WorldWideScience

Sample records for chronic cyclodextrin treatment

  1. Chronic cyclodextrin treatment of murine Niemann-Pick C disease ameliorates neuronal cholesterol and glycosphingolipid storage and disease progression.

    Directory of Open Access Journals (Sweden)

    Cristin D Davidson

    Full Text Available Niemann-Pick type C (NPC disease is a fatal neurodegenerative disorder caused most commonly by a defect in the NPC1 protein and characterized by widespread intracellular accumulation of unesterified cholesterol and glycosphingolipids (GSLs. While current treatment therapies are limited, a few drugs tested in Npc1(-/- mice have shown partial benefit. During a combination treatment trial using two such compounds, N-butyldeoxynojirimycin (NB-DNJ and allopregnanolone, we noted increased lifespan for Npc1(-/- mice receiving only 2-hydroxypropyl-beta-cyclodextrin (CD, the vehicle for allopregnanolone. This finding suggested that administration of CD alone, but with greater frequency, might provide additional benefit.Administration of CD to Npc1(-/- mice beginning at either P7 or P21 and continuing every other day delayed clinical onset, reduced intraneuronal cholesterol and GSL storage as well as free sphingosine accumulation, reduced markers of neurodegeneration, and led to longer survival than any previous treatment regime. We reasoned that other lysosomal diseases characterized by cholesterol and GSL accumulation, including NPC disease due to NPC2 deficiency, GM1 gangliosidosis and mucopolysaccharidosis (MPS type IIIA, might likewise benefit from CD treatment. Treated Npc2(-/- mice showed benefits similar to NPC1 disease, however, mice with GM1 gangliosidosis or MPS IIIA failed to show reduction in storage.Treatment with CD delayed clinical disease onset, reduced intraneuronal storage and secondary markers of neurodegeneration, and significantly increased lifespan of both Npc1(-/- and Npc2(-/- mice. In contrast, CD failed to ameliorate cholesterol or glycosphingolipid storage in GM1 gangliosidosis and MPS IIIA disease. Understanding the mechanism(s by which CD leads to reduced neuronal storage may provide important new opportunities for treatment of NPC and related neurodegenerative diseases characterized by cholesterol dyshomeostasis.

  2. Cyclodextrins

    DEFF Research Database (Denmark)

    Stojanov, Mladen; Mørck Nielsen, Hanne; Larsen, Kim Lambertsen

    2012-01-01

    Bromhexine hydrochloride (bromhexine) is a mucolytic agent with very low aqueous solubility. However, with addition of cyclodextrins (CD) to the formulation, this disadvantage may be limited and therapeutic doses of bromhexine in solution can be achieved. The interaction of bromhexine with α-, β-...

  3. Evaluation of hydroxypropyl-b-cyclodextrin in the treatment of aldicarb poisoning in rats : short communication

    Directory of Open Access Journals (Sweden)

    R.S. Verster

    2004-06-01

    Full Text Available Cyclodextrins are ring-shaped oligosaccharides with a hydrophilic exterior and a hydrophobic interior. The interior cavity is capable of complexing fat-soluble molecules small enough to fit inside. Sprague-Dawley rats were used to evaluate the efficacy of hydroxypropyl-b-cyclodextrin as treatment of aldicarb poisoning in rats. Survival times in the majority of rats dosed with aldicarb and receiving intravenous cyclodextrin were longer compared with the control rats only dosed with aldicarb per os.

  4. [Chronic migraine: treatment].

    Science.gov (United States)

    Pascual, Julio

    2012-04-10

    We define chronic migraine as that clinical situation in which migraine attacks appear 15 or more days per month. Until recently, and in spite of its negative impact, patients with chronic migraine were excluded of the clinical trials. This manuscript revises the current treatment of chronic migraine. The first step should include the avoidance of potential precipitating/aggravating factors for chronic migraine, mainly analgesic overuse and the treatment of comorbid disorders, such as anxiety and depression. The symptomatic treatment should be based on the use of nonsteroidal anti-inflammatory agents and triptans (in this case ergotamine-containing medications. Preventive treatment includes a 'transitional' treatment with nonsteroidal anti-inflammatory agents or steroids, while preventive treatment exerts its actions. Even though those medications efficacious in episodic migraine prevention are used, the only drugs with demonstrated efficacy in the preventive treatment of chronic migraine are topiramate and pericranial infiltrations of Onabotulinumtoxin A. PMID:22532241

  5. Chronic Pain: Symptoms, Diagnosis, & Treatment

    Science.gov (United States)

    ... in the treatment. Treatment With chronic pain, the goal of treatment is to reduce pain and improve ... some treatments used for chronic pain. Less invasive psychotherapy, relaxation therapies, biofeedback, and behavior modification may also ...

  6. A new cyclodextrin-grafted viscose loaded with aescin formulations for a cosmeto-textile approach to chronic venous insufficiency.

    Science.gov (United States)

    Cravotto, G; Beltramo, L; Sapino, S; Binello, A; Carlotti, M E

    2011-10-01

    Cosmeto-textile applications can be used in the treatment of chronic venous insufficiency in legs by means of elastic bandages loaded with natural products which possess flebotonic properties. We have developed an efficient synthetic procedure for the preparation of β-cyclodextrin (β-CD)-grafted viscose by means of a 2-step ultrasound-assisted reaction. The highly grafted fabric bearing bis-urethane bridged β-CD has been characterized by ATR-FTIR and CP-MAS spectra and by an empiric colorimetric method which used phenolphthalein as the CD guest. We have also developed a suitable cosmetic preparation containing natural substances and extracts (aescin, menthol, Centella asiatica and Ginkgo biloba) to recharge the CD-grafted textile. The efficacy of the new cosmeto-textile has been corroborated by in vitro studies of diffusion through membranes, cutaneous permeation and accumulation in porcine skin. Aescin was taken as a reference compound and its concentration in the different compartments was monitored by HPLC analysis. This cost effective cosmeto-textile shows excellent application compliance and is easily recharged and so has the strong base characteristics needed for possible industrial production. PMID:21805331

  7. Cyclodextrin complexes for treatment improvement in infectious diseases.

    Science.gov (United States)

    Imperiale, Julieta C; Sosnik, Alejandro D

    2015-05-01

    Infectious diseases are a heterogeneous group of maladies that represent a serious burden to healthcare systems worldwide. Most of the available antimicrobial drugs display poor biopharmaceutical properties that compromise their effectiveness. Cyclodextrins (CDs) are cyclic oligosaccharides of glucopyranose formed by a variable number of repeating units that combine a hydrophilic surface with a hydrophobic cavity. The production of drug/CD complexes has become one of the most extensively investigated technology approaches to improve the stability, solubility, dissolution rate and bioavailability of drugs. The present work overviews the applications of CDs for the formulation of anti-infective agents along with the most relevant administration routes. Finally, an update on the complexes with CDs available on the market to treat infectious diseases is presented. PMID:26008196

  8. Combination of extrusion and cyclodextrin glucanotransferase treatment to modify wheat flours functionality.

    Science.gov (United States)

    Román, Laura; Dura, Ángela; Martínez, Mario M; Rosell, Cristina M; Gómez, Manuel

    2016-05-15

    This research aims to vary functional properties of native and extruded wheat flours combining cyclodextrin glucanotransferase and extrusion treatments. The level of released cyclodextrins (CD) was assessed, besides the microstructure, crystallinity, pasting properties and starch hydrolysis of the flours. Photomicrographs of enzymatically treated flours suggested the production of fragile structures that broke easily. Enzymatic hydrolysis was significantly higher in extruded flours, as confirmed the CD levels, being predominant the γ-CD followed by α-CD, whereas very low β-CD values were obtained probably due to the formation of CD-lipid complexes, as suggested X-ray diffractometry results. Both extruded and native samples showed very low viscosity and flat pasting profile consequence of the enzyme hydrolytic activity on the starch chains. Enzymatically treated flours (native and extruded) showed higher hydrolysis rates at the early hydrolysis stage, and extruded flours exhibited higher fractal exponent h in agreement with the extended crystalline structures resulting from enzymatic treatment. PMID:26775973

  9. Treatment of chronic inflammatory neuropathies

    NARCIS (Netherlands)

    F. Eftimov

    2015-01-01

    This thesis focuses on the efficacy of existing and alternative treatments in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) and explores predictors of treatment response in patients with CIDP treated with corticosteroids. The efficacy of intra

  10. Chronic effects of hydroxypropyl-β-cyclodextrin on reproduction in the American flagfish (Jordanella floridae) over one complete life cycle.

    Science.gov (United States)

    Anderson, Jordan C; Beyger, Lindsay; Guchardi, John; Holdway, Douglas

    2016-06-01

    Understanding the environmental risks of pharmaceuticals and personal care products (PPCPs) has become very important in the field of aquatic toxicology. Hydroxylpropyl-β-cyclodextrin (HPβCD) is an amphiphilic, toroidal shaped molecule with the ability to form noncovalent inclusion complexes with a variety of guest molecules. The molecule can reduce volatility as well as improve the aqueous solubility of apolar guest compounds and is an emerging PPCP. As such, HPβCD is the active ingredient in Febreze (Procter & Gamble) and is extensively used as an excipient in the pharmaceutical industry. With the potential for entering the environment through waste-water treatment plant (WWTP) effluent, HPβCD poses an unknown risk to nontarget aquatic biota. A 145-d chronic full life-cycle exposure using American flagfish (Jordanella floridae) was completed using flow-through nominal concentrations of 0 µg/L (control), 5 µg/L, 16 µg/L, 50 µg/L, 160 µg/L, 500 µg/L, and 1600 μg/L of HPβCD maintained via a peristaltic pump. Fecundity, growth, and liver somatic index were all monitored, and no significant difference was found between treatments and controls (p > 0.05). However, a significant increase in the gonadosomatic index was observed in females exposed to HPβCD (p ≤ 0.05). Reduced offspring growth was observed after exposure in the same manner as the parental generation (p ≤ 0.05). Furthermore, an acute copper toxicity challenge assay was conducted on second-generation flagfish larvae, and a decrease in copper tolerance was observed in larval progeny from parents exposed to HPβCD. Environ Toxicol Chem 2016;35:1358-1363. © 2015 SETAC. PMID:26467440

  11. Treatment Options by Stage (Chronic Lymphocytic Leukemia)

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Lymphocytic Leukemia Go to Health Professional Version Key Points Chronic ...

  12. Treatment Option Overview (Chronic Lymphocytic Leukemia)

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Lymphocytic Leukemia Go to Health Professional Version Key Points Chronic ...

  13. Treatment Options for Chronic Myelogenous Leukemia

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Myelogenous Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Myelogenous Leukemia Go to Health Professional Version Key Points Chronic ...

  14. Treatment Option Overview (Chronic Myelogenous Leukemia)

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Myelogenous Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Myelogenous Leukemia Go to Health Professional Version Key Points Chronic ...

  15. Chronic Myeloproliferative Neoplasms Treatment

    Science.gov (United States)

    ... Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role in ... on the hands and feet. Muscle pain. Itching. Diarrhea . Stages of Chronic Myeloproliferative Neoplasms Key Points There is no standard staging system ...

  16. Electroacupuncture treatment of chronic insomniacs

    Institute of Scientific and Technical Information of China (English)

    RUAN Jing-wen; WANG Chu-huai; LIAO Xin-xue; YAN Ying-shuo; HU Yue-hua; RAO Zhong-dong; WEN Ming; ZENG Xiao-xiang; LAI Xin-sheng

    2009-01-01

    Background Due to the quick rhythm of life and work pressure, more and more people suffer from sleep quality problems. In this study, we investigated the effect of electroacupuncture on sleep quality of chronic insomniacs and the safety of electroacupuncture therapy.Methods Four courses of electroacupuncture treatment were applied to 47 patients. With pre-treatment and post-treatment self-control statistical method, Pittsburgh sleep quality index (PSQI) scores were used for evaluating sleep quality. Polysomnogram was used for detecting insomniacs' changes in sleep architecture. The safety of electroacupuncture was evaluated by monitoring the self-designed adverse events and side effects during treatment and post-treatment.Results Electroacupuncture considerably improved insomniacs' sleep quality and social function during the daytime.Electroacupuncture had certain repairing effect on the disruption in sleep architecture. At the same time,electroacupuncture prolonged slow wave sleep (SWS) time and relatively rapid eye movement sleep (REM sleep) time.There was no hangover, addiction or decrements in vigilance during the daytime (incidence rate was 0). However,insomnia rebound rate was about 23% within one month.Conclusions These results suggest that electroacupuncture has beneficial effect on sleep quality improvement in the patients with chronic insomnia, which may be associated with repairing sleep architecture, reconstructing sleep continuity,as well as prolonging SWS time and REM sleep time. Electroacupuncture treatment for chronic insomnia is safe.Therefore, electroacupuncture therapy could be a promising avenue of treatment for chronic insomnia.

  17. Cyclodextrin chemistry

    International Nuclear Information System (INIS)

    The chemistry of cyclodextrins was studied. This study included synthesising some cyclodextrin derivatives, preparing selected inclusion complexes with cyclodextrin and investigating the effects of gamma irradiation on cyclodextrins and certain linear oligosaccharides. This report presents a brief review of the structure and properties of cyclodextrins, the synthesis of cyclodextrin derivatives, their complexation and applications. This is followed by a description of the synthesis of some cyclodextrin derivatives and the preparation of inclusion complexes of cyclodextrin with some organic compounds. Finally, the effects of gamma irradiation on cyclodextrins, some of their derivatives and certain structurally related carbohydrates are discussed. The gamma irradiation studies were carried out for two reasons: to study the effects of gamma irradiation on cyclodextrins and their derivatives; and to investigate selectivity during the gamma irradiation of cyclodextrin derivatives

  18. [Neurosurgical treatment of chronic pain].

    Science.gov (United States)

    Fontaine, D; Blond, S; Mertens, P; Lanteri-Minet, M

    2015-02-01

    Neurosurgical treatment of pain used two kind of techniques: 1) Lesional techniques interrupt the transmission of nociceptive neural input by lesionning the nociceptive pathways (drezotomy, cordotomy, tractotomy…). They are indicated to treat morphine-resistant cancer pain and few cases of selected neuropathic pain. 2) Neuromodulation techniques try to decrease pain by reinforcing inhibitory and/or to limit activatory mechanisms. Chronic electrical stimulation of the nervous system (peripheral nerve stimulation, spinal cord stimulation, motor cortex stimulation…) is used to treat chronic neuropathic pain. Intrathecal infusion of analgesics (morphine, ziconotide…), using implantable pumps, allows to increase their efficacy and to reduce their side effects. These techniques can improve, sometimes dramatically, selected patients with severe and chronic pain, refractory to all other treatments. The quality of the analgesic outcome depends on the relevance of the indications. PMID:25681114

  19. Treatment of chronic inflammatory neuropathies

    OpenAIRE

    Schaik, van, I.N.; Eftimov, F.

    2015-01-01

    This thesis focuses on the efficacy of existing and alternative treatments in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) and explores predictors of treatment response in patients with CIDP treated with corticosteroids. The efficacy of intravenous immunoglobulin (IVIg) in CIDP and MMN was confirmed in meta-analyses. In CIDP, IVIg efficacy was similar to the efficacy of plasma exchange, prednisolone and intravenous methylprednisolone. ...

  20. Treatment of Chronic Venous Insufficiency

    OpenAIRE

    KÖKSAL, Cengiz; Alsalehi, Saleh; Kocamaz, Özgür; Sunar, Hasan

    2009-01-01

    Chronic venous insufficiency (CVI), with its high prevalence, high cost of diagnosis and treatment, substantial loss in manpower and negative effects on quality of life, is an important health issue. A comprehensive knowledge of the anatomy and functions of venous system is a must to understand the pathophysiology of CVI. The diagnosis of CVI is made by history, physical examination and noninvasive tests. The traditional surgical strategy for CVI treatment is high ligation of saphenofemoral v...

  1. Treatment of Chronic Venous Insufficiency

    OpenAIRE

    Cengiz Köksal; Saleh Alsalehi; Özgür Kocamaz; Hasan Sunar

    2010-01-01

    Chronic venous insufficiency (CVI), with its high prevalence, high cost of diagnosis and treatment, substantial loss in manpower and negative effects on quality of life, is an important health issue. A comprehensive knowledge of the anatomy and functions of venous system is a must to understand the pathophysiology of CVI. The iagnosis of CVI is made by history, physical examination and noninvasive tests. The traditional surgical strategy for CVI treatment is high ligation of saphenofemoral ve...

