1,277 results on '"DEXAMETHASONE"'
Search Results
2. Implantierbare intravitreale Kortikosteroide bei chronischer nichtinfektiöser Uveitis
- Author
-
Kessler, L. J., Albrecht, M., Naujokaitis, T., Auffarth, G., and Khoramnia, Ramin
- Published
- 2024
- Full Text
- View/download PDF
3. Flammenfiguren – Eosinophile, die die Haut in Brand setzen.
- Author
-
Stahl, Lea-Sophie, Wolters, Ann-Christin, Kautz, Ocko, Patsinakidis, Nikolaos, and Raap, Ulrike
- Abstract
Copyright of Die Dermatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
- View/download PDF
4. Venöse retinale Gefäßverschlüsse: Intravitreale Therapien und Strategien zur Behandlung des Makulaödems.
- Author
-
Hattenbach, Lars-Olof, Chronopoulos, Argyrios, and Feltgen, Nicolas
- Abstract
Copyright of Die Ophthalmologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
- Full Text
- View/download PDF
5. COVID-19-Pneumonie.
- Author
-
Pfeifer, M. and Hamer, O. W.
- Abstract
Copyright of Der Internist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2020
- Full Text
- View/download PDF
6. Update Laparoskopie: postoperative Analgesie und Prävention von Nausea und Vomitus.
- Author
-
Simon, Annika
- Abstract
Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
- Full Text
- View/download PDF
7. Steroidimplantat bei sympathischer Ophthalmie: Intravitreales Dexamethason-Implantat bei zystoidem Makulaödem im Rahmen einer sympathischen Ophthalmie.
- Author
-
Wocker, L. and Januschowski, K.
- Abstract
Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
- Full Text
- View/download PDF
8. [Tolerance and acceptance of intratympanic injections]
- Author
-
Guido, Mühlmeier and Matthias, Tisch
- Subjects
Male ,Injection, Intratympanic ,Treatment Outcome ,Hearing Loss, Sensorineural ,Audiometry, Pure-Tone ,Humans ,Female ,Hearing Loss, Sudden ,Glucocorticoids ,Dexamethasone - Abstract
Intratympanic steroids are a therapeutic component in sudden hearing loss related to cochlear affection. Little has been published on patients' acceptance and tolerance to date.A total of 84 patients were asked about health conditions and circumstances surrounding their intratympanic therapy.The patients comprised 38 women and 46 men, aged 57.2 years on average, who had mostly been referred by their ENT physician for second-line treatment. Reported were injection pain by 3.6%, discomfort by 22.6%, tolerability by 67.9%, and painlessness by 41.7% (more than one answer possible). Whereas 77.4% recommended intratympanic treatment, reasons for no recommendation were lack of efficacy and an unpleasant sensation.The majority of patients rated intratympanic therapy as bearable and recommendable. Close patient guidance seems to be an important part of the treatment.HINTERGRUND: Die intratympanale Gabe von Steroiden ist Bestandteil der Therapie von akuten Hörverlusten. Bislang existieren nur wenig Daten zur Akzeptanz und Toleranz aus Sicht der Patient*innen.Zu den gesundheitlichen Voraussetzungen und den Umstäden ihrer intratympanalen Therapie wurden 84 Patient*innen befragt.Es stellten sich 38 Frauen und 46 Männer im Alter von durchschnittlich 57,2 Jahren meist auf Empfehlung ihres HNO-Arztes zur Zweitlinientherapie vor und empfanden die Injektionen zu 3,6 % als schmerzhaft, 22,6 % unangenehm, 67,9 % erträglich und zu 41,7 % als schmerzfrei (Mehrfachnennungen möglich). Eine Weiterempfehlung gaben 77,4 %, eine fehlende Empfehlung resultierte aus mangelnder Wirkung und unangenehmer Empfindung.Der weit überwiegende Anteil der Behandelten beurteilt die intratympanale Therapie als erträglich und gibt eine Weiterempfehlung. Die enge Patientenführung ist ein entscheidender Therapiebaustein.
- Published
- 2022
9. Neurotoxizität unter CAR-T-Zell-Therapie (CAR: chimärer Antigenrezeptor): Was Neurologen wissen sollten
- Author
-
Möhn, N., Könecke, C., and Skripuletz, T.
- Published
- 2020
- Full Text
- View/download PDF
10. [Role of Dexamethasone for Pain Management in Intervertebral Disc Surgery]
- Author
-
Nikolaus, Schreiber, David, Gebauer, Gregor, Schittek, and Andreas, Sandner-Kiesling
- Subjects
Lumbar Vertebrae ,Humans ,Pain Management ,Intervertebral Disc ,Dexamethasone ,Intervertebral Disc Displacement - Abstract
Intervertebral disc operations are already among the most common and their frequency is increasing. The pain associated with these operations is one of the most common postoperative discomforts, has a significant impact on psychosocial aspects, and should therefore be treated effectively. Therefore, we present the importance of dexamethasone for multimodal pain management after intervertebral disc surgery.Bandscheibenoperationen gehören in Deutschland zu den häufigen Operationen und eine effektive perioperative Schmerztherapie ist entscheidend für die rasche Genesung der Patient*innen. In diesem Beitrag präsentieren wir die aktuelle Studienlage zum Einfluss einer perioperativen Dexamethason-Gabe auf den postoperativen Opioidbedarf sowie das Schmerzempfinden nach Bandscheibenoperationen.
- Published
- 2022
11. [Autonomous cortisol secretion : Laboratory artifact or disease?]
- Author
-
Anna, Riester and Felix, Beuschlein
- Subjects
Hydrocortisone ,Adrenal Gland Neoplasms ,Humans ,Artifacts ,Laboratories ,Dexamethasone - Abstract
Autonomous cortisol secretion was mentioned for the first time in 2016 in the European Guideline on the management of adrenal incidentalomas.Review of the state of knowledge on diagnosis, epidemiology, co-morbidities, mortality and treatment of autonomous cortisol secretion in comparison to non-hormone producing adenomas. Recommendation for clinical practice based on the current European guideline.Analysis of relevant clinical studies, discussion of basic literature and expert opinions.Autonomous cortisol secretion is a term used to describe abnormal cortisol secretion diagnosed by a pathological 1‑mg dexamethasone suppression test in patients with adrenal incidentaloma, but without clinical manifestation of overt Cushing's syndrome. It is associated with increased mortality and morbidity, especially hypertension, diabetes mellitus type II, dyslipidemia and obesity. Adrenalectomy, as the only specific therapy option, should be considered in an interdisciplinary tumour board.HINTERGRUND: Im Jahr 2016 wurde erstmals die autonome Kortisolsekretion bei Inzidentalomen der Nebenniere in der entsprechenden europäischen Leitlinie als eigenständiges Krankheitsbild erwähnt.Zusammenfassung des aktuellen Wissensstands bezüglich Diagnostik, Epidemiologie, Komorbiditäten, Mortalität sowie Therapie der autonomen Kortisolsekretion, insbesondere in Abgrenzung zum nicht hormonproduzierenden Nebennierenadenom. Empfehlungen für die Praxis anhand der gültigen europäischen Leitlinie.Analyse relevanter Studien, Diskussion von Grundlagenarbeiten und Expertenempfehlungen.Eine autonome Kortisolsekretion wird diagnostiziert, wenn durch einen Zufallsbefund ein gutartiges Adenom der Nebenniere (Inzidentalom) mit einem pathologischen niedrig dosierten Dexamethasonhemmtest entdeckt wird, der Patient jedoch keine klinischen Cushing-Zeichen aufweist. Die Erkrankung geht einher mit einer erhöhten Mortalität und Morbidität, insbesondere mit arterieller Hypertonie, Diabetes mellitus Typ 2, Dyslipidämie und Adipositas. Eine Adrenalektomie als einzige spezifische Therapieoption sollte interdisziplinär evaluiert werden.
