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PubMedDate not supplied

[Venlafaxine extended release for the treatment of chronic pain. A series of 50 cases].

INTRODUCTION: The objective of this study is to investigate analgesic effectiveness and safety of venlafaxine extended release in chronic pain of any etiology. METHODS: Six month, observational, open study, carried out in two pain units. Initially, a daily dose of 75 mg of venlafaxine extended release was administered, increasing it to 150 mg, following clinical criteria. Treatment response was measured using the Visual Analogue Scale (VAS), rest and mobilization, Hospital Anxiety and Depression Scale (HAD) and Eastern Cooperative Oncology Group (ECOG) and an adverse event sheet to record adverse events occurring during the study. RESULTS: The study was carried out in a 50 patient sample with a mean age of 57.1 +/- 1.8 years, with chronic pain. A total of 85-90 % of the patients was maintained with a daily dose of 75 mg of venlafaxine extended release. This produced a gradual reduction of the VAS scores at rest (significant reduction of 5.2 +/- 1.1 to 2.7 +/- 1.5 points; (p<0.0005) and mobilization (significant reduction of 5.5 +/- 0.8 to 3.1 +- 1.6 points; p<0.0005). Pain relief increased progressively. Regarding physical activity measured by the ECOG scale, there was a reduction of the percentage of patients and increase of outpatients. Tolerability to venlafaxine was "excellent", "very good" or "good" for 72% of the patients. CONCLUSIONS: Extended release venlafaxine can be an effective and well-tolerated treatment in patients with chronic pain of any etiology, although it must be investigated in depth.

Adult↗

PubMed1992

Surgical curability and prognosis for standard versus extended resection for T1 carcinoma of the pancreas.

The prognosis of 185 patients who underwent surgical resection of small carcinomas of less than 2.0 centimeters (T1) of the pancreas in whom either standard or extended resection was used was analyzed. Pancreatic resection was performed upon 98.3 percent of the patients who were more than 49 years old. The location of the tumor was the head of the pancreas in 83.4 percent of the patients, the body of the pancreas in 13.2 percent and the tail of the pancreas in 3.3 percent. Tumor staging revealed 42.9 percent in stage I and the remainder in advanced stage, that is 33.1 percent stage II, 18.8 percent stage III and 5.1 percent stage IV. When standard resection was performed, surgical cure rates were more than 80 percent in stage I, II and III, but in stage IV, it was only 16.6 percent. After extended resection, the surgical cure rates increased even in stage IV (100 percent). There were no significant differences in the overall postoperative cumulative survival rates between standard and extended operation. In stage II, however, a significant better survival rate was observed after extended resection than after standard resection.

Adult↗

PubMed2004

[Complications of extended lung resection procedures following the neoadjuvant therapy].

UNLABELLED: Local tumor expansion in the sense of the tumor invasion into the extrapulmonary structures, which must be removed in one step, preferably en-bloc, together with the primary tumor, is the reason for extending the lung resection procedure. Although verified lymphogenic metastasing into either unilateral, eventually into contralateral mediastinal lymphonodes (stage N2 resp. N3, according to the TNM), remains the commonest indication for the induction therapy in cases of the lung carcinoma, application of the neoadjuvant therapy in cases when extended resections may be expected, is indicated in case the tumor expands into the surrounding structures, which signifies opening of new, unnatural routes of possible lymphogenic and haematogenic dissemination, and thus, a significantly higher risk of the surgical therapy failure. During the period 1995-2002, our team conducted 15 extended lung resection procedures following the preceding induction therapy in patients suffering from the IIB-IIIB stage of the non-small cellular lung carcinoma (NSCLC). The 30-day lethality rate equalled zero. We recorded two rare complications and the postoperative morbidity was acceptable. CONCLUSION: Exhausting staging, the best possible prediction of the tumor behaviour following the surgical procedure and minimal surgical complications remain the prerequisite for good long-term results following the extended lung resections for the lung carcinoma. Application of the neoadjuvant therapy prior to the resection procedure need not increase the risk of surgical complications and, furthermore, may positively affect the disease prognosis.

Carcinoma, Non-Small-Cell Lung↗

PubMed1992

[The value of extended resection in locally advanced bronchial carcinoma].