  2. [Behavioral treatment for chronic insomnia].

    Science.gov (United States)

    Adachi, Yoshiko; Yamagami, Toshiko

    2002-01-01

    The efficacy of non-pharmacological intervention for chronic insomnia has been proven by several meta-analytic reviews, an NIH report, an American Academy of Sleep Medicine review, and numerous clinical trials. Behavior therapy for chronic insomnia consists of relaxation, stimulus control, sleep restriction, cognitive restructuring and sleep hygiene education, which has produced reliable and durable changes in total sleep time, sleep onset latency, number and duration of awakening. These studies also showed that the post-treatment effect of behavior therapy is equal to that of hypnotic therapy, and that these effects were maintained for 6 months on follow-up assessment. Elderly insomniac patients would gain considerable benefit from behavioral treatments because there are no adverse physical effects as there are from pharmacological therapy. The authors present the basic theory, techniques of behavior therapy for insomnia, and the results of two important key meta-analytic reviews. Any behavioral approach such as convenient education, self-care enhancement by bibliotherapy, and individual face-to-face counseling, seem to be fruitful not only for American but also Japanese insomnia patients. Nonetheless, there are no currently actual intervention studies using behavior therapy in Japan. We have discussed the methodology of intervention study and published a behavioral self-help manual for people with sleep problems. Development of a behavioral approach to chronic insomnia seemed to be very beneficial and a useful contribution to mental health services. PMID:12373807

  3. Treatment of Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Cengiz Köksal

    2010-08-01

    Full Text Available Chronic venous insufficiency (CVI, with its high prevalence, high cost of diagnosis and treatment, substantial loss in manpower and negative effects on quality of life, is an important health issue. A comprehensive knowledge of the anatomy and functions of venous system is a must to understand the pathophysiology of CVI. The iagnosis of CVI is made by history, physical examination and noninvasive tests. The traditional surgical strategy for CVI treatment is high ligation of saphenofemoral vein and saphenous vein stripping. In recent years, novel minimally invasive techniques such as ultrasound-guided foam sclerotherapy, endovenous laser and radiofrequency ablation have been more widely applied. Here, we have reviewed the various treatment strategies used in CVI.

  4. CYCLODEXTRIN: AN OVERVIEW

    OpenAIRE

    Nisar Ahmad Khan * and Mohi Durakshan

    2013-01-01

    Cyclodextrins are versatile pharmaceutical excipients used to enhance the solubility, stability, safety and bioavailability of drugs. Besides, being  used to reduce gastrointestinal drug irritation, convert liquid drugs into microcrystalline or amorphous powder, and prevent drug–drug and drug–excipient interactions, they have shown to display adjuvant activity in vaccine therapy, prophylactic and therapeutic use in the treatment of several host-pathogen infections. Cyclodextrins (CDs) are che...

  5. Oral Delivery of Meglumine Antimoniate-β-Cyclodextrin Complex for Treatment of Leishmaniasis

    OpenAIRE

    Demicheli, Cynthia; Ochoa, Rosemary; da Silva, José B. B.; Falcão, Camila A. B.; Rossi-Bergmann, Bartira; Melo, Alan L.; Sinisterra, Ruben D.; Frézard, Frédéric

    2004-01-01

    The need for daily parenteral administration represents one of the most serious limitations in the clinical use of pentavalent antimonials against leishmaniasis. In this work, we investigated the ability of β-cyclodextrin to enhance the oral absorption of antimony and to promote the oral efficacy of meglumine antimoniate against experimental cutaneous leishmaniasis. The occurrence of interactions between β-cyclodextrin and meglumine antimoniate was demonstrated through the changes induced in ...

  6. Chronic migraine: risk factors, mechanisms and treatment.

    Science.gov (United States)

    May, Arne; Schulte, Laura H

    2016-08-01

    Chronic migraine has a great detrimental influence on a patient's life, with a severe impact on socioeconomic functioning and quality of life. Chronic migraine affects 1-2% of the general population, and about 8% of patients with migraine; it usually develops from episodic migraine at an annual conversion rate of about 3%. The chronification is reversible: about 26% of patients with chronic migraine go into remission within 2 years of chronification. The most important modifiable risk factors for chronic migraine include overuse of acute migraine medication, ineffective acute treatment, obesity, depression and stressful life events. Moreover, age, female sex and low educational status increase the risk of chronic migraine. The pathophysiology of migraine chronification can be understood as a threshold problem: certain predisposing factors, combined with frequent headache pain, lower the threshold of migraine attacks, thereby increasing the risk of chronic migraine. Treatment options include oral medications, nerve blockade with local anaesthetics or corticoids, and neuromodulation. Well-defined diagnostic criteria are crucial for the identification of chronic migraine. The International Headache Society classification of chronic migraine was recently updated, and now allows co-diagnosis of chronic migraine and medication overuse headache. This Review provides an up-to-date overview of the classification of chronic migraine, basic mechanisms and risk factors of migraine chronification, and the currently established treatment options. PMID:27389092

  7. TREATMENT RECOMMENDATIONS FOR CHRONIC MYELOID LEUKEMIA

    OpenAIRE

    Michele Baccarani; Fausto Castagnetti; Gabriele Gugliotta; Francesca Palandri; Gianantonio Rosti

    2014-01-01

    The first treatment of chronic myeloid leukemia (CML) included spleen x-radiation and conventional drugs, mainly Busulfan and Hydroxyurea. This therapy improved the quality of life during the chronic phase of the disease, without preventing nor significantly delaying the progression towards advanced phases. The introduction of allogeneic stem cell transplantation (alloSCT) marked the first important breakthrough in the evolution of CML treatment, because about 50% of the eligible patients wer...

  8. Treatment Recommendations for Chronic Myeloid Leukemia

    OpenAIRE

    Baccarani, Michele; Castagnetti, Fausto; Gugliotta, Gabriele; Palandri, Francesca; Rosti, Gianantonio

    2014-01-01

    The first treatment of chronic myeloid leukemia (CML) included spleen x-radiation and conventional drugs, mainly Busulfan and Hydroxyurea. This therapy improved the quality of life during the chronic phase of the disease, without preventing nor significantly delaying the progression towards advanced phases. The introduction of allogeneic stem cell transplantation (alloSCT) marked the first important breakthrough in the evolution of CML treatment, because about 50% of the eligible patients wer...

  9. Chronic migraine--classification, characteristics and treatment

    DEFF Research Database (Denmark)

    Diener, Hans-Christoph; Dodick, David W; Goadsby, Peter J;

    2012-01-01

    According to the revised 2nd Edition of the International Classification of Headache Disorders, primary headaches can be categorized as chronic or episodic; chronic migraine is defined as headaches in the absence of medication overuse, occurring on =15 days per month for =3 months, of which...... headaches on =8 days must fulfill the criteria for migraine without aura. Prevalence and incidence data for chronic migraine are still uncertain, owing to the heterogeneous definitions used to identify the condition in population-based studies over the past two decades. Chronic migraine is severely...... disabling and difficult to manage, as affected patients experience substantially more-frequent headaches, comorbid pain and affective disorders, and fewer pain-free intervals, than do those with episodic migraine. Data on the treatment of chronic migraine are scarce because most migraine-prevention trials...

  10. Treatment of Chronic Spontaneous Urticaria

    OpenAIRE

    Kaplan, Allen P

    2012-01-01

    Chronic spontaneous urticaria is defined as persistent symptoms of urticaria for 6 weeks or more. It is associated with autoimmunity in approximately 45 percent of patients. Therapy is often difficult however the initial approach should employ high-dose non-sedating antihistamines; 4-6 tablets/day may be necessary. It has been shown that the response to 4 tablets/day exceeds 3, and exceeds 2, which exceeds 1. However the dose that corresponds to the maximal dose of first generation antihistam...

  11. Treatment of refractory chronic urticaria

    Directory of Open Access Journals (Sweden)

    Aayushi Mehta

    2015-01-01

    Full Text Available Chronic spontaneous urticaria is a distressing disease encountered frequently in clinical practice. The current mainstay of therapy is the use of second-generation, non-sedating antihistamines. However, in patients who do not respond satisfactorily to these agents, a variety of other drugs are used. This article examines the available literature for frequently used agents including systemic corticosteroids, leukotriene receptor antagonists, dapsone, sulfasalazine, hydroxychloroquine, H2 antagonists, methotrexate, cyclosporine A, omalizumab, autologous serum therapy, and mycophenolate mofetil, with an additional focus on publications in Indian literature.

  12. New treatment of chronic hepatitis B

    DEFF Research Database (Denmark)

    Andersen, E.S.; Weis, Nina

    2008-01-01

    Worldwide, 350 million people are infected with chronic hepatitis B. Over the last few years, it has been possible to treat chronic hepatitis B. Treatment very often consists of nucleos(t)ide analogs and in a few cases of pegylated alpha-interferon. In 2007, a new nucleoside analog, Telbivudine......, was approved to treat chronic hepatitis B. In phase II and ongoing phase III studies, Telbivudine has proven more effective than the nucleoside analog, Lamivudine, which was very often used up until recently Udgivelsesdato: 2008/11/24...

  13. Current Treatment of Chronic Beryllium Disease

    OpenAIRE

    Sood, Akshay

    2009-01-01

    The current mainstay of management of chronic beryllium disease involves cessation of beryllium exposure and use of systemic corticosteroids. However, there are no randomized controlled trials to assess the effect of these interventions on the natural history of this disease. Despite this limitation, it is prudent to remove patients with chronic beryllium disease from further exposure and consider treating progressive disease early with long-term corticosteroids. The effect of treatment shoul...

  14. Midodrine treatment for chronic fatigue syndrome

    OpenAIRE

    Naschitz, J; Dreyfuss, D; Yeshurun, D.; Rosner, I

    2004-01-01

    The long term results of midodrine treatment in a patient having debilitating chronic fatigue syndrome (CFS) are reported. Midodrine treatment, directed at the autonomic nervous system, resulted in correction of the dysautonomia followed by improvement of fatigue. This finding is consistent with the hypothesis that dysautonomia plays a major part in the pathophysiology of CFS and that therapies directed at the autonomic nervous system may be effective in the treatment of CFS.

  15. Oral ciprofloxacin for treatment of chronic osteomyelitis.

    Science.gov (United States)

    Yamaguti, A; Trevisanello, C; Lobo, I M; Carvalho, M C; Bortoletto, M L; Silva, M L; Brasil Filho, R; Levi, G C; Mendonça, J S

    1993-01-01

    Seventeen adult patients with chronic osteomyelitis were treated with oral ciprofloxacin, 750 mg twice daily. Treatment ranged from 28 to 254 days. Efficacy was considered to be good, based upon clinical resolution observed in 13 patients (76%). Clinical and microbiological failure was observed in 3 patients (18%), and there was one case of reinfection. Tolerance was very satisfactory, since the adverse reactions were mild and transitory; these occurred in 7 patients (41%), being cutaneous rash in 4 patients and diarrhoea in 3 patients. No patient had to discontinue treatment. Thus, oral ciprofloxacin may be useful option for the prolonged treatment of chronic osteomyelitis, provided that it is always associated with surgical debridement. Due to the probable development of ciprofloxacin resistance in the S. aureus multiresistant strain, already observed in two patients in the present investigation, it is suggested that for the treatment of such infections another drug with antistaphylococcal activity should be associated with the ciprofloxacin. PMID:8354592

  16. Diagnosis and treatment for chronic migraine.

    Science.gov (United States)

    Moriarty, Maureen; Mallick-Searle, Theresa

    2016-06-19

    Migraine is a debilitating headache disorder that is underdiagnosed and undertreated worldwide, partially attributable to misdiagnosis and expectations of poor treatment outcomes. This article provides a review of chronic migraine, including pathophysiology, burden, diagnosis, and management, with special emphasis on the role of NPs. PMID:27203455

  17. Pivmecillinam treatment of chronic urinary tract infection.

    Science.gov (United States)

    Kalager, T; Bøe, E; Digranes, A; Høisaether, P; Solberg, C O

    1978-01-01

    Twenty-eight patients with chronic urinary tract infections were treated with 400 mg pivmecillinam orally three times daily for 10 to 15 days. The diagnosis was confirmed by a history of cystitis or cystopyelitis four to six times annually, microscopy of urine sediment, and growth of pathogens in urine specimens obtained by suprapubic bladder puncture. Three days, three and six weeks after completion of therapy the success rates were 24/28, 20/28 and 19/28 respectively. Pivmecillinam was well tolerated. Two patients developed nausea and vomiting. Other side-effects were not observed. Pivmecillinam is a useful drug in the treatment of chronic urinary tract infections. PMID:204581

  18. Chronic idiopathic urticaria: treatment with omalizumab.

    Science.gov (United States)

    Naaman, Sandra; Sussman, Gordon

    2014-01-01

    Chronic idiopathic urticaria (CIU) is a common autoimmune skin condition characterized by spontaneously recurring hives for 6 weeks or longer. The new terminology used for CIU in most countries including Canada is chronic spontaneous urticaria (CSU). CSU is associated with significant psychosocial morbidity with a markedly negative impact on overall quality of life. Conventional approaches with antihistamines, even at high doses, is effective in about 50% of patients suffering from CSU. A new treatment option, omalizumab, a humanized monoclonal antibody against the Fc domain of IgE, has undergone the scrutiny of randomized research studies evaluating the efficacy in CSU. This editorial reviews mechanisms of action of omalizumab, efficacy, cost and potential side effect profile. Omalizumab has emerged as a very promising treatment option for patients with CSU. Future research is necessary to establish standardized protocols related to dosing as well as monitoring possible adverse effects of long-term treatment. PMID:25807072

  19. [Treatment of viral hepatitis (II). Treatment of chronic hepatitis C].

    Science.gov (United States)

    Sánchez-Quijano, Armando; Lissen-Otero, Eduardo

    2006-10-01

    Hepatitis C virus infection is the principal cause of chronic liver disease, cirrhosis and hepatocellular carcinoma in the Western World. Chronic hepatitis C is often silent, most of the times discovered only by routine serologic or biochemical testing and the interval between infection and the development of cirrhosis exceed 30 years. Interestingly the complications of chronic hepatitis C virus infection can be prevented by antiviral therapy. At present, the combination of pegylated interferon-alfa and ribavirina has become the standard treatment of chronic hepatitis C. The management of HCV infection in "special populations" (HIV coinfection and HCV therapy-experienced patient) has improved significantly over the past few years, through a better knowledge of the disease and the publication of several clinical trials performed in these patients. At presents, a number of new anti-HCV therapies are in development. Future drugs for HCV infection might make possible to eradicate HCV in future. PMID:16987471

  20. Pharmacokinetics of Sulfobutylether-Beta-Cyclodextrin and Voriconazole in Patients with End-Stage Renal Failure during Treatment with Two Hemodialysis Systems and Hemodiafiltration▿

    OpenAIRE

    Hafner, Verena; Czock, David; Burhenne, Jürgen; Riedel, Klaus-Dieter; Bommer, Jürgen; Mikus, Gerd; Machleidt, Christoph; Weinreich, Thomas; Haefeli, Walter E.

    2010-01-01

    Sulfobutylether-beta-cyclodextrin (SBECD), a large cyclic oligosaccharide that is used to solubilize voriconazole (VRC) for intravenous administration, is eliminated mainly by renal excretion. The pharmacokinetics of SBECD and voriconazole in patients undergoing extracorporeal renal replacement therapies are not well defined. We performed a three-period randomized crossover study of 15 patients with end-stage renal failure during 6-hour treatment with Genius dialysis, standard hemodialysis, o...

  1. Peginterferon Treatment In Children: A Review Of Chronic Hepatitis B And Chronic Hepatitis C Treatment

    Directory of Open Access Journals (Sweden)

    Makbule EREN

    2009-11-01

    Full Text Available Despite of extensive blood product screening and national immunization programs, chronic hepatitis B and C infections continues to be a global problem with high mortality, morbidity and economic impact. Even though acquisition of these infections mostly occurs in childhood, major problems appear in adulthood. Cirrhosis and HCC are two major expected late events related to chronic hepatitis B and C infections. Rarely, children may also face these complications. To avoid these complications and increase the life expectancy in adults treatment of these two type infections should be started in childhood with appropriate patient selection. In contrast to children, adults are luckier in terms of treatment alternatives. They have the chance to use more potent antivirals with higher genetic barrier and pegylated form of interferons. Recently, the use of pegylated interferon and ribavirin combinations has been approved in children in Chronic HCV infection. However, chronic hepatitis B treatment in children is still dependent on the use of one type antiviral drug and conventional interferon. Treatment in early ages with an antiviral agent that has limited genetic barrier may block the chance of treatment or reduce the response rate in adulthood in chronic hepatitis B infection. This burden indicates the necessity of new therapeutic modalities in children. In this term pegylated interferons may be one of the optiones. In this article we aimed to reviewe the efficacy and safety of conventional and pegylated interferons, for the treatment of Hepatitis C and B infections in children.