- Published
- 2021
12. [COVID 19 - Hospital Admission in the First and Second Wave in Germany].
- Author
-
Lehmann M, Peeters S, Streuter M, Nawrocki M, Kösters K, and Kröger K
- Subjects
- Humans, Hospital Mortality, Anticoagulants therapeutic use, Dexamethasone, Hospitals, Retrospective Studies, COVID-19, Thromboembolism drug therapy
- Abstract
Purpose: We analyzed patients' characteristics and hospital admission in Germany's first and second COVID 19 wave., Methods: We include all patients hospitalized with the proven diagnosis COVID 19 admitted to the HELIOS Hospital Krefeld, Germany, in the first wave (n = 84; from 11.03.2020-30.06.2020) and the second wave (n = 344; from 01.07.2020-31.01.2021)., Results: Patients' age, gender and comorbidities were similar with the exception of venous thrombosis in medical history which was more frequent in the first wave (6 % vs 0.3 %, p = p = 0,001). At admission, there were no differences in the results of the initial lab values (c-reactive protein, leucocytes) and blood gas analyses between both groups. Treatment differed in the application of dexamethasone and anticoagulation. In the first wave, nobody received dexamethasone. However, this changed to 52.6 % of patients in the second wave for a mean length of 3.6 ± 4.1 days. Anticoagulation with double standard prophylaxis (2 × 40 mg low molecular heparin, subcutaneous) was applied in 7.1 % of patients in the first wave but 30.2 % (p = 0.002) in the second wave. In the first wave more thromboembolic events were diagnosed after admission (19.0 % vs 7.0 %, p = 0.001). In-hospital death was 26.2 % in the first wave and 15.4 % in the second wave (p = 0.0234). Most deaths were attributed to acute respiratory distress syndrome (ARDS)., Conclusion: Patients' characteristics did not vary in Germany's first and second COVID 19 wave, but anticoagulation and dexamethasone were applied more frequently in the second wave. In addition, there were fewer thromboembolic complications in the second wave., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
- Published
- 2023
- Full Text
- View/download PDF
13. PONV nach Strabismus-OP : Risikoadaptierte Prophylaxe?
- Author
-
Wolf, R., Morinello, E., Kestler, G., Käsmann-Kellner, B., Bischoff, M., Hager, T., Schöpe, J., Eberhart, L., Käsmann-Kellner, B, Schöpe, J, and Eberhart, L H J
- Subjects
- *
ANTIEMETICS , *ONDANSETRON , *DEXAMETHASONE , *ANESTHESIA , *OPHTHALMIC surgery , *INTRAVENOUS anesthesia , *INTRAVENOUS anesthetics , *RISK assessment , *DISEASE incidence , *PROPOFOL , *THERAPEUTICS ,STRABISMUS surgery - Abstract
Background: Following strabismus surgery, patients frequently develop variable degrees of postoperative nausea and vomiting (PONV). These symptoms cause discomfort and result in serious complications such as intramuscular bleeding and subconjunctival hemorrhage. In children long lasting PONV can lead to and electrolyte imbalance and dehydration. A prolonged course of recovery is the consequence. For the hospital, PONV can also involve negative economic impacts because of a damaged public reputation of the institution. There is still an ongoing debate on wether prophylaxis of PONV is necessary and how the prophylaxis of PONV should be performed. On one hand, there are proponents of a liberal prophylaxis. These intend to treat almost all patients regardless of their individual risk for PONV. On the other hand, opponents point out that every medication has to be indicated individually. In their view, risk scores should be the base of a risk-adapted approach.Objectives: The aim of the study was to reduce the frequency of PONV by using an anesthetic technique adapted to the individual risk for PONV. Until now, all trials studying the efficiency of a score-based antiemetic prophylaxis were performed on adult patients. In this study, a risk-adapted approach was evaluated on children for the first time.Patients and Methods: In 92 patients, the incidence of PONV was analyzed after strabismus surgery. Before surgery we evaluated the risk factors for PONV according to the POVOC score in children (n = 45, 49 %) and the Apfel's score in adults (n = 47, 51 %). Patients with 0-2 risk factors received a balanced anesthesia (n = 47, 51 %). Those with 3-4 risk factors were operated in total IV anesthesia (TIVA) with propofol (n = 45, 49 %). In addition, as an antiemetic prophylaxis, 0.15 mg/kg dexamethason and 0.1 mg/kg ondansetron were applied in the latter patients. we documented the symptoms and severity of PONV 2, 6 and 24 h after surgery by means of a standardized questionnaire for PONV (Wengritzky-Score).Results: The incidence of PONV was 17 % (n = 16) in all of the patients. The incidence in low-risk patients receiving a BA without prophylaxis were 21 % in adults and 38 % in children. Of the patients at high risk for PONV receiving the multimodal antiemetic approach 8 % (adults) and 9 % (children) suffered from PONV. The combination of TIVA and antiemetics could reduce the incidence of PONV compared to the predicted values in a clinically relevant manner (OR = 0.26, KI: 0.76-0.87).Conclusion: The overall incidence could be reduced to a level below 20 %. Particularly in patients with a high risk of PONV, TIVA could clearly reduce the incidence. However, the incidence in patients with 2 risk factors is still high (30-39 %). Therefore, it is important to reconsider the effort involved with risk screening and individually adapting anesthesia. Risk stratification means a pre- and perioperative effort. Therefore, we advocate a more liberal approach for PONV prophylaxis. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
14. Glucocorticoide als Adjuvanz in der peripheren Regionalanästhesie : Unterwegs zum "Heiligen Gral der perineuralen Analgesie"?!
- Author
-
Wiesmann, T., Volk, T., and Steinfeldt, T.
- Subjects
- *
ANALGESIA , *ANESTHESIA adjuvants , *CONDUCTION anesthesia , *GLUCOCORTICOIDS , *NERVE block , *DEXAMETHASONE - Abstract
Background: The role of dexamethasone as an adjunct in peripheral nerve blockades is still unclear.Objectives: This article reviews the actual knowledge and scientific evidence for dexamethasone as an adjunct in peripheral regional anesthesia. Moreover, it discusses the benefits of the systemic versus the perineural mode of application.Results: Dexamethasone prolongs sensible as well as motor blockades in peripheral nerve blocks when applied intravenously or perineurally. Regarding potentially local neurotoxicity, published patient data are not sufficient for final conclusions.Conclusions: After reviewing the actual literature, the authors prefer a systemic application mode (intravenously) over a perineural route of administration of dexamethasone as an adjunct for peripheral nerve blocks. This is due to the better understanding of potential side effects of the drug when applied intravenously. Dexamethasone might be a useful drug adjunct to prolong peripheral single shot nerve blocks. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
15. [Flame figures-eosinophils setting the skin on fire].
