- Combination pharmacotherapy for the treatment of fibromyalgia in adults. [Review]
- CDCochrane Database Syst Rev 2018 Feb 19; 2:CD010585
- CONCLUSIONS: There are few, large, high-quality trials comparing combination pharmacotherapy with monotherapy for fibromyalgia, consequently limiting evidence to support or refute the use of combination pharmacotherapy for fibromyalgia.
- Shingrix: The New Adjuvanted Recombinant Herpes Zoster Vaccine. [Journal Article]
- APAnn Pharmacother 2018 Feb 01; :1060028018758431
- CONCLUSIONS: Based on published immunogenicity, efficacy, and safety data, as well as the recent recommendations by the ACIP, HZ/su should be included on both hospital and community pharmacy formularies and recommended to all immunocompetent patients older than 50 years to prevent herpes zoster.
- Postoperative management with dexmedetomidine in a pregnant patient who underwent AVM nidus removal: a case report. [Journal Article]
- JCJA Clin Rep 2017; 3(1):17
- CONCLUSIONS: Dexmedetomidine infusion was used for postoperative sedation without causing any side effects, and it can be an alternative for sedation, especially when propofol is contraindicated.
- Clarithromycin in the Management of Chronic Rhinosinusitis: Preliminary Results of a Possible Its New Use. [Journal Article]
- IJIndian J Otolaryngol Head Neck Surg 2018; 70(1):87-91
- The aim of this study is to evaluate the efficacy and safety of prolonged therapy with low-dose clarithromycin in patients with chronic rhinosinusitis with polyps (CRSwP) after endoscopic sinus surge...
The aim of this study is to evaluate the efficacy and safety of prolonged therapy with low-dose clarithromycin in patients with chronic rhinosinusitis with polyps (CRSwP) after endoscopic sinus surgery (ESS). A total of 10 patients with CRSwP were identified and subjected to bilateral ESS. In post-operative patients they were treated with nasal wash with saline solution and steroid sprays (beclomethasone). During follow-up, after 30-40 days after the operation (M = 35.4 SD = +4.33), patients reported a worsening of symptoms with onset of nasal obstruction; reduction/loss of smell; headache; onset of viscous secretions and therefore all patients continued therapy with saline nasal irrigation, topical steroid therapy and started macrolide (clarithromycin 500 mg/pill: 1 pill/day for 3 days a week for 1 month). 22-item SinoNasal Outcome Test (SNOT-22) and a score to the endoscopic evaluation (endoscopic appearance score, EAS) before and after treatment were performed to evaluate efficacy of treatment. The results of the SNOT-22 and EAS showed statistically significant improvements (p < 0.05) for some parameters such as: the need to blow nose, sneezing, hyposmia, viscous mucous secretions about the SNOT-22 and reduction of secretions and edema of the nasal mucosa about the EAS. The preliminary results of our study show that the low-dose clarithromycin for a period of 1 month can improve patient complaints with CRSwP not only through the antibacterial properties but also for the immunomodulatory characteristics.
- Facial Weakness, Diplopia, and Fever in a 31-Year-Old: An Atypical Case of Tuberculous Meningitis. [Journal Article]
- CCureus 2017 Dec 07; 9(12):e1918
- Tuberculous meningitis (TBM) is an infection of the central nervous system (CNS) meninges that carries high morbidity and mortality. It is important to recognize, as patients may present with atypica...
Tuberculous meningitis (TBM) is an infection of the central nervous system (CNS) meninges that carries high morbidity and mortality. It is important to recognize, as patients may present with atypical symptoms. We describe the case of a 31-year-old man with a history of diabetes who presented with a sub-acute onset of right-sided facial weakness and right gaze difficulty with diplopia. History revealed low-grade fever, right-sided headache, fatigue and moderate weight loss for the past several weeks. The patient did not report neck stiffness, rigidity, fever, chills or cough. The physical exam revealed sixth nerve palsy with a right Horner's syndrome. Magnetic resonance imaging (MRI) of the brain showed pachymeningeal enhancement. A spinal tap revealed elevated white blood cells (WBCs), glucose and protein; cerebrospinal fluid (CSF) culture showed Mycobacterium tuberculosis. The patient was diagnosed with TBM and treated with isoniazid, rifampin, pyrazinamide, ethambutol and vitamin B6 for 12 months. The timely diagnosis of TBM can be challenging due to a nonspecific clinical presentation. In patients with a sub-acute onset of headache, fever and meningeal signs, TBM should be considered in the differential. If suspected, treatment should be initiated immediately to prevent further neurological impairment and death.