  2. Hypnosis treatment for chronic low back pain.

    Science.gov (United States)

    Tan, Gabriel; Fukui, Tenley; Jensen, Mark P; Thornby, John; Waldman, Karen L

    2010-01-01

    Chronic low back pain (CLBP) is a significant healthcare problem, and many individuals with CLBP remain unresponsive to available interventions. Previous research suggests that hypnosis is effective for many chronic pain conditions; however, data to support its efficacy for CLBP are outdated and have been limited primarily to case studies. This pilot study indicated that a brief, 4-session standardized self-hypnosis protocol, combined with psycho-education, significantly and substantially reduced pain intensity and pain interference. Significant session-to-session improvements were also noted on pain ratings and mood states; however, follow-up data suggest that these benefits may not have been maintained across time in this sample. These findings need to be replicated and confirmed in a larger clinical trial, which could also assess the long-term effects of this treatment. PMID:20183738

  3. TREATMENT RECOMMENDATIONS FOR CHRONIC MYELOID LEUKEMIA

    Directory of Open Access Journals (Sweden)

    Michele Baccarani

    2014-01-01

    Full Text Available The first treatment of chronic myeloid leukemia (CML included spleen x-radiation and conventional drugs, mainly Busulfan and Hydroxyurea. This therapy improved the quality of life during the chronic phase of the disease, without preventing nor significantly delaying the progression towards advanced phases. The introduction of allogeneic stem cell transplantation (alloSCT marked the first important breakthrough in the evolution of CML treatment, because about 50% of the eligible patients were cured. The second breakthrough was the introduction of human recombinant interferon-alfa, able to achieve a complete cytogenetic remission in 15% to 30% of patients, with a significant survival advantage over conventional chemotherapy. At the end of the last century, about 15 years ago, all these treatments were quickly replaced by a class of small molecules targeting the tyrosine kinases (TK, which were able to induce a major molecular remission in most of the patients, without remarkable side effects, and a very prolonged life-span. The first approved TK inhibitor (TKI was Imatinib Mesylate (Glivec or Gleevec, Novartis. Rapidly, other TKIs were developed tested and commercialized, namely Dasatinib (Sprycel, Bristol-Myers Squibb, Nilotinib (Tasigna, Novartis, Bosutinib (Busulif, Pfizer and Ponatinib (Iclusig, Ariad. Not all these compounds are available worldwide; some of them are approved only for second line treatment, and the high prices are a problem that can limit their use. A frequent update of treatment recommendations is necessary. The current treatment goals include not only the prevention of the transformation to the advanced phases and the prolongation of survival, but also a length of survival and of a quality of life comparable to that of non-leukemic individuals. In some patient the next ambitious step is to move towards a treatment-free remission. The CML therapy, the role of alloSCT and the promising experimental strategies are reviewed in

  4. Treatment of stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Rennard, Stephen I

    Chronic obstructive pulmonary disease (COPD) is a readily diagnosable disorder that responds to treatment. Smoking cessation can reduce symptoms and prevent progression of disease. Bronchodilator therapy is key in improvement of lung function. Three classes of bronchodilators-beta agonists, anticholinergics, and theophylline-are available and can be used individually or in combination. Inhaled glucocorticoids can also improve airflow and can be combined with bronchodilators. Inhaled glucocorticoids, in addition, might reduce exacerbation frequency and severity as might some bronchodilators. Effective use of pharmacotherapy in COPD needs integration with a rehabilitation programme and successful treatment of co-morbidities, including depression and anxiety. Treatment for stable COPD can improve the function and quality of life of many patients, could reduce admissions to hospital, and has been suggested to improve survival. PMID:15337408

  5. Treatment options for chronic mucocutaneous candidiasis.

    Science.gov (United States)

    van de Veerdonk, Frank L; Netea, Mihai G

    2016-07-01

    Autosomal dominant chronic mucocutaneous candidiasis (AD-CMC) is a rare and severe primary immunodeficiency that is characterized by mucocutaneous fungal infection, autoimmunity, cerebral aneurysms, and oropharyngeal and esophageal cancer. Recently, it was discovered that STAT1 mutations are responsible for AD-CMC. These mutations lead to the inability of STAT1 to be dephosphorylated, resulting in hyperphosphorylation, increased binding to the DNA, and gain of function (GOF) effects on STAT1 signaling. Furthermore, a characteristic feature of AD-CMC patients is deficiency in the T-helper 17 (Th17) responses, which is believed to be the immunological cause of the mucocutaneous fungal infection. No targeted treatment other than lifelong antifungal prophylaxis exists for AD-CMC. However, the discovery of the genetic and immunological defects makes it now possible to explore new treatment strategies. This review will discuss immunomodulatory treatment options that can be explored in patients with STAT1 GOF mutations. PMID:27161991

  6. New formulation of an old drug in hypertension treatment: the sustained release of captopril from cyclodextrin nanoparticles

    Directory of Open Access Journals (Sweden)

    de Azevedo MB

    2011-05-01

    Full Text Available Mariangela de Burgos M de Azevedo1, Ljubica Tasic2, Juliana Fattori2, Fábio HS Rodrigues2, Fabiana C Cantos1, Leandro P Ribeiro1, Vanice de Paula3, Danielle Ianzer3, Robson AS Santos31Biopharmaceuticals and Hormones, Center of Biotechnology, Instituto de Pesquisas Energéticas e Nucleares (IPEN, Sao Paulo, Brazil; 2Chemical Biology Laboratory, Department of Organic Chemistry, Instituto de Química (UNICAMP, Sao Paulo, Brazil; 3Hypertension Laboratory, Department of Physiology and Biophysics, Instituto de Ciências Biológicas (ICB, Universidade Federal de Minas Gerais (ICB-UFMG, Minas Gerais, BrazilAbstract: Captopril (CAP was the first angiotensin I-converting enzyme (ACE inhibitor to be developed and is widely used in hypertension treatment. On the other hand, cyclodextrins (CDs are cyclic oligosaccharides whose cone-shaped cavity allows formation of noncovalent inclusion complexes with appropriately sized guest molecules, thus modifying guest physical, chemical, and biological properties. Herein, the physicochemical characterization and in vivo ACE inhibition evaluation of seven CAP/CD complexes are reported. The inclusion complexes were prepared by spray-drying, freeze-drying, kneading, or lyophilization methods and characterized by nuclear magnetic resonance, Fourier-transformed infrared spectroscopy, X-ray diffraction, differential scanning calorimetry, and scanning electron microscopy techniques. In vivo assays compared CAP and CAP/CD complex administration (0.5 mg kg-1 or 0.09 mg kg-1, n = 4–7 to evaluate the ACE inhibition by continuous infusion of angiotensin I (30 ng 50 µL-1 min-1 in conscious Wistar rats. The physicochemical analysis demonstrated complete amorphization and complexation between CAP and CDs, indicating the substitution of water molecules inside the CD cavity with CAP. During the infusion of angiotensin I, the administration of all CAP/CD complexes induced a reduction in mean arterial pressure similar to that

  7. Chronic candidiasis - pathogenesis, symptoms, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Klajn-Laslo Marija

    2009-01-01

    Full Text Available The yeast named Candida normally colonizes the gut and vagina without causing any sign of its presence. It is a commensal and opportune fungus but in certain conditions it turns to be pathogenic, causing chronic disturbances in any part of the body. The pathogenesis is complex, signs and symptoms are non-specific. The colonisation is difficult to distinguish from invasive disease. The current diagnostic methods do not always allow a definitive diagnosis to be made. Treatment is complex, individual and no protocol can be created. The author tries to give an overview of the Candida related problem.

  8. Clotrimazole-cyclodextrin based approach for the management and treatment of Candidiasis - A formulation and chemistry-based evaluation.

    Science.gov (United States)

    Mohammed, Noorullah Naqvi; Pandey, Pankaj; Khan, Nayaab S; Elokely, Khaled M; Liu, Haining; Doerksen, Robert J; Repka, Michael A

    2016-08-01

    Clotrimazole (CT) is a poorly soluble antifungal drug that is most commonly employed as a topical treatment in the management of vaginal candidiasis. The present work focuses on a formulation approach to enhance the solubility of CT using cyclodextrin (CD) complexation. A CT-CD complex was prepared by a co-precipitation method. Various characterization techniques such as differential scanning calorimetry, infrared (IR) and X-ray spectroscopy, scanning electron microscopy and nuclear magnetic resonance (NMR) spectroscopy were performed to evaluate the complex formation and to understand the interactions between CT and CD. Computational molecular modeling was performed using the Schrödinger suite and Gaussian 09 program to understand structural conformations of the complex. The phase solubility curve followed an AL-type curve, indicating formation of a 1:1 complex. Molecular docking studies supported the data obtained through NMR and IR studies. Enthalpy changes confirmed that complexation was an exothermic and enthalpically favorable phenomenon. The CT-CD complexes were formulated in a gel and evaluated for release and antifungal activity. The in vitro release studies performed using gels demonstrated a sustained release of CT from the CT-CD complex with the complex exhibiting improved release relative to the un-complexed CT. Complexed CT-CD exhibited better fungistatic activity toward different Candida species than un-complexed CT. PMID:25923135

  9. First-line treatment of chronic myeloid leukaemia

    OpenAIRE

    O'Dwyer, Michael

    2010-01-01

    Since the introduction of imatinib just over a decade ago, there has been a dramatic change in the treatment and prognosis of early chronic phase chronic myeloid Leukaemia (CML). This review article focuses on recent advances, culminating in the approval of nilotinib by the US Food and Drug Administration for the treatment of adult patients with newly diagnosed CML in the chronic phase.

  10. Surgical treatment of pain in chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Stefanović Dejan

    2006-01-01

    Full Text Available INTRODUCTION: The principal indication for surgical intervention in chronic pancreatitis is intractable pain. Depending upon the presence of dilated pancreatic ductal system, pancreatic duct drainage procedures and different kinds of pancreatic resections are applied. OBJECTIVE: The objective of the study was to show the most appropriate procedure to gain the most possible benefits in dependence of type of pathohistological process in chronic pancreatitis. METHOD: Our study included 58 patients with intractable pain caused by chronic pancreatitis of alcoholic genesis. The first group consisted of 30 patients with dilated pancreatic ductal system more than 10 mm. The second group involved 28 patients without dilated pancreatic ductal system. Pain relief, weight gain and glucose tolerance were monitored. RESULTS: All patients of Group I (30 underwent latero-lateral pancreaticojejunal - Puestow operation. 80% of patients had no pain after 6 month, 13.6% had rare pain and 2 patients, i.e. 6.4%, who continued to consume alcohol, had strong pain. Group II consisting of 28 patients was without dilated pancreatic ductal system. This group was subjected to various types of pancreatic resections. Whipple procedure (W was done in 6 patients, pylorus preserving Whipple (PPW in 7 cases, and duodenum preserving cephalic pancreatectomy (DPCP was performed in 15 patients. Generally, 89.2% of patients had no pain 6 month after the operation. An average weight gain was 1.9 kg in W group, 2.8 kg in PPW group and 4.1 kg in DPCP group. Insulin-dependent diabetes was recorded in 66.6% in W group, 57.1% in PPW group and 0% in DPCP group. CONCLUSION: According to our opinion, DPCP may be considered the procedure of choice for surgical treatment of pain in chronic pancreatitis in patients without dilatation of pancreas ductal system because of no serious postoperative metabolic consequences.

  11. Chronic care treatment of obese children and adolescents

    DEFF Research Database (Denmark)

    Holm, Jens-Christian; Gamborg, Michael; Bille, Dorthe S;

    2011-01-01

    Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity.......Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity....

  12. [Surgical treatment of chronic idiopathic constipation].

    Science.gov (United States)

    Menguy, R; Chey, W

    We review current experience with surgical treatment of severe constipation due to primary inertia of the colon. Over the last 10 years, we have operated 18 patients (14 females and 4 males) with severe constipation. The surgical procedure was either nearly total colonectomy with ascending colon/rectum anastomosis (8 cases) or total colonectomy with ileorectal anastomosis (9 cases). In one patient, coloproctectomy was performed with an ileoanal anastomosi. Indications for surgery were based on results of barium emena and functional evaluation of defecation. Results were satisfactory in all patients. In several patients however, we noted that the motility of other levels of the digestive tract was also impaired. Colonectomy was introduced as a treatment for chronic constipation nearly a century ago and although very few indications have been retained in the recent this procedure has now become an acceptable surgical approach in a limited number of well-though-out cases. PMID:7729199

  13. Arthroscopic treatment for chronic lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC in patients with chronic lateral epicondylitis that was refractory to conservative treatment. METHODS: Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS for pain. RESULTS: A total of 15 patients (9 men and 6 women were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100. The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used ( p 0.05. CONCLUSION: Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure.

  14. Citric Acid Treatment of Chronic Wounds in Animals

    OpenAIRE

    B.S. Nagoba,; B.J. Wadher and S.P. Selkar

    2011-01-01

    Chronic wound infections in animals not responding to conventional treatment modality are the important cause of morbidity. Infection is responsible for delayed wound healing. In the present study, an attempt was made to develop simple and effective treatment modality by using citric acid as a sole antimicrobial agent to control chronic wound infections in animals. Thirty eight cases of chronic wounds not responding to conventional treatment modalities were divided into two groups. Each group...

  15. Targeted treatment for chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Masood A

    2011-11-01

    Full Text Available Aisha Masood1, Taimur Sher2, Aneel Paulus2, Kena C Miller2, Kasyapa S Chitta3, Asher Chanan-Khan4 1The Tisch Cancer Institute, Bone Marrow Transplant Unit, Mount Sinai School of Medicine, 2Department of Medicine, Roswell Park Cancer Institute, 3Department of Molecular Targets and Experimental Therapeutics, Roswell Park Cancer Institute, New York, NY, 4Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA Abstract: The treatment of chronic lymphocytic leukemia (CLL has evolved over the last few decades. Recognition has increased of several key components of CLL biology currently manipulated for therapeutics. A milestone in the treatment of CLL was reached with the incorporation of immunotherapy with conventional chemotherapy. The fludarabine/cyclophosphamide/rituximab combination has demonstrated survival advantage for the first time in the treatment of CLL. Several other biological compounds are being explored with the hope of improving responses, impacting survival, and ultimately curing CLL. Important agents being tested are targeted on CLL surface molecules and their ligands, signal transduction protein and oncogenes. This review provides a brief summary of the recent advances made in preclinical and clinical investigation of selected promising therapeutic agents, which lead the target-directed therapeutic approach. Keywords: CLL, Akt inhibitors, Bcl-2 inhibitors, cyclin d kinase inhibitors, heat shock protein inhibitors, immunomodulatory drugs, monoclonal antibodies

  16. Pregabalin for Pain Treatment in Chronic Pancreatitis

    DEFF Research Database (Denmark)

    Olesen, Søren Schou; Bowense, S; Wilder-Smith, Oliver; van Goor, H; Drewes, Asbjørn Mohr

    2011-01-01

    Intractable pain usually dominates the clinical presentation of chronic pancreatitis (CP). Slowing of electroencephalogram (EEG) rhythmicity has been associated with abnormal cortical pain processing in other chronic pain disorders. The aim of this study was to investigate the spectral distribution...

  17. Oriental Medical Treatment of chronic Acalculous Cholecystitis

    OpenAIRE

    Hae-Yeon Lee; Jung-Han Park; Hyun-Seok Cho; Jung-Chul Kim; Tae-Hyun Baik; Jong-Seong Wi

    2004-01-01

    Chronic acalculous cholecystitis gets possession of about 12 to 13 percent of patients with chronic cholecystitis. Pathologically it is characterised by chronic inflammation and thickening of the gallbladder wall but doesn't come across stones. Clinical symptoms are vague and include abdominal discomfort and distension, nausea, flatulence and intolerance of fatty foods. A patient on chronic acalculous cholecystitis diagnosed from his clinical symtoms and abdominal ultrasonogram was treated by...