A retrospective study on 68 patients with non-small-cell lung cancer (NSCLC) treated by extended resections is presented. Compared to simple resections extended resections carried a higher risk for postoperative complications, whereas 30-days-mortality was not influenced by type of resection. Analysis of survival rates after extended resections revealed no influence by T- or N-stage, whereas a residual tumor lowered the survival rates significantly. Overall, a 2-year-survival rate of 35% was observed after extended resections. In conclusion, even in locally advanced cases of NSCLC a resection with curative intent seems to be warranted, provided that a R0-stage can be achieved by surgery.

Carcinoma, Bronchogenic↗

PubMed2004

[The estimation of air--conduction threshold in extended range of high frequencies in young adult patients suffering from primary arterial hypertension].

The aim of the study was evaluation of the hearing ability on the base of air conduction threshold at extended range of high frequencies in young subjects with primary arterial hypertension. Lack of internationally accepted reference value of air conduction hearing threshold at extended frequency range resulted in own evaluation of the audiometric zero point for air conduction at the range 8-18 kHz in "otologically healthy" subjects younger than 20 years. Detection of impaired hearing of the extended high frequencies range in young subjects with primary arterial hypertension may be useful in diagnostics of hypertension as well as in prophylactic examinations in the group of individuals with high risk of primary hypertension. Evaluation of air conduction threshold at extended frequency range allows to detect sensorineural hearing impairment undetectable with application of conventional frequency range.

Adolescent↗

PubMed2005

[Attention deficit hyperactivity disorder therapy update: extended-release methylphenidate].

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a very common condition in neuropaediatric practice and the most widely used medication is methylphenidate (MPT). We discuss the comorbid disorders, diagnosis, aetiopathology and neurochemical bases, and we also stress the importance of pharmacological action on the dopaminergic and noradrenergic pathways, and the problems and benefits of the different formulations of MPT. AIMS: Since extended-release MPT by means of the OROS technique has only recently been commercialised in Spain, we conducted a comparative analysis of immediate-release MPT and extended-release MPT in a series of 93 patients in order to determine which of them is preferable, to evaluate the reasons why this is so, and to analyse the shortcomings and advantages of the two drugs. PATIENTS AND METHODS: We present a study of 93 patients between 6 and 18 years old. Once an initial treatment had been established, changing over to extended-release MPT was proposed. We analysed compliance, effectiveness, safety, the preferences of the family and the degree of control over afternoon symptoms with the new treatment. RESULTS AND CONCLUSIONS: Most of the patients began treatment with immediate-release MPT or other medication. Changing to extended-release MPT brought about greater satisfaction with the control of afternoon symptoms and an improvement in the degree of compliance with respect to the initial treatment with immediate-release MPT or other drugs.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

[Perioperative management of extended surgery for advanced lung cancer].

Extended surgery for advanced non-small cell lung cancer includes combined resection of T3 or T4 organs and extended lymph node dissection in N2 or N3 cases. It is well known that the incidence of complications with extended surgery is higher in comparison with standard surgery due to the greater extent of invasiveness of the former. The management of extended surgery patients requires an understanding of the characteristic complications and their frequency for each type of surgery. Perioperative management including an accurate preoperative diagnosis and the prevention of postoperative complications affects prognosis because mortality rate is higher in patients in whom more complications occur.

Carcinoma, Non-Small-Cell Lung↗

PubMed2005

[Video-assisted thoracoscopic extended thymectomy for myasthenia gravis: analysis of 107 cases].

OBJECTIVE: To evaluate the results of video-assisted thoracoscopic extended thymectomy for myasthenia gravis. METHODS: We retrospectively reviewed data from 107 patients received thoracoscopic extended thymectomy from June 1995 to June 2004. All patients had confirmed diagnosis of myasthenia gravis by clinical manifestation and electromyogram. Thoracoscopic extended thymectomy as well as dissection of all fatty tissue anterior to the pericardium was performed. RESULTS: During a follow-up of 1-98 months, symptom was significantly improved in 83% of patients, including 34 patients experienced complete remission. There was no postoperative mortality. CONCLUSION: Favorable results of video-assisted thoracoscopic extended thymectomy can be achieved in patients with myasthenia gravis. The technique is safe and minimally invasive.

Adolescent↗

PubMed2005

Pharmacokinetics of a new extended-release nifedipine formulation following a single oral dose, in human volunteers.

