetic patients is also unclear.Using population-based representative insurance claims data in Taiwan, 36,270 DM patients and 145,080 comparison subjects without DM were identified from claims from 2005 to 2010. The association between the top ten leading causes of cancer-related death in Taiwan and DM was evaluated. Whether ADT altered the risk of developing cancer was also investigated.Incidence of cancer at any site was significantly higher in patients with DM than in those without (p<0.001. The risk of carcinogenesis imparted by DM was greatest in gastroenterological malignancies (liver, pancreas, and colorectal cancer as well as lung, breast and oral cancer (p<0.001. Among the oral types of ADT, metformin decreased the risk of lung and liver cancer, but had less effect on reducing the risk of colorectal cancer. α-glucosidase inhibitor decreased the risk of developing liver, colorectal, and breast cancer. Apart from intermediate-acting insulin, rapid-acting, long-acting, and combination insulin treatment significantly reduced the overall cancer risk among all DM patients. In subgroup analysis, long-acting insulin treatment significantly decreased the risk of lung, liver, and colorectal cancer.Our results supported the notion that pre-existing DM increases the incidence of gastroenterological cancer. ADT, especially metformin, α-glucosidase inhibitor, and long-acting insulin treatment, may protect patients with DM against these malignancies. It is crucial that oncologists should closely collaborate with endocrinologists to provide an optimal cancer-specific therapy and diabetic treatment to patients simultaneously with cancer and DM.

  15. Comparative evaluation of effects of combined oral anti-diabetic drugs (sulfonylurea plus pioglitazone and sulfonylurea plus metformin over lipid parameters in type 2 diabetic patients

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    Sukanta Sen

    2013-06-01

    Full Text Available Background: Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein (HDL cholesterol levels, and a preponderance of small, dense, low-density lipoprotein (LDL particles. In addition to their glucose-lowering properties, oral anti-diabetic agents may have effects on lipid levels, especially triglycerides (TGs, HDL-C, LDL-C and total cholesterol levels. Methods: A prospective, open-labeled, randomized, parallel-group study was carried out in sizable number of patients (n=40 of established type 2 diabetes on combined oral anti-diabetic drugs, to investigate the effects of combined oral anti-diabetic on lipid parameters who was not receiving any hypolipidemic agent in addition. Results: Statistically significant mean reduction of triglycerides (TGs of 25.1mg/dl (a 15.30% reduction from baseline value and by 13.5 mg/dl (a 8.94% reduction from baseline value in the SU (sulfonylurea plus PIO (pioglitazone and SU plus MET (metformin group respectively. Present study also shows improvement in HDL cholesterol with SU plus PIO group by 13.18% which is almost twice that observed in SU plus MET group (8.06%. Present study also shows increase in LDL cholesterol with SU plus PIO group by 2.10%, is just opposite to SU plus MET group (4.92 % decrease. With SU plus PIO group, a statistically significant mean reduction of total cholesterol (TC of 8.33mg/dl (5.14 % decrease and by 7.62 mg/dl (4.28% decrease in the SU plus MET group. Conclusions: Pioglitazone, a thiazolidinedione, has been shown to improve the lipid profile in patients with type 2 diabetes by increasing HDL-C levels and by decreasing triglyceride and total cholesterol levels in monotherapy or combination regimens with sulfonylurea. Metformin also has been shown to reduce LDL-C, TC, and TG

  16. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    Directory of Open Access Journals (Sweden)

    Wu P

    2016-06-01

    Full Text Available Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB, patients’ beliefs about taking oral antidiabetic drugs (OADs as prescribed, and to measure the correlations between beliefs and medication adherence.Patients and methods: We performed a cross-sectional study of type 2 diabetic patients using structured questionnaires in a Chinese tertiary hospital. A total of 130 patients were enrolled to be interviewed about TPB variables (behavioral, normative, and control beliefs relevant to medication adherence. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8. Spearman’s rank correlation was used to assess the association between TPB and MMAS-8. Logistic regression analysis was performed to examine the relationship between different variables and MMAS-8, with statistical significance determined at P<0.05.Results: From 130 eligible Chinese patients with an average age of 60.6 years and a male proportion of 50.8%, a nonsignificant relationship between behavioral, normative, and the most facilitating control beliefs and OAD adherence was found in our study. Having the OADs on hand (P=0.037 was the only facilitating control belief associated with adherence behavior. Being away from home or eating out (P=0.000, not accepting the disease (P=0.000, ignorance of life-long drug adherence (P=0.038, being busy (P=0.001, or poor memory (P=0.008 were control belief barriers found to be correlated with poor adherence. TPB is the only important determinant influencing OAD adherence among all the factors (P=0.011.Conclusion: The results indicate that the TPB model could be used to examine adherence to OADs. One

  17. Phototoxicity to sulphonamide-derived oral antidiabetics and diuretics: comparative in-vitro and in-vivo investigations

    Science.gov (United States)

    Selvaag, Edgar; Anholt, Helle; Moan, Johan; Thune, Per

    1997-12-01

    Seven oral antidiabetics (chlorpropamide, glibenclamide, glipizide, gliquidone, glymidine, tolazamide, and tolbutamide), and 14 diuretics (bemetizide, bendroflumethiazide, benzylhydrochlorothiazide, bumetanide, butizide, chlortalidone, furosemide, hydrochlorothiazide, hydroflumethiazide, indapamide, piretanide, polythiazide, trichlormethiazide, and xipamide) were investigated for potential phototoxicity in vitro using a cell culture model and in vivo in hairless mice. After exposure to broad band UVA, the majority of the substances tested in vitro yielded phototoxic action leading to loss of culture forming ability. In vivo, all tested substances induced edema or ulceration, and lead to a significant increase in skin fold thickness of the mouse skin. In all a number of substances not described to induce clinical photosensitivity nor phototoxicity in vitro or in vivo were detected in our testing. In determining potential photosensitizers, it seems important to utilize different test methods, as not all substances will exhibit action in a given assay.

  18. Hypocalcaemia following thyroidectomy unresponsive to oral therapy.

    Science.gov (United States)

    Etheridge, Zac C; Schofield, Christopher; Prinsloo, Peter J J; Sturrock, Nigel D C

    2014-01-01

    Hypocalcaemia due to hypoparathyroidism following thyroidectomy is a relatively common occurrence. Standard treatment is with oral calcium and vitamin D replacement therapy; lack of response to oral therapy is rare. Herein we describe a case of hypoparathyroidism following thyroidectomy unresponsive to oral therapy in a patient with a complex medical history. We consider the potential causes in the context of calcium metabolism including: poor adherence, hungry bone syndrome, malabsorption, vitamin D resistance, bisphosphonate use and functional hypoparathyroidism secondary to magnesium deficiency. Malabsorption due to intestinal hurry was likely to be a contributory factor in this case and very large doses of oral therapy were required to avoid symptomatic hypocalcaemia.

  19. Antidiabetic claims of Tinospora cordifolia(Willd.)Miers:critical appraisal and role in therapy

    Institute of Scientific and Technical Information of China (English)

    Rohit; Sharma; Hetal; Amin; Galib; Pradeep; Kumar; Prajapati

    2015-01-01

    Currently,available conventional options for diabetes mellitus have certain limitations of their own,and options from medicinal plants with antihyperglycemic activities are being searched to meet the need.Antidiabetic properties of Tmospora cordifolia are highly appreciated in Ayurveda and even in recent modern researches.Several studies on its extracts(viz,immunemodulatory.anti-hyperglycemic.antioxidant,adaptogenic.hepatoprotective.hormone regulator etc.) and isolated phytoconstituents(like tinosporin,berberine.jatrorrhizine etc.) have reported that it is a preventive and curative antidiabetic herb,which are substantiated by clinical trials.Scattered information pertaining to antidiabetic potential of Tmospora is reported.Present review encompasses(i) in-depth information of reported antidiabetic activities of the plant in light of available experimental and clinical studies,and(ii) understanding on the possible mechanism of its action in combating the complex pathology of diabetes.

  20. Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease

    Institute of Scientific and Technical Information of China (English)

    Valter Donadon; Massimiliano Balbi; Michela Ghersetti; Silvia Grazioli; Antonio Perciaccante; Giovanni Della Valentina; Rita Gardenal; Maria Dal Mas; Pietro Casarin; Giorgio Zanette; Cesare Miranda

    2009-01-01

    AIM:To explore the association between hepatocellular carcinoma (HCC) and type 2 diabetes mellitus,describe the temporal relations between the onset of diabetes and the development of HCC and evaluate the possible effects of antidiabetic therapy on HCC risk.METHODS:We recruited 465 HCC patients, 618 with cirrhosis and 490 control subjects. We evaluated the odds ratio (OR) for HCC by univariate and multivariate analysis. Moreover, OR for HCC in diabetic subjects treated with insulin or sulphanylureas and with metformin were calculated.RESULTS:The prevalence of diabetes mellitus was 31.2% in HCC, 23.3% in cirrhotic patients and 12.7% in the Control group. By univariate and multivariate analysis, the OR for HCC in diabetic patients were respectively 3.12 (CI 2.2-4.4, P < 0.001) and 2.2 (CI 1.2-4.4, P = 0.01). In 84.9% of cases, type 2 diabetes mellitus was present before the diagnosis of HCC. Moreover, we report an OR for HCC of 2.99 (CI 1.34-6.65, P = 0.007) in diabetic patients treated with insulin or sulphanylureas, and an OR of 0.33 (CI 0.1-0.7,P = 0.006) in diabetic patients treated with metformin.= 0.006) in diabetic patients treated with metformin.CONCLUSION:Our study confirms that type 2 diabetes mellitus is an independent risk factor for HCC and pre-exists in the majority of HCC patients. Moreover, in male patients with type 2 diabetes mellitus, our data shows a direct association of HCC with insulin and sulphanylureas treatment and an inverse relationship with metformin therapy.

  1. Changes in endotoxin levels in T2DM subjects on anti-diabetic therapies

    Directory of Open Access Journals (Sweden)

    Kumar Sudhesh

    2009-04-01

    Full Text Available Abstract Introduction Chronic low-grade inflammation is a significant factor in the development of obesity associated diabetes. This is supported by recent studies suggesting endotoxin, derived from gut flora, may be key to the development of inflammation by stimulating the secretion of an adverse cytokine profile from adipose tissue. Aims The study investigated the relationship between endotoxin and various metabolic parameters of diabetic patients to determine if anti-diabetic therapies exerted a significant effect on endotoxin levels and adipocytokine profiles. Methods Fasting blood samples were collected from consenting Saudi Arabian patients (BMI: 30.2 ± (SD5.6 kg/m2, n = 413, consisting of non-diabetics (ND: n = 67 and T2DM subjects (n = 346. The diabetics were divided into 5 subgroups based on their 1 year treatment regimes: diet-controlled (n = 36, metformin (n = 141, rosiglitazone (RSG: n = 22, a combined fixed dose of metformin/rosiglitazone (met/RSG n = 100 and insulin (n = 47. Lipid profiles, fasting plasma glucose, insulin, adiponectin, resistin, TNF-α, leptin, C-reactive protein (CRP and endotoxin concentrations were determined. Results Regression analyses revealed significant correlations between endotoxin levels and triglycerides (R2 = 0.42; p 2 = 0.10; p 2 = 0.076; p 2 = 0.032; p 2 = 0.055; p Conclusion We conclude that sub-clinical inflammation in T2DM may, in part, be mediated by circulating endotoxin. Furthermore, that whilst the endotoxin and adipocytokine profiles of diabetic patients treated with different therapies were comparable, the RSG group demonstrated significant differences in both adiponectin and endotoxin levels. We confirm an association between endotoxin and serum insulin and triglycerides and an inverse relationship with HDL. Lower endotoxin and higher adiponectin in the groups treated with RSG may be related and indicate another mechanism for the effect of RSG on insulin sensitivity.

  2. Oral surgery in patients undergoing chemoradiation therapy.

    Science.gov (United States)

    Demian, Nagi M; Shum, Jonathan W; Kessel, Ivan L; Eid, Ahmed

    2014-05-01

    Oral health care in patients undergoing chemotherapy and/or radiation therapy can be complex. Care delivered by a multidisciplinary approach is timely and streamlines the allocation of resources to provide prompt care and to attain favorable outcomes. A hospital dentist, oral and maxillofacial surgeon, and a maxillofacial prosthodontist must be involved early to prevent avoidable oral complications. Prevention and thorough preparation are vital before the start of chemotherapy and radiation therapy. Oral complications must be addressed immediately and, even with the best management, can cause delays and interruption in treatment, with serious consequences for the outcome and prognosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Heart failure hospitalization risk associated with use of two classes of oral antidiabetic medications: an observational, real-world analysis.

    Science.gov (United States)

    Gautam, Santosh; Agiro, Abiy; Barron, John; Power, Thomas; Weisman, Harry; White, Jeff

    2017-07-31

    Newer oral antidiabetic drug classes are expanding treatment options for type 2 diabetes mellitus (T2DM); however, concerns remain. The objective was to assess relative risk of heart failure hospitalization of sodium-glucose co-transporter-2 (SGLT2) and dipeptidyl peptidase-4 (DPP4) inhibitors in T2DM patients. This retrospective observational study used a national commercially insured claims database. Adults (>18 years) with T2DM newly starting SGLT2 or DPP4 medication between April 2013 and December 2014 were included. Depending on their index fill, patients were grouped into either SGLT2 or DPP4 medication class cohorts. The primary outcome was hospitalization for heart failure and the risk was assessed using Cox regression models. Propensity score matching (1:2 ratio) was used to adjust for potential confounders. Analyses were also stratified by the presence of baseline diabetes complication and age (heart failure hospitalization was lower among SGLT2 users in comparison with matched DPP4 users (2.0% SGLT2 vs 3.1% DPP4; adjusted hazard ratio [aHR] 0.68; 95% confidence interval [CI] 0.54-0.86; p = .001). However, the stratified analyses revealed no risk difference among the majority of the analyzed patients, i.e., those aged heart failure was significantly lower for patients initiating an SGLT2 compared with a DPP4 medication, specifically among older patients and those with diabetes complication.

  4. Association of PAX4 genetic variants with oral antidiabetic drugs efficacy in Chinese type 2 diabetes patients.

    Science.gov (United States)

    Chen, M; Hu, C; Zhang, R; Jiang, F; Wang, J; Peng, D; Tang, S; Sun, X; Yan, J; Luo, Y; Bao, Y; Jia, W

    2014-10-01

    The aim of this study was to investigate the association of PAX4 variants with therapeutic effect of oral antidiabetic drugs in Chinese type 2 diabtes mellitus (T2DM) patients. A total of 209 newly diagnosed T2DM patients were randomly assigned to treatment with repaglinide or rosiglitazone for 48 weeks, and the therapeutic effects were compared. In the rosiglitazone cohort, rs6467136 GA+AA carriers showed greater decrease in 2-h glucose levels (P=0.0063) and higher cumulative attainment rates of target 2-h glucose levels (Plog rank=0.0093) than GG homozygotes. In the subgroup with defective β-cell function, rs6467136 GA+AA carriers exhibited greater decrements of 2-h glucose level and improvement of homeostasis model assessment of insulin resistance (P=0.0143). Moreover, GA+AA carriers were more likely to attain the target fasting and 2-h glucose level (Plog rank=0.0091 and 0.007, respectively). However, these single-nucleotide polymorphisms showed no effect on repaglinide efficacy. In conclusion, PAX4 variant rs6467136 was associated with the therapeutic effect of rosiglitazone in Chinese T2DM patients.

  5. Improving the quality of oral anticoagulant therapy

    NARCIS (Netherlands)

    Gadisseur, Alain Peter Anton

    2006-01-01

    Oral anticoagulant therapy has changed little since the development of the coumarin drugs after the Second World War. The basic nature of the therapy, i.e. the balancing between thrombosis and haemorrhage, makes it a therapy difficult to manage. Add to this the many influences from co-morbidity,

  6. Improving the quality of oral anticoagulant therapy

    NARCIS (Netherlands)

    Gadisseur, Alain Peter Anton

    2006-01-01

    Oral anticoagulant therapy has changed little since the development of the coumarin drugs after the Second World War. The basic nature of the therapy, i.e. the balancing between thrombosis and haemorrhage, makes it a therapy difficult to manage. Add to this the many influences from co-morbidity, c

  7. Improving the quality of oral anticoagulant therapy

    NARCIS (Netherlands)

    Gadisseur, Alain Peter Anton

    2006-01-01

    Oral anticoagulant therapy has changed little since the development of the coumarin drugs after the Second World War. The basic nature of the therapy, i.e. the balancing between thrombosis and haemorrhage, makes it a therapy difficult to manage. Add to this the many influences from co-morbidity, c

  8. Re-Training of Type 2 Diabetic Patients for Better Adherence to Diabetes Care Plan in Oral Anti-Diabetics and Plus Insulin Treatment Groups

    Directory of Open Access Journals (Sweden)

    Soner Cander

    2015-06-01

    Full Text Available Purpose: This prospective observational single-centre study was designed to evaluate the effect of patient re-training for better adherence to regular self-monitoring of blood glucose (SMBG, standard diabetic diet and exercise program in ambulatory patients with type 2 diabetes mellitus (T2DM receiving oral anti-diabetic (OAD and OAD plus insulin treatments. Material and Method: In this study, we enrolled a total of 61 patients with T2DM in whom ongoing therapy with OAD (n=34 and OAD+insulin (n=27 failed to achieve adequate glycemic control. The patients were educated for lifestyle behavior, adherence to diet and exercise therapy, close monitoring with SMBG without change in their ongoing drugs and dosing. Changes in glycemic parameters, serum lipids and anthropometrics at the end of 3rd month were compared between the treatment groups. Results: During the course of the study, a significant decrease in the body weight and fat were observed in OAD (p<0.001 and p=0.002 and OAD+insulin groups (p=0.044 and p=0.008, respectively. A significant decrease in the HbA1c % (6.1%; 8.2% to 7.6% was observed in the overall population (p<0.001 as well as in OAD (p=0.011 and OAD+insulin (p=0.001 groups. A significant decrease was noted in the post-prandial capillary blood glucose levels in only OAD+insulin group. Discussion: Re-training approach with close follow-up and frequent SMBG seems to be important factors for the maintenance of achieved glycemic control. In our study, the effect of diabetes education on postprandial capillary blood glucose levels was more pronounced in OAD+insulin group. Turk Jem 2015; 19: 49-54

  9. Emerging oral therapies for multiple sclerosis.

    Science.gov (United States)

    Miller, Colleen E; Umhauer, Margaret A

    2011-02-01

    Despite notable advances in the understanding of multiple sclerosis (MS) and the availability of several treatment options, there is a need for therapies that are more effective, safe, convenient, and well tolerated. Several new oral MS therapies are being investigated. Because data on these new therapies continue to emerge, nurses will play a pivotal role in educating patients regarding the benefits and risks of potential treatments and in monitoring patients for response, safety, tolerability, and adherence. This article reviews the oral MS therapies recently approved as well as those currently in development or submitted for Food and Drug Administration approval.

  10. POSSIBILITIES OF MODERN ORAL DIABETES THERAPY* -

    African Journals Online (AJOL)

    1971-01-23

    Jan 23, 1971 ... deals with problems and possibilities of oral therapy, especially with the .... 4. Effect of intravenous tolbuta- mide and HB 419 on blood glucose. (BG) and serum ... An additional dose of 50 g carbohydrate given orally -f-hour ...

  11. Cancer therapy-related oral mucositis.

    Science.gov (United States)

    Redding, Spencer W

    2005-08-01

    Oral mucositis is a common side effect of cancer therapies, particularly radiation therapy for head and neck cancer and various forms of chemotherapy. It commonly results in severe oral pain that can compromise the duration and success of cancer management. Hospitalizations are common because patients lose the ability to take anything by mouth due to severe pain and must have alimentation supported during this period. Pain management usually requires potent narcotic analgesia. Cancer therapy-related oral mucositis is commonly described as the most significant and debilitating acute complication associated with radiation therapy and chemotherapy. Until recently, cancer therapy-induced oral mucositis was thought to be a process involving the epithelium only. Evidence is building that the process of oral mucositis involves far more than just the epithelium, but includes multiple cellular processes of the submucosa as well. Many strategies have been evaluated to prevent oral mucositis, but the data is confusing since it is often conflicting. Therapy with the growth factor, KGF1, appears promising, as it is the only medication currently approved by the FDA. A multifaceted approach that targets the entire mucositis process will probably be needed to optimize overall prevention.

  12. [Clinical pharmacology of two new oral antidiabetics of the sulfonamide type (author's transl)].

    Science.gov (United States)

    Haupt, E; Küllmer, K A; Schöffling, K

    1977-07-15

    Pharmacodynamic studies were performed with two new blood glucose lowering sulfonamides of high potency: gliquidone and gliflumide. The aim was to obtain equipotent doses on the basis of a maximum 30% blood glucose decrease in healthy normals (Ed 30) in order to compare the new compounds with the well known effects of tolbutamide and glibenclamide. Our investigations demonstrated a dose dependent blood glucose decrease with each sulfonylurea corresponding with the insulin levels after intravenous application. Gliquidone revealed a "tolbutamide-typed" dynamic both on insulin secretion and on blood glucose decrease whereas gliflumide showed a "glibenclamide-typed" reaction. The delayed and more prolonged insulin decrease, well known for glibenclamide, was even more distinct following gliflumide. Differences of insulin secretion after sulfonulureas can be observed only under intravenous conditions. Following oral application an only small increase of insulin can be noted when measured in peripheral blood.

  13. [The mortality of patients with diabetes mellitus using oral antidiabetic drugs in the Czech Republic decreased over the decade of 2003-2013 and came closer to the population average].

    Science.gov (United States)

    Brož, Jan; Honěk, Petr; Dušek, Ladislav; Pavlík, Tomáš; Kvapil, Milan

    2015-11-01

    Every year official data is published which describes the care of patients with diabetes mellitus in the Czech Republic. An overall number of individuals with diabetes, the number of newly reported cases and the number of patient deaths is always specified. However this data does not allow us to identify the differences in mortality between the individual cohorts of diabetic patients in relation to therapy. Comparison of the mortality development in the periods of 2002-2006 and 2010-2013 in a representative sample of the patient population with type 2 diabetes mellitus using oral antidiabetic drugs, kept in the database of the General Health Insurance Company of the Czech Republic (VZP) which provided health care coverage for 63% of Czech population in 2013. A retrospective epidemiologic analysis. We identified all individuals in the VZP database who had a record of DM diagnosis (E10-E16 based on ICD 10) or who had any antidiabetic therapy prescribed (ATC group A10) in the periods of 2002-2008 and 2009-2013. We only selected those patients for the analysis who were treated with oral antidiabetic medicines (in the given year or the preceding years they had a record of treatment with at least one medicine from A10B group, while having no record of treatment with medicines from A10A group within both years). 237,665 individuals met the selected criteria in 2003 and 315,418 individuals in 2013. Mortality rates dropped for all age groups (from 2003-2013): for 50-59 year olds by 1.2%-0.7%; in 60-69 year olds by 2.6%-1.6%; for 70-79 year olds by 5.8%-3.5%. In 2013 mortality rates came close to the general population where for the same age groups they reached 0.6%, 1.5% and 3.4% respectively. When expressed in relative terms, the mortality among 50-59 year olds declined by 42% (Czechia by 25%), among 60-69 year olds by 39% (Czechia by 17%) and among 70-79 year olds by 40% (Czechia by 28%) from the year 2003. The decline in mortality among the patients with DM treated with

  14. The Novel Oral Drug Subetta Exerts an Antidiabetic Effect in the Diabetic Goto-Kakizaki Rat: Comparison with Rosiglitazone

    Science.gov (United States)

    Bailbé, Danielle; Portha, Bernard

    2013-01-01

    The aim of the present study was to evaluate the potential antidiabetic effects of two-component drug Subetta and its components (release-active dilutions of antibodies to β-subunit insulin receptor (RAD of Abs to β-InsR) and to endothelial nitric oxide synthase (RAD of Abs to eNOS)) in Goto-Kakizaki (Paris colony) (GK/Par) diabetic rats. Subetta was administered orally for 28 days once daily (5 mL/kg) and compared to its two components (2.5 mL/kg), Rosiglitazone (5 mg/kg), and vehicle (5 mL water/kg). At day 28, fasting plasma glucose levels were significantly decreased only in Subetta and Rosiglitazone groups as compared to vehicle (P < 0.01): 147 ± 4 mg/dL and 145 ± 4 mg/dL and 165 ± 4 mg/dL, respectively. The data of glucose tolerance test showed that Subetta and RAD of Abs to β-InsR (similar to Rosiglitazone) prevented significantly (P < 0.01) the age-related spontaneous deterioration of glucose tolerance as seen in the control group. Subetta and RAD of Abs to β-InsR did not significantly modify the glucose-induced insulin secretion. Chronic administration of Subetta and RAD of Abs to β-InsR improves glucose control, to an extent similar to that of Rosiglitazone. We hypothesize that Subetta and RAD of Abs to β-InsR mostly act via an insulin-sensitizing effect upon target tissues. PMID:23762875

  15. Impact of inhalation therapy on oral health

    Directory of Open Access Journals (Sweden)

    Navneet Godara

    2011-01-01

    Full Text Available Inhalation therapy has been employed as the mainstay of the treatment in chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD. Beta-2 agonists, anticholinergic bronchodilators, inhaled corticosteroids, and sodium cromoglycate are often used alone or in combination in an inhaled form. Studies have shown that inhaled drugs used in the treatment have some adverse effects on the oral health based on their dosage, frequency, and duration of use. Several oral conditions such as xerostomia, dental caries, candidiasis, ulceration, gingivitis, periodontitis, and taste changes have been associated with inhalation therapy. Since the prevalence of chronic respiratory diseases is rising, it is important to provide optimal oral care to the individuals receiving inhalation therapy. This article will review the influence of inhaled drugs on the oral health of individuals and adequate management and prevention of the same.

  16. Gene Therapy In Oral Cancer : An Overview

    OpenAIRE

    2010-01-01

    The treatment and prevention of oral cancer is one of the major hurdles in the field ofcancer. Gene therapy is one of the recent advances in this field to tackle this hurdle with promisingprospects. This overview introduces the reader into the basic idea of gene therapy, types of genetherapy and the various modes of introduction of therapeutic gene into the cancer affected cell.

  17. Patterns and obstacles to oral antidiabetic medications adherence among type 2 diabetics in Ismailia, Egypt: a cross section study

    OpenAIRE

    Heissam, Khaled; Abuamer, Zeinab; El-Dahshan, Nahed

    2015-01-01

    Introduction Diabetes is a costly and increasingly common chronic disease. Effective management of diabetes to achieve glycemic control improves patient quality of life. Adherence rates to drug regimens in patients with type 2 diabetes are relatively low and vary widely between populations. There are many factors that could affect patient adherence to drug therapy. The aim of the present study was assessing patterns and obstacles to adherence of type 2 diabetic patients to their oral hypoglyc...

  18. Hypoglycaemia with oral antidiabetic drugs: results from prescription-event monitoring cohorts of rosiglitazone, pioglitazone, nateglinide and repaglinide.

    Science.gov (United States)

    Vlckova, Veronika; Cornelius, Victoria; Kasliwal, Rachna; Wilton, Lynda; Shakir, Saad A W

    2009-01-01

    Hypoglycaemia is an acute complication associated with intensive treatment of patients with diabetes mellitus. This complication poses a major challenge in diabetes management. Furthermore, severe hypoglycaemia may be life threatening. Although hypoglycaemia is more often associated with insulin treatment, oral hypoglycaemic agents have the potential to trigger hypoglycaemia. The aim of this study was to quantify the incidence of hypoglycaemic events and to describe the pattern of these incident events during the first 9 months of treatment with four oral antidiabetic drugs, rosiglitazone, pioglitazone, nateglinide and repaglinide, prescribed in general practice in England. We used data collected for prescription-event monitoring (PEM) studies of rosiglitazone, pioglitazone, nateglinide and repaglinide. PEM is an observational, non-interventional, incept cohort study. Observation time for each patient and incidence rate (IR) per 1000 patient-years of treatment for hypoglycaemia was calculated for each drug cohort. Smoothed hazard estimates were plotted over time. Case/non-case analysis was performed to describe and compare patients who had at least one hypoglycaemic event in the first 9 months of treatment with those who did not. The total number of patients included in the analysis was 14,373, 12,768, 4,549 and 5,727 in rosiglitazone, pioglitazone, nateglinide and repaglinide cohorts, respectively. From these, 276 patients experienced at least one episode of hypoglycaemia. The IR was between 50% and 100% higher in patients receiving treatment with meglitinides compared with those treated with the thiazolidinediones (TZDs) [IR = 9.94, 9.64, 15.71 and 20.32 per 1,000 patient-years for rosiglitazone, pioglitazone, nateglinide and repaglinide, respectively]. The plot of the hazard function and the estimated shape parameter from the Weibull regression model showed that pioglitazone, nateglinide and repaglinide had non-constant (decreasing) hazards over time, whereas

  19. Adherence to oral antineoplastic therapy

    Directory of Open Access Journals (Sweden)

    R. Olivera-Fernandez

    2014-04-01

    Full Text Available Background: Oral chemotherapy agents offer advantages including cost, patient comfort and potential improvement in quality of life versus intravenous drugs. However ensuring adherence and monitoring adverse effects is more difficult. The aim of this study was to examine the real adherence in patients with oral chemotherapy agents in our hospital, to assess the influence of patient and treatment characteristics, to identify reasons for non adherence, to identify pportunities for improvement pharmaceutical care and to assess the potential relation between adherence and treatment outcomes. Method: observational, prospective study for a period of four month, in the patients who were dispensing oral chemotherapy agents in outpatient setting. The medical prescriptions, medical history and patient interviews were used to collect data. Results: 141 patients were assessing. 72% were considered as fully adherent, while 28% reported some kind of non adherence. Adherence was influenced by time from diagnosis and adverse effects. No relationship between adherence and treatment outcomes was found. Conclusions: Adherence to oral chemotherapy was 72%, identifing opportunities for improvement pharmaceutical care to prevent adverse effects and to improve our patient adherence

  20. [Adherence to oral antineoplastic therapy].

    Science.gov (United States)

    Olivera-Fernandez, R; Fernandez-Ribeiro, F; Piñeiro-Corrales, G; Crespo-Diz, C

    2014-11-03

    Introducción: Los tratamientos antineoplasicos orales presentan ventajas en cuanto a coste, comodidad y mejora potencial en la calidad de vida respecto al tratamiento endovenoso, pero es mas dificil controlar la adherencia y monitorizar los efectos adversos. El objetivo de este estudio fue conocer la adherencia real en pacientes con antineoplasicos orales en nuestro centro, analizar la influencia de las caracteristicas del paciente y del tratamiento, identificar motivos de no adherencia, oportunidades de mejora en la atencion farmaceutica y evaluar la posible relacion adherencia y respuesta al tratamiento. Método: estudio prospectivo observacional de cuatro meses de duracion, en los pacientes con tratamiento antineoplasico oral dispensado desde la consulta de farmacia oncologica. Para la recogida de datos se utilizaron: orden medica, historia clinica y visita con entrevistas al paciente. Resultados: Se evaluaron un total de 141 pacientes. Un 72% se considero totalmente adherente, mientras que en un 28% se detecto algun tipo de no adherencia. El tiempo desde el diagnostico y la presencia de efectos adversos fueron las variables que afectaron a la adherencia. No se pudo demostrar relacion entre adherencia y respuesta al tratamiento. Conclusiones: La adherencia al tratamiento antineoplasico oral en nuestro centro fue del 72%, identificando oportunidades de mejora en la atencion farmaceutica dirigidas a prevenir los efectos adversos y a potenciar la adherencia de nuestros pacientes.

  1. The Antidiabetics Market: Tendencies and Research Directions

    Directory of Open Access Journals (Sweden)

    Claudiu MOROGVAN

    2010-03-01

    Full Text Available Diabetes mellitus is a pathology with multiple and severe implications. Its prevalence has been continuously increasing during the last years, as well as the number of drugs introduced in its therapy. The value of the antidiabetics global market was evaluated at over 18 billion USD in 2005. The following five international producers hold the biggest share: NovoNordisk, Takeda, Sanofi-Aventis, GlaxoSmithkline and Eli Lilly. The two bestselling drugs in the USA in 2008 were Actos and Lantus, two products of latest generation, which, however, seems to be a global tendency. As far as the OAD (Oral Antidiabetic Drug category is concerned, the products to be prescribed in the following years will be those of latest generation, such as thiazolidinedione, GLP-1 analogues, DPP-4 inhibitors, as well as their fixed combinations with metformine. Rapid or slow acting Insulin analogues and their combinations with isophane insulins replace the classic insulins which seem to be outdated.

  2. Gene Therapy In Oral Cancer : An Overview

    Directory of Open Access Journals (Sweden)

    Kanaram Choudhary

    2010-07-01

    Full Text Available The treatment and prevention of oral cancer is one of the major hurdles in the field ofcancer. Gene therapy is one of the recent advances in this field to tackle this hurdle with promisingprospects. This overview introduces the reader into the basic idea of gene therapy, types of genetherapy and the various modes of introduction of therapeutic gene into the cancer affected cell.

  3. State of the art: Oral antiplatelet therapy.

    Science.gov (United States)

    Gurbel, Paul A; Myat, Aung; Kubica, Jacek; Tantry, Udaya S

    2016-01-01

    Platelet adhesion, activation, and aggregation are central to the propagation of coronary thrombosis following rupture, fissure, or erosion of an atherosclerotic plaque. This chain of deleterious events underlies the pathophysiological process leading to an acute coronary syndrome. Therefore, oral antiplatelet therapy has become the cornerstone of therapy for the management of acute coronary syndrome and the prevention of ischemic complications associated with percutaneous coronary intervention. Landmark trials have established aspirin, and the addition of clopidogrel to aspirin, as key therapeutic agents in the context of acute coronary syndrome and percutaneous coronary intervention. Dual antiplatelet therapy has been the guideline-mandated standard of care in acute coronary syndrome and percutaneous coronary intervention. Despite the proven efficacy of dual antiplatelet therapy, adverse ischemic events continue to occur and this has stimulated the development of novel, more potent antiplatelet agents. We focus this state-of-the-art review on the most recent advances in oral antiplatelet therapy, treading the tightrope of potency versus bleeding risk, the quest to determine the optimal duration of dual antiplatelet therapy and future of personalized antiplatelet therapy.

  4. Determinants for inadequate glycaemic control in Chinese patients with mild-to-moderate type 2 diabetes on oral antidiabetic drugs alone

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shao-ling; CHEN Zong-cun; YAN Li; CHEN Li-hong; CHENG Hua; JI Li-nong

    2011-01-01

    Background Prevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus (T2DM)remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises in China who were treated with oral antidiabetic drugs (OAD) alone and to determine factors associated with inadequate giycaemic control in this population.Methods An observational, cross-sectional multicentre study was conducted in 16 metropolitan medical centers.People with T2DM who had been followed-up before the index visit which occurred from January to September 2007 were included in the study. All subjects were ≥30 years of age at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Demographic and clinical data were collected from medical records. The main study outcome was the inadequate glucose control rate, which was calculated by the proportion of patients with haemoglobin A1c (HbA1c) ≥6.5% detected on the index visit.Results In this cohort of 455 patients with T2DM whose mean age was 60.6 years and mean disease duration was 6.1 years, 45.5% had inadequate glycaemic control. The mean (SD) HbA1c was 6.7% (1.3). Multivariate Logistic regression showed that physical inactivity, disease duration >10 years, body mass index (BMI) ≥24 kg/m2, low homeostasis model assessment of β-cell function (HOMA-β) index, less frequency of medical visit and hypertriglyceridaemia were independent determinants of inadequate glycaemic control. Higher incidence of self-reported hypoglycemia experience (47.1% vs. 34.8%, P=0.008) and more fear of hypoglycemia quantified by Worry subscaie of the Hypoglycaemia Fear Survey (HFS) Ⅱ were happened in subjects with good glycemic control.Conclusion Approximately one half of these outpatients with T2DM from the metropolitan medical centers in China had inadequate glycaemic control treated with OAD alone, which raises the need for more effective educational and

  5. Oral cyclosporine therapy for refractory severe vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Nikhil S Gokhale

    2012-01-01

    Full Text Available We report the success of oral cyclosporine therapy in a patient with severe vision-threatening vernal keratoconjunctivitis. A child presented with severe allergy which was not controlled with topical steroids, cyclosporine and mast cell stabilizers. Oral steroids were required repeatedly to suppress inflammation. Child showed a dramatic improvement and stabilization with oral cyclosporine therapy. Oral cyclosporine therapy can be tried in severe vision-threatening allergy refractory to conventional therapy.

  6. Metformin-loaded BSA nanoparticles in cancer therapy: a new perspective for an old antidiabetic drug.

    Science.gov (United States)

    Jose, Pinkybel; Sundar, K; Anjali, C H; Ravindran, Aswathy

    2015-03-01

    Clinical and experimental data suggest that there is a strong association between type II diabetic mellitus and pancreatic cancer. The present study focuses on exploring the anticancer and antidiabetic properties of metformin-loaded bovine serum albumin nanoparticles (BSA NPs) on (MiaPaCa-2) pancreatic carcinoma cell lines. Albumin nanoparticles were synthesized using coacervation method and the average size of the particles was found to be 97 nm. The particles were stable and showed a spherical morphology with narrow size distribution. We investigated the impact of two stages characterized in type II diabetes mellitus (hyperglycemia and hyperinsulinemia) on the proliferation of MiaPaCa-2 cells and compared the inhibitory effects of bare metformin to that of MET-BSA NPs. Further, different concentrations of insulin and glucose were added along with bare metformin, bare BSA, and metformin encapsulated BSA carrier on MiaPaCa-2 cells to check the strong association between type II diabetes and pancreatic cancer. The results revealed that MET-BSA NPs showed more toxicity when compared with drug and carrier individually.

  7. [Sulfonylureas in today's blood glucose lowering therapy. New data on advantages and potential barriers of an "old" antidiabetic group].

    Science.gov (United States)

    Winkler, Gábor

    2015-03-29

    Sulfonylurea compounds have been basic elements of antidiabetic treatment in type 2 diabetes for a long time. However, with the introduction of incretin type insulin secretagogues it is often arises, whether is still there a place for sulfonylureas in the today's therapy. To answer this question the author overviews general pharmaceutical characteristics of the sulfonylurea compounds as well as individual particularities of the second generation derivatives used at present in Hungary. The author details also the most important differences between incretin type drugs - first of all dipeptidyl peptidase-4 inhibitors - and sulfonylureas. On the basis of available data it can be concluded in accordance with the latest international guidelines, that sulfonylureas have still role in the blood glucose lowering therapy of type 2 diabetes, though they became somewhat pushed back among insulin secretagogue type drugs. If a sulfonylurea compound is the drug of choice, it is important to select the appropriate molecule (in case of normal renal function gliclazide or glimepiride). It is also important to re-educate the patient, as well as to apply the minimal dose providing the desired glycaemic effect.

  8. Antidiabetic oils.

    Science.gov (United States)

    Berraaouan, Ali; Abid, Sanae; Bnouham, Mohamed

    2013-11-01

    Many studies have demonstrated evidence of the health benefits of natural products. Plant extracts have been tested on a variety of physiological disorders, including diabetes mellitus. Studies have tested aqueous extracts, plant fractions extracts, families of active of compounds, and specific active compounds. In this review, we describe the antidiabetic effects of vegetable oils. Information was collected from ScienceDirect and PubMed databases using the following key words: Diabetes mellitus, Oils, Vegetable oils, Type 1 diabetes, type 2 diabetes, antidiabetic effect, antihyperglycemic, antidiabetic oil. We have compiled approximately ten vegetable oils with including experimental studies that have demonstrated benefits on diabetes mellitus. There are soybean, argan, olive, palm, walnut, black cumin, safflower, Colocynth, Black seed, Rice bran, Cinnamom, and Rocket oils. For each vegetable oil, we investigated on the plant's traditional uses, their pharmacological activities and their antidiabetic effects. It seems that many vegetable oils are really interesting and can be used in the improvement of human health, particularly, to prevent or to treat diabetes mellitus complications.

  9. Magnetic solid-phase extraction based on mesoporous silica-coated magnetic nanoparticles for analysis of oral antidiabetic drugs in human plasma.

    Science.gov (United States)

    de Souza, Karynne Cristina; Andrade, Gracielle Ferreira; Vasconcelos, Ingrid; de Oliveira Viana, Iara Maíra; Fernandes, Christian; de Sousa, Edésia Martins Barros

    2014-07-01

    In the present work, magnetic nanoparticles embedded into mesoporous silica were prepared in two steps: first, magnetite was synthesized by oxidation-precipitation method, and next, the magnetic nanoparticles were coated with mesoporous silica by using nonionic block copolymer surfactants as structure-directing agents. The mesoporous SiO2-coated Fe3O4 samples were functionalized using octadecyltrimethoxysilane as silanizing agent. The pure and functionalized silica nanoparticles were physicochemically and morphologically characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), N2 adsorption, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The resultant magnetic silica nanoparticles were applied as sorbents for magnetic solid-phase extraction (MSPE) of oral antidiabetic drugs in human plasma. Our results revealed that the magnetite nanoparticles were completely coated by well-ordered mesoporous silica with free pores and stable pore walls, and that the structural and magnetic properties of the Fe3O4 nanoparticles were preserved in the applied synthesis route. Indeed, the sorbent material was capable of extracting the antidiabetic drugs from human plasma, being useful for the sample preparation in biological matrices.

  10. Reactivity-activity relationships of oral anti-diabetic vanadium complexes in gastrointestinal media: an X-ray absorption spectroscopic study.

    Science.gov (United States)

    Levina, Aviva; McLeod, Andrew I; Kremer, Lauren E; Aitken, Jade B; Glover, Christopher J; Johannessen, Bernt; Lay, Peter A

    2014-10-01

    The reactions of oral V(V/IV) anti-diabetic drugs within the gastrointestinal environment (particularly in the presence of food) are a crucial factor that affects their biological activities, but to date these have been poorly understood. In order to build up reactivity-activity relationships, the first detailed study of the reactivities of typical V-based anti-diabetics, Na3V(V)O4 (A), [V(IV)O(OH2)5](SO4) (B), [V(IV)O(ma)2] (C, ma = maltolato(-)) and (NH4)[V(V)(O)2(dipic)] (D, dipic = pyridine-2,5-dicarboxylato(2-)) with simulated gastrointestinal (GI) media in the presence or absence of food components has been performed by the use of XANES (X-ray absorption near edge structure) spectroscopy. Changes in speciation under conditions that simulate interactions in the GI tract have been discerned using correlations of XANES parameters that were based on a library of model V(V), V(IV), and V(III) complexes for preliminary assessment of the oxidation states and coordination numbers. More detailed speciation analyses were performed using multiple linear regression fits of XANES from the model complexes to XANES obtained from the reaction products from interactions with the GI media. Compounds B and D were relatively stable in the gastric environment (pH ∼ 2) in the absence of food, while C was mostly dissociated, and A was converted to [V10O28](6-). Sequential gastric and intestinal digestion in the absence of food converted A, B and D to poorly absorbed tetrahedral vanadates, while C formed five- or six-coordinate V(V) species where the maltolato ligands were likely to be partially retained. XANES obtained from gastric digestion of A-D in the presence of typical food components converged to that of a mixture of V(IV)-aqua, V(IV)-amino acid and V(III)-aqua complexes. Subsequent intestinal digestion led predominantly to V(IV) complexes that were assigned as citrato or complexes with 2-hydroxyacidato donor groups from other organic compounds, including certain

  11. Cost effectiveness of insulin glargine plus oral antidiabetes drugs compared with premixed insulin alone in patients with type 2 diabetes mellitus in Canada.

    Science.gov (United States)

    Tunis, Sandra L; Sauriol, Luc; Minshall, Michael E

    2010-01-01

    Several treatment options are available for patients with type 2 diabetes mellitus who are making the transition from oral antidiabetes drugs (OADs) to insulin. Two options currently recommended by the Canadian Diabetes Association for initiating insulin therapy in patients with type 2 diabetes who are no longer responsive to OADs alone are insulin glargine plus OADs, and premixed insulin therapy only. Because of differences in efficacy, adverse events (such as hypoglycaemia) and acquisition costs, these two treatment options may lead to different long-term clinical and economic outcomes. To determine the cost effectiveness of insulin glargine plus OADs compared with premixed insulin without OADs in insulin-naive patients with type 2 diabetes in Canada. Using treatment effects taken from a published clinical trial, the validated IMS-CORE Diabetes Model was used to simulate the long-term cost effectiveness of insulin glargine with OADs, versus premixed insulin. Input treatment effects for the two therapeutic approaches were based on changes in glycosylated haemoglobin A(1c) (HbA(1c)) at clinical trial endpoint, and hypoglycaemia rates. The analysis was conducted from the perspective of the Canadian Provincial payer. Direct treatment and complication costs were obtained from published sources (primarily from Ontario) and reported in $Can, year 2008 values. All base-case costs and outcomes were discounted at 5% per year. Sensitivity analyses were conducted around key parameters and assumptions used in the study. Outcomes included direct medical costs associated with both treatment and diabetes-related complications. Cost-effectiveness outcomes included total average lifetime (35 years) costs, life expectancy (LE), QALYs and incremental cost-effectiveness ratios (ICERs). Base-case analyses showed that, compared with premixed insulin only, insulin glargine in combination with OADs was associated with a 0.051-year increase in LE and a 0.043 increase in QALYs. Insulin

  12. Refractory overactive bladder: Beyond oral anticholinergic therapy

    Directory of Open Access Journals (Sweden)

    Ronald W Glinski

    2007-01-01

    Full Text Available Objectives: In this review, we discuss the treatment of refractory overactive bladder (OAB that has not adequately responded to medication therapy and we propose an appropriate care pathway to the treatment of OAB. We also attempt to address the cost of OAB treatments. Materials and Methods: A selective expert review of the current literature on the subject of refractory OAB using MEDLINE was performed and the data is summarized. We also review our experience in treating refractory OAB. The role and outcomes of various treatment options for refractory OAB are discussed and combined therapy with oral anticholinergics is explored. Emerging remedies including intravesical botulinum toxin injection and pudendal neuromodulation are also reviewed, along with conventional surgical options. Results: In general behavioral therapy, pelvic floor electrical stimulation, magnetic therapy and posterior tibial nerve stimulation (PTNS, have shown symptom decreases in 50-80% of patients with OAB. Depending on the study, combination therapy with oral anticholinergics seems to improve efficacy of behavioral therapy and PTNS in approximately 10-30%. In multicenter, long-term randomized controlled trials, sacral neuromodulation has been shown to improve symptoms of OAB and OAB incontinence in up to 80% of the patients treated. Studies involving emerging therapies such as pudendal serve stimulation suggest that there may be a 15-20% increase in efficacy over sacral neuromodulation, but long-term studies are not yet available. Another emerging therapy, botulinum toxin, is also showing similar success in reducing OAB symptoms in 80-90% of patients. Surgical approaches, such as bladder augmentation, are a last resort in the treatment of OAB and are rarely used at this point unless upper tract damage is a concern and all other treatment options have been exhausted. Conclusion: The vast majority of OAB patients can be managed successfully by behavioral options with or

  13. Oral antiplatelet therapy for acute ischaemic stroke.

    Science.gov (United States)

    Sandercock, Peter A G; Counsell, Carl; Tseng, Mei-Chiun; Cecconi, Emanuela

    2014-03-26

    In people with acute ischaemic stroke, platelets become activated and can cause blood clots to form and block an artery in the brain, resulting in damage to part of the brain. Such damage gives rise to the symptoms of stroke. Antiplatelet therapy might reduce the volume of brain damaged by ischaemia and also reduce the risk of early recurrent ischaemic stroke, thereby reducing the risk of early death and improving long-term outcomes in survivors. However, antiplatelet therapy might also increase the risk of fatal or disabling intracranial haemorrhage. To assess the efficacy and safety of immediate oral antiplatelet therapy (that is started as soon as possible and no later than two weeks after stroke onset) in people with acute presumed ischaemic stroke. We searched the Cochrane Stroke Group Trials Register (last searched 16 October 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2013), MEDLINE (June 1998 to May 2013), and EMBASE (June 1998 to May 2013). In 1998, for a previous version of this review, we searched the register of the Antiplatelet Trialists' Collaboration, MedStrategy and contacted relevant drug companies. Randomised trials comparing oral antiplatelet therapy (started within 14 days of the stroke) with control in people with definite or presumed ischaemic stroke. Two review authors independently applied the inclusion criteria and assessed trial quality. For the included trials, they extracted and cross-checked the data. We included eight trials involving 41,483 participants. No new trials have been added since the last update.Two trials testing aspirin 160 mg to 300 mg once daily, started within 48 hours of onset, contributed 98% of the data. The risk of bias was low. The maximum follow-up was six months. With treatment, there was a significant decrease in death or dependency at the end of follow-up (odds ratio (OR) 0.95, 95% confidence interval (CI) 0.91 to 0.99). For every 1000 people treated with

  14. Reversible retinopathy associated with oral deferasirox therapy.

    Science.gov (United States)

    Walia, Harpreet S; Yan, Jiong

    2013-07-17

    A 17-year-old girl with a history of sickle cell anaemia undergoing chronic blood transfusions and iron-chelation therapy presented for multiple ophthalmic examinations. During treatment with deferoxamine, her examination remained stable but 2 years after changing to deferasirox she presented with decreased visual acuity and only mild funduscopic changes. Marked electrophysiological abnormalities were also evident. After cessation of deferasirox, her visual acuity improved and electrophysiological responses improved. No prior reports of deferasirox-related retinopathy are available. We suggest that oral deferasirox caused a reversible retinopathy in our patient and clinicians be aware of this entity.

  15. Reversible retinopathy associated with oral deferasirox therapy

    Science.gov (United States)

    Walia, Harpreet S; Yan, Jiong

    2013-01-01

    A 17-year-old girl with a history of sickle cell anaemia undergoing chronic blood transfusions and iron-chelation therapy presented for multiple ophthalmic examinations. During treatment with deferoxamine, her examination remained stable but 2 years after changing to deferasirox she presented with decreased visual acuity and only mild funduscopic changes. Marked electrophysiological abnormalities were also evident. After cessation of deferasirox, her visual acuity improved and electrophysiological responses improved. No prior reports of deferasirox-related retinopathy are available. We suggest that oral deferasirox caused a reversible retinopathy in our patient and clinicians be aware of this entity. PMID:23867877

  16. Magnetic solid-phase extraction based on mesoporous silica-coated magnetic nanoparticles for analysis of oral antidiabetic drugs in human plasma

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Karynne Cristina de; Andrade, Gracielle Ferreira [Centro de Desenvolvimento da Tecnologia Nuclear, CDTN/CNEN, Rua Professor Mário Werneck, s/n. Campus Universitário, Belo Horizonte, MG CEP 30.123-970 (Brazil); Vasconcelos, Ingrid; Oliveira Viana, Iara Maíra de; Fernandes, Christian [Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Martins Barros de Sousa, Edésia, E-mail: sousaem@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear, CDTN/CNEN, Rua Professor Mário Werneck, s/n. Campus Universitário, Belo Horizonte, MG CEP 30.123-970 (Brazil)

    2014-07-01

    In the present work, magnetic nanoparticles embedded into mesoporous silica were prepared in two steps: first, magnetite was synthesized by oxidation–precipitation method, and next, the magnetic nanoparticles were coated with mesoporous silica by using nonionic block copolymer surfactants as structure-directing agents. The mesoporous SiO{sub 2}-coated Fe{sub 3}O{sub 4} samples were functionalized using octadecyltrimethoxysilane as silanizing agent. The pure and functionalized silica nanoparticles were physicochemically and morphologically characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), N{sub 2} adsorption, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The resultant magnetic silica nanoparticles were applied as sorbents for magnetic solid-phase extraction (MSPE) of oral antidiabetic drugs in human plasma. Our results revealed that the magnetite nanoparticles were completely coated by well-ordered mesoporous silica with free pores and stable pore walls, and that the structural and magnetic properties of the Fe{sub 3}O{sub 4} nanoparticles were preserved in the applied synthesis route. Indeed, the sorbent material was capable of extracting the antidiabetic drugs from human plasma, being useful for the sample preparation in biological matrices. - Highlights: • SBA-15/Fe{sub 3}O{sub 4} was synthesized and functionalized with octadecyltrimethoxysilane. • Magnetite nanoparticles were completely coated by well-ordered mesoporous silica. • The samples were used as sorbent for magnetic solid-phase extraction (MSPE). • The sorbent material was capable of extracting drugs from human plasma. • The extraction ability makes the material a candidate to be employed as MSPE.

  17. HYPOGLYCEMIA INDUCED BY ANTIDIABETIC SULFONYLUREAS.

    Science.gov (United States)

    Confederat, Luminiţa; Constantin, Sandra; Lupaşcu, Florentina; Pânzariu, Andreea; Hăncianu, Monica; Profire, Lenuţa

    2015-01-01

    Diabetes mellitus is a major health problem due to its increasing prevalence and life-threatening complications. Antidiabetic sulfonylureas represent the first-line drugs in type 2 diabetes even though the most common associated risk is pharmacologically-induced hypoglycemia. In the development of this side effect are involved several factors including the pharmacokinetic and pharmacodynamic profile of the drug, patient age and behavior, hepatic or renal dysfunctions, or other drugs associated with a high risk of interactions. If all these are controlled, the risk-benefit balance can be equal to other oral antidiabetic drugs.

  18. Antidiabetic Plants of Iran

    Directory of Open Access Journals (Sweden)

    Ashrafeddin Goushegir

    2011-10-01

    Full Text Available To identify the antidiabetic plants of Iran, a systematic review of the published literature on the efficacy of Iranian medicinal plant for glucose control in patients with type 2 diabetes mellitus was conducted. We performed an electronic literature search of MEDLINE, Science Direct, Scopus, Proquest, Ebsco, Googlescholar, SID, Cochrane Library Database, from 1966 up to June 2010. The search terms were complementary and alternative medicine (CAM, diabetes mellitus, plant (herb, Iran, patient, glycemic control, clinical trial, RCT, natural or herbal medicine, hypoglycemic plants, and individual herb names from popular sources, or combination of these key words. Available Randomized Controlled Trials (RCT published in English or Persian language examined effects of an herb (limited to Iran on glycemic indexes in type 2 diabetic patients were included. Among all of the articles identified in the initial database search, 23 trials were RCT, examining herbs as potential therapy for type 2 diabetes mellitus. The key outcome for antidiabetic effect was changes in blood glucose or HbA1 c, as well as improves in insulin sensitivity or resistance. Available data suggest that several antidiabetic plants of Iran need further study. Among the RCT studies, the best evidence in glycemic control was found in Citrullus colocynthus, Ipomoea betatas, Silybum marianum and Trigonella foenum graecum.

  19. Treatment intensification using long-acting insulin -predictors of future basal insulin supported oral therapy in the DIVE registry.

    Science.gov (United States)

    Danne, Thomas; Bluhmki, Tobias; Seufert, Jochen; Kaltheuner, Matthias; Rathmann, Wolfgang; Beyersmann, Jan; Bramlage, Peter

    2015-10-07

    In patients with type-2 diabetes receiving oral antidiabetic drugs (OADs), the addition of insulin is frequently required to achieve sufficient control over blood glucose levels. It is, however, difficult to predict if, when and in which patients insulin therapy will be needed. We aimed to identify patient related variables associated with the addition of basal insulin to oral therapy resulting in a basal supported oral therapy (BOT). DIVE (DIabetes Versorgungs-Evaluation) is a prospective, observational, multi-centre diabetes registry established in Germany in 2011. For the present explorative analysis, 31,008 patients with type-2 diabetes prescribed at least one OAD were included. Patients who had previously received insulin and those over 90 years old were excluded. The event of interest was defined as the initiation of BOT during the observational period. Cause-specific Cox proportional hazards models based on a competing risk framework were applied for risk quantification. Multivariable adjusted hazard ratios demonstrated that longer diabetes duration, higher BMI, poorer glycaemic control, documentation of any micro- or macrovascular comorbidity, the presence of concomitant non-antidiabetic pharmacotherapies, and greater numbers of prescribed OADs increased the likelihood of BOT initiation. On the other hand BOT initiation was less likely in patients with older age and female gender. Analysing the likelihood of OAD termination without initiation of BOT provided supportive evidence for the variables predictive of BOT initiation. Analysis of the DIVE registry has resulted in the identification of a number of factors that may be predictive for the initiation of BOT for type-2 diabetes patients initially prescribed one or more OADs. Poor glycaemic control, the presence of vascular comorbidities and concomitant medications, and a greater number of OADs were all detected to increase the risk of a switch to BOT. Female gender and younger age showed protective

  20. Study of variation in price of various antidiabetic drugs available in Indian market

    Directory of Open Access Journals (Sweden)

    Amit Padmakar Date

    2015-02-01

    Conclusion: The average percentage price variation of different brands of the same oral antidiabetic drug manufactured in India is very wide. The appropriate changes in the government policy, sensitizing the prescribers about cost of therapy and proper management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative economic consequences. [Int J Basic Clin Pharmacol 2015; 4(1.000: 36-40

  1. Improved stability and antidiabetic potential of insulin containing folic acid functionalized polymer stabilized multilayered liposomes following oral administration

    DEFF Research Database (Denmark)

    Agrawal, Ashish Kumar; Harde, Harshad; Thanki, Kaushik;

    2014-01-01

    The present study reports the folic acid (FA) functionalized insulin loaded stable liposomes with improved bioavailability following oral administration. Liposomes were stabilized by alternating coating of negatively charged poly(acrylic acid) (PAA) and positively charged poly(allyl amine...

  2. Marine algae as a prospective source for antidiabetic compounds - A brief review.

    Science.gov (United States)

    Unnikrishnan, S P; Jayasri, A M

    2016-12-29

    Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycaemia, which is attributed by several life threatening complications including atherosclerosis, nephropathy, and retinopathy. The current therapies available for the management of DM mainly include oral antidiabetic drugs and insulin injections. However, continuous use of synthetic drugs provides lower healing with many side effects. Therefore, there is an urge for safe and efficient antidiabetic drugs for the management of DM. In the continuing search for effective antidiabetic drugs, marine algae (seaweeds) remains as a promising source with potent bioactivity. It is anticipated that the isolation, characterization, and pharmacological study of unexplored marine algae can be useful in the discovery of novel antidiabetic compounds with high biomedical value. Among marine algae, brown and red algae are reported to exhibit antidiabetic activity. Majority of the investigations on algal derived compounds controls the blood glucose levels through the inhbition of carbohydrate hydroloyzing enzymes and protein tyrosine phosphatase 1B enzymes, insulin sensitization, glucose uptake effect and other protective effects against diabetic complications. Based on the above perspective this review provides; profiles for various marine algae posessing antidiabetic activity. This study also highlights the therapeutic potential of compounds isolated from marine algae for the effective management of diabetes and its associated complications.

  3. ORAL-THERAPY FOR SMALL-CELL LUNG-CANCER

    NARCIS (Netherlands)

    POSTMUS, PE; SMIT, EF

    After a remarkable improvement of the very poor prognosis of small cell lung cancer with very simple therapy such as iv and oral cyclophosphamide the role of oral therapy has become minimal. However, since more than a decade results of combination chemotherapy are at a plateau and it is necessary to

  4. Comparison of the influence of oral antidiabetic drug and combined with basal insulin treatment on diabetic control and micro-inflammatory state in type 2 diabetes mellitus patients

    Institute of Scientific and Technical Information of China (English)

    Gang Wu; Dong-Liang Liu; Xiang-Jun Li; Xiao-Yun Fan

    2016-01-01

    Objective:To investigate the influence of oral antidiabetic drug and combined with basal insulin treatment on diabetic control and micro-inflammatory state in type 2 diabetes mellitus patients.Methods:From May 2014 to June 2015, 128 cases of Type 2 diabetes mellitus were recruited and divided randomly into two groups as observation group and control group. The observation group was given metformin (Glucophage, 0.25 tid) plus basal insulin (glargine) treatment, while the control group was given metformin (Glucophage, initial dose of 0.25 tid; the largest total dose of 2 g) plus other non-euglycemic OADs necessarily for 6 months to adjust dose and control blood glucose at target. The diabetic control indexes, islet function and micro-inflammatory factors were detected and analyzed.Results:After 6 months of medication, the observation group showed significantly lower level of FPG, and HbA1cthan the control group. While AUCc-p, HOMA-β and HOMA-IR of the observation group showed significant difference compared to that of the control group after treatment. Also the micro-inflammatory indexes including hs-CRP, IGF-1, IL-6 and TNF-α of the observation group after treatment were significantly lower than the control group .Conclusions:Type 2 diabetes given metformin plus glargine not only could control and steady blood glucose, but also significant decrease the micro-inflammation state.

  5. Oral complications of cancer therapies. Oral complications in the pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Leggott, P.J. (Univ. of California, San Francisco (USA))

    1990-01-01

    A number of acute oral complications may be associated with cancer therapy in children, but the extent and duration of these complications, and the most effective management techniques. have not been well described. The few studies differ in design, making comparisons difficult. Well-controlled, prospective clinical studies are needed to define the most effective strategies for the management of acute oral complications in children. However, it is clear that dental intervention prior to cancer therapy is an important factor in the optimal preparation of the patient. During cancer therapy, intensive supervised oral preventive protocols appear to be of benefit to the child's oral health, overall comfort, and well-being. Furthermore, the prevention of oral infection may significantly reduce the morbidity associated with cancer therapy. Long-term preventive oral care may help prevent dental disease and infection in medically compromised children and contribute to improving the quality of life. 41 references.

  6. A novel oral dual amylin and calcitonin receptor agonist (KBP-042) exerts antiobesity and antidiabetic effects in rats

    DEFF Research Database (Denmark)

    Andreassen, Kim V; Feigh, Michael; Hjuler, Sara T

    2014-01-01

    The present study investigated a novel oral dual amylin and calcitonin receptor agonist (DACRA), KBP-042, in head-to-head comparison with salmon calcitonin (sCT) with regard to in vitro receptor pharmacology, ex vivo pancreatic islet studies, and in vivo proof of concept studies in diet-induced o......The present study investigated a novel oral dual amylin and calcitonin receptor agonist (DACRA), KBP-042, in head-to-head comparison with salmon calcitonin (sCT) with regard to in vitro receptor pharmacology, ex vivo pancreatic islet studies, and in vivo proof of concept studies in diet......-induced obese (DIO) and Zucker diabetic fatty (ZDF) rats. In vitro, KBP-042 demonstrated superior binding affinity and activation of amylin and calcitonin receptors, and ex vivo, KBP-042 exerted inhibitory action on stimulated insulin and glucagon release from isolated islets. In vivo, KBP-042 induced...... a superior attenuation of diabetic hyperglycemia and alleviated impaired glucose and insulin tolerance. Concomitantly, KBP-042 preserved insulinotropic and induced glucagonostatic action, ultimately preserving pancreatic insulin and glucagon content. In conclusion, oral KBP-042 is a novel DACRA, which exerts...

  7. Lixisenatide Therapy in Older Patients With Type 2 Diabetes Inadequately Controlled on Their Current Antidiabetic Treatment: The GetGoal-O Randomized Trial.

    Science.gov (United States)

    Meneilly, Graydon S; Roy-Duval, Christine; Alawi, Hasan; Dailey, George; Bellido, Diego; Trescoli, Carlos; Manrique Hurtado, Helard; Guo, Hailing; Pilorget, Valerie; Perfetti, Riccardo; Simpson, Hamish

    2017-04-01

    To evaluate the efficacy and safety of lixisenatide versus placebo on glycemic control in older patients with type 2 diabetes uncontrolled on their current antidiabetic treatment. In this phase III, double-blind, randomized, placebo-controlled, two-arm, parallel-group, multicenter trial, patients aged ≥70 years were randomized to receive once-daily lixisenatide 20 μg or placebo before breakfast concomitantly with their existing antidiabetic therapy (including insulin) for 24 weeks. Patients at risk for malnutrition or with moderate to severe cognitive impairment were excluded. The primary end point was absolute change in HbA1c from baseline to week 24. Secondary end points included change from baseline to week 24 in 2-h postprandial plasma glucose (PPG) and body weight. A total of 350 patients were randomized. HbA1c decreased substantially with lixisenatide (-0.57% [6.2 mmol/mol]) compared with placebo (+0.06% [0.7 mmol/mol]) from baseline to week 24 (P < 0.0001). Mean reduction in 2-h PPG was significantly greater with lixisenatide (-5.12 mmol/L) than with placebo (-0.07 mmol/L; P < 0.0001). A greater decrease in body weight was observed with lixisenatide (-1.47 kg) versus placebo (-0.16 kg; P < 0.0001). The safety profile of lixisenatide in this older population, including rates of nausea and vomiting, was consistent with that observed in other lixisenatide studies. Hypoglycemia was reported in 17.6% of patients with lixisenatide versus 10.3% with placebo. In nonfrail older patients uncontrolled on their current antidiabetic treatment, lixisenatide was superior to placebo in HbA1c reduction and in targeting postprandial hyperglycemia, with no unexpected safety findings. © 2017 by the American Diabetes Association.

  8. SGLT-2 inhibitors: the glucosuric antidiabetics

    OpenAIRE

    Rekha Thaddanee; Ajeet Kumar Khilnani; Gurudas Khilnani

    2013-01-01

    Despite availability of a number of oral antidiabetics, a sizeable population of diabetics remains uncontrolled. Thus there is growing need of new group of drugs for diabetic control. Understanding renal conservation of glucose by efficient reabsorption through sodium glucose cotransporter-2 (SGLT-2) has paved way for development of an entirely new group of drugs, the SGLT-2 inhibitors. These glucosuric antidiabetic agents have shown promise in early clinical studies. Canagliflozin is recentl...

  9. Oral anticoagulant therapy related to oral surgery procedures

    OpenAIRE

    Knežević Milan; Petrović Dragan; Jović Nebojša; Bosch Carlos

    2011-01-01

    Today there must be established protocol in oral surgery treatment for the patients which are under anticoagulant treatment via oral (ATO). This is due to danger of the possible complications and also for increased demand for hospital treatment of these patients, which can be estimated now days as high as 8%. In the present study, the authors intent to define all the parameters for creation of one acting protocol applicable to this group of patients and concluding that there is no necessary n...

  10. Radiation therapy for oral verrucous carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hamamoto, Yasushi; Niino, Keiji; Yoshino, Masanari; Yamaguchi, Koichi; Yoshizawa, Nobuo; Takahashi, Koji [Yamagata Univ. (Japan). School of Medicine; Itagaki, Takatomo; Watarai, Jiro

    2000-12-01

    In order to examine the usefulness of radiotherapy for verrucous carcinoma, eight cases of oral verrucous carcinoma treated with radiation therapy were reviewed. Definitive radiotherapy was performed in six patients and preoperative radiotherapy was performed in two patients. Definitive radiotherapy doses ranged from 20 to 60 Gy (median: 47.5 Gy) and preoperative radiotherapy doses were 25 Gy, delivered with a daily fraction size of 2.5 Gy in principle. All cases that received definitive irradiation became CR, but two of these patients underwent local recurrence; one was a patient irradiated with only 20 Gy and the other case underwent local recurrence of squamous cell carcinoma. In the cases irradiated with 45 Gy or more, 4 of 5 cases were locally controlled. No patient underwent regional lymph node metastases. One of two patients that received preoperative radiotherapy had local recurrence in spit of a negative surgical margin. Because the radiosensitivity of verrucous carcinoma was often good and anaplastic transformation was not common, radiotherapy can become a radical treatment for verrucous carcinoma. (author)

  11. Prescription factors associated with medication non-adherence in Japan assessed from leftover drugs in the SETSUYAKU-BAG campaign: Focus on oral antidiabetic drugs

    Directory of Open Access Journals (Sweden)

    Kaori Koyanagi

    2016-07-01

    Full Text Available Background: Medication adherence has an important influence on health outcomes in patients with chronic diseases. However, few studies have been performed in Japan to determine factors related to medication non-adherence. Objective: The aim of this study was to identify prescription factors related to medication non-adherence by investigating patient characteristics, all prescriptions, and prescriptions for oral antidiabetic drugs (OADs.Methods: A retrospective cross-sectional survey of prescription data about implementation of dosing regimen was performed at community pharmacies engaged in appropriate use of leftover drugs. We evaluated the amount of drugs originally prescribed and the reduced amount after use of leftover drugs, and then calculated prescription reduction ratio (PRR. We analyzed prescription factors contributing to non-adherence based on the PRR.Results: Prescription information for 1,207 patients was reviewed, revealing that patients were non-adherent to 58% of prescriptions. Lack of a drug copayment, fewer concurrent drugs, and drugs not in single-dose packaging were associated with non-adherence. Among the 1,207 patients, 234 prescriptions for diabetes and 452 OAD formulations were included. Forty-seven percent of prescriptions and 29% of the formulations were non-adherent. A higher dosing frequency and preprandial administration were associated with non-adherence. Among the OADs, adherence was lower for α-glucosidase inhibitors and biguanides than for sulfonylureas. Conclusions: Several factors related to patient characteristics, general drug prescriptions, and OAD prescriptions were associated with non-adherence. Further consideration will be needed to improve adherence to medication in Japan. Health care providers should perform more careful monitoring of adherence in patients with the factors identified by this study.

