RESUMO
BACKGROUND: Masitinib is a tyrosine kinase inhibitor targeting stem cell factor receptor (c-kit) and platelet-derived growth factor (PDGF) receptor, which are expressed on several cell types including mast cells and bronchial structural cells, respectively. We hypothesized that c-kit and PDGF receptor inhibition may decrease bronchial inflammation and interfere with airway remodeling, which are crucial features of severe asthma. OBJECTIVES: The primary endpoint was the percent change from baseline in oral corticosteroids after 16 weeks of treatment. Change in asthma control (asthma control questionnaire), exacerbation rate, pulmonary function tests, rescue medication requirement and safety were secondary endpoints. METHODS: A 16-week randomized, dose-ranging (3, 4.5, and 6 mg/kg/day), placebo-controlled study was undertaken in 44 patients with severe corticosteroid-dependent asthma who remained poorly controlled despite optimal asthma management. RESULTS: At 16 weeks of treatment, a comparable reduction in oral corticosteroids was achieved with masitinib and placebo (median reduction of -78% and -57% in the masitinib and placebo arms, respectively). Despite this similar reduction, the Asthma Control Questionnaire score was significantly better in the masitinib arm as compared to placebo with a reduction by 0.99 unit at week 16 (P < 0.001) vs 0.43 unit in the placebo arm. Masitinib therapy was associated with more transient skin rash and edema. CONCLUSIONS: Masitinib, a c-kit and PDGF-receptor tyrosine kinase inhibitor, may represent an innovative avenue of treatment in corticosteroid-dependent asthma. These preliminary results warrant further long-term clinical studies in severe asthma
Assuntos
Antiasmáticos/administração & dosagem , Asma/tratamento farmacológico , Inibidores de Proteínas Quinases/administração & dosagem , Receptores do Fator de Crescimento Derivado de Plaquetas/antagonistas & inibidores , Administração Oral , Adolescente , Adulto , Idoso , Antiasmáticos/efeitos adversos , Benzamidas , Edema/etiologia , Exantema/etiologia , Feminino , França , Humanos , Hidroxicorticosteroides/administração & dosagem , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Piperidinas , Inibidores de Proteínas Quinases/efeitos adversos , Proteínas Proto-Oncogênicas c-kit/metabolismo , Piridinas , Tiazóis/administração & dosagem , Tiazóis/efeitos adversos , Resultado do TratamentoRESUMO
The authors report their experience with reference to wisdom tooth transplantation involving fifteen patients over a period of 6 years. They exclude from this paper those transplantations which they have done using buds without roots and those with teeth with completely formed roots, which would not appear to be the best time for transplantation from a physiological standpoint. They feel that the main indication occurs when (multi-ring orthodontic treatment being impossible) the first molar is impossible to preserve and the wisdom tooth cannot apparently become functional. They describe their techniques. Despite the successess obtained (11 cases out of 15) with a follow-up of 6 years to one and a half years, the authors express a degree of reserve as far as the distant future is concerned with regard to possible rhizoclasia.
Assuntos
Dente Molar/transplante , Adolescente , Fatores Etários , Anestesia Dentária , Diastema/cirurgia , Feminino , Humanos , Masculino , Mandíbula , Extração Dentária/efeitos adversos , Germe de Dente/transplante , Transplante AutólogoRESUMO
Echotomography of the parotids in 88 patients was successful in detecting normal parotid morphology or inflammation of the parenchyma (parotitis) in 100 p. cent of such cases, and detecting the precise localization of tumors (adenopathies or intraparotid tumors) up to 3 mm in diameter in 93 p. cent of cases. Though cystadenomas do not provide a specific image, their appearance is typical. Positive diagnosis was possible in 85 p. cent of mixed tumors of 1 cm diameter or more, and in 5 out of 7 cases of malignant lesions. The diagnostic value of this examination is markedly limiting that of parotid sialography.