This study aimed to define the pharmacokinetics of nifedipine following oral administration of a new extended-release formulation. Twelve healthy volunteers of both sexes, aged 39 +/- 4 years, were treated with a single oral tablet of a new extended-release formulation containing 40 mg of nifedipine. Samples of venous blood were taken before dosing, after 30 min and at 1, 2, 4, 8, 12, 16, 20 and 24 h after administration. Nifedipine concentration was measured by means of a high-performance liquid chromatography method. Noncompartmental pharmacokinetics parameters were then calculated. The plasma concentration of nifedipine increased slowly and in seven subjects biphasic peaks occurred. The mean values were as follows: t(max): 8.5 +/- 1.2 h; C(max): 36.55 +/- 6.76 ng/ml; AUC: 347.06 +/- 51.61 ng/h/ml; AUC 409.99 +/- 61.08 ng/h/ml; A(half-life): 2.26 +/- 0.36 h; D(half-life): 2.43 +/- 0.44 h; E(half-life): 4.62 +/- 0.79 h. Twenty-four hours after administration nifedipine was still detectable (3.17 +/- 0.67 ng/ml). Arterial blood pressure decreased and heart rate increased concurrently and proportionally to the increase in nifedipine concentration. Extended-release nifedipine formulations have better tolerability profiles than immediate-release formulations, which are at present not recommended in the treatment of hypertension, hypertensive crises or myocardial infarction. This new extended-release formulation has interesting pharmacokinetic parameters and may be effective in conditions in which dihydropyridine calcium channel blockers are indicated.

Administration, Oral↗

PubMed2005

[Anatomy of the extended transsphenoidal approach under endoscopy and its application on treating the sellar and parasellar lesion].

OBJECTIVE: The endoscopic surgical anatomy of the extended transsphenoidal approach and its application was studied to establish the anatomic basis for parasellar lesion. METHOD: Four adult cadaveric heads were studied by imitating extended transsphenoidal approach and some anatomic parameters were measured. RESULT: The sphenoid sinus was divided into five compartments by posterior bony wall. The periosteum, dura, cavernous sinus, carotid artery,ocular nerve, trochlea nerve and adduce nerve crossing cavernous sinus could be visualized. After sphenoidal planum was removed, optic nerve, chiasm and pituitary gland could be displayed. A patient with gigantic pituitary adenoma was cured by extended transsphenoidal approach. CONCLUSION: The sellar and parasellar region can be visualized through extended transsphenoidal approach and lesion of sellar turcica can be treated by the approach. Surgeons should be skilled at endoscopic or microscopic sellar anatomy and have experience with transsphenoidal surgery.

Adult↗

PubMed2005

Outcome of pancreaticoduodenectomy with extended retroperitoneal lymphadenectomy for adenocarcinoma of the head of the pancreas.

BACKGROUND: Nowadays, there is a remarkable rise in resectability rate of periampullary adenocarcinoma and the mortality and morbidity of the pancreaticoduodenectomy procedure have been reduced remarkably, while the 5 year survival rates of patients with carcinoma of the head of the pancreas are still below 25%. We conducted this retrospective study to evaluate the clinical outcome of radical pancreaticoduodenectomy with extended retroperitoneal lymphadenectomy as a surgical therapy for adenocarcinoma of the head of the pancreas. METHODS: Twenty cases with adenocarcinoma of the head of the pancreas were treated by standard pancreaticoduodenectomy (removing only the peripancreatic lymph nodes en bloc with the tumour) from 1994 to 1997, and 46 cases with the same disease underwent extended retroperitoneal lymphadenectomy associated with standard pancreaticoduodenectomy from 1998 to 2002. The patients for whom there were insufficient follow-up data, or who had received postoperative adjuvant therapy, were excluded from the analysis. Clinical and pathological parameters of both groups were reviewed. The postoperative morbidity, mortality and survival data were compared statistically. RESULTS: Demographic and histopathological characteristics were similar in the two groups of patients. Performance of the extended lymphadenectomy lengthened the procedure. The mean total number of lymph nodes resected was significantly higher in the radical group (P < 0.05). Of the 46 cases in the radical group, 26% (12/46) had metastatic adenocarcinoma in the resected retroperitoneal lymph nodes. There was one perioperative death in the standard group, and two in the radical group. Postoperative diarrhoea and lymphatic leakage were only observed in the radical group. Transfusion requirements and postoperative morbidity rates did not differ between the two groups. The 1-, 2- and 3-year survival rates were 63%, 32% and 21% respectively in the standard group, and 66%, 38% and 21% in the radical group. No statistically significant difference was found between the groups. When subgroups of node positive patients were analysed, the 1-, 2- and 3-year survival rates were 42%, 17% and 8% respectively in the standard group, and 65%, 32% and 16% in the radical group. Better survival was observed in the first 2 years after operation in the radical group, but no survival differences were seen after 2 years post operation. CONCLUSIONS: The addition of an extended lymphadenectomy to a pancreaticoduodenectomy did not significantly increase morbidity rates, but was associated with an early survival advantage.

