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1.
Medicine (Baltimore) ; 100(1): e24146, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429792

RESUMO

ABSTRACT: Since 2008, oral propranolol has evolved as the first-line therapy for infantile hemangiomas (IHs). Meanwhile, oral atenolol gradually shows comparative effectiveness versus oral propranolol with few side effects. Here, we conducted a mobile internal survey among a group of Chinese clinicians about how they choose the dosage, dose regimen, and dose escalation methods of propranolol and atenolol for the treatment of IH.A mobile-ready internal survey on the application of oral propranolol and oral atenolol for IH in mainland China was performed and distributed to 333 potential clinicians from different levels of healthcare institutions in mainland China. Eighty-one doctors responded to the survey. All the respondents had the experience of treating IH with oral propranolol and 32 had the experience with oral atenolol.Most of the doctors from tertiary hospitals chose 2 mg/kg/d twice daily, while most of those with the experience of propranolol from private hospitals chose 1 mg/kg/d once daily. More doctors from tertiary hospitals had the experience of atenolol than those from private hospitals.Oral atenolol has become another medication intervention option for IH in mainland China. This survey is helpful to standardize and develop a guideline of oral atenolol therapy for IH.


Assuntos
Atenolol/farmacologia , Hemangioma/tratamento farmacológico , Propranolol/farmacologia , Administração Oral , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Atenolol/uso terapêutico , China , Feminino , Hemangioma/complicações , Humanos , Lactente , Masculino , Propranolol/uso terapêutico , Inquéritos e Questionários , Resultado do Tratamento
3.
Drug Discov Ther ; 14(2): 89-92, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32378651

RESUMO

Infantile hemangioma is a benign cutaneous tumor, which sometimes rapidly enlarges, causes cosmetic problem, destroys normal tissue, and possibly threatens life. Dye lasers, steroid administration, and watchful waiting had been the treatment options for infantile hemangioma, but in recent years propranolol therapy has become available. The mechanism underlying the action of propranolol, however, is still unknown. We hypothesized that cytokines whose expressions change before and during the treatment are responsible for the efficacy of the drug. This study aims to prove the hypothesis using patients' sera and membrane array. In this study, the serum cytokine concentrations of five patients with infantile hemangioma were measured using membrane array of 20 angiogenic cytokines. We compared them before and during propranolol treatment to identify the cytokines responsible for the effect of propranolol. Signals for angiogenin, epidermal growth factor (EGF), platelet-derived growth factor-BB (PDGF-BB), regulated on activation, normal T-cell expressed and secreted chemokine (RANTES), tissue inhibitor of metalloproteinases 1 (TIMP-1), and tissue inhibitor of metalloproteinases 2 (TIMP-2) were evident in all five cases before treatment. Furthermore, PDGF-BB was the only cytokine of which concentration was decreased during treatment with statistically significant difference. This report is a pilot study with a small number of samples, and further detailed research with increased number of samples is necessary. Nonetheless, our results suggest that PDGF-BB may be involved in the action of propranolol. In addition, its serum concentration can be utilized as a potential marker of the therapeutic effect.


Assuntos
Citocinas/sangue , Hemangioma/tratamento farmacológico , Propranolol/uso terapêutico , Feminino , Hemangioma/sangue , Humanos , Lactente , Masculino
5.
Intern Med ; 59(14): 1727-1730, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32238724

RESUMO

Small-bowel hemangiomas are a possible source of gastrointestinal bleeding for which there is no established treatment approach. In this report, we describe the case of a 58-year-old woman who presented with hematochezia and who was diagnosed with small bowel hemangioma. She was successfully treated using endoscopic sclerotherapy. Initial capsule endoscopy revealed bleeding in the ileum. Subsequent double-balloon enteroscopy showed a 2-cm, bluish-purple, ileal submucosal tumor with an overlying protrusion. The lesion was responsible for the hematochezia and was treated with intralesional injection of polidocanol. The hematochezia completely resolved and at 4 months after sclerotherapy, the size of the lesion was significantly reduced.


