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At least 19 recordsLinked to original sources
PubMed2000

Current recommendations for the treatment of genital herpes.

The incidence of genital herpes continues to increase in epidemic-like fashion. Aciclovir (acyclovir) has been the original gold standard of therapy. The recent addition of famciclovir and valaciclovir as antiherpes drugs has improved convenience as well as the efficacy of treatment. Although aciclovir remains a widely prescribed and reliable drug, its administration schedule falls short of the ease of usage that the newer nucleoside analogues offer, for both episodic and suppressive therapy. Suppression of symptomatic disease and asymptomatic shedding from the genitalia have both become popular approaches, if not the primary targets of antiviral therapy. Knowing that asymptomatic disease leads to most cases of transmission strongly suggests that suppression with antiviral agents could reduce transmission risk in discordant couples. Unfortunately, the role for antivirals in reducing transmission remains to be proven in clinical trials. Neonatal herpes is now successfully treated using aciclovir. Current randomised clinical trials are examining aciclovir and valaciclovir administration, as well as safety and efficacy for post-acute suppressive therapy. Prevention of recurrences in pregnancy is also a topic under investigation, with a view to reducing the medical need for Cesarean section, or alternatively (and far less likely to be accomplished) to protect the neonate. Although resistance is largely limited to the immunocompromised and a change in resistance patterns is not expected, several drugs are available for the treatment of aciclovir-resistant strains of herpes simplex. Foscarnet is the main alternative with proven efficacy in this setting. Unfortunately, administration of foscarnet requires intravenous therapy, although a single anecdote of topical foscarnet efficacy in this setting has been published. Alternatives include cidofovir gel, which is not commercially available but can be formulated locally from the intravenous preparation. Less effective alternatives include trifluridine and interferon. Future possibilities for treatment of genital herpes include a microparticle-based controlled-release formulation of aciclovir and resiquimod (VML-600; R-848). The search for an effective therapeutic vaccine for genital herpes has not been successful to date, although a live virus glycoprotein H-deficient (DISC) vaccine is currently in clinical trials. Recent data suggest that seronegative women are protected (albeit, not fully) by a glycoprotein D recombinant vaccine with adjuvant. Despite the established safety and convenience of current treatment options, better suppressive options and topical treatment options are much needed. Studies using existing agents as potential tools to avoid Cesarean section, or transmission to neonate or partner are ongoing. Both vaccines and antivirals may eventually play a role in prevention of infection.

2-Aminopurine↗
PubMed1980

Lithium carbonate in the treatment of movement disorders. A critical review.

In this paper, the efficacy of lithium therapy in the treatment of tardive dyskinesia is reviewed. It is noted that most of the published papers on this topic are anecdotal and single case reports with contradictory results. The well-designed studies indicate that lithium is useful in certain tardive dyskinesia patients and that the red blood cell lithium level may be related to the therapeutic response. Therefore, on the basis of the available information, we conclude that routine clinical application of lithium in the treatment of tardive dyskinesia is not warranted. However, further evaluation of lithium in the treatment of tardive dyskinesia and identification of the responders are extremely useful. In addition, as suggested by animal studies, the prophylactic value of this agent against tardive dyskinesia needs exploration.

Adult↗
PubMed2002

From Polynesian healers to health food stores: changing perspectives of Morinda citrifolia (Rubiaceae).

Morinda citrifolia L (noni) is one of the most important traditional Polynesian medicinal plants. Remedies from isolated Polynesian cultures, such as that of Rotuma, illustrate traditional indications that focus upon leaves, roots, bark, and green fruit, primarily for topical ailments. Anecdotally collected Hawaiian remedies that employ noni fruit illustrate changing usage patterns with shifts in recent times to preparation of juice made of ripe or decaying fruit. Ralph M. Heinicke promoted a wide range of claims about noni, and these seem to have fueled much of the current commercial interest in the plant. Recent studies of the proliferation of commercial products have shown that noni product manufacturers are promoting a range of therapeutic claims. These claims are based upon traditional Polynesian uses, Heinicke's ideas, and fragments of recent scientific studies including the activity of noni in the treatment of cancer. A review is provided of recent studies of potential anticancer activity of noni fruit. While noni's anticancer potential is still being explored, it continues to be widely used by Polynesians and non-Polynesians alike for both traditional and newly hypothesized indications.

Food, Organic↗
PubMed2003

Treatment of lentigo maligna with topical imiquimod.

A published case report and anecdotal experience suggested that topical imiquimod is an effective treatment for stage 0 melanoma (lentigo maligna). To gauge the efficacy of this therapy, we undertook a trial of topical imiquimod in 30 subjects with histologically confirmed lentigo maligna. Thirty subjects with lentigo maligna were recruited for an open-labelled efficacy trial with daily topical application of imiquimod 5% cream for 3 months. Study subjects were enrolled from the Dermatology service of the University of Oklahoma, the Oklahoma City Veteran's Administration Hospital Dermatology service and from referrals for the study from other practitioners. In order to determine an initial response rate, a four-quadrant biopsy was carried out on all patients 1 month after cessation of treatment, targeting the most clinically and dermatoscopically suspicious areas. Of 28 evaluable subjects who have completed the 3-month treatment phase, 26 (93%) were complete responders and two were treatment failures at the time of the 4-quadrant biopsy. Over 80% of the 28 subjects that completed treatment have been followed for more than 1 year with no relapses. The results of this study demonstrate that topical imiquimod produces a high complete response rate in lentigo maligna when applied daily for 3 months.

Adjuvants, Immunologic↗
PubMed2002

Male teacher female students: a novice teacher reflects.

This paper seeks to explore the gender dynamics of being a novice male teacher working with female nursing students. Using a reflective framework it examines the gender dynamics within the classroom setting. Educational, social, feminist and political theory are discussed to give some insight into teaching and learning strategies that can perpetuate or circumvent unhelpful gender dynamics. Implications for learning and teaching are evaluated, and further topics for investigation are acknowledged.

Adult↗
PubMed1999

Collagen vascular diseases and radiation therapy: a critical review.

PURPOSE: Although many oncologists have the impression that patients with collagen vascular disease tolerate radiotherapy less well than other patients, until now this was never described in a review article. METHODS AND RESULTS: The principal objective was to determine whether patients with collagen vascular diseases have a greater risk of severe radiation therapy complications, than those without a collagen vascular disease. However, most of the publications found on this topic are short anecdotal case reports of patients with increased toxicity after radiation. Consequently, the true incidence of these side effects is unknown. CONCLUSIONS: Unless further studies on this subject are reported, each radiation oncologist should be cautious in treating these patients.

Adult↗
PubMed2001

The use of cancellous screws as an alternative in plate fixation of fibular fractures.

Altering standard AO/ASIF techniques when performing open reduction with internal fixation of fibular fractures by using cancellous screws in place of cortical screws appears to be a viable option. By eliminating a few steps in screw application, the additive effect can lead to a significant decrease in operative and tourniquet time. Close inspection of hardware postoperatively has failed to show any signs of screw loosening or delay in fracture healing. In those cases when hardware has had to be removed, it was noted that screw tightness had not been altered. This topic has been anecdotally discussed within our institution and will be the subject of future scientific investigation. The authors feel that the application of fibular plates with cancellous screws is an acceptable alternative to standard orthopedic technique. Although we do not routinely vary from standard AO/ASIF technique, we feel this particular alteration does not affect outcome other than reducing surgical and tourniquet time, therefore reducing the surgical risks.

Bone Screws↗