An investigation of side-effects and efficacy of foam-based sclerotherapy with carbon dioxide or room air in the treatment of reticular leg veins: a pilot study

2011 ◽  
Vol 27 (2) ◽  
pp. 73-76 ◽  
Author(s):  
J D Peterson ◽  
M P Goldman
Keyword(s):  
Carbon Dioxide ◽  
Pilot Study ◽  
Side Effects ◽  
Half Life ◽  
P Value ◽  
Foam Sclerotherapy ◽  
Sodium Tetradecyl Sulphate ◽  
Foam Concentration ◽  
Local Side

Objectives In sclerotherapy, carbon dioxide (CO2) or room air can be employed by phlebologists for foam creation. We compared room air (RA) and carbon dioxide in treating reticular leg veins with foam sclerotherapy. Methods Twenty patients were randomly treated with RA- or CO2-created sodium tetradecyl sulphate (STS) foam. Concentration and volume of STS, side-effects and efficacy were determined. Results There was no difference in the efficacy, local side-effects or distant side-effects between RA and CO2 foam in the treatment of reticular leg veins. The total volume of foam sclerosant required for treatment was greater with CO2 compared with RA ( P value = 0.01). Conclusion No differences were found in efficacy or side-effects between RA- and CO2-foam sclerotherapy for reticular leg veins. CO2 foam's shorter half-life was hypothesized to be responsible for larger total volumes of CO2 foam sclerosant.

An investigation on the influence of glycerin on sclerosant foam stability

2011 ◽  
Vol 26 (6) ◽  
pp. 232-234 ◽  
Author(s):  
J D Peterson ◽  
M P Goldman
Keyword(s):  
Half Life ◽  
Foam Stability ◽  
Varicose Veins ◽  
Injection Technique ◽  
Foam Sclerotherapy ◽  
System Technique ◽  
Negative Effect ◽  
Sodium Tetradecyl Sulphate ◽  
Time Required ◽  
Disposable Plastic

Background Foam sclerotherapy is an increasingly popular modality in the treatment of varicose veins. Foam stability varies according to foam composition, volume and injection technique. Materials and methods A disposable plastic connector was used to create foam from 0.50% sodium tetradecyl sulphate (STS) mixed with varying volumes of glycerin. As a measure of foam stability, the half liquid time was defined as the time required for half of the original volume of sclerosing solution to settle. Three recordings were determined for each of the three mixtures of sclerosant foam. Results The time for sclerosing solution to settle to half of its initial volume was found to be 89 seconds for 0.50% STS alone, 117.7 seconds with the addition of 0.1 mL of 72% glycerin, and 114.7 seconds with the addition of 0.2 mL of 72% glycerin. Conclusion The small volumes of glycerin added to STS prolonged the half liquid time of STS foam up to 35%. As glycerin alone is unable to be foamed with the double-syringe system technique there may be a point at which further addition of glycerin has a negative effect on the half-life of foam.

scholarly journals Could Hyaluronic acid (HA) reduce Bacillus Calmette-Guérin (BCG) local side effects? Results of a pilot study

BMC Urology ◽  
2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Luca Topazio ◽  
Roberto Miano ◽  
Valentina Maurelli ◽  
Gabriele Gaziev ◽  
Mauro Gacci ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Pilot Study ◽  
Side Effects ◽  
Bacillus Calmette Guerin ◽  
Local Side

scholarly journals MICRO NEEDLING VERSUS CARBON DIOXIDE FRACTIONAL LASER IN MANAGEMENT OF ACNE SCARS

2021 ◽  
Vol 71 (6) ◽  
pp. 2095-98
Author(s):  
Shanza Obaid ◽  
Nadia Iftikhar ◽  
Asher Mashhood ◽  
Ayesha Khokhar ◽  
Zarnab Zainab ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Side Effects ◽  
Adverse Effects ◽  
Laser Treatment ◽  
Military Hospital ◽  
P Value ◽  
Fractional Laser ◽  
Acne Scars ◽  
Number Of Patients ◽  
Laser Group

Objective: To compare the effectiveness of carbon dioxide fractional laser with micro needling in acne scarring. Study Design: Quasi experimental study. Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital Rawalpindi, from Jun 2019 to Mar 2020. Methodology: Overall 40 patients with acne scars assessed by consultant dermatologist were made part of study. The patients were divided into two treatment groups through lottery method. Group A, was managed by micro needling technique, while Group B was managed by carbon dioxide fractional laser, each to be done monthly for a total of three sessions. The response was measured by the dermatologist and patients in both the groups. The side effects were also compared in both the groups. Results: Out of 40 patients with acne scars included in study, 17 (42.5%) underwent micro-needling while 23 (57.5%) underwent carbon dioxide fractional laser treatment after randomization. Thirty (75%) patients were female while 10 (25%) were male. The patients with acne scars responded better in carbon dioxide fractional laser group as compared to micro needling in opinion of dermatologists (p-value=0.01) and also patients themselves (p-value=0.03). Side effects were significantly higher in carbon dioxide fractional laser group as compared to micro needling (p-value=0.02). Conclusion: Significant number of patients respond well to carbon dioxide fractional laser treatment and the response included both expert opinion and patients own opinion, but adverse effects were seen more in same group. Therefore, better response but at the cost of more adverse effects was noted.

Local Treatment of Recent Arterial Thromboembolic Occlusions with Brinase

1975 ◽  
Vol 34 (02) ◽  
pp. 498-503 ◽  
Author(s):  
D Nyman ◽  
M. A da Silva ◽  
L. K Widmer ◽  
F Duckert
Keyword(s):  
Side Effects ◽  
Local Treatment ◽  
Before And After ◽  
Local Side

SummaryBrinase was administered intra-arterially in 16 patients with thrombotic or embolic arterial occlusions. Angiography could be performed before and after treatment in 13 patients. Thrombolysis was obtained in 3 of 9 patients with thrombotic and in 3 of 4 patients with embolic occlusions. In 3 patients severe local side effects occurred.

