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  1. Article ; Online: Paediatric Orbital Juvenile Xanthogranuloma: A Case Series and Review of the Literature.

    Lee, Ming-Han H / Smith, Ebony J / Hardy, Thomas G / Graf, Nicole / Tumuluri, Krishna

    Ophthalmic plastic and reconstructive surgery

    2024  

    Abstract: Purpose: Juvenile xanthogranuloma (JXG) is a subtype of histiocytosis characterised histologically by foamy non-Langerhan cells with Touton giant cells. It typically manifests as a single self-limiting cutaneous nodule in the paediatric population. ... ...

    Abstract Purpose: Juvenile xanthogranuloma (JXG) is a subtype of histiocytosis characterised histologically by foamy non-Langerhan cells with Touton giant cells. It typically manifests as a single self-limiting cutaneous nodule in the paediatric population. Orbital JXG is extremely rare, and its clinical course and management are not well understood or defined. Herein we present 3 cases of orbital JXG and provide a detailed literature review.
    Methods: Review of 3 cases with orbital JXG and literature review of all published cases.
    Results: Three presented cases demonstrate the heterogeneous clinical course of orbital JXG. Although centred around the use of steroids, there is neither robust evidence nor consensus on its management. The wider JXG literature is currently concentrated around the classification of JXG with respect to histiocytosis, especially the exclusion of extracutaneous JXG as separate diseases. This separation is based on clinical, histopathological, and molecular findings. It is unclear where orbital JXG best fits in this emerging classification of JXG.
    Conclusion: Our review of the cases and literature on orbital JXG show that it may manifest with variable clinical course and its molecular pathogenic mechanism may be different to that of the cutaneous JXG.
    Language English
    Publishing date 2024-04-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632830-1
    ISSN 1537-2677 ; 0740-9303
    ISSN (online) 1537-2677
    ISSN 0740-9303
    DOI 10.1097/IOP.0000000000002696
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study.

    Ooi, Kenneth G-J / Lee, Ming-Han H / Burlutsky, George / Gopinath, Bamini / Mitchell, Paul / Watson, Stephanie

    Clinical & experimental ophthalmology

    2018  Volume 47, Issue 2, Page(s) 187–192

    Abstract: Importance: There is limited literature on oral statin use and its association with dry eye.: Background: To analyse the association between dyslipidaemia, use of oral statin drugs, and symptoms of dry eye disease (DED) among older adults.: Design!# ...

    Abstract Importance: There is limited literature on oral statin use and its association with dry eye.
    Background: To analyse the association between dyslipidaemia, use of oral statin drugs, and symptoms of dry eye disease (DED) among older adults.
    Design: Population-based study.
    Participants: Participants of the Blue Mountains Eye Study III (BMESIII), a large cohort study in suburban Sydney, aged 60 years or older (mean age = 74, range = 60-97, n = 1680) were analysed.
    Methods: Information on DED symptoms and statin use were obtained from an interviewer-administered questionnaire. Serum lipid profiles were determined from fasting blood tests.
    Main outcome measures: The association of various DED symptoms, as well as their number and their severity, with dyslipidaemia and oral statin intake was evaluated.
    Results: At least one DED symptom was reported in 52% (n = 1029) of the population. Patients with hypercholesterolaemia (>5.5 mmol/L) did not report more DED symptoms than those without hypercholesterolaemia. Neither serum high-density lipoprotein nor low-density lipoprotein levels were associated with any DED symptoms. Patients taking oral statins were more likely to report one or more moderate to severe symptoms of DED (odds ratio: 2.054, 95% confidence interval: 1.281-3.295).
    Conclusions and relevance: The association between oral statin use and presence of moderate to severe DED symptomatology is a novel finding that deserves further mechanistic and clinical correlation in order to determine its potential, or lack thereof, for the management of dry eye.
    MeSH term(s) Administration, Oral ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Dry Eye Syndromes/chemically induced ; Dry Eye Syndromes/diagnosis ; Dyslipidemias/chemically induced ; Dyslipidemias/diagnosis ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Hypercholesterolemia/drug therapy ; Lipids/blood ; Male ; Middle Aged ; New South Wales/epidemiology ; Odds Ratio ; Retrospective Studies ; Surveys and Questionnaires
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipids
    Language English
    Publishing date 2018-11-19
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2014008-3
    ISSN 1442-9071 ; 1442-6404
    ISSN (online) 1442-9071
    ISSN 1442-6404
    DOI 10.1111/ceo.13388
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Interventions for recurrent corneal erosions.