Adenocarcinoma↗

PubMed2006

[Extended radical resection with nerve-preservation for rectal cancer].

OBJECTIVE: To investigate the clinical value of extended radical resection with nerve- preservation for rectal cancer. METHOD: Ninety-eight patients with rectal cancer received extended radical resection with nerve- preservation in our hospital. The questionnaire were used to collect the data of the patients urination and sexual function. The survival was analyzed retrospectively. RESULTS: 62.3% (61/98) of the patients could erect normally and 57.1% (56/98) of the patients had normal sexual function. The average time of catheterization in 57 patients was 60 hours, the residual urine volume (RUV) was 28 ml and the max-micturition-desire urine volume was 400 ml. The 5-year survival rate of those who underwent extended radical resection with nerve-preservation was 61.2%. CONCLUSION: Extended radical resection with nerve-preservation,which could decrease the incidences of post-operative urination and sexual dysfunction, and have not affect the survival, was the most optimal operation for rectal cancer.

Adult↗

PubMedDate not supplied

Role of video-assisted thoracic surgery for the treatment of myasthenia gravis: extended thymectomy by median sternotomy versus the thoracoscopic approach with sternal lifting.

The role of video-assisted thoracic surgery (VATS) thymectomy is still being studied, and many surgeons remain skeptical of the value of this recent option. We made a retrospective evaluation to ascertain whether VATS-extended thymectomy is as reliable as standard median sternotomy in the treatment of myasthenia gravis (MG) and whether the endoscopic procedure presents any advantages for patients. Eighteen consecutive patients requiring extended thymectomy for MG were treated between April 1997 and September 2003 at our hospital. Nine patients received VATS-extended thymectomy, and the remaining nine patients received standard extended thymectomy by sternotomy. In the VATS group, the anterior mediastinal space was well visualized by sternal lifting. The mean operative time was 268.3 +/- 51.1 minutes in the VATS group and 177.3 +/- 92.5 minutes in the sternotomy group. Operative time was significant longer in the VATS group than in the sternotomy group (P < 0.05). The mean operative bleeding was 68.6 +/- 47.8 ml in the VATS group and 154.1 +/- 109.0 ml in the sternotomy group. Operative bleeding was significantly less in the VATS group than in the sternotomy group (P < 0.05). There was no significant difference between the two groups with regard to postoperative duration of chest tube or the level of serum C-reactive protein on the first operative day. There was a downward trend in nicotinic acetylcholine receptors antibody levels after thymectomy compared with before thymectomy in both groups. VATS thymectomy should be considered a valid alternative to the established approaches aimed at achieving a "curative thymectomy" in patients with MG.

Adolescent↗

PubMed2006

[Effect of triptorelin and an extended-interval dosing regimen in the treatment of patients with endometriosis and adenomyoma].

OBJECTIVE: To study the role of triptorelin in the treatment of patients with endometriosis, adenomyoma and fibromyoma and the effect of an extended-interval dosing regimen. METHODS: Seventy patients suffering from endometriosis, adenomyoma and fibromyoma were divided into two groups: extended-interval dosing (group E) and conventional dosing (group C). There were treated with injection of triptorelin 3.75 mg intramuscularly either every 6 weeks of totally four dose regimen (group E) or every 4 weeks of six dose regimen (group C). Comparison was made in improvement of symptoms, size of uterus and volume of tumor, as well as in serum levels of 17beta-estradiol, luteinizing hormone, and follicle-stimulating hormone. RESULTS: In each group, symptoms and tumor growth significantly improved after treatment (P < 0.05). For the patients of both groups E and C, the levels of gonadotropins and gonadal steroids were obviously reduced throughout the treatment period and up to 8 - 10 weeks after the injection of the last dose (P < 0.05). The hormonal profile of group E was similar to group C (P > 0.05). CONCLUSIONS: Gonadotropin-releasing hormone agonist is efficacious in the treatment of endometriosis and adenomyoma through reducing the serum levels of follicle-stimulating hormone, luteinizing hormone and 17beta-estradiol. The curative effect is satisfactory in most patients receiving an extended interval dosing regimen. To reduce the cost of treatment, the extended-interval dosing regimen of triptorelin should be adopted in well-equipped hospitals.

Adenomyoma↗

PubMed1988

[A clinical study of extended profundaplasty for severely ischemic limbs].