- Author
-
Stahl LS, Wolters AC, Kautz O, Patsinakidis N, and Raap U
- Subjects
- Female, Humans, Middle Aged, Cellulitis, Pruritus drug therapy, Eosinophils, Skin
- Abstract
A 50-year-old female farmer was initially diagnosed with generalized granuloma annulare and treated with local steroids and ultraviolet (UV) light therapy for 10 years, albeit without success. A histopathological examination in our clinic changed the diagnosis to Wells' syndrome, based on the typical findings of eosinophilic cellulitis together with flame figures. A systemic approach with pulse steroid therapy resulted in complete remission of pruritus and skin manifestations. This case demonstrates successful treatment of a patient with eosinophilic cellulitis., (© 2023. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
16. [Retinal vein occlusion : Intravitreal pharmacotherapies and treatment strategies for the management of macular edema].
- Author
-
Hattenbach LO, Chronopoulos A, and Feltgen N
- Subjects
- Humans, Vascular Endothelial Growth Factor A therapeutic use, Bevacizumab therapeutic use, Intravitreal Injections, Retinal Vein Occlusion complications, Macular Edema drug therapy
- Abstract
Intravitreal injection treatment for the management of macular edema as an expression of increased capillary permeability and leakage constitute the mainstay of treatment in retinal vein occlusion. In contrast to diabetic retinopathy or neovascular age-related macular degeneration, permanent and complete functional and morphological restoration can be achieved, as retinal vein occlusions are usually associated with risk factors, but do not represent the manifestation form of an underlying systemic or degenerative chronic disorder; however, successful long-term management of retinal vein occlusion -associated macular edema usually requires intensive and also long-term continued treatment with vascular endothelial growth factor (VEGF) inhibitors or with a less favorable side effect profile, dexamethasone. A functional treatment success can be maintained over the long term by both pro re nata (PRN) or treat and extend (T&E) regimens. In contrast, according to the currently available data, the combination of anti-VEGF administration and grid laser treatment has no additional benefit compared to monotherapy. In patients with recalcitrant macular edema, switching to another intravitreal agent may be considered during the course of treatment, although a true therapeutic benefit with respect to the development of visual acuity has not yet been proven. The current review summarizes the relevant aspects in the management of RVO-associated macular edema and provides the foundations for the application of successful treatment strategies., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2022
- Full Text
- View/download PDF
17. Serotonintransportergen und Stressreagibilität bei unipolarer Depression.
- Author
-
Welper, H., Aller, A., Guttenthaler, V., Höfels, S., Lennertz, L., Pfeiffer, U., Schwab, S. G., and Zobel, A.
- Subjects
- *
SEROTONIN transporters , *HYPOTHALAMIC-pituitary-adrenal axis , *DEPRESSED persons , *DEXAMETHASONE , *CORTICOTROPIN releasing hormone - Abstract
Background: A length polymorphism in the promoter region of the serotonin transporter gene ( 5-HTTLPR) is associated with both depression and hypothalamic-pituitary-adrenal (HPA) system activity. A dysregulation of the HPA system is considered to be a candidate endophenotype of depression. The objective of the present study was an investigation of a possible gene-endophenotype-interaction between 5-HTTLPR and HPA system activity in a sample of inpatients with major depression. Materials and methods: A total of 237 inpatients with major depression were genotyped for 5-HTTLPR and participated in a combined dexamethasone-corticotropin-releasing hormone test (Dex-CRH test) as well as using the Hamilton score (Hamilton rating scale for depression) to determine the severity of the psychopathology. Results: Patients with the ss-genotype showed a significantly higher HPA -system activity in comparison to patients with the lI-genotype, but no association between 5-HTTLPR and the severity of psychopathology could be detected. Conclusions: The results of the current study demonstrate an influence of 5-HTTLPR on dysregulation of the HPA system in patients with major depression and support the hypothesis that 5-HTTLPR- and HPA-system-interaction constitutes an important component in the pathogenesis of depression. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
18. [Clinical Decision Making for Treatment of Diabetic Macular Oedema with DEX Implant: a Consensus Paper]
- Author
-
Albert J, Augustin, Nicolas, Feltgen, Christos, Haritoglou, Hans, Hoerauf, Mathias M, Maier, Christian Yahya, Mardin, and Marc, Schargus
- Subjects
Drug Implants ,Vascular Endothelial Growth Factor A ,Consensus ,Diabetic Retinopathy ,Germany ,Clinical Decision-Making ,Intravitreal Injections ,Diabetes Mellitus ,Humans ,Angiogenesis Inhibitors ,Glucocorticoids ,Dexamethasone ,Macular Edema - Abstract
Currently two intravitreally applied corticosteroids (dexamethasone and fluocinolone) are licensed in Germany for treatment of diabetic macular oedema (DME). The use of DEX implant for DME in daily clinical practice has not been defined in detail. Following a Delphi panel survey, a group of retina experts set out to come up with a consensus for use of the DEX implant in DME.International and national treatment recommendations were identified from the literature. A steering group generated a catalogue of 72 statements on the aetiology and pathogenesis of DME, therapy with DEX implant, use of DEX implant in patients previously treated with VEGF-inhibitors, use of DEX implant in combination therapy, safety of DME therapies as well as patients' burden of treatment. Twenty-two ophthalmologists from private practice and 6 hospital ophthalmologists participated in the Delphi panel via Survey Monkey. Consensus was reached if at least 75% of participants agreed or disagreed with a statement. Statements for which consensus was not reached were discussed once more during the expert consensus meeting and a vote was taken. Based on these results a treatment algorithm for foveal DME was proposed.If a patient does not show sufficient response after 3 - 6 months of anti-VEGF treatment (visual acuity gain of 5 ETDRS letters or reduction of central retinal thickness ≤ 20%), a switch to DEX implant should take place. DEX implant is also suitable in eyes with longer presentation of DME, showing e.g. massive lipid exudates. DEX implant is suitable as first-line therapy especially in pseudophakic patients, patients unwilling or able to comply with tight anti-VEGF injection intervals or patients with known vascular diseases. With fixed control visits every 4 - 8 weeks, use of DEX implant is flexible