  18. The application of cyclodextrins in textile area

    Directory of Open Access Journals (Sweden)

    Đorđević Dragan

    2006-01-01

    Full Text Available The application of Cyclodextrins for textiles was reviewed in this paper. Cyclodextrins are crystalline, water soluble, cyclic, non-reducing oligosaccharides consisting of six, seven, or eight glucopyranose units. Cyclodextrins are known as products which are able to form inclusion complexes. The ability of Cyclodextrins to form inclusion complexes can be used, e.g., to remove malodor from textile materials, etc. Furthermore, some modifications of the parent Cyclodextrins are possible. The derivatives can be reactive (e.g. cyclodextrin with a monochlorotriazinyl group, more hydrophilic (by means of hydrophilic side groups, such as hydroxypropyl and hydroxyethyl, less hydrophilic (by means of lipophilic side groups, such as ethylhexyl glycidyl or ionic (by means of ionic side groups, such as hydroxypropyl trimethyl ammonium chloride.The methods for treating textiles are thus quite simple. The method using anchor-bearing Cyclodextrins is especially useful, since no fixation agent is needed, enabling they use of conventional textile treatment techniques and equipment. Furthermore, this method has virtually no limitations with respect to the textile materials that can be used.

  19. Chronic amphetamine treatment increases striatal calmodulin in rats

    International Nuclear Information System (INIS)

    A radioimmunoassay was developed to measure calmodulin in striatum from rats treated with one dose or repeated injections of amphetamine. Chronic, but not acute, amphetamine treatment resulted in a significant increase in total calmodulin levels in striatal homogenates. This effect may be linked to the behavioral sensitization which develops after chronic amphetamine treatments. (Auth.)

  20. Synthesis and biological evaluation of novel folic acid receptor-targeted, β-cyclodextrin-based drug complexes for cancer treatment.

    Directory of Open Access Journals (Sweden)

    Juan-Juan Yin

    Full Text Available Drug targeting is an active area of research and nano-scaled drug delivery systems hold tremendous potential for the treatment of neoplasms. In this study, a novel cyclodextrin (CD-based nanoparticle drug delivery system has been assembled and characterized for the therapy of folate receptor-positive [FR(+] cancer. Water-soluble folic acid (FA-conjugated CD carriers (FACDs were successfully synthesized and their structures were confirmed by 1D/2D nuclear magnetic resonance (NMR, matrix-assisted laser desorption ionization time-of-flight mass spectrometer (MALDI-TOF-MS, high performance liquid chromatography (HPLC, Fourier transform infrared spectroscopy (FTIR, and circular dichroism. Drug complexes of adamatane (Ada and cytotoxic doxorubicin (Dox with FACD were readily obtained by mixed solvent precipitation. The average size of FACD-Ada-Dox was 1.5-2.5 nm. The host-guest association constant K a was 1,639 M(-1 as determined by induced circular dichroism and the hydrophilicity of the FACDs was greatly enhanced compared to unmodified CD. Cellular uptake and FR binding competitive experiments demonstrated an efficient and preferentially targeted delivery of Dox into FR-positive tumor cells and a sustained drug release profile was seen in vitro. The delivery of Dox into FR(+ cancer cells via endocytosis was observed by confocal microscopy and drug uptake of the targeted nanoparticles was 8-fold greater than that of non-targeted drug complexes. Our docking results suggest that FA, FACD and FACD-Ada-Dox could bind human hedgehog interacting protein that contains a FR domain. Mouse cardiomyocytes as well as fibroblast treated with FACD-Ada-Dox had significantly lower levels of reactive oxygen species, with increased content of glutathione and glutathione peroxidase activity, indicating a reduced potential for Dox-induced cardiotoxicity. These results indicate that the targeted drug complex possesses high drug association and sustained drug release

  1. Oriental Medical Treatment of chronic Acalculous Cholecystitis

    Directory of Open Access Journals (Sweden)

    Hae-Yeon Lee

    2004-12-01

    Full Text Available Chronic acalculous cholecystitis gets possession of about 12 to 13 percent of patients with chronic cholecystitis. Pathologically it is characterised by chronic inflammation and thickening of the gallbladder wall but doesn't come across stones. Clinical symptoms are vague and include abdominal discomfort and distension, nausea, flatulence and intolerance of fatty foods. A patient on chronic acalculous cholecystitis diagnosed from his clinical symtoms and abdominal ultrasonogram was treated by Geonbihwan, acupuncture and herbal acupuncture. Satisfactory symptomatic improvement was achieved and findings of abdominal ultrasonogram came also normal.

  2. Effective physical treatment for chronic low back pain.

    Science.gov (United States)

    Maher, C G

    2004-01-01

    It is now feasible to adopt an evidence-based approach when providing physical treatment for patients with chronic LBP. A summary of the efficacy of a range of physical treatments is provided in Table 1. The evidence-based primary care options are exercise, laser, massage, and spinal manipulation; however, the latter three have small or transient effects that limit their value as therapies for chronic LBP. In contrast, exercise produces large reductions in pain and disability, a feature that suggests that exercise should play a major role in the management of chronic LBP. Physical treatments, such as acupuncture, backschool, hydrotherapy, lumbar supports, magnets, TENS, traction, ultrasound, Pilates therapy, Feldenkrais therapy, Alexander technique, and craniosacral therapy are either of unknown value or ineffective and so should not be considered. Outside of primary care, multidisciplinary treatment or functional restoration is effective; however, the high cost probably means that these programs should be reserved for patients who do not respond to cheaper treatment options for chronic LBP. Although there are now effective treatment options for chronic LBP, it needs to be acknowledged that the problem of chronic LBP is far from solved. Though treatments can provide marked improvements in the patient's condition, the available evidence suggests that the typical chronic LBP patient is left with some residual pain and disability. Developing new, more powerful treatments and refining the current group of known effective treatments is the challenge for the future. PMID:15062718

  3. Current treatment in chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    李嘉惠

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is defined by fixed airflow limitation associated with an abnormal pulmonary and systemic inflammatory response of the lungs to cigarette smoke. COPD represents an increasing burden worldwide, reported to be the sixth leading cause of death in 1990 and the fourth in 2000. Discouragingly, it is projected to jump to third place by the year 2020.There is increasing evidence that COPD is a more complex systemic disease than an airway and lung disease. In particular, cachexia, skeletal muscle abnormalities, diabetes, coronary artery disease, heart failure, cancer and pulmonary vascular disease are the most common comorbidities. It is associated with a wide variety of systemic consequences, most notably systemic inflammation. Because COPD patients have in general ahigher cardiovascular risk than the average population, cardiovascular safety in a COPD medication is of critical importance.SINGH et al performed a systematic review and recta-analysis of 17 clinical trials enrolling 14 783 patients treated with inhaled anticholinergic drugs used for the treatment of COPD. Inhaled anticholinergics significantly increased the risk of cardiovascular death, MI, or stroke ( 1.8 % vs 1.2 % for control; RR, 1.58 (95 % CI,1.21 - 2.06); P < 0.001 ). However, UPLIIFT (Understanding the Potential Long-Term Impacts on Function with Tiotropium) , a large, 4-year, placebo controlled clinical trial with tiotropium in approximately 6 000 patients with COPD. The preliminary results of UPLIFT showed that there was no increased risk of stroke with tiotropium bromide compared to placebo.A meta-analysis is always considered less convincing than a large prospective trial designed to assess the outcome of interest. However, COPD is a systemic disease. COPD management needs to focus on four major areas: smoking cessation, pharmacologic therapy, exercise training, and pulmonary rehabilitation. Clinicians and patients should always carefully consider any

  4. Innovations in chronic anal fissure treatment: A systematic review

    OpenAIRE

    2010-01-01

    A chronic anal fissure is a common perianal condition. This review aims to evaluate both existing and new therapies in the treatment of chronic fissures. Pharmacological therapies such as glyceryl trinitrate (GTN), Diltiazem ointment and Botulinum toxin provide a relatively non-invasive option, but with higher recurrence rates. Lateral sphincterotomy remains the gold standard for treatment. Anal dilatation has no role in treatment. New therapies include perineal support devices, Gonyautoxin i...

  5. Prevalence and treatment of giardiasis in chronic diarrhoea and malnutrition.

    OpenAIRE

    Sullivan, P B; Marsh, M N; Phillips, M B; Dewit, O; Neale, G; Cevallos, A M; Yamson, P; Farthing, M J

    1991-01-01

    To determine the prevalence of giardiasis in Gambian children with chronic diarrhoea and to assess their response to treatment, 31 children with chronic diarrhoea and malnutrition were investigated for giardiasis using a combination of serology (specific antigiardia IgM antibody) and microscopy of faeces and jejunal biopsy specimens. Fourteen of 31 children with chronic diarrhoea had giardiasis compared with only four of 33 healthy age and sex matched control children. Four of 15 malnourished...

  6. Chronic hepatitis C: latest treatment options.

    Science.gov (United States)

    Iosue, Kathleen

    2002-04-01

    The most common chronic bloodborne infection in the United States, hepatitis C virus (HCV) is the most frequent reason for liver transplantation. Unfortunately, most infected individuals don't realize they're HCV positive and only discover the disease after severe liver damage has occurred. Here, update your knowledge on the epidemiology, transmission and risk factors, diagnosis, clinical presentation, and management of chronic HCV. Insight on counseling and quality of life issues for infected patients is also included. PMID:11984417

  7. Chronic Fatigue Syndrome in Adolescents: treatment, clinical features and epidemiology

    NARCIS (Netherlands)

    Nijhof, S.L.

    2013-01-01

    This thesis describes the treatment, epidemiology and clinical features of the adolescent chronic fatigue syndrome (CFS). Fatigue is a common complaint among adolescents, with a reported incidence of up to 20% in girls. This fatigue however is not chronic, does not debilitate and has an identifiable

  8. Citric Acid Treatment of Chronic Wounds in Animals

    Directory of Open Access Journals (Sweden)

    B.S. Nagoba,

    2011-02-01

    Full Text Available Chronic wound infections in animals not responding to conventional treatment modality are the important cause of morbidity. Infection is responsible for delayed wound healing. In the present study, an attempt was made to develop simple and effective treatment modality by using citric acid as a sole antimicrobial agent to control chronic wound infections in animals. Thirty eight cases of chronic wounds not responding to conventional treatment modalities were divided into two groups. Each group included 19 cases. In group 1, 3% citric acid solution and in group 2, 5% citric acid solution was used for local application to find out its efficacy in the treatment of chronic wound infections in animals. Citric acid was found effective in the control of all 38 cases in 7 to 20 applications. In group 1, the wounds healed in 10-20 applications. In group 2, the wounds healed in 7-15 applications. Citric acid treatment was found most effective and economical approach for the successful treatment of chronic infected wounds in animals not responding to conventional antibiotic treatment and local wound care. These results suggest that when healing of chronic wounds in animals is a matter of great concern, the value of topical agents like citric acid should not be forgotten.

  9. The Classic: Chapter XVIII. Operative Treatment in Chronic Articular Ostitis

    OpenAIRE

    Gibney, Virgil P.

    2009-01-01

    This Classic article is a reprint of the original work by Virgil P. Gibney, Chapter XVIII. Operative Treatment in Chronic Articular Ostitis. An accompanying biographical sketch of Virgil P. Gibney, MD, is available at DOI 10.1007/s11999-009-1166-2. The Classic Article is ©1884 and is abridged from Gibney VP. Operative treatment in chronic articular ostitis. In: The Hip and Its Diseases. New York, NY, London, UK: Bermingham & Co; 1884:388–402.

  10. Medication Treatment Efficacy and Chronic Orofacial Pain.

    Science.gov (United States)

    Clark, Glenn T; Padilla, Mariela; Dionne, Raymond

    2016-08-01

    Chronic pain in the orofacial region has always been a vexing problem for dentists to diagnose and treat effectively. For trigeminal neuropathic pain, there are 3 medications (gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors) to use plus topical anesthetics that have therapeutic efficacy. For chronic daily headaches (often migraine in origin), 3 prophylactic medications have reasonable therapeutic efficacy (β-blockers, tricyclic antidepressants, and antiepileptic drugs). The 3 Food and Drug Administration-approved drugs for fibromyalgia (pregabalin, duloxetine, and milnacipran) are not robust, with poor efficacy. For osteroarthritis, nonsteroidal anti-inflammatory drugs have therapeutic efficacy and when gastritis contraindicates them, corticosteriod injections are helpful. PMID:27475515

  11. Family-oriented Treatment of Chronic Pain.

    Science.gov (United States)

    Hudgens, Alletta Jervey

    1979-01-01

    Describes the outcome of a short-term, family-centered, behavioral approach to chronic pain at the University of Minnesota Hospitals. Family members were taught operant conditioning techniques which rewarded nonpain-oriented behavior in patients. By treating the total family, 75 percent of the patients and families were able to lead satisfactory…

  12. Treatment Option Overview (Chronic Myeloproliferative Neoplasms)

    Science.gov (United States)

    ... Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role in ... on the hands and feet. Muscle pain. Itching. Diarrhea . Stages of Chronic Myeloproliferative Neoplasms Key Points There is no standard staging system ...

  13. Treatment Options for Chronic Myeloproliferative Neoplasms

    Science.gov (United States)

    ... Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role in ... on the hands and feet. Muscle pain. Itching. Diarrhea . Stages of Chronic Myeloproliferative Neoplasms Key Points There is no standard staging system ...

  14. Recent developments in the treatment of alcoholic chronic pancreatitis.

    Science.gov (United States)

    Tsujimoto, Tatsuhiro; Kawaratani, Hideto; Yoshiji, Hitoshi; Uemura, Masahito; Fukui, Hiroshi

    2008-06-01

    Chronic pancreatitis is a progressive inflammatory condition characterized by repeated attacks of abdominal pain, and the destruction and fibrosis of the pancreatic parenchyma which causes to reduced exocrine and endocrine functions. Alcohol is the most common cause of chronic pancreatitis. Although abstinence is usually considered a prerequisite for successful treatment of alcoholic chronic pancreatitis, we often encounter patients who have repeated attacks from the compensated stage through the transitional stage. In alcoholic chronic pancreatitis, continued alcohol consumption causes changes in the digestive hormones and vagal nerve function that induce the pancreatic acinar cells to oversecrete protein, increasing the protein concentration and viscosity of the pancreatic juice. This induces protein sedimentation from the pancreatic juice and formation of protein plugs within the pancreatic duct, triggering repeated attacks of acute pancreatitis. The treatment of alcoholic chronic pancreatitis includes alleviation of symptoms, particularly abdominal pain, elimination of trigger factors, prevention of recurrence and disease progression, adjuvant therapies for pancreatic exocrine and endocrine failure. Recently, the main constituent proteins in these protein plugs have been identified, enabling trials of several therapies, such as the administration of secretin formulations and endoscopic removal. Bromhexine hydrochloride, a bronchial mucolytic, has an affinity for the pancreatic acinar cells, inducing them to secrete pancreatic juice of low viscosity. In this review, we summarize the most recent thoughts about alcoholic chronic pancreatitis, and the new treatments, and in particular, we present our findings concerning the efficacy of bromhexine hydrochloride in the treatment of this disease. PMID:19630718

  15. Treatment in chronic migraine: choice of reabilitation strategies

    Directory of Open Access Journals (Sweden)

    Ioana STANESCU

    2015-12-01

    Full Text Available Migraine is a disabling neurologic condition with a spontaneous clinical evolution into a chronic form. Migraine progression from an episodic into a chronic form is realized through a period of time involving several months or years, during which an increase attack frequency occurs. .According to the International Classification of Headache Disorders (ICHD-3 chronic migraine is a type of primary headache occurring on 15 or more days per month for more than 3 months, in which more than 8 days per month headache meet criteria for migraine with or without aura or respond to specific migraine treatment. The prevalence of chronic migraine is estimated between 1- 3% of general population. Persons with chronic migraine are more likely to suffer from severe disability; chronic migraine has an important socio-economic impact. Diagnostic approach in chronic migraine includes exclusion of a secondary headache disorder and confirmation of a primary episodic headache. When a patient is found to overuse pain medication, diagnosis of both chronic migraine and MOH should be considered. Treating episodic migraine early and managing attack frequency using preventive medication and behavioural interventions will be benefic in reducing the risk of chronicisation. Lifestyle changes are important for avoiding triggers for migraine attacks; treatment of comorbidities is equally important because these conditions exacerbate patient’s tendency to have headaches. The initial relief step for drug abusers always relies in drug withdrawal. For migraine attacks treatment begins with non-pharmacologic interventions (staying in a quiet, dark room, pressure on painful areas, applying cold compresses , simple OTC analgetics (NSAIDs, paracetamol, aspirin, acetaminophen. If these are not effective, triptans are the drugs of choice. Preventive treatment is always recommended in patients with chronic migraine because the high frequency of headache attacks. Treatment should be

  16. Chronic pruritus--pathogenesis, clinical aspects and treatment.

    Science.gov (United States)

    Metz, M; Ständer, S

    2010-11-01

    Chronic pruritus is a major symptom in numerous dermatological and systemic diseases. Similar to chronic pain, chronic pruritus can have a dramatic impact on the quality of life and can worsen the general condition of the patient considerably. The pathogenesis of itch is diverse and involves a complex network of cutaneous and neuronal cells. In recent years, more and more itch-specific mediators and receptors, such as interleukin-31, gastrin-releasing peptide receptor or histamine H4 receptor have been identified and the concept of itch-specific neurons has been further characterized. Understanding of the basic principles is important for development of target-specific treatment of patients with chronic pruritus. In this review, we summarize the current knowledge about the pathophysiological principles of itch and provide an overview about current and future treatment options. PMID:20846147

  17. Selection of treatment modalities in children with chronic osteomyelitis

    OpenAIRE

    Unal, Vuslat Sema; Dayican, Avni; Demirel, Murat; Portakal, Suleyman; Ozkan, Guray; Ucaner, Ahmet

    2004-01-01

    Objectives: We evaluated clinical and follow-up findings and treatment methods of pediatric patients with chronic osteomyelitis. Methods: The study included 22 children (14 boys, 8 girls; mean age 8±7 years) who were treated for chronic osteomyelitis. Infection sites were the femur, tibia, ulna, and radius in 11, 8, 1, and 2 patients, respectively. Sixteen patients had a history of trauma. Fourteen patients had fractures, nine of which were associated with segmentary bone defects. All the ...