Assuntos
Enteroscopia de Duplo Balão/métodos , Hemangioma/tratamento farmacológico , Hemangioma/cirurgia , Neoplasias do Íleo/tratamento farmacológico , Neoplasias do Íleo/cirurgia , Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
6.
Pediatrics ; 145(3)2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32051218

RESUMO

Since the discovery of propranolol in the treatment of infantile hemangioma (IH), there has been emergent investigation of ß-adrenergic receptor (ß-AR) signaling in IH and the mechanisms of action for which ß-AR blockers regulate hemangioma cell proliferation. However, ß-AR agonists and antagonists are known to act antithetically via the same intracellular ß-AR-driven proangiogenic pathways. We present the case of a patient with involuted IH treated with propranolol that showed a full and rapid regrowth during the intravenous administration of salbutamol, a selective ß2-adrenergic agonist, for an episode of severe obstructive bronchitis. This observation brings forward the clinical implication of ß-signaling effects in IH and raises awareness of the potential proliferative response of IH to ß-AR agonists such as salbutamol.


Assuntos
Agonistas de Receptores Adrenérgicos beta 2/efeitos adversos , Albuterol/efeitos adversos , Hemangioma/patologia , Recidiva Local de Neoplasia/induzido quimicamente , Neoplasias Cutâneas/patologia , Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem , Albuterol/administração & dosagem , Bronquite/tratamento farmacológico , Pré-Escolar , Feminino , Hemangioma/tratamento farmacológico , Humanos , Infusões Intravenosas , Propranolol/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Vasodilatadores/uso terapêutico
7.
An Bras Dermatol ; 95(2): 207-209, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32061465

RESUMO

Infantile hemangioma is the most common pediatric vascular tumor, with the following risk factors: low birth weight, prematurity, white skin, female gender, multiparity and advanced maternal age. The use of oral and topical beta-blockers, although recent, has emerged as the first line of treatment, with superior safety and efficacy to previously used therapies, such as corticosteroids and surgeries. This report describes two cases of nasal tip infantile hemangioma, treated with oral propranolol. Both presented excellent therapeutic responses.


Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Hemangioma/tratamento farmacológico , Neoplasias Nasais/tratamento farmacológico , Propranolol/administração & dosagem , Administração Oral , Feminino , Hemangioma/patologia , Humanos , Lactente , Neoplasias Nasais/patologia , Resultado do Tratamento
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(1): 59-62, ene.-feb. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-191486

RESUMO

El propranolol, un betabloqueante no selectivo, sigue siendo la primera línea de tratamiento para el hemangioma infantil problemático. Sin embargo, aunque poco frecuente, un subgrupo de pacientes experimenta efectos secundarios indeseables, lo que despierta el interés sobre otros betabloqueantes selectivos. Presentamos una amplia serie de casos de 46 lactantes tratados con éxito con atenolol, un bloqueante selectivo beta-1


Propranolol, a non-selective beta-blocker, remains the first line of treatment for problematic infantile hemangioma. However, although rarely, a subset of patients experience undesirable side effects, raising interest in other selective beta-blockers. We present a large case series of 46 infants treated successfully with oral atenolol, a selective beta-1 blocker


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Atenolol/administração & dosagem , Hemangioma/tratamento farmacológico , Atenolol/antagonistas & inibidores , Antagonistas de Receptores Adrenérgicos beta 1 , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Diarreia/complicações
10.
Am J Dermatopathol ; 42(2): 136-139, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31725486

RESUMO

We report an unusual case of a 49-year-old woman who presented with persistent papulonodules over bilateral fingers and inframammary region in conjunction with features of connective tissue disease including symmetrical polyarthritis and Raynaud phenomenon. Skin biopsy showed an upper-to-mid dermal proliferation of bland spindled cells with thickened collagen bundles and occasional multinucleated giant cells. Dermal blood vessels were only marginally increased. On immunohistochemistry, both the spindled cells and multinucleated giant cells stained negatively for smooth muscle actin. Some of the spindled cells stained positively with CD68 and CD163, whereas the multinucleated giant cells stained negatively for both stains. Elastic fibers were absent on elastic Van Gieson. The clinical and histopathologic features raise a diagnostic dilemma between fibroblastic rheumatism and multinucleate cell angiohistiocytoma. The patient responded well to cyclosporine and methotrexate therapy, with gradual improvement of the finger nodules.