and individual. Decision parameters for repeated use should be visual acuity, retinal thickness and intraocular pressure. Treatment of both eyes on the same day should not take place.The algorithm presented reflects survey as well as expert discussion results and may differ from recommendations issued by the German professional society. The consensus recommendations for the treatment of DME generated during the survey and meeting of retina experts are intended to guide use of DEX implant in daily practice.In Deutschland sind 2 intravitreal anzuwendende Kortikosteroide (Dexamethason und Fluocinolon) für die Behandlung des diabetischen Makulaödems (DMÖ) zugelassen. Der Einsatz von DEX-Implantat bei DMÖ ist in der täglichen Praxis bisher nicht im Detail definiert. Mithilfe eines Delphi-Panels und einer Runde von Retinaspezialisten sollte ein Konsens für die Anwendung von DEX-Implantat erarbeitet werden.Aus der Literatur wurden internationale und nationale Behandlungsempfehlungen identifiziert. Eine Steuerungsgruppe erarbeitete einen Katalog von 72 Aussagen zur Ätiologie und Pathogenese des DMÖ, Therapie mit dem DEX-Implantat, Einsatz bei mit VEGF-Hemmern vorbehandelten Patienten, Verwendung von DEX-Implantat in der Kombination mit anderen Therapien, Sicherheit von DMÖ-Therapien sowie Therapiebelastung des Patienten. 22 niedergelassene Ophthalmologen und 6 Ophthalmologen aus der Klinik gaben über Survey Monkey ihre Bewertung zu den Aussagen ab. Die Definition des Konsenses zu einer Aussage galt als erfüllt, wenn mehr als 75% der Befragten einer Aussage zustimmten bzw. nicht zustimmten. Über nicht konsensfähige Aussagen wurde nach erneuter Diskussion in der Konsensrunde nochmals abgestimmt. In der Folge sollte auch ein Behandlungsschema für DMÖ mit fovealer Beteiligung vorgeschlagen werden.Sofern ein Patient unter VEGF-Hemmern unzureichend anspricht (Visusgewinn 5 ETDRS-Buchstaben oder Reduktion der zentralen Netzhautdicke ≤ 20%), sollte nach 3 – 6 Monaten auf das DEX-Implantat umgestellt werden. DEX-Implantat ist ebenfalls geeignet für Augen mit länger bestehendem DMÖ, bei denen z. B. massive Lipidexsudate vorhanden sind. DEX-Implantat eignet sich als Ersttherapie insbesondere bei Pseudophaken, Patienten, die nicht willens oder in der Lage sind, enge Injektionsintervalle unter Anti-VEGF-Therapie einzuhalten oder für Patienten mit vaskulären Vorerkrankungen. Bei festgelegten Kontrollintervallen von 4 – 8 Wochen kann die Anwendung des DEX-Implantats flexibel und individuell erfolgen. Als Entscheidungsparameter gelten hierbei neben Visus und Netzhautdicke auch der Augeninnendruck. Eine Behandlung von beiden Augen am selben Tag sollte nicht stattfinden.Der hier vorgestellte Algorithmus entspricht den Ergebnissen des Delphi-Prozesses und weicht u. U. von den Empfehlungen der Fachgesellschaft ab. Die im Rahmen der Befragung und Expertenrunde erarbeiteten Konsensempfehlungen für die Therapie von DMÖ können für den Einsatz des DEX-Implantats in der täglichen Praxis dienen.
- Published
- 2019
19. Efficacy of dose-reduced lenalidomide in patients with refractory or recurrent multiple myeloma
- Author
-
Schmidt-Wolf, Ingo G. H., Glasmacher, Axel, Gorschlüter, Marcus, Schwamborn, Katharina, and German Refractory Myeloma Study Group
- Subjects
myeloma ,lenalidomide ,dexamethasone ,lymphoma ,treatment ,Medicine - Abstract
Purpose: Introduction of lenalidomide has expanded the therapeutic options for refractory and recurrent multiple myeloma (MM) patients. However, the application of the approved doses may be difficult in some patients due to adverse effects. Experimental design: Therefore, we evaluated the efficacy and safety of lenalidomide in 10 patients with relapsed and refractory MM who received a reduced dose due to leukopenia (4), polyneuropathy (1), muscle cramps (1), thrombocytopenia (1), renal insufficiency (1), at the request of patient (1), as continuous therapy (1), either from the beginning (2) or during treatment (8). They received lenalidomide at a mean (median) daily dose of 14 (15) mg/d once a day (days 1–21 every 28 days) in combination with dexamethasone at a mean (median) dose of 17.6 (28) mg per day (4–40 mg) on days 1–4, 9–12 and 17–20. Results: Mean (median) duration of treatment with lenalidomide was 15.1 (15) months. Partial response or better was reported in seven and minimal response or better was reported in eight patients. Mean (median) values for time-to-progression (TTP) and for progression-free survival (PFS) were 8.7 (4) months. Mean overall survival (OS) has not been reached, all patients are still alive. Conclusion: In conclusion, dose-reduced lenalidomide is an effective and well tolerated treatment for patients with recurrent or refractory MM who cannot tolerate full doses.
- Published
- 2011
20. Database study of lenalidomide (Revlimid®) in Germany: monitoring off-label use.
- Author
-
Dörks, Michael, Langner, Ingo, Behr, Sigrid, Timmer, Antje, and Garbe, Edeltraut
- Subjects
- *
DATABASE evaluation , *OFF-label use (Drugs) , *COMBINATION drug therapy , *ETHICS , *MULTIPLE myeloma , *HEALTH outcome assessment , *RESEARCH funding , *THALIDOMIDE , *TREATMENT effectiveness , *RETROSPECTIVE studies , *DEXAMETHASONE , *THERAPEUTICS - Abstract
Background: Lenalidomide, a derivate of thalidomide, in combination with dexamethasone is indicated for the treatment of multiple myeloma in patients who have received at least one prior therapy. In the USA, lenalidomide is also licensed for the treatment of a certain form of myelodysplastic syndromes (MDS). Monitoring of off-label use in Germany is part of the risk management plan mandated by the regulatory authority. Material and methods: Our retrospective epidemiological study was based on claims data of the year 2007 from four statutory health insurances with more than 14 million enrollees. Annual incidence was calculated by dividing the total number of new lenalidomide users by the sum of person-years of the at-risk population. Potential off-label use was identified by an algorithm searching for a diagnosis of multiple myeloma in the quarter of the lenalidomide prescription and the four preceding quarters. Results: In 2007, 235 lenalidomide users were identified. Incidence of lenalidomide use was 4.0 per 100,000 person years (95% CI: 3.5-4.5). In 40 (17.0%) users of lenalidomide, no diagnosis of multiple myeloma was found. Of the 40 off-label users, 29 (72.5%) had a diagnosis of MDS. Conclusion: Off-label use of lenalidomide in Germany was low and mainly related to MDS. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
21. Intratympanale Dexamethasongabe.
- Author
-
Burkart, C., Linder, T., and Gärtner, M.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
- Full Text
- View/download PDF
22. 'Low-dose'-Droperidol-Gabe bei Kindern.
- Author
-
Schroeter, E., Schmitz, A., Haas, T., Weiss, M., and Gerber, A.C.
