المؤلفون: Cecilie Siggaard Jørgensen, Søren Rittig, Sonja Izquierdo Riis Meyer, René Frydensberg Andersen, Konstantinos Kamperis, Malthe Jessen Pedersen, Mia Faerch

المصدر: Meyer, S I R, Jørgensen, C S, Kamperis, K, Andersen, R F, Pedersen, M J, Faerch, M & Rittig, S 2021, ' Efficacy and safety of multimodal treatment in nocturnal enuresis-A retrospective cohort study ', Journal of Pediatric Urology, vol. 17, no. 4, pp. 447.e1-447.e7 . https://doi.org/10.1016/j.jpurol.2021.03.005Test

مصطلحات موضوعية: Male, Pediatrics, medicine.medical_specialty, Adolescent, Combination therapy, Urology, Urinary Bladder, 030232 urology & nephrology, BLADDER CAPACITY, CHILDREN, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Enuresis, law, 030225 pediatrics, medicine, Humans, IMIPRAMINE, Deamino Arginine Vasopressin, Child, Desmopressin, Retrospective Studies, Modalities, business.industry, Retrospective cohort study, Multimodal therapy, STANDARDIZATION, Multimodal treatment, Combined Modality Therapy, Discontinuation, OXYBUTYNIN, OUTPUT, Pediatrics, Perinatology and Child Health, Nocturnal Enuresis/therapy, Female, Nocturnal enuresis, RHYTHM, medicine.symptom, business, Deamino Arginine Vasopressin/therapeutic use, Nocturnal Enuresis, medicine.drug

الوصف: Summary Introduction and aim of the study Most treatments of nocturnal enuresis (NE) are targeting the main pathophysiological mechanisms, i.e., excess nocturnal urine production, bladder reservoir dysfunction and inability to awaken to a full bladder. Although many children can be effectively treated with only one treatment modality, there is a significant number of treatment-refractory cases. We experience an increasing tendency to combine treatment modalities in those children. However, there is limited evidence regarding the efficacy and safety of such strategies. Materials and methods We reviewed files from all NE children seen in our outpatient incontinence clinic between January 1st and December 31st 2017 and identified children refractory to first line treatment receiving a combination of at least two treatment modalities concurrently. Age, gender, wet nights per week before treatment, follow-up time, previous treatment with desmopressin or alarm, phenotype of NE, number of simultaneous treatments tried and response as well as registered side effects during treatment was noted. We registered the outcomes and safety of the treatment modalities and evaluated prognostic factors. Results We identified 59 children (13 girls) aged 6–15 yrs (mean 9.6 yrs) of whom 30 were monosymptomatic NE (MNE) and 29 were non-monosymptomatic NE (NMNE) patients. They all suffered at least three wet nights per week before treatment. In total, 38 children (61%) became dry on multimodal therapy. Eighteen children (30%) became dry on a combination of two treatment modalities, 16 (27%) on three modalities, and two (3%) on four modalities. Nine children (15%) achieved partial response whereas three (5%) showed no response despite multiple tries with combination therapies. A total of 18 children (30%) reported side effects to one or more of the modalities tried. Side effects that led to discontinuation of the treatment were uncommon (three patients). Conclusions Treatment refractory NE represents a challenge for the clinician. Although it seems possible to adequately treat refractory NE patients with multimodal treatment one should be aware of side effects as well as inform the families of the challenges in the treatment of refractory enuresis patients. Future RCT's should focus on providing further evidence for the role of multimodal therapy in NE treatment. Download : Download high-res image (119KB) Download : Download full-size image Summary Figure 1 . EN treatment modalities and their target.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dac5db00c54ebe8e4dea9e3f78e1c0b5Test
https://doi.org/10.1016/j.jpurol.2021.03.005Test

