Local Therapy of CMV Retinitis: A New Therapeutical Approach

1997 ◽  
pp. 64-68
Author(s):  
A.V. Fuchs ◽  
A. Scheider ◽  
V. Klauss ◽  
A. Kampik
Keyword(s):  
Local Therapy ◽  
Cmv Retinitis

Local Therapy for Cytomegalovirus Retinitis

1998 ◽  
Vol 32 (2) ◽  
pp. 248-255 ◽  
Author(s):  
Curtis L Smith
Keyword(s):  
Randomized Controlled Trials ◽  
Systemic Therapy ◽  
Local Therapy ◽  
Hiv Treatment ◽  
Controlled Trials ◽  
Advantages And Disadvantages ◽  
Cmv Retinitis ◽  
Randomized Controlled ◽  
Drug Concentrations ◽  
Cmv Disease

OBJECTIVE: To examine the role of intraocular therapy in the management of cytomegalovirus (CMV) retinitis associated with AIDS. DATA SOURCES: A MEDLINE search was conducted for the years 1980–1997. In addition, relevant articles were cross-referenced to screen for additional information. The AIDS/HIV Treatment Directory was searched for information on ongoing studies. STUDY SELECTION/DATA EXTRACTION: Data regarding the use of local antiviral therapy for CMV retinitis are cited. Emphasis was placed on randomized, controlled trials, but descriptive studies are also included. DATA SYNTHESIS: Intraocular drug administration is an alternative therapy for CMV retinitis that avoids some of the disadvantages associated with systemic treatment. Intravitreal ganciclovir 200–2000 μg once weekly has been studied in a number of nonrandomized studies. Although initially effective, intravitreal ganciclovir is associated with a significant relapse rate and development of contralateral CMV retinitis. Intraocular ganciclovir implants offer the advantage of less frequent interventions and constant drug concentrations in the vitreous. Time to progression is significantly longer in patients receiving implants versus intravenous therapy; however, there is a higher incidence of contralateral eye retinitis and extraocular CMV disease with the implants. Currently, the intraocular implant is being studied in combination with oral ganciclovir to decrease the incidence of systemic CMV disease. Foscarnet and cidofovir have also been administered intravitreally for CMV retinitis. Cidofovir may offer the advantage of a long intracellular half-life, which would allow infrequent dosing; however, further study is needed to determine a safe and effective intraocular dosage. CONCLUSIONS: Systemic therapy continues as standard management for CMV retinitis. Local therapy has some advantages and disadvantages, but larger, randomized, controlled trials comparing systemic therapy with local therapy must be completed to define its exact role. Data from an ongoing trial of local plus oral therapy will better define this role.

Docetaxel, estramustine, and short-term androgen withdrawal for patients with biochemical failure after definitive local therapy for prostate cancer

2001 ◽  
Vol 28 (4M) ◽  
pp. 32-39 ◽  
Author(s):  
Mary-Ellen Taplin ◽  
Glenn J. Bubley ◽  
Barur Rajeshkumar ◽  
Todd Shuster ◽  
Yoo-Joung Ko ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Therapy ◽  
Biochemical Failure ◽  
Short Term ◽  
Androgen Withdrawal

The effective local therapy of vaginal discharge

GYNECOLOGY ◽  
2015 ◽  
Vol 17 (1) ◽  
pp. 54-55 ◽  
Author(s):  
A.L. Tikhomirov ◽  
Keyword(s):  
Vaginal Discharge ◽  
Local Therapy

HELIOTHERAPY IN THE TREATMENT OF PSORIATIC ARTHRITIS

2018 ◽  
Vol 28 (2) ◽  
pp. 483-487
Author(s):  
Snezhina Georgieva ◽  
Dilyana Zvezdova
Keyword(s):  
Psoriatic Arthritis ◽  
Clinical Picture ◽  
Local Therapy ◽  
Severe Form ◽  
Climatic Conditions ◽  
Joint Disease ◽  
Immune Mediated ◽  
Social Comfort ◽  
Pigment Type ◽  
Definition Of