  12. Supplemental oxygen therapy: Important considerations in oral and maxillofacial surgery

    National Research Council Canada - National Science Library

    Singh, Virendra; Gupta, Pranav; Khatana, Shruti; Bhagol, Amrish

    2011-01-01

    ...; crossing different medical and surgical specialities. The present review summarizes the role of supportive oxygen therapy in various clinical conditions encountered in our day-to-day practice in the speciality of oral and maxillofacial surgery...

  13. New oral disease-modifying therapies for multiple sclerosis

    OpenAIRE

    2009-01-01

    Several promising, oral disease-modifying therapies for multiple sclerosis are currently being evaluated in clinical trials. The arrival of effective oral agents for multiple sclerosis will be a major advance in the global effort to alter the natural history of this chronic disease.

  14. Oral care of the cancer patient receiving radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Holtzhausen, T. (Medical Univ. of Southern Africa, Pretoria (South Africa). Dept. of Community Dentistry)

    1982-07-01

    Radiation therapy is frequently being used for the patient with oral cancer. The survival rate is increasing, due to more effective treatment technique. The question of whether any teeth should be extracted, the mode of therapy and the side effects of radiation like Xerostomia, caries, stomatitis, trismus and osteo-radionecrosis and also post radiation care are discussed.

  15. Conventional and alternative antifungal therapies to oral candidiasis

    Directory of Open Access Journals (Sweden)

    Paula Cristina Anibal

    2010-12-01

    Full Text Available Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS. These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.

  16. Conventional and alternative antifungal therapies to oral candidiasis.

    Science.gov (United States)

    Anibal, Paula Cristina; de Cássia Orlandi Sardi, Janaina; Peixoto, Iza Teixeira Alves; de Carvalho Moraes, Julianna Joanna; Höfling, José Francisco

    2010-10-01

    Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS). These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.

  17. Monitoring anticoagulant therapy with new oral agents

    Science.gov (United States)

    Ramos-Esquivel, Allan

    2015-01-01

    Thromboembolic disease is a major leading cause of mortality and morbidity in industrialized countries. Currently, the management of these patients is challenging due to the availability of new drugs with proven efficacy and security compared to traditional oral vitamin K antagonists. These compounds are characterized by a predictable pharmacokinetic profile for which blood monitoring is not routinely needed. Nevertheless, some data have suggested inter-patient variability in the anticoagulant effect of these drugs, raising concerns about their effectiveness and safety. Although mass-spectrometry is the gold standard to determine drug plasma concentrations, this method is not widely available in every-day practice and some coagulation assays are commonly used to determine the anticoagulant effect of these drugs. The present review aims to summarize the current knowledge regarding the clinical question of how and when to monitor patients with new anticoagulant oral agents. PMID:26713281

  18. Gene therapy for oral squamous cell carcinoma: an overview.

    Science.gov (United States)

    Saraswathi, T R; Kavitha, B; Vijayashree Priyadharsini, J

    2007-01-01

    A potential approach to the treatment of genetic disorders is gene therapy. The goal of gene therapy is to introduce therapeutic genetic material into the target cell to exert the intended therapeutic effect. Gene therapy has already shown promising results for the treatment of monogenic disorders such as severe combined immunodeficiency and haemophilia. Now the procedure has been extended to the level of treating malignant conditions such as cancer of the lungs, breast, colon etc. The prevalence of tumours of the larynx and oral cavity has increased in both developed and developing countries. This increase underscores the need for a novel therapeutic modality that would decrease or completely terminate the proliferation of malignant cells. This review highlights various types of gene therapy procedures with respect to oral squamous cell carcinoma.

  19. Gene therapy for oral squamous cell carcinoma: An overview

    Directory of Open Access Journals (Sweden)

    Saraswathi T

    2007-01-01

    Full Text Available A potential approach to the treatment of genetic disorders is gene therapy. The goal of gene therapy is to introduce therapeutic genetic material into the target cell to exert the intended therapeutic effect. Gene therapy has already shown promising results for the treatment of monogenic disorders such as severe combined immunodeficiency and haemophilia. Now the procedure has been extended to the level of treating malignant conditions such as cancer of the lungs, breast, colon etc. The prevalence of tumours of the larynx and oral cavity has increased in both developed and developing countries. This increase underscores the need for a novel therapeutic modality that would decrease or completely terminate the proliferation of malignant cells. This review highlights various types of gene therapy procedures with respect to oral squamous cell carcinoma.

  20. Erythema multiforme limited to the oral mucosa in a teenager on oral contraceptive therapy.

    Science.gov (United States)

    Jawetz, Robert E; Elkin, Avigayil; Michael, Lisa; Jawetz, Sheryl A; Shin, Helen T

    2007-10-01

    Erythema multiforme has been linked to numerous drugs and infectious agents. A link to oral contraceptive use has been reported in the past in the adult population but thus far has not been reported in children or adolescents. We report the case of an 18-yr-old female who developed oral erosions consistent with erythema multiforme two and a half weeks after initiating therapy with an oral contraceptive agent. A thorough examination for other inciting factors was negative, and the lesions slowly resolved over the course of 3 weeks. This case illustrates that erythema multiforme should be considered in the differential diagnosis of adolescents with oral erosions who have been prescribed oral contraceptives.

  1. Use of Oral Anticoagulation Therapy in Atrial Fibrillation after Stroke

    DEFF Research Database (Denmark)

    Jespersen, Stine Funder; Christensen, Louisa M; Christensen, Anders;

    2013-01-01

    Background. The knowledge is still sparse about patient related factors, influencing oral anticoagulation therapy (OAC) rates, in stroke patients with atrial fibrillation (AF). Aims. To assess the use of OAC in ischemic stroke patients diagnosed with AF and to identify patient related factors...

  2. Effects of oral motor therapy in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Seray Nural Sigan

    2013-01-01

    Full Text Available Aim: Oral motor dysfunction is a common issue in children with cerebral palsy (CP. Drooling, difficulties with sucking, swallowing, and chewing are some of the problems often seen. In this study, we aimed to research the effect of oral motor therapy on pediatric CP patients with feeding problems. Materials and Methods: Included in this single centered, randomized, prospective study were 81 children aged 12-42 months who had been diagnosed with CP, had oral motor dysfunction and were observed at the Pediatric Neurology outpatient clinic of the Children′s Health and Diseases Department, Istanbul Medical Faculty, Istanbul University. Patients were randomized into two groups: The training group and the control group. One patient from the training group dropped out of the study because of not participating regularly. Following initial evaluation of all patients by a blinded physiotherapist and pedagogue, patients in the training group participated in 1 h oral motor training sessions with a different physiotherapist once a week for 6 months. All patients kept on routine physiotherapy by their own physiotherapists. Oral motor assessment form, functional feeding assessment (FFA subscale of the multidisciplinary feeding profile (MFP and the Bayley scales of infant development (BSID-II were used to evaluate oral motor function, swallowing, chewing, the gag reflex, the asymmetrical tonic neck reflex, tongue, jaw, and mouth function, severity of drooling, aspiration, choking, independent feeding and tolerated food texture during the initial examination and 6 months later. Results: When the initial and post-therapy FFA and BSID-II scores received by patients in the training and the study group were compared, the training group showed a statistically significant improvement (P < 0.05. Conclusion: Oral motor therapy has a beneficial effect on feeding problems in children with CP.

  3. Reversible retinopathy associated with oral deferasirox therapy

    OpenAIRE

    Walia, Harpreet S.; Yan, Jiong

    2013-01-01

    A 17-year-old girl with a history of sickle cell anaemia undergoing chronic blood transfusions and iron-chelation therapy presented for multiple ophthalmic examinations. During treatment with deferoxamine, her examination remained stable but 2 years after changing to deferasirox she presented with decreased visual acuity and only mild funduscopic changes. Marked electrophysiological abnormalities were also evident. After cessation of deferasirox, her visual acuity improved and electrophysiolo...

  4. Monitoring Oral Anticoagulant Therapy: Measuring Coagulant Activity

    DEFF Research Database (Denmark)

    Attermann, Jorn

    and the time for the next visit based on laboratory analyses of the INR. This conventional treatment regimen is relatively inconvenient for the patient, since it requires frequent outpatient visits and venipunctures. Moreover, errors may occur due to insufficient communication between patient and physician...... of anticoagulant therapy. The specific hypotheses were: • The precision of patient’s own measurements of INR performed at home on a portable coagulometer is sufficient to allow for self management of OAT (substudy 1). • For selected pairs of thromboplastins, the relation between logarithmic prothrombin times...... substudy it was shown that for selected patients the precision of the patients’ own measurements of INR is sufficient to allow for reliable routine patient self testing of INR. In the same substudy we found large discrepancies between the INR measurements on portable coagulometers and in the Department...

  5. IATROGENIC EVENTS OF ORAL ANTITHROMBOTIC THERAPY. BETWEEN SCYLLA AND CHARYBDIS

    Directory of Open Access Journals (Sweden)

    L. I. Dvoretsky

    2016-01-01

    Full Text Available Thrombotic complications are a common problem in clinical practice. The most important are coronary thrombosis with myocardial infarction, ischemic cerebral infarcts in patients with atrial fibrillation, venous thrombosis complicated by pulmonary embolism. The use of oral antiplatelet therapy significantly reduced the incidence of fatal thrombotic complications. However, use of this group of drugs is associated with an increased risk of bleeding, which often turn out to be fatal for the patient. In the article presented the modern tactics of treatment of patients receiving a variety of oral antithrombotic agents, described a typical example of clinical complications.

  6. Gene Therapy For Oral Cancer - Journey To A New Horizon

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    Arpita Kabiraj

    2012-01-01

    Full Text Available The past two decades have been golden years for the genetics of cancer. It has become clear through the work of countless laboratory groups that both inherited and sporadic cancers arise through defects or misregulations of their genomes. Despite advances in surgery, radiotherapy, and chemotherapy, the survival of patients with oral squamous cell carcinoma have not significantly improved over the past several decades. Thus, an entirely new approach to its treatment utilizing genetic aids has evolved. The majority of the head and neck cancers comprise of Oral squamous cell carcinoma (OSCC. The traditional therapies for the management of cancer and their various modifications including surgery, radiotherapy and chemotherapy have not refined the survival rates yet. Gene therapy represents a fundamentally new mode for the effective treatment of a disease. It essentially consists of the introduction of the genetic material into the target cells of an individual without producing toxic effects on surrounding tissues. The essence of gene therapy is attributed to the replacement of the defective gene with a normal gene, thus restoring the lost function in the patient’s body. The aim of this review is to analyze the different modalities of gene therapy currently used to manage precancerous and cancerous lesions of the oral cavity.

  7. Evaluation of the Prevalence of Chronic Kidney Disease and Rates of Oral Antidiabetic Prescribing in Accordance with Guidelines and Manufacturer Recommendations in Type 2 Diabetic Patients within a Long-Term Care Setting

    Directory of Open Access Journals (Sweden)

    Ning Wu

    2014-01-01

    Full Text Available This retrospective study assessed the prevalence of moderate to severe chronic kidney disease (CKD among nursing home (NH residents with type 2 diabetes. The pattern of oral antidiabetic drug (OAD use and their concordance with the National Kidney Foundation (NKF guideline and prescribing information (PI was also assessed. About half (47% of diabetic residents had moderate to severe CKD. A little over a quarter of the 186 residents using OADs received at least one NKF-discordant OAD prescription. Metformin was the most commonly misused OAD. PI nonconcordance was observed in 58.6% of residents and was highest in glipizide and metformin users. With the high prevalence of moderate to severe CKD in NH residents with diabetes, physicians should consider residents’ renal function when choosing treatment plans and review treatments regularly to check compliance with the NKF guidelines or PIs.

  8. Self-management of oral anticoagulant therapy in two centers

    DEFF Research Database (Denmark)

    Nilsson, Hanna; Grove, E; Larsen, Torben Bjerregaard

    Self-management of oral anticoagulant therapy in two centers: 11.000 patient-years of follow-up H Nilsson1,2,3, EL Grove2, TB Larsen3, M Maegaard1, TD Christensen1 1Department of Cardiothoracic and Vascular Surgery & Institute of Clinical Medicine, Aarhus University Hospital, Aarhus; 2Department...... of Cardiology, Aarhus University Hospital, Aarhus; 3Department of Cardiology, Aalborg Hospital & Department of Health Science and Technology, Aalborg University, Aalborg, Denmark haana_86@hotmail.com Objectives: Patient-self-management (PSM) of oral anticoagulant therapy with vitamin K antagonists have...... clinical practice. Materials and methods: A case-series study including all patients who had passed an exam in PSM in the period 1995-2012 at Aarhus University Hospital or Aalborg University Hospital, including 2200 patients and 11000 patient-years in total. The effectiveness was measured using...

  9. Stem cell therapy in oral and maxillofacial region: An overview

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    P M Sunil

    2012-01-01

    Full Text Available Cells with unique capacity for self-renewal and potency are called stem cells. With appropriate biochemical signals stem cells can be transformed into desirable cells. The idea behind this article is to shortly review the obtained literature on stem cell with respect to their properties, types and advantages of dental stem cells. Emphasis has been given to the possibilities of stem cell therapy in the oral and maxillofacial region including regeneration of tooth and craniofacial defects.

  10. Oral surgery in patients under antithrombotic therapy. Narrative review.

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    Anggelo Carrizo

    2015-02-01

    Full Text Available Population aging and the increasing rates of cardiovascular diseases have raised the number of patients receiving antithrombotic therapy in elective or emergency dental care, including surgical procedures. The aim of this article is to review the evidence and clinical guidelines for management of patients on antithrombotic therapy published in the past five years. The American Antithrombotic Therapy Guideline - 2012 - generally recommends not to suspend antiplatelet or anticoagulant treatment in dental procedures since they are considered to have low bleeding risk and easy resolution. In the dental field, there is ample published evidence regarding oral surgical procedure management, especially by maxillofacial surgeons, showing a low number of complications associated with extractions or other minor oral surgical procedures without suspending antithrombotic drugs and only taking some minimum safeguards, such as healing by first intention or the use of some local hemostatic agents. In general, patients under chronic antithrombotic therapy should keep their medication when undergoing low and medium complexity dental procedures, since complications are minor and easy to handle. Due to interactions between them, particular care should be taken with patients using more than one drug.

  11. Antidiabetic potential of commonly consumed legumes: a review.

    Science.gov (United States)

    Singhal, Poonam; Kaushik, Geetanjali; Mathur, Pulkit

    2014-01-01

    Over the last few decades, lifestyle changes have resulted in a drastic increase in the incidence of diabetes all over the world, especially in the developing countries. Oral hypoglycemic agents and insulin form the mainstay in controlling diabetes, but they have prominent side effects and fail to significantly alter the course of diabetic complications. Appropriate diet and exercise programs that form a part of lifestyle modifications have proven to be greatly effective in the management of this disease. Dietary therapy is showing a bright future in the prevention and treatment of diabetes. Legumes, owing to their high nutritive value, are increasingly being used in dietetic formulations in the treatment and prevention of diabetes on account of their antidiabetic potential. Given this background, this paper reviews the glucose- and lipid-lowering action possessed by various commonly consumed legumes through several animal and human studies. It is concluded that the various legumes not only have varying degrees of antidiabetic potential but are also beneficial in decreasing the risk factors for cardiovascular and renal disease.

  12. Oral iron therapy and chronic idiopathic urticaria: sideropenic urticaria?

    Science.gov (United States)

    Guarneri, Fabrizio; Guarneri, Claudio; Cannavò, Serafinella Patrizia

    2014-01-01

    Chronic urticaria (CU) is frequent, remains often idiopathic despite diagnostic efforts, and sometimes poorly responds to oral antihistamines and/or corticosteroids. We noticed that hyposideremia is often found in patients with chronic idiopathic urticaria poorly responsive to usual treatments (prCIU), and oral iron therapy is frequently associated to improvement or resolution of urticaria. Between 2003 and 2012, we observed 122 patients with prCIU, of which 81 had moderate hyposideremia at our first visit. They continued the antihistamines already practiced and received oral iron therapy for 30 or 45 days. Two months after our first visit, all had normal serum iron levels; 64 reported complete remission of urticaria and 17 reported improvement superior to 80%. No adverse reactions to treatment were observed. Follow-up visits confirmed stability of results over 6 months. Our preliminary data show that hyposideremia is the only abnormality in many patients with prCIU, and restoration of normal iron serum levels is associated to remission or remarkable clinical improvement of urticaria. In consideration of low cost and potential benefits for some patients, determination of serum levels of iron could be introduced in the diagnostic workup of chronic urticaria, maybe as a second-level exam in patients without other relevant clinical or laboratory abnormalities.

  13. Oral lesions following radiation therapy and their preventive considerations

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    Ghavam M

    2001-09-01

    Full Text Available Oral cancers account for a relatively high percent of neoplasms in the elderly population. Treatment protocols often include anti-neoplastic pharmaco-therapeutics, irradiation of the head and neck region, and surgery. These treatments, specially radiation, have detrimental effects on oral hard and soft tissues. Salivary glands undergo a distinct and longterm dysfunction, which leads to decrease in salivary How. Xerostomia is a common clinical problem in these patients which contributes to dry mouth, mucosites, change in oral ecosystem and dental caries, followed by difficulties in speech, swallowing and use of dentures which cause malnutrition. This phenomenon has an irreversible weakening effect on the patient's health. To prevent this negative impact on oral health in this group of patients, definitive dental treatments prior to the initiation of medical therapies is imperative, and will decrease the morbidity rates. Today's dentistry benefits from improved methods and materials, which enable us to give these patients a better preventive dental treatment. Consultation between dentist and medical team would be the best way to help our sufferer patients.

  14. Nonsurgical Management of Oral Mucocele by Intralesional Corticosteroid Therapy

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    Rupam Sinha

    2016-01-01

    Full Text Available Background. Oral mucocele is a common lesion resulting from an alteration of minor salivary glands due to mucus accumulation. Rapid appearance, specific location, history of trauma, bluish colour, and consistency help in the diagnosis. Conventional surgical removal is the treatment of choice but has several disadvantages like damage to adjacent ducts with further development of satellite lesions. Therefore, the present study was undertaken to evaluate the efficacy of intralesional corticosteroid injection (betamethasone as a nonsurgical treatment procedure in oral mucoceles. Material and Method. A total of 20 cases (males and females, 10–30 years of age with clinically diagnosed oral mucoceles were given 1 mL of betamethasone intralesionally. All the patients were examined after a period of 7, 14, and 21 days to evaluate the response of the lesion towards treatment and consequently given the 2nd, 3rd, 4th injections. If the lesion resolved after one or two injections, the treatment was discontinued. Results. Out of the 20 cases, 18 of them showed complete regression of the lesion whereas the remaining 2 cases showed decrease in size. All the patients received maximum of 4 consecutive shots in weekly interval. Conclusion. Intralesional corticosteroid therapy can be considered as the first choice in the treatment of oral mucoceles.

  15. Photodynamic therapy of oral Candida infection in a mouse model.

    Science.gov (United States)

    Freire, Fernanda; Ferraresi, Cleber; Jorge, Antonio Olavo C; Hamblin, Michael R

    2016-06-01

    Species of the fungal genus Candida, can cause oral candidiasis especially in immunosuppressed patients. Many studies have investigated the use of photodynamic therapy (PDT) to kill fungi in vitro, but this approach has seldom been reported in animal models of infection. This study investigated the effects of PDT on Candida albicans as biofilms grown in vitro and also in an immunosuppressed mouse model of oral candidiasis infection. We used a luciferase-expressing strain that allowed non-invasive monitoring of the infection by bioluminescence imaging. The phenothiazinium salts, methylene blue (MB) and new methylene blue (NMB) were used as photosensitizers (PS), combined or not with potassium iodide (KI), and red laser (660nm) at four different light doses (10J, 20J, 40J and 60J). The best in vitro log reduction of CFU/ml on biofilm grown cells was: MB plus KI with 40J (2.31 log; p<0.001); and NMB without KI with 60J (1.77 log; p<0.001). These conditions were chosen for treating the in vivo model of oral Candida infection. After 5days of treatment the disease was practically eradicated, especially using MB plus KI with 40J. This study suggests that KI can potentiate PDT of fungal infection using MB (but not NMB) and could be a promising new approach for the treatment of oral candidiasis.

  16. Antidiabetic Effects of Tea

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    Qiu-Yue Fu

    2017-05-01

    Full Text Available Diabetes mellitus (DM is a chronic endocrine disease resulted from insulin secretory defect or insulin resistance and it is a leading cause of death around the world. The care of DM patients consumes a huge budget due to the high frequency of consultations and long hospitalizations, making DM a serious threat to both human health and global economies. Tea contains abundant polyphenols and caffeine which showed antidiabetic activity, so the development of antidiabetic medications from tea and its extracts is increasingly receiving attention. However, the results claiming an association between tea consumption and reduced DM risk are inconsistent. The advances in the epidemiologic evidence and the underlying antidiabetic mechanisms of tea are reviewed in this paper. The inconsistent results and the possible causes behind them are also discussed.

  17. New oral anticoagulants and dual antiplatelet therapy: Focus on apixaban.

    Science.gov (United States)

    Pelliccia, Francesco; Rollini, Fabiana; Marazzi, Giuseppe; Greco, Cesare; Gaudio, Carlo; Angiolillo, Dominick J; Rosano, Giuseppe

    2016-12-15

    The combination of AF and coronary artery disease not only is a common clinical setting, it is also a complex setting to deal with anticoagulation and antiplatelet therapy, and it is associated with significantly higher mortality rates. Unfortunately, there are no sufficient data available to optimally guide clinical practice in such settings. This review focuses specifically on newer oral anticoagulants (NOACs) associated with dual antiplatelet therapy (DAPT) in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). There are no randomized studies comparing vitamin K antagonists and NOACs in patients with AF undergoing PCI either for acute coronary syndromes or for stable patients, i.e. those patients who have an indication to receive DAPT. Moreover, new antiplatelet agents such as ticagrelor and prasugrel have entered the market for acute coronary syndromes. So far, there are no large-scale randomized studies published evaluating these newer antiplatelet agents in patients with AF receiving either vitamin K antagonists or NOACs, adding to the uncertainty on how to use these antithrombotics in combination when both coronary artery disease (unstable or stable patients) and AF converge in a given patient. The lack of large outcome trials and the large number of possible combinations are reflected in the wide variety of practices in the real world. To date, given the lack of data, watchfulness when using NOACs as component of DAPT or triple oral antithrombotic therapy is warranted.

  18. Prospective, non-interventional, uncontrolled, open-chart, pharmacoepidemiologic study of prescribing patterns for anti-diabetic drugs at tertiary care hospital in Erode

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    Radhika P

    2009-01-01

    Full Text Available The aim of this study is to determine current prescribing patterns for anti-diabetic drugs adopted by physicians in Erode. The prospective, non interventional, uncontrolled, open-chart, pharmacoepidemiological study was conducted from January -2007 to April -2007 at a diabetic care centre having 350 diabetic patients. The pattern of prescribing anti-diabetic drugs was recorded along with glycosylated haemoglobin levels, total cholesterol, high-density lipoprotein, low-density lipoprotein, very low-density lipoprotein and triglycerides in insulin-dependent diabetes mellitus and non-insulin-dependent diabetes mellitus patients and the values were observed. The prescribing pattern of the oral anti-diabetic drugs shows that out of the various oral anti-diabetic drugs′ available, drugs from only two groups were prescribed. Sulphonylureas, biguanides and combination therapy accounts for 31.43%, 20.28% and 33.71% of prescriptions, respectively, while insulin alone and with OAD′s accounts for 6.28% and 8.29% prescriptions, respectively. Overall, prescribing trend is away from monotherapy with insulin and sulphonylureas and towards combination therapies.

  19. Measurement of warfarin in the oral fluid of patients undergoing anticoagulant oral therapy.

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    Silvia Ghimenti

    Full Text Available BACKGROUND: Patients on warfarin therapy undergo invasive and expensive checks for the coagulability of their blood. No information on coagulation levels is currently available between two controls. METHODOLOGY: A method was developed to determine warfarin in oral fluid by HPLC and fluorimetric detection. The chromatographic separation was performed at room temperature on a C-18 reversed-phase column, 65% PBS and 35% methanol mobile phase, flow rate 0.7 mL/min, injection volume 25 µL, excitation wavelength 310 nm, emission wavelength 400 nm. FINDINGS: The method was free from interference and matrix effect, linear in the range 0.2-100 ng/mL, with a detection limit of 0.2 ng/mL. Its coefficient of variation was <3% for intra-day measurements and <5% for inter-day measurements. The average concentration of warfarin in the oral fluid of 50 patients was 2.5±1.6 ng/mL (range 0.8-7.6 ng/mL. Dosage was not correlated to INR (r = -0.03, p = 0.85 but positively correlated to warfarin concentration in the oral fluid (r = 0.39, p = 0.006. The correlation between warfarin concentration and pH in the oral fluid (r = 0.37, p = 0.009 confirmed the importance of pH in regulating the drug transfer from blood. A correlation between warfarin concentration in the oral fluid and INR was only found in samples with pH values ≥7.2 (r = 0.84, p = 0.004. CONCLUSIONS: Warfarin diffuses from blood to oral fluid. The method allows to measure its concentration in this matrix and to analyze correlations with INR and other parameters.

  20. Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO : methodology and quality of the literature

    NARCIS (Netherlands)

    Brennan, Michael T.; Elting, Linda S.; Spijkervet, Fred K. L.

    Oral complications are commonly experienced by patients undergoing cancer therapies. The Oral Care Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) has completed nine systematic reviews including Bisphosphonate

  1. Tuberculous ulcer of tongue with oral complications of oral antituberculosis therapy

    Directory of Open Access Journals (Sweden)

    Ajay G

    2006-01-01

    Full Text Available Tuberculosis (TB is an infectious disease affecting humans of all ages in all parts of the world. The dentist plays an important role in the identification and control of this condition by early recognition of oral lesions that may precede the detection of the pulmonary form. Occurrence of increased incidence of mycobacterial infections as a part of the spectrum of AIDS only emphasizes the importance of early diagnosis. A case of a tuberculous ulcer on the tongue along with oral ulcerations, which occurred as a consequence of oral antituberculosis therapy (ATT, is presented. Such complications have rarely been reported in the literature and the management of these is described herein. The tuberculous ulcer healed uneventfully in five weeks after institution of ATT and the other ATT-induced ulcers healed after a week of topical anesthetic application. The clinical presentations, differential diagnoses to be considered, and management of such oral manifestations is discussed. The occupational risk posed by TB to the dentist and appropriate precautions to be observed have been highlighted.

  2. Application of Stem Cells in Oral Disease Therapy: Progresses and Perspectives

    Science.gov (United States)

    Yang, Bo; Qiu, Yi; Zhou, Niu; Ouyang, Hong; Ding, Junjun; Cheng, Bin; Sun, Jianbo

    2017-01-01

    Stem cells are undifferentiated and pluripotent cells that can differentiate into specialized cells with a more specific function. Stem cell therapies become preferred methods for the treatment of multiple diseases. Oral and maxillofacial defect is one kind of the diseases that could be most possibly cured by stem cell therapies. Here we discussed oral diseases, oral adult stem cells, iPS cells, and the progresses/challenges/perspectives of application of stem cells for oral disease treatment. PMID:28421002

  3. Effects of computer-assisted oral anticoagulant therapy

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Corell, Pernille; Madsen, Poul

    2012-01-01

    UNLABELLED: BACKGROUND: Computer-assistance and self-monitoring lower the cost and may improve the quality of anticoagulation therapy. The main purpose of this clinical investigation was to use computer-assisted oral anticoagulant therapy to improve the time to reach and the time spent within...... in a computer system by an algorithm specific to each group. The third group received traditional anticoagulation treatment by physicians. The obtained INR values were compared regarding the time to reach, and the time spent within, the therapeutic target range, corresponding to INR values from 2 to 3. RESULTS......: Patients randomized to computer-assisted anticoagulation and the CoaguChek® system reached the therapeutic target range after 8 days compared to 14 days by prescriptions from physicians (p = 0.04). Time spent in the therapeutic target range did not differ between groups. The median INR value measured...

  4. Oral silicon supplementation: an effective therapy for preventing oral aluminum absorption and retention in mammals.

    Science.gov (United States)

    Domingo, José L; Gómez, Mercedes; Colomina, M Teresa

    2011-01-01

    Silicon is an essential element for some lower forms of life. However, it is not generally considered an essential nutrient for mammals and the mechanisms underlying its potential essentiality remain partially unknown. In recent years, a possible association between the aluminum and silicon levels in drinking water and Alzheimer's disease (AD) has been suggested. It has been reported that silicon might have a protective effect for limiting oral aluminum absorption. This review is focused primarily on the potential role of silicon in preventing oral aluminum absorption and retention in mammals. The results of a number of studies suggest that dietary silicon supplementation could be of therapeutic value for preventing chronic aluminum accumulation in the brain, and hence, be a potential therapy for AD. However, it must be noted that controversy remains about whether aluminum accumulation in the brain is a cause or a consequence of AD. It is suggested that further investigation of this issue is warranted.

  5. Treatment of oral leukoplakia with photodynamic therapy: A pilot study

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    Niranzena Panneer Selvam

    2015-01-01

    Full Text Available Aim of the Study: Oral leukoplakia (OL is the most common potentially malignant disorder that may transform into oral carcinoma. By treating leukoplakia in its incipient stage, the risk of occurrence of oral carcinoma can be prevented. In this aspect, photodynamic therapy (PDT can serve as a useful treatment modality. The aim of the study is to treat patients with OL using PDT in which 5-aminolevulinic acid (ALA is used as a photosensitizer. Materials and Methods: Five patients with OL were included in the study. They were treated with 10% ALA mediated PDT (light source: Xenon lamp, power: 0.1 W, wavelength: 630 ± 5 nm, total dose: 100 J/cm 2 per session for 6-8 sessions. Follow-up was done for a period of 1 year. Results: One month (4 weeks after ALA-PDT, the response was evaluated based on clinical examination. It was as follows: Complete response: Two patients; partial response: Two patients; and no response: One patient. There was no recurrence in any of the cases. Conclusion: There was satisfactory reduction in the size of the OL lesion without any side-effects. Thus, ALA mediated PDT seems to be a promising alternative for the treatment of OL.

  6. Bridging of oral anticoagulation therapy for invasive procedures.

    Science.gov (United States)

    Spyropoulos, Alex C

    2005-09-01

    The management of patients who need temporary interruption of chronic oral anticoagulant (OAC) therapy for an elective surgical or invasive procedure is problematic and complex. Patient and procedural risk factors for thrombosis and bleeding, anticoagulant-related risks of bleeding, and clinical consequences of a thrombotic or bleeding event need to be assessed and properly risk-stratified in the perioperative period. Certain procedures, such as dental, endoscopic, and cutaneous procedures, can be completed without discontinuing OAC, but most procedures with a high bleeding risk (including major surgeries) will necessitate temporary discontinuation of OAC. Bridging therapy with shorter-acting anticoagulants, such as heparin, for patients at intermediate to high risk of thromboembolism represents one strategy to maintain functional anticoagulation during this period. Large, prospective cohort studies and registries of patients on chronic OAC who underwent bridging therapy mostly with low-molecular-weight heparin have been completed recently. This paper reviews these clinical data on bridging therapy and provides an evidence-based perioperative management strategy for the at-risk patient on chronic OAC.

  7. Dental procedures in patients receiving oral anticoagulation therapy.

    Science.gov (United States)

    Saour, J N; Ali, H A; Mammo, L A; Sieck, J O

    1994-05-01

    Over a 10-year period a uniform management plan for patients receiving long term oral anticoagulation therapy for prosthetic heart valves and needing dental procedures was instituted. Those undergoing dental extraction or gum hygiene in the presence of gross gum pathology (Group A) had their oral anticoagulation discontinued two days prior to the procedure which was carried out only if the INR was 1.5 or less on the day of the procedure. Patients who needed dental fillings or gum hygiene in the absence of gross gum pathology (Group B) continued their anticoagulation therapy and had these procedures completed provided the INR was 3.0 or less. The main outcome measured were valve thrombosis, thromboembolism and excessive bleeding requiring hospitalization and/or blood transfusion. In Group A, 240 procedures were carried out; 212 dental extractions and 28 dental hygiene in the presence of gross gum pathology. They had a brief period of under-anticoagulation (3-7 days) to an INR of 1.5 or less. In Group B, 156 procedures were performed. No patient developed valve thrombosis or thromboembolism. Two patients, both in Group A needed hospitalization for observation but no blood transfusion. This management plan was easy to implement. Patients needed one extra visit to the anticoagulation clinic within one week of the procedure. It was both safe and effective.

  8. Harnessing the potential clinical use of medicinal plants as anti-diabetic agents

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    Campbell-Tofte JI

    2012-08-01

    Full Text Available Joan IA Campbell-Tofte,1 Per Mølgaard,2 Kaj Winther11Department of Clinical Biochemistry, Frederiksberg University Hospital, Frederiksberg, Denmark; 2Department of Medicinal Chemistry, Faculty of Pharmaceutical Sciences, University of Copenhagen, Copenhagen, DenmarkAbstract: Diabetes is a metabolic disorder arising from complex interactions between multiple genetic and/or environmental factors. The characteristic high blood sugar levels result from either lack of the hormone insulin (type 1 diabetes, T1D, or because body tissues do not respond to the hormone (type 2 diabetes, T2D. T1D patients currently need exogenous insulin for life, while for T2D patients who do not respond to diet and exercise regimes, oral anti-diabetic drugs (OADs and sometimes insulin are administered to help keep their blood glucose as normal as possible. As neither the administration of insulin nor OADs is curative, many patients develop tissue degenerative processes that result in life-threatening diabetes comorbidities. Several surveys of medicinal plants used as anti-diabetic agents amongst different peoples have been published. Some of this interest is driven by the ongoing diabetes pandemic coupled with the inadequacies associated with the current state of-the-art care and management of the syndrome. However, there is a huge cleft between traditional medicine and modern (Western medicine, with the latter understandably demanding meaningful and scientific validation of anecdotal evidence for acceptance of the former. The main problems for clinical evaluation of medicinal plants with promising anti-diabetic properties reside both with the complexity of components of the plant materials and with the lack of full understanding of the diabetes disease etiology. This review is therefore focused on why research activities involving an integration of Systems Biology-based technologies of pharmacogenomics, metabolomics, and bioinformatics with standard clinical data

  9. Efek Antidiabetes Kombinasi Ekstrak Bawang Putih (Allium sativum Linn. dan Rimpang Kunyit (Curcumma domestica Val. dengan Pembanding Glibenklamid pada Penderita Diabetes Melitus Tipe 2

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    Ame Suciati Setiawan

    2011-03-01

    Full Text Available The combination of garlic (Allium sativum Linn. and curcumin extract (Curcumma domestica Val. can be used as an antidiabetic oral to type 2 diabetes mellitus (DM patients and the clinical trial showed that the extract can decrease blood glucose at a dose 2.4 g/day. This clinical trial was conducted to know the antidiabetic effect of the combination of garlic and curcumin extract compared with antidiabetic oral, glibenclamide. The subjects were >35 years of age with type 2 DM who came to internal and endocrine clinic RSUP. Hasan Sadikin Bandung and has been treated with medical nutrition therapy for 2 weeks period November 2007–December 2008. The research design was parallel, randomized and double blind. The combination of garlic and curcumin extract decreased mean value of fasting blood glucose 9.25 mg/dL, 2h PP blood glucose 22.25 mg/dL, HbA1c 1,30% and insulin 12.57 mg/ dL compared with baseline whereas glibenclamide decreased the mean value of fasting blood glucose 72.37 mg/dL, 2h PP 114,25 mg/dL, HbA1c 4.12% and increased insulin 3.34 mg/dL. In conclusion, the extract combination has antidiabetic effect eventhough the effect was not as high as glibenclamide

  10. New and emerging therapies for diseases of the oral cavity.

    Science.gov (United States)

    Popovsky, J L; Camisa, C

    2000-01-01

    It is obvious from the review of the literature that most treatments for oral diseases such as lichen planus, pemphigoid, and pemphigus are based on case reports, anecdotes, and small uncontrolled studies. Efforts must be made to perform more controlled studies to evaluate the efficacy of new treatments. Small numbers of patients at each site and multiple-drug therapy make this task difficult. Dermatologists should familiarize themselves with the newer immunosuppressive agents available. Use of these drugs requires knowledge of their pharmacokinetics and potential side effects, so that they may be used effectively and safely. Relatively low doses of azathioprine, cyclophosphamide, and cyclosporine should then be added to the dermatologist's armamentarium for the treatment of severe or recalcitrant diseases. Old drugs are resurfacing with new (but often off-label) uses as the underlying mechanisms of disease become understood. Thalidomide and mycophenolate mofetil are two examples of promising drugs for the future of dermatology.

  11. Self-management of oral anticoagulant therapy in two centers

    DEFF Research Database (Denmark)

    Nilsson, Hanna; Grove, E; Larsen, Torben Bjerregaard

    of Cardiology, Aarhus University Hospital, Aarhus; 3Department of Cardiology, Aalborg Hospital & Department of Health Science and Technology, Aalborg University, Aalborg, Denmark haana_86@hotmail.com Objectives: Patient-self-management (PSM) of oral anticoagulant therapy with vitamin K antagonists have...... demonstrated efficacy in randomized clinical trials. An important question remains about its clinical effectiveness. We hypothesized that implementation of PSM in everyday clinical practice could improve the quality of treatment. The aim of this study was to evaluate the effectiveness of PSM in everyday...... clinical practice. Materials and methods: A case-series study including all patients who had passed an exam in PSM in the period 1995-2012 at Aarhus University Hospital or Aalborg University Hospital, including 2200 patients and 11000 patient-years in total. The effectiveness was measured using...

  12. Stroke in women - oral contraception, pregnancy, and hormone replacement therapy.

    Science.gov (United States)

    Rantanen, Kirsi; Tatlisumak, Turgut

    2013-01-01

    Stroke is a devastating disease affecting millions of people worldwide every year. Female stroke victims have higher mortality rates and they do not re-cover as well as men. Women's longevity and different vascular risk factor burden like a larger prevalence of atrial fibrillation play a role. Women also have unique risk factors such as oral contraception, pregnancy, estrogen decrease after the menopause and hormone replacement therapy, which should all be evaluated and taken into consideration in treatment decisions both in the acute phase of stroke and in secondary prevention. In this review, the evidence regarding these hormonal aspects and the risk of stroke in women are evaluated. The relevant guidelines are studied and research gaps identified. Future topics for research are recommended and current treatment possibilities and their risks discussed.

  13. Oral mucosal injury caused by cancer therapies: current management and new frontiers in research

    DEFF Research Database (Denmark)

    Jensen, Siri Beier; Peterson, Douglas E.

    2014-01-01

    This invited update is designed to provide a summary of the state-of-the-science regarding oral mucosal injury (oral mucositis) caused by conventional and emerging cancer therapies. Current modeling of oral mucositis pathobiology as well as evidence-based clinical practice guidelines for prevention...

  14. Hypofractionated radiation therapy of oral melanoma in five cats.

    Science.gov (United States)

    Farrelly, John; Denman, David L; Hohenhaus, Ann E; Patnaik, Amiya K; Bergman, Philip J

    2004-01-01

    Five cats with melanoma involving the oral cavity were treated with hypofractionated radiation therapy (RT). Cobalt photons were used to administer three fractions of 8.0 Gray (Gy) for a total dose of 24 Gy. Four cats received radiation on days 0, 7, and 21 and one cat received radiation on days 0, 7, and 13. One of the cats received additional irradiation following the initial treatment course. Two cats received chemotherapy. Their age ranged from 11 to 15 years with a median age of 12 years. Three cats had a response to radiation, including one complete response and two partial responses. All five cats were euthanized due to progression of disease, with one cat having evidence of metastatic disease at the time of euthanasia. The median survival time for the five cats was 146 days (range 66-224 days) from the start of RT. The results of this study suggest that oral melanoma in cats may be responsive to hypofractionated RT, but response does not seem to be durable.

  15. Effect of combination antiretroviral therapy on the frequency of oral candidiasis in HIV/AIDS patient

    Directory of Open Access Journals (Sweden)

    Sayuti Hasibuan

    2007-03-01

    Full Text Available Oral candidiasis is one of the most common opportunistic infections in HIV/AIDS patients. It serves as important markers of HIV infection, viral load, and CD4 cells count in the blood and predict disease progression to AIDS. The development of oral candidiasis in HIV/AIDS patients associated by imbalances between Candida and impaired host immune defenses that caused by decreased of CD4 cell counts and the increased of plasma HIV-viral load. Since the introduction of antiretroviral therapy combination, commonly known as Highly Active Antiretroviral Therapy (HAART, it has been observed that certain oral lesions, such as oral candidiasis as declined. The aim of this paper is to review the mechanism of combination antiretroviral therapy influenced the frequency of oral candidiasis in HIV/AIDS patient. We conclude that combination antiretroviral therapy generally reduced the frequency and severity of oral candidiasis in HIV/AIDS patient.

  16. Combined preoperative therapy for oral cancer with nedaplatin and radiation

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Masatoshi; Shibata, Akihiko; Hayashi, Munehiro [Nippon Dental Univ., Tokyo (Japan). Hospital] (and others)

    2002-03-01

    We performed preoperative combined therapy using nedaplatin (CDGP) and radiation in 12 patients with squamous cell carcinoma originating from the oral cavity and maxillary sinus, and examined for any adverse events that may have occurred during this therapeutic regimen. Regarding the irradiation, external irradiation utilizing a 6 MV linac (linear accelerator) at a dose of 2.0 Gy/day was performed 5 times a week, with the target total radiation dose set at 40 Gy. In addition, CDGP was intravenously administered 30 minutes before irradiation at a dose of 5 mg/m{sup 2}/day. Mucositis was observed in all 12 subjects, however, the severity was observed to be grade 1-2 with no major differences in comparison to the patients given standard radiation monotherapy. Two subjects developed grade 3 leucopenia and were thus given granulocyte colony stimulating factor (G-CSF). In addition, grade 2 and grade 3 thrombocytopenia were both observed in one subject each. The subject with grade 3 thrombocytopenia required a platelet transfusion during surgery. No marked changes in serum creatinine levels were noted. These findings are therefore considered to provide evidence supporting the safety of this combination therapy. (author)

  17. EDGE study in Russian Federation: efficacy and safety of vildagliptine in comparison with other oral antidiabetic agents in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    G R Galstyan

    2013-06-01

    Full Text Available According to international consensus, metformin is acknowledged as a first-line therapeutic agent for type 2 diabetes mellitus (T2DM. However, in most cases this treatment eventually requires intensification by supplementation with other hypoglycemic medications. The aim of the EDGE study (Effective Diabetes control with vildaGliptin and vildagliptin/mEtformin was to assess the efficacy and safety of vildagliptin in comparison with other oral agents in routine management of patients with T2DM that has been poorly controlled by metformin monotherapy.

  18. Drug utilization pattern of antidiabetic agents in a tertiary care hospital of western Odisha, India

    Directory of Open Access Journals (Sweden)

    Ratna Agrawal

    2016-10-01

    Conclusions: The prescribing trend has been monotherapy with insulin followed by oral antidiabetic drugs in the form of glimepiride and metformin combination. [Int J Basic Clin Pharmacol 2016; 5(5.000: 2222-2226

  19. 胰岛素类似物联合口服降糖药治疗2型糖尿病%Insulin analogs combined with oral antidiabetic drugs in treating patients with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    周泽华; 肖蓉; 何煦; 瞿文娟; 杨刚毅; 李伶; 李志勇

    2013-01-01

    目的:评估3种胰岛素类似物(地特胰岛素、甘精胰岛素、双相门冬胰岛素30)联合口服降糖药用于治疗血糖控制欠佳的2型糖尿病患者的有效性及安全性.方法:73例血糖控制不达标的2型糖尿病患者被分为3组:每日睡前1次地特胰岛素组(n=23),每日睡前1次甘精胰岛素组(n=27)和每日早晚餐前各1次双相门冬胰岛素30组(n=23),各组均联合使用口服降糖药,共治疗16周.分析比较3组患者治疗前后糖化血红蛋白(hemoglobin A1c,HbA1c)、空腹血糖(fasting blood glucose,FBG)、餐后血糖(postprandial blood glucose,PBG)、体质指数(body mass index,BMI)的变化.评估3组间HbA1c、FBG、PBG下降幅度、HbA1c达标率(<7%)和低血糖事件的发生率.结果:治疗前3组HbA1c、FBG、PBG均无显著差异.经16周治疗,3组HbA1c、FBG、PBG均较治疗前显著下降(P<0.01),但组间比较无显著差异(P>0.05).各组治疗前后BMI均无显著变化(P>0.05).地特胰岛素组、甘精胰岛素组、双相门冬胰岛素30组HbA1c达标率(<7%)分别为43%、59%、52%,组间比较无显著差异(P>0.05).地特胰岛素组、甘精胰岛素组、双相门冬胰岛素30组分别发生3例(13%)、2例(7%)、5例(22%)轻度低血糖,均无严重低血糖事件发生,各组间低血糖发生率无显著差异(P>0.05).结论:在本研究人群中,有效控制FBG是HbA1c降低及达标的有效手段,3种胰岛素类似物联合口服降糖治疗2型糖尿病,可达到同样的降糖效果,并且体质量无明显增加、低血糖发生率较低.%Objective:To evaluate the efficacy and safety of insulin analogs (Insulin detemir,Insulin glargine,B iphasic insulin aspart 30) combined with oral antidiabetic drugs(OADs) in treating type 2 diabetic mellitus patients whose blood glucose is insufficiently controlled.Methods:Seventy-three type 2 diabetic mellitus patients with insufficiently controlled blood glucose were assigned to three groups

  20. Incidence of potential drug-drug interactions with antidiabetic drugs.

    Science.gov (United States)

    Samardzic, I; Bacic-Vrca, V

    2015-06-01

    In an effort to achieve normoglycemia more than one antidiabetic agent is usually needed. Diabetes is associated with several comorbidities and patients with diabetes are often treated with multiple medications. Therefore, patients with diabetes are especially exposed to drug-drug interactions (DDIs). The aim of this study was to analyse the incidence and type of potential DDIs of antidiabetic drugs in patients with diabetes. This retrospective study analyzed pharmacy record data of 225 patients with diabetes mellitus. Both type 1 and type 2 diabetic patients who were taking at least one antidiabetic agent during the period of six months were included. We investigated associated therapy in that period in order to identify potential DDIs with antidiabetic therapy. Potential interactions were identified by Lexicomp Lexi-Interat Online (Lexi-Comp, Inc., Hudson, USA) software which categorizes potential DDIs according to clinical significance in five types (A, B, C, D and X). Categories C, D and X are of clinical concern and always require medical attention (therapy monitoring, therapy modification or avoiding combination). We found that 80.9% of patients had at least one potential category C interaction while there were no D and X interactions. Most frequently encountered potential DDI (n = 176) included antidiabetic drugs and thiazide or thiazide like diuretics. Patients with diabetes are exposed to a large number of potential clinically significant DDIs that may require appropriate monitoring. Using databases of DDIs could be helpful in reducing the risk of potential clinically significant DDIs.

  1. Adherence to oral anticoagulant therapy in secondary stroke prevention – impact of the novel oral anticoagulants

    Directory of Open Access Journals (Sweden)

    Luger S

    2015-11-01

    Full Text Available Sebastian Luger,1 Carina Hohmann,2 Daniela Niemann,1 Peter Kraft,3 Ignaz Gunreben,3 Tobias Neumann-Haefelin,2 Christoph Kleinschnitz,3 Helmuth Steinmetz,1 Christian Foerch,1 Waltraud Pfeilschifter1 1Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, 2Department of Neurology, Klinikum Fulda gAG, Fulda, 3Department of Neurology, University Hospital Würzburg, Würzburg, Germany Background: Oral anticoagulant therapy (OAT potently prevents strokes in patients with atrial fibrillation. Vitamin K antagonists (VKA have been the standard of care for long-term OAT for decades, but non-VKA oral anticoagulants (NOAC have recently been approved for this indication, and raised many questions, among them their influence on medication adherence. We assessed adherence to VKA and NOAC in secondary stroke prevention. Methods: All patients treated from October 2011 to September 2012 for ischemic stroke or transient ischemic attack with a subsequent indication for OAT, at three academic hospitals were entered into a prospective registry, and baseline data and antithrombotic treatment at discharge were recorded. At the 1-year follow-up, we assessed the adherence to different OAT strategies and patients’ adherence to their respective OAT. We noted OAT changes, reasons to change treatment, and factors that influence persistence to the prescribed OAT. Results: In patients discharged on OAT, we achieved a fatality corrected response rate of 73.3% (n=209. A total of 92% of these patients received OAT at the 1-year follow-up. We observed good adherence to both VKA and NOAC (VKA, 80.9%; NOAC, 74.8%; P=0.243 with a statistically nonsignificant tendency toward a weaker adherence to dabigatran. Disability at 1-year follow-up was an independent predictor of lower adherence to any OAT after multivariate analysis, whereas the choice of OAT did not have a relevant influence. Conclusion: One-year adherence to OAT after stroke is strong (>90% and patients

  2. Analytical tools for determination of new oral antidiabetic drugs, glitazones, gliptins, gliflozins and glinides, in bulk materials, pharmaceuticals and biological samples

    Directory of Open Access Journals (Sweden)

    Gumieniczek Anna

    2016-01-01

    Full Text Available The review presents analytical methods for determination of new oral drugs for the treatment of type 2 diabetes mellitus (T2DM, focusing on peroxisome proliferator-activated receptor gamma agonists (glitazones, dipeptidyl peptidase 4 inhibitors (gliptins and sodium/glucose co-transporter 2 inhibitors (gliflozins. Drugs derived from prandial glucose regulators, such as glinides, are considered because they are present in some new therapeutic options. The review presents analytical procedures suitable for determination of the drugs in bulk substances, such as pharmaceuticals and biological samples, including HPLC-UV, HPLC/LC-MS, TLC/HPTLC, CE/CE-MS, spectrophotometric (UV/VIS, spectrofluorimetric and electrochemical methods, taken from the literature over the past ten years (2006-2016. Some new procedures for extraction, separation and detection of the drugs, including solid phase extraction with molecularly imprinted polymers (SPE-MIP, liquid phase microextraction using porous hollow fibers (HP-LPME, HILIC chromatography, micellar mobile phases, ion mobility spectrometry (IMS and isotopically labeled internal standards, are discussed.

  3. The Recent Progress in Oral Anti-diabetic Drug Research and Development%口服抗糖尿病药物研发新进展

    Institute of Scientific and Technical Information of China (English)

    穆曼娜

    2011-01-01

    The study of oral anti - diabetic drug ( OAD ) is continuously progressing in recent years. Thiazolidinediones, glucagon-like peptide-1 receptor activator, dipeptidyl peptidase Ⅳ inhibitors and amylin analogs are already in the market; Glucokinase activator, vanadium complex compounds and bioactive chromium are in study. Besides,the formulations of the existing drugs are also in constant improvement. Gastrointestinal therapeutic system ( GITS ) tablets, sustained - release tablets and complex compounds are emerging gradually. These progresses provide more ways to treat diabetes for better effects.%口服抗糖尿病药物的研发不断取得成功,已经上市的有噻唑烷二酮类、胰高糖素样肽1受体激动剂、二肽基肽酶Ⅳ抑制剂和胰淀素类似物等,正在进行研究的有葡萄糖激酶激活剂、钒复合物和生物活性铬等.原有的药物也在剂型上不断改进,控释剂、缓释剂和复方型逐渐出现.这些研究的成功为糖尿病的治疗提供更多的手段,以期达到更好的治疗效果.

  4. Antidiabetic activity of Rheum emodi in Alloxan induced diabetic rats.

    Directory of Open Access Journals (Sweden)

    Radhika.R

    2010-09-01

    Full Text Available The present study was carried out to evaluate the antidiabetic effect of Rheum emodi rhizome extract and to study the activities of hexokinase, aldolase and phosphoglucoisomerase, and gluconeogenic enzymes such as glucose-6- phosphatase and fructose 1,6-diphosphatase in liver and kidney of normal and alloxan induced diabetic rats. Oral administration of 75 % ethanolic extract of R. emodi (250 mg/kg body weight for 30 days, resulted in decrease inthe activities of glucose-6-phosphatase, fructose-1,6-disphosphatase, aldolase and an increase in the activity of phosphoglucoisomerase and hexokinase in tissues. The study clearly shows that the R.emodi possesses antidiabetic activity.

  5. Oral complications of cancer and cancer therapy: from cancer treatment to survivorship.

    Science.gov (United States)

    Epstein, Joel B; Thariat, Juliette; Bensadoun, Rene-Jean; Barasch, Andrei; Murphy, Barbara A; Kolnick, Leanne; Popplewell, Leslie; Maghami, Ellie

    2012-01-01

    Answer questions and earn CME/CNE Oral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long-term oral health and general well-being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long-term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long-term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time.

  6. Oral therapy in children with cholera: a comparison of sucrose and glucose electrolyte solutions.

    Science.gov (United States)

    Sack, D A; Islam, S; Brown, K H; Islam, A; Kabir, A K; Chowdhury, A M; Ali, M A

    1980-01-01

    We performed a double-blind trial comparing sucrose electrolyte oral solution with glucose electrolyte oral solution in children less than 5 years of age with severe cholera-like diarrhea. Of 111 patients studied (102 with bacteriologically confirmed cholera), 55 received sucrose solution and 56 received glucose solution. The success rates, as defined by the absence of the need to give unscheduled intravenous therapy, were similar in the two groups (73% and 77% in the sucrose and glucose groups, respectively). There was no difference in purging rates between the two groups. The primary determinant of success for oral fluid regardless of the sugar was the purging rate. Sucrose malabsorption was responsible for oral therapy failure in one child. This study demonstrates that sucrose is an effective alternative to glucose in the oral therapy solution, but either must be used in conjunction with intravenous solution when treating severe dehydrating diarrhea.

  7. Use of Low Level Laser Therapy for Oral Lichen Planus: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Mahdavi O.

    2013-12-01

    Full Text Available Oral Lichen Planus is a chronic inflammatory disease of unknown etiology. Erosive/ ulcerative oral lichen planus is often a painful condition that tends to become malignant, urging appropriate therapy. Laser therapy has recently been suggested as a new treatment option without significant side effects. This article presents two cases of erosive/ ulcerative oral lichen planus, who had not received any treatment before, treated with 630 nm low level laser. Lesion type and pain was recorded before and after treatment. Severity of lesions and pain were reduced after treatment. Low Level Laser Therapy was an effective treatment with no side effects and it may be considered as an alternative therapy for erosive/ulcerative oral lichen planus.

  8. Use of low level laser therapy for oral lichen planus: report of two cases.

    Science.gov (United States)

    Mahdavi, O; Boostani, N; Jajarm, Hh; Falaki, F; Tabesh, A

    2013-12-01

    Oral Lichen Planus is a chronic inflammatory disease of unknown etiology. Erosive/ ulcerative oral lichen planus is often a painful condition that tends to become malignant, urging appropriate therapy. Laser therapy has recently been suggested as a new treatment option without significant side effects. This article presents two cases of erosive/ ulcerative oral lichen planus, who had not received any treatment before, treated with 630 nm low level laser. Lesion type and pain was recorded before and after treatment. Severity of lesions and pain were reduced after treatment. Low Level Laser Therapy was an effective treatment with no side effects and it may be considered as an alternative therapy for erosive/ulcerative oral lichen planus.

  9. Implant therapy for a patient with Down syndrome and oral habits: A clinical report.

    Science.gov (United States)

    Saponaro, Paola C; Deguchi, Toru; Lee, Damian J

    2016-09-01

    This clinical report describes prosthodontic therapy with an implant-supported partial fixed dental prosthesis for a patient with Down syndrome and concomitant oral habits, including tongue thrusting and thumb sucking.

  10. Radiation therapy of the oral cavity: sequelae and management. Part 1

    Energy Technology Data Exchange (ETDEWEB)

    Beumer, J. III; Curtis, T.; Harrison, R.E.

    1979-03-01

    This is the first article in a two-part series dealing with the effects and manifestations in the oral cavity of radiation therapy of head and neck tumors. In this section, oral mucous membranes, taste buds, edema and trismus, diet, salivary glands, bone, peridontium, teeth, and composition of oral flora are discussed. Dental management of the dentulous patient is then approached; criteria for preradiation extraction are delineated.

  11. Factors that affect cancer patient compliance to oral anti-neoplastic therapy

    OpenAIRE

    Marques,Patrícia Andréa Crippa; Pierin, Angela Maria Geraldo

    2008-01-01

    OBJECTIVES: To identify factors that can affect compliance to treatment with neoplastic oral drugs in a group of cancer patients. METHODS: Interviews were performed on 61 patients diagnosed with cancer and under anti-neoplastic oral therapy in a private hospital. The interviews were carried out using instruments to assess compliance. RESULTS: Most patients (95%) reported the oral treatment was not difficult. The Morisky and Green Test were positive in 28% of the patients. Factors that may aff...

  12. A systematic review of oral fungal infections in patients receiving cancer therapy

    NARCIS (Netherlands)

    Lalla, Rajesh V.; Latortue, Marie C.; Hong, Catherine H.; Ariyawardana, Anura; D'Amato-Palumbo, Sandra; Fischer, Dena J.; Martof, Andrew; Nicolatou-Galitis, Ourania; Patton, Lauren L.; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T.

    The aims of this systematic review were to determine, in patients receiving cancer therapy, the prevalence of clinical oral fungal infection and fungal colonization, to determine the impact on quality of life and cost of care, and to review current management strategies for oral fungal infections.

  13. Effects of non-oral postmenopausal hormone therapy on markers of cardiovascular risk: a systematic review

    NARCIS (Netherlands)

    Hemelaar, M.; Mooren, M.J. van der; Rad, M.; Kluft, C.; Kenemans, P.

    2008-01-01

    Objective: To review the effects of non-oral administration of postmenopausal hormone therapy (HT) on risk markers for atherosclerotic and venous thromboembolic disease.Non-oral postmenopausal HT appears not to increase venous thromboembolic risk, whereas the effect on coronary heart disease risk is

  14. Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients

    NARCIS (Netherlands)

    B. karakullukcu (Baris); K. Oudenaarde (Kim); M.P. Copper (Marcel); W.M.C. Klop; R. van Veen (Robert); M. Wildeman (Maarten); I. Bing Tan

    2010-01-01

    textabstractThe indications of photodynamic therapy (PDT) of oral cavity and oropharynx neoplasms are not well defined. The main reason is that the success rates are not well established. The current paper analyzes our institutional experience of early stage oral cavity and oropharynx neoplasms (Tis

  15. A systematic review of oral fungal infections in patients receiving cancer therapy

    NARCIS (Netherlands)

    Lalla, Rajesh V.; Latortue, Marie C.; Hong, Catherine H.; Ariyawardana, Anura; D'Amato-Palumbo, Sandra; Fischer, Dena J.; Martof, Andrew; Nicolatou-Galitis, Ourania; Patton, Lauren L.; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T.

    2010-01-01

    The aims of this systematic review were to determine, in patients receiving cancer therapy, the prevalence of clinical oral fungal infection and fungal colonization, to determine the impact on quality of life and cost of care, and to review current management strategies for oral fungal infections. T

  16. Design of quality indicators for oral nutritional therapy.

    Science.gov (United States)

    Gimenez Verotti, Cristiane Comeron; de Miranda Torrinhas, Raquel Susana Matos; Pires Corona, Ligiana; Waitzberg, Dan Linetzky

    2015-06-01

    Objetivo: los indicadores de calidad en la terapia nutricional han sido propuestos como herramientas útiles para mejorar la terapia nutricional (TN). Este estudio pretende diseñar indicadores de calidad de terapia nutricional oral (ICTNO) factibles en el control de calidad de TN oral. Métodos: el diseño de ICTNO fue realizado por una comisión de nutrición clínica compuesta por brasileños expertos en TN del International Life Science Institute (ILSI). Más tarde, la aprobación de estos ICTNO fue valorada con análisis psicométricos recogiendo las opiniones de otros brasileños dedicados independientemente a la TN (n = 40) vía SurveyMonkey (encuesta por internet). Esta consistió en cuatro atributos valorando cada ICTNO (simplicidad, utilidad, objetividad y bajo precio) seguida de una escala Likert con cinco puntos. Resultados: los expertos en TN de ILSI proporcionaron el diseño de 12 QIONT, que fueron todos consistentemente (Alfa de Cronbach = 0,84) clasificados como válidos por expertos independientes en NT. Por orden de relevancia, los nuevos ICTNO valoraron: la frecuencia de screening nutricional, la prescripción de suplementos de nutrición oral para pacientes desnutridos que ya reciben dieta oral, la prescripción de suplementos de nutrición oral para pacientes con bajo riesgo nutricional que ya reciben dieta oral, el consejo nutricional, la adhesión al suplemento nutricional oral, los pacientes hospitalizados con dieta oral insuficiente y prescripción de suplementos nutricionales orales, los pacientes de UCI con dieta oral insuficiente y prescripción de suplementos nutricionales orales, el consejo de nutrición oral en pacientes de UCI, el consejo de nutrición oral en pacientes en planta, la intolerancia al volumen de suplemento oral debido a dosificación inadecuada, la intolerancia al sabor del suplemento oral y la intolerancia al volumen de suplemento oral. Conclusión: según la opinión experta, 12 potenciales y factibles nuevos ICTNO

  17. Long-lasting response to oral therapy in a young male with monogenic diabetes as part of HNF1B-related disease

    Directory of Open Access Journals (Sweden)

    Elena Carrillo

    2017-06-01

    Full Text Available Mutations in hepatocyte nuclear factor 1β gene (HNF1B are responsible for a multisystemic syndrome where monogenic diabetes (classically known as MODY 5 and renal anomalies, mostly cysts, are the most characteristic findings. Urogenital malformations, altered liver function tests, hypomagnesemia or hyperuricemia and gout are also part of the syndrome. Diabetes in these patients usually requires early insulinization. We present the case of a young non-obese male patient with a personal history of renal multicystic dysplasia and a debut of diabetes during adolescence with simple hyperglycemia, negative pancreatic autoimmunity and detectable C-peptide levels. He also presented epididymal and seminal vesicle cysts, hypertransaminasemia, hyperuricemia and low magnesium levels. In the light of these facts we considered the possibility of a HNF1B mutation. The sequencing study of this gene confirmed a heterozygous mutation leading to a truncated and less functional protein. Genetic studies of his relatives were negative; consequently, it was classified as a de novo mutation. In particular, our patient maintained good control of his diabetes on oral antidiabetic agents for a long period of time. He eventually needed insulinization although oral therapy was continued alongside, allowing reduction of prandial insulin requirements. The real prevalence of mutations in HNF1B is probably underestimated owing to a wide phenotypical variability. As endocrinologists, we should consider this possibility in young non-obese diabetic patients with a history of chronic non-diabetic nephropathy, especially in the presence of some of the other characteristic manifestations.

  18. The intracerebral haemorrhage associated to oral anticoagulant therapy: the practical management of urgent reversal therapy

    Directory of Open Access Journals (Sweden)

    Luca Masotti

    2011-04-01

    Full Text Available Intracerebral haemorrhage (ICH represents the most feared complication of therapy with vitamin K antagonists (VKA, so-called oral anticoagulant therapy (OAT. This is a real emergency in clinical practice, being burdened by high mortality, morbidity and residual functional disability. In recent years, there have been widespread indications for the correct management of VKA associated ICH. The urgent OAT reversal represents the cornerstone of VKA associated ICH therapy. The knowledge of these guidelines is of fundamental importance in clinical practice. The urgent OAT reversal could stop the hematoma enlargement which is considered one of the main risk factor of poor outcome in this clinical setting. The aim of urgent OAT reversal is bringing the INR (International Normalized Ratio to values ≤ 1.4. It is possible by using prothrombin complex concentrate (PCC, fresh frozen plasma (FFP, recombinant activated factor VII (raFVII together with vitamin K1 intravenous infusion. In this article the Authors review the practical management of urgent OAT reversal in patients suffering for VKA related ICH.

  19. STOMATOLOGIC ASPECTS IN THERAPY OF LOCALLY DISTRIBUTED CANCER OF ORAL CAVITY MUCUS

    Directory of Open Access Journals (Sweden)

    G. G. Matyakin

    2013-01-01

    Full Text Available Aim of the investigation: to improve prophylaxis of dental complications during the therapy in the patients with locally distributed cancer of oral cavity mucus.Materials. Results of sanation of oral cavity in 305 patients with cancer of oral and pharyngeal area are analyzed.Results. The best results are noted in the patients given surgical sanation before chemo-radial therapy. The most number of complications is observed when teeth were extracted after chemical therapy in the period of radial therapy at summary focal dose above 20 Gy as well as in the late periods after radial therapy.Conclusion. A complex of preventive measures with using haemostatic sponge with canamycin in such patients decreases the number of complications and the terms of healing of alveoli of extracted teeth.

  20. Administration of Coagulation-Altering Therapy in the Patient Presenting for Oral Health and Maxillofacial Surgery.

    Science.gov (United States)

    Halaszynski, Thomas M

    2016-11-01

    Oral health care providers are concerned with how to manage patients prescribed coagulation-altering therapy during the perioperative/periprocedural period for dental and oral surgery interventions. Management and recommendation can be based on medication pharmacology and the clinical relevance of coagulation factor levels/deficiencies. Caution should be used with concurrent use of medications that affect other components of the clotting mechanisms; prompt diagnosis and any necessary intervention to optimize outcome is warranted. However, evidence-based data on management of anticoagulation therapy during oral and maxillofacial surgery/interventions is lacking. Therefore, clinical understanding and judgment are needed along with appropriate guidelines matching patient- and intervention-specific recommendations.

  1. Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO : methodology and quality of the literature

    NARCIS (Netherlands)

    Brennan, Michael T.; Elting, Linda S.; Spijkervet, Fred K. L.

    2010-01-01

    Oral complications are commonly experienced by patients undergoing cancer therapies. The Oral Care Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) has completed nine systematic reviews including Bisphosphonate Osteonecrosi

  2. Designing and Dosimetry of a Shield for Photon Fields of Radiation Therapy in Oral Cavity Cancer

    OpenAIRE

    Jabbari, Keyvan; Senobari, Somayeh; Roayaei, Mahnaz; Rostampour, Masoumeh

    2015-01-01

    The cancer of oral cavity is related to lesions of mucous membrane of tongue and gum that can be treated with radiation therapy. A lateral photon field can be used to treat this kind of tumor, which has a side-effect on normal tissue in the opposite side of the oral cavity. In this study the dosimetric effect of the various shields in oral cavity is evaluated. In this study, a special phantom similar to the structure of oral cavity with capability of film dosimetry was designed and constructe...

  3. The safety and effectiveness of once daily detemir in patients with type 2 diabetes previously failing oral agents:the Chinese cohort from SOL-VETM observational study

    Institute of Scientific and Technical Information of China (English)

    潘长玉

    2013-01-01

    Objective To evaluate the safety and effectiveness of initiating once-daily insulin detemir(Levemir) as add-on therapy in patients with type 2 diabetes mellitus(T2DM) who failed treatment of oral anti-diabetic drugs(OAD).Methods The present study was derived from the data of

  4. Prevalence of oral candidiasis in HIV/AIDS children in highly active antiretroviral therapy era. A literature analysis.

    Science.gov (United States)

    Gaitán-Cepeda, Luis Alberto; Sánchez-Vargas, Octavio; Castillo, Nydia

    2015-08-01

    SummaryHighly active antiretroviral therapy has decreased the morbidity and mortality related to HIV infection, including oral opportunistic infections. This paper offers an analysis of the scientific literature on the epidemiological aspects of oral candidiasis in HIV-positive children in the combination antiretroviral therapy era. An electronic databases search was made covering the highly active antiretroviral therapy era (1998 onwards). The terms used were oral lesions, oral candidiasis and their combination with highly active antiretroviral therapy and HIV/AIDS children. The following data were collected from each paper: year and country in which the investigation was conducted, antiretroviral treatment, oral candidiasis prevalence and diagnostic parameters (clinical or microbiological). Prevalence of oral candidiasis varied from 2.9% in American HIV-positive children undergoing highly active antiretroviral therapy to 88% in Chilean HIV-positive children without antiretroviral therapy. With respect to geographical location and antiretroviral treatment, higher oral candidiasis prevalence in HIV-positive children on combination antiretroviral therapy/antiretroviral therapy was reported in African children (79.1%) followed by 45.9% reported in Hindu children. In HIV-positive Chilean children on no antiretroviral therapy, high oral candidiasis prevalence was reported (88%) followed by Nigerian children (80%). Oral candidiasis is still frequent in HIV-positive children in the highly active antiretroviral therapy era irrespective of geographical location, race and use of antiretroviral therapy.

  5. Tutorial in oral antithrombotic therapy: Biology and dental implications

    OpenAIRE

    Fakhri, Hamid Reza; Janket, Sok Ja; Jackson, Elizabeth A.; Alison E Baird; Dinnocenzo, Richard; Meurman, Jukka H

    2013-01-01

    Objectives: Recent developments of new direct oral anticoagulants that target specific clotting factors necessitate understanding of coagulation biology. The objective of this tutorial is to offer dental professionals a review of coagulation mechanisms and the pharmacodynamics of the conventional and new oral anticoagulants. Also, we summarized the dental implications of the conventional and new anticoagulants. Method: We searched Medline using search terms “antithrombotic”, “antihemostasis” ...