Assuntos
Fibroblastos/patologia , Células Gigantes/patologia , Doenças Reumáticas/diagnóstico , Dermatopatias/diagnóstico , Neoplasias Cutâneas/diagnóstico , Antirreumáticos/uso terapêutico , Ciclosporina/uso terapêutico , Diagnóstico Diferencial , Feminino , Hemangioma/diagnóstico , Hemangioma/tratamento farmacológico , Hemangioma/patologia , Histiocitoma/diagnóstico , Histiocitoma/tratamento farmacológico , Histiocitoma/patologia , Humanos , Imunossupressores/uso terapêutico , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/patologia , Dermatopatias/tratamento farmacológico , Dermatopatias/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia
11.
JAMA Dermatol ; 156(2): 186-190, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31825455

RESUMO

Importance: Oral propranolol is widely considered to be first-line therapy for complicated infantile hemangioma, but its use in patients with PHACE (posterior fossa malformations, hemangioma, arterial anomalies, cardiac defects, eye anomalies) syndrome has been debated owing to concerns that the cardiovascular effects of the drug may increase the risk for arterial ischemic stroke. Objective: To assess the incidence of adverse events among patients with PHACE syndrome receiving oral propranolol for infantile hemangioma. Design, Setting, and Participants: This multicenter retrospective cohort study assessed the incidence of adverse events among 76 patients with PHACE syndrome receiving oral propranolol for infantile hemangioma at 11 tertiary care, academic pediatric dermatology practices. Medical records from January 1, 2010, through April 25, 2017, were reviewed. Exposures: Patients received oral propranolol, 0.3 mg/kg/dose or more. Main Outcomes and Measures: The main outcome was the rate and severity of adverse events occurring throughout the course of treatment with oral propranolol, as documented in the medical records. Adverse events were graded from 1 to 5 using a scale derived from the Common Terminology Criteria for Adverse Events and were considered to be serious if they were grade 3 or higher. Results: A total of 76 patients (59 girls and 17 boys; median age at propranolol initiation, 56 days [range, 0-396 days]) met the inclusion criteria. There were no reports of serious adverse events (ie, stroke, transient ischemic attack, or cardiovascular events) during treatment with oral propranolol. A total of 46 nonserious adverse events were reported among 29 patients (38.2%); the most commonly reported nonserious adverse events were sleep disturbances and minor gastrointestinal tract and respiratory tract symptoms. In a comparison with 726 infants who received oral propranolol for hemangioma but did not meet criteria for PHACE syndrome, there was no significant difference in the rate of serious adverse events experienced during treatment (0 of 76 patients with PHACE syndrome and 3 of 726 patients without PHACE syndrome [0.4%]). Conclusions and Relevance: This study found that oral propranolol was used to treat infantile hemangioma in 76 patients with PHACE syndrome and that no serious adverse events were experienced. These data provide support for the safety of oral propranolol in this patient population.


Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Coartação Aórtica/fisiopatologia , Anormalidades do Olho/fisiopatologia , Hemangioma/tratamento farmacológico , Síndromes Neurocutâneas/fisiopatologia , Propranolol/administração & dosagem , Administração Oral , Antagonistas Adrenérgicos beta/efeitos adversos , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Propranolol/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
12.
J Dermatolog Treat ; 31(4): 433-434, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30973791

RESUMO

Ulceration is the most common complication of infantile hemangioma (IH). We reported two cases of ulcerated IH treated by new cream formulation of brimonidine 0.2%-timolol 0.5% (a combination of selective α-2-adrenergic agonist and nonselective ß-blocker). In both cases, ulcerations were healed within 7-10 days after twice-daily application. No topical or systemic side effects were reported. In conclusion, brimonidine 0.2%-timolol 0.5% cream is a promising alternative in the topical treatment of ulcerated hemangiomas.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Antagonistas Adrenérgicos beta/administração & dosagem , Tartarato de Brimonidina/administração & dosagem , Hemangioma/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Úlcera Cutânea/tratamento farmacológico , Timolol/administração & dosagem , Administração Tópica , Combinação de Medicamentos , Feminino , Hemangioma/complicações , Humanos , Lactente , Pomadas , Neoplasias Cutâneas/complicações , Úlcera Cutânea/etiologia
13.
J Dermatolog Treat ; 31(3): 279-284, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-30835573