- Subjects
- *
DRUG dosage , *DROPERIDOL (Drug) , *ANTIEMETICS , *ARRHYTHMIA in children , *LONGEVITY , *DEXAMETHASONE , *HEALTH risk assessment - Abstract
Background: Droperidol had been used as an effective antiemetic since the 1970s but was withdrawn from the market in 2001 because of a black box warning about QT prolongation and possible cardiac arrhythmia after high doses. In the meantime the black box warning has seriously been questioned and parenteral droperidol has again been licensed in 2008. Because droperidol acts on dopaminergic receptors different to 5-HT antagonists and dexamethasone, it could possibly serve as a rescue drug after failed postoperative nausea and vomiting (PONV) prophylaxis. Persistent PONV after the recommended prophylaxis is a significant problem in pediatric anesthesia but a satisfactory strategy has not yet been defined. Therefore a retrospective audit was performed in order to evaluate whether low-dose droperidol (10 µg/kgBW) would be an effective rescue drug for failed antiemetic prophylaxis. Patients and methods: The electronic anesthesia patient data base of the University Children's Hospital Zurich was searched from 2004-2009 for patients who received low-dose droperidol in the postanesthesia care unit as rescue therapy for persistent PONV after antiemetic prophylaxis. Based on the recorded electronic data the effectiveness of low-dose droperidol as PONV rescue therapy and possible side effects were analyzed. Results: A total of 338 patients who received droperidol were found from a total of 34,032 patients and the charts were analyzed. Of these patients 134 were excluded because they had received droperidol for indications other than PONV, 43 patients were excluded because they had not received antiemetic prophylaxis before droperidol and in 17 patients the data were incomplete, leaving 144 patients with an average age of 12.3 years (interquartile range IQR 9.5-15.2 years) for analysis. The upper range of ages resulted from patients with chronic diseases who were still being treated in the Children's Hospital. Low-dose droperidol was given because of persistent nausea to 59 patients (41%) and to 85 patients (59%) for persistent vomiting. Initial antiemetic prophylaxis and/or therapy had consisted of dexamethasone plus tropisetrone in 80 patients and tropisetrone or dexamethasone alone in 64 patients. In 128 patients (89%) rescue therapy with a median dose of 10.9 µg/kgBW droperidol was effective but vomiting persisted in 16 patients (11%). Sedation was the only side effect recorded and this was observed in 39 patients (27%). Conclusions: Low-dose droperidol (10 µg/kgBW) was found to be effective as rescue medication in pediatric patients experiencing PONV despite various prophylactic antiemetic regimens. No neurological or cardiopulmonary side effects were recorded after this low dosage. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
23. Die therapierefraktäre überaktive Blase : Alternative Therapieansätze.
- Author
-
Knüpfer, S., Hamann, M., Naumann, C.M., Melchior, D., Jünemann, K.-P., Knüpfer, S, and Jünemann, K-P
- Subjects
CYSTOTOMY ,OVERACTIVE bladder ,BLADDER innervation ,ADRENALINE ,ALTERNATIVE medicine ,BOTULINUM toxin ,COMBINATION drug therapy ,COMPARATIVE studies ,ELECTROTHERAPEUTICS ,IONTOPHORESIS ,LIDOCAINE ,RESEARCH methodology ,MEDICAL cooperation ,PARASYMPATHOMIMETIC agents ,QUALITY of life ,RESEARCH ,SPINAL nerve roots ,DISEASE relapse ,EVALUATION research ,TREATMENT effectiveness ,DEXAMETHASONE ,INTRAVESICAL administration ,CYSTECTOMY ,FERRANS & Powers Quality of Life Index ,THERAPEUTICS - Abstract
Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2011
- Full Text
- View/download PDF
24. Klassisches adrenogenitales Syndrom mit 21-Hydroxylase-Defekt.
- Author
-
Dörr, H.G.
- Abstract
Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2011
- Full Text
- View/download PDF
25. Bedeutung der Late-onset-Form des adrenogenitalen Syndroms in der Kinderwunschbehandlung.
- Author
-
Deckwart, V., Diedrich, K., Bündgen, N., and Beyer, D.A.
- Abstract
Copyright of Gynäkologische Endokrinologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2011
- Full Text
- View/download PDF
26. Endokrine Orbitopathie.
- Author
-
Olivari, N.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2010
- Full Text
- View/download PDF
27. Steroide zur Reduktion der Morbidität nach Tonsillektomie.
- Author
-
Windfuhr, J. P.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2008
- Full Text
- View/download PDF
28. Systemische Kortikoidgaben und additive lokale Applikation von Mitomycin oder Dexamethason.
- Author
-
Kaftan, H. and Hosemann, W.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2005
- Full Text
- View/download PDF
29. Eine faktorielle Studie von 6 Interventionen zur Vermeidung von Ubelkeit und Erbrechen nach Narkosen Ergebnisse des "International Multicenter Protocol to assess the single and combined benefits of antiemetic strategies in a controlled clinical trial of a 2x2x2x2x2x2 factorial design" (IMPACT).
- Author
-
Apfel, C C, Bacher, A, Biedler, A, Danner, K, Danzeisen, O, Eberhart, L H J, Forst, H, Fritz, G, Hergert, M, Frings, G, Goebel, A, Hopf, H-B, Kerger, H, Kranke, P, Lange, M, Mertzlufft, F, Motsch, J, Paura, A, Roewer, N, and Schneider, E
- Subjects
ONDANSETRON ,DROPERIDOL (Drug) ,DEXAMETHASONE ,ANALGESICS ,ANTIEMETICS ,COMBINATION drug therapy ,COMPARATIVE studies ,EXPERIMENTAL design ,FENTANYL ,INTRAVENOUS anesthetics ,RESEARCH methodology ,MEDICAL cooperation ,MEDICAL protocols ,NARCOTICS ,PIPERIDINE ,RESEARCH ,EVALUATION research ,RANDOMIZED controlled trials ,RELATIVE medical risk ,PROPOFOL ,ODDS ratio ,INHALATION anesthetics ,THERAPEUTICS - Abstract
Background: Untreated, one third of patients who undergo surgery will have postoperative nausea and vomiting. Although many trials have been conducted, the relative benefits of prophylactic antiemetic interventions given alone or in combination remain unknown.Methods: In a randomized, controlled trial of factorial design, 5,199 patients at high risk for postoperative nausea and vomiting were randomly assigned to 1 of 64 possible combinations of 6 prophylactic interventions: 1) 4 mg of ondansetron or no ondansetron; 2) 4 mg of dexamethasone or no dexamethasone; 3) 1.25 mg of droperidol or no droperidol; 4) propofol or a volatile anesthetic; 5) nitrogen or nitrous oxide; 6) remifentanil or fentanyl. The primary aim parameter was nausea and vomiting within 24 h after surgery, which was evaluated blindly.Results: Ondansetron, dexamethasone, and droperidol each reduced the risk of postoperative nausea and vomiting by about 26%, propofol reduced the risk by 19%, and nitrogen by 12%. The risk reduction with both of these agents (i.e., total intravenous anesthesia) was thus similar to that observed with each of the antiemetics alone. All the interventions acted independently of each other and independently of the patients' baseline risk. Consequently, the relative risks associated with the combined interventions could be estimated by multiplying the relative risks associated with each intervention. However, absolute risk reduction was a critical function of patients' baseline risk.Conclusions: Because antiemetic interventions are similarly effective and act independently, the safest or least expensive should be used first. Prophylaxis is rarely warranted in low-risk patients, moderate-risk patients may benefit from a single intervention, and multiple interventions should be reserved for high-risk patients. [ABSTRACT FROM AUTHOR]- Published
- 2005
30. Konventionelle Therapie des multiplen Myeloms.
- Author
-
Ludwig, H., Strasser-Weippl, K., and Zojer, N.