  6. Possible neuroimmunomodulation therapy in T-cell-mediated oral diseases

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Sato

    2015-01-01

    Full Text Available Introduction: Recurrent aphthous stomatitis and oral lichen planus are local chronic inflammatory diseases which are implicated in T cell-mediated immunity. According to the systematic review, there is insufficient evidence to support any specific treatment for T-cell mediated oral diseases. The hypothesis: In this paper, we propose a hypothesis that recurrent aphthous stomatitis and oral lichen planus can be treated with selective α7 subunit of nicotinic acetylcholine receptor (α7 -nAChR agonists. Our hypothesis is supported by the following two facts. First, the pathophysiological conditions, T h 1/T h 17 cell activation and autonomic nervous system dysfunction, are observed in T-cell mediated oral diseases as well as in T-cell mediated systemic diseases such as rheumatoid arthritis. Second, the cholinergic anti-inflammatory pathway is inhibited in systemic T-cell mediated chronic inflammatory diseases. On the other hand, treatment with α7 -nAChR agonists which activate the cholinergic anti-inflammatory pathway suppresses neuroinflammation via inhibition of T h 1/T h 17 responses in animal model of systemic T-cell mediated chronic inflammatory diseases. We thus expect that selective α7 -nAChR agonists will be effective for the treatment of T-cell mediated oral diseases. Evaluation of the hypothesis: To test our hypothesis, we need to develop in vivo mouse model of T-cell mediated oral diseases. To evaluate the therapeutic effect of a selective α7 -nAChR agonist, we choose ABT-107 because of its safety and tolerability. We believe that the selective α7 -nAChR agonist, especially ABT-107, may be a therapeutic drug to treat T-cell mediated oral diseases.

  7. Adherence, compliance and persistence to oral antineoplastic therapy: a review focused on chemotherapeutic and biologic agents.

    Science.gov (United States)

    Gebbia, Vittorio; Bellavia, Giuseppe; Ferraù, Francesco; Valerio, Maria Rosaria

    2012-05-01

    To date, orally administered chemotherapy and biologic agents represent a significant percentage of all antineoplastic treatments in several types of cancer, which are most likely to increase in the near future. In this scenario, the issue of adherence and persistence to oral therapy is a key issue since poor compliance to oral antineoplastic treatments may negatively influence patients' clinical outcomes and, in turn, cause an increase in costs, number of hospitalizations and time spent in the hospital. The issue of adherence to new oral chemotherapeutic and/or biologic agents has not been deeply evaluated and data published in medical literature are quite scarce. Adherence is a multidimensional phenomenon, which may be influenced by patient- and health-care provider-related factors, anticancer therapy itself, education and socioeconomic aspects. Patients' selection plays, therefore, a key role in maximizing adherence and persistence to oral therapies. Treating health-care practitioners should first evaluate patient reliability to avoid prescribing oral treatments to patients with socioeconomic and medical conditions, which may predict poor adherence. Adherence and persistence to new oral biologic agents, which are linked to several side effects and whose use is constantly widening, should represent a main endpoint of clinical research in the nearest future.

  8. Antidiabetic Effect of Galantamine: Novel Effect for a Known Centrally Acting Drug.

    Directory of Open Access Journals (Sweden)

    Mennatallah A Ali

    Full Text Available The cholinergic anti-inflammatory pathway is one of the putative biochemical pathways that link diabetes with Alzheimer disease. Hence, we aimed to verify the potential antidiabetic effect of galantamine, unveil the possible mechanisms and evaluate its interaction with vildagliptin. The n5-STZ rat model was adopted and the diabetic animals were treated with galantamine and/or vildagliptin for 4 weeks. Galantamine lowered the n5-STZ-induced elevation in body weight, food/water intake, serum levels of glucose, fructosamine, and ALT/AST, as well as AChE in the tested organs. Moreover, it modulated successfully the lipid profile assessed in serum, liver, and muscle, and increased serum insulin level, as well as % β-cell function, in a pattern similar to that of vildagliptin. Additionally, galantamine confirmed its antioxidant (Nrf2, TAC, MDA, anti-inflammatory (NF-κB, TNF-α, visfatin, adiponectin and anti-apoptotic (caspase-3, cytochrome c capabilities by altering the n5-STZ effect on all the aforementioned parameters. On the molecular level, galantamine/vildagliptin have improved the insulin (p-insulin receptor, p-Akt, GLUT4/GLUT2 and Wnt/β-catenin (p-GSK-3β, β-catenin signaling pathways. On almost all parameters, the galantamine effects surpassed that of vildagliptin, while the combination regimen showed the best effects. The present results clearly proved that galantamine modulated glucose/lipid profile possibly through its anti-oxidant, -apoptotic, -inflammatory and -cholinesterase properties. These effects could be attributed partly to the enhancement of insulin and Wnt/β-catenin signaling pathways. Galantamine can be strongly considered as a potential antidiabetic agent and as an add-on therapy with other oral antidiabetics.

  9. Development of polyherbal antidiabetic formulation encapsulated in the phospholipids vesicle system

    Directory of Open Access Journals (Sweden)

    Vinod Kumar Gauttam

    2013-01-01

    Full Text Available Multifactorial metabolic diseases, for instance diabetes develop several complications like hyperlipidemia, hepatic toxicity, immunodeficiency etc., Hence, instead of mono-drug therapy the management of the disease requires the combination of herbs. Marketed herbal drugs comprise of irrational combinations, which makes their quality control more difficult. Phytoconstituents, despite having excellent bioactivity in vitro demonstrate less or no in vivo actions due to their poor lipid solubility, resulting in high therapeutic dose regimen; phospholipids encapsulation can overcome this problem. Hence, present study was designed to develop a phospholipids encapsulated polyherbal anti-diabetic formulation. In the present study, polyherbal formulation comprises of lyophilized hydro-alcoholic (50% v/v extracts of Momordica charantia, Trigonella foenum-graecum and Withania somnifera 2:2:1, respectively, named HA, optimized based on oral glucose tolerance test model in normal Wistar rats. The optimized formulation (HA entrapped in the phosphatidylcholine and cholesterol (8:2 vesicle system is named HA lipids (HAL. The vesicles were characterized for shape, morphology, entrapment efficiency, polar-dispersity index and release profile in the gastric pH. The antidiabetic potential of HA, marketed polyherbal formulation (D-fit and HAL was compared in streptozotocin-induced diabetic rat model of 21 days study. The parameters evaluated were behavioral changes, body weight, serum glucose level, lipid profile and oxidative stress. The antidiabetic potential of HA (1000 mg/kg was at par with the D-fit (1000 mg/kg. However, the potential was enhanced by phospholipids encapsulation; as HAL (500 mg/kg has shown more significant (P < 0.05 potential in comparison to HA (1000 mg/kg and at par with metformin (500 mg/kg.

  10. Oral complications of cancer therapies. Description and incidence of oral complications

    Energy Technology Data Exchange (ETDEWEB)

    Dreizen, S. (Univ. of Texas Dental Branch, Houston (USA))

    1990-01-01

    No part of the body reflects the complications of cancer chemotherapy as visibly and as vividly as the mouth. The infectious, hemorrhagic, cytotoxic, nutritional, and neurologic signs of drug toxicity are reflected in the mouth by changes in the color, character, comfort, and continuity of the mucosa. The stomatologic complications of radiotherapy for oral cancer are physical and physiological in nature, transient or lasting in duration, and reversible or irreversible in type. Some linger as permanent mementos long after the cancer has been destroyed. They stem from radiation injury to the salivary glands, oral mucosa, oral musculature, alveolar bone, and developing teeth. They are expressed clinically by xerostomia, trismus, radiation dermatitis, nutritional stomatitis, and dentofacial malformation. In both cancer chemotherapy and cancer radiotherapy, the oral complications vary in pattern, duration, intensity, and number, with not every patient developing every complication. 21 references.

  11. Oral surgery in patients under antithrombotic therapy. Narrative review.

    OpenAIRE

    Anggelo Carrizo; David Carrasco

    2015-01-01

    ABSTRACT Aging population and increase of cardiovascular diseases have raised the number of patients receiving antithrombotic therapy in elective or emergency dental care, including surgical procedures. The aim of this article is to review the evidence and clinical guidelines published in the past five years for dental management of patients on antithrombotic therapy. The American Antithrombotic Therapy Guideline - 2012 - generally recommends not to suspend antiplatelet or anticoagulant trea...

  12. Ocular changes with oral and transepidermal diethylcarbamazine therapy of onchocerciasis.

    Science.gov (United States)

    Taylor, H R; Greene, B M

    1981-07-01

    Twenty men with moderate infection of Onchocerca volvulus were studied in a double-masked, controlled clinical trial to compare the safety and efficacy of oral diethylcarbamazine (DEC) with topical DEC lotion. Visual acuity and colour vision did not alter during the 6 months of observation, although 2 patients receiving DEC lotion and 3 patients receiving oral DEC developed either visual field constriction or optic atrophy. Fluffy corneal opacities were common in both groups. Intraocular microfilariae also appeared in both groups but to a greater extent in those receiving DEC lotion. New chorioretinal changes developed in 4 men receiving lotion and in only 1 receiving tablets. It is concluded that DEC lotion offers no advantage over tablets in the treatment of ocular onchocerciasis and in fact may be associated with more ocular complications than the conventional oral treatment.

  13. Review of Urgent Reversal Therapies for Oral Anticoagulation

    Directory of Open Access Journals (Sweden)

    John J. Mondin II

    2016-09-01

    Full Text Available Anticoagulation has proven to be one of the most essential breakthroughs in cardiology in the last 100 years. The first major oral anticoagulant, warfarin, is a 4-hydroxycourmarin first synthesized in the 1940s for use as a rodenticide. It was not until 1954 that warfarin was finally approved by the FDA for use in patients requiring systemic anticoagulation. For over 55 years, warfarin was the only oral anticoagulant available in the United States until the approval of dabigatran in 2010, ushering in the era of the direct oral anticoagulants. This article will review modalities of anticoagulation reversal including activated charcoal, hemodialysis, blood-derived products, and medications currently available as well as in development.

  14. Effects of combined therapy of orbital cobalt Irradiation and oral corticosteroid administration, and pulse therapy for Graves' ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Shigemasa, Chiaki; Ueta, Yoshihiko; Taniguchi, Shinichi; Mitani, Yasuo; Urabe, Keita; Tanaka, Takashi; Yoshida, Akio; Mashiba, Hiroto

    1989-03-01

    This preliminary study was performed to investigate the efficacy of the combined therapy of orbital cobalt irradiation and oral prednisolone administration, and pulse therapy, for Graves' ophthalmopathy. The combined therapy was undergone according to procedure of Bartalena et al. (1983) in 5 patients. Excellent or good response to combined therapy were shown by 3 patients with short-standing ocular symptoms (3-4 months), but not by 2 patients with long-standing ocular symptoms (12-13 months). Pulse therapy was performed on 2 patients who showed no improvement from combined therapy, and on a patient who had acute onset of opthalmopathy. One gram of methylprednisolone sodium succinate was given intravenously daily for 3 successive days. This infusion procedure was repeated 3 to 4 times at intervals of 1 week. One of 2 patients who showed no improvement from combined therapy also had no response to pulse therapy. The other 2 patients showed a good response to pulse therapy and showed no relapse of ophthalmopathy for 10 and 8 months, respectively. These data emphasize the need for early immuno-suppressive therapy for Graves' ophthalmopathy. Pulse therapy may be employed in patients who show no response to other therapy method.

  15. Antidiabetic and Antioxidant Activities of Ethanolic Extract of Dried Flowers of Moringa oleifera in Streptozotocin-induced Diabetic Rats

    National Research Council Canada - National Science Library

    Rotimi Olusanya Arise; Oluwaseun Ruth Aburo; Samuel Tobi Farohunbi; Adenike Adebola Adewale

    2016-01-01

    This study was undertaken to determine the antidiabetic and antioxidant effects of oral administration of ethanolic extract of Moringa oleiferaflower on stretozotocin-induced diabetic rats at 100, 200, and 300 mg/kg b.w. Thirty (30...

  16. Photodynamic Therapy As a Promising Method Used in the Treatment of Oral Diseases.

    Science.gov (United States)

    Prażmo, Ewa J; Kwaśny, Mirosław; Łapiński, Mariusz; Mielczarek, Agnieszka

    2016-01-01

    Photodynamic therapy (PDT) consists of three elements: photosensitizer, light and oxygen. The photosensitizer has the property of selective accumulation in abnormal or infected tissues without causing any damage to the healthy cells. This innovative therapeutic method has already been successfully adapted in many fields of medicine, e.g. dermatology, gynecology, urology and cancer therapy. Dentistry is also beginning to incorporate photodisinfection for treatment of the oral cavity. The antibacterial and fungicidal properties of the photosensitizer have been used to achieve better results in root canal treatment, periodontal therapy and the eradication of candidiasis in prosthodontics. The aim of this article is to discuss the effectiveness of photodynamic methods in the diagnosis and therapy of selected oral diseases. Scientific data and published papers regarding the antibacterial properties of PDT will be subjected to analysis. Photodynamic therapy will be discussed as an alternative treatment protocol in oncology, endodontics, periodontology and other fields of dentistry.

  17. Odontostomatologic management of patients receiving oral anticoagulant therapy: a retrospective multicentric study

    OpenAIRE

    Scacco Salvatore; Inchingolo Alessio D; Marrelli Massimo; Abenavoli Fabio M; Tatullo Marco; Inchingolo Francesco; Papa Francesco; Inchingolo Angelo M; Dipalma Gianna

    2011-01-01

    Abstract Introduction Today, we frequently find patients taking oral anticoagulant therapy (OAT), a prophylaxis against the occurrence of thromboembolic events. An oral surgeon needs to know how to better manage such patients, in order to avoid hemorrhagic and thromboembolic complications. Materials and methods A group of 193 patients (119 men aged between 46 and 82 and 74 women aged between 54 and 76) undergoing OAT for more than 5 years were managed with a standardized management protocol a...

  18. Topical and systemic therapies for oral and perioral herpes simplex virus infections.

    Science.gov (United States)

    Stoopler, Eric T; Balasubramaniam, Ramesh

    2013-04-01

    Oral and perioral herpes simplex virus (HSV) infections in healthy individuals often present with signs and symptoms that are clearly recognized by oral health care providers (OHCPs). Management of these infections is dependent upon a variety of factors and several agents may be used for treatment to accelerate healing and decrease symptoms associated with lesions. This article will review the pertinent aspects of topical and systemic therapies of HSV infections for the OHCP.

  19. 'Ins' and 'outs' of triple therapy: Optimal antiplatelet therapy in patients on chronic oral anticoagulation who need coronary stenting.

    Science.gov (United States)

    Dewilde, W; Verheugt, F W A; Breet, N; Koolen, J J; Ten Berg, J M

    2010-09-01

    Chronic oral anticoagulant treatment is obligatory in patients (class I) with mechanical heart valves and in patients with atrial fibrillation with CHADS2 score >1. When these patients undergo percutaneous coronary intervention with placement of a stent, there is also an indication for treatment with aspirin and clopidogrel. Unfortunately, triple therapy is known to increase the bleeding risk. For this group of patients, the bottom line is to find the ideal therapy in patients with indications for both chronic anticoagulation therapy and percutaneous intervention to prevent thromboembolic complications such as stent thrombosis without increasing the risk of bleeding. (Neth Heart J 2010;18:444-50.).

  20. Pharmacoeconomics of the oral antidiabetic drugs in National Essential Medicine%国家基本药物中口服降糖药的药物经济学分析

    Institute of Scientific and Technical Information of China (English)

    江学容; 成小蔓

    2011-01-01

    比较国家基本药物中口服降糖药治疗2型糖尿病的经济效果.选取体重指数19~27 kg/m2的2型糖尿病患者200例,分为5组,每组40例,分别给予格列本脲(A组)、格列吡嗪(B组)、二甲双胍(C组)、格列本脲+二甲双胍(D组)、格列吡嗪+二甲双胍(E)进行治疗,观察疗效,采用药物经济学中的成本-效果分析法(CEA)进行分析.5组均可有效控制血糖,均可显著降低HbA1c.格列本脲更符合药物经济学原则,但由于易发生严重而持久的低血糖限制其临床广泛应用,老年患者应更加慎重;在以控制空腹血糖和体重为主要目标时选择二甲双胍更经济;在以控制餐后血糖为主要目标时选择格列吡嗪更为合理,尤其是体形偏瘦者更为合适;格列吡嗪+二甲双胍联合用药方案适合单用格列吡嗪或二甲双胍效果不佳者,值得推荐.%To compare the economic efficacies of the oral antidiabetic drugs in National Essential Medicine for treating type 2 diabetes mellitus.200 diabetic patients with body mass indices between 19-27 kg/m2 were assigned into 5 groups:group A received glibenclamide,group B glipizide,group C metformin,group D glibenclamide +metformin,and group E glipizide + metformin.Pharmacoeconomic evaluation was performed by cost-effectiveness analysis( CEA ).Fasting glucose level in patients treated with these 5 drugs all decreased significantly,as well as HbA1c.Glibenclamide was more in line with the principles of pharmacoeconomics,but should be used carefully for its serious and prolonged hypoglycemia,especially in elderly patients.According to the method of cost-effectiveness analysis,it was more economical to use metformin to control fasting glucose level while it is more reasonable to use glipizide to control the postprandial glucose whereas controlling of postprandial blood glucose is considered as a priority.Glipizide+mefformin combination may be recommended to the patients whose blood glucose level is

  1. Oral targeted therapies: managing drug interactions, enhancing adherence and optimizing medication safety in lymphoma patients.

    Science.gov (United States)

    Liewer, Susanne; Huddleston, Ashley N

    2015-04-01

    The advent of newer, targeted oral chemotherapy medications such as small molecule kinase inhibitors, ibrutinib and idelalisib, has created additional options for the treatment of lymphoma. The targeted nature of these agents offers many patient-identified advantages over older, intravenously administered chemotherapy regimens such as ease of self-administration and an increased sense of independence. However, newer oral agents also present unique challenges not previously experienced with older therapies that may affect safety, efficacy and patient adherence. In this article, we review oral agents for the treatment of lymphoma, how to evaluate and manage drug-drug and drug-food interactions with concomitant oral medications, and issues with patient adherence as well as methods to determine adherence for oral chemotherapy.

  2. A VALIDATION STUDY OF THE FACIAL-ORAL TRACT THERAPY SWALLOWING ASSESSMENT OF SALIVA

    DEFF Research Database (Denmark)

    Mortensen, Jesper; Jensen, Ditte; Kjærsgaard, Annette

    Introduction Facial-Oral Tract Therapy (F.O.T.T.) (1) is an approach that provides both clinical assessment and treatment of oropharyngeal dysphagia. In the F.O.T.T. approach, a prerequisite for the initiation of oral intake is safe swallowing of saliva. A recent randomized controlled trial (2......) showed that patients assessed for initiation of oral intake with an F.O.T.T. based clinical assessment, hereinafter referred to as the Swallowing Assessment of Saliva (SAS), were no more likely to develop aspiration pneumonia that patients who were assessed with an endoscopic evaluation. The objective...

  3. Peripapillary subretinal neovascularization in sarcoidosis: remission and exacerbation during oral corticosteroid therapy.

    Science.gov (United States)

    Abe, Koji; Shiraki, Kunihiko; Yasunari, Takaharu; Kohno, Takeya; Miki, Tokuhiko

    2002-01-01

    In sarcoidosis, peripapillary subretinal neovascularization is rare. The role of corticosteroid therapy for subretinal neovascularization is controversial. A 38-year-old female patient weighing 38 kg with histologically diagnosed sarcoidosis presented with peripapillary subretinal neovascularization, retinal phlebitis, a hyperemic disc, and snowball vitreous opacities in the left eye. Oral betamethasone therapy at an initial dose of 3 mg/day reduced the size of subretinal neovascular membrane, and the membrane became fibrous. Despite the total initial 140 mg of betamethasone given over 2.5 months and the additional total 700 mg of prednisolone given over the next 2 months, the subretinal neovascularization recurred. Six months after the first recurrence, a second recurrence developed during the tapering-off period of oral corticosteroid therapy. At the second recurrence, the oral corticosteroid therapy was ineffective in reducing the size of the neovascular membrane. In our patient, oral corticosteroids temporarily suppressed peripapillary subretinal neovascularization but failed to prevent extension of neovascular membrane to the fovea because of recurrent sarcoidosis. Over time, oral corticosteroids appear to lose their effectiveness for treating repeated recurrence of peripapillary subretinal neovascularization associated with sarcoidosis.

  4. Herpes simplex virus detection in oral mucosa lesions in patients undergoing oncologic therapy.

    Science.gov (United States)

    Sepúlveda Tebache, Ester; Brethauer Meier, Ursula; Jiménez Moraga, Marco; Morales Figueroa, Rocío; Rojas Castro, Jaime; Le Fort Canales, Patricia

    2003-01-01

    The presence of Herpes Simplex Virus (HSV) has been a frequent detection in gingivitis and ulcerations of oral mucosa in patients undergoing oncologic therapy. In these patients, lesions tend to show atypical clinical patterns, leading to misdiagnosis. To detect HSV, using an ELISA test, in oral lesions of patients under oncologic therapy, to determine localization of these lesions in the oral cavity, to relate their presence with the general diagnosis of the patient and to compare the test results with the previous clinical diagnosis of the lesions. Thirty lesions where examined in nineteen pediatric patients under oncologic therapy. Direct samples of all lesions were taken and an ELISA test for HSV type I and II was applied to them. General diagnosis of the patients was consigned, as well as localization of the lesions in the oral cavity and clinical diagnosis of them. A database was elaborated with all the information. 33% of lesions were positive to the test, most of them in patients with acute myeloid leukemia. Localization of lesions was not restricted to areas of mucosa attached to periosteum, but also in areas like the dorsum of the tongue. Positive predictivity of clinical diagnosis was 56,25% and negative predictive index was 92,86%. Sensitivity of the test was 90% and specificity was 65%. It is very important to corroborate clinical diagnosis of gingivitis and ulcerative lesions of the oral cavity of patients under oncologic therapy with laboratory tests, because of the atypical clinical presentation that can lead to misdiagnosis.

  5. Effectiveness of oral antibiotics for definitive therapy of Gram-negative bloodstream infections.

    Science.gov (United States)

    Kutob, Leila F; Justo, Julie Ann; Bookstaver, P Brandon; Kohn, Joseph; Albrecht, Helmut; Al-Hasan, Majdi N

    2016-11-01

    There is paucity of data evaluating intravenous-to-oral antibiotic switch options for Gram-negative bloodstream infections (BSIs). This retrospective cohort study examined the effectiveness of oral antibiotics for definitive treatment of Gram-negative BSI. Patients with Gram-negative BSI hospitalised for antibiotics were included in this study. The cohort was stratified into three groups based on bioavailability of oral antibiotics prescribed (high, ≥95%; moderate, 75-94%; and low, antibiotics were prescribed to 106, 179 and 77 patients, respectively, for definitive therapy of Gram-negative BSI. Mean patient age was 63 years, 217 (59.9%) were women and 254 (70.2%) had a urinary source of infection. Treatment failure rates were 2%, 12% and 14% in patients receiving oral antibiotics with high, moderate and low bioavailability, respectively (P = 0.02). Risk of treatment failure in the multivariate Cox model was higher in patients receiving antibiotics with moderate [adjusted hazard ratio (aHR) = 5.9, 95% CI 1.6-38.5; P = 0.005] and low bioavailability (aHR = 7.7, 95% CI 1.9-51.5; P = 0.003) compared with those receiving oral antimicrobial agents with high bioavailability. These data demonstrate the effectiveness of oral antibiotics with high bioavailability for definitive therapy of Gram-negative BSI. Risk of treatment failure increases as bioavailability of the oral regimen declines.

  6. Oral Nanostructured Lipid Carriers Loaded with Near-Infrared Dye for Image-Guided Photothermal Therapy.

    Science.gov (United States)

    Chen, Gang; Wang, Kaikai; Zhou, Yiwen; Ding, Ling; Ullah, Aftab; Hu, Qi; Sun, Minjie; Oupický, David

    2016-09-28

    Photothermal therapy exerts its anticancer effect by converting laser radiation energy into hyperthermia using a suitable photosensitizer. This study reports development of nanostructured lipid carriers (NLCs) suitable for noninvasive oral delivery of a near-infrared photosensitizer dye IR780. The carrier encapsulating the dye (IR780@NLCs) was stable in simulated gastric and intestinal conditions and showed greatly enhanced oral absorption of IR780 when compared with the free dye. As a result of increased oral bioavailability, enhanced accumulation of the dye in subcutaneous mouse colon tumors (CT-26 cells) was observed following oral gavage of IR780@NLCs. Photothermal antitumor activity of orally administered IR780@NLCs was evaluated following local laser irradiation of the CT-26 tumors. We observed significant effect of the photothermal IR780@NLCs treatment on the rate of the tumor growth and no toxicity associated with the oral administration of IR780@NLCs. Overall, orally administered IR780@NLCs represents a safe and noninvasive method to achieve systemic tumor delivery of a photosensitizing dye for applications in photothermal anticancer therapies.

  7. Combined oral and local therapy for the dissolution of urinary calculi.

    Science.gov (United States)

    Götz, F; Frang, D; Hübler, J; Nagy, Z

    1982-01-01

    The factors underlying the formation of Ca-phosphate and struvite calculi, as well as the present possibilities for oral and local therapy, their advantages and drawbacks are discussed in the light of published evidence. In this context a clinical case of multiple injuries is reported in which practically complete chemolitholysis has been achieved by combined oral and local therapy. The rapid growth of the calculi and their alarming tendency to recurrence in case of inadequate treatment is emphasized. The therapeutic method used in this case is regarded as suitable for practical purposes.

  8. NEW ORAL ANTICOAGULANTS IN THE THERAPY OF ANTIPHOSPHOLIPID SYNDROME

    Directory of Open Access Journals (Sweden)

    M. A. Satybaldyeva

    2016-01-01

    Full Text Available The vitamin K antagonist warfarin is an essential medicine from a group of anticoagulants, which is used to treat antiphospholipid syndrome (APS. However, it has a number of disadvantages especially in patients who need longterm and frequently lifetime prevention of thromboses. New oral anticoagulants, such as dabigatran etexilate (Pradaxa®, rivaroxaban (Xarelto®, apixaban (Eliquis and others, have been recently synthesized. Unlike warfarin, they are administered at fixed doses, require neither routine monitoring nor diet, and interact with drugs only in small amounts. The new oral anticoagulants have been approved for certain indications, but the data of performed trials are inapplicable to patients with APS. These medicines are expected to improve quality of life in patients with this condition. 

  9. Acute Demyelinating Disease after Oral Therapy with Herbal Extracts

    Directory of Open Access Journals (Sweden)

    Alex Kostianovsky

    2011-06-01

    Full Text Available Central nervous system demyelinating processes such as multiple sclerosis and acute disseminated encephalomyelitis constitute a group of diseases not completely understood in their physiopathology. Environmental and toxic insults are thought to play a role in priming autoimmunity. The aim of the present report is to describe a case of acute demyelinating disease with fatal outcome occurring 15 days after oral exposure to herbal extracts.

  10. Incidence and predictors of hypoglycemia in Japanese patients with type 2 diabetes treated by insulin glargine and oral antidiabetic drugs in real-life: ALOHA post-marketing surveillance study sub-analysis.

    Science.gov (United States)

    Odawara, Masato; Kadowaki, Takashi; Naito, Yusuke

    2014-02-15

    Add-on Lantus® to Oral Hypoglycemic Agents (ALOHA), an observational, non-interventional, 24-week post-marketing surveillance study in Japanese patients with type 2 diabetes (T2DM) having uncontrolled glycemic control, demonstrated that basal supported oral therapy (BOT) with insulin glargine was an effective and safe treatment in real-life clinical practice. We performed subgroup analysis to identify incidence and predictors associated with risk of hypoglycemia. Among 4219 patients with T2DM, 3732 patients were insulin-naïve and 487 patients were insulin non-naïve who switched from other insulin to insulin glargine. All hypoglycemic episodes were counted by physicians' documentation based on patients' reports. Relationships between baseline patient characteristics and glargine-related hypoglycemic episodes were examined by univariate and multivariate analysis. Among 4219 patients, 44 (1.0%) patients experienced hypoglycemic episodes (41 insulin-naïve patients; 3 insulin non-naïve patients), with a rate of incidence 0.035 episodes/patient-years. Majority of patients with hypoglycemia (37 of 44) had just one hypoglycemic episode during study period. Among insulin-naïve patients, incidence of hypoglycemia differed significantly depending on age, diabetic complications, estimated glomerular filtration rate (eGFR), and postprandial plasma glucose (P multivariate adjusted model, poor renal function (eGFR <60 mL/min/1.73 m2) was a statistically significant risk factor (P < 0.05). Our results suggest that BOT using insulin glargine is an option of insulin therapy with 1% risk of hypoglycemia in patients with T2DM with inadequate glycemic control. Patients with low renal function might need a careful follow-up.

  11. Suppressive therapy versus episodic therapy with oral valacyclovir for recurrent herpes labialis: efficacy and tolerability in an open-label, crossover study.

    Science.gov (United States)

    Gilbert, Stanley C

    2007-04-01

    Oral valacyclovir's efficacy and tolerability as suppressive therapy versus episodic therapy were compared for recurrent herpes labialis (RHL). Subjects with a history of at least 3 RHL episodes in the past year were randomized to receive 6 months of oral valacyclovir episodic therapy at the first sign of prodrome (two 2-g doses separated by 12 hours) and 6 months of oral valacyclovir suppressive therapy (1 g once daily) for 6 months in open-label, crossover fashion. The mean +/- SE number of recurrences per 120 days of follow-up (primary endpoint) was lower with suppressive therapy (0.30 +/- 0.41) than episodic therapy (0.71 +/- 0.79) (P 180 days) for suppressive therapy (P = 0.021). Data for secondary efficacy endpoints (pain severity score, mean duration of recurrences, maximal total lesion area) showed approximately a 30% to 50% reduction in mean values with suppressive therapy compared with episodic therapy, but results were statistically significantly different between the regimens for pain severity only. The percentage of subjects with at least one adverse event over 6 months of treatment that was considered to be drug related was 3% with suppressive therapy and 6% with episodic therapy. Suppressive therapy with oral valacyclovir was more effective than episodic therapy with oral valacyclovir in reducing the frequency of recurrences of herpes labialis and prolonging the time to first recurrence and was also similarly well-tolerated.

  12. Honey - A Novel Antidiabetic Agent

    Directory of Open Access Journals (Sweden)

    Omotayo O. Erejuwa, Siti A. Sulaiman, Mohd S. Ab Wahab

    2012-01-01

    Full Text Available Diabetes mellitus remains a burden worldwide in spite of the availability of numerous antidiabetic drugs. Honey is a natural substance produced by bees from nectar. Several evidence-based health benefits have been ascribed to honey in the recent years. In this review article, we highlight findings which demonstrate the beneficial or potential effects of honey in the gastrointestinal tract (GIT, on the gut microbiota, in the liver, in the pancreas and how these effects could improve glycemic control and metabolic derangements. In healthy subjects or patients with impaired glucose tolerance or diabetes mellitus, various studies revealed that honey reduced blood glucose or was more tolerable than most common sugars or sweeteners. Pre-clinical studies provided more convincing evidence in support of honey as a potential antidiabetic agent than clinical studies did. The not-too-impressive clinical data could mainly be attributed to poor study designs or due to the fact that the clinical studies were preliminary. Based on the key constituents of honey, the possible mechanisms of action of antidiabetic effect of honey are proposed. The paper also highlights the potential impacts and future perspectives on the use of honey as an antidiabetic agent. It makes recommendations for further clinical studies on the potential antidiabetic effect of honey. This review provides insight on the potential use of honey, especially as a complementary agent, in the management of diabetes mellitus. Hence, it is very important to have well-designed, randomized controlled clinical trials that investigate the reproducibility (or otherwise of these experimental data in diabetic human subjects.

  13. Gene therapy in the management of oral cancer: review of the literature.

    Science.gov (United States)

    Ayllón Barbellido, Sonia; Campo Trapero, Julián; Cano Sánchez, Jorge; Perea García, Miguel A; Escudero Castaño, Nayra; Bascones Martínez, Antonio

    2008-01-01

    Gene therapy essentially consists of introducing specific genetic material into target cells without producing toxic effects on surrounding tissue. Advances over recent decades in the surgical, radiotherapeutic and chemotherapeutic treatment of oral cancer patients have not produced a significant improvement in patient survival. Increasing interest is being shown in developing novel therapies to reverse oral epithelial dysplastic lesions. This review provides an update on transfer techniques, therapeutic strategies, and the clinical applications and limitations of gene therapy in the management of oral cancer and precancer. We highlight the combination of gene therapy with chemotherapy (e.g., 5-Fluoracil) and immunotherapy, given the promising results obtained in the use of adenovirus to act at altered gene level (e.g., p53). Other techniques such as suicide gene therapy, use of oncolytic viruses or the use of antisense RNA have shown positive although very preliminary results. Therefore, further research into these promising gene therapy techniques is required to assess their true efficacy and safety in the management of these lesions.

  14. Does hormone replacement therapy and use of oral contraceptives increase the risk of non-melanoma skin cancer?

    DEFF Research Database (Denmark)

    Birch-Johansen, Fatima; Jensen, Allan; Olesen, Anne Braae

    2012-01-01

    We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women.......We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women....

  15. Oral ofloxacin therapy of Pseudomonas aeruginosa sepsis in mice after irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Brook, I.; Ledney, G.D. (Research Institute, Bethesda, MD (USA))

    1990-07-01

    Death subsequent to whole-body irradiation is associated with gram-negative bacterial sepsis. The effect of oral therapy with the new quinolone ofloxacin for orally acquired Pseudomonas aeruginosa infection was tested in B6D2F1 mice exposed to 7.0 Gy of bilateral radiation from 60Co. A dose of 10(7) organisms was given orally 2 days after irradiation, and therapy was started 1 day later. Only 4 of 20 untreated mice (20%) survived for at least 30 days compared with 19 of 20 mice (95%) treated with ofloxacin (P less than 0.005). P. aeruginosa was isolated from the livers of 21 to 28 untreated mice (75%), compared with only 2 of 30 treated mice (P less than 0.005). Ofloxacin reduced colonization of the ileum by P. aeruginosa; 24 of 28 untreated mice (86%) harbored the organisms, compared with only 5 of 30 (17%) with ofloxacin (P less than 0.005). This experiment was replicated twice, and similar results were obtained. These data illustrate the efficacy of the quinolone ofloxacin for oral therapy of orally acquired P. aeruginosa infection in irradiated hosts.

  16. Randomized controlled trial of oral vs intravenous therapy for the clinically diagnosed acute uncomplicated diverticulitis.

    LENUS (Irish Health Repository)

    Ridgway, P F

    2009-11-01

    Despite the high prevalence of hospitalization for left iliac fossa tenderness, there is a striking lack of randomized data available to guide therapy. The authors hypothesize that an oral antibiotic and fluids are not inferior to intravenous (IV) antibiotics and \\'bowel rest\\' in clinically diagnosed acute uncomplicated diverticulitis.

  17. Postoperative Bleeding Risk for Oral Surgery under Continued Clopidogrel Antiplatelet Therapy

    Directory of Open Access Journals (Sweden)

    Alexander Gröbe

    2015-01-01

    Full Text Available Object. To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin. Design. Retrospective single center observatory study of two study groups and a control group. Methods. A total of 64 and 60 oral osteotomy procedures carried out under continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were followed for two weeks for postoperative bleeding. Another 281 similar procedures were also followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis. Results. We observed postoperative bleeding in 2/281 (0.7% cases in the control group, in 1/64 (1.6% cases in the clopidogrel group, and in 2/60 (3.3% cases in the dual clopidogrel/aspirin group. The corresponding 95% confidence intervals are 0–1.7%, 0–4.7%, and 0–7.8%, respectively, and the incidences did not differ significantly among the three groups (P>0.09. Postoperative hemorrhage was treated successfully in all cases with local measures. No changes of antiplatelet medication, transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded. Conclusions. Our results indicate that minor oral surgery can be performed safely under continued monoantiplatelet medication with clopidogrel or dual antiplatelet medication with clopidogrel/aspirin.

  18. Head and neck intensity modulated radiation therapy leads to an increase of opportunistic oral pathogens

    NARCIS (Netherlands)

    Schuurhuis, Jennifer M.; Stokman, Monique A.; Witjes, Max J. H.; Langendijk, Johannes A.; van Winkelhoff, Arie J.; Vissink, Arjan; Spijkervet, Frederik K. L.

    2016-01-01

    Objectives: The introduction of intensity modulated radiation therapy (IMRT) has led to new possibilities in the treatment of head and neck cancer (HNC). Limited information is available on how this more advanced radiation technique affects the oral microflora. In a prospective study we assessed the

  19. Basic evidence of molecular targeted therapy for oral cancer and salivary gland cancer.

    NARCIS (Netherlands)

    Hamakawa, H.; Nakashiro, K.; Sumida, T.; Shintani, S.; Myers, J.N.; Takes, R.P.; Rinaldo, A.; Ferlito, A.

    2008-01-01

    BACKGROUND: Recently, attention has been focused on molecular targeted cancer therapy in various tumors. Although there is no single consistent molecular target specific for oral squamous cell carcinoma (OSCC) and salivary gland cancer (SGC), there are a number of promising candidate proteins. The a

  20. Stabilization of oral anticoagulant therapy in hospitalized patients and characteristics associated with lack of stabilization

    NARCIS (Netherlands)

    van den Bemt, PMLA; Joosten, P; Risselada, A; van den Boogaart, MHA; Egberts, ACG; Brouwers, JRBJ

    2000-01-01

    The initiation and stabilization of oral anticoagulant therapy in hospitalized patients in a setting without specialized medical or pharmaceutical advice, was studied. In addition, potential risk factors for lack of stabilization were studied. All patients from three wards (orthopaedic surgery, gene

  1. Childhood vitiligo : Response to methylprednisolone oral minipulse therapy and topical fluticasone combination

    Directory of Open Access Journals (Sweden)

    Majid Imran

    2009-01-01

    Full Text Available Background: Childhood vitiligo is always a challenge to treat, especially when the disease is progressing rapidly in such a patient. Oral minipulse with betamethasone has been tried in childhood vitiligo and also in some other immune mediated skin disorders with good results. Aims: The aim of the present study was to see the overall efficacy of methylprednisolone oral minipulse therapy in combination with topical fluticasone in progressive childhood vitiligo. The combination was tried to achieve a significant amount of repigmentation of vitiligo lesions already present at the initial visit. Materials and Methods: Four hundred children with progressive vitiligo were enrolled for this study and were prescribed oral methylprednisolone on two consecutive days every week in a minipulse form for a period of six months. In addition, the patients were instructed to apply fluticasone ointment topically once a day on their vitiligo lesions. The patients were assessed for the remission achieved as well as the extent of repigmentation of their already existent lesions. Results: More than 90% of patients went into complete remission after the start of the therapy. Moreover, about 65% (two-thirds of patients achieved good to excellent repigmentation of lesions at the end of six months of therapy. The therapy was also well tolerated and the side effects seen were almost negligible. Conclusions: Oral minipulse treatment with methylprednisolone is an effective treatment option for controlling the disease spread in childhood vitiligo and with the addition of topical fluticasone the extent of repigmentation achieved is also quite significant.

  2. Antimicrobial Photodynamic Therapy to treat chemotherapy-induced oral lesions: Report of three cases.

    Science.gov (United States)

    Rocha, Breno Amaral; Melo Filho, Mário Rodrigues; Simões, Alyne

    2016-03-01

    The development of Angular Cheilitis and the reactivation of Herpes Simplex Virus, could be related to a decrease in the resistance of the immune system in the infected host, being common in cancer patients receiving antineoplastic chemotherapy. The objective of the present manuscript is to report Antimicrobial Photodynamic Therapy as a treatment of infected oral lesions of patients submitted to chemotherapy.

  3. Oral Vancomycin Therapy in a Child with Primary Sclerosing Cholangitis and Severe Ulcerative Colitis

    Science.gov (United States)

    Buness, Cynthia; Miloh, Tamir

    2016-01-01

    Primary sclerosing cholangitis (PSC), a rare progressive liver disease characterized by cholestasis and bile duct fibrosis, has no accepted, effective therapy known to delay or arrest its progression. We report a 15 year old female patient diagnosed with PSC and moderate chronic active ulcerative colitis (UC) who achieved normalization of her liver enzymes and bile ducts, and resolution of her UC symptoms with colonic mucosal healing, after treatment with a single drug therapy of the antibiotic oral vancomycin. We postulate that the oral vancomycin may be acting both as an antibiotic by altering the intestinal microbiome and as an immunomodulator. Oral vancomycin may be a promising treatment for PSC that needs to be further studied in randomized trials. PMID:27738604

  4. Pharmacological investigations of the anti-diabetic effect of Cortex Moutan and its active component paeonol.

    Science.gov (United States)

    Lau, C H; Chan, C M; Chan, Y W; Lau, K M; Lau, T W; Lam, F C; Law, W T; Che, C T; Leung, P C; Fung, K P; Ho, Y Y; Lau, C B S

    2007-11-01

    Cortex Moutan (CM, root bark of Paeonia suffruticosa Andr.) is one of the common herbs found in anti-diabetic traditional Chinese medicine formulae. To study the potential anti-diabetic mechanisms of CM, four in vitro models (intestinal brush border membrane vesicles (BBMV), rat hepatoma cell line H4IIE, human skin fibroblasts cell line Hs68 and mouse adipocytes 3T3-L1) were used. CM showed significant in vitro anti-diabetic effects by inhibiting glucose uptake of BBMV and enhancing glucose uptake into Hs68 and 3T3-L1 cells. Using bioassay-guided fractionation, paeonol was confirmed to be one of the active constituents for inhibiting BBMV glucose uptake. With neonatal-streptozotocin diabetic rats, paeonol (200 and 400mg/kgbody wt.) was found to improve oral glucose tolerance in vivo. To the best of our knowledge, this is the first report on the anti-diabetic effect of paeonol.

  5. Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 3: oral therapies.

    Science.gov (United States)

    Del Rosso, James Q; Harper, Julie C; Graber, Emmy M; Thiboutot, Diane; Silverberg, Nanette B; Eichenfield, Lawrence F

    2015-12-01

    Parts 1 and 2 of this 3-part series provided an overview of the epidemiology, visible patterns, and important considerations for clinical and laboratory evaluation of acne vulgaris (AV) in adult women and reviewed the role of proper skin care and topical therapies in this patient population. In Part 3, oral therapies including combination oral contraceptives, spironolactone, antibiotics, and isotretinoin are discussed along with important considerations that clinicians should keep in mind when selecting oral agents for management of AV in adult women.

  6. Antidiabetic treatment with gliptins: focus on cardiovascular effects and outcomes.

    Science.gov (United States)

    Fisman, Enrique Z; Tenenbaum, Alexander

    2015-01-01

    The traditional oral pharmacological therapy for type 2 diabetes mellitus (T2DM) has been based on the prescription of metformin, a biguanide, as first line antihyperglycemic agent world over. It has been demonstrated that after 3 years of treatment, approximately 50% of diabetic patients could achieve acceptable glucose levels with monotherapy; but by 9 years this had declined to only 25%. Therefore, the implementation of a combined pharmacological therapy acting via different pathways becomes necessary, and its combination with a compound of the sulfonylurea group was along decades the most frequently employed prescription in routine clinical practice. Meglitinides, glitazones and alpha-glucosidase inhibitors were subsequently developed, but the five mentioned groups of oral antihyperglycemic agents are associated with variable degrees of undesirable or even severe cardiovascular events. The gliptins-also called dipeptidyl peptidase 4 (DPP4) inhibitors--are an additional group of antidiabetic compounds with increasing clinical use. We review the status of the gliptins with emphasis on their capabilities to positively or negatively affect the cardiovascular system, and their potential involvement in major adverse cardiovascular events (MACE). Alogliptin, anagliptin, linagliptin, saxagliptin, sitagliptin, teneligliptin and vildagliptin are the compounds currently in clinical use. Regardless differences in chemical structure and metabolic pathways, gliptins as a group exert favorable changes in experimental models. These changes, as an almost general rule, include improved endothelial function, reduction of inflammatory markers, oxidative stress ischemia/reperfusion injury and atherogenesis. In addition, increased adiponectin levels and modest decreases in lipidemia and blood pressure were reported. In clinical settings, several trials--notably the longer one, employing sitagliptin, with a mean follow-up period of 3 years--did not show an increased risk for ischemic

  7. Update - Behandlung der Multiplen Sklerose: Orale Therapie und neue Biologika

    Directory of Open Access Journals (Sweden)

    Seifert-Held T

    2014-01-01

    Full Text Available In der Schubprophylaxe der Multiplen Sklerose werden künftig mehrere, oral einzunehmende Substanzen zur Verfügung stehen, die in dieser Übersichtsarbeit in ihrer aus klinischen Phase-III-Studien bekannten Wirkung und dem Nebenwirkungsprofil dargestellt werden. Mit Fingolimod findet sich darunter die in der Medizin neue Substanzklasse der Sphingosin-1- Phosphat-Rezeptor-Modulatoren. Andere Präparate (Teriflunomid, Dimethylfumarat sind bereits aus Anwendungen in der Rheumatologie und Dermatologie bekannt. In der Hämatologie verwendete Lymphozyten-depletierende monoklonale Antikörper (Alemtuzumab, Anti-CD20-Antikörper können künftig möglicherweise auch als Optionen zur Therapieeskalation zur Verfügung stehen.

  8. Adverse effects of oral antiviral therapy in chronic hepatitis B

    Science.gov (United States)

    Kayaaslan, Bircan; Guner, Rahmet

    2017-01-01

    Oral nucleoside/nucleotide analogues (NAs) are currently the backbone of chronic hepatitis B (CHB) infection treatment. They are generally well-tolerated by patients and safe to use. To date, a significant number of patients have been treated with NAs. Safety data has accumulated over the years. The aim of this article is to review and update the adverse effects of oral NAs. NAs can cause class adverse effects (i.e., myopathy, neuropathy, lactic acidosis) and dissimilar adverse effects. All NAs carry a “Black Box” warning because of the potential risk for mitochondrial dysfunction. However, these adverse effects are rarely reported. The majority of cases are associated with lamivudine and telbivudine. Adefovir can lead to dose- and time-dependent nephrotoxicity, even at low doses. Tenofovir has significant renal and bone toxicity in patients with human immunodeficiency virus (HIV) infection. However, bone and renal toxicity in patients with CHB are not as prominent as in HIV infection. Entecavir and lamivudine are not generally associated with renal adverse events. Entecavir has been claimed to increase the risk of lactic acidosis in decompensated liver disease and high Model for End-Stage Liver Disease scores. However, current studies reported that entecavir could be safely used in decompensated cirrhosis. An increase in fetal adverse events has not been reported with lamivudine, telbivudine and tenofovir use in pregnant women, while there is no adequate data regarding entecavir and adefovir. Further long-term experience is required to highlight the adverse effects of NAs, especially in special patient populations, including pregnant women, elderly and patients with renal impairment. PMID:28261380

  9. Glycated hemoglobin and antidiabetic strategies as risk factors for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Valter; Donadon; Massimiliano; Balbi; Francesca; Valent; Angelo; Avogaro

    2010-01-01

    AIM: To evaluate the relationship between glycemic control [assessed by glycated hemoglobin (HbA1c)], antidiabetic therapies and the risk of hepatocellular carcinoma (HCC).METHODS: We recruited 465 patients with HCC, 618 cases with liver cirrhosis and 490 controls with no liver disease. Among subjects with type 2 diabetes mellitus (DM2), the associations between the antidiabetic strategies and HbA1c level with HCC were determined through 2 series of multivariate logistic regression models using cirrhotic pa...

  10. The effect on cartilage of different forms of application of postmenopausal estrogen therapy: comparison of oral and transdermal therapy

    DEFF Research Database (Denmark)

    Ravn, Pernille; Warming, Lise; Christgau, Stephan

    2004-01-01

    -estradiol+1 mg drosperinone or 1 mg 17-beta-estradiol+2 mg drosperinone or 1 mg 17-beta-estradiol+3 mg drosperinone or placebo. Doses in the transdermal estradiol treatment groups (continuous combined therapy) were 45 microg 17-beta-estradiol+30 levonorgestrel or 45 microg 17-beta-estradiol+40 microg...... levonorgestrel or placebo. The effect of oral and transdermal estradiol therapy on cartilage degradation was reflected as a decrease of 19-30% in uCTX-II (P=0.02 and P=0.003 vs. placebo) after 1 year of treatment. uCTX-I decreased 70% (P

  11. Relapse after Oral Terbinafine Therapy in Dermatophytosis: A Clinical and Mycological Study

    Science.gov (United States)

    Majid, Imran; Sheikh, Gousia; Kanth, Farhath; Hakak, Rubeena

    2016-01-01

    Background: The incidence of recurrent tinea infections after oral terbinafine therapy is on the rise. Aim: This study aims to identify the appearance of incomplete cure and relapse after 2-week oral terbinafine therapy in tinea corporis and/or tinea cruris. Materials and Methods: A total of 100 consecutive patients clinically and mycologically diagnosed to have tinea corporis and/or tinea cruris were included in the study. The enrolled patients were administered oral terbinafine 250 mg once daily for 2 weeks. All clinically cured patients were then followed up for 12 weeks to look for any relapse/cure. Results: The common dermatophytes grown on culture were Trichophyton rubrum and Trichophyton tonsurans in 55% and 20% patients, respectively. At the end of 2-week oral terbinafine therapy, 30% patients showed a persistent disease on clinical examination while 35% patients showed a persistent positive fungal culture (persisters) at this time. These culture positive patients included all the clinically positive cases. Rest of the patients (65/100) demonstrated both clinical and mycological cure at this time (cured). Over the 12-week follow-up, clinical relapse was seen in 22 more patients (relapse) among those who had shown clinical and mycological cure at the end of terbinafine therapy. Thus, only 43% patients could achieve a long-term clinical and mycological cure after 2 weeks of oral terbinafine treatment. Majority of the relapses (16/22) were seen after 8 weeks of completion of treatment. There was no statistically significant difference in the body surface area involvement or the causative organism involved between the cured, persister, or relapse groups. Conclusions: Incomplete mycological cure as well as relapse is very common after standard (2-week) terbinafine therapy in our patients of tinea cruris/corporis. PMID:27688443

  12. Relapse after oral terbinafine therapy in dermatophytosis: A clinical and mycological study

    Directory of Open Access Journals (Sweden)

    Imran Majid

    2016-01-01

    Full Text Available Background: The incidence of recurrent tinea infections after oral terbinafine therapy is on the rise. Aim: This study aims to identify the appearance of incomplete cure and relapse after 2-week oral terbinafine therapy in tinea corporis and/or tinea cruris. Materials and Methods: A total of 100 consecutive patients clinically and mycologically diagnosed to have tinea corporis and/or tinea cruris were included in the study. The enrolled patients were administered oral terbinafine 250 mg once daily for 2 weeks. All clinically cured patients were then followed up for 12 weeks to look for any relapse/cure. Results: The common dermatophytes grown on culture were Trichophyton rubrum and Trichophyton tonsurans in 55% and 20% patients, respectively. At the end of 2-week oral terbinafine therapy, 30% patients showed a persistent disease on clinical examination while 35% patients showed a persistent positive fungal culture (persisters at this time. These culture positive patients included all the clinically positive cases. Rest of the patients (65/100 demonstrated both clinical and mycological cure at this time (cured. Over the 12-week follow-up, clinical relapse was seen in 22 more patients (relapse among those who had shown clinical and mycological cure at the end of terbinafine therapy. Thus, only 43% patients could achieve a long-term clinical and mycological cure after 2 weeks of oral terbinafine treatment. Majority of the relapses (16/22 were seen after 8 weeks of completion of treatment. There was no statistically significant difference in the body surface area involvement or the causative organism involved between the cured, persister, or relapse groups. Conclusions: Incomplete mycological cure as well as relapse is very common after standard (2-week terbinafine therapy in our patients of tinea cruris/corporis.

  13. A STUDY OF COMPARATIVE EFFEICIENCY OF ORAL MINI PULSE THERAPY VERSUS ORAL ACITRET IN IN GENARALISED LICHEN PLANUS

    Directory of Open Access Journals (Sweden)

    Guru Prasad

    2015-10-01

    Full Text Available BACKGROUND: Lichen planus is a chronic inflammatory disease that effects skin, mucous membranes, hair and nails. There are several drugs both topical and systemic for the treatment of lichen planus. AIMS AND OBJECTIVES: Present study was done to compare the efficacy between oral mini pulse therapy with betamethasone and with acetretin in the management of generalised lichen planus. MATERIALS AND METHODS: The study was carried out on patients who were clinically diagnosed as generalised lichen plan us, attending the outpatient department of dermatology, venereology and leprosy, King George hospital, affiliated to Andhra medical college, Vis h akhapatnam from November 2011 to December 2012. A total of 60 patients were included in study and divided into two equal groups. Group1 patients were treated with 0.1 mg/kg of oral betamethasone given on 2 consecutive days in a week till 8 weeks and tapered. Group 2 patients were treated with 0.5 mg/kg of acetretin for 8 weeks and tapered. INCLUSION CRITERIA: All pa tients of age group in between 11 - 60 years , of either sex, suffering f rom lichen planus of duration > 3 months, and women in group 2 who were in reproductive age group on two methods of contraception were included. EXCLUSION CRITERIA: Pregnant and lactating women, in Group 1: patients suffering from diabetes, hypertension, peptic ulcer disease, renal, hepatic, heart disease or tuberculosis, in Group 2: patients with abnormal lipid profile, diabetes, hypertension, renal, liver or heart disease were excluded. RESULTS: out of 60 patients enrolled in study, 2 patients from group 1 and 5 patients from group 2 were dropped from study and results were concluded. Majority of patients were in age group of 31 - 60 (78.3% with male to female ratio of 2.1:1.Group 1 patient s at the end of 8 weeks response was seen in 92.8%, with relapse rate of 15.38% after 6 months of follow up. Group 2 patients at end of 8 weeks response was seen in 72 % with relapse

  14. Antiplatelet therapy for stable coronary artery disease in atrial fibrillation patients taking an oral anticoagulant

    DEFF Research Database (Denmark)

    Lamberts, Morten; Gislason, Gunnar H.; Lip, Gregory Y. H.

    2014-01-01

    Background The optimal long-term antithrombotic treatment of patients with coexisting atrial fibrillation and stable coronary artery disease is unresolved, and commonly, a single antiplatelet agent is added to oral anticoagulation. We investigated the effectiveness and safety of adding antiplatelet...... or thromboembolism, whereas risk of bleeding is increased significantly. The common practice of adding antiplatelet therapy to oral VKA anticoagulation in patients with atrial fibrillation and stable coronary artery disease warrants reassessment........23-1.82]) or clopidogrel (hazard ratio, 1.84 [95% confidence interval, 1.11-3.06]) was added to VKA. Conclusions In atrial fibrillation patients with stable coronary artery disease, the addition of antiplatelet therapy to VKA therapy is not associated with a reduction in risk of recurrent coronary events...

  15. The anti-diabetic effects and pharmacokinetic profiles of berberine in mice treated with Jiao-Tai-Wan and its compatibility.

    Science.gov (United States)

    Chen, Guang; Lu, Fuer; Xu, Lijun; Dong, Hui; Yi, Ping; Wang, Fang; Huang, Zhaoyi; Zou, Xin

    2013-07-15

    Jiao-Tai-Wan (JTW), a classical Chinese prescription, has been clinically employed to treat diabetes mellitus in recent years. To investigate the comparative evaluations on anti-diabetic effects and pharmacokinetics of the active ingredient berberine in mice treated with JTW in various combinations of its constituent herbs. In our study, the anti-diabetic study was carried out in diabetic mice induced by intraperitoneal injection of streptozotocin. The diabetic mice were randomly assigned to three therapy groups and orally administered with different prescription proportions of Rhizoma Coptidis and Cinnamomum cassia respectively. The level of plasma glucose, lipid profile and parameters related to oxidative stress were determined. The concentrations of berberine in non-diabetic mice plasma were determined using HPLC, and main pharmacokinetic parameters were investigated. The results indicated that the compatibility effects of ingredients present in Cinnamomum cassia could affect the anti-diabetic ability and pharmacokinetics of berberine in JTW. Copyright © 2013 Elsevier GmbH. All rights reserved.

  16. Antidiabetic potential of Conocarpus lancifolius

    Directory of Open Access Journals (Sweden)

    Malik Saadullah

    2014-06-01

    Full Text Available The antidiabetic activity of Conocarpus lancifolius extract was investigated in vitro, as alpha glucosidase inhibition and in vivo as alloxan induced diabetic rabbits with other biochemical parameters (LDL, HDL, SGPT, SGOT, cretinine, urea and triglyceride. Alpha-glucosidase inhibition activity was performed by using acorbose as standred. Methanolic extract show alpha-glucosidase inhibition activity. The dose of 200 mg/kg body weight significantly (p<0.05 decreases the blood glucose level, plasma total cholesterol, triglycerides and LDL in treated rabbits as compared to diabetic rabbits. This dose significantly increased the level of HDL in treated group. The activity of SGOT and SGPT also significantly (p<0.05 decreased in treated diabetic rabbits. Phytochemical studies show the presence of glycosides, tannins, saponins and terpenoids. The antidiabetic potential is may be due to its saponin contents.

  17. Effects of Long Term Antibiotic Therapy on Human Oral and Fecal Viromes.

    Directory of Open Access Journals (Sweden)

    Shira R Abeles

    Full Text Available Viruses are integral members of the human microbiome. Many of the viruses comprising the human virome have been identified as bacteriophage, and little is known about how they respond to perturbations within the human ecosystem. The intimate association of phage with their cellular hosts suggests their communities may change in response to shifts in bacterial community membership. Alterations to human bacterial biota can result in human disease including a reduction in the host's resilience to pathogens. Here we report the ecology of oral and fecal viral communities and their responses to long-term antibiotic therapy in a cohort of human subjects. We found significant differences between the viral communities of each body site with a more heterogeneous fecal virus community compared with viruses in saliva. We measured the relative diversity of viruses, and found that the oral viromes were significantly more diverse than fecal viromes. There were characteristic changes in the membership of oral and fecal bacterial communities in response to antibiotics, but changes in fecal viral communities were less distinguishing. In the oral cavity, an abundance of papillomaviruses found in subjects on antibiotics suggests an association between antibiotics and papillomavirus production. Despite the abundance of papillomaviruses identified, in neither the oral nor the fecal viromes did antibiotic therapy have any significant impact upon overall viral diversity. There was, however, an apparent expansion of the reservoir of genes putatively involved in resistance to numerous classes of antibiotics in fecal viromes that was not paralleled in oral viromes. The emergence of antibiotic resistance in fecal viromes in response to long-term antibiotic therapy in humans suggests that viruses play an important role in the resilience of human microbial communities to antibiotic disturbances.

  18. GLP-1 biology and GLP-1 based antidiabetic therapy%GLP-1生物学及基于GLP-1的抗糖尿病药物研究

    Institute of Scientific and Technical Information of China (English)

    易凡; 李栋; 马伟志; 杜权

    2013-01-01

    在过去的几十年中,环境和生活方式的改变使得2型糖尿病患者的数量急剧增加,其中一个重要的病理基础是胰岛素分泌缺陷.胰高血糖素样肽1(GLP-1)是一种由肠道细胞产生及分泌的多肽激素,该激素以葡萄糖浓度依赖性方式促进胰岛β细胞分泌胰岛素,调节血糖水平.研究表明GLP-1是糖尿病治疗中的一个有效靶点,药物研发目前主要集中于GLP-1受体激动剂和降解酶抑制剂两个方面.以其强大的生物学活性为基础,GLP-1药物在临床上表现出高效、低副作用的显著优势.在此,我们对GLP-1生物学和基于GLP-1的抗糖尿病药物研发进行综述.%Environmental and lifestyle factors together account for the dramatic increase of type 2 diabetes in the past decades,in which defective insulin secretion emerges as the major culprit.Glucagon-like peptide 1 (GLP-1) is a peptide secreted from the intestine in response to nutrient ingestion,and plays an essential role in the regulation of blood glucose level by stimulating glucoses-dependent insulin secretion.Recently,GLP-1 develops to be a viable therapeutic target for the treatment of type 2 diabetes,by means of GLP-1 receptor agonists and dipeptidyl peptidase-4 inhibitors.Stemmed from its potent physiological activities,GLP-l-based therapies are clinically efficient and safe for both early and late stages of the disease,with low risk of adverse events.In this review,a comprehensive understanding of GLP-1 biology and the recent development ofGLP-l-based antidiabetic therapy are summarized.

  19. TransOral Robotic Photodynamic Therapy for the Oropharynx

    Science.gov (United States)

    Quon, Harry; Finlay, Jarod; Cengel, Keith; Zhu, Timothy; O’Malley, Bert; Weinstein, Gregory

    2015-01-01

    Photodynamic therapy (PDT) has been used for head and neck carcinomas with little experience in the oropharynx due to technical challenges in achieving adequate exposure. We present the case of a patient with a second right tonsil carcinoma following previous treatment with transoral robotic surgery (TORS) and postoperative chemoradiation for a left tonsil carcinoma. Repeat TORS for the right tonsil carcinoma reviewed multiple positive surgical margins. The power output from the robotic camera was modified to facilitate safe intraoperative three dimensional visualization of the tumor bed. The robotic arms facilitated clear exposure of the tonsil and tongue base with stable administration of the fluence. Real-time measurements confirmed stable photobleaching with augmentation of the prescribed light fluence secondary to light scatter in the oropharynx. We report a potential new role using TORS for exposure and accurate PDT in the oropharynx. PMID:21333937

  20. A decision-algorithm defining the rehabilitation approach: 'Facial oral tract therapy'

    DEFF Research Database (Denmark)

    Hansen, Trine S; Jakobsen, Daniela

    2010-01-01

    and eating; oral hygiene; breathing, voice, and speech articulation; facial expression, giving guidance on interventions. The algorithm outlines all important components in the treatment that the therapist should decide to use or not to use in the intervention. The algorithm is supported by a manual......AIM: The aim of this study was to describe and define the rehabilitation approach: 'Facial Oral Tract Therapy' (F.O.T.T.). METHOD: We defined the content and process of the rehabilitation approach (F.O.T.T.) in a decision-algorithm supported by a manual with supplementary material. The algorithm...

  1. Prospects in the Application of Photodynamic Therapy in Oral Cancer and Premalignant Lesions

    Directory of Open Access Journals (Sweden)

    Rajan Saini

    2016-09-01

    Full Text Available Oral cancer is a global health burden with significantly poor survival, especially when the diagnosis is at its late stage. Despite advances in current treatment modalities, there has been minimal improvement in survival rates over the last five decades. The development of local recurrence, regional failure, and the formation of second primary tumors accounts for this poor outcome. For survivors, cosmetic and functional compromises resulting from treatment are often devastating. These statistics underscore the need for novel approaches in the management of this deadly disease. Photodynamic therapy (PDT is a treatment modality that involves administration of a light-sensitive drug, known as a photosensitizer, followed by light irradiation of an appropriate wavelength that corresponds to an absorbance band of the sensitizer. In the presence of tissue oxygen, cytotoxic free radicals that are produced cause direct tumor cell death, damage to the microvasculature, and induction of inflammatory reactions at the target sites. PDT offers a prospective new approach in controlling this disease at its various stages either as a stand-alone therapy for early lesions or as an adjuvant therapy for advanced cases. In this review, we aim to explore the applications of PDT in oral cancer therapy and to present an overview of the recent advances in PDT that can potentially reposition its utility for oral cancer treatment.

  2. Laser therapy and sclerotherapy in the treatment of oral and maxillofacial hemangioma and vascular malformations

    Science.gov (United States)

    Crişan, Bogdan; BǎciuÅ£, Mihaela; BǎciuÅ£, Grigore; Crişan, Liana; Bran, Simion; Rotar, Horatiu; Moldovan, Iuliu; Vǎcǎraş, Sergiu; Mitre, Ileana; Barbur, Ioan; Magdaş, Andreea; Dinu, Cristian

    2016-03-01

    Hemangioma and vascular malformations in the field of oral and maxillofacial surgery is a pathology more often found in recent years in patients. The aim of this study was to evaluate the efficacy of the laser photocoagulation performed with a diode laser (Ga-Al-As) 980 nm wavelength in the treatment of vascular lesions which are located on the oral and maxillofacial areas, using color Doppler ultrasonography for evaluation of the results. We also made a comparison between laser therapy and sclerotherapy in order to establish treatment protocols and recommendations associated with this pathology. We conducted a controlled study on a group of 92 patients (38 male and 54 female patients, with an average age of 36 years) having low flow hemangioma and vascular malformations. Patients in this trial received one of the methods of treatment for vascular lesions such as hemangioma and vascular malformations: laser therapy or sclerotherapy. After laser therapy we have achieved a reduction in size of hemangioma and vascular malformations treated with such a procedure, and the aesthetic results were favorable. No reperfusion or recanalization of laser treated vascular lesions was observed after an average follow-up of 6 to 12 months. In case of sclerotherapy a reduction in the size of vascular lesions was also obtained. The 980 nm diode laser has been proved to be an effective tool in the treatment of hemangioma and vascular malformations in oral and maxillofacial area. Laser therapy in the treatment of vascular lesions was more effective than the sclerotherapy procedure.

  3. 5-Aminolevulinic acid-mediated photodynamic therapy for oral cancers and precancers

    Directory of Open Access Journals (Sweden)

    Hsin-Ming Chen

    2012-12-01

    Full Text Available Previous studies have used both systemic and topical 5-aminolevulinic acid (ALA-mediated photodynamic therapy (PDT to treat oral precancers including oral leukoplakia (OL, oral erythroleukoplakia (OEL, and oral verrucous hyperplasia (OVH as well as oral cancers including oral verrucous carcinoma (OVC and oral squamous cell carcinoma (OSCC. Systemic ALA-PDT has been used to treat oral dysplastic lesions and oral cancers with promising clinical outcomes. The efficacy of a regular topical ALA-PDT (fluence rate, 100 mW/cm2; light dose, 100 J/cm2 was tested on an extensive buccal OVC and an enhanced topical ALA-PDT (fluence rate, 200 mW/cm2; light dose, 200 J/cm2 on an early-invasive OSCC; complete regression of the carcinomas was demonstrated after 28 and 18 PDT treatments, respectively. Several previous studies showed relatively good outcomes for OL lesions treated with topical ALA-PDT. However, it was found that the regular topical ALA-PDT is very effective for OVH and OEL lesions but less so for OL lesions. Better PDT outcomes are significantly associated with OVH and OEL lesions with smaller size, pink to red color, epithelial dysplasia, or thinner surface keratin layer. Moreover, the thicker surface keratin layer on the OL lesions is responsible for the relatively poorer PDT outcomes for OL lesions. In addition, both light emitting diode light- and laser light-mediated topical ALA-PDTs are comparative treatment modalities for OVH and OEL lesions. Methotrexate- or vitamin D3-preconditioned prostate or skin carcinoma cells can accumulate more intracellular protoporphyrin IX, resulting in an increased killing of these preconditioned cells by subsequent ALA-PDT. Because chemotherapy can help destroy carcinoma cells and tumor-associated vasculatures and cryotherapy pretreatment may help the diffusion of ALA into lesional epithelial cells, the chemotherapy or cryotherapy-combined topical ALA-PDT may be a new effective PDT alternative for

  4. [Therapeutic effect of rebamipide for oral mucositis associated with FEC therapy for breast cancer].