  18. Treatment Preferences for CAM in Children with Chronic Pain

    OpenAIRE

    Tsao, Jennie C. I.; Marcia Meldrum; Kim, Su C.; Jacob, Margaret C.; Zeltzer, Lonnie K

    2006-01-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years ± 2.4; range = 8–18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examin...

  19. Latin American consensus on guidelines for chronic migraine treatment

    OpenAIRE

    Alex Rodrigo Espinoza Giacomozzi; Alexander Parajeles Vindas; Ariovaldo Alberto da Silva Junior; Carlos Alberto Bordini; Carlos Federico Buonanotte; Celia Aparecida de Paula Roesler; Claudio Manoel Brito; Cristina Perez; Deusvenir de Souza Carvalho; Djacir Dantas Pereira de Macedo; Elcio Juliato Piovesan; Elder Machado Sarmento; Eliana Meire Melhado; Fabiola Dach Eckeli; Fernando Kowacs

    2013-01-01

    Chronic migraine is a condition with significant prevalence all around the world and high socioeconomic impact, and its handling has been challenging neurologists. Developments for understanding its mechanisms and associated conditions, as well as that of new therapies, have been quick and important, a fact which has motivated the Latin American and Brazilian Headache Societies to prepare the present consensus. The treatment of chronic migraine should always be preceded by a careful diagnosis...

  20. Chronic inflammatory disease and its treatment during pregnancy

    OpenAIRE

    Bröms, Gabriella

    2015-01-01

    The decision to have children is often coupled with varying degrees of apprehension. Women with chronic disease often worry about how the disease itself or its treatment will affect pregnancy and the fetus. The aim of this thesis was to add to the current knowledge concerning pregnancy and birth outcomes in chronic inflammatory disease. First, we studied pregnancy and delivery complications in women with Crohn’s disease and ulcerative colitis, the main types of inflammatory bowel diseas...

  1. Telbivudine: A new treatment for chronic hepatitis B

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Three hundred and fifty million people worldwide are estimated to be chronically infected with hepatitis B virus. 15%-40% of these subjects will develop cirrhosis,liver failure or hepatocellular carcinoma during their life. The treatment of chronic hepatitis B has improved dramatically over the last decade merits to the advent of nucleoside/nucleotide analogues and the use of pegylated interferons. Approved drugs for chronic hepatitis B treatment include: standard interferonalpha 2b, pegylated interferon-alpha 2a, lamivudine,adefovir dipivoxil, and entecavir. Unfortunately, these agents are not effective in all patients and are associated with distinct side effects. Interferons have numerous side effects and nucleoside or nucleotide analogues,which are well tolerated, need to be used for prolonged periods, even indefinitely. However, prolonged treatment with nucleoside or nucleotide analogues is associated with a high rate of resistance. Telbivudine is a novel,orally administered nucleoside analogue for use in the treatment of chronic hepatitis B. In contrast to other nucleoside analogues, Telbivudine has not been associated with inhibition of mammalian DNA polymerase with mitochondrial toxicity. Telbivudine has demonstrated potent activity against hepatitis B with a significantly higher rate of response and superior viral suppression compared with lamivudine, the standard treatment.Telbivudine has been generally well tolerated, with a low adverse effect profile, and at its effective dose, no doselimiting toxicity has been observed. Telbivudine is one of the most potent antiviral agents for chronic hepatitis B virus and was approved by the FDA in late 2006.

  2. Current concepts in the treatment of canine chronic hepatitis.

    Science.gov (United States)

    Honeckman, Adam

    2003-11-01

    Chronic hepatitis is a common disorder in dogs seen by general practitioners. Several new drugs have been marketed for treating this disease. Unfortunately, there are few controlled studies that examine the efficacy of these medications for the treatment of canine chronic hepatitis. A rational therapeutic approach can be implemented based on histopathologic findings of a liver biopsy. A liver biopsy is essential for establishing a definitive diagnosis and guiding the optimal therapy. The biopsy allows characterizing the inflammatory process, quantitating hepatic copper concentrations, and determining if fibrosis is present. Copper associated hepatopathy is treated with zinc and copper chelators. Idiopathic chronic hepatitis is thought to be immune mediated. The treatment of idiopathic chronic hepatitis consists of controlling inflammation (prednisone, azathioprine), reversing fibrosis (colchicine), and protecting against oxidant damage (vitamin E, ursodeoxycholic acid, S-adenosylmethionine). The prognosis for chronic hepatitis is quite variable. Dogs with end-stage disease have a poor prognosis, while dogs diagnosed earlier can have a mean survival of years. Early diagnosis and intervention are key to the successful treatment of dogs with chronic hepatitis. PMID:14738204

  3. Treatment of chronic inflammatory demyelinating polyneuropathy with cyclosporin-A.

    OpenAIRE

    Mahattanakul, W; Crawford, T O; Griffin, J. W.; Goldstein, J. M.; Cornblath, D. R.

    1996-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune mediated polyneuropathy for which there are effective therapies. However, not all patients improve with these treatments. Eight patients with CIDP, two with IgG monoclonal gammopathies, were treated with cyclosporin-A (3 to 5 mg/kg/day). In three, this treatment was successful. It was unsuccessful in four patients who were resistant to other treatments and in one who had initially received cyclosporin-A. There were no serio...

  4. Craniosacral Therapy for the Treatment of Chronic Neck Pain

    OpenAIRE

    Haller, Heidemarie; Lauche, Romy; Cramer, Holger; Rampp, Thomas; Saha, Felix J.; Ostermann, Thomas; Dobos, Gustav

    2016-01-01

    Objectives: With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients. Materials and Methods: A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20)...

  5. Current and future developments in the treatment of chronic wounds

    Directory of Open Access Journals (Sweden)

    Chin KY

    2013-11-01

    Full Text Available Kuen Yeow Chin, Suresh M Anandan,* Karan Koshal,* Prashant Gujadhur* Department of Plastic Surgery, Wexham Park Hospital, Slough, United Kingdom *These authors contributed equally to this work Abstract: Chronic wounds are common and their incidence has been on the increase. They place an enormous burden on health care services and have a major impact on several aspects of patients' wellbeing. It is vital for clinicians to recognize the complexity of the underlying processes leading to the development of a chronic wound. With this knowledge, the key factors that led to their development in each patient can be identified and appropriate steps taken to address modifiable factors. There is currently a wide range of treatments available for treatment of chronic wounds, with a range of exciting new treatments being developed. This paper aims to give an overview of the common etiology and pathophysiology of chronic wounds followed by a discussion of a range of current and future developments in their treatment. Keywords: chronic wound, wound healing, cutaneous

  6. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Chiarioni; Corrado Asteria; William E Whitehead

    2011-01-01

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: A recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.

  7. Evaluation of treatment with carboxymethylcellulose on chronic venous ulcers*

    Science.gov (United States)

    Januário, Virginia; de Ávila, Dione Augusto; Penetra, Maria Alice; Sampaio, Ana Luisa Bittencourt; Noronha Neta, Maria Isabel; Cassia, Flavia de Freire; Carneiro, Sueli

    2016-01-01

    BACKGROUND: Among the chronic leg ulcers, venous ulcers are the most common and constitute a major burden to public health. Despite all technology available, some patients do not respond to established treatments. In our study, carboxymethylcellulose was tested in the treatment of refractory chronic venous ulcers. OBJECTIVE: To evaluate the efficacy of carboxymethylcellulose 20% on the healing of chronic venous ulcers refractory to conventional treatments. METHODS: This is an analytical, pre-experimental study. Thirty patients were included with refractory venous ulcers, and applied dressings with carboxymethylcellulose 20% for 20 weeks. The analysis was based on measurement of the area of ulcers, performed at the first visit and after the end of the treatment. RESULTS: There was a reduction of 3.9 cm2 of lesion area (p=0.0001), corresponding to 38.8% (p=0.0001). There was no interruption of treatment and no increase in lesion area in any patient. CONCLUSIONS: Carboxymethylcellulose 20% represents a low cost and effective therapeutic alternative for the treatment of refractory chronic venous ulcers. However, controlled studies are necessary to prove its efficacy. PMID:26982773

  8. The Treatment of Chronic Pleural Empyema with Aspergillosis

    Directory of Open Access Journals (Sweden)

    Feride Sapmaz

    2012-07-01

    Full Text Available Chronic pleural empyema with aspergillus is a rare complication that usually presents after lung resection operations. Etiologic factors of pleural aspergillus includes healed or presence pulmonary tuberculosis, bronchopleural fistula, pleural catheterisation or drainage, lung resection, complex antibiotic uses. Medical and surgical treatments of chronic pleural empyema with aspergillus were examined in this study. Antifungal agents is used as medical treatment. Surgical therapy has a widely spectrum which includes tube tho-racostomy, open drainage, (Eleosser flap, Clagett Procedures, thoracostoma, decortication, omentum and/or extrathoracic or abdominal muscles transpo-sition to intrathoracic space.

  9. Pegylated interferons in the treatment of chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    张福奎

    2003-01-01

    Purpose To review the efficacy and safety of pegylated interferons (peginterferons) in the treatment of chronic hepatitis C.Data sources An English language literature search (MEDLINE 1988-2001) was performed and a total of 19 original articles related to the issue were selected.Data extraction After careful review of the selected papers, the meaningful results and conclusions were extracted using scientific criteria. The papers reviewed pertained mainly to the efficacy and safety profiles of peginterferons in the treatment of chronic hepatitis C.

  10. Easing Chronic Pain: Better Treatments and Medications

    Science.gov (United States)

    ... and relieve stress. Psychological methods These include counseling, hypnosis, and cognitive-behavioral therapy—a treatment that involves a wide variety of coping skills and relaxation methods to help prepare for and cope with pain. Surgery Although not always an option, surgery may ...

  11. Hyperkalaemic quadriparesis secondary to chronic diclofenac treatment

    OpenAIRE

    Patel, P; Mandal, B.; Greenway, M

    2001-01-01

    A 76 year old woman presented with a quadriparesis associated with hyperkalaemia. She had a 10 month history of treatment with oral diclofenac sodium. On admission she had hyperkalaemic metabolic acidosis with a normal anion gap and mild renal impairment. Her weakness resolved after withdrawal of diclofenac and medical correction of her hyperkalaemia. Non-steroidal anti-inflammatory drugs are known to cause hyperkalaemic acidosis and should be used with caution, especially in the presence of ...

  12. Latin American consensus on guidelines for chronic migraine treatment

    Directory of Open Access Journals (Sweden)

    Alex Rodrigo Espinoza Giacomozzi

    2013-07-01

    Full Text Available Chronic migraine is a condition with significant prevalence all around the world and high socioeconomic impact, and its handling has been challenging neurologists. Developments for understanding its mechanisms and associated conditions, as well as that of new therapies, have been quick and important, a fact which has motivated the Latin American and Brazilian Headache Societies to prepare the present consensus. The treatment of chronic migraine should always be preceded by a careful diagnosis review; the detection of possible worsening factors and associated conditions; the stratification of seriousness/impossibility to treat; and monitoring establishment, with a pain diary. The present consensus deals with pharmacological and nonpharmacological forms of treatment to be used in chronic migraine.

  13. Gabapentin and pregabalin for the treatment of chronic pruritus.

    Science.gov (United States)

    Matsuda, Kazuki M; Sharma, Divya; Schonfeld, Ariel R; Kwatra, Shawn G

    2016-09-01

    Chronic pruritus is a distressing symptom that is often refractory to treatment. Patients frequently fail topical therapies and oral over-the-counter antihistamines, prompting the clinician to consider alternative therapies such as neuroactive agents. Herein, the use of gabapentin and pregabalin, 2 medications well known for treating neuropathic pain and epilepsy that are occasionally used for relieving chronic pruritus is explored. The findings from original sources published to date to evaluate the use of gabapentin and pregabalin as antipruritic agents are explored. They are found to be promising alternative treatments for the relief of several forms of chronic pruritus, particularly uremic pruritus and neuropathic or neurogenic itch, in patients who fail conservative therapies. PMID:27206757

  14. Nutritional Support Treatment for Severe Chronic Hepatitis and Posthepatitic Cirrhosis

    Institute of Scientific and Technical Information of China (English)

    QIN Huimin; LI Hongtao; XING Mingyou; WU Chunming; LI Guojun; SONG Jianxin

    2006-01-01

    The therapeutic effectiveness of nutritional support in the treatment of severe chronic hepatitis and posthepatitic cirrhosis was evaluated. 143 patients with severe chronic hepatitis and 83 with posthepatitic cirrhosis were evaluated with SGA for assessing the nutritional status before the treatment. Patients with severe chronic hepatitis were divided into three groups: group A subject to enteral nutrition (EN) and parenteral nutrition (PN), group B subject to comprehensive treatment (CT) +PN; group C subject to CT+ EN. The patients with posthepatitic cirrhosis were divided into two groups: group D receiving CT and group E receiving CT+PN+EN. The function of liver and kidney and nutritional status were monitored to assess the therapy in 6 weeks. The results showed before treatment, over 90 % patients had moderate to severe malnutrition. After nutritional support, the liver function (ALT, T-biil) and nutritional status (TP, TC) in group A was improved significantly as compared with that in groups B and C (P<0.05). Compared with group D,the values of TP and Alb were increased significantly in group E (P<0.05), but the levels of ALT, AST and T-bil had no obvious change. It was suggested that most patients with severe chronic hepatitis or posthepatitic cirrhosis had malnutrition to varying degrees. The nutritional support treatment could obviously improve the nutritional status of these patients, and was helpful to ameliorate the liver function of the patients with severe chronic hepatitis. Among the methods of nutritional support treatment, PN combined with EN had the best effectiveness.

  15. Laser treatment of experimentally induced chronic arthritis

    Science.gov (United States)

    Guerino, M. R.; Baranauskas, V.; Guerino, A. C.; Parizotto, N.

    2000-02-01

    In this work, we investigated the effects of He-Ne laser irradiation on the inflammatory process induced in the articular cartilage of the right knee of guinea pigs. Through electron microscopy analysis it was possible to identify the induced arthritis in the articular cartilage and its modification after the laser treatment. The laser radiation promoted a reduction in the proliferation of the inflammatory cells in the damaged tissue and also induced the formation of cartilage bridges that tied the destroyed parts favoring the formation of a repaired tissue in the injured cartilage.