المؤلفون: Jan Blaakær, Sonja Izquierdo Riis Meyer, Katrine Fuglsang

المصدر: Meyer, S I R, Fuglsang, K & Blaakær, J 2014, ' Cell-mediated immune response: a clinical review of the therapeutic potential of human papillomavirus vaccination ', Acta Obstetricia et Gynecologica Scandinavica (AOGS), pp. 1209-1218 . https://doi.org/10.1111/aogs.12480Test
Meyer, S I, Fuglsang, K & Blaakaer, J 2014, ' Cell-mediated immune response : a clinical review of the therapeutic potential of human papillomavirus vaccination ', Acta Obstetricia et Gynecologica Scandinavica, vol. 93, no. 12, 93, pp. 1209-1218 . https://doi.org/10.1111/aogs.12480Test

مصطلحات موضوعية: Adult, Cellular immunity, Uterine Cervical Neoplasms, HPV vaccines, Cervical intraepithelial neoplasia, Papillomavirus Vaccines, Young Adult, Medicine, Humans, Cervix, Randomized Controlled Trials as Topic, Cervical cancer, Human papillomavirus 16, Immunity, Cellular, Human papillomavirus 18, business.industry, Obstetrics and Gynecology, General Medicine, medicine.disease, Vaccine efficacy, Uterine Cervical Dysplasia, Vaccination, medicine.anatomical_structure, Immunology, Female, business, Follow-Up Studies

الوصف: Objective This clinical review aims to assess the efficacy of human papillomavirus 16/18 (HPV16/18) vaccination on the cell-mediated immune response in women with existing cervical intraepithelial neoplasia or cervical cancer induced by HPV16 or HPV18. Data sources and study selection A focused and thorough literature search conducted in five different databases found 996 publications. Six relevant articles were chosen for further review. In total, 154 patients (>18 years of age) were enrolled in prospective study trials with 3–15 months of follow up. The vaccine applications were administered two to four times. The vaccines contained different combinations of HPV16 and HPV18 and early proteins, E6 and E7. The primary outcome was the cell-mediated immune response. Correlation to clinical outcome (histopathology) and human leukocyte antigen genes were secondary endpoints. Results All vaccines triggered a detectable cell-mediated immune response, some of which were statistically significant. Correlations between immunological response and clinical outcome (histopathology) were not significant, so neoplasms may not be susceptible to vaccine-generated cytotoxic T cells (CD8+). Conclusions Prophylactic HPV vaccines have been introduced to reduce the incidence of cervical cancer in young women. Women already infected with HPV could benefit from a therapeutic HPV vaccination. Hence, it is important to continue the development of therapeutic HPV vaccines to lower the rate of HPV-associated malignancies and crucial to evaluate vaccine efficacy clinically. This clinical review represents an attempt to elucidate the theories supporting the development of an HPV vaccine with a therapeutic effect on human papillomavirus-induced malignancies of the cervix.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::77b7a2379d4b541d2e1b86964021ccbeTest
https://pure.au.dk/portal/da/publications/cellmediated-immune-response-a-clinical-review-of-the-therapeutic-potential-of-human-papillomavirus-vaccinationTest(4745c2f9-23c1-4d7e-86bb-c9b00b105fb4).html

المؤلفون: Sonja Izquierdo Riis Meyer, Cecilie Siggaard Jørgensen, Rene Andersen, Konstantinos Kamperis, Malthe Jessen Pedersen

المصدر: Aarhus University

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::35d3a8881865837f2d21062353629cabTest
https://pure.au.dk/portal/en/publications/efficacy-and-safety-of-multimodal-treatment-in-nocturnal-enuresis--a-retrospective-cohort-studyTest(45d4856d-de1e-4a30-b0bd-c9589d10ec1e).html

المؤلفون: Sonja Izquierdo Riis Meyer

المصدر: Aarhus University
Meyer, S I R 2018, ' Efficacy and safety of multimodal treatment in nocturnal enuresis-A retrospective cohort study ', International Children Continence Society Conference, Rome, Italien, 26/09/2018-29/09/2018 s. 447.e1-447.e7 . < http://i-c-c-s.org/events-archiveTest/ >

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::2a617a2e72499874c3fa14ab9b1f3e96Test
https://pure.au.dk/portal/en/publications/efficacy-and-safety-of-multimodal-treatment-in-nocturnal-enuresis--a-retrospective-cohort-studyTest(7f7d5836-cd06-49d9-9408-528b23b66284).html