    Science.gov (United States)

    Enami, Akiko; Masuda, Norikazu; Yamamura, Jun; Mizutani, Makiko; Yasojima, Hiroyuki; Shikata, Ayako; Masaoka, Miyuki; Takada, Seiko; Bamba, Nao; Yamamoto, Mie; Abe, Megumi; Makihara, Katsuya

    2014-11-01

    No guidelines for supportive drug therapy have been established for oral mucositis occurring during cancer chemotherapy. We retrospectively examined the progression of oral mucositis in 91 patients with breast cancer who received the 5-fluorouracil, epirubicin, and cyclophosphamide (FEC)-100 regimen between September 2007 and August 2008. Daily rebamipide was administered to patients with oral mucositis as per hospital protocol to evaluate the hypothesized preventive and mucosal protective effects of rebamipide(Mucosta®). Oral mucositis was observed in 43 patients (47%)during 4 courses of FEC. The median age of the patients was 55 years(range, 32-76 years). Of the 91 patients, 49 patients who did not receive rebamipide during the 4 FEC courses were classified as group A, 14 patients who received rebamipide before the start of FEC were classified as group B, and 28 patients who received rebamipide after developing oral mucositis were classified as group C. The incidence of oral mucositis at the start of FEC with or without rebamipide administration was observed in 5 patients in group B (36%) and 38 patients in groups A and C (49%) (p=0.3472). The mucositis grade was G1 in 4 patients and G2 in 1 patient in group B, and G1 in 20 patients and G2 plus G3 in 18 patients in groups A and C (p=0.2467). In group C, the grade decreased in 25 patients (89%) and did not occur (G0) in 17 patients (61%) during the next course, and 15 patients (54%) continued to the final course without any occurrence of mucositis. These results suggest that rebamipide is effective for the treatment of oral mucositis. Although significant differences were not observed in the groups, rebamipide has the potential to prevent development of oral mucositis and alleviate its symptoms, and seems promising as a new supportive drug therapy. We hope to verify the preventive and protective effects of rebamipide by conducting a prospective, randomized trial while treating oral mucositis with basic oral care

  5. Investigation of photodynamic therapy on streptococcus mutans of oral biofilm

    Institute of Scientific and Technical Information of China (English)

    Zhaohui Zou; Ping Gao; Huijuan Yin; Yingxin Li

    2008-01-01

    We investigated the effect of photodynamic therapy (PDT) with hematoporphyrin monomethyl ether (HMME) on the viability of Streptococcus mutans (S. mutans) cells on biofilms in vitro. Streptococcus mutans is the primary etiological agent of human dental caries. Since dental caries are localized infections, such plaque-related diseases would be well suited to PDT. The diode laser used in this study had the wavelength of 635 nm, whose output power was 10 mW and the energy density was 12.74 J/cm2. HMME was used as photosensitizer. Samples were prepared and divided into five groups: (1) HMME; (2) Laser; (3) HMME+Laser; (4) Control group (+) with chlorhexidine; and (5) Control group (-) with sterile physiological saline. Inoculum of S. mutans incubated with HMME also examined with fluorescence microscopy. PDT exhibited a significantly (P < 0.05) increased antimicrobial potential compared with 20 μm/mL HMME only, laser only, 0.05% chlorhexidine, and 0.9% sterile physiological saline, which reduced the S. mutans of the biofilm most effectively. Laser and 0.05% chlorhexidine were caused reduction in the viable counts of S. mutans significantly different (P < 0.05) also, but these two test treatments did not statistically differ from each other. HMME group did not statistically differ with negative control group. Fluorescence microscopy indicated that HMME localized primarily in the S. mutans of the biofilm. It was demonstrated that HMME-mediated PDT was efficient at killing S. mutans of biofilms and a useful approach in the treatment of dental plaque-related diseases.

  6. Oral contraceptive use, hormone replacement therapy, reproductive history and risk of colorectal cancer in women.

    Science.gov (United States)

    Kabat, Geoffrey C; Miller, Anthony B; Rohan, Thomas E

    2008-02-01

    Evidence from epidemiologic studies suggests a possible role of exogenous and endogenous hormones in colorectal carcinogenesis in women. However, with respect to exogenous hormones, in contrast to hormone replacement therapy, few cohort studies have examined oral contraceptive use in relation to colorectal cancer risk. We used data from a large cohort study of Canadian women enrolled in a randomized controlled trial of breast cancer screening to assess the association of oral contraceptive use, hormone replacement therapy and reproductive factors with risk of colorectal cancer, overall and by subsite within the colorectum. Cancer incidence and mortality were ascertained by linkage to national databases. Among 89,835 women aged 40-59 at enrollment and followed for an average of 16.4 years, we identified 1,142 incident colorectal cancer cases. Proportional hazards models were used to estimate the associations between the exposures of interest and risk of colorectal cancer. Ever use of oral contraceptives at baseline was associated with a modest reduction in the risk of colorectal cancer (hazard ratio 0.83, 95% confidence interval 0.73-0.94), with similar effects for different subsites within the colorectum. No trend was seen in the hazard ratios with increasing duration of oral contraceptive use. No associations were seen with use of hormone replacement therapy (ever use or duration of use) or reproductive factors. Our results are suggestive of an inverse association between oral contraceptive use and colorectal carcinogenesis. However, given the lack of a dose-response relationship and the potential for confounding, studies with more complete assessment of exogenous hormone use throughout the life course are needed to clarify this association. (c) 2007 Wiley-Liss, Inc.

  7. A review of traditional and novel oral anticoagulant and antiplatelet therapy for dermatologists and dermatologic surgeons.

    Science.gov (United States)

    Brown, Deanna G; Wilkerson, Eric C; Love, W Elliot

    2015-03-01

    Dermatologic surgeons will increasingly encounter patients on novel oral antiplatelet and anticoagulant medications. We conducted a complete overview of the pharmacokinetics, pharmacodynamics, and side effects of traditional and novel oral anticoagulant and antiplatelet therapies along with dietary supplements with anticoagulant or antiplatelet properties. A PubMed search was completed for "aspirin," "warfarin," "clopidogrel," "dabigatran," "rivaroxaban," "apixaban," "prasugrel," and "ticagrelor." Review articles and publications emphasizing perioperative management of oral anticoagulant or antiplatelet medications were selected. An additional PubMed search was completed for "hemorrhage," "bleeding," and "thrombosis" in conjunction with "dermatology," "dermatologic surgery," and "cutaneous surgery." Aspirin, clopidogrel, and warfarin have shortfalls in dosing, monitoring, and efficacy. Several trials show superior efficacy with dabigatran, rivaroxaban, and apixaban, with equal or reduced risk of bleeding compared with warfarin. Prasugrel and ticagrelor may be associated with an increased bleeding risk. Many over-the-counter medications also have anticoagulant properties with associated bleeding risks that cannot be overlooked. There are few publications evaluating the novel oral anticoagulants' effects on outpatient surgical procedures. Novel anticoagulant and antiplatelet drugs are revolutionizing therapy for cardiovascular diseases. As these medications become more prevalent, dermatologists and dermatologic surgeons must be mindful of the bleeding risk that will apply in our everyday practices. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  8. Responsiveness to parenteral iron therapy in children with oral iron-refractory iron-deficiency anemia.

    Science.gov (United States)

    Akin, Mehmet; Atay, Enver; Oztekin, Osman; Karadeniz, Cem; Karakus, Yasin Tugrul; Yilmaz, Bilal; Erdogan, Firat

    2014-02-01

    Intravenous (IV) ferric iron (Fe)-carbohydrate complexes are used for treating Fe deficiency in children with iron-refractory iron-deficiency anemia (IRIDA). An optimal treatment has yet to be determined. There are relatively little publications on the responsiveness to IV iron therapy in children with IRIDA. This study analyzed responses to IV iron sucrose therapy given to 11 children, ranging in age from 2 to 13 years (mean 4.8 years), with iron-deficiency anemia who were unresponsive to oral iron therapy. The hemoglobin and ferritin values (mean) of the 11 children with IRIDA were 7.7 g/dL and 4.8 ng/mL at diagnosis. Both hemoglobin and ferritin levels increased to 9.5 g/dL, and 24 ng/mL, respectively, at 6 weeks after the first therapy. Although the level of hemoglobin was steady at 6 months after the first, and 6 weeks after the second therapy, the ferritin levels continued to increase up to 30 ng/mL and 47 ng/mL at 6 months after the first and 6 weeks after the second therapy, respectively. We recommend that IRIDA should be considered in patients presenting with iron-deficiency anemia of unknown cause that is unresponsive to oral iron therapy. Our results suggest that IV iron therapy should be administered only once in cases of IRIDA. Continued administration of IV iron would be of no benefit to increase hemoglobin levels. On the contrary, ferritin levels may continue to increase resulting in untoward effects of hyperferritinemia.

  9. Effectiveness and tolerability of treatment intensification to basal–bolus therapy in patients with type 2 diabetes on previous basal insulin-supported oral therapy with insulin glargine or supplementary insulin therapy with insulin glulisine: the PARTNER observational study

    Directory of Open Access Journals (Sweden)

    Pfohl M

    2015-11-01

    Full Text Available Martin Pfohl,1 Thorsten Siegmund,2 Stefan Pscherer,3 Katrin Pegelow,4 Jochen Seufert5 1Medizinische Klinik I, Evangelisches Bethesda-Klinikum GmbH, Duisburg, Germany; 2Städtisches Klinikum München GmbH, Klinikum Bogenhausen, III. Medizinische Abteilung, München, Germany; 3Klinisches Diabeteszentrum Südostbayern, Innere Medizin – Diabetologie, Traunstein, Germany; 4Sanofi-Aventis Deutschland GmbH, Berlin, Germany; 5Medizinische Universitätsklinik, Klinik für Innere Medizin II, Abteilung für Endokrinologie und Diabetologie, Freiburg, Germany Background: Due to the progressive nature of type 2 diabetes mellitus (T2DM, antidiabetic treatment needs to be continuously intensified to avoid long-term complications. In T2DM patients on either basal insulin-supported oral therapy (BOT or supplementary insulin therapy (SIT presenting with HbA1c values above individual targets for 3–6 months, therapy should be intensified. This study investigated effectiveness and tolerability of an intensification of BOT or SIT to a basal–bolus therapy (BBT regimen in T2DM patients in daily clinical practice. Methods: This noninterventional, 8-month, prospective, multicenter study evaluated parameters of glucose control, occurrence of adverse events (eg, hypoglycemia, and acceptance of devices in daily clinical practice routine after 12 and 24 weeks of intensifying insulin therapy to a BBT regimen starting from either preexisting BOT with insulin glargine (pre-BOT or preexisting SIT with ≥3 daily injections of insulin glulisine (pre-SIT. Results: A total of 1,530 patients were documented in 258 German medical practices. A total of 1,301 patients were included in the full analysis set (55% male, 45% female; age median 64 years; body mass index median 30.8 kg/m2; pre-BOT: n=1,072; pre-SIT: n=229, and 1,515 patients were evaluated for safety. After 12 weeks, HbA1c decreased versus baseline (pre-BOT 8.67%; pre-SIT 8.46% to 7.73% and 7.66%, respectively (Δ mean

  10. Insulin Initiation in Insulin-Naïve Korean Type 2 Diabetic Patients Inadequately Controlled on Oral Antidiabetic Drugs in Real-World Practice: The Modality of Insulin Treatment Evaluation Study

    Directory of Open Access Journals (Sweden)

    Sang Soo Kim

    2015-12-01

    Full Text Available BackgroundThe Modality of Insulin Treatment Evaluation (MOTIV study was performed to provide real-world data concerning insulin initiation in Korean type 2 diabetes mellitus (T2DM patients with inadequate glycemic control with oral hypoglycemic agents (OHAs.MethodsThis multicenter, non-interventional, prospective, observational study enrolled T2DM patients with inadequate glycemic control (glycosylated hemoglobin [HbA1c] ≥7.0% who had been on OHAs for ≥3 months and were already decided to introduce basal insulin by their physician prior to the start of the study. All treatment decisions were at the physician's discretion to reflect real-world practice.ResultsA total of 9,196 patients were enrolled, and 8,636 patients were included in the analysis (mean duration of diabetes, 8.9 years; mean HbA1c, 9.2%. Basal insulin plus one OHA was the most frequently (51.0% used regimen. After 6 months of basal insulin treatment, HbA1c decreased to 7.4% and 44.5% of patients reached HbA1c <7%. Body weight increased from 65.2 kg to 65.5 kg, which was not significant. Meanwhile, there was significant increase in the mean daily insulin dose from 16.9 IU at baseline to 24.5 IU at month 6 (P<0.001. Overall, 17.6% of patients experienced at least one hypoglycemic event.ConclusionIn a real-world setting, the initiation of basal insulin is an effective and well-tolerated treatment option in Korean patients with T2DM who are failing to meet targets with OHA therapy.

  11. [A case of possible retroperitoneal metastasis of breast cancer successfully treated with oral S-1 and cyclophosphamide therapy after TC therapy].

    Science.gov (United States)

    Yoneyama, Kimiyasu; Takeshita, Toshio; Suzuki, Hiroshi; Morise, Masaki; Suzuki, Tetsutarou; Kishi, Shinya; Tsutsui, Atsuko; Matsumoto, Akiko

    2011-03-01

    We report a case of possible retroperitoneal metastasis of breast cancer successfully treated with oral S-1 and cyclophosphamide therapy after docetaxel and cyclophosphamide (TC) therapy. A 57-year-old woman with a history of bilateral breast cancer showed an increase in tumor markers during treatment with oral anastrozole as postoperative adjuvant therapy 4 years after her second cancer surgery. After careful examination, the patient was diagnosed as having multiple bone metastases and her medication was changed to oral letrozole. After 3 months, the patient developed left back pain and was referred to our hospital. CT scanning showed an enhanced mass in the region from the left perirenal and posterior pararenal spaces to the left psoas major muscle and the anterior aspect of the left iliacus muscle, suggesting retroperitoneal metastasis. TC therapy was performed and, as a result, tumor markers decreased and the mass disappeared on CT imaging. After discontinuation of TC therapy, the tumor markers increased again, following which oral S-1 and cyclophosphamide therapy were administered, and the tumor markers decreased. At the time of this writing, the patient is still undergoing therapy, and no recurrence has been observed. We concluded that oral S-1 and cyclophosphamide therapy were useful in the present case and were associated with few adverse effects.

  12. Endocrine studies in postmenopausal women during oral replacement therapy with unconjugated oestrogens.

    Science.gov (United States)

    Vasquez, J M; Samaras, C A; Nezhat, C

    1982-01-01

    Two groups of postmenopausal women were seen at monthly intervals during a three-month trial of continuous therapy with oral unconjugated oestrogens. Ten women in the first group were administered daily Hormonin No. 1 containing oestriol (E3) 0.135 mg, oestradiol (E2) 0.3 mg and oestrone (E1) 0.7 mg. Eight women in the second group received Hormonin No. 2 containing E3 0.27 mg, E2 0.6 mg and E1 1.4 mg. E1, E2, E3 and dehydroepiandrosterone (DHA) as well as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured by radioimmunoassay. Maturation index of vaginal smears and clinical effects were also evaluated. Oral replacement therapy with these unconjugated oestrogens produced a significant elevation of E1 (p less than 0.05) and E2 (p less than 0.05) to values corresponding well with the premenopausal range measured in our laboratory. Postmenopausal levels of FSH and LH showed only a moderate but significant decrease (p less than 0.05). There was consistent relief of vasomotor symptoms. One case of endometrial focal adenomatous hyperplasia uncovered during the period of treatment was transformed to functional secretory endometrium after an appropriate course with progestogens. Oral administration of unconjugated oestrogens and periodic withdrawal bleeding induced with a progestational agent seems to be an effective method of replacement therapy in postmenopausal women.

  13. Treatment of Oral Candidiasis Using Photodithazine®- Mediated Photodynamic Therapy In Vivo.

    Science.gov (United States)

    Carmello, Juliana Cabrini; Alves, Fernanda; G Basso, Fernanda; de Souza Costa, Carlos Alberto; Bagnato, Vanderlei Salvador; Mima, Ewerton Garcia de Oliveira; Pavarina, Ana Cláudia

    2016-01-01

    This study evaluated the effectiveness of antimicrobial photodynamic therapy (aPDT) in the treatment of oral candidiasis in a murine model using Photodithazine® (PDZ). This model of oral candidiasis was developed to allow the monitoring of the infection and the establishment of the aPDT treatment. Six-week-old female mice were immunosuppressed and inoculated with C. albicans to induce oral candidiasis. PDZ-mediated aPDT and nystatin treatment were carried out for 5 consecutive days with one application per day. The macroscopic evaluation of oral lesions was performed. After each treatment, the tongue was swabbed to recover C. albicans cells. Viable colonies were quantified and the number of CFU/ml determined. The animals were sacrificed 24 hours and 7 days after treatment and the tongues were surgically removed for histological analysis and analysis of inflammatory cytokines expression (IL-1, TNF-α and IL-6) by RT-qPCR. Data were analyzed by two-way ANOVA. PDZ-mediated aPDT was as effective as Nystatin (NYS group) in the inactivation of C. albicans, reducing 3 and 3.2 logs10 respectively, 24 h after treatment (poral lesions, while animals treated with NYS presented partial remission of oral lesions in both periods assessed. Histological evaluation revealed mild inflammatory infiltrate in the groups treated with aPDT and NYS in both periods assessed. The aPDT induced the TNF-α expression when compared with the control (P-L-) (poral candidiasis.

  14. The effect of low level laser therapy in different wavelengths in the treatment of oral mucositis—proposal for extra-oral implementation

    Science.gov (United States)

    Moraes, J. J. C.; Queiroga, A. S.; de Biase, R. C. C. G.; Leite, E. P.; Cabral Júnior, C. R.; Limeira Júnior, F. A.

    2009-09-01

    The oral mucositis is the most frequent acute oral complication resulting from antineoplastic treatment and may worsen the clinical condition of the patient and interfere with his/her quality of life. This study aimed to comparatively evaluate, from a clinical point of view, the effect of Laser Therapy λ660 nm (wavelength of the red Laser) and λ830 nm (wavelength of the infrared Laser), at extra-oral points, in remission of severity of oral mucositis and pain associated with it in pediatric oncological patients undergoing chemotherapy with the anticancer drug methotrexate, noting which of the two wavelength is the most appropriate to this new technique. The sample consisted of 13 patients placed at random in each group and subjected to sessions of Low Level Laser Therapy, at pre-determined extra-oral points for five consecutive days, starting at the beginning of the observation of mucositis injuries. It became possible to note that from the group of patients in the group of Laser λ830 nm ( n = 6; 46.15%), four ( n = 4; 66.67%) of these patients had remission of injuries to grade 0 (WHO), and as for pain, five patients ( n = 5; 83.33%) showed no painful symptoms for mucositis injuries. In the Laser λ660 nm group ( n = 7; 53.85%), only two patients ( n = 2; 28.57%) achieved a regression of lesions to grade 0 (WHO), while four patients ( n = 4; 57.14%) had no pain. So, the extra-oral application of Laser Therapy was effective in treating injuries of oral mucositis in the patients treated; and Laser Therapy in the infrared spectrum (λ830 nm) was more effective in the treatment of oral mucositis injuries compared to the red spectrum (λ660 nm), which can be explained by the greater power of penetration of infrared rays, acting in a more expressive way in deeper places.

  15. Characterization of the Antidiabetic Role of Parkinsonia aculeata (Caesalpineaceae

    Directory of Open Access Journals (Sweden)

    Ana Catarina Rezende Leite

    2011-01-01

    Full Text Available This paper reports the characterization of the antidiabetic role of a hydroethanolic extract from Parkinsonia aerial parts (HEPA, in normal and alloxan-induced diabetic rats, treated with HEPA (125 and 250 mg/kg; p.o.. Oral glucose tolerance test, acute oral toxicity test and preliminary phytochemical analyses were performed. The diabetic rats treated with HEPA showed a significant reduction in serum and urinary glucose, urinary urea and triglyceride levels, as compared to the diabetic untreated group. However, in the normal treated groups, a significant reduction was found only in serum triglyceride levels. In all treated diabetic groups, an improvement in hepatic glycogen was observed, as well as a decrease in liquid intake and urinary volume, and an enhancement in the weight of skeletal muscles (soleus and extensor digitorum longus, kidneys and epididymal adipose tissue. Nevertheless, body and liver weights were ameliorated only in the diabetic group treated with HEPA (250 mg/kg. Moreover, oral glucose tolerance was higher in animals treated with HEPA, while results also showed that HEPA could be considered toxicologically safe. Phytochemical analysis revealed the presence of tanins, flavonoids and steroids in HEPA. In conclusion, P. aculeata presents an antidiabetic activity and other beneficial effects that ameliorate diabetes and associated complications.

  16. Adherence to depot versus oral antipsychotic medication in schizophrenic patients during the long-term therapy

    Directory of Open Access Journals (Sweden)

    Stanković Žana

    2013-01-01

    Full Text Available Background/Aim. There is a high rate of schizophrenic patients who do not adhere to their prescribed therapy, despite the implementation of antipsychotic long-acting injections and the introduction of atypical antipsychotics. The aim of this study was to investigate the differences in sociodemographic, clinical and medication adherence variables between the two groups of schizophrenic patients on maintenance therapy with depot antipsychotic fluphenazine decanoate and oral antipsychotics only as well as a correlation between the medication adherence and other examined variables. Methods. A total of 56 patients of both genders, aged < 60 years, with the diagnosis of schizophrenia (F20 (ICD-10, 1992 clinically stable for at least 6 months were introduced in this cross-sectional study. The patients from the depot group (n = 19 were on classical depot antipsychotic fluphenazine decanoate administering intramuscularly every 4 weeks (with or without oral antipsychotic augmentation and the patients from the oral group (n = 37 were on oral therapy alone with classical or atypical antipsychotics, either as monotherapy or combined. The Positive and Negative Syndrome Scale (PANSS was used to assess symptom severity. Item G12 of the PANSS was used to assess insight into the illness. The patients completed the Medical Adherence Rating Scale (MARS was used to assess adherence to the therapy. A higher MARS score indicates behavior [Medical Adherence Questionnaire (MAQ subscale] and attitudes toward medication [Drug Attitude Inventory (DAI subscale] that are more consistent with treatment adherence. The exclusion criteria were determined. The Pearson's χ2 test was used to compare categorical variables, Student's t-test to compare continuous variables and Pearson's correlation to test the correlation significance; p = 0.05. Results. Significant betweengroup differences in age, illness duration, chlorpromazine equivalents, PANSS score and DAI subscore were found

  17. Prescribing of Antidiabetic Medicines before, during and after Pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel A.; Klungsøyr, Kari; Neville, Amanda J.;

    2016-01-01

    Aim: To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe. Methods: A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Women ...... in the treatment of gestational diabetes despite international guidelines....... and 88.8% in the Netherlands received an insulin analogue alone or in combination with human insulin, this proportion increasing over time. Oral products were mainly metformin and prescribing was highest in the 3 months before pregnancy. Metformin use during pregnancy increased in some countries...

  18. Preliminary study on radio-chemo-induced oral mucositis and low level laser therapy

    Science.gov (United States)

    Merigo, Elisabetta; Fontana, Matteo; Fornaini, Carlo; Clini, Fabio; Cella, Luigi; Vescovi, Paolo; Oppici, Aldo

    2012-09-01

    Background: Oral mucositis remains one of the most common and troubling side effects of antineoplastic radiation and drug therapy: its incidence in onco-hematological radio-chemotreated patients is variable between 50 and 100% and its impact on this populations is directly linked with the experience of intense pain causing reduction and modification of therapy regimens, decreased survival rates and increased cost of care. Purpose: Aim of this study is the preliminary evaluation of a Low Level Laser therapy (LLLT) protocol on healing process of oral mucositis and on pain and quality of life of patients experiencing this dramatic side-effect. Materials and methods: Patients were evaluated and treated at the Unita` Operativa Semplice Dipartimentale di Odontostomatologia e Chirurgia Maxillo-Facciale of the Hospital of Piacenza were they were treated for primary disease with protocols of chemotherapy and/or radiotherapy. LLLT protocol was performed with a diode laser (808 nm -XD Smile - Fotona -Slovenia) on a two weeks-6 treatments schedule with power of 0.5 W and application of 30 seconds. Mucositis grading was scored on the basis of WHO classification by two blind operators at each treatment and at 1 and 2 weeks after treatment. Pain and capability of deglutition were described by patients by means questionnaires based on Visual Analogue Scale, Numerical Rating Scale and Quality of Life. Results: A relevant improvement of healing of oral mucositis, in terms of reduction of grading score, and of pain, swallowing discomfort and quality of life was recorded. Discussion and conclusion: Results of this preliminary study are encouraging for the realization of larger studies focused on the application of LLLT protocols in management of radio-chemotreated patients with oral mucositis.

  19. Implementing evidence-based patient and family education on oral anticoagulation therapy: a community-based participatory project.

    Science.gov (United States)

    Shaha, Maya; Wüthrich, Erika; Stauffer, Yvonne; Herczeg, Franziska; Fattinger, Karin; Hirter, Kathrin; Papalini, Marianne; Herrmann, Luzia

    2015-06-01

    This study aimed at developing and implementing evidence-based patient and family education on oral anticoagulation therapy. The number of persons with chronic diseases who live at home is increasing. They have to manage multiple diseases and complex treatments. One such treatment is oral anticoagulation therapy, a high risk variable dose medication. Adherence to oral anticoagulation therapy is jeopardised by limited information about the medications, their risk and complications, the impact of individual daily routine and the limited inclusion of family members in education. Hence, improved and tailored education is essential for patients and families to manage oral anticoagulation therapy at home. A community-based participatory research design combined with the Precede-Proceed model was used including a systematic literature review, posteducation analysis, an online nurse survey, a documentation analysis and patient/family interviews. The study was conducted between April 2010-December 2012 at a department of general internal medicine in a teaching hospital in Switzerland. Participants were the department's nursing and medical professionals including the patients and their families. The evidence-based patient and family education on oral anticoagulation therapy emerged comprising a learning assessment, teaching units, clarification of responsibilities of nurse professionals and documentation guidelines. The inclusion of the whole department has contributed to the development and implementation of this evidence-based patient family education on oral anticoagulation therapy, which encompasses local characteristics and patient preferences. This education is now being used throughout the department. © 2015 John Wiley & Sons Ltd.

  20. Medication adherence to oral iron therapy in patients with iron deficiency anemia

    Science.gov (United States)

    Gereklioglu, Cigdem; Asma, Suheyl; Korur, Asli; Erdogan, Ferit; Kut, Altug

    2016-01-01

    Objective: This study aimed at investigating the factors affecting medication adherence in patients who use oral iron therapy due to iron deficiency anemia. Methods: A total of 96 female patients in fertile age with mean age of 30±10.1 years (range 18-53) who were admitted to Family Medicine Clinic between 01 January and 31 March 2015 and who had received iron therapy within the recent three years were enrolled in the study. Data were collected through a questionnaire form. Results: Of the patients, 39 (40,6%) were detected not to use the medication regularly or during the recommended period. A statistically significant relationship was found between non-adherence to therapy and gastrointestinal side effects and weight gain (p<0.05). Conclusion: Medication adherence is deficient in patients with iron deficiency anemia. The most important reason for this seems gastrointestinal side effects, in addition to weight gain under treatment. PMID:27375698

  1. Insulin-based versus triple oral therapy for newly diagnosed type 2 diabetes: which is better?

    Science.gov (United States)

    Lingvay, Ildiko; Legendre, Jaime L; Kaloyanova, Polina F; Zhang, Song; Adams-Huet, Beverley; Raskin, Philip

    2009-10-01

    Early use of insulin after diagnosis of type 2 diabetes is met with resistance because of associated weight gain, hypoglycemia, and fear of decreased compliance and quality of life (QoL). In treatment-naive patients with newly diagnosed type 2 diabetes, insulin and metformin were initiated for a 3-month lead-in period, then patients were randomly assigned to insulin and metformin (insulin group) or metformin, pioglitazone, and glyburide (oral group) for 36 months. Hypoglycemic events, compliance, A1C, weight, QoL, and treatment satisfaction were assessed. Of 29 patients randomly assigned into each group, 83% (insulin group) and 72% (oral group) completed this 3-year study. At study completion, A1C was 6.1 +/- 0.6% (insulin group) versus 6.0 +/- 0.8% (oral group). Weight increased similarly in both groups (P = 0.09) by 4.47 kg (95% CI 0.89-8.04 kg) (insulin group) and 7.15 kg (95% CI 4.18-10.13 kg) (orals group). Hypoglycemic events did not differ between groups (mild 0.51 event/person-month in the insulin group vs. 0.68 event/person-month in the orals group, P = 0.18 and severe 0.04 event/person-year in the insulin group vs. 0.09 event/person-year in the orals group, P = 0.53). Compliance, QoL, and treatment satisfaction were similar between groups, with 100% of patients randomly assigned to insulin willing to continue such treatment. When compared with a clinically equivalent treatment regimen, insulin-based therapy is effective and did not cause greater weight gain or hypoglycemia nor decrease compliance, treatment satisfaction, or QoL. Insulin is safe, well-accepted, and effective for ongoing treatment of patients with newly diagnosed type 2 diabetes.

  2. Oral carnitine therapy in children with cystinosis and renal Fanconi syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Gahl, W.A.; Bernardini, I.; Dalakas, M.; Rizzo, W.B.; Harper, G.S.; Hoeg, J.M.; Hurko, O.; Bernar, J.

    1988-02-01

    11 children with either cystinosis or Lowe's syndrome had a reduced content of plasma and muscle carnitine due to renal Fanconi syndrome. After treatment with oral L-carnitine, 100 mg/kg per d divided every 6 h, plasma carnitine concentrations became normal in all subjects within 2 d. Initial plasma free fatty acid concentrations, inversely related to free carnitine concentrations, were reduced after 7-20 mo of carnitine therapy. Muscle lipid accumulation, which varied directly with duration of carnitine deficiency (r = 0.73), improved significantly in three of seven rebiopsied patients after carnitine therapy. One Lowe's syndrome patient achieved a normal muscle carnitine level after therapy. Muscle carnitine levels remained low in all cystinosis patients, even though cystinotic muscle cells in culture took up L-(/sup 3/H)carnitine normally. The half-life of plasma carnitine for cystinotic children given a single oral dose approximated 6.3 h; 14% of ingested L-carnitine was excreted within 24 h. Studies in a uremic patient with cystinosis showed that her plasma carnitine was in equilibrium with some larger compartment and may have been maintained by release of carnitine from the muscle during dialysis. Because oral L-carnitine corrects plasma carnitine deficiency, lowers plasma free fatty acid concentrations, and reverses muscle lipid accumulation in some patients, its use as therapy in renal Fanconi syndrome should be considered. However, its efficacy in restoring muscle carnitine to normal, and the optimal dosage regimen, have yet to be determined.

  3. Histopathological Change of Oral Malignant Tumour and Epithelial Dysplasia Subjected to Photodynamic Therapy

    Directory of Open Access Journals (Sweden)

    Masataka Uehara

    2010-07-01

    Full Text Available Objectives: The purpose of this study is to analyze the morphological change of cell nuclei and the change of proliferating activity of oral malignancy and epithelial dysplasia between before and after photodynamic therapy in order to predict recurrence.Material and Methods: We experienced 14 cases of oral squamous cell carcinoma, one case of verrucous carcinoma and seven cases of epithelial dysplasia treated by photodynamic therapy (PDT. The mean nuclear area (NA and coefficient of variation of the nuclear area (NACV of 100 nuclei per slide were calculated using computer-assisted image analysis in hematoxylin and eosin stained biopsy specimens before and after PDT. Additionally, proliferating cell nuclear antigen (PCNA immunohistochemistry was carried out in each specimen.Results: The mean NA after PDT was significantly lower than that before PDT in the nonrecurrent group. However, there was no significant difference in mean NA before and after PDT in the recurrent group. There were no significance differences in NACV before and after PDT in either the nonrecurrent or recurrent group. Furthermore, the PCNA labelling indices of the specimens after PDT was significantly lower than that before PDT in both the nonrecurrent and the recurrent group.Conclusions: Mean nuclear area in the biopsy specimen after photodynamic therapy is likely to be a predictive marker for the recurrence of oral squamous cell carcinoma or epithelial dysplasia subjected to photodynamic therapy, while coefficient of variation of the nuclear area and proliferating cell nuclear antigen labelling indices are less helpful in predicting the recurrence of such lesions.

  4. The complete control of glucose level utilizing the composition of ketogenic diet with the gluconeogenesis inhibitor, the anti-diabetic drug metformin, as a potential anti-cancer therapy.

    Science.gov (United States)

    Oleksyszyn, Józef

    2011-08-01

    In the animal models of glucose dependent cancer growth, the growth is decreased 15-30% through the use of low-carbohydrate, calorically restricted and/or ketogenic diet. The remaining growth depends on glucose formed by the liver-kidney gluconeogenesis as is the case in the cancer cachexia. It is hypothesized that a new treatment for cancer diseases should be explored which includes the ketogenic diet combined with the inhibition of gluconeogenesis by the anti-diabetic drug metformin.

  5. Long-term oral appliance therapy in obstructive sleep apnea syndrome: a controlled study on temporomandibular side effects.

    Science.gov (United States)

    Doff, Michiel H J; Veldhuis, Steffanie K B; Hoekema, Aarnoud; Slater, James J R Huddleston; Wijkstra, P J; de Bont, Lambert G M; Stegenga, Boudewijn

    2012-06-01

    The objective of this study was to assess variations in the occurrence of temporomandibular disorders (TMDs) and the risk of developing pain and function impairment of the temporomandibular complex in obstructive sleep apnea syndrome (OSAS) patients treated with either an oral appliance (mandibular advancement device) or continuous positive airway pressure (CPAP) in a 2-year follow-up study. In addition, we assessed the relationship between the mean mandibular protrusion and the frequency of wearing the appliance during follow-up with the occurrence of pain and function impairment of the temporomandibular complex. Fifty-one patients were randomized to oral appliance therapy and 52 patients to CPAP therapy. TMDs (diagnosed according to the Axis I Research Diagnostic Criteria for TMD), pain intensity and disability and mandibular function impairment were recorded at baseline, after 2 months, 1 year and 2 years of therapy. Only in the initial period of treatment the occurrence of pain-related TMDs was considerably higher (24%) in the oral appliance group compared to CPAP (6%). Oral appliance therapy furthermore resulted in more temporomandibular pain compared to CPAP (odds ratio 2.33, 95% confidence interval (1.22-4.43)). However, there were no limitations in mandibular function in both groups during the (entire) follow-up period. Although generally not serious and of transient nature, oral appliance therapy results in more pain-related TMDs in the initial period of use compared with CPAP therapy. Oral appliance therapy is associated with increased pain in the temporomandibular complex in the initial period of use. Because of the transient nature, this pain is not a reason to contra-indicate an oral appliance in OSAS patients. Moreover, TMDs and the risk of developing pain and function impairment of the temporomandibular complex appear limited with long-term oral appliance use.

  6. Subtrochanteric stress fractures in patients on oral bisphosphonate therapy: an emerging problem.

    LENUS (Irish Health Repository)

    Murphy, Colin G

    2012-01-31

    The emergence of a new variant of subtrochanteric stress fractures of the femur, affecting patients on oral bisphosphonate therapy, has only recently been described. This fracture is often preceded by pain and distinctive radiographic changes (lateral cortical thickening), and associated with a characteristic fracture pattern (transverse fracture line and medial cortical spike). A retrospective review (2007-2009) was carried out for patients who were taking oral bisphosphonates and who sustained a subtrochanteric fracture after a low velocity injury. Eleven fractures were found in 10 patients matching the inclusion criteria outlined. All were females, and taking bisphosphonates for a mean of 43 years. Five of the 10 patients mentioned prodromal symptoms, for an average of 9.4 months before the fracture. Although all fractures were deemed low velocity, 5 of 11 were even atraumatic. Two patients had previously sustained contralateral subtrochanteric fractures. Plain radiographs of two patients showed lateral cortical thickening on the contralateral unfractured femur; the bisphosphonate therapy was stopped and close surveillance was started. Patients taking oral bisphosphonates may be at risk of a new variant of stress fracture of the proximal femur. Awareness of the symptoms is the key to ensure that appropriate investigations are undertaken.

  7. Subtrochanteric stress fractures in patients on oral bisphosphonate therapy: an emerging problem.

    Science.gov (United States)

    Murphy, Colin G; O'Flanagan, Shay; Keogh, Peter; Kenny, Patrick

    2011-10-01

    The emergence of a new variant of subtrochanteric stress fractures of the femur, affecting patients on oral bisphosphonate therapy, has only recently been described. This fracture is often preceded by pain and distinctive radiographic changes (lateral cortical thickening), and associated with a characteristic fracture pattern (transverse fracture line and medial cortical spike). A retrospective review (2007-2009) was carried out for patients who were taking oral bisphosphonates and who sustained a subtrochanteric fracture after a low velocity injury. Eleven fractures were found in 10 patients matching the inclusion criteria outlined. All were females, and taking bisphosphonates for a mean of 43 years. Five of the 10 patients mentioned prodromal symptoms, for an average of 9.4 months before the fracture. Although all fractures were deemed low velocity, 5 of 11 were even atraumatic. Two patients had previously sustained contralateral subtrochanteric fractures. Plain radiographs of two patients showed lateral cortical thickening on the contralateral unfractured femur; the bisphosphonate therapy was stopped and close surveillance was started. Patients taking oral bisphosphonates may be at risk of a new variant of stress fracture of the proximal femur. Awareness of the symptoms is the key to ensure that appropriate investigations are undertaken.

  8. Ocimum basilicum extract exhibits antidiabetic effects via inhibition of hepatic glucose mobilization and carbohydrate metabolizing enzymes

    Science.gov (United States)

    Ezeani, Chinelo; Ezenyi, Ifeoma; Okoye, Theophine; Okoli, Charles

    2017-01-01

    Aim: Ocimum basilicum L (Lamiaceae) is used as a traditional remedy for different ailments, including diabetes mellitus. This study investigated the antidiabetic effects of an extract of aerial parts of O. basilicum. Methods: Antihyperglycemic effect of the extract was determined by its effects on α-amylase and α-glucosidase in vitro, while antidiabetic properties were studied in alloxan induced diabetic rats treated for 28 days with extract and compared to those treated with oral metformin (150 mg/kg). The study and analysis was conducted between 2014 and 2015. Results: The treatment with 100 and 200 mg/kg extract significantly (P glycogenolysis and/or stimulate glycogenesis. PMID:28163956

  9. Currently approved and emerging oral therapies in multiple sclerosis: An update for the ophthalmologist.

    Science.gov (United States)

    Eckstein, Christopher; Bhatti, M Tariq

    2016-01-01

    Although our understanding of multiple sclerosis (MS) has grown substantially, its cause remains unknown. Nonetheless, in the past 3 decades, there have been tremendous advancements in the development of disease-modifying drugs (DMDs). In July 1993, the United States Food and Drug Administration approved the first disease-modifying drug-interferon β- and there are currently 13 medications approved for use in relapsing MS. All the early medications are administered either as a subcutaneous or intramuscular injection, and despite the clinical efficacy and safety of these medications, many patients were hampered by the inconvenience of injections and injection-related side effects. In September 2010, the first oral DMD-fingolimod-was approved. Since then, 2 additional oral DMDs (teriflunomide and dimethyl fumarate) have been approved, and several other oral medications are being evaluated in extensive MS development programs. Because of frequent ocular involvement, ophthalmologists are often involved in the care of MS patients and therefore need to be aware of the current treatment regimens prescribed by neurologists, some of which can have significant ophthalmic adverse events. We update the current advancements in the treatment of MS and discuss the published clinical data on the efficacy and safety of the currently approved and emerging oral therapies in MS.

  10. Low level laser therapy in the treatment of oral mucositis in cancer patients: systematic review of literature

    Science.gov (United States)

    El-Sabbagh, Rula Fawzi; Selting, Wayne J.

    2016-03-01

    Oral mucositis is a debilitating and dose limiting side effect of oncotherapy in cancer patients. Low Level Laser Therapy (LLLT) is a promising new intervention for the treatment of oral mucositis. Aims and objectives: 1. Perform a systematic review of available literature on the therapeutic effect of LLLT on established oral mucositis. 2. Formulate recommendations for future studies based on results of review. Methods: Electronic search oflow level laser therapy in the treatment of oral mucositis was conducted and eligible studies reviewed. Results: Four studies met the inclusion criteria and were analyzed. A total of 109 patients were included, 59 of which received LLLT as a therapeutic measure. An overall success rate of 81.4% success rate was reported in regard to OM. Conclusion: The review demonstrated the positive therapeutic effect of LLLT on oral mucositis. However, the need for future studies with standardized reporting of parameters and methods is needed to increase the level of evidence of this intervention.

  11. From pedialyte to popsicles: a look at oral rehydration therapy used in the United States and Canada.

    Science.gov (United States)

    Snyder, J D

    1982-01-01

    To obtain information on the attitudes and practices concerning oral rehydration therapy in the United States and Canada, a questionnaire was sent to the chairmen of departments of pediatrics of 142 medical colleges. Some form of oral fluid therapy for treatment of diarrheal dehydration is used by the institutions of all 128 survey respondents. The most commonly used fluids, commercial sugar-electrolyte solutions (89%), clear liquids (78%), and fruit juices (58%) have very different compositions and concentrations of ingredients. Oral therapy is based on a specific written protocol at 30% of the institutions and is used most frequently to treat outpatients with mild dehydration. To determine a uniform and optimal approach to oral fluid treatment for diarrhea, comparative clinical trials are needed to assess which fluid compositions and concentrations are most effective in preventing dehydration and in treating dehydration once it has occurred.

  12. Blood Vessel Normalization in the Hamster Oral Cancer Model for Experimental Cancer Therapy Studies

    Energy Technology Data Exchange (ETDEWEB)

    Ana J. Molinari; Romina F. Aromando; Maria E. Itoiz; Marcela A. Garabalino; Andrea Monti Hughes; Elisa M. Heber; Emiliano C. C. Pozzi; David W. Nigg; Veronica A. Trivillin; Amanda E. Schwint

    2012-07-01

    Normalization of tumor blood vessels improves drug and oxygen delivery to cancer cells. The aim of this study was to develop a technique to normalize blood vessels in the hamster cheek pouch model of oral cancer. Materials and Methods: Tumor-bearing hamsters were treated with thalidomide and were compared with controls. Results: Twenty eight hours after treatment with thalidomide, the blood vessels of premalignant tissue observable in vivo became narrower and less tortuous than those of controls; Evans Blue Dye extravasation in tumor was significantly reduced (indicating a reduction in aberrant tumor vascular hyperpermeability that compromises blood flow), and tumor blood vessel morphology in histological sections, labeled for Factor VIII, revealed a significant reduction in compressive forces. These findings indicated blood vessel normalization with a window of 48 h. Conclusion: The technique developed herein has rendered the hamster oral cancer model amenable to research, with the potential benefit of vascular normalization in head and neck cancer therapy.

  13. Odontostomatologic management of patients receiving oral anticoagulant therapy: a retrospective multicentric study.

    Science.gov (United States)

    Inchingolo, Francesco; Tatullo, Marco; Abenavoli, Fabio M; Marrelli, Massimo; Inchingolo, Alessio D; Scacco, Salvatore; Papa, Francesco; Inchingolo, Angelo M; Dipalma, Gianna

    2011-07-19

    Today, we frequently find patients taking oral anticoagulant therapy (OAT), a prophylaxis against the occurrence of thromboembolic events. An oral surgeon needs to know how to better manage such patients, in order to avoid hemorrhagic and thromboembolic complications. A group of 193 patients (119 men aged between 46 and 82 and 74 women aged between 54 and 76) undergoing OAT for more than 5 years were managed with a standardized management protocol and a 2-months follow-up. The aim of the present study was to apply a protocol, which could provide a safe intra- and postoperative management of patients on OAT. Among the 193 patients, only 2 had postoperative complications. We think that the protocol used in the present study can be used for complete safety in the treatment of this type of patients.

  14. Odontostomatologic management of patients receiving oral anticoagulant therapy: a retrospective multicentric study

    Directory of Open Access Journals (Sweden)

    Scacco Salvatore

    2011-07-01

    Full Text Available Abstract Introduction Today, we frequently find patients taking oral anticoagulant therapy (OAT, a prophylaxis against the occurrence of thromboembolic events. An oral surgeon needs to know how to better manage such patients, in order to avoid hemorrhagic and thromboembolic complications. Materials and methods A group of 193 patients (119 men aged between 46 and 82 and 74 women aged between 54 and 76 undergoing OAT for more than 5 years were managed with a standardized management protocol and a 2-months follow-up. The aim of the present study was to apply a protocol, which could provide a safe intra- and postoperative management of patients on OAT. Results Among the 193 patients, only 2 had postoperative complications. Conclusions We think that the protocol used in the present study can be used for complete safety in the treatment of this type of patients.

  15. Comparative study of oral and topical ketoconazole therapy in pityriasis versicolor

    Directory of Open Access Journals (Sweden)

    Nagpal V

    2003-07-01

    Full Text Available Introduction: Both topical and systemic ketoconazole are reported to be effective against pityriasis versicolor. Material and Methods: Forty patients suffering from pityriasis versicolor were treated either with oral ketoconazole 200 mg per day or 2% ketoconazole cream topically once daily for 2 weeks. Results: On global assessment, after 2 weeks of start of therapy, 18 (90% out of 20 patients treated with oral ketoconazole were cured while 2 patients had considerable residual disease. In the ketoconazole cream group, 16 (80% out of 20 patients were cured and 4 patients had considerable residual disease. Conclusion: No significant difference was observed in the response rates in the two groups. Relapse occurred in two patients of the systemic ketoconazole group and six patients of the topical ketoconazole group during the follow-up period of three months.

  16. Measures to reduce maintenance therapy with oral corticosteroid in adults with severe asthma

    DEFF Research Database (Denmark)

    Nguyen, Vivi Q; Ulrik, Charlotte S

    2016-01-01

    BACKGROUND: Maintenance therapy with oral corticosteroid (OCS) is used, although not based on evidence, for patients with severe asthma, but OCS is associated with serious adverse effects; therefore, management strategies aimed at steroid sparing are important. OBJECTIVE: To provide an update...... oral steroidsparing strategies (n = 5), the following lowered the OCS dose: Internet-based tapering strategy (44% reduction in OCS dose), inhaled corticosteroids (mometasone furoate [mean daily OCS dose reduction of 39% and 31% in patients treated with 800 mcg/day and 1600 mcg/day, respectively......), masitinib (78% reduction in OCS dose), mepolizumab (50%83% reduction in OCS dose), and omalizumab (30%64% of enrolled patients achieved a reduction in OCS dose, and one study reported a dose reduction of 45%). CONCLUSIONS: In adults with severe asthma, several corticosteroid-sparing interventions were shown...

  17. A Comparative Study of Oral Cyclosporine and Betamethasone Minipulse Therapy in the Treatment of Alopecia Areata

    Science.gov (United States)

    Jang, Yong Hyun; Kim, Sang Lim; Lee, Kyou Chae; Kim, Min Ji; Park, Kyung Hea; Lee, Weon Ju; Lee, Seok-Jong

    2016-01-01

    Background Various systemic agents have been assessed for the treatment of alopecia areata (AA); however, there is a paucity of comparative studies. Objective To assess and compare cyclosporine and betamethasone minipulse therapy as treatments for AA with regard to effectiveness and safety. Methods Data were collected from 88 patients who received at least 3 months of oral cyclosporine (n=51) or betamethasone minipulse therapy (n=37) for AA. Patients with ≥50% of terminal hair regrowth in the alopecic area were considered responders. Results The responder of the cyclosporine group was 54.9% and that of the betamethasone minipulse group was 37.8%. In the cyclosporine group, patients with mild AA were found to respond better to the treatment. Based on the patient self-assessments, 70.6% of patients in the cyclosporine group and 43.2% of patients in the betamethasone minipulse group rated their hair regrowth as excellent or good. Side effects were less frequent in the cyclosporine group. Conclusion Oral cyclosporine appeared to be superior to betamethasone minipulse therapy in terms of treatment effectiveness and safety. PMID:27746635

  18. Oral antiplatelet therapy in diabetes mellitus and the role of prasugrel: an overview

    Science.gov (United States)

    Hillegass, William B; Brott, Brigitta C; Dobbs, James C; Papapietro, Silvio E; Misra, Vijay K; Zoghbi, Gilbert J

    2011-01-01

    Diabetics have a prothrombotic state that includes increased platelet reactivity. This contributes to the less favorable clinical outcomes observed in diabetics experiencing acute coronary syndromes as well as stable coronary artery disease. Many diabetics are relatively resistant to or have insufficient response to several antithrombotic agents. In the setting of percutaneous coronary intervention, hyporesponsiveness to clopidogrel is particularly common among diabetics. Several strategies have been examined to further enhance the benefits of oral antiplatelet therapy in diabetics. These include increasing the dose of clopidogrel, triple antiplatelet therapy with cilostazol, and new agents such as prasugrel. The large TRITON TIMI 38 randomized trial compared clopidogrel to prasugrel in the setting of percutaneous coronary intervention for acute coronary syndromes. The diabetic subgroup (n = 3146) experienced considerable incremental benefit with a 4.8% reduction in cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke at 15-month follow-up with prasugrel treatment. Among diabetics on insulin this combined endpoint was reduced by 7.9% at 15 months. Major bleeding was not increased in the diabetic subgroup. This confirms the general hypothesis that more potent oral antiplatelet therapy can partially overcome the prothrombotic milieu and safely improve important clinical outcomes in diabetics. PMID:21822392

  19. Surviving with lung cancer: medication-taking and oral targeted therapy.

    Science.gov (United States)

    Wickersham, Karen E; Happ, Mary Beth; Bender, Catherine M; Engberg, Sandra J; Tarhini, Ahmad; Erlen, Judith A

    2014-01-01

    Oral epidermal growth factor receptor inhibitors (EGFRIs) improve survival for non-small cell lung cancer (NSCLC) patients; however, medication-taking implications are unknown. We used grounded theory to explore the process of medication-taking for NSCLC patients receiving oral EGFRIs. Thirty-two interviews were conducted for 13 participants purposively selected for gender, race/ethnicity, age, time in therapy, dose reductions, and therapy discontinuation and theoretically sampled for age and health insurance carrier. The study produced a grounded theory, Surviving with Lung Cancer, in which participants framed EGFRI therapy within recognition of NSCLC as a life-limiting illness without cure. Medication-taking was a "window" into participants' process of surviving with metastatic cancer that included deciding and preparing to take EGFRIs and treating lung cancer as a chronic condition. Our results contribute to understanding how NSCLC patients view themselves in the context of a life-limiting illness and support development of a theoretically-based intervention to improve medication-taking with EGFRIs.

  20. From Therapy to Instruction: The Effect of Systemic Strategies on the Oral Performance of Foreign Language Learners

    Science.gov (United States)

    Sánchez Solarte, Ana Clara; Sánchez Solarte, Andrés

    2017-01-01

    This paper reports the results of a group intervention based on strategies derived from the systemic therapy model--brief strategic therapy. These strategies aimed at decreasing the anxiety levels commonly found in oral performance tasks related to L2 learning. Thirteen students from different semesters who belonged to two foreign language…

  1. Effect of Premedication with Oral Clonidine on Hemodynamic Response during Electroconvulsive Therapy.

    Science.gov (United States)

    Deganwa, Mangi Lal; Sharma, Rajesh; Khare, Avneesh; Sharma, Divya

    2017-01-01

    Electroconvulsive therapy (ECT) is the most effective treatment available for the acute treatment of depression in patients who do not respond to medications. It is generally used as a second line treatment for many psychological disorders, mainly major depression and schizophrenia where medication is not effective. ECT is often associated with some complications such as hypertension, tachycardia arrhythmia and even myocardial infarction. Various methods have been used for prevention or control of these cardiovascular side effects. The aim of this study was evaluating the effect of oral clonidine (0.3 mg) with control group to know the effect of oral clonidine on hemodynamic response during ECT. This prospective randomized crossover clinical trial was performed on 25 patients aged 20-50 years, weight 50-70 kg with ASA I and II who were candidates for ECT. Prior to ECT, each patient received oral doses of clonidine (0.3 mg) or a placebo 90 minutes before ECT. Baseline Heart rate, systolic, diastolic and mean arterial pressures were noted just before securing the intravenous cannula. The same parameters were noted after induction, immediately after seizure cessation following delivery of the electric shock and at 1 minute interval for 10 minutes. Data was analyzed by ANOVA test (analysis of variance). P heart rate and mean arterial pressure by clonidine (0.3 mg) was evident and statistically significant when compared with control group. Oral clonidine (0.3 mg) decreases the acute hypertensive response after electroconvulsive therapy; however, this antihypertensive effect was achieved by decreasing the blood pressure before the electrical stimulus.

  2. Prophylaxis and antibiotic therapy in management protocols of patients treated with oral and intravenous bisphosphonates

    Science.gov (United States)

    Bermúdez-Bejarano, Elena-Beatriz; Serrera-Figallo, María-Ángeles; Gutiérrez-Corrales, Aida; Romero-Ruiz, Manuel-María; Castillo-de-Oyagüe, Raquel; Gutiérrez-Pérez, José-Luis

    2017-01-01

    Introduction Osteonecrosis of the jaw (MRONJ) linked to bisphosphonate treatment has specific characteristics that render its therapeutic management challenging for clinicians. Poor response to standard treatment makes it essential to take special precautions when treating this type of disease; therefore, antibiotic prophylaxis and/or antibiotic therapy have been proposed as effective and helpful tools in these situations. Objectives This article seeks to assess published evidence in order to evaluate the different protocols used for antibiotic prophylaxis and/or antibiotic therapy in the general context of patients treated with bisphosphonates. Material and Methods A literature review of the last 10 years was carried out in PubMed using the following keywords: “antibiotic prophylaxis and osteonecrosis,” “bisphosphonates AND osteonecrosis AND dental management,” “bisphosphonate AND osteonecrosis AND antibiotic prophylaxis AND oral surgery.” A total of 188 articles were obtained, of which 18 were ultimately selected. Results and Discussion In patients treated with oral and intravenous bisphosphonates without chemotherapy-associated osteonecrosis of the jaw, antibiotic prophylaxis prior to oral surgery is an important tool to avoid osteonecrosis and promote healing of the affected area. If the patient previously exhibited chemotherapy-associated osteonecrosis after tooth extraction, antibiotic prophylaxis is indicated to prevent recurrent osteonecrosis and promote healing of the extraction site. If chemotherapy-associated osteonecrosis is already present, antibiotic therapy is a vital part of conservative management to reduce the symptomatology of MRONJ and keep it from worsening. Finally, a lack of clinical data and randomized controlled trials makes it difficult to choose the most appropriate protocol for the various clinical situations studied. Key words:Bisphosphonates, antibiotic prophylaxis, maxillary osteonecrosis, antibiotic treatment. PMID

  3. Adherence and discontinuation of oral hormonal therapy in patients with hormone receptor positive breast cancer.

    Science.gov (United States)

    Ayres, Lorena Rocha; Baldoni, André de Oliveira; Borges, Anna Paula de Sá; Pereira, Leonardo Régis Leira

    2014-02-01

    Oral treatment in women with breast cancer has been increasingly used. However, a potentially negative side of oral medication is poor patient adherence and/or discontinuation, which reduces the treatment effectiveness, accelerating progression of the disease and reducing the patient survival rate. To compare the rates of adherence and/or discontinuation and the methodologies used to assess these outcomes. It was conducted an integrative review of original articles published from 2000 to 2012, in which their primary outcome was to quantify medication adherence and/or discontinuation of oral hormonal therapy in patients with hormone receptor positive breast cancer. Original studies were searched in the PubMed/MEDLINE, Scopus, Embase and SciELO databases. The Medical Subject Heading was used to define descriptors. The descriptor "breast neoplasms" was used in all combinations. Each of the descriptors "medication adherence" and "patient compliance" were combined with each of the following descriptors "tamoxifen", "aromatase inhibitors", "selective estrogen receptor modulators", or the terms "letrozole", "anastrozole", and "exemestane". Twenty-four original articles were included. Our study showed a wide range of adherence and discontinuation rates, ranging from 45-95.7 and 12-73 %, respectively. Regarding the methodological development of the selected articles, a high prevalence (87.5 %) of prospective and/or retrospective longitudinal studies was found. In addition, there was a high prevalence of studies using a database (70.8 %). Among some of the studies, it was shown that patient adherence to hormonal therapy gradually reduces, while discontinuation increases during the treatment. It was observed a great diversity among rates of adherence and/or discontinuation of hormonal therapy for breast cancer, which may be due to a lack of methodology standardization. Therefore, adequate and validated methods to ensure reliability of the results and allow comparison in the

  4. Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral?

    Science.gov (United States)

    McDonagh, Theresa; Macdougall, Iain C

    2015-03-01

    This article considers the use and modality of iron therapy to treat iron deficiency in patients with heart failure, an aspect of care which has received relatively little attention compared with the wider topic of anaemia management. Iron deficiency affects up to 50% of heart failure patients, and is associated with poor quality of life, impaired exercise tolerance, and mortality independent of haematopoietic effects in this patient population. The European Society of Cardiology Guidelines for heart failure 2012 recommend a diagnostic work-up for iron deficiency in patients with suspected heart failure. Iron absorption from oral iron preparations is generally poor, with slow and often inefficient iron repletion; moreover, up to 60% of patients experience gastrointestinal side effects. These problems may be exacerbated in heart failure due to decreased gastrointestinal absorption and poor compliance due to pill burden. Evidence for clinical benefits using oral iron is lacking. I.v. iron sucrose has consistently been shown to improve exercise capacity, cardiac function, symptom severity, and quality of life. Similar findings were observed recently for i.v. ferric carboxymaltose in patients with systolic heart failure and impaired LVEF in the double-blind, placebo-controlled FAIR-HF and CONFIRM-HF trials. I.v. iron therapy may be better tolerated than oral iron, although confirmation in longer clinical trials is awaited. Routine diagnosis and management of iron deficiency in patients with symptomatic heart failure regardless of anaemia status is advisable, and, based on current evidence, prompt intervention using i.v. iron therapy should now be considered.

  5. Safety and efficacy of bone wax in patients on oral anticoagulant therapy.

    Science.gov (United States)

    Krasny, Marta; Krasny, Kornel; Fiedor, Piotr

    2014-01-01

    Cardiovascular conditions, apart from neoplastic diseases, remain the major cause of death in developed countries; therefore, the number of patients receiving oral anticoagulants is constantly increasing. Anticoagulant therapy considerably reduced mortality in patients with history of myocardial infarction among others. Although many interventions may be performed without withdrawal of the anticoagulant and tooth extraction was qualified as a procedure of low hemorrhage risk, a majority of dentists refer the patient to a cardiologist several days before the elective tooth extraction to withdraw anticoagulants. The aim of the study was to evaluate the efficacy and safety of bone wax used to stop bleeding after dental procedures in a group of patients on chronic anticoagulant therapy and find an answer to a question, whether it is justified to temporarily withdraw anticoagulants for this type of procedures. The study involved 176 patients on chronic anticoagulant therapy undergoing tooth extraction (154 subjects) or surgical extraction of a retained tooth (48 subjects). After the procedure, in each case the alveolus was filled with bone wax to stop bleeding. In all patients involved in the study bleeding from the alveolus was successfully stopped during the procedure. None of the subjects reported increased bleeding from the operational site after coming back home. Bone wax is a good, efficient, and safe material to block bleeding from the alveolus following tooth extractions, also in patients on chronic anticoagulant therapy. The study demonstrated that withdrawal or adjustment of anticoagulant therapy is not necessary before an elective tooth extraction.

  6. Risk of venous thromboembolic disease in postmenopausal women taking oral or transdermal hormone replacement therapy

    Institute of Scientific and Technical Information of China (English)

    Barbara RUSZKOWSKA; Gra(z)yna GADOMSKA; Liliana BIELIS; Marzena GRUSZKA; Barbara G(O)RALCZYK; Danuta RO(S)(C); Gra(z)yna ODROW(A)(Z)-SYPNIEWSKA

    2011-01-01

    Objective: The influence of hormone replacement therapy(HRT)on hemostasis processes depends on the type of hormone,the combination of doses,the time of taking HRT,and the route of administration(oral,transdermal,implanted).The aim of the current study was to assess some parameters of coagulation,especially tissue factor pathway inhibitor(TFPI)and tissue factor(TF)in postmenopausal women using oral or transdermal HRT.Methods: The study was conducted on 76 healthy women,including 46 women aged 44-58 years who were taking oral(26)or transdermal(20)HRT,and 30 women aged 44-54 years who did not take HRT as the control group.Plasma concentrations of TF,TFPI,thrombin-antithrombin complex(TAT),and D-dimer were performed by enzyme-linked immunosorbent assay(ELISA).Moreover,the concentration of fibrinogen and activity of protein C were measured by chromogenic and chronometric methods.Results: We observed a significantly higher concentration of TF and a significantly lower concentration of TFPI in women taking oral and transdermal HRT in comparison with the control group.We also found a significantly lower concentration of fibrinogen in women taking oral HRT vs.the control group.Moreover,no statistically significant changes in concentrations of TAT and D-dimer,or activity of protein C were noted.Conclusions: In this study,the occurrence of an increased TF concentration simultaneously with a decreased concentration of TFPI in women taking HRT indicates hypercoagulability.No significant modification of TAT or D-dimer occurred,and thus there may not be increased risk of thrombosis.

  7. Oral and subcutaneous therapy of canine atopic dermatitis with recombinant feline interferon omega.

    Science.gov (United States)

    Litzlbauer, Petra; Weber, Karin; Mueller, Ralf S

    2014-03-01

    Canine atopic dermatitis (CAD) is a common allergic skin disease that has been treated with subcutaneously administered interferons (IFN). Recombinant feline IFN-ω (rFeIFN-ω) was reported to be efficacious for CAD. Whether dogs develop neutralizing antibodies against rFeIFN-ω during long-term treatment and whether orally administered IFNs are efficacious in CAD is unknown. The aim of this study was to evaluate the potential development of antibodies against rFeIFN-ω in atopic dogs and to compare subcutaneous and oral IFN therapy. Twenty-six atopic dogs were randomly assigned to two groups. The first group (n=15) received eight subcutaneous injections of rFeIFN-ω (Virbagen® omega, Virbac, Carros, France) over four months, the second group (n=11) received rFeIFN-ω daily orally. Concurrent medication was permitted, except systemically acting glucocorticoids and cyclosporin, which had to be withdrawn at least two weeks prior to the study. Serum samples for antibody detection were collected before and after the study. On days 0, 60 and 120 skin lesions and pruritus were evaluated using a validated lesion score (Canine Atopic Dermatitis Extent and Severity Index=CADESI) and a validated pruritus score. Concurrent medications were recorded. For every visit a total score, consisting of CADESI, pruritus score and medication score was created. For antibody detection an indirect ELISA, using Virbagen® omega as antigen, was performed. Comparison of pruritus scores, CADESI and total scores between days 0 and 120 showed improvement in both groups, however, significant improvement could only be detected in the oral group with CADESI and total scores (61%, P=0.04 and 36%, P=0.02 respectively). Serum antibodies against rFeIFN-ω could not be detected in any of the dogs. In this study antibody production could not be demonstrated. It suggests better efficacy with oral IFN administration, which should be further verified in larger, randomized, controlled studies.

  8. Topical Tacrolimus and Periodontal Therapy in the Management of a Case of Oral Chronic GVHD Characterized by Specific Gingival Localization

    Directory of Open Access Journals (Sweden)

    Davide Conrotto

    2014-01-01

    Full Text Available Background. Chronic graft versus host disease (cGVHD is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.

  9. Topical tacrolimus and periodontal therapy in the management of a case of oral chronic GVHD characterized by specific gingival localization.

    Science.gov (United States)

    Conrotto, Davide; Broccoletti, Roberto; Carcieri, Paola; Giaccone, Luisa; Arduino, Paolo G

    2014-01-01

    Background. Chronic graft versus host disease (cGVHD) is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.

  10. Kenny-Caffey Syndrome: oral findings and 4-year follow-up of overlay denture therapy.

    Science.gov (United States)

    Demir, Tahsin; Kecik, Defne; Cehreli, Zafer C

    2007-01-01

    Kenny-Caffey Syndrome (KCS) is an extremely rare osteosclerotic bone dysplasia associated with hypocalcemia and ocular abnormalities. Although the condition is well reported in the medical literature, dental manifestations have not been discussed in great detail. The purpose of this report is to present specific oral features and prosthetic management in a KCS patient. Overlay dentures were utilized in the management of low vertical dimension of occlusion, congenital absence of several permanent teeth, and problems associated with function and esthetics. Results of the 4-year follow-up overlay denture therapy are presented.

  11. Evaluation of effect of topical ozone therapy on salivary Candidal carriage in oral candidiasis

    Directory of Open Access Journals (Sweden)

    Isha Khatri

    2015-01-01

    Results and Conclusion: There was gradual but significant reduction in Candidal CFU count in both groups. At the end of the treatment, Candidal CFU count reduction in ozone group (60.5% reduction was more than the clotrimazole group (32.3% reduction. 14 patients (70% with candidiasis in ozone group were reduced to 6 (30% whereas only 8 patients (40% out of 13 (65% in clotrimazole group, although intergroup comparison was not statistically significant. Ozone therapy was much more effective in reducing the patients with candidiasis to a state of carriers. These findings suggest that ozonated water might be useful to treat oral candidiasis.

  12. Mineral derivatives in alleviating oral mucositis during cancer therapy: a systematic review

    Directory of Open Access Journals (Sweden)

    Sonia Lee

    2015-02-01

    Full Text Available Objectives. Oral mucositis (mouth ulcers is a cancer therapy side effect. Costly treatment interventions are often neglected in favor of cost-effective agents. This review assessed the general efficacy of mineral derivatives (a cost-effective agent in alleviating oral mucositis (OM during cancer therapy compared to the standard care, or placebo—including a decision tree to aide healthcare workers.Data Sources. Electronic searches of MEDLINE via OVID, EMBASE, CENTRAL, CANCERLIT via PubMed, and CINAHL via EBSCO (year 2000 to 11 September 2014 were undertaken for randomised controlled trials. A meta-search strategy extracted content from aggregate online databases.Review Methods. Randomized controlled trials were assessed (participants, intervention, outcome, results, and risk of bias for inclusion. The author abstracted binary and continuous data synthesised to Hedges’ g in a random effects model. The primary outcome measures were severity (incidence of peak oral mucositis, duration of oral mucositis, and time to onset; secondary outcome measures were the incidence of pain, and analgesic use. Serum mineral levels, total parenteral nutrition, and adverse events were discussed. The decision tree was mapped using sensitivity, specificity, pre-test and post-test Bayesian probability.Results. 1027 citations were identified and 16 studies were included (n = 1120; mean age 49 years. Cancer therapies consisted of chemotherapy, radiotherapy, chemo-radiotherapy, or hematopoietic stem cell transplantation. Outcome mineral derivatives were zinc (n = 549, calcium phosphate (n = 227, povidone-iodine (n = 228, or selenium (n = 116. Severity was measured across variable OM grading systems: In 13 studies, individuals in treatment groups (n = 958 experienced peak OM less than controls (g = −0.47, 95% CI −0.7 to −0.2, p = 0.0006; time to OM onset was significantly delayed in treatment than controls (g = −0.51, 95% CI−0.8 to −0.2, p = 0.0002; five

  13. Use of Orally Disintegrating Olanzapine During Electroconvulsive Therapy for Prevention of Postictal Agitation.

    Science.gov (United States)

    Hermida, Adriana P; Janjua, A Umair; Tang, Yilang; Syre, Sharyn R; Job, Gregory; McDonald, William M

    2016-11-01

    A major medical problem for patients undergoing electroconvulsive therapy (ECT) is the occurrence of postictal agitation (PIA). This phenomenon is associated with confusion and disorientation that can have severe clinical implications for the safety of the patient and health care professionals. Many different pharmacological strategies have been used to prevent PIA. We present data on 40 patients who suffered from PIA after a course of ECT and evaluate the prophylactic use of orally disintegrating olanzapine in the prevention of PIA in subsequent ECT treatments.

  14. Oral surgery for patients on anticoagulant therapy: current thoughts on patient management.

    Science.gov (United States)

    Doonquah, Ladi; Mitchell, Anika D

    2012-01-01

    Minor oral surgical procedures make up a significant part of the daily practice of dentistry. With the increased sophistication of medical technology and medications there is increased likelihood of performing surgery on patients who are being treated for conditions that require some type of anticoagulant therapy. These patients are at an increased risk for perioperative bleeding or thrombotic complications if anticoagulation is discontinued or the dosage is adjusted. Therefore, a fine balance needs to be obtained and adequate preparation of these patients is the key to establishing this balance. This article reviews suggested approaches to the management of such patients.

  15. Oral propranolol therapy for infantile hemangiomas beyond the proliferation phase: a multicenter retrospective study.

    Science.gov (United States)

    Zvulunov, Alex; McCuaig, Catherine; Frieden, Ilona J; Mancini, Anthony J; Puttgen, Kate B; Dohil, Magdalene; Fischer, Gayle; Powell, Julie; Cohen, Bernard; Ben Amitai, Dan

    2011-01-01

    Pharmacological therapies for infantile hemangiomas were considered effective only during the proliferative phases. Recently reported beneficial effects of propranolol may extend beyond the proliferative phase of infantile hemangiomas. The purpose of the study was to assess the effect of oral propranolol therapy for infantile hemangiomas beyond the proliferative phase of these lesions. Members of the Society for Pediatric Dermatology were invited to participate in a multicenter retrospective study. Only children with infantile hemangiomas with documented cessation of lesions' growth or those older than 12 months of age were eligible for the study. Clinical and demographic information and digital photographs before, at the start, and following the treatment were collected. Scaled panels of photographs were distributed among preselected experienced pediatric dermatologists. Visual analog scale was used to assess photographs for each case. Paired t-test was used for statistical analyses. Data on 49 eligible patients from eight pediatric dermatology centers was collected. Seven cases were excluded because of insufficient photographic documentation. The age of the patients at the start of propranolol therapy ranged 7 to 120 months (mean 28 mos, median 22 mos). The duration of propranolol therapy ranged 1 to 8 months (mean 3.6 mos). The mean visual analog scale score before the treatment was 6.8 ± 2.15, and mean reduction in the visual analog scale score at the assessment was 2.6 ± 1.74 (p < 0.001). The rate of visual analog scale reduction was 0.4 per month before the start of the therapy, while this rate was accelerated to 0.9 per months following the therapy (p < 0.001). No significant side effects were reported. We conclude that propranolol is effective in infantile hemangiomas, including post-proliferative phase, and should be considered as the first-line therapy in that setting.