- Abstract
Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2004
- Full Text
- View/download PDF
31. Topische Dexamethason-Therapie: Einfluss auf antigenpräsentierende Zellen in der Hornhaut der Maus.
- Author
-
Müller, A., Zhang, E.P., and Hoffmann, F.
- Abstract
Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2003
- Full Text
- View/download PDF
32. Intravitreale Chemotherapie bei okulozerebralem Lymphom.
- Author
-
Helbig, H., Cerny, Th., and de Smet, M.D.
- Abstract
Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2003
- Full Text
- View/download PDF
33. [Perioperative dexamethasone]
- Author
-
B. Sinner
- Subjects
Anesthesiology and Pain Medicine ,Postoperative Nausea and Vomiting ,Antiemetics ,Humans ,General Medicine ,Dexamethasone - Abstract
Dexamethasone is a synthetic steroid that has been used for many years in the clinical routine due to its anti-inflammatory, anti-allergic and immunosuppressive properties. Furthermore, dexamethasone has been used for a long time for prophylaxis and treatment of chemotherapy-induced nausea and vomiting. In the meantime dexamethasone has been approved as standard for the prophylaxis and treatment of postoperative nausea and vomiting (PONV). This review article outlines the indications and side effects of the perioperative administration of dexamethasone.
- Published
- 2019
34. [Systemic and local therapy options for sudden sensorineural hearing loss in diabetics]
- Author
-
B, Leggewie, A, Zimmermann, S, Strieth, and H, Gouveris
- Subjects
Diabetes Complications ,Salvage Therapy ,Treatment Outcome ,Tympanic Membrane ,Germany ,Hearing Loss, Sensorineural ,Quality of Life ,Humans ,Hearing Loss, Sudden ,Glucocorticoids ,Dexamethasone - Abstract
Sudden sensorineural hearing loss is not an emergency, but an urgency. Depending on severity, the disease may have a major impact on quality of life. Gold standard in Germany is a systemic, high-dosage glucocorticoid therapy. During oral or intravenous therapy with glucocorticoids, systemic side effects may occur. Especially in diabetics, this therapy may cause acute prominent disorders in glucose metabolism and therefore may be contraindicated. An alternative therapeutic option is intratympanic injection of steroids into the middle ear. Hereby the systemic side effects are absent and only local otologic complications may occasionally occur.
- Published
- 2019
35. [Treatment of multiple myeloma with elotuzumab plus pomalidomide and dexamethasone]
- Author
-
L, Rasche, H, Einsele, and S, Nitschmann
- Subjects
Antineoplastic Combined Chemotherapy Protocols ,Humans ,Immunologic Factors ,Antineoplastic Agents ,Antibodies, Monoclonal, Humanized ,Multiple Myeloma ,Dexamethasone ,Thalidomide - Published
- 2019
36. [Intravitreal Therapy Combining Dexamethasone and Bevacizumab in Treating Radiation Retinopathy and Opticopathy]
- Author
-
Filip S, Filev and Alireza, Mirshahi
- Subjects
Bevacizumab ,Vascular Endothelial Growth Factor A ,Diabetic Retinopathy ,Intravitreal Injections ,Humans ,Angiogenesis Inhibitors ,Glucocorticoids ,Dexamethasone ,Tomography, Optical Coherence - Abstract
Radiation Retinopathy is a progressive chronic disease triggered by ionising radiation and is characterised by vascular endothelial damage that can lead to macular edema, optic disc edema and proliferative retinopathy. We discuss a case of a patient with radiation retinopathy and optic disc edema who we treated with a combination of intravitreal bevacizumab and dexamethasone. After 3 injections of bevacizumab, and one of dexamethasone, the patient experienced a resolution of optic disc edema and a marked increase of his visual acuity and remained stable throughout the follow-up period.Die Strahlenretinopathie ist eine chronische, fortschreitende Erkrankung, die durch die Wirkung ionisierender Strahlung verursacht wird. Häufig ist die Ursache einer Strahlenretinopathie die Behandlung eines intra- oder periokulären Tumors.Ein pseudophaker Patient stellte sich im August 2016 mit einer seit ca. 1 Woche bestehenden Visusverschlechterung des linken Auges in unserer Klinik vor. In der Patientengeschichte war eine Protonenbestrahlung des linken Auges vor 3 Jahren bei Aderhautmelanom bekannt. Es zeigte sich ein Makulaödem mit Exsudatbildung und Papillenödem. Wir stellten die Diagnose einer Strahlenoptiko- und -retinopathie. Es erfolgten intravitreale Injektionen mit Dexamethason (OzurdexDie Kombination aus intravitrealer Gabe von Steroiden und Anti-VEGF erwies sich in diesem Fall als effektive Behandlungsmodalität bei iatrogen induzierter Strahlenoptikopathie und -retinopathie. Weitere Studien sind zur Ermittlung des Stellenwerts der kombinierten Therapie notwendig.
- Published
- 2018
37. [Autonomous cortisol secretion : Laboratory artifact or disease?]
- Author
-
Riester A and Beuschlein F
- Subjects
- Artifacts, Dexamethasone, Humans, Hydrocortisone, Laboratories, Adrenal Gland Neoplasms diagnosis
- Abstract
Background: Autonomous cortisol secretion was mentioned for the first time in 2016 in the European Guideline on the management of adrenal incidentalomas., Objectives: Review of the state of knowledge on diagnosis, epidemiology, co-morbidities, mortality and treatment of autonomous cortisol secretion in comparison to non-hormone producing adenomas. Recommendation for clinical practice based on the current European guideline., Materials Und Methods: Analysis of relevant clinical studies, discussion of basic literature and expert opinions., Results and Conclusions: Autonomous cortisol secretion is a term used to describe abnormal cortisol secretion diagnosed by a pathological 1‑mg dexamethasone suppression test in patients with adrenal incidentaloma, but without clinical manifestation of overt Cushing's syndrome. It is associated with increased mortality and morbidity, especially hypertension, diabetes mellitus type II, dyslipidemia and obesity. Adrenalectomy, as the only specific therapy option, should be considered in an interdisciplinary tumour board., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2022
- Full Text
- View/download PDF
38. Therapie des Hirsutismus bei Frauen mit adrenalen Enzymdefekten der Steroidhormonbiosynthese: Vergleich von Dexamethason mit Cyproteronacetat.
- Author
-
Frank-Raue, K., Junga, G., Raue, F., Vecsei, P., and Ziegler, R.
