Search results for "AGENTS"

Chromoendoscopy in Barrett's oesophagus: is cresyl violet the magic bullet?

2006

The endoscopic detection of Barrett’s epithelium remains challenging even for modern endoscopy. This is mainly due to the fact that Barrett’s epithelium is often patchy and can easily be overlooked by conventional endoscopy with random biopsies. Thus, chromoendoscopy and magnifying endoscopy were introduced to facilitate diagnosis of Barrett’s epithelium and Barrett’s associated neoplasias. Methylene blue-aided chromoendoscopy was firstly introduced by Canto et al. [1]. The authors could show that methylene blue selectively stains specialised columnar epithelium, which is pathognomonic for Barrett’s epithelium. In contrast, dysplastic areas revealed no or weaker staining due to changes in t…

Comparing medical treatments for Crohn’s disease

2013

The drugs available for inflammatory bowel disease are aminosalicylates, antibiotics, steroids, immunosuppressors and biologics. The effectiveness of these drugs has been evaluated in many randomized clinical trials, mainly versus placebo. Few studies have been conducted comparing the different drugs among themselves, owing to the methodological problems raised by comparative trials, such as sample size and blindness. This review focuses mainly on the randomized clinical trials that have compared different treatments. Of course comparisons are mainly between drugs used in a particular setting (mild, moderate and severe disease). However, on many occasions there is no homogeneity in these cl…

Deflazacort in Duchenne dystrophy: Study of long-term effect

1994

A randomized double-blind controlled trial of deflazacort was conducted in 28 Duchenne muscular dystrophy patients either treated with deflazacort 2.0 mg/kg alternate-day therapy or placebo. The deflazacort group showed significant improvement in climbing stairs (P < 0.01), in rising from a chair, Gower's maneuver, and walking (P < 0.0025) after 6 months of treatment. After 1 year, all the above changes remained significantly improved and the MRC index was significantly better (P < 0.05) in the treated group. After 2 years, a significant change was found in the MRC index: higher scores in walking, chair rising (P < 0.02), and grade and time of Gower's maneuver (P < 0.05) were found. The mea…

The paradox of the evidence about invasive fungal infections prevention

2016

Invasive fungal infections (IFIs) are characterized by high morbidity and mortality in non-neutropenic critically ill patients. Attributable mortality due to Candida spp. infections ranges from about 42 to 63 % [1, 2]. Data from large observational and retrospective studies show an association between early antifungal treatment and improved survival [3, 4]. Updated clinical practice guidelines for the management of candidiasis have been recently published [5]. In 2006, Playford et al. published a Cochrane systematic review investigating the use of antifungal agents for prevention of IFIs in non-neutropenic critically ill patients [6]. In that review, the outcome of proven IFI was defined as…

2015

Recent data suggest that the traditional definition of bisphosphonate-associated osteonecrosis of the jaw (ONJ) may exclude patients who present with the non-exposed variant of the condition. To test the hypothesis that a proportion of patients with ONJ remain undiagnosed because their symptoms do not conform to the traditional case definition, we did a secondary analysis of data from MISSION (Multicentre study on phenotype, definition and classification of osteonecrosis of the jaws associated with bisphosphonates), a cross-sectional study of a large population of patients with bisphosphonate-associated ONJ who were recruited in 13 European centres. Patients with exposed and non-exposed ONJ…

Chelation treatment in sickle-cell-anaemia: much ado about nothing?

2011

Summary Blood transfusions may prevent and treat serious complications related to sickle-cell disease (SCD) when performed according to specific guidelines. However, blood transfusion requirements in SCD inevitably lead to increased body iron burden. An adequate chelation treatment may prevent complications and reduce morbidity and mortality. This review evaluates the effectiveness, safety and costs of chelation treatment. The included trials were examined according to the recommendations of the American College of Cardiology (ACC) and the American Heart Association (AHA). Overall, 14 trials and a total of 502 patients with SCD were included in this review. Deferoxamine alone (s.c. or i.v.)…

How to manage aspergillosis in non-neutropenic intensive care unit patients.

2014

Invasive aspergillosis has been mainly reported among immunocompromised patients during prolonged periods of neutropenia. Recently, however, non-neutropenic patients in the ICU population have shown an increasing risk profile for aspergillosis. Associations with chronic obstructive pulmonary disease and corticosteroid therapy have been frequently documented in this cohort. Difficulties in achieving a timely diagnosis of aspergillosis in non-neutropenic patients is related to the non-specificity of symptoms and to lower yields with microbiological tests compared to neutropenic patients. Since high mortality rates are typical of invasive aspergillosis in critically ill patients, a high level …

The concentration of para-phenylenediamine (PPD) for routine patch testing in a standard series needs to be redefined

2005

Agreement within Europe about antihypertensive treatment and education – results from the European Society of Hypertension questionnaire

2010

The dilemma for patients with chronic hepatitis C: treat now or warehouse?

2013

Dual therapy with peginterferon and ribavirin, the only treatent for chronic hepatitis C available In Italy and in many other ountries worldwide up to 2013, obtains satisfactory response ates in infections with hepatitis C virus (HCV) genotype 2, but far rom optimal for other genotypes [1,2]. Eradication requires 6–12 onths of therapy, with significant inconvenience for patients: dverse reactions force premature termination in about 20% of atients and reduced the quality of life for almost all who persist n treatment. In view of the important and prolonged side effects, nterferon-based treatment is perceived as a nightmare by many symptomatic,well-being, socially activepatients (the largema…