    Watson, Stephanie L / Lee, Ming-Han H / Barker, Nigel H

    The Cochrane database of systematic reviews

    2012  , Issue 9, Page(s) CD001861

    Abstract: Background: Recurrent corneal erosion is a common cause of disabling ocular symptoms and predisposes the cornea to infection. It may follow corneal trauma. Measures to prevent the development of recurrent corneal erosion following corneal trauma have ... ...

    Abstract Background: Recurrent corneal erosion is a common cause of disabling ocular symptoms and predisposes the cornea to infection. It may follow corneal trauma. Measures to prevent the development of recurrent corneal erosion following corneal trauma have not been firmly established. Once recurrent corneal erosion develops simple medical therapy (standard treatment) may lead to resolution of the episode. However, some patients continue to suffer when such therapy fails and once resolved further episodes of recurrent erosion may occur. A number of treatment and prophylactic options are then available but there is no agreement as to the best option.
    Objectives: To assess the effectiveness and safety of prophylactic and treatment regimens for recurrent corneal erosion.
    Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (January 1946 to June 2012), EMBASE (January 1980 to June 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 June 2012. We also contacted researchers in the field.
    Selection criteria: We included randomised and quasi-randomised trials that compared a prophylactic or treatment regimen with another prophylaxis/treatment or no prophylaxis/treatment for patients with recurrent corneal erosion.
    Data collection and analysis: Two authors independently extracted data and assessed trial quality. We contacted study authors for additional information.
    Main results: Seven randomised and one quasi-randomised controlled trial were included in the review. The trials were heterogenous and of poor quality. Safety data presented were incomplete. For the treatment of recurrent corneal erosion, a single-centre trial in the UK with 30 participants showed that oral tetracycline 250 mg twice daily for 12 weeks or topical prednisolone 0.5% four times daily for one week, or both, in addition to standard treatment, accelerated healing rates and improved symptoms. A single-centre trial in Sweden with 56 participants showed that excimer laser ablation in addition to mechanical debridement may reduce the number of erosions and improve symptoms. Furthermore, in a single-centre trial in Germany with 100 participants, transepithelial technique for excimer laser ablation had the same efficacy as the traditional subepithelial excimer laser technique but caused less pain. In a small study of 24 participants in UK, therapeutic contact lens wear was inferior to lubricant drops and ointment in abolishing the symptoms of recurrent corneal erosion and had a high complication rate, although the contact lenses used were the older generation with low oxygen permeability. A recent study in Hong Kong with 48 participants found diamond burr polishing to reduce episodes of recurrent corneal erosion. For prophylaxis of further episodes of recurrent corneal erosion, there was no difference in the occurrence of objective signs of recurrent erosion between hypertonic saline ointment versus tetracycline ointment or lubricating ointment in a small Japanese study with 26 participants. Also, in a single-centre study in the UK with 117 participants, there was no difference in symptom improvement between hypertonic saline versus paraffin ointment when used for prophylaxis. In a UK study with 42 participants, lubricating ointment at night in addition to standard treatment to prevent recurrence following traumatic corneal abrasion (erosion) caused by fingernail injury led to increased symptoms of recurrent corneal erosion compared to standard therapy alone.
    Authors' conclusions: Well-designed, masked, randomised controlled trials using standardised methods are needed to establish the benefits of new and existing prophylactic and treatment regimes for recurrent corneal erosion. International consensus is also needed to progress research efforts towards evaluation of the major effective treatments for recurrent corneal erosions.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Contact Lenses ; Corneal Diseases/prevention & control ; Corneal Diseases/therapy ; Corneal Injuries ; Debridement/methods ; Eye Infections/etiology ; Eye Infections/prevention & control ; Glucocorticoids/therapeutic use ; Humans ; Prednisolone/therapeutic use ; Randomized Controlled Trials as Topic ; Secondary Prevention ; Tetracycline/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; Glucocorticoids ; Prednisolone (9PHQ9Y1OLM) ; Tetracycline (F8VB5M810T)
    Language English
    Publishing date 2012-09-12
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ISSN 1469-493X
    ISSN (online) 1469-493X
    DOI 10.1002/14651858.CD001861.pub3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: A benefit-risk assessment of benzbromarone in the treatment of gout. Was its withdrawal from the market in the best interest of patients?