  16. Self-management of oral anticoagulant therapy for mechanical heart valve patients

    DEFF Research Database (Denmark)

    Christensen, Thomas D; Attermann, Jørn; Pilegaard, Hans K;

    2001-01-01

    .4%–2.9%) for the control group. Conclusion: Self-management of OAT is a feasible and safe concept for selected patients with mechanical heart valve prostheses also on a long-term basis. It provides at least as good and most likely better quality of anticoagulant therapy than conventional management assessed by time within......Objective: Self-management of oral anticoagulant therapy (OAT) has shown good results on a short-term basis. We hypothesize that self-management of OAT provides a better quality of treatment than conventional management also on a long-term basis. The aim of this study was to assess the quality...... of self-management of OAT in patients with mechanical heart valve prostheses on a 4-year perspective in a prospective, non-randomized study. Design: Twenty-four patients with mechanical heart valves and on self-managed OAT were followed for up to 4 years. A matched, retrospectively selected group...

  17. Preadmission oral anticoagulant therapy and clinical outcome in patients hospitalised with acute stroke and atrial fibrillation

    DEFF Research Database (Denmark)

    Ottosen, Tobias Pilgaard; Svendsen, Marie Louise; Hansen, Morten Lock;

    2014-01-01

    INTRODUCTION: Information about the effect of preadmission oral anticoagulant therapy (OAT) on stroke outcome in patients with atrial fibrillation (AF) is scarce. A systematic review was done of the existing data on the association between preadmission OAT and stroke outcome in patients with AF....... METHOD: We performed a systematic search in the PubMed Database, the Embase Database and the Cochrane Database of Systematic Reviews identifying 13 studies that met the inclusion criteria. RESULTS: The studies included a total of 18,523 patients with AF and admission with stroke. Of these, 1,169 had...... a haemorrhagic stroke. The proportion of patients in preadmission OAT varied from 5 to 37%, and the proportion who did not receive any antithrombotic therapy (AT) varied from 22 to 75%. The risk of having a severe stroke for patients with an international normalised ratio (INR)

  18. Management of antiplatelet and anticoagulant therapy for endoscopic procedures: introduction to novel oral anticoagulants

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    Martha L. González-Bárcenas

    Full Text Available The development of novel antithrombotic therapy in the past few years and its prescription in patients with cardiovascular and circulatory disease has widened the spectrum of drugs that need to be considered when performing an endoscopic procedure. The balance between the thrombotic risk patients carry due to their medical history and the bleeding risk involved in endoscopic procedures should be thoroughly analyzed by Gastroenterologists. New oral anticoagulants (NOACs impose an additional task. These agents, that specifically target factor IIa or Xa, do not dispose of an anticoagulation monitoring method nor have an antidote to revert their effect, just as with antiplatelet agents. Understanding the fundamental aspects of these drugs provides the necessary knowledge to determine the ideal period the antithrombotic therapy should be interrupted in order to perform the endoscopic procedure, offering maximum safety for patients and optimal results.

  19. Management of antiplatelet and anticoagulant therapy for endoscopic procedures: Introduction to novel oral anticoagulants.

    Science.gov (United States)

    González Bárcenas, Martha L; Pérez Aisa, Ángeles

    2016-02-01

    The development of novel antithrombotic therapy in the past few years and its prescription in patients with cardiovascular and circulatory disease has widened the spectrum of drugs that need to be considered when performing an endoscopic procedure. The balance between the thrombotic risk patients carry due to their medical history and the bleeding risk involved in endoscopic procedures should be thoroughly analyzed by Gastroenterologists. New oral anticoagulants (NOACs) impose an additional task. These agents, that specifically target factor IIa or Xa, do not dispose of an anticoagulation monitoring method nor have an antidote to revert their effect, just as with antiplatelet agents. Understanding the fundamental aspects of these drugs provides the necessary knowledge to determine the ideal period the antithrombotic therapy should be interrupted in order to perform the endoscopic procedure, offering maximum safety for patients and optimal results.

  20. The role of oral L-Carnitine therapy in chronic hemodialysis patients

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    Sabry Alaa

    2010-01-01

    Full Text Available To evaluate the effects of L-carnitine oral supplementation on anemia and cardiac function in patients on maintenance hemodialysis (HD, we studied 55 adult chronic HD patients at our center during the period from January 2006 to June 2006 and divided them into two groups; a group of 20 patients who received 1,500 mg/day oral L-carnitine and a control group of 35 patients. Both groups were on erythropoietin therapy. Echogardiographic studies were performed before and at the end of the study. The mean hemoglobin levels were comparable in the L--carnitine group and the control group at the start and after 6 months of therapy (8.63 ± 1.77 and 9.39 ± 2.02 gm/dL, P= 0.18; 10.49 ± 1.65 and 10.92 ± 2.48 gm/dL, P= 0.76, respectively. The mean weekly maintenance dose of erythropoietin was not statistically significantly different in L-carnitine group (80.16 ± 35.61 units/kg and the control group (91.9 ± 38.21 units/kg, P= 0.20. In addition no significant improvement could be observed in the echogardiographic findings in the L-carnitine group after therapy. We conclude that our study revealed no significant improvement in hemoglobin, erythropoietin dose and echocardiographic findings after six months of therapy. Long-term studies including larger number of patients are required to clarify the questionable role of L-carnitine in the HD patients.

  1. The practical management of bleedings during treatment with direct oral anticoagulants: the emergency reversal therapy

    Directory of Open Access Journals (Sweden)

    Luca Masotti

    2013-12-01

    Full Text Available Bleeding represents the most feared complication of the new oral anticoagulants, direct oral anticoagulants (DOACs, as well as all the antithrombotic therapies. During the acute phase of bleeding in patients taking anticoagulants, restoration of an effective hemostasis represents the cornerstone of practical management. While vitamin K antagonists are effectively and promptly reversed by specific antidotes such as prothrombin complex concentrates (PCCs, fresh frozen plasma or vitamin K, it is still not clear how to manage the urgent reversal of DOACs during life-threatening or major bleedings due to the lack of specific antidotes. However, in vitro and ex vivo studies have suggested some potential strategies to reverse DOACs in clinical practice, other than general support measures that are always recommended. Activated charcoal could be used in subjects with DOAC-related bleedings presenting to the emergency department within two hours of the last oral intake. Non-activated or activated PCCs (FEIBA and recombinant activated Factor VII (raFVII seem to be the optimal strategy for urgent reversal of dabigatran, while non-activated PCCs seem to have efficacy in reversing rivaroxaban. Due to its low plasma protein binding, dabigatran could be also dialyzed in urgent cases. Clinically relevant non-major bleedings and minor bleedings should be treated with general and local measures, respectively, and, when necessary, with dose delay or drug withdrawal. In this article, the Authors describe the practical approach to bleedings occurring during DOACs treatment.

  2. Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: clinical outcomes in a context of specialized oral care using low-level laser therapy.

    Science.gov (United States)

    Eduardo, Fernanda de Paula; Bezinelli, Leticia Mello; de Carvalho, Danielle Lima Corrêa; Lopes, Roberta Marques da Graça; Fernandes, Juliana Folloni; Brumatti, Melina; Vince, Carolina Sgaroni Camargo; de Azambuja, Alessandra Milani Prandini; Vogel, Cristina; Hamerschlak, Nelson; Correa, Luciana

    2015-05-01

    OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies have demonstrated OM clinical outcomes in young patients undergoing HSCT. Feasibility of oral care and LLLT on OM prophylaxis and treatment is also poorly discussed. The aim of this study was to describe a specialized oral care protocol that included LLLT for pediatric patients undergoing transplantation and to demonstrate the clinical outcomes after OM prevention and treatment. Data from OM-related morbidity were collected from 51 HSCT pediatric patients treated daily with LLLT, followed by standard oral care protocols. All the patients, even infants and young children, accepted the daily oral care and LLLT well. The majority (80.0%) only exhibited erythema in the oral mucosa, and the maximum OM degree was WHO II. Patients who had undergone autologous and HLA-haploidentical transplants showed OM with the lowest severity. The frequency of total body irradiation and methotrexate prescriptions was higher in adolescents when compared with infants (p = 0.044), and adolescents also exhibited OM more severely than infants and young children. We found that good clinical outcomes were obtained using this therapy, mainly in regard to the control of OM severity and pain reduction in the oral cavity. Specialized oral care, including LLLT, is feasible and affordable for HSCT pediatric patients, although some adaptation in the patient's oral hygiene routine must be adopted with help from parents/companions and clinical staff.

  3. Associations among the use of highly active antiretroviral therapy, oral candidiasis, oral Candida species and salivary immunoglobulin A in HIV-infected children

    Science.gov (United States)

    Pomarico, Luciana; Ferraz Cerqueira, Daniella; de Araujo Soares, Rosangela Maria; Ribeiro de Souza, Ivete Pomarico; Barbosa de Araujo Castro, Gloria Fernanda; Socransky, Sigmund; Haffajee, Anne; Palmier Teles, Ricardo

    2009-01-01

    Objectives To examine the impact of antiretroviral therapy on the prevalence of oral candidiasis, recovery of oral Candida species (spp) and salivary levels of total secretory immunoglobulin A (SIgA) and Candida-specific SIgA in human immunodeficiency virus (HIV)-infected children. Methods Sixty six HIV-positive and 40 HIV-negative children were cross-sectionally examined for the presence of oral lesions. Whole stimulated saliva samples were collected for the identification of Candida spp using culture and measurement of total and specific SIgA using enzyme-linked immunosorbent assay (ELISA). Results HIV-positive children had a higher prevalence of oral candidiasis (p < 0.05); higher frequency of detection of Candida spp (p < 0.05) and higher levels of total (p < 0.05) and Candida-specific SIgA (p < 0.001) than did HIV-negative children. Among HIV-positive subjects, antiretroviral users had lower viral loads (p < 0.001), lower levels of Candida spp (p < 0.05) and total SIgA (p < 0.05) compared with antiretroviral non-users. Conclusions The use of antiretroviral therapy was associated with decreases in the prevalence of oral candidiasis. This diminished exposure to Candida spp was accompanied by decreases in levels of total and Candida-specific SIgA. PMID:19615660

  4. Antiplatelet therapy strategies after percutaneous coronary intervention in patients needing oral anticoagulation.

    Science.gov (United States)

    Saint Etienne, Christophe; Angoulvant, Denis; Simeon, Edouard; Fauchier, Laurent

    2013-11-01

    Long-term oral anticoagulant (OAC) and dual-antiplatelet therapy are commonly needed in patients with atrial fibrillation and in patients undergoing percutaneous coronary intervention (PCI), respectively. The combination of atrial fibrillation and PCI is frequent, and leads to a dilemma for antithrombotic therapy, where risk of stroke or stent thrombosis must be balanced with bleeding risk. In the WOEST study, 573 patients on OAC undergoing PCI were randomly assigned to receive clopidogrel alone or clopidogrel plus aspirin. The primary end point was the occurrence of any bleeding episode during 1-year follow-up. Clopidogrel alone administered to patients taking OAC after PCI was associated with a significantly lower rate of bleeding complications than clopidogrel plus aspirin. Moreover, a composite secondary end point of death, myocardial infarction and stent thrombosis was significantly lower in the dual-therapy group compared with the triple-therapy group. In spite of its limitations, the WOEST study constitutes a major breakthrough, showing that long-term aspirin after PCI may be obsolete in certain circumstances. This needs to be confirmed in further studies.

  5. Mucosite bucal rádio e quimioinduzida Radiation therapy and chemotherapy-induced oral mucositis

    Directory of Open Access Journals (Sweden)

    Luiz Evaristo Ricci Volpato

    2007-08-01

    Full Text Available O aumento da intensidade da quimioterapia e radioterapia no tratamento do câncer tem elevado a incidência de efeitos colaterais, em especial da mucosite bucal. OBJETIVO E MÉTODO: Através de revisão bibliográfica realizou-se atualizar informações quanto à definição, características clínicas, incidência, etiologia, patofisiologia, morbidade associada, prevenção e tratamento dessa manifestação clínica. RESULTADOS: Estudos atuais definem a mucosite bucal como uma inflamação e ulceração dolorosa bastante freqüente na mucosa bucal apresentando formação de pseudomembrana. Sua incidência e severidade são influenciadas por variáveis associadas ao paciente e ao tratamento a que ele é submetido. A mucosite é conseqüência de dois mecanismos maiores: toxicidade direta da terapêutica utilizada sobre a mucosa e mielossupressão gerada pelo tratamento. Sua patofisiologia é composta por quatro fases interdependentes: fase inflamatória/vascular, fase epitelial, fase ulcerativa/bacteriológica e fase de reparação. É considerada fonte potencial de infecções com risco de morte, sendo a principal causa de interrupção de tratamentos antineoplásicos. Algumas intervenções mostraram-se potencialmente efetivas para sua prevenção e tratamento. Entretanto, faz-se necessária a realização de novos estudos clínicos mais bem conduzidos para obtenção de melhor evidência científica acerca do agente terapêutico de escolha para o controle da mucosite bucal, permitindo a realização da quimioterapia e radioterapia do câncer em parâmetros ideais.Tincreasing the intensity of radiation therapy and chemotherapy in the management of cancer has increased the incidence of adverse effects, especially oral mucositis. AIM AND METHODS: a bibliographical review was conducted on the definition of oral mucositis, its clinical findings, the incidence, its etiology, the pathofisiology, associated morbidity, prevention and treatment

  6. Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria

    Science.gov (United States)

    Lingscheid, Tilman; Steiner, Florian; Stegemann, Miriam S.; Bélard, Sabine; Menner, Nikolai; Pongratz, Peter; Kim, Johanna; von Bernuth, Horst; Mayer, Beate; Damm, Georg; Seehofer, Daniel; Salama, Abdulgabar; Suttorp, Norbert; Zoller, Thomas

    2016-01-01

    Episodes of delayed hemolysis 2–6 weeks after treatment of severe malaria with intravenous artesunate have been described. We performed a prospective observational study of patients with uncomplicated malaria to investigate whether posttreatment hemolysis also occurs after oral artemisinin-based combination therapy. Eight of 20 patients with uncomplicated malaria who were given oral artemisinin-based combination therapy met the definition of posttreatment hemolysis (low haptoglobin level and increased lactate dehydrogenase level on day 14). Five patients had hemolysis persisting for 1 month. Patients with posttreatment hemolysis had a median decrease in hemoglobin level of 1.3 g/dL (interquartile range 0.3–2.0 g/dL) in the posttreatment period, and patients without posttreatment hemolysis had a median increase of 0.3 g/dL (IQR −0.1 to 0.7 g/dL; p = 0.002). These findings indicate a need for increased vigilance for hemolytic events in malaria patients, particularly those with predisposing factors for anemia. PMID:27434054

  7. Role of serum interleukin-6 in deciding therapy for multidrug resistant oral lichen planus

    Science.gov (United States)

    Marwah, Akanksha; Kaushik, Smita; Garg, Vijay K.; Gupta, Sunita

    2015-01-01

    Background Oral lichen planus (OLP) is a T cell mediated immune response. T cells locally present in the involved tissues release cytokines like interleukin-6 (IL-6), which contributes to pathogenesis of OLP. Also IL-6 has been associated with multidrug resistance protein (MRP) expression by keratinocytes. Correspondingly, upregulation of MRP was found in OLP. We conducted this study to evaluate the effects of various drugs on serum IL-6 in OLP; and correlation of these effects with the nature of clinical response and resistance pattern seen in OLP lesions with various therapeutic modalities. Thus we evaluated the role of serum IL-6 in deciding therapy for multidrug resistant OLP. Material and Methods Serum IL-6 was evaluated in 42 erosive OLP (EOLP) patients and 10 normal mucosa and 10 oral squamous cell carcinoma cases using ELISA technique. OLP patients were randomly divided into 3 groups of 14 patients each and were subjected to Pimecrolimus local application, oral Mycophenolate Mofetil (MMF) and Methotrexate (MTX) alongwith Pimecrolimus local application. IL-6 levels were evaluated before and after treatment. Results Serum IL-6 levels were raised above 3pg/ml in 26.19% erosive OLP (EOLP) cases (mean- 3.72±8.14). EOLP (5%) cases with IL-6 levels above 5pg/ml were resistant in MTX group. However significant decrease in serum IL-6 corresponding with the clinical resolution was seen in MMF group. Conclusions Significantly raised IL-6 levels in EOLP reflect the chronic inflammatory nature of the disease. As serum IL-6 levels significantly decreased in MMF group, correspondingly no resistance to treatment was noted. However with MTX there was no significant decrease in IL-6 and resistance to treatment was noted in some, especially plaque type lesions. Thus IL-6 can be a possible biomarker in deciding the best possible therapy for treatment resistant OLP. Key words:Lichen planus, biological markers, cytokines, enzyme-linked immunosorbent assay, immunosuppressive

  8. ORGANIZATION OF AVAILABILITY OF THE CIRCULATION OF ANTIDIABETIC MEDICINES BASED ON PHARMACEUTICAL LAW IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Zbrozhek SI

    2016-12-01

    Full Text Available Introduction. In recent years as the global problem of healthcare in many countries acts diabetes, number of patients with this disease is growing and is already 4-6% of the population in developed countries. These indicators enable WHO experts include diabetes to one of the four priority non-infectious diseases and non-infectious epidemic of the 21st century. Because of chronic disease of diabetes decreases the quality of life of citizens, develops related diseases such as stroke, heart attack, blindness, kidney failure, amputation of the lower extremities causing deaths. Therefore, programs to combat diabetes and its prevention is a priority for national healthcare systems without exception countries. Materials and methods. Circulation of the registered antidiabetic medicines in Ukraine during pricing and delivery (example; forensic and pharmaceutical practice of the complaints and appeals on the availability for them of the antidiabetic medicines; pricing characteristics of the antidiabetic medicines over the period of 2012–2015. Methods: normative and legal, documentary, bibliographic, statistical, comparative, forensic and pharmaceutical, graphical analysis. Results and discussion. The study of organization of circulation of the antidiabetic medicines requires a systematic approach from the organizational, legal and forensic and pharmaceutical research. Today in Ukraine the arsenal of drugs for the treatment of diabetes presented with more than 85 registered antidiabetic drugs for trade names, of which 60% – insulin, and the remaining 40% – oral hypoglycemic drugs offered in a 210 release forms. Given forensic and pharmaceutical example shows that the barrier, which reduces the availability of antidiabetic medicines for diabetics at discounted prescription is mandatory registration of wholesale prices, because that price mechanism of registration by the Ministry of Healthcare of Ukraine interferes with the right of privileged

  9. 口服降糖药不良反应对2型糖尿病患者心理健康和生活质量的影响%Association between side effects of oral anti-diabetic drugs and self- reported mental health and quality of life among patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    陈宗存; 张少玲; 严励; 吴木潮; 陈黎红; 纪立农

    2011-01-01

    目的 探讨口服降糖药常见不良反应低血糖和体重增加对2型糖尿病患者心理建康和生存质量的影响.方法 全国16家三甲医院于2007年1至6月对486例2型糖尿病患者采用统一的患者问卷(AP RECAP-DM研究)进行病史采集,以低血糖担忧勘测量表(HFS-Ⅱ)测量患者治疗后对低血糖的担忧状况,欧洲生存质量五维量表(EQ-5D)测量患者治疗后的健康相关生存质量.结果 203例(41.8%)发生低血糖,其中18例(8.8%)为严重或极严重低血糖.93例(19.2%)有体重增加,其中11例(11.7%)体重增加超过5 kg.发生低血糖组HFS-Ⅱ分值高于无低血糖组[7.00(2.00~19.00)比0.00(0.00~7.00),P<0.01]而EQ-5D健康指数低于未发生低血糖组(0.90±0.12比0.93±0.13,P=0.003),其中严重或极严重低血糖组HFS-Ⅱ分值高于轻度低血糖组[20.00(8.00~30.00)比5.00(0.00~14.00),P<0.01].回归分析显示,HFS-Ⅱ分值与低血糖反应呈正相关(β=5.78,P<0.01),EQ-5D健康指数与低血糖反应呈负相关(β=-0.04,P<0.05),其中相对于轻度低血糖,严重低血糖或极严重低血糖组的HFS-Ⅱ分值较高(β=10.92,P<0.01).结论 在口服降糖药治疗过程中存在着较高的低血糖发生风险,与自我感觉不良和负性心理健康相关,有可能影响糖尿病远期预后.%Objective To examine the association between the side effects of oral anti-diabetic drugs (OAD) and self-reported mental health and quality of life among patients with type 2 diabetes mellitus (T2DM). Methods An observational, cross-sectional multicenter study with a retrospective medical chart review was conducted at 16 medical centers from around China. The T2DM patients were followed-up and treated with OAD alone prior to the index visit from January to September 2007. All subjects were ≥30 years old at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Health-related quality of life was measured

  10. Thromboembolic risk in 16 274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy

    DEFF Research Database (Denmark)

    Hansen, Morten Lock; Jepsen, Rikke Malene H G; Olesen, Jonas Bjerring;

    2015-01-01

    AIMS: To study the risk of thromboembolism in a nationwide cohort of atrial fibrillation patients undergoing direct current (DC) cardioversion with or without oral anticoagulant coverage. METHODS AND RESULTS: A retrospective study of 16 274 patients in Denmark discharged from hospital after a first......-time DC cardioversion for atrial fibrillation between 2000 and 2008. Use of oral anticoagulant therapy within 90 days prior and 360 days after DC cardioversion was obtained from the Danish Register of Medicinal Product Statistics. The risk of thromboembolism was estimated by calculating incidence rates...... and by multivariable adjusted Cox proportional-hazard models. During the initial 30 days following discharge, the thromboembolic incidence rate was 10.33 per 100 patient-years for the no prior oral anticoagulant therapy group [n = 5084 (31.2%)], as compared with 4.00 per 100 patient-years for the prior oral...

  11. IRON DEFICIENCY ANEMIA IN PREGNANCY INTRAVENOUS IRON SUCROSE AN ALTERNATIVE TO ORAL FERROUS SULPHATE THERAPY

    Directory of Open Access Journals (Sweden)

    Shireen

    2014-10-01

    Full Text Available : BACKGROUND AND OBJECTIVE: Iron deficiency anemia in pregnancy is a commonest medical problem throughout the developing world with the burden of disease impacting in both mother and newborn. 46 Anaemia affects nearly half of all the pregnant women in the world, these figures are 52%1 in the developing and 23%26 in the developed world. The high prevalence of iron deficiency anaemia among women during pregnancy in developing countries is of concern and a cause of considerable morbidity and mortality. 27 The aim of the study is to know whether intravenous iron sucrose can be an better alternative in terms of safety, efficacy and compliance over oral ferrous sulphate in the treatment of anaemia in pregnancy. METHOD: This prospective study is conducted in Obstetrics & Gynaecology Department of Cheluvamba hospital, Mysore Medical College and Research Institute, Mysore. All these women are randomly assigned (100 women each to receive either calculated dose of intravenous iron sucrose (Group B or oral ferrous suphate 200mg BD per day (Group A. Hemoglobin, hematocrit and mean corpuscular estimation is done before treatment and after 4wks of correction in both groups to note the improvement in values and monitored for adverse reactions. OBSERVATIONS AND RESULTS: The percentage rise in hemoglobin is statistically significant when baseline hemoglobin levels are compared with that at fourth week of treatment. Statistically significant rise in hemoglobin, hematocrit and mean corpuscular levels are found at fourth week in IV group when compared to oral group. None of the patients had any serious side effects. There were no treatment failures and none of them required blood transfusions. CONCLUSION: This study concluded that intravenous iron sucrose is safe, highly efficacious with better compliance for the treatment of iron deficiency anemia in pregnancy. Iron sucrose therapy is more effective in achieving the optimum results, an increase in hemoglobin

  12. Designing and Dosimetry of a Shield for Photon Fields of Radiation Therapy in Oral Cavity Cancer

    Science.gov (United States)

    Jabbari, Keyvan; Senobari, Somayeh; Roayaei, Mahnaz; Rostampour, Masoumeh

    2015-01-01

    The cancer of oral cavity is related to lesions of mucous membrane of tongue and gum that can be treated with radiation therapy. A lateral photon field can be used to treat this kind of tumor, which has a side-effect on normal tissue in the opposite side of the oral cavity. In this study the dosimetric effect of the various shields in oral cavity is evaluated. In this study, a special phantom similar to the structure of oral cavity with capability of film dosimetry was designed and constructed. The various shield slabs were made of five materials: Lead, Plexiglas, Acrylic resin, Silicon and Plaster. For irradiation, Cobalt 60 (60Co) and 6 MV photon beams were used. The film dosimetry before and after the shield was performed using GAFCHROMIC EBT2 films. The film before the shield measures the magnitude of backscattering radiation from the shield. The prescribed dose was 150 cGy. Results showed that 3 cm of the lead in both energies had the maximum absorption of radiation. The absorbed dose to opposite side of shield for 6 MV photon beams and 60Co were 21 and 32 cGy, respectively. The minimum attenuation on radiation was observed in silicon shield for which the dose of opposite side were 116 and 147 cGy for 6 MV and 60Co respectively. The maximum backscattered dose was measured 177 cGy and 219 cGy using 3 cm thickness of lead, which was quite considerable. The minimum backscattering where for acrylic resin 101 and 118 cGy for 6 MV and cobalt. In this study, it was concluded that the amount of backscattering for 3 cm Lead shield is quite considerable and increases the dose significantly. A composite layer of shield with 1–2 cm lead and 1 cm acrylic resin can have the protective effect and low backscattering radiation at the same time. PMID:26120570

  13. Immunomodulatory effects of oral antidiabetic drugs in lymphocyte cultures from patients with type 2 diabetes Efeito imunomodulador de hipoglicemiantes orais em cultura de linfócitos de pacientes com diabetes tipo 2

    OpenAIRE

    2011-01-01

    INTRODUCTION AND OBJECTIVE: It has been suggested that type 2 diabetes is an inflammatory response manifestation. The main drugs used to treat type 2 diabetes are sulphonylureas and biguanides. The aim of this study was to demonstrate the modulatory effects of oral hypoglycemic drugs (chlorpropamide and metformin) on lymphocyte proliferation in vitro and ex vivo. METHODS: Peripheral blood mononuclear cells were isolated from human blood by gradient centrifugation. T-lymphocytes were stimulate...

  14. Antidiabetic activities of aqueous and ethanolic extracts of Piper betle leaves in rats.

    Science.gov (United States)

    Arambewela, L S R; Arawwawala, L D A M; Ratnasooriya, W D

    2005-11-14

    Leaves of Piper betle (Piperaceae) possess several bioactivities and are used in traditional medicinal systems. However, its antidiabetic activity has not been scientifically investigated so far. The aim of this study therefore, was to investigate the antidiabetic activity of Piper betle leaves. This was tested in normoglycaemic and strepozotocin (STZ)-induced diabetic rats using oral administration of hot water extract (HWE) and cold ethanolic extract (CEE). In normoglycaemic rats, both HWE and CEE significantly lowered the blood glucose level in a dose-dependent manner. In glucose tolerance test, both extracts markedly reduced the external glucose load. The antidiabetic activity of HWE is comparable to that of CEE. Moreover, HWE failed to inhibit the glucose absorption from the small intestine of rats. Both extracts were found to be non-toxic and well tolerated after following chronic oral administration (no overt signs of toxicity, hepatotoxicity or renotoxicity). However, the weight of the spleen had increased in treated groups possibly indicating lymphoproliferative activity. It is concluded that HWE and CEE of Piper betle leaves possess safe and strong antidiabetic activity.

  15. A study on ethosomes as mode for transdermal delivery of an antidiabetic drug.

    Science.gov (United States)

    Bodade, Siddhodhan S; Shaikh, Karimunnisa Sameer; Kamble, Meghana S; Chaudhari, Praveen D

    2013-01-01

    A transdermal delivery system is warranted for repaglinide (RPG) which possesses half-life of 1 h and oral bioavailability of 56%. Ethosomes are useful tools for transdermal drug delivery. To prepare and evaluate ethosomes as mode for transdermal delivery of RPG. Ethosomes loaded with RPG were prepared from dipalmitoyl phosphatidylcholine and ethanol by the cold method. They were characterized using Fourier transform infrared spectroscopy and differential scanning calorimetry. They were evaluated for vesicle size, entrapment efficiency and ex-vivo skin permeation. Ethosomal composition was optimized using the 3(2) factorial design. Gel containing optimzsed ethosomes was studied for antidiabetic activity in rats. RPG ethosomes possessing the size of 0.171-1.727 µm and entrapment efficiency of 75-92% were obtained. They demonstrated a significantly higher permeation (64-97% of the administered dose) across excised rat skin when compared to free drug and its hydro alcoholic solution. In-vivo, RPG ethosomal system caused sustained antidiabetic effect. The lipid and ethanol concentration affected the physicochemical attributes and performance of ethosomes. The flexible ethosomes permeated the stratum corneum and improvized the availability of RPG for antidiabetic action. They prolonged the antidiabetic effect of RPG over a significantly longer period of time in comparison with the equivalent oral dose. Ethosomal system can successfully deliver RPG transdermally; sustain its effect and thus reduce its dosing frequency. Ethosomes are useful for enhancing the efficacy of RPG in the treatment of diabetes.

  16. Effect of Exenatide on Plasma Glucose,Weight and Body Fat in Poorly Controlled Type 2 Diabetes Patients Using Oral Antidiabetic Drug%艾塞那肽对2型糖尿病患者疗效、体重及体质成分的影响

    Institute of Scientific and Technical Information of China (English)

    卢林娜; 高政南; 朱珠; 罗兰; 刘羽晗; 王冰; 李欣宇; 牛敏; 侯桂梅

    2014-01-01

    Objective:To evaluate the effect of exenatide on plasma glucose,weight and body fat in poorly controlled type 2 diabetes patients using oral antidiabetic drug.Method:15 cases of poorly controlled type 2 diabetes who used oral antidiabetic drug in our hospital were selected. Exenatide was injected subcutaneously together with the original basis of oral hypoglycemic agents for three months,and the body weight,body mass index(BMI),the percentage of body fat tissue, the percentage of fat tissue of waist to hip and visceral fat range were analyzed by body composition analyzer before and after treatment. In the mean time,Dual-energy X-ray absorptiometry was used to determine the fat mass and percentage,muscle and bone mineral salts mass of upper limb,Lower limb,trunk,and whole body. Result:After 3 months’treatment,HbA1c were significantly decreased than before,had statistical differences(t=3.472,P0.05). The body weight,BMI, the percentage of body fat and visceral fat range were significantly decreased before and after treatment(t=4.424,P0.05). After 3 months’ treatment,the fat tissue mass of lower limb,trunk,and whole body were significantly decreased than before,had statistical differences(t=4.008,P0.05). The muscle and bone mineral salts mass were not altered(P>0.05). After 3 months’ treatment,the decrease of body weight was highly correlated with the decrease of trunk fat and whole body fat(r=0.860,0.819,P0.05);治疗后体重、体重指数、体脂百分比及内脏脂肪区域均明显下降,与治疗前比较差异均有统计学意义(t体重=4.424,P0.05);治疗后下肢、躯干、全身脂肪量较治疗前均明显下降,差异有统计学意义(t下肢脂肪量=4.008,P0.05);治疗前后上肢、下肢、躯干、全身肌肉及骨矿物盐含量无明显改变;治疗后体重下降幅度与躯干和全身脂肪量下降幅度高度相关(r=0.860、0.819,P<0.01);治疗后全身脂肪量下降幅度与下肢和躯干脂

  17. Comparison of oral and subcutaneous iron chelation therapies in the prevention of major endocrinopathies in beta-thalassemia major patients.

    Science.gov (United States)

    Wang, Chung-Hsing; Wu, Kang-Hsi; Tsai, Fuu-Jen; Peng, Ching-Tien; Tsai, Chang-Hai

    2006-01-01

    While hypertransfusion and subcutaneous iron chelation therapy have increased longevity of patients with beta-thalassemia (thal) major, endocrinopathies have become more common and impair the quality of their lives. Additionally, subcutaneous iron chelation therapy is an uncomfortable experience and can prevent patients from regular compliance with iron chelation therapy. We compared the efficacy of oral deferiprone (L1) to subcutaneous desferrioxamine (DFO) chelation therapy for the prevention of major endocrinopathies (growth hormone insufficiency, diabetes mellitus and gonadal dysfunction) among patients with beta-thal major to see if we could offer these patients an easier and more painless way to reduce their body iron load and related endocrine complications.

  18. Impact of oncology pharmacist-managed oral anticancer therapy in patients with chronic myelogenous leukemia.

    Science.gov (United States)

    Lam, Masha Sh; Cheung, Nathan

    2016-12-01

    Studies have identified non-adherence as one of the major contributing factors to treatment failure in chronic myelogenous leukemia (CML) patients receiving imatinib. Published literature has demonstrated a unique role of oncology pharmacists, as part of a multidisciplinary team, in contributing to overall positive outcomes for patients. To evaluate the impact of an oncology pharmacist-managed oral anticancer therapy program on oral medication adherence in CML patients versus usual care. Electronic refill history and medical records of patients diagnosed with CML treated with oral tyrosine kinase inhibitors (TKIs) managed by oncology pharmacists during a 6-year period, were retrospectively reviewed. Imatinib adherence rate, as the primary endpoint, was compared with the rate for those in the usual care group within the same organization. The secondary endpoints were descriptive to characterize pharmacist interventions for all TKIs. A total of 56 patients including 45 who were treated with imatinib, were evaluated. The group managed by oncology pharmacists resulted in a higher percentage of imatinib adherence rate compared to usual care (88.6% vs 65.8%, p = 0.0046). A total of 3432 pharmacist encounters were reviewed, and 567 interventions of six categories including side effect monitoring/management (n = 95; 16.8%); drug interaction detection (n = 109; 19.2%); TKI dose adjustment (n = 82; 14.5%); laboratory monitoring (n = 200; 35.3%); non-CML related drug choice (n = 74; 13.1%); and copay assistance (n = 7; 1.2%), were documented. This resulted in a mean of 10.1 interventions per patient. Our oncology pharmacist-managed oral anticancer therapy program significantly improved TKI adherence rates in CML patients. We attribute the success of our program to consistent follow-up by utilizing routine phone, and secure email follow-ups, that allowed our oncology pharmacists to build a close and trustworthy relationship with patients and

  19. close: Closure of patent foramen ovale, oral anticoagulants or antiplatelet therapy to prevent stroke recurrence: Study design.

    Science.gov (United States)

    Mas, Jean-Louis; Derumeaux, Geneviève; Amarenco, Pierre; Arquizan, Caroline; Aubry, Pierre; Barthelet, Martine; Bertrand, Bernard; Brochet, Eric; Cabanes, Laure; Donal, Erwan; Dubois-Randé, Jean-Luc; Durand-Zaleski, Isabelle; Ernande, Laura; Finet, Gérard; Fraisse, Alain; Giroud, Maurice; Guérin, Patrice; Habib, Gilbert; Juliard, Jean-Michel; Leys, Didier; Lièvre, Michel; Lusson, Jean-René; Marcon, François; Michel, Patrick; Moulin, Thierry; Mounier-Vehier, François; Pierard, Luc; Piot, Christophe; Rey, Christian; Rodier, Gilles; Roudaut, Raymond; Schleich, Jean-Marc; Teiger, Emmanuel; Turc, Guillaume; Vuillier, Fabrice; Weimar, Christian; Woimant, France; Chatellier, Gilles

    2016-08-01

    Currently available data do not provide definitive evidence on the comparative benefits of closure of patent foramen ovale, oral anticoagulants and antiplatelet therapy in patients with patent foramen ovale-associated cryptogenic stroke To assess whether transcatheter patent foramen ovale closure plus antiplatelet therapy is superior to antiplatelet therapy alone and whether oral anticoagulant therapy is superior to antiplatelet therapy, for secondary stroke prevention in patients aged 16 to 60 years with a large patent foramen ovale or a patent foramen ovale associated with an atrial septal aneurysm, and an otherwise unexplained ischaemic stroke or retinal ischaemia. Six hundred and sixty-four patients were included in the study. CLOSE is an academic-driven, multicentre, randomized, open-label, three-group, superiority trial with blinded adjudication of outcome events. The trial has been registered with Clinical Trials Register (Clinicaltrials.gov, NCT00562289). Patient recruitment started in December 2007. Patient follow-up will continue until December 2016. Expected mean follow-up = 5.6 years. The primary efficacy outcome is the occurrence of fatal or nonfatal stroke. Safety outcomes include fatal, life-threatening or major procedure- or device-related complications and fatal, life-threatening or major haemorrhagic complications. CLOSE is the first specifically designed trial to assess the superiority of patent foramen ovale closure over antiplatelet therapy alone and the superiority of oral anticoagulants over antiplatelet therapy to prevent stroke recurrence in patients with patent foramen ovale-associated cryptogenic stroke. © 2016 World Stroke Organization.

  20. Phenytoin mouthwash to treat cancer therapy-induced oral mucositis: A pilot study

    Directory of Open Access Journals (Sweden)

    M Baharvand

    2015-01-01

    Full Text Available Background: Oral mucositis is one of the most common side effects of cancer therapy with no definite treatment. Phenytoin has positive effects on healing of mucosal and dermal wounds. In this study efficacy of 1% phenytoin mouthwash on severity of mucositis (on the basis of WHO scale, pain relief (based on Visual Analogue Scale, and improvement of patients' quality of life (on the basis of EORTC-QLQ-H and N35 questionnaire was evaluated. Materials And Methods: In a pilot -double-blind randomized clinical trial, eight patients in study group were given 1% phenytoin mouthwash while eight patients in control group used normal saline. Data analysis was performed by Mann-Whitney and Repeated Measured ANOVA tests. Results: Reduction of mucositis severity was observed, but the difference was not significant. On the other hand, patients on phenytoin therapy had better pain relief (VAS# 6.75 ± 1.58 at the beginning of the study reached to # 3.75 ± 1.16 after 3 weeks in phenytoin group and improvement in quality of life (score of QOL was 70.63 ± 5.5 that reached to 63.61 ± 6.39 in phenytoin group than normal saline group significantly (P < 0.05. Conclusion: One percent phenytoin mouthwash caused pain relief and improvement of life quality significantly in patients with mucositis due to cancer therapy, but it did not reduce the severity of mucositis in a statistically significant scale.

  1. Blood gold concentrations in children with juvenile rheumatoid arthritis undergoing long-term oral gold therapy.

    Science.gov (United States)

    Giannini, E H; Brewer, E J; Person, D A

    1984-04-01

    During an uncontrolled, open-labelled, open-ended clinical trial of auranofin in children with juvenile rheumatoid arthritis (JRA) we obtained serial blood samples for the purpose of assessing gold content. Our objectives were (1) to observe the pattern of blood gold concentrations over a period of time in children undergoing long-term oral gold therapy, and (2) to observe the effect of changing dosage levels on blood gold concentrations. The initial dosage of auranofin was 0.1 mg/kg/day with allowable increases to 0.2 mg/kg/day. A concurrent nonsteroidal anti-inflammatory drug was allowed. Twenty-one patients were enrolled in the study, and we obtained 2 or more serial samples on 13 of the children. At a constant dosage of 0.1 mg/kg/day, steady state blood gold concentrations were attained in 11 to 13 weeks of therapy and, in the absence of a dosage change, remained remarkably constant through extended periods. The blood gold concentration was related to total daily dosage rather than to the cumulative amount of gold received. Increasing or decreasing the dose resulted in a direct effect on concentration. The clinical value of blood gold levels resulting from auranofin therapy in JRA will have to be established through double-blind controlled trials.

  2. Immunomodulatory effects of oral antidiabetic drugs in lymphocyte cultures from patients with type 2 diabetes Efeito imunomodulador de hipoglicemiantes orais em cultura de linfócitos de pacientes com diabetes tipo 2

    Directory of Open Access Journals (Sweden)

    Karina Faccio Mello

    2011-02-01

    Full Text Available INTRODUCTION AND OBJECTIVE: It has been suggested that type 2 diabetes is an inflammatory response manifestation. The main drugs used to treat type 2 diabetes are sulphonylureas and biguanides. The aim of this study was to demonstrate the modulatory effects of oral hypoglycemic drugs (chlorpropamide and metformin on lymphocyte proliferation in vitro and ex vivo. METHODS: Peripheral blood mononuclear cells were isolated from human blood by gradient centrifugation. T-lymphocytes were stimulated by phytohemagglutinin (PHA and oral hypoglycemic drugs. RESULTS: In both in vitro and ex vivo experiments, there was a reduction in cell proliferation after treatment with oral hypoglycemic drugs. When both drugs were used in combination, a high level of cytotoxicity was observed, which made analysis of immunomodulatory effects unfeasible. DISCUSSION AND CONCLUSION: We demonstrated that diabetes itself may reduce cell proliferation significantly when stimulated by PHA, which may indicate that diabetic patients have difficulties in promoting an efficient inflammatory response. Moreover, the use of oral hypoglycemic drugs may aggravate this situation.INTRODUÇÃO E OBJETIVOS: Tem sido sugerido que o diabetes mellitus tipo 2 (DM2 é uma manifestação da resposta inflamatória. As principais drogas utilizadas no tratamento do DM2 são as sulfonilureias e as biguanidas. O objetivo deste trabalho é demonstrar os efeitos moduladores na proliferação de linfócitos causada pelos hipoglicemiantes orais (clorpropamida e metformina, in vitro e ex vivo. MÉTODOS: Células mononucleares de sangue periférico foram isoladas de seres humanos por gradiente de centrifugação. Os linfócitos T foram estimulados com fito-hemaglutinina (PHA e hipoglicemiantes. RESULTADOS: Nos experimentos in vitro e ex vivo, mostramos a redução da proliferação celular quando do tratamento com drogas hipoglicemiantes orais. Quando as drogas foram utilizadas em combinação, foi

  3. Impact of oral simvastatin therapy on acute lung injury in mice during pneumococcal pneumonia

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    Boyd Angela R

    2012-05-01

    Full Text Available Abstract Background Recent studies suggest that the reported protective effects of statins (HMG-CoA reductase inhibitors against community-acquired pneumonia (CAP and sepsis in humans may be due to confounders and a healthy user-effect. To directly test whether statins are protective against Streptococcus pneumoniae, the leading cause of CAP, we examined the impact of prolonged oral simvastatin therapy at physiologically relevant doses in a mouse model of pneumococcal pneumonia. BALB/c mice were placed on rodent chow containing 0 mg/kg (control, 12 mg/kg (low simvastatin diet [LSD]; corresponds to 1.0 mg/kg/day, or 120 mg/kg (high simvastatin diet [HSD]; corresponds to 10 mg/kg/day simvastatin for four weeks, infected intratracheally with S. pneumoniae serotype 4 strain TIGR4, and sacrificed at 24, 36, or 42 h post-infection for assessment of lung histology, cytokine production, vascular leakage and edema, bacterial burden and bloodstream dissemination. Some mice received ampicillin at 12-h intervals beginning at 48 h post-infection and were monitored for survival. Immunoblots of homogenized lung samples was used to assess ICAM-1 production. Results Mice receiving HSD had reduced lung consolidation characterized by less macrophage and neutrophil infiltration and a significant reduction in the chemokines MCP-1 (P = 0.03 and KC (P = 0.02 and ICAM-1 in the lungs compared to control mice. HSD mice also had significantly lower bacterial titers in the blood at 36 (P = 0.007 and 42 (P = 0.03 hours post-infection versus controls. LSD had a more modest effect against S. pneumoniae but also resulted in reduced bacterial titers in the lungs and blood of mice after 42 h and a reduced number of infiltrated neutrophils. Neither LSD nor HSD mice had reduced mortality in a pneumonia model where mice received ampicillin 48 h after challenge. Conclusions Prolonged oral simvastatin therapy had a strong dose-dependent effect on protection

  4. 口服降糖药联合甘精胰岛素及餐前一次门冬胰岛素的治疗达标研究——1+1研究%Efficacy of the addition of a single bolus of insulin glulisine in combination with basal insulin glargine and oral antidiabetic drugs

    Institute of Scientific and Technical Information of China (English)

    天津市"1+1研究"协作组

    2011-01-01

    目的 观察2型糖尿病患者经口服降糖药联合甘精胰岛素治疗仍未达标时,于餐前增加1次门冬胰岛素的有效性、安全性和可行性.方法 采用多中心、开放、自身对照的方法.59例经口服降糖药及甘精胰岛素治疗而糖化血红蛋白(Hb)A1c>6.5%但<9%的患者,于主餐前加用门冬胰岛素治疗16周.结果 16周后,患者HbA1c由治疗前的(8.04±0.58)%降至(6.78±0.30)%(P<0.01),其中13例(22.03%)达到≤6.5%,43例(72.88%)达到<7.0%.早餐前、午餐前及晚餐前注射门冬胰岛素组3餐后血糖均较前明显降低,HbA1c分别为(6.70±0.29)%,(6.80±0.32)%及(6.90±0.21)%.患者低血糖发生率为0.38次/(患者·年),无夜间低血糖和严重低血糖事件发生.患者平均体重及体重指数均明显下降.结论 对于口服降糖药联合甘精胰岛素治疗血糖控制欠佳的2型糖尿病患者,于主餐前增加1次门冬胰岛素可以有效、安全地降低患者血糖,提高达标率,且具有较高可行性.%Objective To investigate the efficacy,safety and feasibility of the addition of a single bolus of insulin glulisine before meal, in combination with basal insulin glargine and oral antidiabetic drugs (OADs) in the treatment of patients with type 2 diabetes. Methods 59 patients with type 2 diabetes who were suboptimally controlled (HbA1c 6.5%-9.0% )on their previous glargine and OADs regimen were included in this 16 weeks, multicentre, open-label and self-control study. A single injection of glulisine was added,at main mealtime,to their existing therapy. Results HbA1c was decreased from (8.04 ±0.58)% to (6.78 ±0.30) % after 16 weeks(P <0.01 ). 13 patients(22.03% ) obtained the target of HbA1c ≤6.5%,43 patients (72.88%)obtained the target of HbA1c <7.0%. Glulisine given at breakfast,lunch or dinner was equally effective in controlling plasma glucose level, and the HbA1c was ( 6.70 ± 0.29 ) %, ( 6.80 ±0.32 ) %, (6.90 ± 0.21 ) % separately. The

  5. Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors

    DEFF Research Database (Denmark)

    Rasmussen, Emma L Kaderly; Hannibal, Charlotte Gerd; Dehlendorff, Christian

    2017-01-01

    OBJECTIVE: Few studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim. METHODS: This nationwide case-control study included all women with an SBT...... diagnosis in Denmark, 1978-2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy...... birth also decreased the SBT risk (p=0.03). An increased SBT risk was associated with infertility (OR=3.31; 95% CI: 2.44-4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR=1.32; 95% CI: 1.02-1.72), whereas OC use decreased the risk (OR=0.40; 95% CI: 0...

  6. Oral pharmacological chaperone migalastat compared with enzyme replacement therapy in Fabry disease

    DEFF Research Database (Denmark)

    Hughes, Derralynn A; Nicholls, Kathleen; Shankar, Suma P

    2017-01-01

    therapy (ERT), stabilises specific mutant (amenable) forms of α-Gal to facilitate normal lysosomal trafficking. METHODS: The main objective of the 18-month, randomised, active-controlled ATTRACT study was to assess the effects of migalastat on renal function in patients with Fabry disease previously...... ventricular mass index decreased significantly with migalastat treatment (-6.6 g/m(2) (-11.0 to -2.2)); there was no significant change with ERT. Predefined renal, cardiac or cerebrovascular events occurred in 29% and 44% of patients in the migalastat and ERT groups, respectively. Plasma...... globotriaosylsphingosine remained low and stable following the switch from ERT to migalastat. PROs were comparable between groups. Migalastat was generally safe and well tolerated. CONCLUSIONS: Migalastat offers promise as a first-in-class oral monotherapy alternative treatment to intravenous ERT for patients with Fabry...

  7. From a pump handle to oral rehydration therapy: a model of translational research.

    Science.gov (United States)

    Schultz, Stanley G

    2007-12-01

    Few afflictions have attracted as much attention and impacted on as many societal and biomedical areas as cholera. Dr. John Snow's studies launched the field of epidemiology, were early applications of medical cartography, and promoted the use of statistical methods in medicine. The finding that cholera was due to the ingestion of contaminated water lent to the demise of the prevalent "miasmatic theory of contagion," set the platform for the "germ theory of disease," and promoted the growth of public health concerns for water purification and sanitation. More recent attention to this disease led to the notion of "secretory diarrhea" and the translation of basic principles to the development of oral rehydration therapy and its "spin-offs" (Gatorade and Pedilyte).

  8. Successful treatment of a large oral verrucous hyperplasia with photodynamic therapy combined with cryotherapy

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    Yu-Chao Chang

    2013-03-01

    Full Text Available Studies have shown that topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT can be used successfully for the treatment of oral verrucous hyperplasia (OVH. Studies have also demonstrated that cryotherapy could be used as a treatment modality for OVH lesions. In this case report, we tested the efficacy of topical ALA-PDT, combined with cryogun cryotherapy, for an extensive OVH lesion on the right buccal mucosa of a 65-year-old male areca quid chewer. The tumor was cleared after six treatments of combined topical ALA-PDT and cryogun cryotherapy. No recurrence of the lesion was found after a follow-up period of 18 months. We suggest that our combined treatment protocol may be effective in treating OVH lesions. The treatment course may be slightly shortened with this combined protocol and was well tolerated by the patient.

  9. Photodynamic Therapy Using Temoporfin Before Surgery in Treating Patients With Recurrent Oral Cavity or Oropharyngeal Cancer

    Science.gov (United States)

    2014-09-02

    Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  10. Preclinical study of a cost-effective photodynamic therapy protocol for treating oral candidoses.

    Science.gov (United States)

    da Silva, Nathalia Ramos; Ribeiro, Daniela Garcia; Issa, João Paulo Mardegan; Bonfá, Karla; Menezes, Michelli Sobreiro; Oliveira, Viviane de Cássia; de Souza, Raphael Freitas

    2017-08-01

    Photodynamic therapy (PDT) is a promising treatment for oral candidoses. Its use as an alternative to antifungals prevents several adverse effects, including microbial resistance. However, most PDT protocols do not employ devices and consumables commonly available in dental practice, thus influencing treatment affordability. This study aimed to determine the efficacy of a PDT method based on light curing units' blue LEDs combined to a plaque-disclosing composition (5% erythrosine) against C. albicans in culture and in a murine model of oral candidosis. Standard and resistant fungal strains were tested in vitro in planktonic and biofilm forms. PDT (pre-irradiation time periods: 30 and 60 s; irradiation time: 3 min) was compared to control conditions without light and/or erythrosine. Mice with induced oral candidosis (n = 40) randomly received PDT or similar control conditions with subsequent C. albicans count. These mice underwent histological analysis, as well as 12 healthy mice submitted to experimental treatments. PDT completely inactivated C. albicans planktonic cells and biofilm. Control conditions presented minor differences (ANOVA, p < 0.05), with mean values ranging from 5.2 to 6.8 log10 (UFC/mL). Infected mice presented no significant difference in C. albicans counts consequent to treatments (ANOVA, p = 0.721), although the PDT protocol was able to enhance the inflammatory infiltrate in healthy mice. It can be concluded that the tested PDT protocol can inactivate C. albicans but still needs further investigation in order to achieve efficacy and safety.

  11. Oral resveratrol therapy inhibits cancer-induced skeletal muscle and cardiac atrophy in vivo.

    Science.gov (United States)

    Shadfar, Scott; Couch, Marion E; McKinney, Kibwei A; Weinstein, Lisa J; Yin, Xiaoying; Rodríguez, Jessica E; Guttridge, Denis C; Willis, Monte

    2011-01-01

    The mechanism by which cancer mediates muscle atrophy has been delineated in the past 3 decades and includes a prominent role of tumor-derived cytokines, such as IL-6, TNFα, and IL-1. These cytokines interact with their cognate receptors on muscle to activate the downstream transcription factor NF-κB and induce sarcomere proteolysis. Experimentally, inhibiting NF-κB signaling largely prevents cancer-induced muscle wasting, indicating its prominent role in muscle atrophy. Resveratrol, a natural phytoalexin found in the skin of grapes, has recently been shown to inhibit NF-κB in cancer cells, which led us to hypothesize that it might have a protective role in cancer cachexia. Therefore, we investigated whether daily oral resveratrol could protect against skeletal muscle loss and cardiac atrophy in an established mouse model. We demonstrate resveratrol inhibits skeletal muscle and cardiac atrophy induced by C26 adenocarcinoma tumors through its inhibition of NF-κB (p65) activity in skeletal muscle and heart. These studies demonstrate for the first time the utility of oral resveratrol therapy to provide clinical benefit in cancer-induced atrophy through the inhibition of NF-κB in muscle. These findings may have application in the treatment of diseases with parallel pathophysiologies such as muscular dystrophy and heart failure.

  12. Boron microquantification in oral mucosa and skin following administration of a neutron capture therapy agent

    Energy Technology Data Exchange (ETDEWEB)

    Kiger, S.W. III; Micca, P.L.; Morris, G.M.; Coderre, J.A

    2002-07-01

    Clinical trials of boron neutron capture therapy (BNCT) for intracranial tumours using boronphenylalanine-fructose undertaken at Harvard-MIT and Brookhaven National Laboratory have observed acute normal tissue reactions in the skin and oral mucosa. Because the range of the {sup 10}B(n,a){sup 7}Li reaction products is very short, 10-14 {mu}m combined, knowledge of the 10B microdistribution in tissue is critical for understanding the microdosimetry and radiobiology of BNCT. This paper reports measurements of the microdistribution of {sup 10}B in an animal model, rat skin and tongue, using high resolution quantitative autoradiography (HRQAR), a neutron-induced track etch autoradiographic technique. The steep spatial gradient and high absolute value relative to blood of the {sup 10}B concentration observed in some strata of the rat tongue epithelium and skin are important for properly evaluating the radiobiology and the biological effectiveness factors for normal tissue reactions such as oral mucositis, which are generally assessed using the blood boron concentration rather than the tissue boron concentration. (author)

  13. Antimicrobial photodynamic therapy with two photosensitizers on two oral streptococci: an in vitro study

    Science.gov (United States)

    Vahabi, S.; Fekrazad, R.; Ayremlou, S.; Taheri, S.; Lizarelli, R. F. Z.; Kalhori, K. A. M.

    2011-12-01

    Periodontal diseases are caused by infection of tissues supporting the teeth due to complex aggregate of bacteria known as biofilm and firstly colonized by streptococci. The aim of this in vitro study was to evaluate the effect of Radachlorin® and Toluidine Blue O (TBO)-mediated photodynamic therapy (PDT) on the viability of two oral streptococci. Bacterial suspensions of Streptococcus mutans and Streptococcus sanguis were subjected to either TBO or Radachlorin®, Then exposed to two different diode laser light at energy densities of 3, 6 J/cm2 at 633 nm and 6, 12 J/cm2 at 662 nm, respectively. The control groups were subjected to laser light alone, photosensitizer alone or received neither photosensitizer nor light exposure. The suspensions were then spread over specific agar mediums and viable microorganisms were counted after overnight incubation aerobically at 37°C, 5% CO2 and then reported as colony forming unit. The results indicated that photosensitization by the energy density of 6 J/cm2 with Radachlorin® and both 3 and 6 J/cm2 with TBO caused significant reduction in bacterial colony formation ( p oral streptococci in vitro.

  14. Comparative pharmacokinetics of oral and intravenous ifosfamide/mesna/methylene blue therapy.

    Science.gov (United States)

    Aeschlimann, C; Küpfer, A; Schefer, H; Cerny, T

    1998-09-01

    Oral treatment with ifosfamide results in dose-limiting encephalopathy. Methylene blue is effective in reversal and prophylaxis of this side effect. In the present study, the pharmacokinetics of ifosfamide after iv and po therapy in combination with prophylactic administration of methylene blue were investigated. Nine patients with metastatic non-small cell lung cancer were treated by a combination of ifosfamide (3 days), sodium 2-mercaptoethane sulfonate (4 days), and etoposide (8 days). Cycles were repeated every 28 days. Ifosfamide was administered orally, with the exception of one of the first two cycles, when it was administered as a short infusion (randomly assigned). The patients received methylene blue in doses of 50 mg po 3 times daily; an initial dose of 50 mg was given the evening before chemotherapy. Urine samples were collected over the entire treatment period, and concentrations of ifosfamide and its major metabolite, 2-chloroethylamine, were measured by gas liquid chromatography. By the same technique, 2- and 3-dechloroethylifosfamide were determined in plasma and urine. Overall alkylating activity in urine was assayed by reaction of the alkylating metabolites with 4-(4'-nitrobenzyl)-pyridine. The chemotherapeutic regimen was well-tolerated by all of the patients studied. There was no evidence of a shift in the metabolic pattern dependent on the route of administration. From the data, we conclude that methylene blue has a neuroprotective effect and that the pharmacokinetics of ifosfamide are not influenced by its comedication.

  15. Characteristics of Symptomatic Intracranial Hemorrhage in Patients Receiving Non-Vitamin K Antagonist Oral Anticoagulant Therapy.

    Directory of Open Access Journals (Sweden)

    Hisanao Akiyama

    Full Text Available The first non-vitamin K antagonist oral anticoagulant (NOAC introduced to the market in Japan was dabigatran in March 2011, and three more NOACs, rivaroxaban, apixaban, and edoxaban, have since become available. Randomized controlled trials of NOACs have revealed that intracranial hemorrhage (ICH occurs less frequently with NOACs compared with warfarin. However, the absolute incidence of ICH associated with NOACs has increased with greater use of these anticoagulants, and we wanted to explore the incidence, clinical characteristics, and treatment course of patients with NOACs-associated ICH.We retrospectively analyzed the characteristics of symptomatic ICH patients receiving NOACs between March 2011 and September 2014.ICH occurred in 6 patients (5 men, 1 woman; mean ± SD age, 72.8 ± 3.2 years. Mean time to onset was 146.2 ± 111.5 days after starting NOACs. Five patients received rivaroxaban and 1 patient received apixaban. None received dabigatran or edoxaban. Notably, no hematoma expansion was observed within 24 h of onset in the absence of infusion of fresh frozen plasma, activated prothrombin complex concentrate, recombinant activated factor VIIa or hemodialysis. When NOAC therapy was initiated, mean HAS-BLED and PANWARDS scores were 1.5 ± 0.5 and 39.5 ± 7.7, respectively. Mean systolic blood pressure was 137.8 ± 15.9 mmHg within 1 month before spontaneous ICH onset.Six symptomatic ICHs occurred early in NOAC therapy but hematoma volume was small and did not expand in the absence of infusion of reversal agents or hemodialysis. The occurrence of ICH during NOAC therapy is possible even when there is acceptable mean systolic blood pressure control (137.8 ± 15.9 mmHg and HAS-BLED score ≤ 2. Even stricter blood pressure lowering and control within the acceptable range may be advisable to prevent ICH during NOAC therapy.

  16. Novel Oral Therapies for Opioid-induced Bowel Dysfunction in Patients with Chronic Noncancer Pain.

    Science.gov (United States)

    Holder, Renee M; Rhee, Diane

    2016-03-01

    Opioid analgesics are frequently prescribed and play an important role in chronic pain management. Opioid-induced bowel dysfunction, which includes constipation, hardened stool, incomplete evacuation, gas, and nausea and vomiting, is the most common adverse event associated with opioid use. Mu-opioid receptors are specifically responsible for opioid-induced bowel dysfunction, resulting in reduced peristaltic and secretory actions. Agents that reverse these actions in the bowel without reversing pain control in the central nervous system may be preferred over traditional laxatives. The efficacy and safety of these agents in chronic noncancer pain were assessed from publications identified through Ovid and PubMed database searches. Trials that evaluated the safety and efficacy of oral agents for opioid-induced constipation or opioid-induced bowel dysfunction, excluding laxatives, were reviewed. Lubiprostone and naloxegol are approved in the United States by the Food and Drug Administration for use in opioid-induced constipation. Axelopran (TD-1211) and sustained-release naloxone have undergone phase 2 and phase 1 studies, respectively, for the same indication. Naloxegol and axelopran are peripherally acting μ-opioid receptor antagonists. Naloxone essentially functions as a peripherally acting μ-opioid receptor antagonist when administered orally in a sustained-release formulation. Lubiprostone is a locally acting chloride channel (CIC-2) activator that increases secretions and peristalsis. All agents increase spontaneous bowel movements and reduce other bowel symptoms compared with placebo in patients with noncancer pain who are chronic opioid users. The most common adverse events were gastrointestinal in nature, and none of the drugs were associated with severe adverse or cardiovascular events. Investigations comparing these agents to regimens using standard laxative and combination therapy and trials in special populations and patients with active cancer are

  17. Low standard oral anticoagulation therapy for Chinese patients with St.Jude mechanical heart valves

    Institute of Scientific and Technical Information of China (English)

    孙晓刚; 胡盛寿; 祁国奇; 周玉燕

    2003-01-01

    Objective To study the efficacy of the low standard oral anticoagulation therapy following St Jude Medical (SJM) valve implantation for Chinese patients.Methods Totally 805 patients with a mean age of 42.70±11.09 years, enrolled into this study. Among them, 230 underwent aortic valve replacements (AVR), 381 mitral valve replacements (MVR), 189 double valve replacements (DVR) and 5 tricuspid valve replacememts (TVR). All patients received postoperative oral anticoagulation therapy based on a low standard of international normalized ratio (INR, 2.0-2.5). Of the 805 patients, 710 were followed up for 0.25-13 years (a median, 4.15 years). Results Postoperatively, 17 adverse events occurred. Operative mortality was 2.11%. The most frequent cause of operative mortality was a low cardiac output. During follow-up, there were 47 anticoagulant-induced hemorrhages [1.59%/patient-year (pt-yr)], 10 cases of thromboembolism (0.34%/pt-yr), and 3 mechanical valve thromboses (0.19%/pt-yr). There were 44 late deaths and the linearized late mortality rates were 0.51%pt-yr. Estimates of actuarial survival for all patients at 5 and 10 years was 97.45% (0.70%) and 77.96% (17.44%), respectively.Conclusions A low target INR range of 2.0-2.5 is preferable for Chinese patients so as to reduce the severe bleeding complications in those with conventionally higher levels of INR. The long-term results were satisfactory in terms of the numbers of those who suffered thrombosis, embolism and bleeding.

  18. Feasibility Study of a Mobile Health Intervention for Older Adults on Oral Anticoagulation Therapy

    Directory of Open Access Journals (Sweden)

    Jung-Ah Lee PhD, RN

    2016-10-01

    Full Text Available Background: Oral anticoagulation treatment (OAT such as warfarin therapy is recommended for older adults with atrial fibrillation, heart failure, or who are at risk for venous thromboembolism. Despite its proven benefits, older adults report both dissatisfaction with OAT and reduced quality of life that can potentially lead to low adherence to OAT and decreased treatment efficacy. Objective: To test the feasibility of Mobile Applications for Seniors to enhance Safe anticoagulation therapy (MASS, a mobile-based health technology intervention designed to promote independence and self-care. Methods: This pilot study used a single-arm experimental pre–post design to test the feasibility of a 3-month intervention using MASS in 18 older adults (male: n = 14; White: n = 9; Hispanic: n = 7; Other: n = 2; M age = 67. MASS was available in English or Spanish. Participants completed surveys about their OAT knowledge, attitudes, quality of life with OAT, and adherence at baseline and at a 3-month follow-up. Satisfaction with the MASS intervention was also assessed at follow-up. Results: Anticoagulation knowledge significantly improved from baseline to follow-up (Mbase = 12.5 ± 5.51, Mfollow-up = 14.78 ± 3.93, p = .007. Other outcomes were not different, pre- and post-tests. Participants reported they were generally satisfied with MASS, its ease of use and its usefulness. Conclusion: The results showed use of MASS improved older adults’ knowledge of OAT. Using mHealth apps may enhance self-care among older adults with chronic conditions who are also taking oral anticoagulants.

  19. Effect of oil gum massage therapy on common pathogenic oral microorganisms - A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Nishu Singla

    2014-01-01

    Full Text Available Objectives: (i To assess reduction in Streptococcus mutans and Lactobacillus species count in saliva sample after ten minutes of oil gum massage therapy (massage of gingival tissues per day for three weeks with sesame oil, olive oil, and coconut oil in three different groups of subjects. (ii To compare the efficacy between three different oils and the "gold standard" chlorhexidine gel. (iii To assess reduction in gingival scores and plaque scores of study subjects. Materials and Methods: Study design - Single center, parallel design, and triple blind randomized clinical study with four treatment groups. Participants: 32 of the 40 study subjects working as housekeeping personnel at Kasturba Hospital, Manipal; aged 18-55 years completed the three-week study period. Interventions: Subjects were randomly assigned to massage their gingiva everyday for three weeks with sesame oil, olive oil, coconut oil (tests, and Chlorhexidine gel (control. Oral health status and paraffin stimulated saliva samples were obtained at baseline and after three weeks of oil gum massage therapy. Outcome measures: Microbial culture, plaque index, and gingival index. Statistical analysis: Paired t test and Kruskal Wallis test. Results: There was a significant reduction in mean Streptococcus mutans count, Lactobacillus count, plaque scores, and gingival scores in all four groups after the study. However, there was no significant difference found in percentage reduction of these variables between the four groups. Conclusion: These oils can be used as valuable preventive agents in maintaining and improving oral health in low socioeconomic status population. However, it is recommended that further research should be conducted in other populations with a larger sample and longer duration of follow-up period.

  20. Pentoxifylline therapy : A new adjunct in the treatment of oral submucous fibrosis

    Directory of Open Access Journals (Sweden)

    Rajendran R

    2006-01-01

    Full Text Available OBJECTIVE : This study was designed to determine the effect of pentoxifylline (Trental on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. STUDY DESIGN : This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets. The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls were included in this study and 100% compliance was reported at the end ofthe test period. RESULTS : Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000, tongue protrusion (t= 3.898, p = 0.002, and relief from perioral fibrotic bands (p = 0.0001554. Subjective symptoms of intolerance to spices (p = 0.0063218, burning sensation of mouth (p = 0.0005797, tinnitus (p=0.000042, difficulty in swallowing (p=0.0000714. and difficulty in speech (p=0.0000020 were also recorded significant improvement at the end of the trial period. CONCLUSION : This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.

  1. Feasibility Study of a Mobile Health Intervention for Older Adults on Oral Anticoagulation Therapy

    Directory of Open Access Journals (Sweden)

    Jung-Ah Lee PhD, RN

    2016-10-01

    Full Text Available Background: Oral anticoagulation treatment (OAT such as warfarin therapy is recommended for older adults with atrial fibrillation, heart failure, or who are at risk for venous thromboembolism. Despite its proven benefits, older adults report both dissatisfaction with OAT and reduced quality of life that can potentially lead to low adherence to OAT and decreased treatment efficacy. Objective: To test the feasibility of Mobile Applications for Seniors to enhance Safe anticoagulation therapy (MASS, a mobile-based health technology intervention designed to promote independence and self-care. Method s: This pilot study used a single-arm experimental pre–post design to test the feasibility of a 3-month intervention using MASS in 18 older adults (male: n = 14; White: n = 9; Hispanic: n = 7; Other: n = 2; M age = 67. MASS was available in English or Spanish. Participants completed surveys about their OAT knowledge, attitudes, quality of life with OAT, and adherence at baseline and at a 3-month follow-up. Satisfaction with the MASS intervention was also assessed at follow-up. Results: Anticoagulation knowledge significantly improved from baseline to follow-up ( M base = 12.5 ± 5.51, M follow-up = 14.78 ± 3.93, p = .007. Other outcomes were not different, pre- and post-tests. Participants reported they were generally satisfied with MASS, its ease of use and its usefulness. Conclusion: The results showed use of MASS improved older adults’ knowledge of OAT. Using mHealth apps may enhance self-care among older adults with chronic conditions who are also taking oral anticoagulants.

  2. Which oral antidiabetic drug to combine with metformin to minimize the risk of hypoglycemia when initiating basal insulin?: A randomized controlled trial of a DPP4 inhibitor versus insulin secretagogues.

    Science.gov (United States)

    Gautier, J F; Monguillon, P; Verier-Mine, O; Valensi, P; Fiquet, B; Dejager, S; Charbonnel, B

    2016-06-01

    We conducted a pilot study to evaluate two therapeutic strategies at the time of insulin initiation in type 2 diabetic patients insufficiently controlled with metformin+insulin-secretagogues (IS, sulfonylureas or glinides). Patients were randomized to remain under the same dual therapy or to receive metformin+DPP4 inhibitors while starting insulin. Similar glycemic control was achieved in both groups. However less hypoglycemia was observed with DPP4 inhibitors despite higher doses of insulin.

  3. Antidiabetic and hypolipidemic activities of Kigelia pinnata flowers extract in streptozotocin induced diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Kumar S; Kumar V; Prakash OM

    2012-01-01

    Objective:To evaluate antidiabetic and hypolipidemic activities of Kigelia pinnata methanolic flowers extract in streptozotocin (STZ) induced diabetic wistar rat. Methods: Rats were made diabetic by a single dose of STZ at 60 mg/kg body weight i.p. The blood glucose level was checked before and 72 h after STZ injection to confirm the development of diabetes. The flower extract and glibenclamide were administered orally at the doses of 250 and 500 mg/kg body weight for 21 days. Results:Daily oral treatment with the extract and standard drug for 21 days significantly reduced blood glucose, serum cholesterol and triglycerides levels. High density lipoprotein-cholesterol level was found to be improved (P<0.01) as compared to diabetic control group. Conclusions:It is concluded that Kigellia pinnata flowers extract have significant antidiabetic and hypolipidemic effect.