- Xanthogranulomatous pituitary adenoma: A case report and literature review. [Journal Article]
- MCMol Clin Oncol 2018; 8(3):445-448
- Xanthogranuloma, also referred to as cholesterol granuloma or xanthogranulomatous reaction, is a granulomatous lesion that is infrequently found in the sellar and parasellar regions. Xanthogranulomat...
Xanthogranuloma, also referred to as cholesterol granuloma or xanthogranulomatous reaction, is a granulomatous lesion that is infrequently found in the sellar and parasellar regions. Xanthogranulomatous pituitary adenoma is relatively rare and, thus, the etiology, diagnosis, management and prognosis of this condition remain incompletely understood. We herein report the case of a 56-year-old female patient who presented to our institution with intermittent headache, vomiting and distending pain in the bilateral orbital regions. Brain magnetic resonance imaging revealed a sellar mass with a heterogeneous signal. The mass was subtotally resected, and histopathological examination confirmed the diagnosis of xanthogranulomatous pituitary adenoma. Although the patient's symptoms were relieved following surgical treatment, intractable hyponatremia and diabetes insipidus developed and she received hormone replacement therapy. At the last follow-up (November 2016), the patient remained recurrence-free. A total of 14 cases of pituitary adenoma with concomitant xanthogranuloma were identified in the literature, and the clinical and radiological manifestations are discussed. Sellar xanthogranuloma is usually associated with craniopharyngioma or Rathke's cleft cyst; however, it may also occur in isolation. Xanthogranulomatous pituitary adenomas are infrequent, making their diagnosis challenging. Surgical resection is the preferred treatment, and attention should be paid to postoperative hypopituitarism and development of diabetes insipidus.
- A Review on Central Nervous System Effects of Gastrodin. [Review]
- FPFront Pharmacol 2018; 9:24
- Rhizoma Gastrodiae(also known asTian ma), the dried rhizome ofGastrodia elataBlume, is a famous Chinese herb that has been traditionally used for the treatment of headache, dizzin...
Rhizoma Gastrodiae(also known asTian ma), the dried rhizome ofGastrodia elataBlume, is a famous Chinese herb that has been traditionally used for the treatment of headache, dizziness, spasm, epilepsy, stoke, amnesia and other disorders for centuries. Gastrodin, a phenolic glycoside, is the main bioactive constituent ofRhizoma Gastrodiae. Since identified in 1978, gastrodin has been extensively investigated on its pharmacological properties. In this article, we reviewed the central nervous system (CNS) effects of gastrodin in preclinical models of CNS disorders including epilepsy, Alzheimer's disease, Parkinson's disease, affective disorders, cerebral ischemia/reperfusion, cognitive impairment as well as the underlying mechanisms involved and, where possible, clinical data that support the pharmacological activities. The sources and pharmacokinetics of gastrodin were also reviewed here. As a result, gastrodin possesses a broad range of beneficial effects on the above-mentioned CNS diseases, and the mechanisms of actions include modulating neurotransmitters, antioxidative, anti-inflammatory, suppressing microglial activation, regulating mitochondrial cascades, up-regulating neurotrophins, etc. However, more detailed clinical trials are still in need for positioning it in the treatment of neurological disorders.
- Evaluation of Clinical and Magnetic Resonance Imaging Profile of Pituitary Macroadenoma: A Prospective Study. [Journal Article]
- JNJ Nat Sci Biol Med 2018 Jan-Jun; 9(1):34-38
- CONCLUSIONS: We conclude that the knowledge of clinical and imaging profile of pituitary macroadenoma can help the radiologists to diagnose these sellar lesions, and hence their therapeutic approach can be defined timely.
- Clinical Features and Psychiatric Comorbidity of Epicrania Fugax. [Journal Article]
- JNJ Neurosci Rural Pract 2018 Jan-Mar; 9(1):143-148
- CONCLUSIONS: Our study conclusively proves the existence of EF as a rare, distinct primary headache syndrome in our study population. It has a significant psychiatric comorbidity consisting of 60% of generalized anxiety disorder, 10% of panic attacks, and 10% of depression.
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- The Evolving Pattern and Outcome of Stroke at Moderate Altitude. [Journal Article]
- JNJ Neurosci Rural Pract 2018 Jan-Mar; 9(1):68-72
- CONCLUSIONS: The occurrence of stroke decreased among hospitalized patients. Hypertension, diabetes mellitus, and coronary artery disease increased but smoking decreased among patients of stroke.