    Lee, Ming-Han H / Graham, Garry G / Williams, Kenneth M / Day, Richard O

    Drug safety

    2008  Volume 31, Issue 8, Page(s) 643–665

    Abstract: Benzbromarone, a potent uricosuric drug, was introduced in the 1970s and was viewed as having few associated serious adverse reactions. It was registered in about 20 countries throughout Asia, South America and Europe. In 2003, the drug was withdrawn by ... ...

    Abstract Benzbromarone, a potent uricosuric drug, was introduced in the 1970s and was viewed as having few associated serious adverse reactions. It was registered in about 20 countries throughout Asia, South America and Europe. In 2003, the drug was withdrawn by Sanofi-Synthélabo, after reports of serious hepatotoxicity, although it is still marketed in several countries by other drug companies. The withdrawal has greatly limited its availability around the world, and increased difficulty in accessing it in other countries where it has never been available.The overall aim of this paper is to determine if the withdrawal of benzbromarone was in the best interests of gouty patients and to present a benefit-risk assessment of benzbromarone. To determine this, we examined (i) the clinical benefits associated with benzbromarone treatment and compared them with the success of alternative therapies such as allopurinol and probenecid, particularly in patients with renal impairment; (ii) the attribution of the reported cases of hepatotoxicity to treatment with benzbromarone; (iii) the incidence of hepatotoxicity possibly due to benzbromarone; (iv) adverse reactions to allopurinol and probenecid. From these analyses, we present recommendations on the use of benzbromarone.Large reductions in plasma urate concentrations in patients with hyperuricaemia are achieved with benzbromarone and most patients normalize their plasma urate. The half-life of benzbromarone is generally short (about 3 hours); however, a uricosuric metabolite, 6-hydroxybenzbromarone, has a much longer half-life (up to 30 hours) and is the major species responsible for the uricosuric activity of benzbromarone, although its metabolism by cytochrome P450 (CYP) 2C9 in the liver may vary between patients as a result of polymorphisms in this enzyme. It is effective in patients with moderate renal impairment. Standard dosages of benzbromarone (100 mg/day) tend to produce greater hypouricaemic effects than standard doses of allopourinol (300 mg/day) or probenecid (1000 mg/day).Adverse effects associated with benzbromarone are relatively infrequent, but potentially severe. Four cases of benzbromarone-induced hepatotoxicity were identified from the literature. Eleven cases have been reported by Sanofi-Synthélabo, but details are not available in the public domain. Only one of the four published cases demonstrated a clear relationship between the drug and liver injury as demonstrated by rechallenge. The other three cases lacked incontrovertible evidence to support a diagnosis of benzbromarone-induced hepatotoxicity. If all the reported cases are assumed to be due to benzbromarone, the estimated risk of hepatotoxicity in Europe was approximately 1 in 17 000 patients but may be higher in Japan.Benzbromarone is also an inhibitor of CYP2C9 and so may be involved in drug interactions with drugs dependent on this enzyme for clearance, such as warfarin. Alternative drugs to benzbromarone have significant adverse reactions. Allopurinol is associated with rare life-threatening hypersensitivity syndromes; the risk of these reactions is approximately 1 in 56 000. Rash occurs in approximately 2% of patients taking allopurinol and usually leads to cessation of prescription of the drug. Probenecid has also been associated with life-threatening reactions in a very small number of case reports, but it frequently interacts with many renally excreted drugs. Febuxostat is a new xanthine oxidoreductase inhibitor, which is still in clinical trials, but abnormal liver function is the most commonly reported adverse reaction.Even assuming a causal relationship between benzbromarone and hepatotoxicity in the identified cases, benefit-risk assessment based on total exposure to the drug does not support the decision by the drug company to withdraw benzbromarone from the market given the paucity of alternative options. It is likely that the risks of hepatotoxicity could be ameliorated by employing a graded dosage increase, together with regular monitoring of liver function. Determination of CYP2C9 status and consideration of potential interactions through inhibition of this enzyme should be considered. The case for wider and easier availability of benzbromarone for treating selected cases of gout is compelling, particularly for patients in whom allopurinol produces insufficient response or toxicity.We conclude that the withdrawal of benzbromarone was not in the best interest of patients with gout.
    MeSH term(s) Animals ; Benzbromarone/adverse effects ; Benzbromarone/pharmacokinetics ; Benzbromarone/therapeutic use ; Chemical and Drug Induced Liver Injury ; Clinical Trials as Topic ; Drug Approval ; Gout/drug therapy ; Gout/epidemiology ; Humans ; Risk Factors ; Uricosuric Agents/adverse effects ; Uricosuric Agents/pharmacokinetics ; Uricosuric Agents/therapeutic use
    Chemical Substances Uricosuric Agents ; Benzbromarone (4POG0RL69O)
    Language English
    Publishing date 2008-07-18
    Publishing country New Zealand
    Document type Comparative Study ; Journal Article ; Review
    ZDB-ID 1018059-x
    ISSN 1179-1942 ; 0114-5916
    ISSN (online) 1179-1942
    ISSN 0114-5916
    DOI 10.2165/00002018-200831080-00002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2127: Show issues Location:
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  5. Article ; Online: Insights into the poor prognosis of allopurinol-induced severe cutaneous adverse reactions: the impact of renal insufficiency, high plasma levels of oxypurinol and granulysin.