  16. Intravenous immunoglobulin treatment in chronic inflammatory demyelinating polyneuropathy

    NARCIS (Netherlands)

    P.A. van Doorn (Pieter)

    1990-01-01

    textabstractPatients with a chronic inflammatory demyelinating polyneuropathy (CIDP) may respond to treatment with corticosteroids and to plasmapheresis, which was demonstrated in controlled clinical studies. In an uncontrolled study it was found that 13/17 CIDP patients had a rapid and clinical imp

  17. Ondansetron Treatment in a Child Presenting with Chronic Intractable Pruritus

    OpenAIRE

    Chantal Frigon; Joëlle Desparmet

    2006-01-01

    The case of a seven-year-old boy with chronic pruritus secondary to a giant congenital melanocytic nevus is presented. The pruritus did not respond to conventional antipruritic drug treatment, but responded to ondansetron, a selective antagonist of 5-hydroxytryptamine type 3 receptors.

  18. Ondansetron Treatment in a Child Presenting with Chronic Intractable Pruritus

    Directory of Open Access Journals (Sweden)

    Chantal Frigon

    2006-01-01

    Full Text Available The case of a seven-year-old boy with chronic pruritus secondary to a giant congenital melanocytic nevus is presented. The pruritus did not respond to conventional antipruritic drug treatment, but responded to ondansetron, a selective antagonist of 5-hydroxytryptamine type 3 receptors.

  19. Managing chronic thromboembolic pulmonary hypertension: pharmacological treatment options

    OpenAIRE

    I.M. Lang

    2009-01-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening condition in which organised thrombi obstruct the pulmonary vessels, causing increased pulmonary vascular resistance, progressive pulmonary hypertension (PH) and right heart failure. The treatment of choice is pulmonary endarterectomy, which restores pulmonary haemodynamics with acceptable periprocedural mortality rates in the majority of suitable patients. However, CTEPH may be inoperable owing to surgically inaccess...

  20. Heliox in the treatment of chronic obstructive pulmonary disease

    OpenAIRE

    Andrews, R.; Lynch, M

    2004-01-01

    Objective: To determine if breathing helium oxygen mixtures in addition to conventional therapy in non-intubated adult chronic obstructive airways disease (COPD) patients reduces the arterial partial pressure of carbon dioxide (PaCO2) more than conventional treatment alone, and confers an advantage in terms of the odds of intubation in the acute setting.

  1. Methylphenidate in Treatment of ADHD and Comorbid Chronic Tic Disorder

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-07-01

    Full Text Available The safety and efficacy of immediate-release methylphenidate (MPH-IR for the treatment of attention deficit hyperactivity disorder (ADHD in children (ages 6-12 years with Tourette's syndrome (96% or chronic motor tic disorder (4% were evaluated at State University of New York, Stony Brook.

  2. Psychosocial perspectives in the treatment of pediatric chronic pain

    OpenAIRE

    Carter Bryan D; Threlkeld Brooke M

    2012-01-01

    Abstract Chronic pain in children and adolescents is associated with major disruption to developmental experiences crucial to personal adjustment, quality of life, academic, vocational and social success. Caring for these patients involves understanding cognitive, affective, social and family dynamic factors associated with persistent pain syndromes. Evaluation and treatment necessitate a comprehensive multimodal approach including psychological and behavioral interventions that maximize retu...

  3. TREATMENT OF CHRONIC HEART FAILURE: FOCUS ON METOPROLOL SUCCINATE

    OpenAIRE

    2015-01-01

    Advantages of metoprolol succinate in patients with chronic heart failure (CHF) are covered. Results of MERIT-HF study are taken as the main evidences. Patterns of the metoprolol succinate use in the treatment of different categories of patients with CHF (women, the elderly , severe CHF forms, CHF with concomitant hypertension or diabetes) are considered.

  4. TREATMENT OF CHRONIC HEART FAILURE: FOCUS ON METOPROLOL SUCCINATE

    Directory of Open Access Journals (Sweden)

    O. D. Ostroumova

    2015-12-01

    Full Text Available Advantages of metoprolol succinate in patients with chronic heart failure (CHF are covered. Results of MERIT-HF study are taken as the main evidences. Patterns of the metoprolol succinate use in the treatment of different categories of patients with CHF (women, the elderly , severe CHF forms, CHF with concomitant hypertension or diabetes are considered.

  5. Tuberculosis complicating imatinib treatment for chronic myeloid leukaemia

    NARCIS (Netherlands)

    Daniels, J. M. A.; Vonk-Noordegraaf, A.; Janssen, J. J. W. M.; Postmus, P. E.; van Altena, R.

    2009-01-01

    Although imatinib is not considered a predisposing factor for tuberculosis (TB), the present case report describes three patients in whom imatinib treatment for chronic myeloid leukaemia was complicated by TB. This raises the question of whether imatinib increases susceptibility to TB. There are sev

  6. Interferon alpha for treatment of chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Simonsson, Bengt; Hjorth-Hansen, Henrik; Bjerrum, Ole Weis;

    2011-01-01

    Treatment of chronic myeloid leukemia (CML) with interferon-alpha (IFN-α) was introduced in the early 1980s. Several clinical trials showed a survival advantage for patients treated with IFN-α compared to conventional chemotherapy. Some patients achieved longstanding complete cytogenetic remissions...

  7. Interferon alpha for treatment of chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Simonsson, Bengt; Hjorth-Hansen, Henrik; Bjerrum, Ole Weis;

    2011-01-01

    Treatment of chronic myeloid leukemia (CML) with interferon-alpha (IFN-a) was introduced in the early 1980s. Several clinical trials showed a survival advantage for patients treated with IFN-a compared to conventional chemotherapy. Some patients achieved longstanding complete cytogenetic remissions...

  8. Weekly Treatment of 2-Hydroxypropyl-β-cyclodextrin Improves Intracellular Cholesterol Levels in LDL Receptor Knockout Mice

    Directory of Open Access Journals (Sweden)

    Sofie M. A. Walenbergh

    2015-09-01

    Full Text Available Recently, the importance of lysosomes in the context of the metabolic syndrome has received increased attention. Increased lysosomal cholesterol storage and cholesterol crystallization inside macrophages have been linked to several metabolic diseases, such as atherosclerosis and non-alcoholic fatty liver disease (NAFLD. Two-hydroxypropyl-β-cyclodextrin (HP-B-CD is able to redirect lysosomal cholesterol to the cytoplasm in Niemann-Pick type C1 disease, a lysosomal storage disorder. We hypothesize that HP-B-CD ameliorates liver cholesterol and intracellular cholesterol levels inside Kupffer cells (KCs. Hyperlipidemic low-density lipoprotein receptor knockout (Ldlr−/− mice were given weekly, subcutaneous injections with HP-B-CD or control PBS. In contrast to control injections, hyperlipidemic mice treated with HP-B-CD demonstrated a shift in intracellular cholesterol distribution towards cytoplasmic cholesteryl ester (CE storage and a decrease in cholesterol crystallization inside KCs. Compared to untreated hyperlipidemic mice, the foamy KC appearance and liver cholesterol remained similar upon HP-B-CD administration, while hepatic campesterol and 7α-hydroxycholesterol levels were back increased. Thus, HP-B-CD could be a useful tool to improve intracellular cholesterol levels in the context of the metabolic syndrome, possibly through modulation of phyto- and oxysterols, and should be tested in the future. Additionally, these data underline the existence of a shared etiology between lysosomal storage diseases and NAFLD.

  9. Ziconotide in the treatment of pcoa chronic pain: cases report

    Directory of Open Access Journals (Sweden)

    Sabrina Giusto

    2009-05-01

    Full Text Available Chronic pain related to PCOA is a clinical condition which affects more than 5 percent of the population. This article presents two clinical cases of severe pain related to the disease treated with opioids and epidural SCS with inadequate results. Treatment by intrathecal ziconotide showed, in both cases, a good reduction of pain. These clinical cases represent the first experience of ischemic pain treatment with ziconotide.

  10. Ziconotide in the treatment of pcoa chronic pain: cases report

    OpenAIRE

    Sabrina Giusto; Domenico Quattrone; Placido Calì

    2009-01-01

    Chronic pain related to PCOA is a clinical condition which affects more than 5 percent of the population. This article presents two clinical cases of severe pain related to the disease treated with opioids and epidural SCS with inadequate results. Treatment by intrathecal ziconotide showed, in both cases, a good reduction of pain. These clinical cases represent the first experience of ischemic pain treatment with ziconotide.

  11. Standard and escalating treatment of chronic inflammatory demyelinating polyradiculoneuropathy

    OpenAIRE

    Yoon, Min-Suk; Chan, Andrew; Gold, Ralf

    2011-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired, immune-mediated polyradiculoneuritis that is progressive or relapsing over a period of at least 8 weeks. Although the exact pathogenesis is unclear, it is thought to be mediated by both cellular and humoral immune reactions directed against the peripheral nerve myelin or axon. CIDP also involves spinal nerve roots. Early medical treatment of CIDP is important to prevent axonal loss. Only three treatment regimens for CIDP...

  12. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy.

    OpenAIRE

    van Doorn, P. A.

    1994-01-01

    Intravenous immunoglobulin (IVIg) treatment is shown to be effective in a selected group of patients with a chronic inflammatory demyelinating polyneuropathy (CIDP). The proportion of patients that improve after IVIg treatment varies between studies. Because 40% of a group of IVIg treated CIDP patients needed intermittent IVIg infusions to maintain their improved clinical condition, it is expected that IVIg is effective, at least in this subgroup of patients. However, the proportion of patien...

  13. Intravenous immunoglobulin treatment in chronic inflammatory demyelinating polyneuropathy

    OpenAIRE

    Doorn, Pieter

    1990-01-01

    textabstractPatients with a chronic inflammatory demyelinating polyneuropathy (CIDP) may respond to treatment with corticosteroids and to plasmapheresis, which was demonstrated in controlled clinical studies. In an uncontrolled study it was found that 13/17 CIDP patients had a rapid and clinical important improvement after infusion of Fresh Frozen Plasma (FFP). A beneficial response was also seen after-mtravenous rmmunoglobulin (Mg) treatment. The aims of this study were: - to evaluate the cl...

  14. Transdermal delivery of the in situ hydrogels of curcumin and its inclusion complexes of hydroxypropyl-β-cyclodextrin for melanoma treatment.

    Science.gov (United States)

    Sun, Yunbo; Du, Lina; Liu, Yangpu; Li, Xin; Li, Miao; Jin, Yiguang; Qian, Xiaohong

    2014-07-20

    Curcumin (Cur) is a hydrophobic polyphenol with diverse pharmacological effects, especially for cancer treatment. However, its weak water solubility and stability was the major obstacle for the formulation research of Cur. The complexation of Cur and hydroxypropyl-β-cyclodextrin (HP-β-CD) was done by grinding. The increasing solubility of Cur was achieved due to complexation and the photochemical stability of Cur was improved. The inclusion of Cur could happen when two ends of Cur were embedded into the cavity of the HP-β-CD rings. The in situ hydrogels (ISGs) of Cur and its inclusion complexes were prepared using poloxamers 407 and 188 as the matrix. The extent of drug's in vitro release from the ISGs depended on the dissolution of drugs. Both of the ISGs had transdermal effect and cytotoxicity on B16-F10 cells. However, the effects of the ISGs containing Cur inclusion complexes were much higher than those of Cur ISGs because of the improved Cur solubility in the former. The cytotoxicity of Cur on melanoma cells was related to blocking of cellular proliferation in the G2/M stage followed by cellular apoptosis. The ISGs of Cur inclusion complexes are a promising formulation for melanoma treatment. PMID:24746691

  15. Safety of interferon treatment for chronic HCV hepatitis

    Institute of Scientific and Technical Information of China (English)

    D Festi; L Sandri; G Mazzella; E Roda; T Sacco; T Staniscia; S Capodicasa; A Vestito; A Colecchia

    2004-01-01

    Hepatitis C is a major cause of liver-related morbidity and mortality worldwide, In fact, chronic hepatitis C is considered as one of the primary causes of chronic liver disease, cirhosis and hepatocellular carcinoma, and is the most common reason for liver transplantation. The primary objectives for the treatment of HCV-related chronic hepatitis is to eradicate infection and prevent progression of the disease. The treatment has evolved from the use of α-interferon (TFNα)alone to the combination of IFNα plus ribavirin, with a significant improvement in the overall efficacy, and to the newer PEG-IFNs which have further increased the virological response, used either alone or in combination with ribavirin.Despite these positive results, in terms of efficacy, concerns are related to the safety and adverse events. Many patients must reduce the dose of PEG-IFN or ribavirin, others must stop the treatment and a variable percentage of subjects are not suitable owing to intolerance toward drugs. IFNβ represents a potential therapeutic alternative for the treatment of chronic viral hepatitis and in some countries it plays an important role in therapeutic protocols. Aim of the present paper was to review available data on the safety of IFNβ treatment in HCV-related chronic hepatitis.The rates of treatment discontinuation and/or dose modification due to the appearance of severe side effects during IFNβ are generally low and in several clinical studies no requirements for treatment discontinuation and/or dose modifications have been reported. The most frequent side effects experienced during IFNβ treatment are flu-like syndromes, fever, fatigue and injection-site reactions. No differences in terms of side-effect frequency and severity between responders and non-responders have been reported.A more recent study, performed to compare IFNβ alone or in combination with ribavirin, confirmed the good safety profile of both treatments. Similar trends of adverse event

  16. Medium-Level Laser in Chronic Tinnitus Treatment

    OpenAIRE

    K. Dejakum; Piegger, J.; C. Plewka; A. Gunkel; Thumfart, W.; S. Kudaibergenova; Goebel, G.; Kral, F.; Freysinger, W

    2013-01-01

    The purpose of this study was to evaluate the effect of medium-level laser therapy in chronic tinnitus treatment. In a prospective double-blind placebo-controlled trial, either active laser (450 mW, 830 nm combined Ga-Al-As diode laser) or placebo irradiation was applied through the external acoustic meatus of the affected ear towards the cochlea. Fourty-eight patients with chronic tinnitus were studied. The main outcome was measured using the Goebel tinnitus questionnaire, visual analogue sc...

  17. Sarcoidosis and chronic hepatitis C: treatment with prednisone and colchicine.

    Science.gov (United States)

    Pereira, Eduardo Guimarães; Guimarães, Tais Ferreira; Bottino, Caroline Bertolini; D'Acri, Antonio Macedo; Lima, Ricardo Barbosa; Martins, Carlos José

    2016-04-01

    Sarcoidosis is a disease which still has uncertain etiology. Possible environmental causes are cited in the literature, like organic and inorganic particles and infectious agents. Recent studies have demonstrated the occurrence of sarcoidosis in patients with chronic C hepatitis; however, this association remains without statistical or causal evidence. In this report a case of sarcoidosis associated with chronic hepatitis C will be described, with subcutaneous lesions, considered rare, and good response to treatment with colchicine and prednisone. The hepatitis C virus was isolated in sarcoid tissue and the association between the two diseases will be discussed. PMID:27192527

  18. Glycopyrronium bromide for the treatment of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Riario-Sforza, Gian Galeazzo; Ridolo, Erminia; Riario-Sforza, Edoardo; Incorvaia, Cristoforo

    2015-02-01

    Glycopyrronium bromide is a new long-acting muscarinic antagonist to be used once-daily, which is approved as a bronchodilator for the symptomatic maintenance treatment of adult patients with chronic obstructive pulmonary disease (COPD). In the Glycopyrronium bromide in chronic Obstructive pulmonary disease airWays trials, treatment with inhaled glycopyrronium bromide at 50 μg once daily achieved a significantly better lung function than placebo, as measured by the trough forced expiratory volume in 1 s in patients with moderate-to-severe COPD. The lung function improvement was maintained for up to 52 weeks. Other improved indexes were dyspnea scores, health status, exacerbation rates and time of exercise endurance. Studies comparing the efficacy of glycopyrronium versus tiotropium bromide found substantial equivalence of the two drugs. Glycopyrronium was generally well tolerated. These data add inhaled glycopyrronium bromide to the treatment of patients with moderate to severe COPD as an effective once-daily LAMA. PMID:25547422

  19. Change in Suicidal Ideation Following Interdisciplinary Treatment of Chronic Pain

    Science.gov (United States)

    Kowal, John; Wilson, Keith G.; Henderson, Peter R.; McWilliams, Lachlan A.