Intoxication with Phenprocoumon (Marcoumar) Pharmacokinetics and Side Effects

1969 ◽  
Vol 21 (02) ◽  
pp. 320-324 ◽  
Author(s):  
K Seiler ◽  
F Duckert
Keyword(s):  
Plasma Concentration ◽  
Side Effects ◽  
Half Life ◽  
Plasma Proteins ◽  
Repeated Administration ◽  
High Plasma ◽  
Vitamin K1 ◽  
Clotting Factors ◽  
Therapeutic Concentration ◽  
High Plasma Concentration

SummaryA case of severe Marcoumar intoxication is described. Eleven hours after the intake a plasma concentration of 15.75 µg/ml was found which corresponds approximately to the 5-fold therapeutic concentration. Repeated administration of vitamin K1 made it possible to avoid extreme lowering of the activity of the clotting factors II, VII and X and to prevent bleeding. Side effects were not observed. The biologic half-life of Phenprocoumon has been found to be shortened at high plasma concentration (3.7 instead of 5.9 days). It is probable that in extreme concentration the drug is less strongly bound to the plasma proteins.

scholarly journals Utility of routinely collected electronic health records data to support effectiveness evaluations in inflammatory bowel disease: a pilot study of tofacitinib

2021 ◽  
Vol 28 (1) ◽  
pp. e100337
Author(s):  
Vivek Ashok Rudrapatna ◽  
Benjamin Scott Glicksberg ◽  
Atul Janardhan Butte
Keyword(s):  
Inflammatory Bowel Disease ◽  
Pilot Study ◽  
Disease Activity ◽  
Real World ◽  
Bowel Disease ◽  
P Value ◽  
Health Records ◽  
Real World Evidence ◽  
Inflammatory Bowel

ObjectivesElectronic health records (EHR) are receiving growing attention from regulators, biopharmaceuticals and payors as a potential source of real-world evidence. However, their suitability for the study of diseases with complex activity measures is unclear. We sought to evaluate the use of EHR data for estimating treatment effectiveness in inflammatory bowel disease (IBD), using tofacitinib as a use case.MethodsRecords from the University of California, San Francisco (6/2012 to 4/2019) were queried to identify tofacitinib-treated IBD patients. Disease activity variables at baseline and follow-up were manually abstracted according to a preregistered protocol. The proportion of patients meeting the endpoints of recent randomised trials in ulcerative colitis (UC) and Crohn’s disease (CD) was assessed.Results86 patients initiated tofacitinib. Baseline characteristics of the real-world and trial cohorts were similar, except for universal failure of tumour necrosis factor inhibitors in the former. 54% (UC) and 62% (CD) of patients had complete capture of disease activity at baseline (month −6 to 0), while only 32% (UC) and 69% (CD) of patients had complete follow-up data (month 2 to 8). Using data imputation, we estimated the proportion achieving the trial primary endpoints as being similar to the published estimates for both UC (16%, p value=0.5) and CD (38%, p-value=0.8).Discussion/ConclusionThis pilot study reproduced trial-based estimates of tofacitinib efficacy despite its use in a different cohort but revealed substantial missingness in routinely collected data. Future work is needed to strengthen EHR data and enable real-world evidence in complex diseases like IBD.

scholarly journals Carbon dioxide levels in neonates: what are safe parameters?

2021 ◽  
Author(s):  
Sie Kei Wong ◽  
M. Chim ◽  
J. Allen ◽  
A. Butler ◽  
J. Tyrrell ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Systematic Review ◽  
Side Effects ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
List Type ◽  
Permissive Hypercapnia ◽  
Prisma Statement ◽  
Carbon Dioxide Levels ◽  
Online Software

Abstract There is no consensus on the optimal pCO2 levels in the newborn. We reviewed the effects of hypercapnia and hypocapnia and existing carbon dioxide thresholds in neonates. A systematic review was conducted in accordance with the PRISMA statement and MOOSE guidelines. Two hundred and ninety-nine studies were screened and 37 studies included. Covidence online software was employed to streamline relevant articles. Hypocapnia was associated with predominantly neurological side effects while hypercapnia was linked with neurological, respiratory and gastrointestinal outcomes and Retinpathy of prematurity (ROP). Permissive hypercapnia did not decrease periventricular leukomalacia (PVL), ROP, hydrocephalus or air leaks. As safe pCO2 ranges were not explicitly concluded in the studies chosen, it was indirectly extrapolated with reference to pCO2 levels that were found to increase the risk of neonatal disease. Although PaCO2 ranges were reported from 2.6 to 8.7 kPa (19.5–64.3 mmHg) in both term and preterm infants, there are little data on the safety of these ranges. For permissive hypercapnia, parameters described for bronchopulmonary dysplasia (BPD; PaCO2 6.0–7.3 kPa: 45.0–54.8 mmHg) and congenital diaphragmatic hernia (CDH; PaCO2 ≤ 8.7 kPa: ≤65.3 mmHg) were identified. Contradictory findings on the effectiveness of permissive hypercapnia highlight the need for further data on appropriate CO2 parameters and correlation with outcomes. Impact There is no consensus on the optimal pCO2 levels in the newborn. There is no consensus on the effectiveness of permissive hypercapnia in neonates. A safe range of pCO2 of 5–7 kPa was inferred following systematic review.

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