  4. Predictors of Oral Rehydration Therapy use among under-five children with diarrhea in Eastern Ethiopia: a community based case control study

    Directory of Open Access Journals (Sweden)

    Mengistie Bezatu

    2012-11-01

    Full Text Available Abstract Background Rehydration therapy is a critical intervention to save the lives of children during the episodes of diarrhea. However, millions of children die every year due to failure to replace fluid effectively. The objective of this study was to identify the predictors of Oral Rehydration Therapy use among under-five children with diarrhea. Method A community based unmatched case control study was conducted in Kersa district, Eastern Ethiopia, in February, 2011. The cases were 241 under-five children with diarrhea in the preceding two weeks before the survey and who had received Oral Rehydration Therapy while the controls were 253 under-five children with diarrhea in the preceding two weeks before the survey and who had not received Oral Rehydration Therapy. The cases and the controls were compared to find out the factors that were associated with the utilization of Oral Rehydration Therapy. Result The study revealed that caregivers’ previous experience of Oral Rehydration Therapy use (AOR = 4.05, 95% CI = 2.63–6.22, seeking advice or treatment from health facilities, (AOR = 3.25, 95% CI = 2.06–5.11 and knowledge of Oral Rehydration Therapy (AOR = 3.09, 95% CI = 1.97–4.85 were found to be the positive determinants of Oral Rehydration Therapy use. Perception of teething as a cause of diarrhea was negatively associated with the utilization of Oral rehydration Therapy (AOR = 0.61, 95% CI = 0.37–0.98. Conclusion Health education should be strengthened on the benefit, preparation, early initiation of Oral Rehydration Therapy and the causes of diarrhea. Attention should be given to those who do not have previous experience of Oral Rehydration Therapy use and have less frequent contacts with the health facilities.

  5. Predictors of Oral Rehydration Therapy use among under-five children with diarrhea in Eastern Ethiopia: a community based case control study.

    Science.gov (United States)

    Mengistie, Bezatu; Berhane, Yemane; Worku, Alemayehu

    2012-11-24

    Rehydration therapy is a critical intervention to save the lives of children during the episodes of diarrhea. However, millions of children die every year due to failure to replace fluid effectively. The objective of this study was to identify the predictors of Oral Rehydration Therapy use among under-five children with diarrhea. A community based unmatched case control study was conducted in Kersa district, Eastern Ethiopia, in February, 2011. The cases were 241 under-five children with diarrhea in the preceding two weeks before the survey and who had received Oral Rehydration Therapy while the controls were 253 under-five children with diarrhea in the preceding two weeks before the survey and who had not received Oral Rehydration Therapy. The cases and the controls were compared to find out the factors that were associated with the utilization of Oral Rehydration Therapy. The study revealed that caregivers' previous experience of Oral Rehydration Therapy use (AOR = 4.05, 95% CI = 2.63-6.22), seeking advice or treatment from health facilities, (AOR = 3.25, 95% CI = 2.06-5.11) and knowledge of Oral Rehydration Therapy (AOR = 3.09, 95% CI = 1.97-4.85) were found to be the positive determinants of Oral Rehydration Therapy use. Perception of teething as a cause of diarrhea was negatively associated with the utilization of Oral rehydration Therapy (AOR = 0.61, 95% CI = 0.37-0.98). Health education should be strengthened on the benefit, preparation, early initiation of Oral Rehydration Therapy and the causes of diarrhea. Attention should be given to those who do not have previous experience of Oral Rehydration Therapy use and have less frequent contacts with the health facilities.

  6. Candidiasis and other oral mucosal lesions during and after interferon therapy for HCV-related chronic liver diseases

    Directory of Open Access Journals (Sweden)

    Nagao Yumiko

    2012-11-01

    Full Text Available Abstract Background Oral lichen planus (OLP is seen frequently in patients with hepatitis C virus (HCV infection. The aim of this study was to evaluate the occurrence of oral candidiasis, other mucosal lesions, and xerostomia during interferon (IFN therapy for HCV infection. Methods Of 124 patients with HCV-infected liver diseases treated with IFN therapy in our hospital, 14 (mean age 56.00 ± 12.94 years who attended to receive administration of IFN once a week were identified and examined for Candida infection and other oral lesions and for the measurement of salivary flow. Serological assays also were carried out. Results Cultures of Candida from the tongue surfaces were positive in 7 (50.0% of the 14 patients with HCV infection at least once during IFN therapy. C. albicans was the most common species isolated. The incidence of Candida during treatment with IFN did not increase above that before treatment. Additional oral mucosal lesions were observed in 50.0% (7/14 of patients: OLP in three (21.4%, angular cheilitis in three (21.4% and recurrent aphthous stomatitis in one (7.1%. OLP occurred in one patient before treatment with IFN, in one during treatment and in one at the end of treatment. 85.7% of the oral lesions were treated with topical steroids. We compared the characteristics of the 7 patients in whom Candida was detected at least once during IFN therapy (group 1 and the 7 patients in whom Candida was not detected during IFN therapy (group 2. The prevalence of oral mucosal lesions (P=0.0075 and incidence of external use of steroids (P=0.0308 in group 1 were significantly higher than in group 2. The average body weight of group 1 decreased significantly compared to group 2 (P=0.0088. Salivary flow decreased in all subjects throughout the course of IFN treatment and returned at 6th months after the end of treatment. In group 1, the level of albumin at the beginning of the 6th month of IFN administration was lower than in group 2 (P=0

  7. Cost-effectiveness of combined oral bisphosphonate therapy and falls prevention exercise for fracture prevention in the USA.

    Science.gov (United States)

    Mori, T; Crandall, C J; Ganz, D A

    2017-02-01

    We developed a Markov microsimulation model among hypothetical cohorts of community-dwelling US white women without prior major osteoporotic fractures over a lifetime horizon. At ages 75 and 80, adding 1 year of exercise to 5 years of oral bisphosphonate therapy is cost-effective at a conventionally accepted threshold compared with bisphosphonates alone.

  8. Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland

    LENUS (Irish Health Repository)

    O’Shea, M. P.

    2014-05-01

    Few studies have investigated regional variation in medication-taking behaviour. The purpose of this study was to investigate whether there are regional differences in non-persistence and non-adherence to oral anti-hyperglycaemic agents in patients initiating therapy and examine if any association exists between different types of comorbidity in terms of medication-taking behaviour.\\r\

  9. PROTOCOL FOR THE PREVENTION AND TREATMENT OF ORAL SEQUELAE RESULTING FROM HEAD AND NECK RADIATION-THERAPY

    NARCIS (Netherlands)

    JANSMA, J; VISSINK, A; SPIJKERVET, FKL; ROODENBURG, JLN; PANDERS, AK; VERMEY, A; SZABO, BG; SGRAVENMADE, EJ

    1992-01-01

    In addition to the desired antitumor effects, head and neck radiation therapy induces damage in normal tissues that may result in oral sequelae such as mucositis, hyposalivation, radiation caries, taste loss, trismus, soft-tissue necrosis, and osteoradionecrosis. These sequelae may be dose-limiting

  10. Factors Associated with Adherence Rates for Oral and Intravenous Anticancer Therapy in Commercially Insured Patients with Metastatic Colon Cancer.

    Science.gov (United States)

    Seal, Brian S; Anderson, Sibyl; Shermock, Kenneth M

    2016-03-01

    Over the past decade, oncology therapies have trended toward orally administered regimens, and there has been growing attention on evaluation of factors that affect adherence. There has not been a rigorous investigation of factors associated with adherence to intravenous (i.v.) and oral anticancer drugs in the setting of metastatic colorectal cancer (mCRC). To (a) assess potential patient-specific factors related to adherence to mCRC chemotherapy regimens and (b) compare adherence with IV versus oral dosage forms. A retrospective analysis was performed using the Optum Oncology Management claims database. Patients aged 18 years and older diagnosed with mCRC between July 1, 2004, and December 31, 2010, who were insured by a commercial health plan were included in the study. Adherence to i.v. and oral chemotherapy regimens was assessed using the National Comprehensive Cancer Network (NCCN) guidelines as the standard for expected cycle/regimen duration. The most commonly prescribed chemotherapy regimens were assessed. Adherence was evaluated using the medication possession ratio (MPR), calculated as the number of days a patient was covered by their chemotherapy regimen, according to NCCN guidelines, divided by the number of days elapsed from the first to the last infusion of that regimen. For most analyses, the MPR was considered a continuous variable that could take on values between 0 and 1. In other analyses, a dichotomous categorical variable designated if the MPR was at least 0.8 versus less than 0.8. The Wilcoxon rank sum, Kruskal-Wallis, and Student's t-test were used to detect differences in continuous measures between patients receiving oral capecitabine therapy versus i.v. chemotherapy. The chi square test (X(2) test) or Fisher's exact test was used to assess differences in the dichotomous MPR variable. Generalized estimating equation (GEE) models were used for regimen-level analyses to account for correlated responses within individuals. A total of 6

  11. Oral immune therapy: targeting the systemic immune system via the gut immune system for the treatment of inflammatory bowel disease.

    Science.gov (United States)

    Ilan, Yaron

    2016-01-01

    Inflammatory bowel diseases (IBD) are associated with an altered systemic immune response leading to inflammation-mediated damage to the gut and other organs. Oral immune therapy is a method of systemic immune modulation via alteration of the gut immune system. It uses the inherit ability of the innate system of the gut to redirect the systemic innate and adaptive immune responses. Oral immune therapy is an attractive clinical approach to treat autoimmune and inflammatory disorders. It can induce immune modulation without immune suppression, has minimal toxicity and is easily administered. Targeting the systemic immune system via the gut immune system can serve as an attractive novel therapeutic method for IBD. This review summarizes the current data and discusses several examples of oral immune therapeutic methods for using the gut immune system to generate signals to reset systemic immunity as a treatment for IBD.

  12. Nanostructured Lipid Carriers Loaded with Baicalin: An Efficient Carrier for Enhanced Antidiabetic Effects

    OpenAIRE

    Feng Shi; Zheng Wei; Yingying Zhao; Ximing Xu

    2016-01-01

    Context: Recent studies have demonstrated that baicalin has antihyperglycemic effects by inhibiting lipid peroxidation. Baicalin is low hydrophilic and poorly absorbed after oral administration. Thus, a suitable formulation is highly desired to overcome the disadvantages of baicalin. Objective: The objective of this work was to prepare baicalin-loaded nanostructured lipid carriers (B-NLCs) for enhanced antidiabetic effects. Materials and Methods: B-NLCs were prepared by high-pressure homogeni...

  13. Marine Organisms with Anti-Diabetes Properties.

    Science.gov (United States)

    Lauritano, Chiara; Ianora, Adrianna

    2016-12-01

    Diabetes is a chronic degenerative metabolic disease with high morbidity and mortality rates caused by its complications. In recent years, there has been a growing interest in looking for new bioactive compounds to treat this disease, including metabolites of marine origin. Several aquatic organisms have been screened to evaluate their possible anti-diabetes activities, such as bacteria, microalgae, macroalgae, seagrasses, sponges, corals, sea anemones, fish, salmon skin, a shark fusion protein as well as fish and shellfish wastes. Both in vitro and in vivo screenings have been used to test anti-hyperglycemic and anti-diabetic activities of marine organisms. This review summarizes recent discoveries in anti-diabetes properties of several marine organisms as well as marine wastes, existing patents and possible future research directions in this field.

  14. Marine Organisms with Anti-Diabetes Properties

    Directory of Open Access Journals (Sweden)

    Chiara Lauritano

    2016-12-01

    Full Text Available Diabetes is a chronic degenerative metabolic disease with high morbidity and mortality rates caused by its complications. In recent years, there has been a growing interest in looking for new bioactive compounds to treat this disease, including metabolites of marine origin. Several aquatic organisms have been screened to evaluate their possible anti-diabetes activities, such as bacteria, microalgae, macroalgae, seagrasses, sponges, corals, sea anemones, fish, salmon skin, a shark fusion protein as well as fish and shellfish wastes. Both in vitro and in vivo screenings have been used to test anti-hyperglycemic and anti-diabetic activities of marine organisms. This review summarizes recent discoveries in anti-diabetes properties of several marine organisms as well as marine wastes, existing patents and possible future research directions in this field.

  15. Oral pressure therapy for treatment of obstructive sleep apnea: clinical feasibility

    Directory of Open Access Journals (Sweden)

    Farid-Moayer M

    2013-05-01

    Full Text Available Mehran Farid-Moayer,1 Lawrence C Siegel,2,3 Jed Black41Peninsula Sleep Center, Burlingame, CA, USA; 2Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA; 3Department of Clinical Affairs, ApniCure, Inc, Redwood City, CA, USA; 4Stanford Center for Sleep Research and Medicine, Stanford University School of Medicine, Stanford, CA, USAPurpose: This feasibility study examined the initial-use safety and effectiveness of a new noninvasive oral pressure therapy (OPT system developed to treat obstructive sleep apnea (OSA.Methods: The OPT system consists of a console that connects with flexible tubing to a premanufactured polymer mouthpiece. Through the mouthpiece, a pump in the console creates oral vacuum intended to move the soft palate anteriorly to decrease obstruction of the airway during sleep. The mouthpiece was produced in ten different sizes to accommodate a range of oral dimensions. Subjects with OSA in this single-center, single-night study underwent a polysomnography (PSG study at baseline, followed by PSG during use of OPT.Results: Fifty-six men and 20 women, aged 50.8 ± 12.0 years (mean ± standard deviation [SD], had OSA with apnea–hypopnea indices (AHI greater than five events per hour at baseline. Body weight averaged 98.0 ± 18.2 kg (mean ± SD, body mass index ranged from 22.6 kg/m2 to 57.9 kg/m2 and averaged 32.5 ± 5.8 kg/m2 (mean ± SD. OPT was generally well tolerated without any serious adverse events. Baseline AHI was 38.7 ± 27.5 events/hour (mean ± SD and was reduced with treatment to 24.6 ± 25.7 events/hour (P < 0.001, Cohen's d 0.53. Treatment produced AHI less than or equal to ten events/hour in 38% of the subjects. Oxygen desaturation index was 30.1 ± 23.7 events/hour at baseline versus 15.8 ± 19.1 events/hour with treatment (P < 0.001, Cohen's d 0.66. The minimum oxygen saturation increased with treatment from 77.9 ± 8.3 to 82.2 ± 7.9 (P < 0.001, Cohen's d 0.53. Stage-N1 sleep shifts

  16. [Protein catabolism and malnutrition in liver cirrhosis - impact of oral nutritional therapy].

    Science.gov (United States)

    Norman, K; Valentini, L; Lochs, H; Pirlich, M

    2010-07-01

    Malnutrition with loss of muscle is common in patients with liver cirrhosis and has negative impact on morbidity and mortality. The aetiology of malnutrition is multifactorial and includes inflammation, early onset of gluconeogenesis due to impaired glycogen storage and sometimes hypermetabolism. Reduced nutritional intake, however, plays the most important role in the pathogenesis of malnutrition. There is, however, ample evidence that nutritional intake and therapy are inadequate in liver cirrhosis although studies have clearly shown that dietary counselling and nutritional therapy with oral supplements improve intake in these patients. Protein requirement is considered to be increased in liver cirrhosis and high protein intake has been shown to be well tolerated and associated with an improvement of liver function and nutritional status. Protein intolerance on the other hand is uncommon and hepatic encephalopathy can thus rarely be attributed to high protein consumption. Recommendations for general protein restriction must therefore be considered obsolete and rather a risk factor for an impaired clinical outcome. Furthermore, the administration of late evening meals is highly beneficial in patients with liver disease since the rapid onset of the overnight catabolic state is counteracted. The serum concentration of branched-chain amino acids (BCAA) is decreased in patients with liver cirrhosis and long-term supplementation of BCAA has been shown to improve nutritional status and prolong event-free survival and quality of life.

  17. Effect of class IV laser therapy on chemotherapy-induced oral mucositis: a clinical and experimental study.

    Science.gov (United States)

    Ottaviani, Giulia; Gobbo, Margherita; Sturnega, Mauro; Martinelli, Valentina; Mano, Miguel; Zanconati, Fabrizio; Bussani, Rossana; Perinetti, Giuseppe; Long, Carlin S; Di Lenarda, Roberto; Giacca, Mauro; Biasotto, Matteo; Zacchigna, Serena

    2013-12-01

    Oral mucositis (OM) is a serious and acute side effect in patients with cancer who receive chemotherapy or radiotherapy, often leading to the suspension of therapy and a need for opioid analgesic and enteral/parenteral nutrition, with an effect on patient survival. Among the various interventions proposed in OM management, laser therapy is becoming a recommended treatment option but has limitations due to its heterogeneous laser parameters. Here, we report on our successful clinical experience on the use of class IV laser therapy to treat OM induced by different chemotherapy regimens. To shed light on the mechanisms of action of laser therapy in improving OM resolution, we have developed an animal model of chemotherapy-induced OM, in which we compare the efficacy of the standard low-power laser therapy protocol with an innovative protocol, defined as high-power laser therapy. We show that high-power laser therapy is more effective than low-power laser therapy in improving OM lesion healing, reducing the inflammatory burden, and preserving tissue integrity. In addition, high-power laser therapy has been particularly effective in promoting the formation of new arterioles within the granulation tissue. Our results provide important insights into the mechanism of action of biostimulating laser therapy on OM in vivo and pave a way for clinical experimentation with the use of high-power laser therapy.

  18. Oral anticoagulation therapy after radiofrequency ablation of atrial fibrillation and the risk of thromboembolism and serious bleeding

    DEFF Research Database (Denmark)

    Karasoy, Deniz; Gislason, Gunnar Hilmar; Hansen, Jim

    2015-01-01

    AIM: To investigate the long-term risk of thromboembolism and serious bleeding associated with oral anticoagulation (OAC) therapy beyond 3 months after radiofrequency ablation (RFA) of atrial fibrillation (AF). METHODS AND RESULTS: Linking Danish administrative registries, 4050 patients undergoing...... first-time RFA (2000-11) were identified. Risk of thromboembolism and serious bleeding according to OAC therapy were analysed by incidence rates (presented per 100 person-years) and Cox proportional-hazard models. The median age was 59.5 years (interquartile range, IQR: 52.8-65.2); 26.5% were females.......42(0.86-2.35)95%CI] in multivariable analysis. Beyond 3 months after RFA 87 (2.1%) serious bleedings occurred; incidence rates with and without OAC were 0.99 (0.77-1.27)95%CI and 0.44 (0.29-0.65)95%CI, respectively. Oral anticoagulation therapy was significantly associated with serious bleeding risk [hazard ratio 2...

  19. Short-term antidiabetic treatment with insulin or metformin has a similar impact on the components of metabolic syndrome in women with gestational diabetes mellitus requiring antidiabetic agents: results of a prospective, randomised study.

    Science.gov (United States)

    Zawiejska, A; Wender-Ozegowska, E; Grewling-Szmit, K; Brazert, M; Brazert, J

    2016-04-01

    Gestational diabetes mellitus (GDM) is associated with an increased prevalence of fetal and maternal complications primarily caused by maternal hyperglycemia, which results in abnormal fetal growth. Diet modification is a common first step in the treatment of GDM, followed by antidiabetic pharmacotherapy if this approach fails. Insulin therapy is generally accepted; however, oral hypoglycemic agents have been used in this population. In this prospective, randomised study, we compared maternal metabolic status after treatment with insulin or metformin. Pregnant women (gestational age: ≥ 20 weeks) with GDM requiring medical hypoglycemic treatment were randomly allocated to the Metformin (n = 35) or Insulin (n = 43) Groups. Maternal metabolic status - assessed by glycated hemoglobin (HBA1c) level, glycemic profile, insulin concentration, Homeostatic Model Assessment - Insulin Resistance index, and lipids - was recorded at booking and throughout pregnancy. The characteristics of the study group were: maternal age 33.5 ± 5.9 years, gestational age at baseline 28.5 ± 3.5 weeks, prepregnancy body mass index (BMI) 32.2 ± 3.5 kg/m(2), HbA1c at baseline 5.6 ± 0.6%, and average daily glycemia 5.9 ± 0.6 mmol/dl. Fasting glycemia at term was significantly lower in the Insulin Group but there were no significant differences in mean daily glycemia, HbA1c and BMI at term between the groups. Longitudinally, there was a small but significant increase in BMI and a significant increase in high-density lipoprotein-cholesterol in the Insulin Group and a significant increase in the atherogenic index of plasma (AIP) and a trend towards higher triglycerides in the Metformin Group. Both fasting and average daily glycemia were significantly reduced following treatment in both groups. No such change was evident for HbA1c. In a relative risk analysis, metformin treatment was associated with an insignificant elevated risk of HbA1c, triglycerides and lipid indices falling within the

  20. Antidiabetic and antidiarrhoeal potentials of ethanolic extracts of aerial parts of Cynodon dactylon Pers

    Institute of Scientific and Technical Information of China (English)

    Md.Saidur; Rahman; Rasheda; Akter; Santosh; Mazumdar; Faridul; Islam; Nusrat; Jahan; Mouri; Nemai; Chandra; Nandi; Abu; Syeed

    2015-01-01

    Objective: To explore the antidiabetic and the antidiarrhoeal effects of ethanolic extracts of Cynodon dactylon Pers. aerial parts(EECA) in Wistar rats.Methods: To assess the antidiabetic activity of EECA, oral glucose tolerance test(OGTT) model and alloxan induced diabetic test(AIDT) model were performed. The EECA was used at the doses of 2 g/kg, 1 g/kg and 500 mg/kg body weight in OGTT model and 1.5 g/kg was used for AIDT model. Castor oil-induced diarrhoeal model and gastrointestinal motility test with barium sulphate milk model were performed for evaluating the antidiarrhoeal effects at doses of 1 g/kg, 750 mg/kg respectively.Results: The dose 2 g/kg in OGTT and 1.5 g/kg in AIDT model blood glucose levels decreased significantly(P < 0.01) in Wistar rats that showed antidiabetic effect of EECA. After administration of EECA at the dose of 1 g/kg, the extract showed significant(P < 0.05) antidiarrhoeal activity in castor oil-induced diarrhoeal model. The results were also significant(P < 0.01) in barium sulphate milk model for the same dose by using above mentioned animals.Conclusions: It is concluded that EECA contains both antidiabetic and the antidiarrhoeal properties.

  1. Development of oral agent in the treatment of multiple sclerosis: how the first available oral therapy, Fingolimod will change therapeutic paradigm approach

    Directory of Open Access Journals (Sweden)

    Gasperini C

    2012-07-01

    Full Text Available Claudio Gasperini,1 Serena Ruggieri21Department of Neurosciences, S Camillo Forlanini Hospital, 2Department of Neurology and Psychiatry, University of Rome “Sapienza,” Rome, ItalyAbstract: Multiple sclerosis (MS is a chronic inflammatory disorder of the central nervous system, traditionally considered to be an autoimmune, demyelinating disease. Based on this understanding, the initial therapeutic strategies were directed at immune modulation and inflammation control. At present, there are five licensed first-line disease-modifying drugs and two second-line treatments in MS. Currently available MS therapies have shown significant efficacy throughout many trials, but they produce different side-effect profiles in patients. Since they are well known and safe, they require regular and frequent parenteral administration and are associated with limited long-term treatment adherence. Thus, there is an important need for the development of new therapeutic strategies. Several oral compounds are in late-stage development for treating MS. Fingolimod (FTY720; Novartis, Basel, Switzerland is an oral sphingosine-1-phosphase receptor modulator which has demonstrated superior efficacy compared with placebo and interferon β-1a in Phase III studies and has been approved in the treatment of MS. We summarily review the oral compounds in study, focusing on the recent development, approval and the clinical experience with FTY720.Keywords: multiple sclerosis, oral compounds, fingolimod, fty720, sphingosine 1, phosphate, patient satisfaction

  2. DENTAL MANAGEMENT AND BLEEDING COMPLICATIONS OF PATIENTS ON LONG-TERM ORAL ANTIPLATELET THERAPY. REVIEW OF EXISTING STUDIES AND GUIDELINES.

    Directory of Open Access Journals (Sweden)

    Atanaska Dinkova

    2013-06-01

    Full Text Available Antiplatelet drugs are currently widely used in primary and especially secondary prevention of cardiovascular events. Dental management of patients on antiplatelet therapy is still not clearly defined: the discontinuation of antiplatelet therapy increases the risk of thrombotic complications, whereas uninterrupted antiplatelet therapy is assumed to increase the bleeding complications after dental surgical procedures. The aim of this article is to review the main antiplatelet drugs used for long-term oral antiplatelet therapy, the laboratory methods for evaluating effectiveness of this therapy, to identify the studies and guidelines available for dental management of patients on antiplatelet drugs and to summarize their conclusions and recommendations.The methodology used through the research for the literature review includes the following sources: Medscape, Pubmed - Medline database, Science Direct, and EBSCO host, the data base of Medical University Plovdiv and specialised published books in general medicine and dentistry.

  3. Photodynamic Therapy With HPPH in Treating Patients With Squamous Cell Carcinoma of the Oral Cavity

    Science.gov (United States)

    2016-04-19

    Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Verrucous Carcinoma of the Oral Cavity

  4. Phenytoin (Dilantin) and acupuncture therapy in the treatment of intractable oral and facial pain.

    Science.gov (United States)

    Lu, Dominic P; Lu, Winston I; Lu, Gabriel P

    2011-01-01

    Phenytoin is an anti-convulsant and anti-arrhythmic medication. Manufactured by various pharmaceutical companies with various brand names, phenytoin (PHT) is also known as Dilantain, Hydantoin or Phenytek in the United States; Dilantain or Remytoine in Canada; Epamin, Hidantoina in Mexico; and Fenidatoin or Fenitron or other names elsewhere in the world. Phenytoin (PHT) is especially useful for patients suffering from intractable oral and facial pain especially those who exhibit anger, stress, depression and irrational emotions commonly seen in the patients with oral and facial pain. When used properly, Phenytoin is also an effective anxiolysis drug in addition to its theraputic effects on pain and can be used alone or, even better, if combined with other compatible sedatives. Phenytoin is particularly valuable when combined with acupuncture for patients with trigeminal neuralgia, glossopharyneal neuralgia, Bell's palsy, and some other facial paralysis and pain. It also has an advantage of keeping the patient relatively lucid after treatment. Either PHT or acupuncture alone can benefit patients but the success of treatment outcome may be limited. We found by combining both acupuncture and PHT with Selective Drug Uptake Enhancement by stimulating middle finger at the first segment of ventral (palmar) and lateral surfaces, as well as prescribing PHT with the dosage predetermined for each patient by Bi-Digital O-Ring Test (BDORT), the treatment outcome was much better resulted with less recurrence and intensity of pain during episodes of attack. Patients with Bell's palsy were most benefited by acupuncture therapy that could completely get rid of the illness.

  5. Biodistribution of sodium borocaptate (BSH) for boron neutron capture therapy (BNCT) in an oral cancer model.

    Science.gov (United States)

    Garabalino, Marcela A; Heber, Elisa M; Monti Hughes, Andrea; González, Sara J; Molinari, Ana J; Pozzi, Emiliano C C; Nievas, Susana; Itoiz, Maria E; Aromando, Romina F; Nigg, David W; Bauer, William; Trivillin, Verónica A; Schwint, Amanda E

    2013-08-01

    Boron neutron capture therapy (BNCT) is based on selective accumulation of ¹⁰B carriers in tumor followed by neutron irradiation. We previously proved the therapeutic success of BNCT mediated by the boron compounds boronophenylalanine and sodium decahydrodecaborate (GB-10) in the hamster cheek pouch oral cancer model. Based on the clinical relevance of the boron carrier sodium borocaptate (BSH) and the knowledge that the most effective way to optimize BNCT is to improve tumor boron targeting, the specific aim of this study was to perform biodistribution studies of BSH in the hamster cheek pouch oral cancer model and evaluate the feasibility of BNCT mediated by BSH at nuclear reactor RA-3. The general aim of these studies is to contribute to the knowledge of BNCT radiobiology and optimize BNCT for head and neck cancer. Sodium borocaptate (50 mg ¹⁰B/kg) was administered to tumor-bearing hamsters. Groups of 3-5 animals were killed humanely at nine time-points, 3-12 h post-administration. Samples of blood, tumor, precancerous pouch tissue, normal pouch tissue and other clinically relevant normal tissues were processed for boron measurement by optic emission spectroscopy. Tumor boron concentration peaked to therapeutically useful boron concentration values of 24-35 ppm. The boron concentration ratio tumor/normal pouch tissue ranged from 1.1 to 1.8. Pharmacokinetic curves showed that the optimum interval between BSH administration and neutron irradiation was 7-11 h. It is concluded that BNCT mediated by BSH at nuclear reactor RA-3 would be feasible.

  6. Effect of oral sirolimus therapy on inflammatory biomarkers following coronary stenting

    Directory of Open Access Journals (Sweden)

    W.C.M. Rosa

    2010-08-01

    Full Text Available We studied the effect of oral sirolimus, administered to prevent and treat in-stent restenosis (ISR, on the variation of serum levels of inflammatory markers following coronary stenting with bare metal stents. The mean age of the patients was 56 ± 13 years, 65% were males and all had clinically manifested ischemia. Serum levels of high sensitivity C-reactive protein (hs-CRP concentration were determined by chemiluminescence and serum levels of all other biomarkers by ELISA. One group of patients at high risk for ISR received a loading oral dose of 15 mg sirolimus and 5 mg daily thereafter for 28 days after stenting (SIR-G. A control group (CONT-G was submitted to stenting without sirolimus therapy. The increase in hs-CRP concentration was highest at 24 h after stenting in both groups. A significant difference between SIR-G and CONT-G was observed at 4 weeks (-1.50 ± 5.0 vs -0.19 ± 0.4, P = 0.008 and lost significance 1 month after sirolimus discontinuation (-1.73 ± 4.3 vs -0.01 ± 0.7, P = 0.0975. A continuous fall in MMP-9 concentration was observed in SIR-G, with the greatest reduction at 4 weeks (-352.9 ± 455 vs +395.2 ± 377, P = 0.0004, while a positive variation was noted 4 weeks after sirolimus discontinuation (227 ± 708 vs 406.2 ± 472.1, P = 0.0958. SIR-G exhibited a higher increase in P-selectin after sirolimus discontinuation at week 8 (46.1 ± 67.9 vs 5.8 ± 23.7, P = 0.0025. These findings suggest that the anti-restenotic actions of systemic sirolimus include anti-proliferative effects and modulation of the inflammatory response with inhibition of adhesion molecule expression.

  7. Metronomic therapy with oral 6-mercaptopurine in elderly acute myeloid leukemia: A prospective pilot study

    Directory of Open Access Journals (Sweden)

    Akhil Kapoor

    2016-01-01

    Full Text Available Introduction: Acute myeloid leukemia (AML in elderly patients differs biologically from that in younger patients and is known to have unfavorable chromosomal rearrangements, higher resistance, and lower tolerance to chemotherapy. In such circumstances, instead of giving full-blown chemotherapy, palliative metronomic chemotherapy (MCT could be a treatment option. Patients and Methods: We performed a prospective pilot study of old AML patients (age >60 years not amenable to curative treatment. Thirty-two patients were enrolled into the study and were treated with daily oral 6-mercaptopurine 75 mg/m 2 . The following inclusion criteria were used: age >60 years, nonpromyelocytic AML, the absence of uncontrolled comorbidities, and patient not amenable to curative treatment. Overall survival (OS was calculated using Kaplan-Meier method and Cox regression analysis were used to calculate the hazards ratio of significant factors. Results: The median age of the patients was 69 years (range: 61-86 years with male: female ratio of 2.5:1. About 59.4% of patients had Eastern Cooperative Oncology Group performance status of 2 while rest had the status of 3. The median OS was 6 months (95% confidence interval [CI]: 4.4-7.6. Males had median OS of 7 months (95% CI: 5.4-8.6 versus females with OS of 3 months (95% CI: 1.5-4.4; P = 0.008. There was no survival difference on the basis of baseline hemoglobin or French-American-British class. There were no Grade 4 toxicities and no episode of febrile neutropenia. Conclusions: MCT with oral 6-mercaptopurine is an attractive treatment option in elderly AML patients who are not amenable to curative therapy with minimal toxicities.

  8. Oral Recombinant Feline Interferon-Omega as an alternative immune modulation therapy in FIV positive cats: clinical and laboratory evaluation.

    Science.gov (United States)

    Gil, S; Leal, R O; McGahie, D; Sepúlveda, N; Duarte, A; Niza, M M R E; Tavares, L

    2014-02-01

    Recombinant-Feline Interferon-Omega (rFeIFN-ω) is an immune-modulator licensed for use subcutaneously in Feline Immunodeficiency virus (FIV) therapy. Despite oral protocols have been suggested, little is known about such use in FIV-infected cats. This study aimed to evaluate the clinical improvement, laboratory findings, concurrent viral excretion and acute phase proteins (APPs) in naturally FIV-infected cats under oral rFeIFN-ω therapy (0.1 MU/cat rFeIFN-ω PO, SID, 90 days). 11 FIV-positive cats were treated with oral rFeIFN-ω (PO Group). Results were compared to previous data from 7 FIV-positive cats treated with the subcutaneous licensed protocol (SC Group). Initial clinical scores were similar in both groups. Independently of the protocol, rFeIFN-ω induced a significant clinical improvement of treated cats. Concurrent viral excretion and APP's variation were not significant in the PO Group. Oral rFeIFN-ω can be an effective alternative therapy for FIV-infected cats, being also an option for treatment follow-up in cats submitted to the licensed protocol.

  9. Differential effects of oral and transdermal menopausal hormone therapy on prostacyclin and thromboxane in platelets.

    Science.gov (United States)

    Raz, Limor; Hunter, Larry W; Jayachandran, Muthuvel; Heit, John A; Miller, Virginia M

    2014-01-01

    Abstract Menopausal hormone therapies (MHT) may increase thrombotic risk but modulate endothelial function and reduce development of vascular lesions. This study compared effects of MHT on prostanoid-modulated adenosine triphosphate (ATP) secretion from platelets in relationship with endothelial reactive hyperemia (RH) index and carotid intima medial thickness (CIMT). Participants were healthy, recently menopausal women of the Kronos Early Estrogen Prevention Study (KEEPS) randomized to one of three treatments: oral conjugated equine estrogen (oCEE, 0.45 mg/day), transdermal 17β-estradiol (tE2, 50 μg/day) each with intermittent oral progesterone or placebo pills and patch (PL). Prostacyclin and thromboxane A2 were assessed by quantification of their stable metabolites (6-keto-prostaglandin F1α, 6-k-PGF1α; thromboxane B2, TXB2), using ELISA. Dense granule ATP secretion from activated platelets was determined by bioluminescence; RH and CIMT were determined by fingertip tonometry and ultrasound, respectively. After 48 months of treatment, platelet content of 6-k-PGF1α and TXB2 was significantly lower in oCEE compared to the PL. Inhibition of ATP secretion by exogenous activation of cAMP associated with platelet 6-k-PGF1α (r = -0.41, P = 0.04) and TXB2 (r = 0.71, P = 0.0005) only in the oCEE group. Serum and platelet content of 6-k-PGF1α and TXB2 associated positively in the PL and tE2 groups. Serum 6-k-PGF1α positively associated with RH in the oCEE group (r = 0.73, P = 0.02), while serum TXB2 positively associated with CIMT in the tE2 group (r = 0.64, P = 0.01). Thus, oCEE and tE2 differentially affect prostanoid-mediated platelet secretory pathways but alone would not account for an increased thrombotic risk for oral MHT. Furthermore, platelet-derived prostanoids may contribute to RH and vascular remodeling in healthy menopausal women.

  10. Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus.

    Science.gov (United States)

    Bakhtiari, Sedigheh; Mojahedi, Seyyed Masoud; Azari-Marhabi, Saranaz; Namdari, Mahshid; Rankohi, Zahra Elmi

    2017-06-29

    Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. The present study compared the clinical effects of the photodynamic therapy and dexamethasone mouthwash in the treatment of oral lichen planus lesions. In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30seconds (630nm wavelength and 7.2-14.4J/CM2 dose) for 4 sessions in the days 1,4,7,14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15,30,60,90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. No significant difference existed between two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects. Copyright © 2017. Published by Elsevier B.V.

  11. Oral administration of lactulose: a novel therapy for acute carbon monoxide poisoning via increasing intestinal hydrogen production.

    Science.gov (United States)

    Fan, Dan-Feng; Hu, Hui-Jun; Sun, Xue-Jun; Meng, Xiang-En; Zhang, Yu; Pan, Shu-Yi

    2016-01-01

    It has been known that the pathophysiology of carbon monoxide (CO) poisoning is related to hypoxia, the increased production of reactive oxygen species (ROS) and oxidative stress. Studies have shown that the novel, safe and effective free radical scavenger, hydrogen, has neuroprotective effects in both acute CO poisoning and delayed neuropsychological sequelae in CO poisoning. Orally administered lactulose, which may be used by some intestinal bacteria as a food source to produce endogenous hydrogen, can ameliorate oxidative stress. Based on the available findings, we hypothesize that oral administration of lactulose may be a novel therapy for acute CO poisoning via increasing intestinal hydrogen production.

  12. Nuevas terapias en diabetes: más allá de la insulina inyectable y de los antidiabéticos orales New therapies for diabetes: beyond injectable insulin and oral antidiabetics

    OpenAIRE

    John Edwin Feliciano Alfonso; Iván Darío Sierra Ariza

    2008-01-01

    Novos medicamentos para o tratamento do diabetes tipo 1 e tipo 2 foram incorporados à lista de fármacos tradicionais: antidiabéticos orais e insulinas injetáveis. Estas alternativas de tratamento têm novos mecanismos de ação que aproveitam as propriedades antidiabéticas de certos peptídeos como é o caso da amilina ou do peptídeo similar ao glucagon (GLP-1), cujos níveis são deficientes ou insuficientes no diabetes. Isto acontece pelos análogos da amilina ou do GLP-1, embora também possa ser o...

  13. Adherence and patients' attitudes to oral anticancer drugs: a prospective series of 201 patients focusing on targeted therapies.

    Science.gov (United States)

    Barthélémy, Philippe; Asmane-De la Porte, Irène; Meyer, Nicolas; Duclos, Brigitte; Serra, Sebastian; Dourthe, Louis-Marie; Amé, Shanti; Litique, Valère; Giron, Cathy; Goldbarg, Veronica; Fornecker, Luc; Quoix, Elisabeth; Kurtz, Jean-Emmanuel

    2015-01-01

    Patient adherence is a challenge in oncology and hematology practice. Hormone therapy data in breast cancer suggest insufficient adherence and poor persistence. Limited data are available for targeted therapies (TT) including tyrosine kinase and mammalian target of rapamycin inhibitors. We performed a prospective survey using a 15-item questionnaire in patients with solid tumors and hematologic malignancies receiving oral anticancer therapy. Treatment duration, setting (adjuvant vs. metastatic), cancer type, age, and comedication were recorded. 201 patients (median age 65.5 years) participated, 102 with TT and 99 with hormone therapy or chemotherapy (HC). The median time of drug intake was 11.0 months. Written information was more frequently given to TT patients (68.6 vs. 23.2%, p adherence to therapy (72.5 vs. 69.6%, p = n.s.) despite TT patients experiencing more side effects (p adherence among TT patients, efforts towards better patient education are warranted including dedicated staff for monitoring outpatient anticancer oral therapy. © 2014 S. Karger AG, Basel.

  14. Evaluation of oral manifestations and oral health status among pediatric human immunodeficiency virus patients-under anti-retroviral therapy: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Monika Aroquiadasse

    2016-01-01

    Full Text Available Introduction: The human immunodeficiency virus (HIV acquired immunodeficiency syndrome disease has evolved to become a social and economic catastrophe, with far-reaching implications affecting every phase of life of the diseased individual. Data on adults and children diagnosed with HIV infection are useful for determining populations needing prevention and treatment services. Oral lesions may be the presenting symptoms of HIV infection and may differ entirely from those manifested in the adult population. Aim and Objective: We aimed to evaluate the prevalence of HIV related oral lesions among pediatric HIV patients and to assess the oral health status of HIV infected children residing in a selected childcare facility in Puducherry. Materials and Methods: A cross-sectional study was conducted during September 2015 in child care facility for HIV infected children located in Puducherry U.T, India. All children <18 years, who are diagnosed with HIV infection and are put on anti-retroviral therapy (ART or pre-ART care, were included in the study. After obtaining informed consent from the care-givers and assent of the children, they were interviewed and examined by a team comprising a qualified dental surgeon and a trained physician. Results: Majority of the children were under first-line ART (73% and were on ART for more than 4 years. The CD4 count of 23 (52.3 was between 500–1000 cells/μL. The recent viral load assay in 32 (72.7 patients was <150/not detected. Tooth decay was the most common oral manifestation with 28 (63.6 being affected. Nonspecific lymphadenopathy 26 (59.1 was the most common coexisting systemic illness. Conclusion: This study proves that constant surveillance by monitoring the general health status, CD4 counts, viral load coupled with stringent ART care has improved the overall quality of life of these children and consequently resulted in lesser oral manifestations.

  15. Antidiabetic drugs and risk of cancer.

    Science.gov (United States)

    Tokajuk, Anna; Krzyżanowska-Grycel, Edyta; Tokajuk, Adrian; Grycel, Sławomir; Sadowska, Anna; Car, Halina

    2015-12-01

    Antidiabetic drugs are an important group of medications used worldwide. They differ from each other in the mechanisms of lowering blood glucose as well as in adverse effects that may affect the course of the treatment and its efficacy. In recent years, new drugs have been discovered in order to improve the maintenance of proper blood glucose level and to reduce unwanted effects of these drugs. Their growing administration is related to the increasing incidence of diabetes observed in all countries in the world. Epidemiological data indicate that diabetes increases the risk of cancer, as well as the risk of death linked with neoplasms. It is still unknown whether this is an effect of antidiabetic drugs or just the effect of diabetes itself. In recent years there have been numerous investigations and meta-analyzes, based on both comparative and cohort studies trying to establish the relationship between antidiabetic pharmacotherapy and the incidence and mortality due to cancer. According to their findings, most of antidiabetic drugs increase the risk of cancer while only few of them show antitumor properties. Different mechanisms of action of glucose-lowering drugs may be responsible for these effects. However, most of the published studies concerning the influence of these drugs on cancer incidence were designed with some limitations and differed from each other in the approach. In this review, we discuss the association between antidiabetic drugs used in monotherapy or polytherapy and cancer risk, and consider potential mechanisms responsible for the observed effects. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  16. [Efficacy of oral drug Thrombovasim® in therapy of lower extremity deep vein thromboses].

    Science.gov (United States)

    Mishenina, S V; Madonov, P G; Kinsht, D N; Émedova, T A; Zotov, S P; Ufimtsev, M S; Leont'ev, S G

    Within the framework of the multicenter randomized placebo-controlled double-blind clinical trial "VETTER-1" the authors carried out assessment of therapeutic efficacy and safety of oral drug Thrombovasim® possessing a thrombolytic effect in comprehensive treatment of lower-extremity deep vein thrombosis (LEDVT). The clinical study comprised a total of 154 patients. All patients received standard therapy accepted in LEDVT. The patients were subdivided into 4 groups. Patients from the three study groups received Thrombovasim® at a daily dose of 1,600, 3,200, and 4,800 IU. The control group patients were given placebo. Efficacy was assessed by the results of ultrasound duplex scanning first performed before treatment commenced and then after it terminated. The relative frequency of positive dynamics according to the findings of instrumental methods of study in patients taking Thrombovasim® amounted to 0.728 and in the group of patients receiving placebo to 0.585, p=0.0031. Comparing the degree of blood flow normalization in the zone of the compromised blood flow revealed a pronounced dose-dependent effect: in patients taking the drug at a daily dose of 1,600 IU, the relative frequency of positive dynamics amounted to 0.707 corresponding to an increase in therapeutic efficacy by 21%, for a dose of 3,200 IU these parameters amounted to 0.0257 and 24% and for 4,800 IU - 0.747 and 28%, respectively. In patients taking Thrombovasim® there were no cases of negative dynamics observed. Of the patients taking Thrombovasim®, none developed undesirable or severe adverse events. Inclusion of Thrombovasim® into the composition of comprehensive therapy for LEDVT increases efficacy of treatment at the expense of a spontaneous thrombolytic effect. The most effective dose amounted to 4,800 IU daily. Thrombovasim® turned out to be an efficient and safe agent in treatment of venous thromboses.

  17. Gymnema sylvestre R. Br. suspension cell extract show antidiabetic potential in Alloxan induced diabetic albino male rats

    Institute of Scientific and Technical Information of China (English)

    R Karthic; S Nagaraj; P Arulmurugan; S Seshadri; R Rengasamy; K Kathiravan

    2012-01-01

    Objective: To study the antidiabetic effects of suspension cell extract of Gymnema sylvestre (G.sylvestre in vitro grown suspension cells of G. sylvestre along with field grown and wild plant leaves of G.sylvestre was tested on alloxan induced diabetic rats. Results: While oral administration of the extracts reduced the glucose content in blood and urine, sugar and lipids in serum significantly (P≤0.05), it also increased the body weight, total haemoglobin and plasma protein content.Conclusions:It can be concluded that G. sylvestre suspension cell extract show excellent) along with field grown and wild plants. Methods: The effect of ethanolic extracts of the antidiabetic potential against alloxan induced diabetic albino male rats therefore be considered as potent antidiabetic drug.

  18. Preparation and properties of microencapsulated genetically engineered bacteria cells for oral therapy of uremia

    Institute of Scientific and Technical Information of China (English)

    GAO Hong; YU Yaoting; CAI Baoli; WANG Manyan

    2004-01-01

    Microencapsulated genetically engineered bacteria cells are a novel approach of oral therapy for uremia.Klebsiella aerogenes urease genes (UreaDABCEFG) are transformed into E. coli DH5α cells through plasmid pKAU17. The transformant can use urea or ammonia as its sole nitrogen source through strain training. The urease genetically engineered bacteria cells are entrapped in polyvinyl alcohol (PVA) microcapsules, which can be used to remove urea from uremia patients. The mechanical strength of PVA microcapsules is significantly higher than that of APA microcapsules. This suggests that the problem of friability of APA can be solved in this way. The optimal conditions for the preparation of PVA microencapsulated genetically engineered bacterial cells are: polyvinyl alcohol (PVA, 2450±50)used as the carrier at a concentration 6%, the pH value of boric acid as crosslinking reagent 6.5, crosslinking time 24 h,entrapment ratio of bacteria 8%, air flow rate of the encapsulate device 3 L/min and liquid flow rate at 1 mL/10 min.The average diameter of microcapsules prepared under these optimal conditions is 20-40 mesh. Experiments in vitro showed that one hundred milligrams of wet bacterial cells in PVA microcapsules could remove 18.4 mg of urea in 4 h.

  19. Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

    Science.gov (United States)

    Sood, Neeraj; Wagner, Zachary

    2014-01-01

    Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13–17) than public providers and 12% points more likely to provide other treatments (95% CI 10–15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored. PMID:24732456

  20. Effectiveness of self-managed oral anticoagulant therapy in patients with recurrent venous thromboembolism

    DEFF Research Database (Denmark)

    Larsen, Torben Bjerregaard; Skjøth, Flemming; Grove, Erik Lerkevang;

    2016-01-01

    Patient-self-management (PSM) of oral anticoagulant therapy (OAT) with vitamin K antagonists for venous thromboembolism (VTE) has demonstrated efficacy in randomised, controlled trials. The aim of this study was to evaluate the effectiveness of PSM of OAT in everyday clinical practice...... on recurrent VTE and bleeding up to a weighted rate difference of 0.86 (95 % CI 0.00-1.72) in favour of PSM. In conclusion, PSM of anticoagulant treatment was associated with a statistically significant lower rate of recurrent VTE and all-cause death compared to patients on conventionally managed anticoagulant...... to the control group with a hazard ratio (HR) of 0.63; 95 % confidence interval (CI) 0.42-0.95, whereas no difference was seen with bleeding (HR: 0.95; 95 % CI 0.44-2.02). The risk of all-cause death was lower for PSM patients (HR: 0.41; 95 % CI 0.21-0.81). A net clinical benefit analysis sums the effect...

  1. Is the oral contraceptive or hormone replacement therapy a risk factor for cholelithiasis

    Science.gov (United States)

    Wang, Siqi; Wang, Yuqiong; Xu, Jinming; Chen, Yuxin

    2017-01-01

    Abstract Background: Association between exogenous estrogen intake and cholelithiasis risk has been reported in several epidemiological studies, including oral contraceptive (OC) and hormone replacement therapy (HRT), while the results were controversial. This study aimed to perform a comprehensive meta-analysis of this issue. Methods: PUBMED, EMBASE, and Cochrane library database were searched up to October 2016. Two reviewers independently extracted data from eligible studies, relative risks (RRs), and/or odds ratios (ORs) with 95% confidence intervals (95% CIs) for the highest versus lowest categories of intake were adopted. Either a fixed- or a random-effects model was adopted to estimate overall RRs or ORs. Besides, subgroup and publication bias analyses were applied to explain the heterogeneity. An original study was also conducted to verify our conclusion. Results: A total of 19 studies with approximately 556,620 participants were included in this meta-analysis. The pooled RR of cholelithiasis for the highest versus the lowest categories was 1.59 (95% CI: 1.44–1.75), indicating that exogenous estrogen was positive associated with the intake of exogenous estrogen. However, the pooled RR of OC intake and cholelithiasis risk was 1.19 (95% CI: 0.97–1.45), and the RR for HRT was 1.79 (95% CI: 1.61–2.00). Conclusion: The HRT was positively associated with the cholelithiasis risk, and the OC will not increase the risk of cholelithiasis. PMID:28383429

  2. Dosimetric study of photobiomodulation therapy in 5-FU-induced oral mucositis in hamsters

    Science.gov (United States)

    Cotomacio, Claudia Carrara; Campos, Luana; Nesadal de Souza, Douglas; Arana-Chavez, Victor Elias; Simões, Alyne

    2017-01-01

    Oral mucositis (OM) is a debilitating consequence of cancer treatment that could be treated with photobiomodulation therapy (PBMT); however, there is no consensus about its dosimetric parameters for OM healing. The aim of this study was to compare different PBMT protocols on OM treatment, through clinical and histological analysis. Thirty hamsters were used, in an induced model of OM by 5-fluorouracil (5-FU) and superficial scratching, in seven days of follow-up. The animals were divided into five groups: control (C), which received only anesthesia and chemotherapeutic vehicle; chemotherapy (Ch), which received anesthesia, 5-FU, and scratches; laser 1 (L1), the same as Ch group, PBMT 6 J/cm2 and 0.24 J (one point); laser 2 (L2), the same as Ch group, PBMT 25 J/cm2 and 1 J (one point); and laser 3 (L3), the same as Ch group, PBMT 4 points of 0.24 J and 6 J/cm2 each. The laser used has λ=660 nm, 0.04 cm2 of spot area, and 40 mW. The best PBMT protocol to maintain lowest OM levels compared to Ch group was L1, followed by L2 and L3. Our results suggest that the application mode of PBMT and the energy delivered per area could interfere with the OM healing.

  3. Anti-angiogenic therapy (bevacizumab) in the management of oral lichen planus.

    Science.gov (United States)

    Mahmoud, Maha M; Afifi, Marwa M

    2016-04-01

    Oral lichen planus (OLP), a mucocutaneous chronic inflammatory disease, is conventionally managed using topical corticosteroid therapy. Given the fact that OLP is strongly linked to angiogenesis, anti-angiogenic drugs, such as bevacizumab, might be introduced as an alternative treatment for contraindicated, non-responsive patients. The aim of the present study was to report the short-term effectiveness and safety of intralesional bevacizumab injection in the management of atrophic/erosive OLP. A case series study was conducted in patients with atrophic/erosive OLP in the buccal mucosa, assigned to receive either 2.5 mg of bevacizumab, by intralesional injection (n = 20, test), or topical 0.1% triamcinolone acetonide ointment (n = 20, control). The size, score, and pain intensity of the lesions were assessed pre- and post-treatment. Tissue biopsies were collected for histopathologic, immunohistochemical, and ultrastructural examination. After 1 wk, the test group had significant reductions both in lesion seize and in pain scores compared with controls. A marked decrease in vascular endothelial growth factor (VEGF) and interleukin-8 immunoexpression was noted in tissue biopsies from bevacizumab-treated lesions compared with control lesions. Furthermore, ultrastructural examination of OLP tissue specimens revealed significant healing signs associated with bevacizumab treatment. Short-term data suggest that intralesional bevacizumab injection effectively and safely achieved resolution of atrophic/erosive OLP lesions without disease exacerbations during a 3-month follow-up period.

  4. GC-MS analysis, preliminary phytochemical screening, physicochemical analysis and anti-diabetic activity of ethanol extract of Jasminum cuspidatum leaves

    Directory of Open Access Journals (Sweden)

    Singumsetty Vinay

    2014-12-01

    Full Text Available The purpose of the present study was investigating the GC-MS analysis, preliminary phytochemical screening, physicochemical analysis and anti-diabetic activity of ethanol extract of the leaves of Jasminum cuspidatum. The anti-diabetic activity was investigated in streptozotocin-induced diabetes rats with treatment of ethanol extract at the dose level of 200 and 400 mg/kg, which was compared with glibenclamide at a dose level of 4 mg/kg and the parameter measured being the blood glucose, total cholesterol, HDL, LDL, VLDL, triglycerides, and total protein. An oral glucose tolerance test (OGTT was also investigated in experimental rats. The GC-MS analysis revealed that the ethanol extract contained seven phytoconstituents. Preliminary phytochemical screening showed the presence of triterpenoids, flavonoids, glycosides and steroids. The result of in vivo anti-diabetic activity revealed that the ethanol extract of J. cuspidatum showed significant anti-diabetic activity.

  5. A drug utilization and pharmacoeconomic study of anti-diabetic drugs prescribed to type 2 diabetes mellitus patients visiting the medicine out-patient department of a tertiary care hospital of north India

    Directory of Open Access Journals (Sweden)

    Amandeep Singh

    2016-08-01

    Conclusions: Metformin was the most common OAD agent and insulin aspart was the most common injectable anti-diabetic drug prescribed in patients with T2DM. The newer anti-diabetic drugs sitagliptin and newer insulin analogues were also prescribed to a great extent. Overall, the prescribing trend was rational to a great extent and had improved since the earlier study in the same institute. The most cost-effective anti-diabetic therapy was combination therapy of glipizide and metformin. The cost of diabetes management is high, especially for insulin therapy. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1220-1227

  6. Diabetes mellitus:An overview on its pharmacological aspects and reported medicinal plants having antidiabetic activity

    Institute of Scientific and Technical Information of China (English)

    Patel DK; Kumar R; Laloo D; Hemalatha S

    2012-01-01

    Diabetes mellitus is not a single disease but is a group of metabolic disorders affecting a huge number of population in the world. It is mainly characterized by chronic hyperglycemia, resulting from defects in insulin secretion or insulin action. It is predicated that the number of diabetes person in the world could reach upto 366 million by the year 2030. Even though the cases of diabetes are increasing day by day, except insulin and oral hypoglycemic drugs no other way of treatment has been successfully developed so far. Thus, the objective of the present review is to provide an insight over the pathophysiological and etiological aspects of diabetes mellitus along with the remedies available for this metabolic disorder. The review also contains brief idea about diabetes mellitus and the experimental screening model with their relevant mechanism and significance mainly used nowadays. Alloxan and streptozotocin are mainly used for evaluating the antidiabetic activity of a particular drug. This review contain list of medicinal plants which have been tested for their antidiabetic activity in the alloxan induced diabetic rat model. From the available data in the literature, it was found that plant having antidiabetic activity is mainly due to the presence of the secondary metabolite. Thus, the information provided in this review will help the researchers for the development of an alternative methods rather than insulin and oral hypoglycemic agents for the treatment of diabetes mellitus, which will minimize the complication associated with the diabetes and related disorder.

  7. From Therapy to Instruction: The Effect of Systemic Strategies on the Oral Performance of Foreign Language Learners

    Directory of Open Access Journals (Sweden)

    Ana Clara Sánchez Solarte

    2017-07-01

    Full Text Available This paper reports the results of a group intervention based on strategies derived from the systemic therapy model—brief strategic therapy. These strategies aimed at decreasing the anxiety levels commonly found in oral performance tasks related to L2 learning. Thirteen students from different semesters who belonged to two foreign language teaching programs participated in four weekly 40-minute group sessions. The pre- and post-assessments suggest a meaningful reduction of anxiety levels (t = 8.978 p < 0.05; ES = 2.49. The results suggest that the application of the strategies is highly effective and beneficial for anxious L2 learners.

  8. Triple antithrombotic therapy versus double antiplatelet therapy after percutaneous coronary intervention with stent implantation in patients requiring chronic oral anticoagulation: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Jayswal Saheb K; DENG Bing-qing; HU Qing-song; XIE Shuang-lun; GENG Deng-feng; NIE Ru-qiong

    2013-01-01

    Background Whether an addition of OAC to double antiplatelet therapy for patients with an indication of chronic oral anticoagulation undergoing PCI-S may improve clinical outcomes is still debated.This meta-analysis aimed to update and re-compare the benefits and risks of triple antithrombotic therapy (TT) with double anti-platelet therapy (DAPT) after in patients who requiring oral anticoagulation after percutaneous coronary interventions with stenting (PCI-s).Methods Ten reports of observational retrospective or prospective studies were retrieved,including a total of 6296 patients,follow-up period ranging from 1 year to 2 years.Results Baseline characteristics were similar in both groups.The main finding of this study is the overall incidence of major adverse cardiovascular events (MACE),myocardial infarction (MI) and stent thrombosis was comparable between two groups.Patients with П was associated with significant reduction in ischemic stroke (OR:0.27; 95% CI:0.13-0.57;P=0.0006) as compared to DAPT.We reaffirmed triple therapy significantly increased the risk of major bleeding (OR:1.47;95% CI:1.22-1.78; P <0.0001) and minor bleeding (OR:1.55; 95% CI:1.07-2.24; P=0.02).Conclusions Triple therapy is more efficacious in reducing the occurrence of ischemic stroke in PCI-s patients with an indication of chronic oral anticoagulation (OAC),compared with DAPT.However,it significantly increased major and minor risk of bleeding.It is imperative that further prospective randomized controlled trials are required to define the best therapeutic strategy for patients with an indication of chronic OAC undergoing PCI-s.

  9. Effect of insulin detemir versus neutral protamine zinc insulin combined with oral anti-diabetes drugs in treating type 2 diabetes mellitus%地特胰岛素对比中性鱼精蛋白锌胰岛素联合口服降糖药治疗2型糖尿病的疗效和安全性观察

    Institute of Scientific and Technical Information of China (English)

    吕蕾; 郭俊杰; 郭晓霏

    2012-01-01

    Objective To compare of effect of insulin detemir (Det) versus neutral protamine hagedorn (NPI1) combined with oral anti-diabetes drugs (OADs) in treating type 2 diabetes mellitus (T2DM). Methods The 60 T2DM patients divided into two groups were treated with Det + OADs versus NPH + OADs respectively. The comparisons of fasting plasma glucose (FPG), two-hour postprandial plasma glucose (2 hPG), incidence of hypoglycemia, body mass index (BMI), and hemoglobin A1c (HbA1c) between the two groups before versus after treatment were performed to observe the final effect. Results The levels of FPG, 2 hPG, and HbA1c of the two groups were decreased after treatment for 12 weeks, while the decrease in the Det+OADs group was more significant (P<0. 05). The Det+OADs group was superior to the NPH + OADs group in the BMI control (P<0. 05) and less hypoglycemia. Conclusion Comparing with NPH+ OADs, the effect of Det+OADs is better in treating T2DM with less incidence of hypoglycemia and less influence on body weight.%目的 探讨地特胰岛素(Det)对比中性鱼精蛋白锌胰岛素(NPH)联合口服降糖药(OADs)治疗T2DM的疗效和安全性.方法 选择60例T2DM患者分别应用Det和NPH联合OADs治疗,比较两组治疗前后FPG、2 hPG、低血糖事件发生、BMI及HbA1 c变化.结果 两组患者治疗12周后FPG、2 hPG、HbA1 c均较治疗前下降(P<0.05),但Det组下降更显著(P<0.05),Det组对BMI控制优于NPH组(P<0.05),低血糖发生率低.结论 与NPH相比,Det联合OADs治疗T2DM疗效更好,低血糖发生率低,对体重影响小.

  10. Management of dental patients receiving antiplatelet therapy or chronic oral anticoagulation: A review of the latest evidence.

    Science.gov (United States)

    Dézsi, Csaba András; Dézsi, Balázs Bence; Dézsi, András Döme

    2017-12-01

    The perioperative management of patients treated with antithrombotic medications who undergo surgical procedures represents a common clinical problem. Dental interventions are usually associated with a low risk of bleeding; however, the dental implications of new antithrombotic agents are not yet fully understood. The present review is based on the latest evidence and recommendations published on the periprocedural management of dental patients treated with single or dual antiplatelet therapy, vitamin K antagonists, or direct oral anticoagulants for a variety of indications.

  11. Comparison of laboratory and immediate diagnosis of coagulation for patients under oral anticoagulation therapy before dental surgery

    OpenAIRE

    2005-01-01

    Abstract Background Dental surgery can be carried out on patients under oral anticoagulation therapy by using haemostyptic measures. The aim of the study was a comparative analysis of coagulation by laboratory methods and immediate patient diagnosis on the day of the planned procedure. Methods On the planned day of treatment, diagnoses were carried out on 298 patients for Prothrombin Time (PT), the International Normalised Ratio (INR), and Partial Thromboplastin Time (PTT). The decision to pr...

  12. Promotional Model: A New Direction for National Program in Immunization (NPI) and Oral Rehydration Therapy (ORT) in Nigeria

    OpenAIRE

    P.EKERETE, Paulinus

    2000-01-01

    The National Program on Immunization (NPI), formerly known as the Expanded Program on Immunization (EPI) and Oral Rehydration Therapy (ORT), were relaunched in1984 after the problems of vaccine supply have been corrected. The NPI aimed to protect children against six childhood killer disease and ORT, to remedy dehydration. In order to achieve these objectives, Partner-in-Health strategy was set up to educate, convince and motivate mothers, pregnant women and community to accept the programme....

  13. Treatment of Oral Cavity Squamous Cell Carcinoma With Adjuvant or Definitive Intensity-Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sher, David J., E-mail: dsher@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Thotakura, Vijaya [Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Balboni, Tracy A. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Norris, Charles M.; Haddad, Robert I.; Posner, Marshall R.; Lorch, Jochen [Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Goguen, Laura A.; Annino, Donald J. [Department of Surgery, Division of Otolaryngology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Tishler, Roy B. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States)

    2011-11-15

    Purpose: The optimal management of oral cavity squamous cell carcinoma (OCSCC) typically involves surgical resection followed by adjuvant radiotherapy or chemoradiotherapy (CRT) in the setting of adverse pathologic features. Intensity-modulated radiation therapy (IMRT) is frequently used to treat oral cavity cancers, but published IMRT outcomes specific to this disease site are sparse. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for OCSCC. Methods and Materials: Retrospective study of all patients treated at Dana-Farber Cancer Institute for OCSCC with adjuvant or definitive IMRT between August 2004 and December 2009. The American Joint Committee on Cancer disease stage criteria distribution of this cohort included 5 patients (12%) with stage I; 10 patients (24%) with stage II (n = 10, 24%),; 14 patients (33%) with stage III (n = 14, 33%),; and 13 patients (31%) with stage IV. The primary endpoint was overall survival (OS); secondary endpoints were locoregional control (LRC) and acute and chronic toxicity. Results: Forty-two patients with OCSCC were included, 30 of whom were initially treated with surgical resection. Twenty-three (77%) of 30 surgical patients treated with adjuvant IMRT also received concurrent chemotherapy, and 9 of 12 (75%) patients treated definitively without surgery were treated with CRT or induction chemotherapy and CRT. With a median follow-up of 2.1 years (interquartile range, 1.1-3.1 years) for all patients, the 2-year actuarial rates of OS and LRC following adjuvant IMRT were 85% and 91%, respectively, and the comparable results for definitive IMRT were 63% and 64% for OS and LRC, respectively. Only 1 patient developed symptomatic osteoradionecrosis, and among patients without evidence of disease, 35% experienced grade 2 to 3 late dysphagia, with only 1 patient who was continuously gastrostomy-dependent. Conclusions: In this single-institution series, postoperative IMRT was associated with promising LRC

  14. Doxazosin oral intake therapy to relieve stent - related urinary symptoms and pain: a prospective, randomized, controlled study

    Directory of Open Access Journals (Sweden)

    Long Zhang

    Full Text Available ABSTRACT Objective: To assess the impact of Doxazosin Oral Intake Therapy on urinary symptoms and pain in patients with indwelling ureteral stents Patients and Methods: A total of 239 patients with ureteral stone-related hydronephrosis who underwent a double-J stent insertion after ureteroscopic lithotripsy were enrolled. Patients were randomized to receive doxazosin cotrolled release 4 mg once daily for 4 weeks or matching placebo. Patients completed the brief-form Chinese version Ureteric Stent Symptom Questionnaire (USSQ and quality of life (QoL score 2 weeks and 4 weeks after stent placement and 4 weeks after stent withdrawal. The analgesic use was also recorded during the stenting period. Results: Patients in Doxazosin Oral Intake Therapy group, in the first 2 weeks and second 2 weeks with the stent in situ, expressed significant lower daytime frequency (p=0.028 and p=0.038, nocturia (p=0.021 and p=0.008 and urgency (p=0.012 and p=0.014, respectively. Similarly, flank pain score, QoL score and analgesic use were also significant less in the stenting period. There was no significant difference in scores of urinary symptoms, pain and QoL during the post-stent period between two cohorts. Conclusions: Doxazosin Oral Intake Therapy reduced stent-related urinary symptoms, pain and the negative impact on QoL.

  15. Clinical Assessment of the Efficiency of Low Level Laser Therapy in the Treatment of Oral Lichen Planus

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    Hanaa M. Elshenawy

    2015-10-01

    Full Text Available BACKGROUND: Oral lichen planus (OLP is a chronic inflammatory disease of the oral mucosa of uncertain etiology. AIM: To evaluate the effect of using low level laser therapy (LLLT (970 nm Siro laser Advance for the treatment of symptomatic (OLP. SUBJECTS AND METHODS: The present study was conducted on ten patients suffering from persistent oral lichen planus (OLP.Patients were treated with diode laser (970nm for the symptomatic relief of pain and burning sensation. The patients were assessed before, during and after the completion of the laser treatment which was done twice weekly for two successive months with maximum of ten sessions. The assessment was performed using visual analogue scale (VAS and clinical investigation for each patient. RESULTS: Detailed significant reduction in lesion size and showed complete remission of burning sensation and pain. No reported complications or therapy side effects were observed in any of the treated patients. CONCLUSION: Diode laser therapy seems to be an effective adjunctive treatment modality for relieving pain and clinical symptoms of OLP.

  16. Low-level Laser Therapy: A Review of Its Applications in the Management of Oral Mucosal Disorders.

    Science.gov (United States)

    Spanemberg, Juliana Cassol; Figueiredo, Maria Antonia Zancanaro; Cherubini, Karen; Salum, Fernanda Gonçalves

    2016-11-01

    Due to its analgesic, anti-inflammatory, and biostimulating effects, low-level laser therapy (LLLT) has been widely used for oral disorders, such as oral lichen planus (OLP), xerostomia, recurrent aphthous stomatitis (RAS), herpes labialis, burning mouth syndrome (BMS), and oral mucositis (OM). The research team for the present study has reviewed the literature on the subject, with an emphasis on the applicability of LLLT in general and of its various clinical protocols for the management of those oral disorders. In lesions such as the ones occurring in OM, RAS, herpes labialis, and OLP, the course of wound healing and the pain have been shown to decrease, with a few, or most often, no adverse side effects. The literature shows that LLLT can also be effective in reducing symptoms in patients with BMS. For the treatment of hyposalivation and xerostomia, the use of LLLT has been described in the literature, but no consensus has resulted. Very few controlled clinical studies with well-established therapeutic protocols have occurred, except for OM, for which LLLT has been widely researched. Although information on the use of the laser for some lesions has already been consolidated, further research is needed, especially randomized, controlled clinical trials with long-term follow-up. Those studies will allow the safe use of LLLT, permitting the creation of care protocols for the management of oral disorders.

  17. The effects of nifekalant hydrochloride on the spatial dispersion of repolarization after direct current defibrillation in patients with oral amiodarone and β-blocker therapy

    Directory of Open Access Journals (Sweden)

    Keiko Maeda

    2014-06-01

    Conclusions: NIF suppressed the deterioration of the SDR after ICD shock. This might be one of the mechanisms by which NIF suppresses recurrence of ventricular tachyarrhythmia just after ICD shock in patients with oral amiodarone and β-blocker therapy.