Psoriatic arthritis is an inflammatory joint disease associated with psoriasis vulgaris, with routinely negative rheumatoid factors and the absence of rheumatoid nodules. This is an immune-mediated disease, according to generally accepted definition of Wright and Moll from 1973. American Association against Rheumatism classified psoriatic arthritis as an independent disease in 1964. Psoriatic arthritis is a single disease with a varied clinical picture. It belongs to the group of seronegative spondyloarthropathies with which there are general clinical features. It is believed that similar mechanisms determine the onset of psoriasis and psoriatic arthritis. The clinical picture includes various clinical forms that damage the peripheral and sacroiliac joints, spine, internal organs. The treatment of psoriatic arthritis is directed simultaneously to the influence of skin and joint changes. Purpose: Our study aims to summarize our long-standing experience in the treatment of psoriatic arthritis with heliotherapy. Subject of observation: Monitoring includes 132 patients with moderate and severe form of psoriasis treated at the sanatorium in town of Pomorie for 5 years in the period 2001-2006. Results and discussion: 132 patients with psoriasis with no effect on the local therapy and have proven psoriatic arthritis were selected. In our climatic conditions, heliotherapy is appointed during the warm half-year. Sun treatment was conducted under the conditions of a healing beach, which had shielding, radiation-protective devices. In patients with erythema - pigment and pigment type skin reactivity begins with 1-2 bioadoses reached to 8-10 biodoses, carried out in the area of overcomfort. Conclusion: The studies demonstrated that heliotherapy combined with medications significantly improves the prognosis of patients with this disease. The ultimate success would mean overcoming the frequent depression conditions, better survival and social comfort for patients with psoriatic arthritis.

New Technological Approach for Glycyrrethic Acid Oral and Topical Administration

2020 ◽  
Vol 26 (6) ◽  
pp. 664-674 ◽  
Author(s):  
Cinzia Pagano ◽  
Luana Perioli ◽  
Paola Calarco ◽  
Alessandro Di Michele ◽  
Maria C. Tiralti ◽  
...  
Keyword(s):  
Dissolution Rate ◽  
Water Solubility ◽  
Local Therapy ◽  
Topical Administration ◽  
Application Site ◽  
Vaginal Mucosa ◽  
Anionic Clays ◽  
Dissolution Rate Enhancement ◽  
Technological Approach ◽  
Bioactive Component

Background: 18β- glycyrrhetinic acid (Gly) is the major bioactive component of licorice roots and rhizomes of the Glycyrrhiza glabra species. It shows many activities such as antiviral, anti-inflammatory, antioxidant, antimicrobial, and antifungal, however, its use in the health field is very limited due to the low water solubility. Methods: This paper deals with the development of a new technological approach for Gly dissolution rate enhancement. It consists of Gly intercalation (guest) in the interlamellar spaces between the inorganic spaces (host) of the anionic clays “hydrotalcites” (HTlc) to obtain hybrids MgAl-HTlc-Gly and ZnAl-HTlc-Gly. Gly can find applications in both systemic and local therapies, thus advantages of the use of the hybrids in these two fields were investigated. Results: Gly dissolution rate from hybrids in the intestinal environment, site in which it is preferentially absorbed, resulted enhanced (ZnAl-HTlc-Gly > MgAl-HTlc-Gly) compared to the crystalline form, thereby, making them suitable for oral administration as dry powder in hard capsules. : For a local therapy, bioadhesive, vaginal emulgels loaded with the hybrids were developed. These showed suitable mucoadhesive property to the vaginal mucosa, necessary to prolong the residence time in the application site. The emulgel containing ZnAl-HTlc-Gly showed a faster and higher release profile than that containing MgAl- HTlc-Gly. Conclusions: The obtained results suggest that Gly intercalation into HTlc, especially in ZnAl-HTlc, allows to enhance Gly dissolution when the hybrids are formulated both as oral or topical products.