Between January 1986 October 1987, extended profundaplasty was performed on 11 severely ischemic limbs of eight patients with extended arteriosclerotic occlusions, associated with surgery for improvement in inflow. The subjects were all males, and ages ranged from 62 to 84 years (mean: 72.8 years). Symptoms were disabling claudication in one limb (1 case), rest pain in 5 (4 cases), and gangrene of the foot or ulcer of the toes in 5 (3 cases). Preoperative ankle pressure index (API) was 0 in 7 limbs (5 cases), and between 0.11 and 0.27 in the remaining 4 limbs (3 cases). Thrombectomy was performed in two cases, axillo-bifemoral bypass in 5, femoro-femoral bypass in one, and aorto-bifemoral bypass in one, as surgery for improvement in inflow. Although postoperative API remained 0 in 4 limbs, it increased between 0.36 and 0.56 in the remaining limbs. One subject died of heart failure on the 22nd postoperative day, and two limbs required below-knee amputation. Limb salvage rate was 81.8%. Extended profundaplasty seems to be a worthwhile choice of treatment as a limb salvage operation for severely ischemic limbs due to extended arteriosclerotic occlusions involving not only aorto-iliac but also femoro-popliteal or crural segment.

Aged↗

PubMed1979

Extended wear of hydrophilic contact lenses in aphakia - an alternative to intraocular lens implantation.

Since not every patient will be a candidate for an intraocular lens, there will always be a portion of aphakic patients who are candidates for extended wear hydrophilic lenses. Aphakic patients to be fitted successfully with extended wear contacts must be motivated, aware of the risks, and require frequent lens cleaning and replacement on an individual basis. While future improvement of hydrophilic lenses is to be expected and anticipated, the extent of these improvements is still uncertain. However, preliminary reports are encouraging. Extended wear contact lenses are not the only answer to aphakia. They are but one alternative available to the ophthalmologist for maximizing the visual rehabilitation of the aphakic patient. Even with the increasing use and acceptance of intraocular lenses, the use of extended soft lens wear has a place in this rehabilitation.

Aphakia, Postcataract↗

PubMed1982

[Thermal stability study of yolk extenders for the cryopreservation of semen].

Investigated was the fate of proteins in some yolk extenders--NN (Nagasse--Niva), GH18 (after Kichev), Zr (after Zlatarev), and ZhGTs (after Milovanov)--following heat treatment. Centrifugation at 14 000 rpm of untreated extenders (NN, GH18, Zr, and ZhGTs was found to lead to the strong drop of proteins of the start with NN and GH18, whereas there was no change in the proteins of the start with Zr and ZhGTs. The heat denaturation of the four extenders at 55 degrees C, 60 degrees C, and 65 degrees C for 30 min. and their centrifugation at 14 000 for 40 min. resulted in the change of proteins--most strongly expressed with the proteins of the start and those immediately in front of it with Zr and ZhGTs. The changes in the protein macromolecules of the four extenders were best expressed at the heat denaturation for 30 min. at 70 degrees C. The densitometric profiles were strongly simplified with Zr and ZhGTs, at which first group proteins (of the front) completely disappeared. NN and GH18 changed but slightly. Second and third group proteins of NN and GH18 showed high stability as against the remaining proteins. With Zr and ZhGTs most stable proved the proteins of the second group. The strong drop of the percent share of the start proteins of NN and GH18 and the disappearance of first group proteins of Zr and ZhGTs was associated with essential denaturation changes that affected adversely the structure of protein macromolecules.

Animals↗

PubMed1981

Part I Clinical overview of the management and fitting of the extended wear patient.

With the advent of extended wear contact lenses, new potential benefits, risk and responsibilities have come into existence for contact lens patients and practitioners alike. Without a careful, thorough and systematic clinical approach, the practitioner will find himself experiencing only the pitfalls without enjoying the possible benefits. This paper will attempt to present such a clinical approach, emphasizing a deductive and holistic approach to extended wear lens fitting. Previous clinical and laboratory work will be reviewed as it pertains to this presentation. Through the use of a thorough case history and diagnostic evaluation, patients can be effectively screened and counseled as to their acceptability and selection into an extended wear lens program. Mutual patient and a doctor goals must be established and be compatible. Subsequent contact lens selection and patient management will be discussed as they relate to the fulfillment of these goals. Commonly found complications with extended wear of contact lenses will be reviewed as they pertain to both the lenses and the ocular structures. Methods of management of these complications will be discussed.

Adolescent↗