  18. Insulin and longevity: antidiabetic biguanides as geroprotectors.

    Science.gov (United States)

    Anisimov, Vladimir N; Semenchenko, Anna V; Yashin, Anatoli I

    2003-01-01

    The results of previous experimental studies of effects of antidiabetic biguanides (phenformin and buformin) on life span and spontaneous tumor incidence in mice and rats were recalculated and reanalyzed using standard demographic models of mortality. The chronic treatment of female C3H/Sn mice with phenformin prolonged the mean life span by 21.1% (P biguanide, buformin, slightly increased their mean life span (by 7.3%; P > 0.05). The mean life span of the last 10% survivors increased by 12% (P biguanides slightly decreased the body weight, slowed down the age-related decline of the reproductive function in female rats. The results of our experiments provide evidence that antidiabetic biguanides are promising geroprotectors as well as drugs which can be used in the prevention of cancer.

  19. Synthesis and Antidiabetic Evaluation of Benzenesulfonamide Derivatives

    Science.gov (United States)

    Hosseinzadeh, Nouraddin; Seraj, Soodeh; Bakhshi-Dezffoli, Mohamad Ebrahim; Hasani, Mohammad; Khoshneviszadeh, Mehdi; Fallah-Bonekohal, Saeed; Abdollahi, Mohammad; Foroumadi, Alireza; Shafiee, Abbas

    2013-01-01

    The complex metabolic syndrome, diabetes mellitus, is a major human health concern in the world and is estimated to affect 300 million people by the year 2025. Several drugs such as sulfonylureas and biguanides are presently available to reduce hyperglycemia in diabetes mellitus. These drugs have side effects and thus searching for a new class of compounds is essential to overcome this problems. A series of seven novel N-(4-phenylthiazol-2-yl)benzenesulfonamides derivatives were synthesized and assayed in-vivo to investigate their antidiabetic activities by streptozotocin-induced model in rat. These derivatives showed considerable biological efficacy when compared to glibenclamide, a potent and well-known antidiabetic agent, as a reference drug. Four of the compounds were effective, amongst which 13 show more prominent activity at 100 mg/Kg p.o. The experimental results are statistically significant at p < 0.05 level. PMID:24250607

  20. Rehabilitation of oral function in head and neck cancer patients after radiotherapy with implant-retained dentures : Effects of hyperbaric oxygen therapy

    NARCIS (Netherlands)

    Schoen, P.J.; Raghoebar, G.M.; Bouma, J.; Reintsema, H.; Vissink, A.; Sterk, W.; Roodenburg, J.L.N.

    2007-01-01

    Surgical treatment of malignancies in the oral cavity and subsequent radiotherapy often result in an anatomic and physiological oral condition unfavorable for prosthodontic rehabititation. The objective of this prospective study was to assess the effect of hyperbaric oxygen therapy on treatment outc

  1. A study on efficacy of oral zinc therapy for treatment of acrodermatitis enteropathica

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2013-04-01

    Full Text Available Introduction: Acrodermatitis enteropathica (AE is a disorder of zinc metabolism that occurs in one of two forms: an inborn (congenital form and an acquired form. The inborn form of AE is a rare genetic disorder characterized by intestinal abnormalities that leads to inability to absorb zinc from the intestine. The lack of zinc presents, characteristically, as skin inflammation with pustules occurring around the mouth and/or anus, diarrhea.Aims: To study the efficacy of oral zinc therapy on thirty patients of acrodermatitis enteropathica.Methods: Thirty clinically diagnosed patients of acrodermatitis enteropathica were taken for the study. The criterion of diagnosis of this condition was the clinical picture of symmetrical vesiculo-pustular dermatitis, in upper and lower limbs and periorificial regions.Results and Discussion: In our study maximum (50% patients were below 1 year of age, 33.3% patients were between 13-24 months of age, 6.66% patients were between 25- 36 months and 37- 48 months each and 3.33% patients were between 49- 60 months of age. Nail changes were seen in 60% children. Also, it was seen that perioral area was the commonest (86.6% site involved, followed by anogenital area in 80% patients, palms and soles were involved in 66.6% patients, arms in 46.6% patients and legs were seen in 40% patients. Regarding clinical features, dermatitis was seen in 100%patients, alopecia was seen in 40% patients, diarrhea in 60% patients and mental disturbances were seen in 30 % patients.

  2. Prevalence and determinants of adherence to oral adjuvant endocrine therapy among breast cancer patients in Singapore

    Directory of Open Access Journals (Sweden)

    Eskinder Eshetu Ali

    2017-01-01

    Full Text Available Objective: The success of oral adjuvant endocrine therapy (OAET is greatly influenced by patients' level of adherence to treatment. The objective of this study is to measure the prevalence and determinants of adherence to OAET among breast cancer patients in Singapore. Methods: A cross-sectional survey of patients supplemented by analysis of their prescription records was used to collect data. Adherence to OAET was assessed using the Morisky Medication Adherence Scale-4 items and evaluation of refill gaps. Univariate and multivariate analyses were done to evaluate the association between patients' characteristics and adherence to OAET. Results: A total of 157 women who have started OAET at least 6 months before the time of interview participated in the study, of which less than half (64 patients, 40.8% of the patients had high adherence. Univariate analysis identified patients who were 57 years or older (P = 0.027, unemployed (P = 0.027, on aromatase inhibitors (P = 0.023, on three or more concurrent medications (P = 0.001, and had one or more comorbidities (P = 0.000 to be significantly more adherent. However, only the number of comorbidities was found to be an independent predictor of adherence in a multiple logistic regression analysis (adjusted odds ratio = 2.60; 95% confidence interval = 1.208–5.593; P = 0.015. Forgetfulness was the main reason for nonadherence mentioned by 63 (67.7% of the 93 nonadherent patients. Conclusions: Low level of OAET adherence was found in this study, and forgetfulness was cited as the main reason for nonadherence. Patients were generally receptive to the implementation of various strategies to assist them with their medication-taking behavior

  3. Patients' perspectives on self-testing of oral anticoagulation therapy: Content analysis of patients' internet blogs

    Directory of Open Access Journals (Sweden)

    Robinson Ian

    2011-02-01

    Full Text Available Abstract Background Patients on oral anticoagulant therapy (OAT require regular testing of the prothrombin time (PT and the international normalised ratio (INR to monitor their blood coagulation level to avoid complications of either over or under coagulation. PT/INR can be tested by a healthcare professional or by the patient. The latter mode of the testing is known as patient self-testing or home testing. The objective of this study was to elicit patients' perspectives and experiences regarding PT/INR self-testing using portable coagulometer devices. Methods Internet blog text mining was used to collect 246 blog postings by 108 patients, mainly from the USA and the UK. The content of these qualitative data were analysed using XSight and NVivo software packages. Results The key themes in relation to self-testing of OAT identified were as follows: Patient benefits reported were time saved, personal control, choice, travel reduction, cheaper testing, and peace of mind. Equipment issues included high costs, reliability, quality, and learning how to use the device. PT/INR issues focused on the frequency of testing, INR fluctuations and individual target (therapeutic INR level. Other themes noted were INR testing at laboratories, the interactions with healthcare professionals in managing and testing OAT and insurance companies' involvement in acquiring the self-testing equipment. Social issues included the pain and stress of taking and testing for OAT. Conclusions Patients' blogs on PT/INR testing provide insightful information that can help in understanding the nature of the experiences and perspectives of patients on self-testing of OAT. The themes identified in this paper highlight the substantial complexities involved in self-testing programmes in the healthcare system. Thus, the issues elicited in this study are very valuable for all stakeholders involved in developing effective self-testing strategies in healthcare that are gaining

  4. Antidiabetic effects of Justicia spicigera Schltdl (Acanthaceae).

    Science.gov (United States)

    Ortiz-Andrade, Rolffy; Cabañas-Wuan, Angel; Arana-Argáez, Víctor E; Alonso-Castro, Angel Josabad; Zapata-Bustos, Rocio; Salazar-Olivo, Luis A; Domínguez, Fabiola; Chávez, Marco; Carranza-Álvarez, Candy; García-Carrancá, Alejandro

    2012-09-28

    Justicia spicigera is a plant species used for the Teenak (Huesteca Potosina) and Mayan (Yucatan peninsula) indigenous for the empirical treatment of diabetes, infections and as stimulant. To evaluate the cytotoxicity, antioxidant and antidiabetic properties of J. spicigera. The effects of ethanolic extracts of J. spicigera (JSE) on the glucose uptake in insulin-sensitive and insulin-resistant murine 3T3-F442A and human subcutaneous adipocytes was evaluated. The antioxidant activities of the extract of JSE was determined by ABTS and DPPH methods. Additionally, it was evaluated the antidiabetic properties of JSE on T2DM model. JSE stimulated 2-NBDG uptake by insulin-sensitive and insulin-resistant human and murine adipocytes in a concentration-dependent manner with higher potency than rosiglitazone 1mM. JSE showed antioxidant effects in vitro and induced glucose lowering effects in normoglycemic and STZ-induced diabetic rats. The antidiabetic effects of administration of J. spicigera are related to the stimulation of glucose uptake in both insulin-sensitive and insulin-resistant murine and human adipocytes and this evidence justify its empirical use in Traditional Medicine. In addition, J. spicigera exerts glucose lowering effects in normoglycemic and STZ-induced diabetic rats. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Antidiabetic Drugs: Mechanisms of Action and Potential Outcomes on Cellular Metabolism.

    Science.gov (United States)

    Meneses, Maria J; Silva, Branca M; Sousa, Mário; Sá, Rosália; Oliveira, Pedro F; Alves, Marco G

    2015-01-01

    Diabetes mellitus (DM) is one of the most prevalent chronic diseases and has been a leading cause of death in the last decades. Thus, methods to detect, prevent or delay this disease and its co-morbidities have long been a matter of discussion. Nowadays, DM patients, particularly those suffering with type 2 DM, are advised to alter their diet and physical exercise regimens and then proceed progressively from monotherapy, dual therapy, and multi-agent therapy to insulin administration, as the disease becomes more severe. Although progresses have been made, the pursuit for the "perfect" antidiabetic drug still continues. The complexity of DM and its impact on whole body homeodynamics are two of the main reasons why there is not yet such a drug. Moreover, the molecular mechanisms by which DM can be controlled are still under an intense debate. As the associated risks, disadvantages, side effects and mechanisms of action vary from drug to drug, the choice of the most suitable therapy needs to be thoroughly investigated. Herein we propose to discuss the different classes of antidiabetic drugs available, their applications and mechanisms of action, particularly those of the newer and/or most widely prescribed classes. A special emphasis will be made on their effects on cellular metabolism, since these drugs affect those pathways in several cellular systems and organs, promoting metabolic alterations responsible for either deleterious or beneficial effects. This is a crucial property that needs to be carefully investigated when prescribing an antidiabetic.

  6. Efficacy of low-level laser therapy in management of symptomatic oral lichen planus: a systematic review.

    Science.gov (United States)

    Al-Maweri, Sadeq Ali; Kalakonda, Butchibabu; Al-Soneidar, Walid A; Al-Shamiri, Hashem Motahir; Alakhali, Mohammed Sultan; Alaizari, Nader

    2017-08-01

    Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology and indefinite cure. This systematic review assessed the efficacy of low-level laser therapy in the treatment of symptomatic OLP. Electronic databases (PubMed, Scopus, and Web of Science) were searched from date of inception till and including December 2016, using various combinations of the following keywords: oral lichen planus, laser therapy, low-level laser therapy, and phototherapy. Owing to heterogeneity of data, no statistical analyses were conducted. Initially, 227 publications were identified. After selection, only six studies were included in this systematic review. In these studies, the laser wavelengths, power output, and duration of irradiation ranged between 630-980 nm, 20-300 mW, and 10 s-15 min, respectively. All of the included studies found laser to be effective in management of OLP, without any reported adverse effects. The results of the included studies confirm that low-level laser therapy is effective in management of symptomatic OLP and can be used as an alternative to corticosteroids. However, due to variety of methods and substantial variations in laser parameters among these studies, more randomized clinical trials with large sample sizes are highly warranted.

  7. Oral Tolerance: A New Tool for the Treatment of Gastrointestinal Inflammatory Disorders and Liver-Directed Gene Therapy

    Directory of Open Access Journals (Sweden)

    Yaron Ilan

    1999-01-01

    Full Text Available Oral tolerance is a method of downregulating an immune response by feeding antigens. The use of oral tolerance toward adenoviruses and colitis-extracted proteins for long term gene therapy and alleviation of experimental colitis, and the mechanisms of tolerance induction are presented. Adenoviruses are efficient vectors in liver-directed gene therapy; however, the antiviral immune response precludes the ability to achieve long term gene expression and prohibits the ability to reinject the recombinant virus. Oral tolerance induction via feeding of viral-extracted proteins prevented the antiadenoviral humoral and cellular immune responses, thus enabling long term gene therapy using these viruses. Moreover, pre-existing immune response to the virus was overcome by tolerance induction, enabling prolonged gene expression in a presensitized host. Inflammatory bowel diseases are immune-mediated disorders where an imbalance between proinflammatory (T helper cell type 1 and anti-inflammatory (T helper cell type 2 cytokines are thought to play a role in the pathogenesis. In the experimental colitis model, the feeding of colitis-extracted proteins downregulated the anticolon immune response. Tolerance induction toward colitis-extracted proteins ameliorated colonic inflammation as shown by decreased diarrhea and reduction of colonic ulcerations, intestinal and peritoneal adhesions, wall thickness and edema. Histological parameters for colitis were markedly improved in tolerized animals. In both models, tolerized animals developed an increase in transforming growth factor-beta, interleukin-4 and interleukin-10, and a decrease in the mRNA of interferon-gamma lymphocytes and serum levels. Adoptive transfer of tolerized lymphocytes enabled the transfer of tolerance toward adenoviruses and colon-extracted proteins. Thus, oral tolerance induces suppressor lymphocytes that mediate immune response downregulation by induction of a shift from a proinflammatory T

  8. Adjuvant antifungal therapy using tissue tolerable plasma on oral mucosa and removable dentures in oral candidiasis patients: a randomised double-blinded split-mouth pilot study.

    Science.gov (United States)

    Preissner, Saskia; Kastner, Isabell; Schütte, Eyke; Hartwig, Stefan; Schmidt-Westhausen, Andrea Maria; Paris, Sebastian; Preissner, Robert; Hertel, Moritz

    2016-07-01

    Extended use of antimycotics in oral candidiasis therapy gives rise to problems related to fungal drug resistance. The aim of this pilot study was to investigate the efficacy of tissue tolerable plasma (TTP) in denture stomatitis patients. It was hypothesised that (I): erythema and (IIa): complaint remission would be accelerated and (IIb): colony forming unit (CFU) reduction would be improved. The halves of the upper jaws of eight patients were randomly assigned to control (nystatin, chlorhexidine and placebo treatment) and test sides (nystatin, chlorhexidine and TTP administered six times each 7 days). The patients and the investigators, who were different from the therapists, were both blinded. Compared to the control sides, the erythema surface was reduced significantly more extensively on the test sides between 2 and 6 weeks of antifungal therapy (P ≤ 0.05). Visual analogue scale values and the frequency of moderate or heavy growth of Candida post-treatment did not differ significantly between both sides (P > 0.05). The primary hypothesis was confirmed, which may be interpreted as an accelerated remission. As drug therapy is usually limited to the time in which signs of infection are present, TTP might help reducing antifungal use. Even though the secondary hypotheses were not confirmed, persistence of Candida might be only colonisation.

  9. Less mammographic density after nasal versus oral administration of postmenopausal hormone therapy

    NARCIS (Netherlands)

    Dijck, J.A. van; Otten, J.D.M.; Karssemeijer, N.; Kenemans, P.; Verbeek, A.L.M.; Mooren, M.J. van der

    2011-01-01

    ABSTRACT Objective Nasal administration gives a more acute but shorter rise in serum hormone levels than oral administration and may therefore have less effect on the fibroglandular tissue in the breasts. We studied the change in mammographic breast density after nasal vs. oral administration of pos

  10. The numerous microbial species in oral biofilms: how could antibacterial therapy be effective?

    NARCIS (Netherlands)

    ten Cate, J.M.; Zaura, E.

    2012-01-01

    Hundreds of bacterial species inhabit the oral cavity. Many of these have never been cultivated and can be assessed only with DNA-based techniques. This new understanding has changed the paradigm of the etiology of oral disease from that associated with ‘traditional pathogens’ as being primarily res

  11. Oral Ofloxacin Therapy of Pseudomonas aeruginosa Sepsis in Mice after Irradiation

    Science.gov (United States)

    1990-07-01

    mice and six uninfected mice I and 23.5 h after oral aseptically removed and immediately homogcnized in sterile administration of ofloxacin on day 5 of...1987. Oral norfioxacin for prevention of gram negative Teintraluminal concenr~tation of of’oxacin achieved in bacterial infections in patients with

  12. Topical Tacrolimus with Custom Trays in the Treatment of Severe Oral cGVHD Refractory to a Potent Topical Steroid Therapy: A Case Report

    Science.gov (United States)

    Brown, Ronald S.; Edwards, Dean; Walsh-Chocolaad, Tracey; Childs, Richard W.

    2012-01-01

    Background The authors present a case demonstrating the success of topical tacrolimus (TAC) therapy with custom trays in the treatment of oral chronic graft versus host disease (cGVHD). The 41 year-old male patient initially responded to topical steroid therapy (clobetasol propionate 0.05% ointment) applied both topically and with flexible carrier trays, but later became refractory to this potent topical agent. Topical TAC therapy with flexible carrier trays and systemic prednisone therapy was initiated. Results The patient responded favorably with the change to topical TAC therapy with custom trays (and oral prednisone). His oral cGVHD lesions resolved within a period of four weeks. The improvement has remained stable at 14 month follow-up. Clinical Implications This is the first case reported with regard to the successful resolution of steroid recalcitrant cGVHD successfully treated with topical TAC with custom trays. PMID:23102802

  13. Direct effects of Facio-Oral Tract Therapy(®) on swallowing frequency of non-tracheotomised patients with acute neurogenic dysphagia.

    Science.gov (United States)

    Konradi, Jürgen; Lerch, Annekatrin; Cataldo, Marilena; Kerz, Thomas

    2015-01-01

    The aim of this study was to investigate the direct effect of Facio-Oral Tract Therapy(®) on swallowing frequency of non-tracheotomised patients with acute neurogenic dysphagia. Within a pre-, post-/during and follow-up study design, 19 non-tracheotomised dysphagic patients were included consecutively and treated according to three specific preselected Facio-Oral Tract Therapy stimulation techniques. The primary outcome was the direct effect of the three different Facio-Oral Tract Therapy stimulation techniques on the number of swallows. We found a significant effect of Facio-Oral Tract Therapy on swallowing frequency as compared to baseline with an increase by 65.63% and medium effect size of D = 0.62. No significant difference could be demonstrated when comparing baseline to follow-up. For the first time, this positive therapy effect could be demonstrated on a population of non-tracheotomised patients. Facio-Oral Tract Therapy seems to be an appropriate means for improving effectiveness and safety of swallowing. Since improvement was not long lasting, it appears to be reasonable to apply therapy frequently during the day with the plausible result of minimising the amount of aspirated saliva and thereby reducing the risk of aspiration pneumonia. Further studies may consider choosing a randomised controlled trial design to demonstrate that change in swallow frequency is related to the target intervention only.

  14. Direct effects of Facio-Oral Tract Therapy® on swallowing frequency of non-tracheotomised patients with acute neurogenic dysphagia

    Directory of Open Access Journals (Sweden)

    Jürgen Konradi

    2015-03-01

    Full Text Available Objectives: The aim of this study was to investigate the direct effect of Facio-Oral Tract Therapy® on swallowing frequency of non-tracheotomised patients with acute neurogenic dysphagia. Methods: Within a pre-, post-/during and follow-up study design, 19 non-tracheotomised dysphagic patients were included consecutively and treated according to three specific preselected Facio-Oral Tract Therapy stimulation techniques. Results: The primary outcome was the direct effect of the three different Facio-Oral Tract Therapy stimulation techniques on the number of swallows. We found a significant effect of Facio-Oral Tract Therapy on swallowing frequency as compared to baseline with an increase by 65.63% and medium effect size of D = 0.62. No significant difference could be demonstrated when comparing baseline to follow-up. Conclusion: For the first time, this positive therapy effect could be demonstrated on a population of non-tracheotomised patients. Facio-Oral Tract Therapy seems to be an appropriate means for improving effectiveness and safety of swallowing. Since improvement was not long lasting, it appears to be reasonable to apply therapy frequently during the day with the plausible result of minimising the amount of aspirated saliva and thereby reducing the risk of aspiration pneumonia. Further studies may consider choosing a randomised controlled trial design to demonstrate that change in swallow frequency is related to the target intervention only.

  15. cDNA microarray analysis of human keratinocytes cells of patients submitted to chemoradiotherapy and oral photobiomodulation therapy: pilot study.

    Science.gov (United States)

    Antunes, Heliton S; Wajnberg, Gabriel; Pinho, Marcos B; Jorge, Natasha Andressa Nogueira; de Moraes, Joyce Luana Melo; Stefanoff, Claudio Gustavo; Herchenhorn, Daniel; Araújo, Carlos M M; Viégas, Celia Maria Pais; Rampini, Mariana P; Dias, Fernando L; de Araujo-Souza, Patricia Savio; Passetti, Fabio; Ferreira, Carlos G

    2017-08-24

    Oral mucositis is an acute toxicity that occurs in patients submitted to chemoradiotherapy to treat head and neck squamous cell carcinoma. In this study, we evaluated differences in gene expression in the keratinocytes of the oral mucosa of patients treated with photobiomodulation therapy and tried to associate the molecular mechanisms with clinical findings. From June 2009 to December 2010, 27 patients were included in a randomized double-blind pilot study. Buccal smears from 13 patients were obtained at days 1 and 10 of chemoradiotherapy, and overall gene expression of samples from both dates were analyzed by complementary DNA (cDNA) microarray. In addition, samples from other 14 patients were also collected at D1 and D10 of chemoradiotherapy for subsequent validation of cDNA microarray findings by qPCR. The expression array analysis identified 105 upregulated and 60 downregulated genes in our post-treatment samples when compared with controls. Among the upregulated genes with the highest fold change, it was interesting to observe the presence of genes related to keratinocyte differentiation. Among downregulated genes were observed genes related to cytotoxicity and immune response. The results indicate that genes known to be induced during differentiation of human epidermal keratinocytes were upregulated while genes associated with cytotoxicity and immune response were downregulated in the laser group. These results support previous clinical findings indicating that the lower incidence of oral mucositis associated with photobiomodulation therapy might be correlated to the activation of genes involved in keratinocyte differentiation.

  16. Long-lasting anti-diabetic efficacy of PEGylated FGF-21 and liraglutide in treatment of type 2 diabetic mice.

    Science.gov (United States)

    Ye, Xianlong; Qi, Jianying; Ren, Guiping; Xu, Pengfei; Wu, Yunzhou; Zhu, Shenglong; Yu, Dan; Li, Shujie; Wu, Qiang; Muhi, Rasool Lubna; Li, Deshan

    2015-08-01

    Fibroblast growth factor-21 (FGF-21) is a new member of the FGF family and potential drug candidate for the treatment of type 2 diabetes mellitus. However, FGF-21 protein has short half-life in vivo, which severely affects its clinical application. In the present study, PEGylated FGF-21 was prepared by modifying the N-terminus of hFGF-21 with 20 kDa mPEG-ALD. The long-acting hypoglycemic effect of PEGylated FGF-21 and liraglutide was compared on type 2 diabetic db/db mice. The pharmacological efficacy of the compounds was evaluated by blood glucose levels, body weight, glycosylated hemoglobin levels, insulin levels, oral glucose tolerance test, lipid levels, and liver function parameters. We noticed that both PEGylated FGF-21 and liraglutide could significantly decrease plasma glucose in db/db mice. However, comparing to liraglutide treatments, PEGylated FGF-21 therapy resulted in more significant effect in lowering blood glucose levels and glycosylated hemoglobin levels, alleviating insulin resistance, improving lipid profile, liver function, and glucose control of the experimental mice. Our results suggest that PEGylated FGF-21 appears more beneficial anti-diabetic effect in type 2 diabetic mice than liraglutide, which holds significant promise as an ideal candidate for the treatment of type 2 diabetic patients.

  17. 'Ins' and 'outs' of triple therapy: Optimal antiplatelet therapy in patients on chronic oral anticoagulation who need coronary stenting.

    NARCIS (Netherlands)

    Dewilde, W.; Verheugt, F.W.A.; Breet, N.; Koolen, J.J.; Berg, J.M. ten

    2010-01-01

    Chronic oral anticoagulant treatment is obligatory in patients (class I) with mechanical heart valves and in patients with atrial fibrillation with CHADS2 score >1. When these patients undergo percutaneous coronary intervention with placement of a stent, there is also an indication for treatment

  18. Utilization study of antidiabetic agents in a teaching hospital of Sikkim and adherence to current standard treatment guidelines

    Directory of Open Access Journals (Sweden)

    Sushrut Varun Satpathy

    2016-01-01

    Full Text Available Objective: Diabetes has gradually emerged as one of the most serious public health problems in our country. This underlines the need for timely disease detection and decisive therapeutic intervention. This prospective cross-sectional observational study aims at analyzing the utilization pattern of antidiabetic agents in a remote North-East Indian tertiary care teaching hospital in the perspective of current standard treatment guidelines. Materials and Methods: Diabetic patients receiving antidiabetic medication, both as outpatients and inpatients in our hospital over a period of 12 months (May 2013–May 2014, were included in this study. The data obtained were sorted and analyzed on the basis of gender, type of therapy, and hospital setting. Results: A total of 310 patients were included in the study. Metformin was the single most frequently prescribed antidiabetic agent (66.8% followed by the sulfonylureas group (37.4%. Insulin was prescribed in 23.2% of the patients. Combination antidiabetic drug therapy (65.1% was used more frequently than monotherapy (34.8%. The use of biguanides (P < 0.0001 and sulfonylureas (P = 0.02 in combination was significant as compared to their use as monotherapy. A total of 48% of all antidiabetic combinations used, comprised metformin and sulfonylureas (n = 96. Insulin use was significantly higher as monotherapy and in inpatients (P< 0.0001. The utilization of drugs from the National List of Essential Medicines was 51.2%, while 11% of antidiabetics were prescribed by generic name. Conclusion: The pattern of utilization largely conforms to the current standard treatment guidelines. Increased use of generic drugs is an area with scope for improvement.

  19. Oral sensorimotor therapy in the developmentally disabled: a multiple baseline study.

    Science.gov (United States)

    Ottenbacher, K; Hicks, J; Roark, A; Swinea, J

    1983-08-01

    The efficacy of a program of sensorimotor facilitation procedures to improve oral motor function and feeding behaviors in students with severe developmental delay was explored. Four severely handicapped students were administered the oral habilitation program using a multiple baseline across-subjects design with staggered introduction of the treatment. Graphic analysis and the split middle method of trend estimation revealed that one subject evidenced an increase in weight and improved oral motor evaluation as a result of the intervention. Two other subjects displayed partial improvement. The correlates of treatment effectiveness are briefly discussed and the need for continued investigation is emphasized.

  20. Combination therapy of potential gene to enhance oral cancer therapeutic effect

    Science.gov (United States)

    Yeh, Chia-Hsien; Hsu, Yih-Chih

    2015-03-01

    The epidermal growth factor receptor (EGFR) over-regulation related to uncontrolled cell division and promotes progression in tumor. Over-expression of human epidermal growth factor receptor (EGFR) has been detected in oral cancer cells. EGFR-targeting agents are potential therapeutic modalities for treating oral cancer based on our in vitro study. Liposome nanotechnology is used to encapsulate siRNA and were modified with target ligand to receptors on the surface of tumor cells. We used EGFR siRNA to treat oral cancer in vitro.

  1. Needs and barriers to improve the collaboration in oral anticoagulant therapy: a qualitative study

    Directory of Open Access Journals (Sweden)

    Drewes Hanneke W

    2011-12-01

    Full Text Available Abstract Background Oral anticoagulant therapy (OAT involves many health care disciplines. Even though collaboration between care professionals is assumed to improve the quality of OAT, very little research has been done into the practice of OAT management to arrange and manage the collaboration. This study aims to identify the problems in collaboration experienced by the care professionals involved, the solutions they proposed to improve collaboration, and the barriers they encountered to the implementation of these solutions. Methods In the Netherlands, intensive follow-up of OAT is provided by specialized anticoagulant clinics (ACs. Sixty-eight semi-structured face-to-face interviews were conducted with 103 professionals working at an AC. These semi-structured interviews were transcribed verbatim and analysed inductively. Wagner's chronic care model (CCM and Cabana's framework for improvement were used to categorize the results. Results AC professionals experienced three main bottlenecks in collaboration: lack of knowledge (mostly of other professionals, lack of consensus on OAT, and limited information exchange between professionals. They mentioned several solutions to improve collaboration, especially solutions of CCM's decision support component (i.e. education, regular meetings, and agreements and protocols. Education is considered a prerequisite for the successful implementation of other proposed solutions such as developing a multidisciplinary protocol and changing the allocation of tasks. The potential of the health care organization to improve collaboration seemed to be underestimated by professionals. They experienced several barriers to the successful implementation of the proposed solutions. Most important barriers were the lack motivation of non-AC professionals and lack of time to establish collaboration. Conclusions This study revealed that the collaboration in OAT is limited by a lack of knowledge, a lack of consensus, and a

  2. Clinical consequences of hospital variation in use of oral anticoagulant therapy after first-time admission for atrial fibrillation

    DEFF Research Database (Denmark)

    Hansen, M L; Gadsbøll, N; Rasmussen, S;

    2009-01-01

    -2796.2008.02061.xObjective. To analyse how hospital factors influence the use of oral anticoagulants (OAC) in atrial fibrillation (AF) patients and address the clinical consequences of hospital variation in OAC use. Design and subjects. By linkage of nationwide Danish administrative registers we conducted...... thromboembolic events were observed amongst patients from low OAC use hospitals. Our study emphasizes the need for a continued vigilance on implementation of international AF management guidelines.......-Copenhagen University Hospital; Glostrup Hospital; Rigshospitalet-Copenhagen University Hospital; University of Copenhagen; Copenhagen, Denmark). Clinical consequences of hospital variation in use of oral anticoagulant therapy after first-time admission for atrial fibrillation. J Intern Med 2009; doi:10.1111/j.1365...

  3. Hematological response to short-term oral cyanocobalamin therapy for the treatment of cobalamin deficiencies in elderly patients.

    Science.gov (United States)

    Andrès, E; Kaltenbach, G; Noblet-Dick, M; Noel, E; Vinzio, S; Perrin, A E; Berthel, M; Blicklé, J F

    2006-01-01

    The aim of this trial was to demonstrate the efficacy of one month of oral cobalamin (vitamin B12) therapy in elderly patients with cobalamin deficiency related to food-cobalamin malabsorption (FCM). Twenty elderly patients (mean age: 78+/-17 years) with established cobalamin deficiency related to FCM were included in an open-label, non-randomized, non-placebo trial. They were treated with a maximum of 1,000 microgram per day of oral crystalline cyanocobalamin for at least 1 month. Serum cobalamin levels (primary endpoint), blood count abnormalities and reticulocytes count (secondary endpoints) were determined at baseline and during the first month of treatment. 85% of the patients normalized their serum cobalamin levels with a mean increase of+167 pg/ml (pcyanocobalamin is effective to correct serum vitamin B12 levels and to obtain hematological responses in elderly patients with cobalamin deficiency related to FCM.

  4. [The importance of adherence to oral therapies in the field of oncology: the example of breast cancer].

    Science.gov (United States)

    Huiart, Laetitia; Bardou, Valérie-Jeanne; Giorgi, Roch

    2013-10-01

    Today, over 40 different oral anticancer therapies are available in the French prescription pricing authority dictionary. Adherence to these therapies has become a major issue in the field of oncology. Most of the available research has focused on adherence to hormonal therapy for breast cancer (BC). The objective of this paper is to synthesize current knowledge on adherence and persistence to hormonal therapy for BC. Available studies display significant heterogeneity due to variability in the measurements and data sources used, as well as in the timing of the measurements. Adherence and persistence estimates have recently been summarized in a meta-regression analysis. For tamoxifen, adherence ranges from 79% at one year to 65% at five years, and for Aromatase Inhibitors (AI), from 80% at one year to 72% at five years. Persistence decreases with the increasing duration of treatment: from a high of 86% of patients persistent at 1 year to a low of 53% at five years for tamoxifen, and from 88% to 69% for AI. Some of the modifiable determinants of adherence are directly linked to the patient-physician relation, to information provided during consultations, or to the specialty of the physician involved in the patient follow-up. Non-modifiable determinants, such as age or comorbidities, can be used to identify sub-groups of patients at high risk of non-adherence in order to target interventions. Few trials have been conducted in oncology to evaluate the efficacy of interventions to improve adherence. Adherence directly impacts both the efficacy of treatment and long-term treatment costs. Interventions to improve adherence to oral therapies should be systematically promoted in oncology. Improving adherence should be considered a priority in the field, lest physicians continue writing inefficient prescriptions for highly efficacious treatments.

  5. Levonorgestrel-Releasing Intrauterine Systems Versus Oral Cyclic Medroxyprogesterone Acetate in Endometrial Hyperplasia Therapy: A Meta-Analysis.

    Science.gov (United States)

    Yuk, Jin-Sung; Song, Jae Yen; Lee, Jung Hun; Park, Won I; Ahn, Hyeong Sik; Kim, Hyun Jung

    2017-05-01

    This study aimed to compare the levonorgestrel-releasing intrauterine system (LNG-IUS) with oral cyclic medroxyprogesterone acetate (MPA) in endometrial hyperplasia therapy using randomized controlled trials (RCTs). The study searched MEDLINE, EMBASE, CENTRAL, and other databases. All regression outcomes were calculated for dichotomous outcomes in terms of relative risk (RR) and 95% confidence intervals (CIs) using a Mantel-Haenszel random effects model. The search found 543 articles but selected 342 articles after the removal of duplicates. A meta-analysis found five RCTs (377 patients). The study did not analyze RR for total outcome because of high heterogeneity (I (2) = 87%). In a subgroup analysis of studies with non-obese women, the LNG-IUS treatment appeared to have a higher regression rate than oral MPA (RR 1.41; 95% CI 1.23-1.62; 4 trials, 265 patients; I (2) = 0%). In a subgroup analysis of studies with obese women, LNG-IUS appeared to have a regression rate similar to that of oral MPA (RR 1.03; 95% CI 0.94-1.13; 1 trial, 60 patients). In a subgroup analysis according to histology in the non-obese group, the LNG-IUS treatment appeared to have a higher regression rate than oral cyclic MPA in a meta-analysis of women with non-atypical endometrial hyperplasia (RR 1.36; 95% CI 1.07-1.73; 2 trials, 92 patients; I (2) = 6%) and mixed endometrial hyperplasia (atypical and non-atypical) (RR 1.44; 95% CI 1.21-1.71; 2 trials, 173 patients; I (2) = 0%). The LNG-IUS treatment has a higher regression rate than cyclic MPA in non-atypical endometrial hyperplasia and mixed endometrial hyperplasia therapy for non-obese women but has a similar regression rate, albeit limited, for obese women.

  6. Efficacy and toxicity of an accelerated hypofractionated radiation therapy protocol in cats with oral squamous cell carcinoma.

    Science.gov (United States)

    Poirier, Valérie J; Kaser-Hotz, Barbara; Vail, David M; Straw, Rodney C

    2013-01-01

    Squamous cell carcinoma (SCC) is the most common feline oral tumor. Standard radiation protocols have been reported to achieve tumor control durations of 1.5-5.5 months (45-165 days). The purpose of this study was to describe the efficacy and toxicity of an accelerated hypofractionated radiation therapy protocol in cats with oral SCC. Twenty-one cats with histologically confirmed oral SCC and T1-3N0M0 were treated with 10 once-daily fractions (Monday-Friday) of 4.8 Gy. Seventeen cats had macroscopic disease and four were microscopic after incomplete excision. Acute toxicity consisted of grade 2 mucositis in all cats and this was effectively managed using esophageal or gastric tube feeding, pain medication, and antibiotics. Late toxicity effects for cats with available follow-up data included alopecia (4 cats), leukotricia (6), tongue ulceration (1), and oronasal fistula (1). Response could be assessed in 17 cats (seven complete response and five partial response). Four cats (19%) developed metastatic disease without evidence of local progression. The median progression-free survival (PFS) was 105 days (1 year PFS of 23%), median local progression-free survival (LPFS) was 219 days (1 year LPFS of 41%), and median overall survival (OS) was 174 days (1 year OS of 29%). Only tumor stage was prognostic, with T1 having a median PFS of 590 days. Findings indicated that this accelerated hypofractionated radiation therapy protocol was well tolerated in cats with oral SCC, with manageable adverse events. Tumor response was observed in most cats and long tumor control durations were achieved in some cats.

  7. Research status quo of oral cavity cold therapy to prevent oral cavity mucositis caused by chemotherapy%口腔冷疗预防放化疗所致口腔黏膜炎研究现状

    Institute of Scientific and Technical Information of China (English)

    陆茵; 徐桂华; 金胜姬

    2011-01-01

    综述了口腔冷疗预防放化疗所致口腔黏膜炎研究现状,指出应对口腔冷疗方法、时间及应用范围进行进一步深入分析,以更好地发挥口腔冷疗对放化疗所致口腔黏膜炎的预防作用.%It summarized the research status quo of oral cavity cold therapy to prevent oral cavity mucositis of patients caused by chemotherapy.And it pointed out that method, time and application of oral cavity cold therapy should be further analyzed so as to play a preventive role better in oral cavity mucositis caused by chemotherapy.

  8. Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy.

    NARCIS (Netherlands)

    Staa, T.P. van; Laan, R.F.J.M.; Barton, I.P.; Cohen, S.; Reid, D.M.; Cooper, C.

    2003-01-01

    OBJECTIVE: To evaluate predictors of vertebral fractures, including a threshold for bone mineral density (BMD), in patients receiving oral glucocorticoids (GCs). METHODS: Data were obtained from 2 randomized clinical trials (prevention and treatment trials of risedronate) using similar methods, but

  9. Effect of highly active antiretroviral therapy use on oral manifestations in pediatric patients infected with HIV

    Directory of Open Access Journals (Sweden)

    Nathalia Ferraz Oliscovicz

    2015-01-01

    Conclusions: Although the prevalence of oral lesions was similar between the groups, it was less in patients without AIDS and those under HAART. The duration of HAART usage had a significant influence on the prevalence of these lesions.

  10. The numerous microbial species in oral biofilms: how could antibacterial therapy be effective?

    Science.gov (United States)

    ten Cate, J M; Zaura, E

    2012-09-01

    Hundreds of bacterial species inhabit the oral cavity. Many of these have never been cultivated and can be assessed only with DNA-based techniques. This new understanding has changed the paradigm of the etiology of oral disease from that associated with 'traditional pathogens' as being primarily responsible for all diseases. Increasingly, associations between oral bacteria and systemic diseases are being reported. The emergence of antibiotic resistance is alarming and calls for in-depth studies of biofilms, bacterial physiology, and a body-wide approach to infectious diseases. We propose that the borderline between commensal bacteria and pathogens is no longer discrete. In a field of science where so many of the established paradigms are being undermined, a thorough analysis of threats and opportunities is required. This article addresses some of the questions that can be raised and serves to identify research opportunities and needs to leverage the prevention of oral diseases through novel antimicrobial strategies.

  11. Antidiabetic and antidiarrheal effects of the methanolic extract of Phyllanthus reticulatus leaves in mice

    Institute of Scientific and Technical Information of China (English)

    Mst Hajera Khatun; Mst Luthfun Nesa; Rafikul Islam; Farhana Alam Ripa; Al mamum; Shahin Kadir

    2014-01-01

    Objective: To assess the anti-diabetic and antidiarrheal activity of methanolic extract of Phyllanthus reticulates (P. reticulates) leaves in an animal model. Methods: Phytochemical screening of methanolic extract of P. reticulatus leaves has been performed. Antidiabetic activity have been done by OGTT, normoglycemic hyperglycemia and alloxan induced diabetic mice. Plant extracts (150 mg/kg and 300 mg/kg, b.w.) were administered orally in fasting glucose loaded mice with regard to normal control and in alloxan induced (110 mg/kg body weight i.p.) diabetic mice in comparison with reference drug Metformin hydrochloride (100 mg/kg) during 7 day test period. Antidiarrheal test was conducted by castor oil and magnesium sulfate. Results:Findings confirmed that the continuous post-treatment for 7 days with both extracts showed significant (P<0.05) hypoglycemic activity in OGTT, normoglycemic and alloxan induced mouse models. Castor oil and Magnesium sulfate induced diarrheal test of the extract (200 and 400 mg/kg) has given significant effect in compairing to control diarrheal group. Conclusion:Methanolic extract of P. reticulatus leaves have shown significant antidiabetic and antidiarrheal properties.

  12. ANTI-DIABETIC EFFECT OF MORUS ALBA ON RABBIT AS ANIMAL MODEL

    Directory of Open Access Journals (Sweden)

    Laddha G. P.

    2012-04-01

    Full Text Available A study of ancient literature indicates that diabetes was fairly well known and well conceived as an entity in India. The nature has provided abundant plant wealth for all the living creatures, which possess medicinal virtues. Therefore, there is a necessity to explore their uses and to conduct Pharmacognostic and pharmacological studies to ascertain their therapeutic properties. In fact, nowadays diabetes is a global problem. Hence, the present study aims to open new avenues for the improvement of medicinal uses of Morus alba. for the area for diabetes. Another important objective of such study is to bring the anti-diabetic medicinal plants sector on a firm scientific footing, raise awareness and add value to the resource. Dried petroleum ether (60-80°C extracts of leaves of Morus alba. were subjected for hypoglycemic activity in New Zealand rabbits (1.5-3.5 kg. Blood sugar level was determined using digital glucometer. The oral administration of leaf extracts at doses of 200 mg/ kg− lead to a significant blood glucose reduction. This laid the foundation to study the active compounds of such anti-diabetic plants that are responsible for the hypoglycemic activities. It also proves the traditional claim of Kachh region with regard to Morus Alba for its anti-diabetic activity.

  13. Enhancement of sodium caprate on intestine absorption and antidiabetic action of berberine.

    Science.gov (United States)

    Lv, Xiao-Yan; Li, Jing; Zhang, Ming; Wang, Chun-Mei; Fan, Zheng; Wang, Chun-Yan; Chen, Li

    2010-03-01

    Berberine, a plant alkaloid used in traditional Chinese medicine, has a wide spectrum of pharmacological actions, but the poor bioavailability limits its clinical use. The present aim was to observe the effects of sodium caprate on the intestinal absorption and antidiabetic action of berberine. The in situ, in vitro, and in vivo models were used to observe the effect of sodium caprate on the intestinal absorption of berberine. Intestinal mucosa morphology was measured to evaluate the toxic effect of sodium caprate. Diabetic model was used to evaluate antidiabetic effect of berberine coadministered with sodium caprate. The results showed that the absorption of berberine in the small intestine was poor and that sodium caprate could significantly improve the poor absorption of berberine in the small intestine. Sodium caprate stimulated mucosal-to-serosal transport of berberine; the enhancement ratios were 2.08, 1.49, and 3.49 in the duodenum, jejunum, and ileum, respectively. After coadministration, the area under the plasma concentration-time curve of berberine was increased 28% than that in the absence of sodium caprate. Furthermore, both berberine and coadministration with sodium caprate orally could significantly decrease fasting blood glucose and improve glucose tolerance in diabetic rats (P effect of coadministration group was remarkably stronger, and the areas under the glucose curves was decreased 22.5%, compared with berberine treatment group (P berberine in intestine and enhance its antidiabetic effect without any serious mucosal damage.

  14. A bioactivity guided study on the antidiabetic activity of Juniperus oxycedrus subsp. oxycedrus L. leaves.

    Science.gov (United States)

    Orhan, Nilüfer; Aslan, Mustafa; Demirci, Betül; Ergun, Fatma

    2012-03-27

    Juniperus (Cupressaceae) species are widely used as folk medicine in spreading countries. Decoction of Juniperus oxycedrus subsp. oxycedrus L. leaves is used internally to lower blood glucose levels in Turkey. To determine hypoglycaemic and antidiabetic activities of Juniperus oxycedrus subsp. oxycedrus leaves and to identify active compounds through bioactivity guided isolation technique. Ethanol and water extracts of Juniperus oxycedrus subsp. oxycedrus (Joso), leaves on oral administration were studied using in vivo models in normal, glucose-hyperglycemic and streptozotocin-induced diabetic rats. Through in vivo bioactivity-guided fractionation processes, a nonpolar fraction was separated from the n-hexane subextract by silica gel column chromatography as the main active fraction. Subfractions of this fraction was found to possess antidiabetic activity and their chemical composition was investigated by GC-FID and GC-MS, simultaneously. This is the first report on the antidiabetic constituents of Joso leaves. Fatty acids, such as palmitic, linoleic and linolenic acid were found as the major compounds in subfractions. Results indicated that Joso leaf extract and its active constituents might be beneficial for diabetes mellitus. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Blood pressure and cardiovascular effects of new and emerging antidiabetic agents.

    Science.gov (United States)

    Balfour, Pelbreton C; Rodriguez, Carlos J; Ferdinand, Keith C

    2014-08-01

    Despite remarkable declines in US cardiovascular disease morbidity and mortality over the last several decades, the prevalence of risk factors such as type 2 diabetes and hypertension remains high, associated with increasing obesity rates. Although optimal glycemic control remains a primary focus to decrease the disease burden, the FDA has issued guidance recommendations for documenting cardiovascular disease-related safety with research trials on new antidiabetic agents with more demanding requirements compared to past approval of existing therapies. This review will discuss the public health impact of type 2 diabetes, specifically with comorbid hypertension; mechanisms of action of the newest antidiabetic drug classes; and preliminary findings and potential clinical significance of the favorable blood pressure and body weight effects of the sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists; and additionally discuss two recent large cardiovascular outcome trials with dipeptidyl peptidase-4 inhibitors.

  16. Assessment of ghrelin and leptin receptor levels in postmenopausal women who received oral or transdermal menopausal hormonal therapy

    Institute of Scientific and Technical Information of China (English)

    Barbara RUSZKOWSKA; Alina SOKUP; Arleta KULWAS; Maciej W.SOCHA; Krzysztof GˊORALCZYK; Barbara GˊORALCZYK; Danuta ROˊSˊC

    2012-01-01

    Objective:In postmenopausal women,an increased leptin concentration and reduced levels ofghrelin and adiponectin were observed.The aim of this study was to evaluate the concentrations of the active form of ghrelin,total ghrelin,leptin receptor,lipoprotein(a) (Lp(a)),and plasminogen activator inhibitor type 1 (PAI-1) in postmenopausal women who received oral or transdermal menopausal hormonal therapy (MHT).Methods:The study involved 76 healthy women:46 women aged from 44 to 58 years who received oral (26) or transdermal (20) MHT; the control group consisted of 30 women aged from 44 to 54 years who did not receive MHT.The plasma concentrations of total ghrelin,the active form of ghrelin,Lp(a),and PAI-1:Ag were measured by enzyme-linked immunosorbent assay (ELISA).The concentration of the leptin receptor was measured by enzyme immunometric assay (EIA).Results:We observed a significantly higher concentration of total ghrelin and the active form of ghrelin in women who received transdermal MHT in comparison with those who took oral MHT.We also found a significantly lower concentration of total ghrelin in women who received oral MHT compared with the control group.A higher concentration of PAI-1:Ag was found in the group of women who took transdermal MHT in comparison with those who took oral MHT and with the control group.The differences were statistically significant.Additionally,we found a significant negative correlation between the concentrations of total ghrelin and PAI-1:Ag and a positive correlation between the concentrations of total ghrelin and leptin receptor in women who received transdermal MHT.Conclusions:The study showed that women who used transdermal MHT had higher levels of total ghrelin than women who took oral MHT.This indicates a beneficial effect of the transdermal route of MHT.However,transdermal therapy was associated with adverse effects with regard to the observed higher levels of PAI-1:Ag,which in turn,can lead to a reduction in fibrinolytic

  17. ANTIOXIDANT AND ANTIDIABETIC ACTIVITY OF CURCUMA AROMATICA

    Directory of Open Access Journals (Sweden)

    Ammayappan Rajam Srividya

    2012-06-01

    Full Text Available The objective of this paper is to find out the antidiabetic activity of Curcuma aromatica. In this research paper we dealt with antioxidant activities by DPPH method, ABTS method, Lipid peroxidation assay and scavenging ability of the extract for the hydrogen peroxide radical, Glucose uptake by rat hemi diaphragm method. Antidiabetic activity using healthy adult Wister rats were also carried out. Toluene extract of Curcuma aromatica showed the potent scavenging activity by DPPH method with the IC 50 value of 50.62±0.998 µg/ml, by lipid per oxidation method with the IC 50 value of 75±0.87 µg/ml, hydrogen peroxide radical scavenging activity with the IC 50 value 43.75±1.24 µg/ml, and ABTS radical scavenging method with the IC 50 value 0.038±1.54 µg/ml. After the treatment with the toluene extract of Curcuma aromatica, serum glucose level was found to be decreased from 278.53 to 116.5 mg/dl, total protein level increased from 3.09 to 5.78 mg/dl. There was a decrease in total cholesterol level from 292.33 to 134.50 mg/dl, decrease in serum triglyceride level from 85.66 to 64.16mg/dl when compared to diabetic control group. Toluene extract of Curcuma aromatica exhibited significant antioxidant and antidiabetic activities in both in vitro and in vivo models. So, it can be used as alternative herbal medicine in the treatment of diabetes and diabetic induced complication.

  18. Oral Gentamicin Gut Decontamination for Prevention of KPC-Producing Klebsiella pneumoniae Infections: Relevance of Concomitant Systemic Antibiotic Therapy

    Science.gov (United States)

    Tascini, Carlo; Sbrana, Francesco; Flammini, Sarah; Tagliaferri, Enrico; Arena, Fabio; Leonildi, Alessandro; Ciullo, Ilaria; Amadori, Francesco; Di Paolo, Antonello; Ripoli, Andrea; Lewis, Russell; Rossolini, Gian Maria

    2014-01-01

    Gut colonization represents the main source for KPC-producing Klebsiella pneumoniae (KPC-Kp) epidemic dissemination. Oral gentamicin, 80 mg four times daily, was administered to 50 consecutive patients with gut colonization by gentamicin-susceptible KPC-Kp in cases of planned surgery, major medical intervention, or need for patient transfer. The overall decontamination rate was 68% (34/50). The median duration of gentamicin treatment was 9 days (interquartile range, 7 to 15 days) in decontaminated patients compared to 24 days (interquartile range, 20 to 30 days) in those with persistent colonization (P < 0.001). In the six-month period of follow-up, KPC-Kp infections were documented in 5/34 (15%) successfully decontaminated patients compared to 12/16 (73%) persistent carriers (P < 0.001). The decontamination rate was 96% (22/23) in patients receiving oral gentamicin only, compared to 44% (12/27) of those treated with oral gentamicin and concomitant systemic antibiotic therapy (CSAT) (P < 0.001). The multivariate analysis confirmed CSAT and KPC-Kp infection as the variables associated with gut decontamination. In the follow-up period, KPC-Kp infections were documented in 2/23 (9%) of patients treated with oral gentamicin only and in 15/27 (56%) of those also receiving CSAT (P = 0.003). No difference in overall death rate between different groups was documented. Gentamicin-resistant KPC-Kp strains were isolated from stools of 4/16 persistent carriers. Peak gentamicin blood levels were below 1 mg/liter in 12/14 tested patients. Oral gentamicin was shown to be potentially useful for gut decontamination and prevention of infection due to KPC-Kp, especially in patients not receiving CSAT. The risk of emergence of gentamicin-resistant KPC-Kp should be considered. PMID:24419337

  19. Synthesis and Antidiabetic Evaluation of Benzothiazole Derivatives

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    G, Mariappan; P, Prabhat; L, Sutharson; J, Banerjee; U, Patangia; S, Nath [Himalayan Pharmacy Institute, Majhitar (India)

    2012-04-15

    A novel series of benzothiazole derivatives were synthesized and assayed in vivo to investigate their hypogly-cemic activity by streptozotocin-induced diebetic model in rat. These derivatives showed considerable biological efficacy when compared to glibenclamide, a potent and well known antidiabetic agent as a reference drug. All the compounds were effective, amongst them 3d showed more prominent activity at 100 mg/kg p.o. The experimental results are statistically significant at p<0.01 and p<0.05 level.

  20. [A 50-year history of new drugs in Japan-the development and progress of anti-diabetic drugs and the epidemiological aspects of diabetes mellitus].

    Science.gov (United States)

    Ozawa, Hikaru; Murai, Yuriko; Ozawa, Terutaka

    2003-01-01

    -meal hyperglycemia of Type 2 diabetes. Epalrestat (Ono Yakuhin Co., 1992) is effective for diabetic neuropathy by reducing the formation of sorbitol. These anti-DM drugs were recently studied and developed in Japan. 4) The Japan Diabetes Society proposed a guideline on diagnostic criteria and treatment of diabetes mellitus (DM) in 1999 and revised it in 2002. DM is classified as insulin-dependent DM (Type l) and non-insulin dependent DM (Type 2). Type 1, juvenile onset DM, requires insulin therapy to prevent ketosis and to sustain life. Treatment of type 2, adult onset DM, is recommended as a step-by-step method, starting with dietary-exercise therapy, followed by oral hypoglycemic drugs and then insulin therapy. DM patients with complications should have a therapy devised to match their circumstances. 5) Epidemiological aspects: The mortality rate of DM compared to the time of drug appearance was traced from 1920 to 2000. The curve goes down slowly in the time frame of World War II, but rises from 1950 to 1970. The elevation could not be suppressed by the appearance of SUs, BGs or improved insulin preparations. The curve runs flat from 1980 to 1990, which might be related to the use of purified insulin or human insulin therapy. The mortality rate of DM indicates that death by hyperglycemic coma and other deaths resulting from complications are excluded. The survey of the principal cause of death by DM during the period of 1981-1990 indicates that the death rate due to hyperglycemic coma is only 1.7% of the total deaths caused by DM. The effect of drug therapy on all of the death resulting from DM is not detected. Hospital visitation and admission rates of the DM patients have been recorded since 1952 in Japan. This curve is rising continuously, and none of the antidiabetic drugs has been able to suppress it. These data show that the antidiabetic drugs relieve DM symptoms through their effective hypoglycemic actions, but that they cannot suppress the mortality rate of DM. It is

  1. Red ginseng powder fermented with probiotics exerts antidiabetic effects in the streptozotocin-induced mouse diabetes model.

    Science.gov (United States)

    Jang, Sun-Hee; Park, Jisang; Kim, Sae-Hae; Choi, Kyung-Min; Ko, Eun-Sil; Cha, Jeong-Dan; Lee, Young-Ran; Jang, Hyonseok; Jang, Yong-Suk

    2017-12-01

    Red ginseng (heat-processed Panax ginseng) is a well-known alternative medicine with pharmacological antidiabetic activity. It exerts pharmacological effects through the transformation of saponin into metabolites by the intestinal microbiota. Given that intestinal conditions and intestinal microflora vary among individuals, the pharmacological effects of orally administered red ginseng likely may vary among individuals. To overcome this variation and produce homogeneously effective red ginseng, we evaluated the antidiabetic effects of probiotic-fermented red ginseng in a mouse model. The antidiabetic efficacy of orally administered probiotic-fermented red ginseng was assessed in ICR mice after induction of diabetes using streptozotocin (170 mg/kg body weight). Samples were given orally for 8 weeks, and indicators involved in diabetic disorders such as body weight change, water intake, blood glucose, glucose tolerance and various biochemical parameters were determined. Oral administration of probiotic-fermented red ginseng significantly decreased the level of blood glucose of about 62.5% in the fasting state and induced a significant increase in glucose tolerance of about 10.2% compared to the control diabetic mice. Additionally, various indicators of diabetes and biochemical data (e.g., blood glycosylated haemoglobin level, serum concentrations of insulin, and α-amylase activity) showed a significant improvement in the diabetic conditions of the mice treated with probiotic-fermented red ginseng in comparison with those of control diabetic mice. Our results demonstrate the antidiabetic effects of probiotic-fermented red ginseng in the streptozotocin-induced mouse diabetes model and suggest that probiotic-fermented red ginseng may be a uniformly effective red ginseng product.

  2. Antidiabetic, antihyperlipidemic and antioxidant properties of ethanol extract of Grewia asiatica Linn. bark in alloxan-induced diabetic rats

    OpenAIRE

    2016-01-01

    Background Inspite of introduction of oral hypoglycemic agents, diabetes and its related complications remains to be a major clinical problem. The aim of this study was to investigate the antidiabetic, antihyperlipidemic and antioxidant activities of Grewia asiatica (Linn) stem bark in alloxan induced diabetic rats. Methods Diabetes was induced by a single dose of intraperitoneal injection of alloxan (110 mg/kg) in Norwegian Long Evans rats. Ethanol extract of barks from Grewia asiatica (GAE ...

  3. Nanostructured Lipid Carriers Loaded with Baicalin: An Efficient Carrier for Enhanced Antidiabetic Effects.

    Science.gov (United States)

    Shi, Feng; Wei, Zheng; Zhao, Yingying; Xu, Ximing

    2016-01-01

    Recent studies have demonstrated that baicalin has antihyperglycemic effects by inhibiting lipid peroxidation. Baicalin is low hydrophilic and poorly absorbed after oral administration. Thus, a suitable formulation is highly desired to overcome the disadvantages of baicalin. The objective of this work was to prepare baicalin-loaded nanostructured lipid carriers (B-NLCs) for enhanced antidiabetic effects. B-NLCs were prepared by high-pressure homogenization method using Precirol as the solid lipid and Miglyol as the liquid lipid. The properties of the NLCs, such as particle size, zeta potential (ZP), and drug encapsulation efficiency (EE), were investigated. The morphology of NLCs was observed by transmission electron microscopy. In addition, drug release and antidiabetic activity were also studied. The results revealed that B-NLCs particles were uniformly in the nanosize range and of spherical morphology with a mean size of 92 ± 3.1 nm, a ZP of -31.35 ± 3.08 mV, and an EE of 85.29 ± 3.42%. Baicalin was released from NLCs in a sustained manner. In addition, B-NLCs showed a significantly higher antidiabetic efficacy compared with baicalin. B-NLCs described in this study are well-suited for the delivery of baicalin. Currently, herbal medicines have attracted increasing attention as a complementary approach for type 2 diabetesBaicalin has antihyperglycemic effects by inhibiting lipid peroxidationA suitable formulation is highly desired to overcome the disadvantages (poor solubility and low bioavailability) of baicalinNanostructured lipid carriers could enhance the antidiabetic effects of baicalin. Abbreviations used: B-NLCs: Baicalin-Loaded Nanostructured Lipid Carriers, B-SUS: Baicalin Water Suspension, EE: Encapsulation Efficiency, FBG: Fasting Blood Glucose, HbAlc: Glycosylated Hemoglobin, HPLC: High-performance Liquid Chromatography; NLCs: Nanostructured Lipid Carriers, PI: Polydispersity Index, SD: Sprague-Dawley, SLNs: Solid lipid nanoparticles, STZ

  4. Factors Affecting Patients' Perception On, and Adherence To, Anticoagulant Therapy: Anticipating the Role of Direct Oral Anticoagulants.

    Science.gov (United States)

    Pandya, Ekta Y; Bajorek, Beata

    2017-04-01

    The role of the direct oral anticoagulants (DOACs) in practice has been given extensive consideration recently, albeit largely from the clinician's perspective. However, the effectiveness and safety of using anticoagulants is highly dependent on the patient's ability to manage and take these complex, high-risk medicines. This structured narrative review explores the published literature to identify the factors underpinning patients' non-adherence to anticoagulants in atrial fibrillation (AF), and subsequently contemplates to what extent the DOACs might overcome the known challenges with traditional warfarin therapy. This review comprised a two-tier search of various databases and search platforms (CINAHL, Cochrane, Current Contents Connect, EMBASE, MEDLINE Ovid, EBSCO, PubMed, Google, Google Scholar) to yield 47 articles reporting patients perspectives on, and patients adherence to, anticoagulant therapy. The findings from the literature were synthesised under five interacting dimensions of adherence: therapy-related factors, patient-related factors, condition-related factors, social-economic factors and health system factors. Factors negatively affecting patients' day-to-day lives (especially regular therapeutic drug monitoring, dose adjustments, dietary considerations) predominantly underpin a patient's reluctance to take warfarin therapy, leading to non-adherence. Other patient-related factors underpinning non-adherence include patients' perceptions and knowledge about the purpose of anticoagulation; understanding of the risks and benefits of therapy; socioeconomic status; and expectations of care from health professionals. In considering these findings, it is apparent that the DOACs may overcome some of the barriers to traditional warfarin therapy at least to an extent, particularly the need for regular monitoring, frequent dose adjustment and dietary considerations. However, their high cost, twice-daily dosing and gastrointestinal adverse effects may present

  5. Nurses′ knowledge and education about oral care of cancer patients undergoing chemotherapy and radiation therapy

    Directory of Open Access Journals (Sweden)

    Radhika R Pai

    2015-01-01

    Setting and design: A cross sectional descriptive survey was conducted among 158 staff nurses working in oncology related areas from 4 different hospitals of Dakshina Kannada district and Udupi district of Karnataka state, India. Statistical Analysis: descriptive and inferential statistics was used by using SPSS 16 version. Results: Majority 81 (51.3% of the staff nurses had poor knowledge of oral care in cancer patients whereas 87 (55.1% reported that knowledge acquired through basic education in oral care is not sufficient. Most of the staff nurses 115 (72.8% did not receive basic education in oral care of cancer patients. There was significant association between knowledge and variables such as designation (.005, years of work experience (.040 and years of experience in cancer wards (.000 at 0.05 levels. Conclusion: Lack of knowledge suggest the need to develop and implement continuing nursing education programs on oral care specifically for patients receiving cancer treatments, for improving knowledge of staff nurses′ in order to render comprehensive care to the patients. This study also recommends the importance of inclusion of cancer patient specific oral care in the curriculum which can enhance competency of the qualified nurses in cancer wards.

  6. Factors related to patient adherence to antidiabetic drug therapy Factores relacionados a la adhesión del paciente diabético a la terapéutica medicamentosa Fatores relacionados à adesão do paciente diabético à terapêutica medicamentosa

    Directory of Open Access Journals (Sweden)

    Heloisa Turcatto Gimenes

    2009-02-01

    Full Text Available The objective of the present study was to assess patient adherence to antidiabetic drug therapy and its association with factors related to the patient, patient-provider relationship, therapeutic regimen and the disease itself. The study comprised 46 diabetic patients enrolled in a research and extension education center in the State of Sao Paulo, southeastern Brazil, in 2007. Data was collected through interviews using a questionnaire and the Treatment Adherence Measure (TAM. The patient adherence level to antidiabetic drug therapy was 78.3%. In conclusion, since prevalence of adherence is below that recommended in the literature, and in the light of poor blood glucose control and alleged failure of therapeutic regimen, health providers are urged to measure diabetic patient treatment adherence, because it is key to adequate diabetes management with drugs.Este estudio tuvo el objetivo de determinar la adhesión del paciente diabético a la terapéutica medicamentosa y verificar la asociación de la adhesión con factores relacionados al paciente, a la relación profesional-paciente, al esquema terapéutico y a la enfermedad. Participaron 46 diabéticos registrados en un centro de investigación y extensión universitaria en el interior del Estado de San Pablo, en 2007. Los datos fueron obtenidos mediante entrevista, utilizándose un cuestionario y la prueba de Medida de Adhesión al Tratamiento - MAT. Los resultados mostraron que la adhesión del paciente diabético al tratamiento medicamentoso para tratamiento de la diabetes fue de 78,3%. Se concluye que, al considerar que la prevalencia de la adhesión obtenida en el presente estudio estuvo por debajo de la recomendada en la literatura y frente a la vigencia del mal control de la glucemia y de la supuesta falencia en el esquema terapéutico, se urgente que los profesionales de la salud reconozcan la importancia de evaluar la adhesión de los pacientes diabéticos, al tratamiento medicamentoso

  7. Newer antidiabetic drugs and calorie restriction mimicry

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2016-01-01

    Full Text Available De-acceleration of aging and delayed development of age-related morbidity accompanies the restriction of calories (without malnutrition in laboratory mice, nematodes, yeast, fish, and dogs. Recent results from long-term longitudinal studies conducted on primates have suggested longevity benefits of a 30% restriction of calories in rhesus monkeys as well. Among calorie restricted rhesus monkeys one of the mechanisms for the improvement in lifespan was the reduction in the development of glucose intolerance and cardiovascular disease. Although there are no comparable human studies, it is likely that metabolic and longevity benefits will accompany a reduction in calories in humans as well. However, considering the difficulties in getting healthy adults to limit food intake science has focused on understanding the biochemical processes that accompany calorie restriction (CR to formulate drugs that would mimic the effects of CR without the need to actually restrict calories. Drugs in this emerging therapeutic field are called CR mimetics. Some of the currently used anti-diabetic agents may have some CR mimetic like effects. This review focuses on the CR mimetic properties of the currently available anti-diabetic agents.

  8. Pharmacogenetics of Anti-Diabetes Drugs

    Directory of Open Access Journals (Sweden)

    Johanna K. DiStefano

    2010-08-01

    Full Text Available A variety of treatment modalities exist for individuals with type 2 diabetes mellitus (T2D. In addition to dietary and physical activity interventions, T2D is also treated pharmacologically with nine major classes of approved drugs. These medications include insulin and its analogues, sulfonylureas, biguanides, thiazolidinediones (TZDs, meglitinides, α-glucosidase inhibitors, amylin analogues, incretin hormone mimetics, and dipeptidyl peptidase 4 (DPP4 inhibitors. Pharmacological treatment strategies for T2D are typically based on efficacy, yet favorable responses to such therapeutics are oftentimes variable and difficult to predict. Characterization of drug response is expected to substantially enhance our ability to provide patients with the most effective treatment strategy given their individual backgrounds, yet pharmacogenetic study of diabetes medications is still in its infancy. To date, major pharmacogenetic studies have focused on response to sulfonylureas, biguanides, and TZDs. Here, we provide a comprehensive review of pharmacogenetics investigations of these specific anti-diabetes medications. We focus not only on the results of these studies, but also on how experimental design, study sample issues, and definition of ‘response’ can significantly impact our interpretation of findings. Understanding the pharmacogenetics of anti-diabetes medications will provide critical baseline information for the development and implementation of genetic screening into therapeutic decision making, and lay the foundation for “individualized medicine” for patients with T2D.

  9. Pharmacogenetics of Anti-Diabetes Drugs.

    Science.gov (United States)

    Distefano, Johanna K; Watanabe, Richard M

    2010-08-01

    A variety of treatment modalities exist for individuals with type 2 diabetes mellitus (T2D). In addition to dietary and physical activity interventions, T2D is also treated pharmacologically with nine major classes of approved drugs. These medications include insulin and its analogues, sulfonylureas, biguanides, thiazolidinediones (TZDs), meglitinides, α-glucosidase inhibitors, amylin analogues, incretin hormone mimetics, and dipeptidyl peptidase 4 (DPP4) inhibitors. Pharmacological treatment strategies for T2D are typically based on efficacy, yet favorable responses to such therapeutics are oftentimes variable and difficult to predict. Characterization of drug response is expected to substantially enhance our ability to provide patients with the most effective treatment strategy given their individual backgrounds, yet pharmacogenetic study of diabetes medications is still in its infancy. To date, major pharmacogenetic studies have focused on response to sulfonylureas, biguanides, and TZDs. Here, we provide a comprehensive review of pharmacogenetics investigations of these specific anti-diabetes medications. We focus not only on the results of these studies, but also on how experimental design, study sample issues, and definition of 'response' can significantly impact our interpretation of findings. Understanding the pharmacogenetics of anti-diabetes medications will provide critical baseline information for the development and implementation of genetic screening into therapeutic decision making, and lay the foundation for "individualized medicine" for patients with T2D.

  10. Newer antidiabetic drugs and calorie restriction mimicry.

    Science.gov (United States)

    Kalra, Sanjay; Jacob, Jubbin Jagan; Gupta, Yashdeep

    2016-01-01

    De-acceleration of aging and delayed development of age-related morbidity accompanies the restriction of calories (without malnutrition) in laboratory mice, nematodes, yeast, fish, and dogs. Recent results from long-term longitudinal studies conducted on primates have suggested longevity benefits of a 30% restriction of calories in rhesus monkeys as well. Among calorie restricted rhesus monkeys one of the mechanisms for the improvement in lifespan was the reduction in the development of glucose intolerance and cardiovascular disease. Although there are no comparable human studies, it is likely that metabolic and longevity benefits will accompany a reduction in calories in humans as well. However, considering the difficulties in getting healthy adults to limit food intake science has focused on understanding the biochemical processes that accompany calorie restriction (CR) to formulate drugs that would mimic the effects of CR without the need to actually restrict calories. Drugs in this emerging therapeutic field are called CR mimetics. Some of the currently used anti-diabetic agents may have some CR mimetic like effects. This review focuses on the CR mimetic properties of the currently available anti-diabetic agents.

