The diagnostic work-up, investigational tests, and differential diagnosis to confirm or reject the diagnosis of VKH as well as the management of the case will be described by the experts.
Background: Although FD may affect up to 10% of the general population, the therapy for FD is not standard. Recently, ginger-based food supplements have been proposed in order to restore FD symptoms. Our aim was to assess the efficacy of a new nutraceutical formulation containing extract of gingerol and thymus as a possible natural treatment in managing the symptoms of functional dyspepsia (FD). Methods: We retrospectively analyzed the efficacy and safety profiles of a nutraceutical formulation containing Zingiber of¬ficinalis root extract and a standardized Thymus extract. It was adminis¬tered as 1 ml/day twice a day for 90 days. Patients were assessed at baseline and af¬ter 1, 2 and 3 months of treatment, following a month of pharmacological washout by completing a questionnaire reporting the trend of the following symptoms: epigastric pain, epigastric heaviness, early satiety, belching, and regurgitation. Every symptom was assessed by a Visual Analogic Scale (VAS), ranging from 0= absence to 10= maximal severity. Results: We enrolled 272 patients (99 males and 173 females; median IQR age 49.5, 36-64 yrs). Obesity (BMI>30) was present in 28 (12.5%) patients; smokers were 83 (30.5%); and comorbidities were present in 107 (39.3%) patients. Improvement of symptom scores during treatment and one month after its suspension was extremely significant (p<0.000). Conclusion: This large study found that nutraceutical formulation could be one of the tools for an empirical approach to treat patients with FD, especially when a non-conventional drug treatment is preferable for the patient and considered suitable by the physician.
However, it has been suggested that neonates exposed to hypoxic injury are at increased risk of developing necrotizing enterocolitis (NEC) and so feeds should be withheld until rewarming.3
BackgroundMultiple sclerosis develops differently in different patients (P), demands personalised drug treatment and is difficult to manage. Biological drugs (BD) may reduce symptoms and modify the progression of the disease.PurposeWe sought to measure P compliance when prescribed BDs, and to evaluate whether switching drugs could increase their compliance.Material and methodsPatients were interviewed in the period from January to April 2014.Specifically:24 P with INTERFERON BETA1a (9 Avonex, 15 Rebif)6 P with INTERFERON BETA1b (4 Betaferon, 2 Extavia)14 P with GLATIRAMER (Copaxone)2 P with FINGOLIMOD (Gilenya).ResultsOnly 9 P expressed dissatisfaction with the treatments listed above.5 of the patients complained of adverse drug reactions, 3 objected to the number of administrations and 1 lamented the poor efficacy.Specifically:The side effects of AVONEX and BETAFERON were well tolerated with 1 dissatisfied patient.The side effects of REBIF and EXATVIA were less tolerable with 5 patients reporting flu-like symptoms (in accordance with SPC data on side effects) which caused them to miss days at work. Differences in efficacy and tolerability were observed between these interferons, in agreement with literature.COPAXONE caused minimal side effects, but P complained about the multiple administrations.GILENYA as second-line treatment was the best tolerated with no side effects.In twenty cases, in response to P complaints, treatment was switched to a different drug. Thirteen of these P subsequently exhibited better compliance, while 7 were dissatisfied with the different treatment as well.The treatments of these twenty P were switched for two reasons. In fifteen cases, the switch was motivated by side effects, while in the remaining five, the change was due to reactivation of the pathology.ConclusionCompliance with all the MS treatments is generally very high. The same active ingredient has given different outcomes therefore it is recommended to switch the treatment.References and/or acknowledgementsNikfar S, Rahimi R, Abdollahi M. A meta-analysis of the efficacy and tolerability of interferon-β in multiple sclerosis, overall and by drug and disease type. Clin Ther 2010;32(11):1871–88No conflict of interest.
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