- Abstract
In patients with adrenal hirsutism or enzyme deficiencies in steroidogenesis, elevated adrenal androgens could be normalized by dexamethasone. We were interested to see if dexamethasone would be as effective as cyproterone acetate in treating hirsutism in selected patients with adrenal pathogenesis. Therefore 28 patients with hirsutism of adrenal origin or enzyme deficiency were treated cyclically either with cyproterone acetate and ethinylestradiol (2 mg cyproterone acetate+0.035 mg ethinyl-estradiol days 1-21, +10mg cyproterone acetate days 1-15) ( n=15) or with 0.25-0.5 mg dexamethasone daily at 10 pm ( n=13). In the dexamethasone group there was a significant drop in dehydroepiandrosterone and dehydroepiandrosterone sulfate levels within 9 months, but there was a diminution in hirsutism in only four women (31%); in four out of seven menstrual irregularities decreased. In the cyproterone acetate group hirsutism diminished significantly in 66% ( n=10) without suppression of adrenal androgens. Weight gain occurred in a few cases in both groups; other side effects developed in 33% in the cyproterone acetate group. Preselection of patients with hirsutism is useful with respect to diagnosis; adrenal pathogenesis should not generally indicate dexamethasone treatment of hirsutism unless there is a desire for pregnancy, because cyproterone acetate is a more powerful agent in reducing hair growth. [ABSTRACT FROM AUTHOR]
- Published
- 1990
- Full Text
- View/download PDF
39. Stellenwert der Radiochirurgie in der Primärtherapie des Glioblastoma multiforme. Heidelberger Erfahrungen im Literaturvergleich.
- Author
-
van Kampen, M, Engenhart-Cabillic, R, Debus, J, Fuss, M, Rhein, B, and Wannenmacher, M
- Subjects
ANTI-inflammatory agents ,ANTINEOPLASTIC agents ,DEXAMETHASONE ,BRAIN tumors ,CLINICAL trials ,COMPARATIVE studies ,GLIOMAS ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,POSTOPERATIVE care ,RADIATION doses ,RADIOISOTOPE brachytherapy ,RADIOSURGERY ,RESEARCH ,TERMS & phrases ,TIME ,EVALUATION research ,KARNOFSKY Performance Status - Abstract
Aim: To describe the clinical results and the feasibility of a phase II dose escalation study of small boost target volumes with a radiosurgical technique in patients with positive early postoperative MRI scans.Patients and Method: Since 1986, 35 patients were treated within a concept for first line therapy. Including criteria were residual tumor < or = 5 cm and Karnofsky performance score > or = 70. The mean age was 54.5 years. The treatment concept included an operation for reduction of tumor volume and a postoperative irradiation. The postoperative irradiation was divided in 2 parts: first, a hyperfractionated (1.8 Gy single dose twice a day, 54 Gy total dose) irradiation was performed containing the tumor and the edema with a 2 cm safety margin. Secondly, a radiosurgical boost dose was delivered. The target volume of this radiosurgery was the contrast enhancing residual tumor in early postoperative MRI scans. The median boost dose was 15 Gy. Survival curves were calculated according to the Kaplan-Meier method. Quality of life was evaluated using objective criteria such as neurological findings, frequency of seizures and steroid medication.Results: The median survival calculated from the time of diagnosis was 10.1 months. The 1- and 2-year survival rate were 35% and 6%, respectively. Young age tended to longer survival, patients younger than 53 years had a median survival of 10.4 months whereas patients older than 53 years showed a median survival of 9.2 months. The mean value of the boost volume was 22 cm3. Patients with smaller volumes had a median survival of 10.1 months and patients with bigger volumes showed a median survival of 9.9 months, 4.5 months after therapy, 75% of the patients showed improved or stable quality of life.Conclusion: The feasibility of a radiosurgically delivered boost dose after postoperative irradiation could be demonstrated. The observed survival rate is comparable to the survival rates reported in the literature. Whether or not the radiosurgery after postoperative irradiation is able to prolong survival can only be evaluated in a randomized phase III trial. [ABSTRACT FROM AUTHOR]- Published
- 1998
40. Spezifische Glucocorticoidrezeptoraktivität in den Lungen und Corticosteroidgehalt im Plasma neugeborener Kaninchen in den ersten Lebensstunden.
- Author
-
Bichler, A., Wiesinger, H., and Mayr, M.
- Abstract
Copyright of Archiv für Gynäkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 1978
- Full Text
- View/download PDF
41. Erfahrungen mit der intra- und perioperativen Steroidapplikation bei mikroneurochirurgischen lumbalen Rezidivbandscheibenoperationen.
- Author
-
Prestar, F. and Jöllenbeck, B.
- Abstract
Copyright of Der Schmerz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 1995
- Full Text
- View/download PDF
42. [In process]
- Author
-
Egid, Strehl
- Subjects
Meningitis, Pneumococcal ,Humans ,Drug Therapy, Combination ,Meningitis, Meningococcal ,Dexamethasone ,Anti-Bacterial Agents - Published
- 2018
43. [CME: Multiple Myeloma - a Review]
- Author
-
Michelle, Bräutigam and Ewelina, Biskup
- Subjects
Aged, 80 and over ,Lethargy ,Male ,Smoldering Multiple Myeloma ,Diphosphonates ,Osteolysis ,Blood Viscosity ,Monoclonal Gammopathy of Undetermined Significance ,Dexamethasone ,Bortezomib ,Diagnosis, Differential ,Antineoplastic Combined Chemotherapy Protocols ,Hypercalcemia ,Humans ,Kidney Failure, Chronic ,Multiple Myeloma ,Spinal Cord Compression - Abstract
CME: Multiple Myeloma - a Review Abstract. Multiple myeloma accounts for 1 % of all malignancies, and its incidence increases with age. Both the symptoms and the course of the disease are heterogeneous. While some patients experience unspecific complaints, e.g. malaise or lethargy, others might present with emergency situations like hypercalcemia, spinal cord compression or hyperviscosity, so that an urgent therapy initiation is crucial. The aim of this article is to review the most common initial symptoms, typical emergencies, as well as diagnostics and therapy of multiple myeloma.Zusammenfassung. Das Multiple Myelom macht 1 % aller Malignome aus, wobei die Inzidenz mit zunehmendem Alter steigt. Das Krankheitsbild verläuft sehr heterogen und die Symptome sind vielgestaltig. Während sich einige Patienten mit unspezifischen Beschwerden,wie Müdigkeit, Lethargie und Infektneigung präsentieren, gibt es Notfallsituationen wie die Hyperkalziämie, die Rückenmarkskompression oder das Hyperviskositätssyndrom, die einer sofortigen Therapieeinleitung bedürfen. Ziel dieses Artikels ist es, einen Überblick über Symptome und Notfallsituationen, die wichtigsten Abklärungsstrategien und die Therapie zu geben.
- Published
- 2018
44. [Steroid implant in treatment of sympathetic ophthalmia : Intravitreal implant of dexamethasone in cystoid macular edema in the context of sympathetic ophthalmia]
- Author
-
L, Wocker and K, Januschowski
- Subjects
Adult ,Intravitreal Injections ,Ophthalmia, Sympathetic ,Humans ,Female ,Glucocorticoids ,Triamcinolone Acetonide ,Dexamethasone ,Macular Edema - Abstract
We present the case of a 39-year-old female patient with cystoid macular edema of the left eye in the context of sympathetic ophthalmia. The right eye underwent several surgical interventions of both cornea and retina after ocular trauma and was enucleated after first clinical signs compatible with sympathetic ophthalmia and after exclusion of other infectious/non-infectious etiologies. The patient was treated with parabulbar triamcinolone injections and intravitreal injections of a dexamethasone slow-release implant with a good clinical course with respect to the macular edema. A steroid response did not occur over the treatment period of more than 12 months.