scholarly journals De-escalation of radiation therapy in patients with stage I, node-negative, HER2-positive breast cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jose G. Bazan ◽  
Sachin R. Jhawar ◽  
Daniel Stover ◽  
Ko Un Park ◽  
Sasha Beyer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Local Therapy ◽  
Adjuvant Radiation ◽  
Her2 Positive ◽  
Node Negative ◽  
Risk Of Death ◽  
Her2 Breast Cancer ◽  
Neoadjuvant Systemic Therapy ◽  
Increased Risk

AbstractIn the modern era, highly effective anti-HER2 therapy is associated with low local-regional recurrence (LRR) rates for early-stage HER2+ breast cancer raising the question of whether local therapy de-escalation by radiation omission is possible in patients with small-node negative tumors treated with lumpectomy. To evaluate existing data on radiation omission, we used the National Cancer Database (NCDB) to test the hypothesis that RT omission results in equivalent overall survival (OS) in stage 1 (T1N0) HER2+ breast cancer. We excluded patients that received neoadjuvant systemic therapy. We stratified the cohort by receipt of adjuvant radiation. We identified 6897 patients (6388 RT; 509 no RT). Patients that did not receive radiation tended to be ≥70 years-old (odds ratio [OR] = 3.69, 95% CI: 3.02–4.51, p < 0.0001), to have ≥1 comorbidity (OR = 1.33, 95% CI: 1.06–1.68, p = 0.0154), to be Hispanic (OR = 1.49, 95% CI: 1.00–2.22, p = 0.049), and to live in lower income areas (OR = 1.32, 95% CI: 1.07–1.64, p = 0.0266). Radiation omission was associated with a 3.67-fold (95% CI: 2.23–6.02, p < 0.0001) increased risk of death. While other selection biases that influence radiation omission likely persist, these data should give caution to radiation omission in T1N0 HER2+ breast cancer.

scholarly journals Primary tumor surgery improves survival in non-metastatic primary urethral carcinoma patients: a large population-based investigation

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Wu ◽  
Yu-Chen Wang ◽  
Wen-Jie Luo ◽  
Bo-Dai ◽  
Ding-Wei Ye ◽  
...  
Keyword(s):  
Regression Model ◽  
Competing Risks ◽  
Primary Tumor ◽  
Cox Regression ◽  
Radical Surgery ◽  
Large Population ◽  
Local Therapy ◽  
Primary Site ◽  
Urethral Carcinoma ◽  
The Impact

Abstract Background Primary urethral carcinoma (PUC) is a rare genitourinary malignancy with a relatively poor prognosis. The aim of this study was to examine the impact of surgery on survival of patients diagnosed with PUC. Methods A total of 1544 PUC patients diagnosed between 2004 and 2016 were identified based on the SEER database. The Kaplan-Meier estimate and the Fine and Gray competing risks analysis were performed to assess overall survival (OS) and cancer-specific mortality (CSM). The multivariate Cox regression model and competing risks regression model were used to identify independent risk factors of OS and cancer-specific survival (CSS). Results The 5-yr OS was significantly better in patients who received either local therapy (39.8%) or radical surgery (44.7%) compared to patients receiving no surgery of the primary site (21.5%) (p < 0.001). Both local therapy and radical surgery were each independently associated with decreased CSM, with predicted 5-yr cumulative incidence of 45.4 and 43.3%, respectively, compared to 64.7% for patients receiving no surgery of the primary site (p < 0.001). Multivariate analyses demonstrated that primary site surgery was independently associated with better OS (local therapy, p = 0.037; radical surgery, p < 0.001) and decreased CSM (p = 0.003). Similar results were noted regardless of age, sex, T stage, N stage, and AJCC prognostic groups based on subgroup analysis. However, patients with M1 disease who underwent primary site surgery did not exhibit any survival benefit. Conclusion Surgery for the primary tumor conferred a survival advantage in non-metastatic PUC patients.

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