  11. Autoantigens produced in plants for oral tolerance therapy of autoimmune diseases.

    Science.gov (United States)

    Ma, S; Jevnikar, A M

    1999-01-01

    Oral administration of protein antigens can induce antigen-specific immune hyporesponsiveness and may be useful in treating autoimmune diseases or preventing transplant rejection. However, the therapeutic value of oral tolerance may be limited when candidate autoantigens cannot be produced by conventional system in quantities sufficient for clinical studies. Plants may be ideally suited for this purpose, as they can produce hugh quantities of functional mammalian proteins at extremely competitive cost. Furthermore, transgenic food plants could provide a simple and direct method of autoantigen delivery for oral tolerance. Here we show that the diabetes-associated autoantigen glutamic acid decarboxylase (GAD) is efficiently expressed in both tobacco and potato plants, and that mice, when fed with fresh transgenic potato tubers, are fully protected from diabetes.

  12. Hypofractionated Radiation Therapy Followed by Surgery in Treating Patients With Advanced Squamous Cell Carcinoma of the Oral Cavity

    Science.gov (United States)

    2017-01-19

    Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  13. Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review.

    Science.gov (United States)

    Firoz, T; Magee, L A; MacDonell, K; Payne, B A; Gordon, R; Vidler, M; von Dadelszen, P

    2014-09-01

    Pregnant and postpartum women with severe hypertension are at increased risk of stroke and require blood pressure (BP) reduction. Parenteral antihypertensives have been most commonly studied, but oral agents would be ideal for use in busy and resource-constrained settings. To review systematically, the effectiveness of oral antihypertensive agents for treatment of severe pregnancy/postpartum hypertension. A systematic search of MEDLINE, EMBASE and the Cochrane Library was performed. Randomised controlled trials in pregnancy and postpartum with at least one arm consisting of a single oral antihypertensive agent to treat systolic BP ≥ 160 mmHg and/or diastolic BP ≥ 110 mmHg. Cochrane RevMan 5.1 was used to calculate relative risk (RR) and weighted mean difference by random effects. We identified 15 randomised controlled trials (915 women) in pregnancy and one postpartum trial. Most trials in pregnancy compared oral/sublingual nifedipine capsules (8-10 mg) with another agent, usually parenteral hydralazine or labetalol. Nifedipine achieved treatment success in most women, similar to hydralazine (84% with nifedipine; relative risk [RR] 1.07, 95% confidence interval [95% CI] 0.98-1.17) or labetalol (100% with nifedipine; RR 1.02, 95% CI 0.95-1.09). Less than 2% of women treated with nifedipine experienced hypotension. There were no differences in adverse maternal or fetal outcomes. Target BP was achieved ~ 50% of the time with oral labetalol (100 mg) or methyldopa (250 mg) (47% labetelol versus 56% methyldopa; RR 0.85 95% CI 0.54-1.33). Oral nifedipine, and possibly labetalol and methyldopa, are suitable options for treatment of severe hypertension in pregnancy/postpartum. © 2014 The Authors BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  14. Antibiotic susceptibilities of bacteria isolated within the oral flora of Florida blacktip sharks: guidance for empiric antibiotic therapy.

    Science.gov (United States)

    Unger, Nathan R; Ritter, Erich; Borrego, Robert; Goodman, Jay; Osiyemi, Olayemi O

    2014-01-01

    Sharks possess a variety of pathogenic bacteria in their oral cavity that may potentially be transferred into humans during a bite. The aim of the presented study focused on the identification of the bacteria present in the mouths of live blacktip sharks, Carcharhinus limbatus, and the extent that these bacteria possess multi-drug resistance. Swabs were taken from the oral cavity of nineteen live blacktip sharks, which were subsequently released. The average fork length was 146 cm (±11), suggesting the blacktip sharks were mature adults at least 8 years old. All swabs underwent standard microbiological work-up with identification of organisms and reporting of antibiotic susceptibilities using an automated microbiology system. The oral samples revealed an average of 2.72 (±1.4) bacterial isolates per shark. Gram-negative bacteria, making up 61% of all bacterial isolates, were significantly (pshark gender or fork length with bacterial density or antibiotic resistance was observed. Antibiotics with the highest overall susceptibility rates included fluoroquinolones, 3rd generation cephalosporins and sulfamethoxazole/trimethoprim. Recommended empiric antimicrobial therapy for adult blacktip shark bites should encompass either a fluoroquinolone or combination of a 3rd generation cephalosporin plus doxycycline.

  15. Safe Oral Triiodo-L-Thyronine Therapy Protects from Post-Infarct Cardiac Dysfunction and Arrhythmias without Cardiovascular Adverse Effects.

    Directory of Open Access Journals (Sweden)

    Viswanathan Rajagopalan

    Full Text Available A large body of evidence suggests that thyroid hormones (THs are beneficial for the treatment of cardiovascular disorders. We have shown that 3 days of triiodo-L-thyronine (T3 treatment in myocardial infarction (MI rats increased left ventricular (LV contractility and decreased myocyte apoptosis. However, no clinically translatable protocol is established for T3 treatment of ischemic heart disease. We hypothesized that low-dose oral T3 will offer safe therapeutic benefits in MI.Adult female rats underwent left coronary artery ligation or sham surgeries. T3 (~6 μg/kg/day was available in drinking water ad libitum immediately following MI and continuing for 2 month(s (mo. Compared to vehicle-treated MI, the oral T3-treated MI group at 2 mo had markedly improved anesthetized Magnetic Resonance Imaging-based LV ejection fraction and volumes without significant negative changes in heart rate, serum TH levels or heart weight, indicating safe therapy. Remarkably, T3 decreased the incidence of inducible atrial tachyarrhythmias by 88% and improved remodeling. These were accompanied by restoration of gene expression involving several key pathways including thyroid, ion channels, fibrosis, sympathetic, mitochondria and autophagy.Low-dose oral T3 dramatically improved post-MI cardiac performance, decreased atrial arrhythmias and cardiac remodeling, and reversed many adverse changes in gene expression with no observable negative effects. This study also provides a safe and effective treatment/monitoring protocol that should readily translate to humans.

  16. Development of low-cost devices for image-guided photodynamic therapy treatment of oral cancer in global health settings

    Science.gov (United States)

    Liu, Hui; Rudd, Grant; Daly, Liam; Hempstead, Joshua; Liu, Yiran; Khan, Amjad P.; Mallidi, Srivalleesha; Thomas, Richard; Rizvi, Imran; Arnason, Stephen; Cuckov, Filip; Hasan, Tayyaba; Celli, Jonathan P.

    2016-03-01

    Photodynamic therapy (PDT) is a light-based modality that shows promise for adaptation and implementation as a cancer treatment technology in resource-limited settings. In this context PDT is particularly well suited for treatment of pre-cancer and early stage malignancy of the oral cavity, that present a major global health challenge, but for which light delivery can be achieved without major infrastructure requirements. In recent reports we demonstrated that a prototype low-cost batterypowered 635nm LED light source for ALA-PpIX PDT achieves tumoricidal efficacy in vitro and vivo, comparable to a commercial turn-key laser source. Here, building on these reports, we describe the further development of a prototype PDT device to enable intraoral light delivery, designed for ALA- PDT treatment of precancerous and cancerous lesions of the oral cavity. We evaluate light delivery via fiber bundles and customized 3D printed light applicators for flexible delivery to lesions of varying size and position within the oral cavity. We also briefly address performance requirements (output power, stability, and light delivery) and present validation of the device for ALA-PDT treatment in monolayer squamous carcinoma cell cultures.

  17. Factors that affect cancer patient compliance to oral anti-neoplastic therapy Factores que influyen en la adhesión de pacientes con cáncer a la terapia antineoplásica oral Fatores que influenciam a adesão de pacientes com câncer à terapia antineoplásica oral

    OpenAIRE

    Patrícia Andréa Crippa Marques; Angela Maria Geraldo Pierin

    2008-01-01

    OBJECTIVES: To identify factors that can affect compliance to treatment with neoplastic oral drugs in a group of cancer patients. METHODS: Interviews were performed on 61 patients diagnosed with cancer and under anti-neoplastic oral therapy in a private hospital. The interviews were carried out using instruments to assess compliance. RESULTS: Most patients (95%) reported the oral treatment was not difficult. The Morisky and Green Test were positive in 28% of the patients. Factors that may aff...

  18. Human Volunteers Receiving Escherichia coli Phage T4 Orally: a Safety Test of Phage Therapy

    OpenAIRE

    Bruttin, Anne; Brüssow, Harald

    2005-01-01

    Fifteen healthy adult volunteers received in their drinking water a lower Escherichia coli phage T4 dose (103 PFU/ml), a higher phage dose (105 PFU/ml), and placebo. Fecal coliphage was detected in a dose-dependent way in volunteers orally exposed to phage. All volunteers receiving the higher phage dose showed fecal phage 1 day after exposure; this prevalence was only 50% in subjects receiving the lower phage dose. No fecal phage was detectable a week after a 2-day course of oral phage applic...

  19. Self management of oral anticoagulant therapy in children with congenital heart disease

    DEFF Research Database (Denmark)

    Christensen, Thomas D; Attermann, Jørn; Hjortdal, Vibeke E.

    2001-01-01

    Objective: The concept of self – management of oral anticoagulation has been shown to entail better quality of treatment than conventional management when assessed in selected adults. We have extended the concept of self – management to include children with congenital cardiac disease......, hypothesizing self-management of oral anticoagulation is also possible in this subset of patients. Our aim was to assess the quality of self-management. Methods: We trained 14 children aged from 2.2 to 15.6 years, with a mean age of 9.7 years, and their parents, in domiciliary analysis of the International...

  20. Review of antidiabetic mechanism of Metformin%二甲双胍降糖机制研究进展

    Institute of Scientific and Technical Information of China (English)

    潘小康

    2016-01-01

    [Summary] Metformin is the first‐line oral antidiabetic drug.However ,its antidiabetic mechanism is not well understood.The glucose‐lowering effect of Metformin has been attributed to increase insulin sensitivity and glucose disposal ,suppress hepatic gluconeogenesis and inhibit glucagon action.Metformin can decrease the glucose level by activating AMPK dependent/independent pathway ,but its antidiabetic effect is not limited to this.Here we reviewed antidiabetic mechanism of Metformin.%二甲双胍(M et )是临床一线口服降糖药物,但其降低血糖(BG )的机制还不完全清楚。M et降低BG主要通过增加IS、增加外周组织对葡萄糖(PG )的摄取、抑制肝脏糖异生和拮抗胰升血糖素的作用。Met可通过激活腺苷酸激活蛋白激酶(AMPK)降低BG ,同时,Met也能不依赖AMPK降低BG。本文就M et主要的降糖机制作一综述。

  1. Phytochemical Study and Anti-inflammatory, Antidiabetic and Free Radical Scavenger Evaluations of Krameria pauciflora Methanol Extract

    Directory of Open Access Journals (Sweden)

    A. Berenice Aguilar-Guadarrama

    2012-01-01

    Full Text Available The plant Krameria pauciflora MOC et. Sessé ex DC. is used as an anti-inflammatory and antidiabetic in traditional medicine. The aim of this study was to evaluate the in vivo anti-inflammatory and antidiabetic effects of a methanol extract from the roots of K. pauciflora. Dichloromethane and ethyl acetate extracts obtained by partitioning the methanol extract were also evaluated. Complete methanol and dichloromethane extracts showed anti-inflammatory effects at 3 mg/kg. An anti-inflammatory effect similar to indomethacin (10 mg/kg was observed when the methanol and dichloromethane extracts, which contain a cycloartane-type triterpene and an sterol, were administered orally at several doses (3, 10, 30 and 100 mg/kg, whereas no anti-inflammatory effect was observed at any dose for the ethyl acetate extract, which contains catechin-type flavonoids. The antidiabetic effect of each extract was also determined. An antihyperglycaemic effect was observed in diabetic rats, but no effect in normoglycaemic animals was observed when the methanol extract was administrated at 30 mg/kg. All of the extracts exhibited radical scavenger activity. Additionally, constituents from all of the extracts were identified by NMR. This article supports the use of K. pauciflora as an anti-inflammatory because it exhibits a similar effect to indomethacin. However, its antidiabetic effect is not completely clear, although it could be useful for preventing diabetic complications.

  2. Oral combined therapy with probiotics and alloantigen induces B cell-dependent long-lasting specific tolerance.

    Science.gov (United States)

    Mercadante, Ana C T; Perobelli, Suelen M; Alves, Ana P G; Gonçalves-Silva, Triciana; Mello, Wallace; Gomes-Santos, Ana C; Miyoshi, Anderson; Azevedo, Vasco; Faria, Ana M C; Bonomo, Adriana

    2014-02-15

    Allogeneic hematopietic stem cell transplantation (aHSCT) is widely used for the treatment of hematologic malignancies. Although aHSCT provides a good response against the malignant cells (graft-versus-leukemia [GVL]), it also leads to the development of graft-versus-host disease (GVHD), a severe disease with high mortality and morbidity rates. Therapy for GVHD is commonly based on nonspecific immunosupression of the transplanted recipient, resulting in the concomitant inhibition of the GVL effect. In this study, we propose an alternative approach to specifically suppress GVHD while sparing the GVL, based on oral treatment of transplant donors with recipient Ags, associated with the intake of probiotic Lactococcus lactis as tolerogenic adjuvant (combined therapy). We show that treatment of C57BL/6 donor mice with combined therapy before the transplant protects the recipients F1 (C57BL/6 × BAL/c) mice from clinical and pathological manifestations of disease, resulting in 100% survival rate. Importantly, the animals keep the immunological competence maintaining the GVL response as well as the response to third-party Ags. The protection is specific, long lasting and dependent on donor IL-10-sufficient B cells activity, which induces regulatory T cells in the host. These data suggest that combined therapy is a promising strategy for prevention of GVHD with preservation of GVL, opening new possibilities to treat human patients subjected to transplantation.

  3. Acute Diarrhoea in Children: Determination of Duration Using a Combined Bismuth Hydroxide Gel and Oral Rehydration Solution Therapy vs. Oral Rehydration Solution

    Directory of Open Access Journals (Sweden)

    Adriana Oviedo

    2016-12-01

    Full Text Available Oral rehydration salt (ORS treatment in young children with acute diarrhoea (AD has contributed to decrease mortality associated with dehydration although effective strategies to reduce morbidity associated with this disease are required. The aim of this study was to evaluate the diarrhoea duration when using combined colloidal bismuth hydroxide gel (CBHG and oral rehydration salt treatment compared with ORS therapy in children with AD. We designed a double-blind, randomised prospective study with treatment and control groups. Patients aged one to 12 years, with no prior pathology and with AD of less than 48 h were included. The Chi-squared and Mann-Whitney tests were used, as well as the Cox proportional hazards model and the Kaplan-Meier estimator. Patients were randomised into an ORS and CBHG treatment group and a control group for ORS plus placebo. (Average age: 3.2 years. The result of the post-treatment evaluation with respect to the average duration of AD was 25.5 h for the treated group vs. 41.5 h for the control group (p = 0.015. The average number of stools was 4.8 in the treated group and 8.2 in the control group (p = 0.032. We conclude that the use of CBHG plus ORS significantly reduced the duration of AD, the number of stools and the percentage of children with persistent AD after 24 h of treatment compared to the control group. AD remitted almost twice as fast in patients treated with CBHG and ORS compared to those who received ORS plus placebo.

  4. Acute Diarrhoea in Children: Determination of Duration Using a Combined Bismuth Hydroxide Gel and Oral Rehydration Solution Therapy vs. Oral Rehydration Solution

    Science.gov (United States)

    Oviedo, Adriana; Díaz, Mirna; Valenzuela, María Laura; Vidal, Victoria; Racca, Liliana; Bottai, Hebe; Priore, Graciela; Peluffo, Graciela; Di Bartolomeo, Susana; Cabral, Graciela; Toca, María del Carmen

    2016-01-01

    Oral rehydration salt (ORS) treatment in young children with acute diarrhoea (AD) has contributed to decrease mortality associated with dehydration although effective strategies to reduce morbidity associated with this disease are required. The aim of this study was to evaluate the diarrhoea duration when using combined colloidal bismuth hydroxide gel (CBHG) and oral rehydration salt treatment compared with ORS therapy in children with AD. We designed a double-blind, randomised prospective study with treatment and control groups. Patients aged one to 12 years, with no prior pathology and with AD of less than 48 h were included. The Chi-squared and Mann-Whitney tests were used, as well as the Cox proportional hazards model and the Kaplan-Meier estimator. Patients were randomised into an ORS and CBHG treatment group and a control group for ORS plus placebo. (Average age: 3.2 years). The result of the post-treatment evaluation with respect to the average duration of AD was 25.5 h for the treated group vs. 41.5 h for the control group (p = 0.015). The average number of stools was 4.8 in the treated group and 8.2 in the control group (p = 0.032). We conclude that the use of CBHG plus ORS significantly reduced the duration of AD, the number of stools and the percentage of children with persistent AD after 24 h of treatment compared to the control group. AD remitted almost twice as fast in patients treated with CBHG and ORS compared to those who received ORS plus placebo. PMID:28009823

  5. Clinical impact of PET/CT imaging after adjuvant therapy in patients with oral cavity squamous cell carcinoma.

    Science.gov (United States)

    Lin, Huan-Chun; Kang, Chung-Jan; Huang, Shiang-Fu; Wang, Hung-Ming; Lin, Chien-Yu; Lee, Li-Yu; Liao, Chun-Ta; Yen, Tzu-Chen

    2017-09-01

    This single-center retrospective study of prospectively collected data was aimed at comparing the clinical outcomes of positron emission tomography/computed tomography (PET/CT) for patients with oral cavity squamous cell carcinoma (OSCC) with symptomatic recurrences identified by PET/CT imaging following adjuvant therapy (Group A) versus those of cases with asymptomatic recurrences diagnosed through periodic post-adjuvant therapy PET/CT surveillance (Group B). We also sought to establish the priority of salvage therapy in the two study groups. We identified 111 patients with advanced resected OSCC who developed recurrences following adjuvant therapy (51 in Group A and 60 in Group B). Histopathology served as the gold standard for recurrent lesions. The impact of post-adjuvant therapy PET/CT surveillance was examined with Kaplan-Meier curves and Cox proportional hazards regression models. The 2-year DSS and OS rates were marginally or significantly higher in Group B than in Group A (P = 0.073 and P = 0.025, respectively). Time-dependent ROC curve analysis demonstrated that the optimal cutoff values for time to positive PET/CT findings in relation to OS were 12 months for Group A and 9 months for Group B, respectively. Independent risk factors identified in multivariate analyses were used to devise two prognostic scoring systems for 2-year DSS and OS in each study group (all P PET/CT surveillance is a valuable tool for early detection of recurrent lesion(s) in asymptomatic OSCC patients who bear risk factors for disease recurrence. The presence of clinical symptoms and a short time to positive PET/CT findings were adverse prognostic factors for clinical outcome in patients with advanced OSCC. The priority of salvage therapy is discussed in each patient subgroup according to the devised prognostic scoring systems.

  6. Sangramento durante a anticoagulação oral: alerta sobre um mal maior Sangrado durante la anticoagulación oral: alerta sobre un mal mayor Bleeding during oral anticoagulant therapy: warning against a greater hazard

    Directory of Open Access Journals (Sweden)

    Paulo de Lara Lavítola

    2009-08-01

    del sexo femenino. La estenosis mitral estaba presente en 218 pacientes (64,4%, la prótesis biológica mitral en 64 (18,9% y la insuficiencia de la válvula mitral en 56 (16,5%. El sangrado ocurrió en 65 pacientes (19,2% y de forma grave en 7 (10%. En 38/65 pacientes (58,5%, se identificó nueva enfermedad asociada, facilitadora del sangrado. En el 100% de los pacientes con sangrado en el intervalo terapéutico, se encontró enfermedad asociada, contra el 49,05% de diagnóstico de enfermedades asociadas en aquellos con INR > 3,5 (p = 0,001. CONCLUSIÓN: El diagnóstico de enfermedad local asociada al sangrado fue frecuente entre los medicados con anticoagulante oral (58,5%. Hubo asociación entre sangrado con INR en el intervalo terapéutico (INR 2,0-3,5 y diagnóstico de patología predisponente a sangrado (p BACKGROUND: Bleeding is one of the main concerns in patients undergoing oral anticoagulation therapy. OBJECTIVE: To investigate the determinant causes of bleeding in patients undergoing oral anticoagulant therapy. METHODS: A total of 360 patients with atrial fibrillation (AF undergoing oral anticoagulant (ACo therapy, with a target INR of 2.0-3.5, were followed prospectively for a period of 48 ± 7.2 months. The patients were evaluated on average every 30 days and were investigated regarding the presence of associated pathology that could lead to bleeding. RESULTS: A total of 338 patients participated in the present study. Of these, 210 (62.13% were females. Mitral stenosis was present in 218 patients (64.4%, a mitral biological prosthesis in 64 (18.9% and mitral valve failure in 56 (16.5% patients. Bleeding occurred in 65 patients (19.2%, being severe in 7 (10% patients. In 38/65 patients, a new associated disease was identified, which facilitated bleeding. An associated disease was identified in 100% of the patients with bleeding within the therapeutic range, against 49.05% of associated disease diagnosis in those with an INR > 3.5 (p=0.001. CONCLUSION: The

  7. Assessment of indomethacin oral spray for the treatment of oropharyngeal mucositis-induced pain during anticancer therapy.

    Science.gov (United States)

    Momo, Kenji; Nagaoka, Hiroka; Kizawa, Yoshiyuki; Bukawa, Hiroki; Chiba, Shigeru; Kohda, Yukinao; Homma, Masato

    2017-07-15

    The efficacy and safety of indomethacin (IM) oral spray (OS) as a pain control therapy for oropharyngeal mucositis due to anticancer chemo- and radiotherapy were assessed in patients with head and neck carcinomas and haematological tumours. We observed 35 patients (male/female, 20/15; 53 ± 17 years) with oropharyngeal mucositis who were treated with IM-OS preparation for pain relief at University of Tsukuba Hospital, Japan. Analgesic effects were assessed using the six-grade face scale for pain in 28 patients at the start of IM oral spray treatment. Systemic exposure was assessed by determining urinary excretions of IM in seven patients. Pain relief was achieved in 26 (93%) patients at 25 (5-60) min after applying the IM-OS preparation (15.6 ± 3.4 μg/kg) and analgesic effects were maintained for 120 (10-360) min. The pain was significantly decreased after using the spray (3.6 ± 0.7 vs. 2.4 ± 0.9, p < 0.01). Moreover, urinary IM excretion rates after applying the IM spray preparation were 1.8 ± 0.8% of the IM oral spray dose (130.5 ± 77.7 μg/kg/day), which was markedly lower than that following oral administration of IM (60%). No adverse events were observed following application of the spray. The present IM spray is an effective and safe preparation for pain relief and can be used as an alternative therapeutic option for oropharyngeal mucositis in cancer patients.

  8. Multiple subcutaneous mycetomas caused by Pseudallescheria boydii: response to therapy with oral potassium iodide solution.

    Science.gov (United States)

    Khan, Fida A; Hashmi, Shahrukh; Sarwari, Arif R

    2010-02-01

    We describe the case of a sixteen-year-old male who presented with multiple subcutaneous mycetomas proven on culture to be secondary to Pseudallescheria boydi., The lesions responded completely to oral potassium iodide solution. To our knowledge this has never been reported in humans.

  9. Chelation Therapy with Oral Solution of Deferiprone in Transfusional Iron-Overloaded Children with Hemoglobinopathies

    Directory of Open Access Journals (Sweden)

    Alexandros Makis

    2013-01-01

    Full Text Available Iron overload in hemoglobinopathies is secondary to blood transfusions, chronic hemolysis, and increased iron absorption and leads to tissue injury requiring the early use of chelating agents. The available agents are parenteral deferoxamine and oral deferiprone and deferasirox. There are limited data on the safety and efficacy of deferiprone at a very young age. The aim of our study was the presentation of data regarding the use of oral solution of deferiprone in 9 children (mean age 6.5, range 2–10 with transfusion dependent hemoglobinopathies (6 beta thalassemia major, 1 thalassemia intermedia, and 2 sickle cell beta thalassemia. The mean duration of treatment was 21.5 months (range 15–31. All children received the oral solution without any problems of compliance. Adverse reactions were temporary abdominal discomfort and diarrhea (1 child, mild neutropenia (1 child that resolved with no need of discontinuation of treatment, and transient arthralgia (1 child that resolved spontaneously. The mean ferritin levels were significantly reduced at the end of 12 months (initial 2440 versus final 1420 μg/L, . This small study shows that oral solution of deferiprone was well tolerated by young children and its use was not associated with major safety concerns. Furthermore, it was effective in decreasing serum ferritin.

  10. Parents' attitudes toward oral rehydration therapy in children with mild-to-moderate dehydration.

    Science.gov (United States)

    Nir, Vered; Nadir, Erez; Schechter, Yaffa; Kline-Kremer, Adi

    2013-01-01

    According to current guidelines, the first line of treatment for mild-to-moderate dehydration is oral rehydration; the second line is rehydration through a nasogastric tube. Both methods are widely underused. This study was conducted to evaluate parents' attitudes towards rehydration methods used in pediatric emergency departments. 100 questionnaires were distributed to parents of children who visited emergency room due to gastroenteritis and suspected dehydration. 75 of the parents expected their child to get IV fluids. 49 of them would refuse to consider oral rehydration. 75 of the parents would refuse to consider insertion of nasogastric tube. Parents whose children were previously treated intravenously tended to be less likely to agree to oral treatment. Parents were more prone to decline oral rehydration if the main measurement of dehydration was the child's clinical appearance, clinical appearance with vomiting, or child's refusal to drink and were more likely to agree if the main measurement was diarrhea, diarrhea with clinical appearance, or clinical personnel opinion. This is the first study to examine parents' expectations. We found that in the majority of cases, parents' expectations contradict current guidelines. Efforts should be taken to educate parents in order to allow full implementation of the guidelines.

  11. Neue immunsuppressive und immunmodulierende orale Therapie in der Behandlung der Multiplen Sklerose

    Directory of Open Access Journals (Sweden)

    Storch MK

    2010-01-01

    Full Text Available Schon bald könnte eine neue – lange erwartete – Ära in der Behandlung der schubförmigen Multiplen Sklerose beginnen: oral verabreichbare immunmodulierende/immunsuppressive Intervall-Therapeutika. In den USA wurde Fingolimod (Gilenya® am 22. September 2010 als erste orale Substanz als Basistherapeutikum für die schubförmige Multiple Sklerose zugelassen. Für die nächsten Jahre ist mit der Zulassung weiterer neuer immunmodulierender/ immunsuppressiver oraler Medikamente zur Prophylaxe von Schüben in der Multiplen Sklerose zu rechnen, wodurch sich Therapieadhärenz und Lebensqualität der Patienten weiter verbessern könnten. Einige der neuen, oral verabreichten Substanzen könnten einen besonders „attraktiven“ therapeutischen Ansatz bieten: Die Kombination von Immunmodulation mit neuroprotektiven Wirkmechanismen. In dieser Übersicht wird ein Überblick über die als nächstes zu erwartenden, neuen oralen Immunmodulatoren/Immunsuppressiva gegeben. Das Einsatzgebiet dieser Substanzen in der Stufentherapie der schubförmigen Multiplen Sklerose wird erst nach Abschluss der Zulassungsverfahren bzw. Vorliegen der Daten von Langzeit-Sicherheitsregistern sicher einzuschätzen sein.

  12. Management of pulmonary infection : experimental studies on oral immunization and surfactant replacement therapy

    NARCIS (Netherlands)

    G.J. van Daal

    1991-01-01

    textabstractThis thesis aims at evaluating two "new" concepts for the management of pneumonia. The first concept, oral immunization, seems a promising approach towards prevention of pneumonia. Extensive programs have been developed for active immunoprophylaxis to immunize against specific microbial

  13. Effects of intravenous and oral esomeprazole in the prevention of recurrent bleeding from peptic ulcers after endoscopic therapy.

    Science.gov (United States)

    Sung, Joseph J Y; Suen, Bing-Yee; Wu, Justin C Y; Lau, James Y W; Ching, Jessica Y L; Lee, Vivian W Y; Chiu, Philip W Y; Tsoi, Kelvin K F; Chan, Francis K L

    2014-07-01

    The use of intravenous proton-pump inhibitors (PPIs) has shown to reduce recurrent bleeding and improve patient outcome after endoscopic hemostasis on patients with peptic ulcer. However, the efficacy of oral PPI is uncertain. Studies from Asia indicated that even oral PPI can achieve the same therapeutic effect. This study is designed to compare the efficacy of high-dose intravenous PPI to oral PPI in preventing recurrent bleeding after endoscopic hemostasis. This is a single-center, randomized-controlled, double-blind, and double-dummy study. Patients had Forrest IA/IB or IIA/IIB peptic ulcer bleeding and received endoscopic hemostasis before recruitment into the study. They were randomized to receive either (i) esomeprazole IV bolus at a dose of 80 mg plus infusion at 8 mg/h for 72 h and oral placebo every 12 h (IVP group), or (ii) IV placebo bolus plus infusion for 72 h and high-dose oral esomeprazole at a dose of 40 mg every 12 h (ORP group). Patients were followed up for 30 days after index bleeding. The primary end point was defined as the 30-day recurrent bleeding after successful endoscopic hemostasis. A total of 118 patients were randomized to the IVP group and 126 to the ORP group in this study. In all, 39.8% in the IVP and 42.9% in the ORP group used non-steroidal anti-inflammatory drug and/or aspirin before bleeding. In the IVP group (vs. ORP), Forrest IA represented 1.7% (5.6%), IB 41.5% (38.1%), IIA 52.5% (50.8%), and IIB 4.2% (5.6%). Recurrent bleeding in 30 days was reported in 7.7% of patients in the IVP group and 6.4% of patients in the ORP group, and the difference of recurrent bleeding was -1.3% (95% CI: -7.7%, 5.1%). There was no difference in blood transfusion, repeated endoscopic therapy, and hospital stay between the two groups. High-dose oral esomeprazole at 40 mg BID may be considered as a useful alternative to IV bolus plus infusion of esomeprazole in the management of ulcer bleeding in patients who are not candidates for high-dose IV

  14. A critical assessment of oral care protocols for patients under radiation therapy in the regional University Hospital Network of Madrid (Spain)

    OpenAIRE

    Lanzós, Isabel; Herrera, David; Lanzos González, Eduardo; Sanz Alonso, Mariano

    2015-01-01

    Background This research was aimed to critically evaluate, under the light of the available scientific evidence, the oral care protocols recommended by different hospitals in head and neck cancer (HNC) patients under radiation therapy. Material and Methods A questionnaire requesting all the relevant information for the oral care of these patients was sent to the 9 University Hospitals in Madrid. The answers were categorized and analyzed. In addition, an electronic search was conducted to iden...

  15. New oral anticoagulants in addition to single or dual antiplatelet therapy after an acute coronary syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Oldgren, Jonas; Wallentin, Lars; Alexander, John H; James, Stefan; Jönelid, Birgitta; Steg, Gabriel; Sundström, Johan

    2013-06-01

    Oral anticoagulation in addition to antiplatelet treatment after an acute coronary syndrome might reduce ischaemic events but increase bleeding risk. We performed a meta-analysis to evaluate the efficacy and safety of adding direct thrombin or factor-Xa inhibition by any of the novel oral anticoagulants (apixaban, dabigatran, darexaban, rivaroxaban, and ximelagatran) to single (aspirin) or dual (aspirin and clopidogrel) antiplatelet therapy in this setting. All seven published randomized, placebo-controlled phase II and III studies of novel oral anticoagulants in acute coronary syndromes were included. The database consisted of 30 866 patients, 4135 (13.4%) on single, and 26 731 (86.6%) on dual antiplatelet therapy, with a non-ST- or ST-elevation acute coronary syndrome within the last 7-14 days. We defined major adverse cardiovascular events (MACEs) as the composite of all-cause mortality, myocardial infarction, or stroke; and clinically significant bleeding as the composite of major and non-major bleeding requiring medical attention according to the study definitions. When compared with aspirin alone the combination of an oral anticoagulant and aspirin reduced the incidence of MACE [hazard ratio (HR) and 95% confidence interval 0.70; 0.59-0.84], but increased clinically significant bleeding (HR: 1.79; 1.54-2.09). Compared with dual antiplatelet therapy with aspirin and clopidogrel, adding an oral anticoagulant decreased the incidence of MACE modestly (HR: 0.87; 0.80-0.95), but more than doubled the bleeding (HR: 2.34; 2.06-2.66). Heterogeneity between studies was low, and results were similar when restricting the analysis to phase III studies. In patients with a recent acute coronary syndrome, the addition of a new oral anticoagulant to antiplatelet therapy results in a modest reduction in cardiovascular events but a substantial increase in bleeding, most pronounced when new oral anticoagulants are combined with dual antiplatelet therapy.

  16. The effect of highly active antiretroviral therapy on the prevalence of oral manifestation in human immunodeficiency virus-infected patients in Karnataka, India

    Science.gov (United States)

    Patil, Neelkant; Chaurasia, Vishwajit Rampratap; Babaji, Prashant; Ramesh, Dnsv; Jhamb, Kshitij; Sharma, Akanksha Manmohan

    2015-01-01

    Objectives: Acquired Immunodeficiency Syndrome (AIDS) is a highly lethal, progressively epidemic viral infection characterized by profound impairment of the immune system. Oral manifestations are common in Human Immunodeficiency Virus (HIV) infected AIDS patients, and are usually the first indicator of symptom and disease progression. The main objective of the current study was to compare the prevalence of oral manifestations in HIV patients on Highly Active Antiretroviral Therapy (HAART) with those, not on HAART therapies. Materials and Methods: A cross sectional study was conducted among 100 patients diagnosed as human immune virus sero-positive. These patients were divided equally into two groups (50 each); Group I patients on HAART and Group II patients who were not on HAART. Information regarding age, sex and cluster of differentiation 4 cell count was obtained from the medical records. Oral examination was done, and findings were recorded by using internationally accepted presumptive clinical criteria. Statistical analysis was performed using Chi-square statistical test. Results: The presence of oral manifestations was significantly decreased in subjects on HAART (32%) compared to those who are not on HAART (56%). The most common oral lesions detected in patients on HAART were increased oral hyper-pigmentation (14%), recurrent aphthous stomatitis (8%), non-specific ulcerations (4%), pseudo-membranous candidiasis (2%), periodontitis (2%) and xerostomia (2%), whereas in non HAART oral hyperpigmentation (10%), pseudo-membranous candidiasis (8%), angular cheilitis (4%), and erythematous candidiasis (4%) and Periodontitis (14%) were more prevalent. Conclusion: The number and severity of oral manifestation decreased, and even there was a change in the type of oral manifestations on HAART, which may be because of the improvement in immunity gained by the therapy. PMID:25713484

  17. Antidiabetic Properties, Bioactive Constituents, and Other Therapeutic Effects of Scoparia dulcis

    Directory of Open Access Journals (Sweden)

    Geethi Pamunuwa

    2016-01-01

    Full Text Available This review discusses the antidiabetic activities of Scoparia dulcis as well as its antioxidant and anti-inflammatory properties in relation to the diabetes and its complications. Ethnomedical applications of the herb have been identified as treatment for jaundice, stomach problems, skin disease, fever, and kidney stones, reproductory issues, and piles. Evidence has been demonstrated through scientific studies as to the antidiabetic effects of crude extracts of S. dulcis as well as its bioactive constituents. The primary mechanisms of action of antidiabetic activity of the plant and its bioactive constituents are through α-glucosidase inhibition, curbing of PPAR-γ and increased secretion of insulin. Scoparic acid A, scoparic acid D, scutellarein, apigenin, luteolin, coixol, and glutinol are some of the compounds which have been identified as responsible for these mechanisms of action. S. dulcis has also been shown to exhibit analgesic, antimalarial, hepatoprotective, sedative, hypnotic, antiulcer, antisickling, and antimicrobial activities. Given this evidence, it may be concluded that S. dulcis could be promoted among the masses as an alternative and complementary therapy for diabetes, provided further scientific studies on the toxicological and pharmacological aspects are carried out through either in vivo or clinical means.

  18. Perioperative management of oral antiplatelet therapy and clinical outcomes in coronary stent patients undergoing surgery. Results of a multicentre registry.

    Science.gov (United States)

    Rossini, Roberta; Musumeci, Giuseppe; Capodanno, Davide; Lettieri, Corrado; Limbruno, Ugo; Tarantini, Giuseppe; Russo, Nicolina; Calabria, Paolo; Romano, Michele; Inashvili, Ana; Sirbu, Vasile; Guagliumi, Giulio; Valsecchi, Orazio; Senni, Michele; Gavazzi, Antonello; Angiolillo, Dominick J

    2015-02-01

    The aim was to investigate the perioperative risk of ischaemic and bleeding events in patients with coronary stents undergoing cardiac and non-cardiac surgery and how these outcomes are affected by the perioperative use of oral antiplatelet therapy. This was a multicentre, retrospective, observational study conducted in patients with coronary stent(s) undergoing cardiac or non-cardiac surgery. The primary efficacy endpoint was the 30-day incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction (MI) or stroke. The primary safety endpoint was the 30-day incidence of Bleeding Academic Research Consortium (BARC) bleeding ≥ 2. A total of 666 patients were included. Of these, 371 (55.7 %) discontinued their antiplatelet medication(s) (all or partly) before undergoing surgery. At 30 days, patients with perioperative discontinuation of antiplatelet therapy experienced a significantly higher incidence of MACE (7.5 % vs 0.3 %, pantiplatelet discontinuation was the strongest independent predictor of 30-day MACE (odds ratio [OR]=25.8, confidence interval [CI]=3.37-198, p=0.002). Perioperative aspirin (adjusted OR 0.27, 95 % CI 0.11-0.71, p=0.008) was significantly associated with a lower risk of MACE. The overall incidence of BARC ≥ 2 bleeding events at 30-days was significantly higher in patients who discontinued oral antiplatelet therapy (25.6 % vs 13.9 %, pantiplatelet discontinuation was not independently associated with BARC ≥ 2 bleeding. In conclusion antiplatelet discontinuation increases the 30-day risk of MACE, in patients with coronary stents undergoing cardiac and non-cardiac surgery, while not offering significant protection from BARC≥ 2 bleeding.

  19. Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome

    Institute of Scientific and Technical Information of China (English)

    Konstantinos C Thomopoulos; Konstantinos P Mimidis; George J Theocharis; Anthie G Gatopoulou; Georgios N Kartalis; Vassiliki N Nikolopoulou

    2005-01-01

    AIM: Acute gastrointestinal bleeding is a severe complication in patients receiving long-term oral anticoagulant therapy.The purpose of this study was to describe the causes and clinical outcome of these patients.METHODS: From January 1999 to October 2003, 111patients with acute upper gastrointestinal bleeding (AUGIB)were hospitalized while on oral anticoagulants. The causes and clinical outcome of these patients were compared with those of 604 patients hospitalized during 2000-2001with AUGIB who were not taking warfarin.RESULTS: The most common cause of bleeding was peptic ulcer in 51 patients (45%) receiving anticoagulants compared to 359/604 (59.4%) patients not receiving warfarin (P<0.05). No identifiable source of bleeding could be found in 33 patients (29.7%) compared to 31/604(5.1%) patients not receiving anticoagulants (P= 0.0001).The majority of patients with concurrent use of non-steroidal anti-inflammatory drugs (NSATDs) (26/35, 74.3%) had a peptic ulcer as a cause of bleeding while 32/76 (40.8%)patients not taking a great dose of NSATDs had a negative upper and lower gastrointestinal endoscopy. Endoscopic hemostasis was applied and no complication was reported.Six patients (5.4%) were operated due to continuing or recurrent hemorrhage, compared to 23/604 (3.8%) patients not receiving anticoagulants. Four patients died, the overall mortality was 3.6% in patients with AUGIB due to anticoagulants, which was not different from that in patients not receiving anticoagulant therapy.CONCLUSION: Patients with AUGIB while on long-term anticoagulant therapy had a clinical outcome, which is not different from that of patients not taking anticoagulants.Early endoscopy is important for the management of these patients and endoscopic hemostasis can be safely applied.

  20. Diagnosis and indications for low-intensity laser therapy of the pathology of the oral cavity mucosa of patients with hematologic and gastroenteric diseases

    Science.gov (United States)

    Kunin, Anatoly A.; Minakov, E. V.; Sutscenko, A. V.; Vornovsky, V. A.; Dunaeva, S. V.; Stepanov, Nicolay N.; Shumilovitch, Bogdan R.

    1996-11-01

    In the recent years low intensity laser irradiation is made use of in stomatology with the view of treating numerous diseases of the oral cavity mucosa and parodontium. The oral cavity mucosa lesions caused by the internal organs diseases, especially those of blood and the gastroenteric tract, constitute a particular group. Such diseases are usually manifested by an inflammation, erosions, ulcers, hemorrhages. An abundant microflora of the oral cavity and diminished immunity of the patients contribute to the possibility of septicaemia development. Laser therapy of the oral cavity mucosa lesions according to strictly defined indications promotes rapid healing of ulcers, arresting the oral cavity mucosa inflammation, providing a reduction in bleeding and presents a safe prophylactic means of stomatogenic sepsis.

  1. Prescribing of Antidiabetic Medicines before, during and after Pregnancy: A Study in Seven European Regions.

    Directory of Open Access Journals (Sweden)

    Rachel A Charlton

    Full Text Available To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe.A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany, Wales and the rest of the UK. Women with a pregnancy starting and ending between 2004 and 2010, (Denmark, 2004-2009; Norway, 2005-2010; Emilia Romagna, 2008-2010, which ended in a live or stillbirth, were identified. Prescriptions for antidiabetic medicines issued (UK or dispensed (non-UK during pregnancy and/or the year before or year after pregnancy were identified. Prescribing patterns were compared across databases and over calendar time.1,082,673 live/stillbirths were identified. Pregestational insulin prescribing during the year before pregnancy ranged from 0.27% (CI95 0.25-0.30 in Tuscany to 0.45% (CI95 0.43-0.47 in Norway, and increased between 2004 and 2009 in all countries. During pregnancy, insulin prescribing peaked during the third trimester and increased over time; third trimester prescribing was highest in Tuscany (2.2% and lowest in Denmark (0.5%. Of those prescribed an insulin during pregnancy, between 50.5% in Denmark and 88.8% in the Netherlands received an insulin analogue alone or in combination with human insulin, this proportion increasing over time. Oral products were mainly metformin and prescribing was highest in the 3 months before pregnancy. Metformin use during pregnancy increased in some countries.Pregestational diabetes is increasing in many areas of Europe. There is considerable variation between and within countries in the choice of medication for treating pregestational diabetes in pregnancy, including choice of insulin analogues and oral antidiabetics, and very large variation in the treatment of gestational diabetes despite international guidelines.

  2. Drug-induced sleep endoscopy as a selection tool for mandibular advancement therapy by oral device in patients with mild to moderate obstructive sleep apnoea.

    Science.gov (United States)

    De Corso, E; Bastanza, G; Della Marca, G; Grippaudo, C; Rizzotto, G; Marchese, M R; Fiorita, A; Sergi, B; Meucci, D; Di Nardo, W; Paludetti, G; Scarano, E

    2015-12-01

    Nowadays oral appliance therapy is recognised as an effective therapy for many patients with primary snoring and mild to moderate obstructive sleep apnoea (OSA), as well as those with more severe OSA who cannot tolerate positive airway pressure (PAP) therapies. For this reason, it is important to focus on objective criteria to indicate which subjects may benefit from treatment with a mandibular advancement device (MAD). Various anthropometric and polysomnographic predictors have been described in the literature, whereas there are still controversies about the role of drug-induced sleep endoscopy (DISE) and advancement bimanual manoeuvre as predictor factors of treatment outcome by oral device. Herein, we report our experience in treatment of mild moderate OSA by oral appliance selected by DISE. We performed a single institution, longitudinal prospective evaluation of a consecutive group of mild moderate patients with obstructive sleep apnoea syndrome who underwent DISE. During sleep endoscopy, gentle manoeuvre of mandibular advancement less than 5 mm was performed. In 30 of 65 patients (46.2%) we obtained an unsuccessful improvement of airway patency whereas in 35 of 65 patients (53.8%) the improvement was successful and patients were considered suitable for oral device application. Because 7 of 35 patients were excluded due to conditions interfering with oral appliance therapy, we finally treated 28 patients. After 3 months of treatment, we observed a significant improvement in the Epworth medium index [(7.35 ± 2.8 versus 4.1 ± 2.2 (p DISE for MAD therapy. In the current study, mandibular advancement splint therapy was successfully prescribed on the basis not only of severity of disease, as determined by the subject's initial AHI, but also by DISE findings combined with results of gentle mandibular advancement manoeuvre allowing direct view of the effects of mandibular protrusion on breathing spaces in obstruction sites, and showing good optimisation of

  3. Oral leukoplakia

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Dabelsteen, Erik

    2016-01-01

    The idea of identifying oral lesions with a precancerous nature, i.e. in the sense of pertaining to a pathologic process with an increased risk for future malignant development, of course is to prevent frank malignancy to occur in the affected area. The most common oral lesion with a precancerous...... nature is oral leukoplakia, and for decades it has been discussed how to treat these lesions. Various treatment modalities, such as systemic therapies and surgical removal, have been suggested. The systemic therapies tested so far include retinoids, extracts of green tea, inhibitors of cyclooxygenase-2...

  4. Manual de Adiestramiento sobre Terapia de Rehidratacion Oral y Control de las Enfermedades Diarreicas (Oral Rehydration Therapy and the Control of Diarrheal Diseases). Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-53.

    Science.gov (United States)

    Clark, Mari; And Others

    This Spanish-language manual was developed to train Peace Corps volunteers and other community health workers in Spanish-speaking countries in oral rehydration therapy (ORT) and the control of diarrheal diseases. Using a competency-based format, the manual contains three training modules (organized in seven sessions) that focus on interrelated…

  5. 上海市金山区2型糖尿病患者血糖控制及用药现状调查%Survey on status of glycemic control and antidiabetic drugs therapy in patients with type 2 diabetes mellitus in Jinshan District of Shanghai

    Institute of Scientific and Technical Information of China (English)

    吕家爱; 李轶群; 高霞

    2013-01-01

    OBJECTIVE To evaluate the glycemic control in patients with type 2 diabetes mellitus in Jinshan District Community of Shanghai and describe the medication status.METHODS 110 patients with type 2 diabetes mellitus in the community were collected by random sampling method and managed with community diabetes management software.Questionnaire surveys and physical examinations were conducted on these patients.RESULTS The mean HbAlc concentration was (7.3 ±1.3) % of 110 patients with type 2 diabetes.According to the recommended targets of Chinese Diabetes Society (CDS),28.2% of the participants achieved the goal of HbA1c level (< 6.5%) while 4.5% of the participants achieved all three target goals of HbA1c level (< 6.5%),blood pressure (< 130/80 mm Hg) and triglyceride level (< 1.5 mmol/L).The ordinal ratios of antidiabetic drug consumption were Sulfonylureas (63.5%),Biguanides (50%) and Insulin (15.4%).The ratio of using single antidiabetic drug in glycemic control group was higher than that in poor glycemic control group.CONCLUSION As considerable proportion of patients with type 2 diabetes mellitus can not achieve the goal of HbAlc level with a low ratio of using insulin therapy.Therefore,it is a urgent need to improve prevention and control of diabetes mellitus.%目的 评价金山区社区管理的2型糖尿病患者的血糖控制情况,描述2型糖尿病患者的用药现状.方法 采用单纯随机抽样的方法抽取本区2型糖尿病患者110人进行问卷调查和体检.结果 110位患者,糖化血红蛋白(HbA1c)平均值为(7.3±1.3)%.根据2007年中华医学会糖尿病学分会(CDS)推荐的控制目标,28.2%的患者HbA1c达标(<6.5%),4.5%的患者HbA1c、血压(BP)和甘油三酯(TG)都达标(HbA1c< 6.5%,BP< 130/80 mm Hg,TG< 1.5 mmol/L);降糖药使用位居前3位的依次为磺脲类、双胍类、胰岛素,分别占使用降糖药总人数的63.5%、50.0%和15.4%;血糖控制组患者单用

  6. Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications

    Directory of Open Access Journals (Sweden)

    James M. Richter

    2016-01-01

    Full Text Available Background. Ulcerative proctitis (UP is typically treated initially with oral 5-aminosalicylate (“5-ASA”, mesalamine suppository, or mesalamine enema (“UP Rx”. Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1 initiation of UP Rx; (2 endoscopy in prior 30 days resulting in diagnosis of UP; and (3 no prior encounters for ulcerative colitis or Crohn’s disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations.

  7. Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications.

    Science.gov (United States)

    Richter, James M; Arshi, Nabeela K; Oster, Gerry

    2016-01-01

    Background. Ulcerative proctitis (UP) is typically treated initially with oral 5-aminosalicylate ("5-ASA"), mesalamine suppository, or mesalamine enema ("UP Rx"). Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1) initiation of UP Rx; (2) endoscopy in prior 30 days resulting in diagnosis of UP; and (3) no prior encounters for ulcerative colitis or Crohn's disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations.

  8. Clinical, biological, histological features and treatment of oral mucositis induced by radiation therapy: a literature review; Aspectos clinicos, biologicos, histopatologicos e tratamentos propostos para a mucosite oral induzida por radioterapia: revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Bonan, Paulo Rogerio Ferreti [Universidade Estadual de Montes Claros e Faculdades Unidas do Norte de Minas, MG (Brazil). Dept. de Odontologia]. E-mail: pbonan@yahoo.com; Lopes, Marcio Ajudarte; Almeida, Oslei Paes de [Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP (Brazil). Faculdade de Odontologia. Dept. de Diagnostico Oral; Alves, Fabio de Abreu [Hospital do Cancer AC Camargo, Sao Paulo, SP (Brazil). Dept. de Estomatologia

    2005-07-01

    The oral mucositis is a main side effect of radiotherapy on head and neck, initiating two weeks after the beginning of the treatment. It is characterized by sensation of local burning to intense pain, leading in several cases, to the interruption of the treatment. The purpose of this work is to review the main published studies that discuss the clinical, biological and histopathological features of oral mucositis induced by radiation therapy and to describe the main approaches recommended to prevent or to treat it. Although the clinical features of mucositis are intensively described in the literature, few studies address the histopathological alterations in oral mucositis and only recently, its biological processes have been investigated. The biological mechanisms involved in the radiation tissue damage have been only recently discussed and there is no consensus among treatment modalities. Yet, the progressive knowledge in the histopathology and biological characteristics of oral mucositis probably will lead to more effective in prevention and control strategies. (author)

  9. Antidiabetic, antioxidant and anti inflammatory properties of water and n-butanol soluble extracts from Saharian Anvillea radiata in high-fat-diet fed mice.

    Science.gov (United States)

    Kandouli, Chouaib; Cassien, Mathieu; Mercier, Anne; Delehedde, Caroline; Ricquebourg, Emilie; Stocker, Pierre; Mekaouche, Mourad; Leulmi, Zineb; Mechakra, Aicha; Thétiot-Laurent, Sophie; Culcasi, Marcel; Pietri, Sylvia

    2017-07-31

    polyphenolics-enriched hydroalcoholic and ethyl acetate extracts, the lyophilized aqueous (AQL) and butanol extracts were not toxic in cells (≤ 400µg/mL) or when given orally in normal mice (≤ 2000mg/kg), exerted a dose-dependent hypoglycemic action in diabetic mice, which was maximal at the dose of 150mg/kg. Upon administering this dose for 12 weeks, both extracts significantly ameliorated body weight control capacity, recovery of plasma glucose and insulin level, reduced oxidative stress in blood, myocardial and skeletal muscles, and improved hyperlipidemic and inflammatory status. Moreover, diabetes-related complications were optimally ameliorated by oral therapy based on halved doses (75mg/kg) of a mixture of AQL and metformin. Current investigation supports the traditional medicinal usage of Anvillea radiata and suggests that both readily accessible and low-cost bio-extracts have the potency to develop an antihyperglycemic, antihyperlipidemic and protective agent against beta-cells and muscle dysfunction at doses compatible with the common practices of indigenous people for the management of metabolic disorders. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  10. Predictors of Adherence to Oral Bisphosphonate Therapy: A Register-based National Open Cohort Study

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Pedersen, B D; Konradsen, Hanne;

    Abstract: Aim: To assess adherence to oral bisphosphonates and determine what predicts early cessation of treatment as opposed to low refill compliance. We hypothesized that patients who stopped treatment very early would differ in demographics and comorbidity from other patients with poor adhere...... with increasing age and in patients taking proton pump inhibitors. These findings suggest that other factors — such as patient understanding, education level and socioeconomics may be more important determinants of adherence to osteoporosis treatment....

  11. [Therapy education for patients receiving oral anti-coagulants vitamin K antagonists].

    Science.gov (United States)

    Satger, Bernadette; Blaise, Sophie; Fontaine, Michèle; Yver, Jacqueline; Allenet, Benoît; Baudrant, Magali; Pernod, Gilles; Bosson, Jean-Luc

    2009-12-01

    The vitamin K antagonists (VKA) remain to this day the only oral form of therapeutic anticoagulation. Approximately 1% of the French population, mainly elderly, is treated with these anticoagulants. Oral anticoagulants have significant risks of iatrogenic complications; indeed they are the leading cause of such drug-induced complications, predominantly hemorrhages. AFSSAPS (French Drug and Medical Products Agency) clinical practice recommendations, repeatedly disseminated, emphasize the education of patients receiving VKAs. Managing oral anticoagulant treatment is challenging, with a significant risk of under- or overdosing and consequently, thrombosis or hemorrhage. The therapeutic window is narrow, multiple drug-interactions are possible, and the specific dose required for a particular individual to achieve appropriate International Normalized Ratio (INR) levels is unpredictable. The literature contains few randomized controlled trials about the efficacy of education for patients treated with oral anticoagulants. These education programs are not standardized and are therefore varied and difficult to compare. Nevertheless, studies demonstrate the importance of patient education programs in reducing the risk of hemorrhage and achieving better treatment stability. The Grenoble region hospital-community network for vascular diseases (GRANTED) has developed an education program for these patients, consisting of individual sessions for the patient and/or a friend or family member (either at a health care facility or at the patient's home), telephone support and group sessions, and using educational tools and supports. There is also a link with the general practitioner who receives a report. This approach makes it possible to adapt the educational message to individual patients and their daily lives, as well as directly involving them in the management of their treatment.

  12. The Use of Oral Disease-Modifying Therapies in Multiple Sclerosis.

    Science.gov (United States)

    Kretzschmar, Benedikt; Pellkofer, Hannah; Weber, Martin S

    2016-04-01

    Three oral disease-modifying drugs-fingolimod, teriflunomide, and dimethyl fumarate (DMF)-are available for treatment of relapsing forms of multiple sclerosis (MS). All three agents were approved in the last decade, primarily on the basis of a moderate to substantial reduction in the occurrence of MS relapses and central nervous system lesion formation detected by MRI. In the trials leading to approval, the first oral disease-modifying drug, fingolimod, reduced the annualized relapse rate (ARR) from 0.40 in placebo-treated patients to 0.18 (FREEDOMS) and from 0.33 in patients treated with interferon β1a intramuscularly to 0.16 (TRANSFORMS). Teriflunomide, approved on the basis of the two placebo-controlled trials TEMSO and TOWER, demonstrated a reduction in the ARR from 0.54 to 0.37 and from 0.50 to 0.32 respectively. The latest oral MS medication, approved in 2014, is DMF, which had been used in a different formulation for treatment of psoriasis for decades. In the 2-year DEFINE study, the proportion of patients with a relapse was reduced to 27 %, compared with 46 % in placebo arm, whereas in the CONFIRM trial, the ARR was reduced from 0.40 (placebo) to 0.22 in the DMF-treated group of patients. In this review, we will elucidate the mechanisms of action of these three medications and compare their efficacy, safety, and tolerability as a practical guideline for their use. We will further discuss effects other than relapse reduction these small molecules may exert, including potential activities within the central nervous system, and briefly summarize emerging data on new oral MS drugs in clinical development.

  13. Boron neutron capture therapy for recurrent oral cancer and metastasis of cervical lymph node

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Y. [Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Osaka Medical College, 2-7 Daigaku-machi Takatsuki City, Osaka (Japan)], E-mail: ora018@poh.osaka-med.ac.jp; Ariyoshi, Y.; Shimahara, M. [Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Osaka Medical College, 2-7 Daigaku-machi Takatsuki City, Osaka (Japan); Miyatake, S.; Kawabata, S. [Department of Neurosurgery, Division of Surgery, Osaka Medical College, 2-7 Daigaku-machi Takatsuki City, Osaka (Japan); Ono, K.; Suzuki, M. [Particle Radiation Oncology Research Center, Kyoto University, Kumatori-cho, Sennan-gun, Osaka (Japan); Maruhashi, A. [Medical Physics, Department of Radiation Life Sciences, Research Reactor Institute, Kyoto University, Kumatori-cho, Sennan-gun, Osaka (Japan)

    2009-07-15

    We treated 6 patients with recurrent oral cancer and metastasis to the cervical lymph nodes after conventional treatments in 5 and non-conventional in 1 using BNCT, and herein report our results. The clinical response in our patients ranged from CR to PD. In 5 cases, spontaneous pain decreased immediately after BNCT. Three of the 6 are alive at the time of writing and we found that BNCT contributed to QOL improvement in all.

  14. Oral drug therapy in elderly with dysphagia: between a rock and a hard place!

    Science.gov (United States)

    Logrippo, Serena; Ricci, Giovanna; Sestili, Matteo; Cespi, Marco; Ferrara, Letizia; Palmieri, Giovanni F; Ganzetti, Roberta; Bonacucina, Giulia; Blasi, Paolo

    2017-01-01

    Demographic indicators forecast that by 2050, the elderly will account for about one-third of the global population. Geriatric patients require a large number of medicines, and in most cases, these products are administered as solid oral solid dosage forms, as they are by far the most common formulations on the market. However, this population tends to suffer difficulties with swallowing. Caregivers in hospital geriatric units routinely compound in solid oral dosage forms for dysphagic patients by crushing the tablets or opening the capsules to facilitate administration. The manipulation of a tablet or a capsule, if not clearly indicated in the product labeling, is an off-label use of the medicine, and must be supported by documented scientific evidence and requires the patient's informed consent. Compounding of marketed products has been recognized as being responsible for an increased number of adverse events and medical errors. Since extemporaneous compounding is the rule and not the exception in geriatrics departments, the seriousness and scope of issues caused by this daily practice are probably underestimated. In this article, the potential problems associated with the manipulation of authorized solid oral dosage forms are discussed.

  15. Improving Safety of Preemptive Therapy with Oral Valganciclovir for Cytomegalovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Corinna Barkam

    2012-01-01

    Full Text Available Valganciclovir (VGC, an oral prodrug of ganciclovir (GCV, has been shown to clear cytomegalovirus (CMV viremia in preemptive treatment of patients after allogeneic hematopoietic stem cell transplantation (alloHSCT, apparently without significant toxicity. Since VGC obviates hospitalization, it is increasingly being adopted, although not approved, in alloHSCT. When we retrospectively evaluated preemptive treatment with VGC versus GCV, foscarnet or cidofovir, in all 312 consecutive CMV viremias of 169 patients allotransplanted at our institution between 1996 and 2006, we found VGC more efficacious (79% than non-VGC therapies (69%. The advantage of outpatient VGC, however, was outbalanced by more profound neutropenias (including two cases of agranulocytosis, one with graft loss requiring subsequent prolonged rehospitalization. Thus, in a second, prospective cohort from 2007 to 2011 (all 202 consecutive CMV viremias of 118 yet older and sicker patients, we implemented twice weekly neutrophil monitoring during outpatient VGC treatment and avoided VGC maintenance therapy. While conserving efficacy (VGC 71%, non-VGC 72%, we could now demonstrate a reduced mean duration of hospitalization with VGC (9 days (0–66 compared to non-VGC (25 days (0–115, without any agranulocytosis episodes. We conclude that safe outpatient VGC therapy is possible in alloHSCT recipients, but requires frequent monitoring to prevent severe myelotoxicity.

  16. Antidiabetic herbal drugs officially approved in China.

    Science.gov (United States)

    Jia, Wei; Gao, Wenyuan; Tang, Lida

    2003-12-01

    Over the centuries, Chinese herbal drugs have served as a major source of medicines for the prevention and treatment of diseases including diabetes mellitus (known as 'Xiao-ke'). It is estimated that more than 200 species of plants exhibit hypoglycaemic properties, including many common plants, such as pumpkin, wheat, celery, wax guard, lotus root and bitter melon. To date, hundreds of herbs and traditional Chinese medicine formulas have been reported to have been used for the treatment of diabetes mellitus. This paper provides a brief review of the antidiabetic drugs of plant origin that have been approved by the Chinese health regulatory agency for commercial use in China. It was believed, through pharmacological studies, that medicinal herbs were meticulously organized in these antidiabetic drug formulas such that polysaccharide containing herbs restore the functions of pancreatic tissues and cause an increase in insulin output by the functional beta cells, while other ingredients enhance the microcirculation, increase the availability of insulin and facilitate the metabolism in insulin-dependent processes. Pharmacological and clinical evaluations indicated that these drugs had a mild, but significant, blood glucose lowering effect and that the long-term use of these agents may be advantageous over chemical drugs in alleviating some of the chronic diseases and complications caused by diabetes. Additionally, the use of these natural agents in conjunction with conventional drug treatments, such as a chemical agent or insulin, permits the use of lower doses of the drug and/or decreased frequency of administration which decreases the side effects most commonly observed. Copyright 2003 John Wiley & Sons, Ltd.

  17. Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications

    Directory of Open Access Journals (Sweden)

    Huri HZ

    2015-08-01

    Full Text Available Hasniza Zaman Huri,1,2 Lay Peng Lim,1 Soo Kun Lim3 1Department of Pharmacy, Faculty of Medicine, University of Malaya, 2Clinical Investigation Centre, University Malaya Medical Centre, 3Renal Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Good glycemic control can delay the progression of kidney diseases in type 2 diabetes mellitus (T2DM patients with renal complications. To date, the association between antidiabetic agents and glycemic control in this specific patient population is not well established.Purpose: This study aimed to identify antidiabetic regimens as well as other factors that associated with glycemic control in T2DM patients with different stages of chronic kidney disease (CKD.Patients and methods: This retrospective, cross-sectional study involved 242 T2DM inpatients and outpatients with renal complications from January 2009 to March 2014 and was conducted in a tertiary teaching hospital in Malaysia. Glycated hemoglobin (A1C was used as main parameter to assess patients’ glycemic status. Patients were classified to have good (A1C <7% or poor glycemic control (A1C ≥7% based on the recommendations of the American Diabetes Association.Results: Majority of the patients presented with CKD stage 4 (43.4%. Approximately 55.4% of patients were categorized to have poor glycemic control. Insulin (57.9% was the most commonly prescribed antidiabetic medication, followed by sulfonylureas (43%. Of all antidiabetic regimens, sulfonylureas monotherapy (P<0.001, insulin therapy (P=0.005, and combination of biguanides with insulin (P=0.038 were found to be significantly associated with glycemic control. Other factors including duration of T2DM (P=0.004, comorbidities such as anemia (P=0.024 and retinopathy (P=0.033, concurrent medications such as erythropoietin therapy (P=0.047, a-blockers (P=0.033, and antigouts (P=0.003 were also correlated with A1C.Conclusion: Identification of

  18. Significant Depletion of CD4+ T Cells Occurs in the Oral Mucosa during Simian Immunodeficiency Virus Infection with the Infected CD4+ T Cell Reservoir Continuing to Persist in the Oral Mucosa during Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Jeffy George

    2015-01-01

    Full Text Available Human and simian immunodeficiency virus (HIV and SIV infections are characterized by manifestation of numerous opportunistic infections and inflammatory conditions in the oral mucosa. The loss of CD4+ T cells that play a critical role in maintaining mucosal immunity likely contributes to this process. Here we show that CD4+ T cells constitute a minor population of T cells in the oral mucosa and display a predominantly central memory phenotype mirroring other mucosal sites such as the rectal mucosa. Chronic SIV infection was associated with a near total depletion of CD4+ T cells in the oral mucosa that appear to repopulate during antiretroviral therapy (ART. Repopulating CD4+ T cells harbored a large fraction of Th17 cells suggesting that ART potentially reconstitutes oral mucosal immunity. However, a minor fraction of repopulating CD4+ T cells harbored SIV DNA suggesting that the viral reservoir continues to persist in the oral mucosa during ART. Therapeutic approaches aimed at obtaining sustainable CD4+ T cell repopulation in combination with strategies that can eradicate the latent viral reservoir in the oral mucosa are essential for better oral health and long-term outcome in HIV infected patients.

  19. Antidiabetic Activity of Zinc Oxide and Silver Nanoparticles on Streptozotocin-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Ali Alkaladi

    2014-01-01

    Full Text Available The use of nanoparticles in medicine is an attractive proposition. In the present study, zinc oxide and silver nanoparticles were evaluated for their antidiabetic activity. Fifty male albino rats with weight 120 ± 20 and age 6 months were used. Animals were grouped as follows: control; did not receive any type of treatment, diabetic; received a single intraperitoneal dose of streptozotocin (100 mg/kg, diabetic + zinc oxide nanoparticles (ZnONPs, received single daily oral dose of 10 mg/kg ZnONPs in suspension, diabetic + silver nanoparticles (SNPs; received a single daily oral dose of SNP of 10 mg/kg in suspension and diabetic + insulin; received a single subcutaneous dose of 0.6 units/50 g body weight. Zinc oxide and silver nanoparticles induce a significant reduced blood glucose, higher serum insulin, higher glucokinase activity higher expression level of insulin, insulin receptor, GLUT-2 and glucokinase genes in diabetic rats treated with zinc oxide, silver nanoparticles and insulin. In conclusion, zinc oxide and sliver nanoparticles act as potent antidiabetic agents.

  20. Antidiabetic and Hypolipidemic effect of methanol extract of Lippia nodiflora L. in streptozotocin induced diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Rangachari Balamurugan; Savarimuthu Ignacimuthu

    2011-01-01

    Objective: To assess the antidiabetic and hypolipidemic properties of Lippia nodiflora (L. nodiflora).Methods:Acute toxicity test was done to check the toxicity of L. nodiflora methanol extract and oral glucose tolerance test was performed in normal rats. L. nodiflora methanol extract at three dose levels was administerd orally to streptozotocin (STZ) (40mg/kg bw) induced diabetic rats for 15 days. The various parameters were studied including body weight, fasting blood glucose levels, plasma insulin, lipid profile, glycogen content, glycoslylated hemoglobin (HbA1c) and serum marker enzyme levels in normal, treated and diabetic rats. Histochemical analysis of pancreas was also carried out in normal, treated and diabetic rats. Results: The treatment group with the extract at three dose levels showed a significant increase in the liver, muscle glycogen and serum insulin level and a significant decrease in fasting blood glucose, glycosylated hemoglobin levels and serum marker enzyme levels. The total cholesterol and serum triglycerides levels were also significantly reduced and the high density lipoprotein level was significantly increased upon treatment with the L. nodiflora methanol extract. Histochemical study of pancreas also confirmed the biochemical findings. Acute toxicity studies revealed the non-toxic nature of the L. nodiflora methanol extract. Conclusions: The results of the experiments presented here suggest that methanol extract of L. nodiflora exerts significant antidiabetic and hypolipidaemic effect in STZ-induced diabetic rats.

  1. Antidiabetic and antioxidant activities of ethanolic extract of Semecarpus anacardium (Linn.) bark.

    Science.gov (United States)

    Ali, Md Ashraf; Wahed, Mir Imam Ibne; Khatune, Naznin Ara; Rahman, Bytul Mokaddesur; Barman, Ranjan Kumar; Islam, Md Rafiqul

    2015-04-29

    Diabetes mellitus is a global health problem and constantly increasing day by day. The number of diabetic people in world is expected to rise to 366 million in 2030. The available drugs for diabetes, insulin or oral hypoglycemic agents have one or more side effects and search for new antidiabetic drugs with minimal or no side effects from medicinal plants is a challenging for us. The present study was undertaken to investigate the antidiabetic and antioxidant activity of Semecarpus anacardium (Linn.) (abbreviated as SF). The antidiabetic activity was determined by using alloxan-induced diabetic rats. After 15 days of treatment, serum biochemical parameters such as TC, TG, LDL, HDL, SGOT and SGPT were estimated. The survival rate, body weight, organ weight, liver glycogen and blood parameters (RBC and Hb) were also measured. The antioxidant activity was measured by DPPH free radical scavenging assay. Phytochemical screening, total phenolic and total flavonoid content were determined by using standard methods. The results showed that the survival rate was 100% in rats of Group SA 400. The effect of extract on blood glucose level in Groups SA 100, SA 200 and SA 400 were dose-dependent throughout the treatment period. No significant changes in organ weight to body weight ratio were observed, liver weights significantly improved in Groups SA 200 and SA 400. The bark extract exhibited significant (p < 0.05) anti-diabetic activity with lowering TC, TG, LDL level dose-dependently and protected liver which may be partially explained by attenuation of SGOT and SGPT levels and increases liver glycogen. The percentage of Hb and RBC counts were negatively correlated with the doses of extracts. In DPPH scavenging assay, IC50 values of SA extract and ascorbic acid were found 72.24 μg/ml and 17.81 μg/ml, respectively. Phytochemical screening showed the presence of steroids, triterpenoids, flavonoids, glycosides, saponins, and tannins that were contribute to biological activi