    2014-01-01

    Objectives To examine suicidal ideation in individuals with chronic pain, especially change in suicidal thinking following interdisciplinary treatment. Methods Consecutive patients (n = 250) admitted to a 4-week, group-based chronic pain management program completed measures of pain intensity, functional limitations, depressive symptoms, overall distress, pain catastrophizing, self-perceived burden, and suicidal ideation at pre- and post-treatment. Results Before treatment, 30 (12.0%) participants were classified as having a high level of suicidal ideation, 56 (22.4%) had a low level of suicidal ideation, and 164 (65.6%) reported none. Following treatment, there was a significant reduction in suicidal ideation and improvements in all other outcomes, but there were still some individuals with high (n = 22, 8.8%) or low (n = 28, 11.2%) levels at discharge. Patients with high suicidal ideation at baseline differed from those with no suicidal thinking on pre- and post-treatment measures of depression, distress, catastrophizing, and self-perceived burden, but not on pain intensity or functional limitations. Patients high in suicidal ideation endorsed greater pain catastrophizing and self-perceived burden than those low in suicidal thinking. Sustained suicidal ideation after treatment was associated with higher baseline levels of suicidal thinking and self-perceived burden to others, as well as a more limited overall response to treatment. Discussion Suicidal ideation was common in individuals with chronic pain, although mostly at a low level. Interdisciplinary treatment may result in reduced suicidal thinking; however, some patients continue to express thoughts of self-harm. Future studies could examine processes of change and interventions for treatment-resistant suicidal concerns. PMID:24281291

  20. Omacetaxine mepesuccinate in the treatment of intractable chronic myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Chen Y

    2014-01-01

    Full Text Available Yaoyu Chen,1 Shaoguang Li2 1Department of Oncology, Novartis Institutes for Biomedical Research, Cambridge, 2Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA Abstract: In a significant proportion of patients with chronic myeloid leukemia, resistance to BCR-ABL tyrosine kinase inhibitors develops due to acquisition of BCR-ABL kinase domain mutations and insensitivity of leukemia stem cells to tyrosine kinase inhibitors. Omacetaxine mepesuccinate (formerly called homoharringtonine is a natural alkaloid that inhibits protein synthesis and induces cell death. Omacetaxine mepesuccinate has been recently approved by the US Food and Drug Administration to treat patients with chronic myeloid leukemia who failed to respond to multiple tyrosine kinase inhibitors and/or acquired the BCR-ABL-T315I mutation. In this review, we discuss the use and effectiveness of omacetaxine mepesuccinate in the treatment of chronic myeloid leukemia, with coverage of its pharmacology, mode of action, and pharmacokinetics. We believe that omacetaxine mepesuccinate will be beneficial to many patients with chronic myeloid leukemia who do not respond well to tyrosine kinase inhibitors. Keywords: BCR-ABL, leukemic stem cells, chronic myeloid leukemia, biomarker, hematopoietic stem cells, cancer stem cells

  1. INFRARED DIODE LASER RETINAL TREATMENT FOR CHRONIC HEADACHE

    Directory of Open Access Journals (Sweden)

    Subba Rao

    2013-12-01

    Full Text Available ABSTRACT: Nearly 60 to 70 crores of people all over the world are suffering from various types of chronic headache. This is one of the commonest medical problems. To get relief from headache various medical treatments are used with little success. The aim of our study is to give permanent treatment to chronic headache patients by using infrared diode laser selective retinal photocoagulati on. NIDEK infrared diode laser with NIDEK SL40 slit - lamp and NIDEK digital fundus camera for retinal evaluation, MAINSTER 135D lens for laser beam focusing and retinal examination and TOPCON non - contact tonometer for intra ocular pressure measurements are used. Diode laser is chosen because of its deep penetration into all the layers of retina and choroid. 500 cases of chronic headache were studied. Laser photocoagulation was given in selective areas of retina in 2 to 3 sessions with 15 days interval. 10 to 60 years age group were studied. 90% of patients who got laser treatment are relieved from their headache in severity and in frequency. 80% of patients needed 2 sittings and 20% of patients needed 3 sittings. 70% of patients got relief from headache by fi rst sitting itself. 50% of patients are not only relieved from their headaches but also noticed visual clarity improvement. Retinal ischaemia is one of the main cause for ocular pain and headache. Laser treatment will improve circulation by reducing ischae mia thereby relieves ocular pain and headache

  2. Chronic pain: the burden of disease and treatment innovations.

    Science.gov (United States)

    Monti, S; Caporali, R

    2015-01-01

    Musculoskeletal conditions are the most frequent cause of chronic pain and affect around 1 in 5 adults in Europe. When chronic pain occurs, it becomes disease itself, with substantial clinical, social and economic impact. Efficacy and tolerability problems are encountered with all therapeutic strategies available to treat musculoskeletal pain. This often limits effective analgesia and patients' long term compliance, with the result that chronic pain is persistently underestimated and undertreated. Tapentadol is a novel, centrally acting analgesic that has been recently commercialized for the treatment of chronic pain. This new molecule, by combining two distinct mechanisms of action, μ-opioid receptor agonism (MOR) and noradrenaline reuptake inhibition (NRI), introduces a new pharmacological class called MOR-NRI. Several studies demonstrated promising results in the management of both nociceptive and neuropathic pain and good tolerability profile, particularly concerning side effects, compared to traditional opioids. This novel analgesic represents a possible therapeutic option also in the rheumatologic field, particularly in the treatment of osteoarthritis and low back pain. PMID:26492961

  3. Chronic pain: the burden of disease and treatment innovations

    Directory of Open Access Journals (Sweden)

    S. Monti

    2015-10-01

    Full Text Available Musculoskeletal conditions are the most frequent cause of chronic pain and affect around 1 in 5 adults in Europe. When chronic pain occurs, it becomes disease itself, with substantial clinical, social and economic impact. Effi cacy and tolerability problems are encountered with all therapeutic strategies available to treat musculoskeletal pain. This often limits effective analgesia and patients’ long term compliance, with the result that chronic pain is persistently underestimated and undertreated. Tapentadol is a novel, centrally acting analgesic that has been recently commercialized for the treatment of chronic pain. This new molecule, by combining two distinct mechanisms of action, μ-opioid receptor agonism (MOR and noradrenaline reuptake inhibition (NRI, introduces a new pharmacological class called MOR-NRI. Several studies demonstrated promising results in the management of both nociceptive and neuropathic pain and good tolerability profi le, particularly concerning side effects, compared to traditional opioids. This novel analgesic represents a possible therapeutic option also in the rheumatologic fi eld, particularly in the treatment of osteoarthritis and low back pain.

  4. Treatment of chronic inflammatory demyelinating polyradiculoneuropathy with methotrexate

    OpenAIRE

    Fialho, D; Chan, Y‐C; Allen, D C; Reilly, M.M.; Hughes, R A C

    2006-01-01

    We discovered many reports of other immunosuppressive drugs being used in adults with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) but none of methotrexate. As weekly low dose oral methotrexate is safe, effective, and well tolerated in other diseases, we treated 10 patients with otherwise treatment resistant CIDP. Seven showed improvement in strength by at least two points on the MRC sum score and three worsened. Only two showed an improvement in disability and both were a...

  5. Lenalidomide in the treatment of chronic lymphocytic leukemia

    OpenAIRE

    Agostino Cortelezzi; Mariarita Sciumè; Gianluigi Reda

    2012-01-01

    The application of nucleoside analogue-based chemotherapy and immunotherapy with rituximab or alemtuzumab has increased both response rate and survival in patients with Chronic Lymphocytic Leukemia (CLL). However, because none of these therapies is curative, sequential therapeutic regimens are required. The majority of patients with relapsed or refractory CLL carry poor prognostic factors and show shorter overall survival and resistance to standard treatment. Numerous drugs have recently be...

  6. Chronic Generalized Parodontitis. Part II. Modern Treatment and Prevention Techniques

    OpenAIRE

    Lukinykh L.M.; Kruglova N.V.

    2011-01-01

    To optimize a therapeutic process due to technological development in dentistry there have appeared new progressive technologies that allow improving life quality of patients with periodontal inflammatory diseases. Modern techniques of a complex etiopathogenic treatment of periodontal inflammatory diseases including conservative, orthopedic, orthodontic and surgical measures have been presented. There has been proved the use of preparations of systemic and local effect to treat chronic ge...

  7. AMELOTEX IN THE TREATMENT OF CHRONIC BACK PAIN SYNDROMES

    Directory of Open Access Journals (Sweden)

    Irina Yuryevna Suvorova

    2010-01-01

    Full Text Available Recently there has been a considerable increase in the number of patients with lingering recurrent and chronic pain syndromes of various origin. Forty-one patients with dorsopathies were examined. Two types of pain were identified; these were vertebrogenic and nonvertebrogenic pains. The appropriateness of this identification was confirmed by instrumental studies. Treatment was performed using a selective nonsteroidal antiinflammatory drug (Amelotex. Pain syndrome relief was noted during the therapy

  8. AMELOTEX IN THE TREATMENT OF CHRONIC BACK PAIN SYNDROMES

    Directory of Open Access Journals (Sweden)

    Irina Yuryevna Suvorova

    2010-09-01

    Full Text Available Recently there has been a considerable increase in the number of patients with lingering recurrent and chronic pain syndromes of various origin. Forty-one patients with dorsopathies were examined. Two types of pain were identified; these were vertebrogenic and nonvertebrogenic pains. The appropriateness of this identification was confirmed by instrumental studies. Treatment was performed using a selective nonsteroidal antiinflammatory drug (Amelotex. Pain syndrome relief was noted during the therapy

  9. Chronic hepatitis C: This and the new era of treatment.

    Science.gov (United States)

    Bertino, Gaetano; Ardiri, Annalisa; Proiti, Maria; Rigano, Giuseppe; Frazzetto, Evelise; Demma, Shirin; Ruggeri, Maria Irene; Scuderi, Laura; Malaguarnera, Giulia; Bertino, Nicoletta; Rapisarda, Venerando; Di Carlo, Isidoro; Toro, Adriana; Salomone, Federico; Malaguarnera, Mariano; Bertino, Emanuele; Malaguarnera, Michele

    2016-01-18

    Over the last years it has started a real revolution in the treatment of chronic hepatitis C. This occurred for the availability of direct-acting antiviral agents that allow to reach sustained virologic response in approximately 90% of cases. In the near future further progress will be achieved with the use of pan-genotypic drugs with high efficacy but without side effects. PMID:26807205

  10. Treatment of Chronic Myelomonocytic Leukemia with 5-Azacytidine: Case Reports

    OpenAIRE

    Peter Rohon; Jana Vondrakova; Anna Jonasova; Milena Holzerova; Marie Jarosova; Karel Indrak

    2012-01-01

    Epigenetic therapy with hypomethylating agent (5-azacytidine; AZA) is common in the management of specific subtypes of myelodysplastic syndrome (MDS), but there are only few studies in chronic myelomonocytic leukemia (CMML) patients. In this paper our experience with 3 CMML patients treated with AZA is described. In one patient transfusion independency was observed after 4 treatment cycles; in one case a partial response was recorded, but a progression to acute myeloid leukemia (AML) after 13...

  11. Intervention treatments for chronic pain syndrome in cancer patients

    OpenAIRE

    V. V. Bryuzgin

    2010-01-01

    Noninvasive treatments for chronic pain syndrome benefit in 80-90% of cancer patients. Invasive, intervention procedures for analgesia should be used in other cases. These include neuroablative and neuromodulatory measures. Neuroablation is defined as the physical suspension of painful impulse transmission pathways by a surgical, chemical, or thermal method and comprises lytic and other blocks. Neuromodulation is the dynamic and functional suppression of pain impulse pathways by the intraspin...

  12. Diagnosis and treatment of pancreatic pseudocysts in chronic pancreatitis.

    Science.gov (United States)

    Aghdassi, Ali; Mayerle, Julia; Kraft, Matthias; Sielenkämper, Andreas W; Heidecke, Claus-Dieter; Lerch, Markus M

    2008-03-01

    Pancreatic pseudocysts are a well-known complication of acute or chronic pancreatitis, with a higher incidence in the latter. Diagnosis is accomplished most often by computed tomographic scanning, by endoscopic retrograde cholangiopancreatography, or by ultrasound, and a rapid progress in the improvement of diagnostic tools enables detection with high sensitivity and specificity. Different strategies contribute to the treatment of pancreatic pseudocysts: endoscopic transpapillary or transmural drainage, percutaneous catheter drainage, or open surgery. The feasibility of endoscopic drainage is highly dependent on the anatomy and topography of the pseudocyst, but provides high success and low complication rates. Percutaneous drainage is used for infected pseudocysts. However, its usefulness in chronic pancreatitis-associated pseudocysts is questionable. Internal drainage and pseudocyst resection are frequently used as surgical approaches with a good overall outcome, but a somewhat higher morbidity and mortality compared with endoscopic intervention. We therefore conclude that pseudocyst treatment in chronic pancreatitis can be effectively achieved by both endoscopic and surgical means. This review entails publications referring to the classification of pancreatic pseudocysts, epidemiology, diagnostic tools, and therapeutic options for pancreatic pseudocysts. Only full articles were considered for the review. Based on a search in PubMed, the MeSH terms "pancreatic pseudocysts and classification," "diagnosis," and "endoscopic, percutaneous, and surgical treatment" were used either alone or in combination. PMID:18376299

  13. Iron metabolism in chronic hepatitis C patients on antiviral treatment

    Directory of Open Access Journals (Sweden)

    K. V. Zhdanov

    2009-01-01

    Full Text Available Purpose of the present research studying dynamics of the parameters describing a metabolism of iron at chronic hepatitis С patients on a combined antiviral therapy peg-interferon-2а and ribavirin. Has served 50 patients chronic hepatitis C (anti-HCV “+”, РНК HCV “+”, 1b genotype in the age from 18 till 59 years, on the average 33±1,5years, at various stages of disease and stages of monitoring antiviral treatments. To patients the parameters describing a metabolism of iron (serum iron, transferrin, ferritin, haptoglobin, ceruplasmin, total iron binding capacity, transferrin saturation by iron were defined. The sustain virology response (SVR was estimated - definition RNA HCV in half a year after end of treatment (72 week. It was carried out liver biopsy with the subsequent estimation of a degree of inflammatory activity and fibrosis on system METAVIR. Therapy peg-interferon-2а and ribavirin was accompanied by decrease serum iron, transferrin, ferritin, ceruplasmin, haptoglobin, transferrin saturation by iron irrespective of the answer to treatment. Thus, SVR directly correlated with higher level of iron and ceruplasmin of blood before therapy, on its background and during supervision. Normalization of biochemical activity chronic hepatitis C and positive morphological dynamics correspond with the parameters describing changes in a metabolism of iron at its patients, possibly, were compensatory-adaptive and to some extent endogen antiviral reaction of an organism of the person on HCV - infection. 

  14. Treatment of severe chronic hypotonic hyponatremia: a new treatment model

    Directory of Open Access Journals (Sweden)

    Antonio Burgio

    2013-03-01

    Full Text Available Recommended treatment of severe hypotonic hyponatremia is based on the infusion of 3% sodium chloride solution, with a daily correction rate below 10 mEq/L of sodium concentration, according to the Adrogué and Madias formula that includes the current desired change in sodium concentrations. However, such treatment needs close monitoring of the rate of infusion and does not take into account the body weight or age of the patient. This may result in hypercorrection and neurological damage. We made an inverse calculation using the same algorithms of the Adrogué and Madias formula to estimate the number of vials of sodium chloride needed to reach a correction rate of the serum sodium concentration below 0.4 mEq/h, taking into account the body weight and age of the patient. Three tables have been produced, each containing the number of vials to be infused, according to the patient’s age and body weight, the serum sodium concentration, and the rate of correction over 24 h to avoid the risk of brain damage. We propose a new practical model to calculate the need of sodium chloride infusate to safely correct the hyponatremia. The tables make treatment easier to manage in daily clinical practice in a wide range of patient ages and body weights.