- Published
- 2018
45. [Acute Mountain Sickness and High-Altitude Cerebral Edema]
- Author
-
Christoph, Dehnert and Peter, Bärtsch
- Subjects
Acetazolamide ,Oxygen ,Adrenal Cortex Hormones ,Blood-Brain Barrier ,Acclimatization ,Hypertension, Pulmonary ,Premedication ,Anti-Inflammatory Agents, Non-Steroidal ,Oxygen Inhalation Therapy ,Humans ,Altitude Sickness ,Magnetic Resonance Imaging ,Dexamethasone - Published
- 2018
46. [Functional diagnostics in endocrinology]
- Author
-
C J, Auernhammer and M, Reincke
- Subjects
Evidence-Based Medicine ,Hydrocortisone ,Critical Illness ,Adrenal Gland Neoplasms ,Pheochromocytoma ,Endocrine System Diseases ,Dexamethasone ,Diagnostic Techniques, Endocrine ,Pancreatic Neoplasms ,Adrenocorticotropic Hormone ,Adrenal Cortex Hormones ,Gastrinoma ,Hyperaldosteronism ,Internal Medicine ,Humans ,Adrenal Cortex Function Tests ,Guideline Adherence ,Cushing Syndrome ,Adrenal Insufficiency - Abstract
When investigating many endocrinological diseases, basal laboratory parameters are not sufficient to distinguish between physiological and pathological hormone secretion. Functional diagnostics plays a decisive role in this context. Stimulation and suppression tests are used depending on whether under- or over-function needs to be diagnosed. This review article discusses selected functional tests, each of which plays an important role in current guidelines. Indications and test principles, including their performance, reliability, and limitations, are discussed. Topics covered include the ACTH stimulation test for the diagnosis of adrenal cortex insufficiency and the dexamethasone inhibition test for suspected Cushing's syndrome, as well as functional tests for the diagnosis of primary hyperaldosteronism, pheochromocytoma, acromegaly, growth hormone deficiency, thyroid nodules and suspicion of medullary thyroid carcinoma, insulinoma, and Zollinger-Ellison syndrome. Functional tests that are explicitly not recommended are also addressed.
- Published
- 2017
47. Auffälliger Linsenfremdkörper nach intravitrealer Injektion.
- Author
-
Koller, S., Neuhann, T., and Neuhann, I.
- Abstract
Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2012
- Full Text
- View/download PDF
48. [Antenatal Steroid Therapy in Threatened Premature Birth - State of the Art]
- Author
-
Dimitra, Stavropoulou and Roland, Hentschel
- Subjects
Respiratory Distress Syndrome, Newborn ,Fetal Growth Retardation ,Pregnancy Outcome ,Gestational Age ,Betamethasone ,Dexamethasone ,Disease Models, Animal ,Chorioamnionitis ,Obstetric Labor, Premature ,Fetal Organ Maturity ,Pre-Eclampsia ,Pregnancy ,Risk Factors ,Animals ,Humans ,Premature Birth ,Female ,Lung - Abstract
The aim of this work is to provide an overview of the recommendations in the current literature for the induction of lung maturation therapy. In particular, special attention is focused on specific situations, such as chorioamnionitis, intrauterine growth retardation and preeclampsia, which often lead to premature birth. Additionally, some aspects of antenatal steroid therapy, despite its widespread use, still require clarification. Among them is the repetitive administration of steroid therapy. On the basis of the Cochrane analysis of 2015, advantages and disadvantages for children and pregnant women are explained. Furthermore, the data on the use of antenatal steroid therapy in multiple pregnancies remain insufficient.Die vorliegende Arbeit versucht, anhand der aktuellen Literatur eine Übersicht über die zurzeit geltenden Empfehlungen zur sinnvollen Lungenreife-Induktionstherapie zu geben. Fokussiert wird insbesondere auf spezielle Situationen, wie die Chorioamnionitis, die intrauterine Wachstumsretardierung und die Präeklampsie, die gehäuft zu einer Frühgeburt führen. Zusätzlich werden Aspekte der antenatalen Steroidtherapie erläutert, die trotz der weit verbreiteten Anwendung noch einer Klärung bedürfen. Darunter fällt insbesondere die repetitive Gabe der Steroidtherapie. Anhand der Cochrane Analyse vom 2015 werden Vor- und Nachteile für die Kinder und die Schwangeren erläutert. Ungenügend sind weiterhin die Daten über die Anwendung der antenatalen Steroidtherapie bei Mehrlingsschwangerschaften.
- Published
- 2017
49. [Preoperative therapy switch before glaucoma filtration surgery : Influence of the systemic antiglaucomatous and local antiphlogistic therapy on the intraocular pressure]
- Author
-
I, Oberacher-Velten, F, Zeman, F, Lehmann, T, Barth, P, Peters, H, Helbig, and R, Greslechner
- Subjects
Aged, 80 and over ,Male ,Anti-Inflammatory Agents ,Administration, Oral ,Glaucoma ,Trabeculectomy ,Middle Aged ,Dexamethasone ,Drug Administration Schedule ,Acetazolamide ,Preoperative Care ,Humans ,Drug Therapy, Combination ,Female ,Ophthalmic Solutions ,Antihypertensive Agents ,Intraocular Pressure ,Aged ,Retrospective Studies - Abstract
The preoperative switch from local to systemic antiglaucomatous therapy and the additional application of local antiphlogistic drugs represents an important component of perioperative wound healing modulation within the framework of glaucoma filtration surgery.The aim of the present study was to compare the intraocular pressure (IOP) under a maximum local and oral antiglaucomatous therapy with or without additional application of local steroids.A retrospective clinical analysis of 121 consecutive patients who underwent primary trabeculectomy for open-angle glaucoma in 2013 and who attended the outpatient clinic at least 3 weeks before surgery was carried out. The patients were set on preoperative therapy as follows: continuation of the maximum local antiglaucomatous therapy (with or without local dexamethasone 1 mg/ml 3 times daily) or administration of 750 mg acetazolamide orally per day (with or without local steroids).The switch to oral antiglaucomatous therapy led to a mean IOP rise of 3.14 mm Hg which was short of statistical significance (p = 0.052). The additional administration of local steroids did not significantly influence the IOP (p = 0.218). Some patients with oral acetazolamide therapy and local steroid application showed large increases in IOP up to 30 mm Hg.The mean IOP rise of 3.14 mm Hg 3 weeks after replacement of antiglaucomatous eye drops by acetazolamide was short of missing statistical significance and seems to be clinically negligible for this relatively short period. The advantages of a lower postoperative fibrotic activity have to be weighed up against this change in IOP. Surprisingly, the effect of administration of local steroids for 3 weeks was minor compared to the effect of the switch from local to oral antiglaucomatous medication. Individual major IOP increases under the preoperative therapy change should be taken into consideration.
- Published
- 2016
50. [Chalazion - diagnosis and therapy]
- Author
-
Isabel, Görsch, Christiane, Loth, and Christos, Haritoglou
- Subjects
Male ,Drug Combinations ,Administration, Topical ,General Practice ,Remission, Spontaneous ,Chalazion ,Eyelids ,Humans ,Neomycin ,Gentamicins ,Dexamethasone ,Polymyxin B - Published
- 2016
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.