RESUMO

Background: Infantile hemangioma (IH) in most cases can be a self-limited condition; however, it may be ulcerated, infected, causing organ function disability and even death. Vascular endothelial growth factor (VEGF) has a role in IH. Bevacizumab is a monoclonal antibody against VEGF-A.Objectives: We aimed to evaluate and compare the efficacy of intralesional injection of bevacizumab versus triamcinolone acetonide (TAC) in IH.Methods: Thirty patients with IH were included in this study, divided into two equal groups, and treated with intralesional injection; the first group by bevacizumab and the second group by TAC. The injections in both groups were given every 4 weeks for six sessions. Assessment of the clinical response was done by the hemangioma activity score (HAS) and visual analog scale (VAS).Results: Both treatment modalities gave similar initial improvement after three sessions. However, with continuing injection sessions, bevacizumab reached a response's plateau and TAC gave better significant results after six injection sessions reading both HAS (p = .0017) and VAS (p ≤.001).Conclusion: Both intralesional injection of bevacizumab and TAC were safe and effective treatments in early proliferative IH after three sessions, however, TAC injection was significantly better than bevacizumab after six sessions.


Assuntos
Anti-Inflamatórios/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Bevacizumab/uso terapêutico , Hemangioma/tratamento farmacológico , Triancinolona Acetonida/uso terapêutico , Feminino , Hemangioma/patologia , Humanos , Lactente , Injeções Intralesionais , Masculino , Resultado do Tratamento
15.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 27(Special Issue): 594-597, 2019 Aug.
Artigo em Russo | MEDLINE | ID: mdl-31747151

RESUMO

The article deals with the actual problem of modern treatment of infant hemangiomas. The accumulated 10-year experience of using propranolol in 512 patients has shown its effectiveness and safety. The team of authors developed a protocol for managing patients with infantile hemangiomas of various localization at all stages of treatment. Special attention was paid to the cardiological aspect of patient monitoring using modern methods of instrumental diagnostics. Due to the clear application of the created protocol with the use of ultrasound control, in most cases, it was possible to achieve complete cure of this pathology, minimize incidence of undesirable effects and avoid the formation of relapses (rebound effect). The effectiveness of the developed algorithm of diagnosis and treatment is confirmed by both clinical results and the results of instrumental examinations.


Assuntos
Antagonistas Adrenérgicos beta , Hemangioma , Propranolol , Antagonistas Adrenérgicos beta/uso terapêutico , Algoritmos , Tratamento Conservador , Hemangioma/tratamento farmacológico , Humanos , Lactente , Propranolol/uso terapêutico , Resultado do Tratamento
16.
BMJ Case Rep ; 12(11)2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-31727637

RESUMO

A patient with choroidal haemangioma in the right eye developed photodynamic therapy (PDT)-induced acute exudative maculopathy within a week of being subjected to PDT (for treating the choroidal haemangioma). The condition was managed with an intravitreal injection of bevacizumab and responded well to therapy.


Assuntos
Neoplasias da Coroide/tratamento farmacológico , Hemangioma/tratamento farmacológico , Degeneração Macular/induzido quimicamente , Fotoquimioterapia/efeitos adversos , Adulto , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Humanos , Degeneração Macular/tratamento farmacológico , Masculino , Baixa Visão/etiologia
17.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(9): 728-733, nov. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185564

RESUMO

Los hemangiomas infantiles son los tumores benignos más frecuentes en la población pediátrica. Cuando afectan al área lumbar y perineal, algunos casos pueden asociarse a alguna malformación subyacente como una disrafia espinal oculta. El manejo de estos hemangiomas carece de consenso. Describimos 3 casos de niños con hemangiomas lumbosacros y perineales con anomalías en la resonancia magnética y revisamos la literatura para valorar qué pruebas y en qué momento se deben realizar para completar el estudio en estos pacientes. Por lo general, se solicita una ecografía lo más precozmente posible, ya que esta técnica no es posible realizarla una vez que los elementos espinales posteriores se han osificado, lo que generalmente ocurre a los 6 meses de edad. La resonancia magnética es la prueba de referencia para diagnosticar una disrafia espinal oculta. De acuerdo con la literatura, la edad media para este examen debe ser alrededor de los 6 meses, cuando la formación de grasa en el filum terminale se ha visto incrementada. En nuestra opinión, se debería realizar una resonancia magnética a los 6 meses de edad en todos los niños con hemangioma lumbar o perineal, independientemente del tamaño de la lesión, la ausencia de síntomas neurológicos o los resultados de la ecografía