    Chung, Wen-Hung / Chang, Wan-Chun / Stocker, Sophie L / Juo, Chiun-Gung / Graham, Garry G / Lee, Ming-Han H / Williams, Kenneth M / Tian, Ya-Chung / Juan, Kuo-Chang / Jan Wu, Yeong-Jian / Yang, Chih-Hsun / Chang, Chee-Jen / Lin, Yu-Jr / Day, Richard O / Hung, Shuen-Iu

    Annals of the rheumatic diseases

    2015  Volume 74, Issue 12, Page(s) 2157–2164

    Abstract: Objective: Allopurinol, an antihyperuricaemic agent, is one of the common causes of life-threatening severe cutaneous adverse reactions (SCAR), including drug rash with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and toxic ...

    Abstract Objective: Allopurinol, an antihyperuricaemic agent, is one of the common causes of life-threatening severe cutaneous adverse reactions (SCAR), including drug rash with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN). The prognostic factors for allopurinol-related SCAR remain unclear. This study aimed to investigate the relationship of dosing, renal function, plasma levels of oxypurinol and granulysin (a cytotoxic protein of SJS/TEN), the disease severity and mortality in allopurinol-SCAR.
    Methods: We prospectively enrolled 48 patients with allopurinol-SCAR (26 SJS/TEN and 22 DRESS) and 138 allopurinol-tolerant controls from 2007 to 2012. The human leucocyte antigen (HLA)-B*58:01 status, plasma concentrations of oxypurinol and granulysin were determined.
    Results: In this cohort, HLA-B*58:01 was strongly associated with allopurinol-SCAR (p<0.001, OR (95% CI) 109 (25 to 481)); however, the initial/maintenance dosages showed no relationship with the disease. Poor renal function was significantly associated with the delayed clearance of plasma oxypurinol, and increased the risk of allopurinol-SCAR (p<0.001, OR (95% CI) 8.0 (3.9 to 17)). Sustained high levels of oxypurinol after allopurinol withdrawal correlated with the poor prognosis of allopurinol-SCAR. In particular, the increased plasma levels of oxypurinol and granulysin linked to the high mortality of allopurinol-SJS/TEN (p<0.01), and strongly associated with prolonged cutaneous reactions in allopurinol-DRESS (p<0.05).
    Conclusions: Impaired renal function and increased plasma levels of oxypurinol and granulysin correlated with the poor prognosis of allopurinol-SCAR. Allopurinol prescription is suggested to be avoided in subjects with renal insufficiency and HLA-B*58:01 carriers. An early intervention to increase the clearance of plasma oxypurinol may improve the prognosis of allopurinol-SCAR.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allopurinol/adverse effects ; Antigens, Differentiation, T-Lymphocyte/blood ; Drug Eruptions/blood ; Drug Eruptions/etiology ; Drug Eruptions/mortality ; Female ; Follow-Up Studies ; HLA-B Antigens/immunology ; Humans ; Male ; Middle Aged ; Oxypurinol/blood ; Prognosis ; Prospective Studies ; Renal Insufficiency/blood ; Renal Insufficiency/etiology ; Renal Insufficiency/mortality ; Survival Rate/trends ; Taiwan/epidemiology ; Young Adult
    Chemical Substances Antigens, Differentiation, T-Lymphocyte ; GNLY protein, human ; HLA-B Antigens ; Allopurinol (63CZ7GJN5I) ; Oxypurinol (G97OZE5068)
    Language English
    Publishing date 2015-12
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/annrheumdis-2014-205577
    Database MEDical Literature Analysis and Retrieval System OnLINE

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