Cutaneous hemangiomas are the most frequent benign tumors in children. When they affect the lumbar and perineal area some cases can be associated with an occult spinal dysraphism. The management of these hemangiomas lack consensus. We report 3 cases of children with lumbosacral and perineal hemangiomas with magnetic resonance image abnormalities and we review the literature to find out the type and timing of tests that should be performed to complete the study in these patients. Ultrasound is typically requested as young as possible, as this imaging technique is not possible 11 the posterior spinal elements have ossified. MRI is the gold standard for diagnosing occult spinal dysraphism. According to the literature, the mean age for MRI screening should be around 6 months, when the fat formation in the filum terminale is expanded. In our opinion, an MRI scan should be performed at 6 months of age in every children with lumbar or perineal hemangioma regardless the lesion size, neurological symptoms or the ultrasound results


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Hemangioma/diagnóstico por imagem , Hemangioma/tratamento farmacológico , Espectroscopia de Ressonância Magnética/métodos , Plexo Lombossacral/diagnóstico por imagem , Plexo Lombossacral/patologia , Disrafismo Espinal/diagnóstico por imagem , Propranolol/administração & dosagem , Neurocirurgia
18.
Pediatr Dermatol ; 36(6): 958-960, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31566792

RESUMO

This study compares the quality of life (QoL) of infantile hemangioma (IH) patients and their parents at the beginning of the involution phase with QoL in the growth phase. Additionally, the differences in QoL between propranolol-treated patients and non-treated patients are assessed. Overall, QoL seems to improve, even before involution occurs. Due to the efficacy of propranolol treatment, the impact on QoL remains relatively mild even in patients with severe IH.


Assuntos
Hemangioma/tratamento farmacológico , Pais/psicologia , Propranolol/uso terapêutico , Qualidade de Vida , Neoplasias Cutâneas/tratamento farmacológico , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Lactente , Masculino , Índice de Gravidade de Doença , Vasodilatadores/uso terapêutico
19.
Med J Malaysia ; 74(5): 447-449, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31649228

RESUMO

PHACE syndrome describes the association of large segmental haemangioma with extracutaneous features (posterior fossa anomalies, arterial, cardiac, eye and endocrine anomalies). We report a case of segmental facial infantile haemangioma with PHACE syndrome treated successfully with oral propranolol without neurological sequelae.


Assuntos
Coartação Aórtica/complicações , Anormalidades do Olho/complicações , Neoplasias Faciais/etiologia , Hemangioma/etiologia , Síndromes Neurocutâneas/complicações , Propranolol/administração & dosagem , Administração Oral , Antagonistas Adrenérgicos beta/administração & dosagem , Progressão da Doença , Neoplasias Faciais/diagnóstico , Neoplasias Faciais/tratamento farmacológico , Hemangioma/diagnóstico , Hemangioma/tratamento farmacológico , Humanos , Recém-Nascido , Masculino
20.
Acta Otolaryngol ; 139(12): 1117-1121, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31556768

RESUMO

Background: Head and neck haemangiomas in the pharynx and larynx are rare, and the injection of bleomycin is currently one of the effective treatments. However, data on the therapeutic efficacy of this treatment are scarce.Objectives: To evaluate the clinical efficacy of bleomycin injection in the treatment of laryngopharyngeal haemangioma in adults and determine factors affecting efficacy.Materials and Methods: The clinical data of 42 adult patients with laryngopharyngeal haemangioma treated by intralesional bleomycin injection were retrospectively analysed to evaluate the clinical efficacy. Two groups (haemangioma reduction <50% and haemangioma reduction ≥50%) were compared to analyse factors affecting efficacy.Results: Seventy-five injections were administered to 42 patients: 34 (34/42 81%) patients with a haemangioma reduction ≥50% and 8 (8/42 19%) with a haemangioma reduction <50%. There was no difference in age, sex, haemangioma shape or number of operations between the two groups, but there was a significant difference in the base area of the haemangioma.Conclusions and Significance: Intralesional bleomycin injection is effective for the treatment of laryngopharyngeal haemangioma in adults. The base area of the haemangioma affects the therapeutic efficacy.


Assuntos
Antibióticos Antineoplásicos/administração & dosagem , Bleomicina/administração & dosagem , Hemangioma/tratamento farmacológico , Neoplasias Hipofaríngeas/tratamento farmacológico , Adulto , Feminino , Hemangioma/diagnóstico por imagem , Humanos , Neoplasias Hipofaríngeas/diagnóstico por imagem , Injeções Intralesionais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
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