  15. Is exercise an alternative treatment for chronic insomnia?

    Directory of Open Access Journals (Sweden)

    Giselle Soares Passos

    2012-01-01

    Full Text Available The purposes of this systematic/critical review are: 1 to identify studies on the effects of exercise on chronic insomnia and sleep complaints in middle-aged and older adults and to compare the results of exercise with those obtained with hypnotic medications and 2 to discuss potential mechanisms by which exercise could promote sleep in insomniac patients. We identified studies from 1983 through 2011 using MEDLINE, SCOPUS and Web of Science. For systematic analyses, only studies assessing the chronic effects of exercise on sleep in people with sleep complaints or chronic insomnia were considered. We used the following keywords when searching for articles: insomnia, sleep, sleep complaints, exercise and physical activity. For a critical review, studies were selected on the effects of exercise and possible mechanisms that may explain the effects of exercise on insomnia. We identified five studies that met our inclusion criteria for systematic review. Exercise training is effective at decreasing sleep complaints and insomnia. Aerobic exercise has been more extensively studied, and its effects are similar to those observed after hypnotic medication use. Mechanisms are proposed to explain the effects of exercise on insomnia. There is additional documented evidence on the antidepressant and anti-anxiety effects of exercise. Exercise is effective to decrease sleep complaints and to treat chronic insomnia. Exercise presented similar results when compared with hypnotics; however, prospective studies comparing the effects of exercise with medical and non-medical treatments are warranted before including exercise as a first-line treatment for chronic insomnia are necessary.

  16. 76 FR 66307 - Scientific Information Request on Phototherapy for Treatment of Chronic Plaque Psoriasis

    Science.gov (United States)

    2011-10-26

    ... for Treatment of Chronic Plaque Psoriasis AGENCY: Agency for Healthcare Research and Quality (AHRQ... Phototherapy medical devices for treatment of chronic plaque psoriasis. Scientific information is being... Phototherapy for Treatment of Chronic Plaque Psoriasis, which is currently being conducted by the...

  17. Treatment of Chronic Migraine with Focus on Botulinum Neurotoxins

    Directory of Open Access Journals (Sweden)

    Sara M. Schaefer

    2015-07-01

    Full Text Available Migraine is the most common neurological disorder, and contributes to disability and large healthcare costs in the United States and the world. The treatment of migraine until recently has focused on medications, both abortive and prophylactic, but treatment of chronic migraine has been revolutionized with the introduction of botulinum toxin injection therapy. In this review, we explore the current understanding of migraine pathophysiology, and the evolution of the use of botulinum toxin therapy including proposed pathophysiological mechanisms through animal data. We also discuss the similarities and differences between three injection techniques.

  18. How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

    OpenAIRE

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-01-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the v...

  19. Sol-Gel Synthesis of Ordered β-Cyclodextrin-Containing Silicas

    OpenAIRE

    Trofymchuk, Iryna Mykolaivna; Roik, Nadiia; Belyakova, Lyudmila

    2016-01-01

    New approaches for β-cyclodextrin-containing silicas synthesis were demonstrated. Materials with hexagonally ordered mesoporous structure were prepared by postsynthesis grafting and by co-condensation methods. β-Cyclodextrin activated by a N,N′-carbonyldiimidazole was employed for postsynthesis treatment of 3-aminopropyl-modified MCM-41 support as well as for sol-gel synthesis with β-cyclodextrin-containing organosilane and tetraethyl orthosilicate participation in the presence of cetyltrimet...

  20. Potential Use of C60/2-Hydroxypropyl-β-cyclodextrin Nanoparticles as a New Photosensitizer in the Treatment of Cancer

    Directory of Open Access Journals (Sweden)

    Abdulmalik Altaf

    2014-01-01

    Full Text Available The photosensitizing ability of C60/2-hydroxypropyl-β-cyclodextrin (HP-β-CyD nanoparticles under visible light irradiation was studied by electron spin resonance (ESR and phototoxicity on cancer cells. In addition, the photoinduced antitumor effect to the tumor-bearing mice was evaluated. C60 nanoparticles were prepared by grinding a mixture of HP-β-CyD. The resulting C60/HP-β-CyD nanoparticles were highly-sensitive to visible light and generated higher levels of 1O2 than protoporphyrin IX (PpIX. C60/HP-β-CyD reduced the viability of cancer cells (HeLa cells and A549 cells in response to irradiation by visible light in a dose-dependent manner. The IC50 values of the C60/HP-β-CyD nanoparticles was 10 μM for HeLa cells and 60 μM for A549 cells at an irradiation level of 35 mW/cm2. The photodynamic effect of C60/HP-β-CyD nanoparticles on the in vivo growth of mouse sarcoma S-180 cells was evaluated after intratumor injection. The outcome of PDT by C60/HP-β-CyD was directly dependent on the dose of irradiated light. Treatment with C60/HP-β-CyD nanoparticles at a C60 dose of 2.0 mg/kg under visible light irradiation at 350 mW/cm2 (63 J/cm2 markedly suppressed tumor growth, whereas that at 30 J/cm2 was less effective. These findings suggest that C60/HP-β-CyD nanoparticles represent a promising candidate for use in cancer treatment by PDT.

  1. Treatment of chronic osteomyelitis with one-stage allograft

    Institute of Scientific and Technical Information of China (English)

    LU Wei-ju; LI Bin; BAO Ni-rong; QIAN Hong-bo; ZENG Xiao-feng; XU Bin; CHEN Yong; ZHAO Jian-ning

    2006-01-01

    Objective: To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs.Methods: Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis (8 cases of nonunion )underwent one-stage allograft after debridement in our hospital.Results: Thirty-five cases were followed up for an average period of 28 months (range, 13 to 55 months), in which 32 cases (91.43%) were found no infection, and 3cases (8.57 %) were confirmed recurrence of infection.Four out of 8 cases of bone nonunion healed in 9.5 months on average (range, 3 to 12 months), and another case also acquired union after redebridement and autograft of ilium due to infection recurrence 35 days after surgery.Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment.Conclusions: A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.

  2. Effect of chronic (-)-nicotine treatment on rat cerebral benzodiazepine receptors

    International Nuclear Information System (INIS)

    The purpose of this study was to clarify the effect of (-)-nicotine on cerebral benzodiazepine receptors (BzR) with radiotracer methods. The effect of (-)-nicotine on BzR was examined in in vitro studies using chronic (-)-nicotine-treated rats using 3H-diazepam. The in vitro radioreceptor assay showed a 14% increase in the maximum number of binding sites of BzR in chronic (-)-nicotine-treated rats in comparison with the control rats. Moreover, a convenient in vivo uptake index of 125I-iomazenil was calculated and a higher uptake of the radioactivity was observed in the chronic (-)-nicotine-treated group than in the control group. Although further studies of the mechanism of (-)-nicotine on such BzR changes are required, an increase in the amount of BzR in the cerebral cortex was found in rats that underwent chronic (-)-nicotine treatment, and this result contributed to the understanding of the effects of (-)-nicotine and smoking on neural functions

  3. [Subcutaneous immunoglobulin. Treatment in chronic inflammatory demyelinating polyradiculo-neuropathy].

    Science.gov (United States)

    Nogués, Martín A; Varela, Francisco J; Seminario, Gisela; Insúa, María C; Bezrodnik, Liliana

    2016-01-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired disease that may affect nerve roots and peripheral nerves. Despite its low incidence, diagnosis is particularly important because there are different effective treatments. Human immunoglobulin is one of the mainstays of the treatment. Although there are few studies up to date, subcutaneous immunoglobulin (IgSC) has been proposed as an alternative to intravenous administration with similar efficacy. We present three cases with definite CIDP, classified according to the European Federation of Neurological Societies / Peripheral Nerve, Society (EFNS /PNS) criteria in which was used SCIgG as a treatment after success with the intravenous route. The Overall Neuropathy Limitations Scale (ONLS) was used to estimate the changes in the muscular strength before and after treatment. PMID:26826992

  4. Neurobehavioral response to increased treatment dosage in chronic, severe aphasia

    Directory of Open Access Journals (Sweden)

    Jennifer L Mozeiko

    2014-04-01

    •\tIncreased activation in S2’s bilateral inferior frontal gyrus following the second treatment session indicates that a second Treatment Period can influence continued neuroplastic change in severe, chronic aphasia. •\tS1 appears to show the most activation following Treatment Period I. It is possible that his greater lesion volume or site did not allow for benefit from a second dose to the same degree as S2. •\tActivation changes (or lack thereof in both cases corresponded with performance on the naming task in the scanner, reflecting the effect of treatment. •\tFor S2, neuroimaging supported the behavioral results which favor a second dose of ILAT. For S1, behavioral results, particularly in his consistent increases on the BNT, are not supported by either the behavioral results in the scanner or the BOLD response.

  5. Systematic Review of Multidisciplinary Chronic Pain Treatment Facilities.

    Science.gov (United States)

    Fashler, Samantha R; Cooper, Lynn K; Oosenbrug, Eric D; Burns, Lindsay C; Razavi, Shima; Goldberg, Lauren; Katz, Joel

    2016-01-01

    This study reviewed the published literature evaluating multidisciplinary chronic pain treatment facilities to provide an overview of their availability, caseload, wait times, and facility characteristics. A systematic literature review was conducted using PRISMA guidelines following a search of MEDLINE, PsycINFO, and CINAHL databases. Inclusion criteria stipulated that studies be original research, survey more than one pain treatment facility directly, and describe a range of available treatments. Fourteen articles satisfied inclusion criteria. Results showed little consistency in the research design used to describe pain treatment facilities. Availability of pain treatment facilities was scarce and the reported caseloads and wait times were generally high. A wide range of medical, physical, and psychological pain treatments were available. Most studies reported findings on the percentage of practitioners in different health care professions employed. Future studies should consider using more comprehensive search strategies to survey facilities, improving clarity on what is considered to be a pain treatment facility, and reporting on a consistent set of variables to provide a clear summary of the status of pain treatment facilities. This review highlights important information for policymakers on the scope, demand, and accessibility of pain treatment facilities. PMID:27445618

  6. Antioxidant Phytochemicals for the Prevention and Treatment of Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Yu-Jie Zhang

    2015-11-01

    Full Text Available Overproduction of oxidants (reactive oxygen species and reactive nitrogen species in the human body is responsible for the pathogenesis of some diseases. The scavenging of these oxidants is thought to be an effective measure to depress the level of oxidative stress of organisms. It has been reported that intake of vegetables and fruits is inversely associated with the risk of many chronic diseases, and antioxidant phytochemicals in vegetables and fruits are considered to be responsible for these health benefits. Antioxidant phytochemicals can be found in many foods and medicinal plants, and play an important role in the prevention and treatment of chronic diseases caused by oxidative stress. They often possess strong antioxidant and free radical scavenging abilities, as well as anti-inflammatory action, which are also the basis of other bioactivities and health benefits, such as anticancer, anti-aging, and protective action for cardiovascular diseases, diabetes mellitus, obesity and neurodegenerative diseases. This review summarizes recent progress on the health benefits of antioxidant phytochemicals, and discusses their potential mechanisms in the prevention and treatment of chronic diseases.

  7. Medium-Level Laser in Chronic Tinnitus Treatment

    Directory of Open Access Journals (Sweden)

    K. Dejakum

    2013-01-01

    Full Text Available The purpose of this study was to evaluate the effect of medium-level laser therapy in chronic tinnitus treatment. In a prospective double-blind placebo-controlled trial, either active laser (450 mW, 830 nm combined Ga-Al-As diode laser or placebo irradiation was applied through the external acoustic meatus of the affected ear towards the cochlea. Fourty-eight patients with chronic tinnitus were studied. The main outcome was measured using the Goebel tinnitus questionnaire, visual analogue scales measuring the perceived loudness of tinnitus, the annoyance associated with tinnitus, and the degree of attention paid to tinnitus as well as psycho-acoustical matches of tinnitus pitch and loudness. The results did show only very moderate temporary improvement of tinnitus. Moreover, no statistically relevant differences between laser and placebo group could be found. We conclude that medium-level laser therapy cannot be regarded as an effective treatment of chronic tinnitus in our therapy regime considering the limited number of patients included in our study.

  8. The neurobiology, investigation, and treatment of chronic insomnia.

    Science.gov (United States)

    Riemann, Dieter; Nissen, Christoph; Palagini, Laura; Otte, Andreas; Perlis, Michael L; Spiegelhalder, Kai

    2015-05-01

    Chronic insomnia is defined by difficulties in falling asleep, maintaining sleep, and early morning awakening, and is coupled with daytime consequences such as fatigue, attention deficits, and mood instability. These symptoms persist over a period of at least 3 months (Diagnostic and Statistical Manual 5 criteria). Chronic insomnia can be a symptom of many medical, neurological, and mental disorders. As a disorder, it incurs substantial health-care and occupational costs, and poses substantial risks for the development of cardiovascular and mental disorders, including cognitive deficits. Family and twin studies confirm that chronic insomnia can have a genetic component (heritability coefficients between 42% and 57%), whereas the investigation of autonomous and central nervous system parameters has identified hyperarousal as a final common pathway of the pathophysiology, implicating an imbalance of sleep-wake regulation consisting of either overactivity of the arousal systems, hypoactivity of the sleep-inducing systems, or both. Insomnia treatments include benzodiazepines, benzodiazepine-receptor agonists, and cognitive behavioural therapy. Treatments currently under investigation include transcranial magnetic or electrical brain stimulation, and novel methods to deliver psychological interventions. PMID:25895933

  9. Managing chronic thromboembolic pulmonary hypertension: pharmacological treatment options

    Directory of Open Access Journals (Sweden)

    I. M. Lang

    2009-03-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is a life-threatening condition in which organised thrombi obstruct the pulmonary vessels, causing increased pulmonary vascular resistance, progressive pulmonary hypertension (PH and right heart failure. The treatment of choice is pulmonary endarterectomy, which restores pulmonary haemodynamics with acceptable periprocedural mortality rates in the majority of suitable patients. However, CTEPH may be inoperable owing to surgically inaccessible thrombi or comorbid diseases that confer an unacceptably high risk. Pharmacotherapies, although not yet approved, may be useful in this situation or for treating residual or recurrent PH following surgery. Vasodilator drugs for PH are attracting growing interest as potential treatments for CTEPH because this disease has recently been labelled as a "dual" pulmonary vascular disorder: major vessel obstruction and remodelling is combined with a small vessel arteriopathy that is histologically indistinguishable from the classical pulmonary arteriopathy observed in pulmonary arterial hypertension. Of three completed randomised controlled trials in patients with CTEPH, only one was powered to detect a treatment effect. The BENEFIT trial employed the dual endothelin-receptor antagonist bosentan. Although haemodynamics improved significantly, the second component of the primary end-point, exercise capacity, was not met. More evidence is required to resolve whether vasodilator treatments are beneficial for inoperable chronic thromboembolic pulmonary hypertension.

  10. Targeted treatment for chronic lymphocytic leukemia: clinical potential of obinutuzumab

    Directory of Open Access Journals (Sweden)

    Smolej L

    2014-12-01

    Full Text Available Lukáš Smolej 4th Department of Internal Medicine – Hematology, University Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic Abstract: Introduction of targeted agents revolutionized the treatment of chronic lymphocytic leukemia (CLL in the past decade. Addition of chimeric monoclonal anti-CD20 antibody rituximab to chemotherapy significantly improved efficacy including overall survival (OS in untreated fit patients; humanized anti-CD52 antibody alemtuzumab and fully human anti-CD20 antibody ofatumumab lead to improvement in refractory disease. Novel small molecule inhibitors such as ibrutinib and idelalisib demonstrated excellent activity and were very recently licensed in relapsed/refractory CLL. Obinutuzumab (GA101 is the newest monoclonal antibody approved for the treatment of CLL. This novel, glycoengineered, type II humanized anti-CD20 antibody is characterized by enhanced antibody-dependent cellular cytotoxicity and direct induction of cell death compared to type I antibodies. Combination of obinutuzumab and chlorambucil yielded significantly better OS in comparison to chlorambucil monotherapy in untreated comorbid patients. These results led to approval of obinuzutumab for the treatment of CLL. Numerous clinical trials combining obinutuzumab with other cytotoxic drugs and novel small molecules are currently under way. This review focuses on the role of obinutuzumab in the treatment of CLL. Keywords: chronic lymphocytic leukemia, anti-CD20 antibodies, chlorambucil, rituximab, ofatumumab, obinutuzumab, overall survival

  11. Psychological Interventions in the Treatment of Chronic Itch.

    Science.gov (United States)

    Schut, Christina; Mollanazar, Nicholas K; Kupfer, Jörg; Gieler, Uwe; Yosipovitch, Gil

    2016-03-01

    Patients with chronic itch suffer from higher levels of depression and anxiety than their healthy counterparts. Furthermore, psychological factors, such as stress, are known to aggravate itch. The mere act of thinking about itching can induce the sensation. Interventions like habit reversal training and arousal reduction have been shown to have positive effects on itch relief. Yet, there is still limited data on the psychological management to control the itch scratch cycle and a description of methods suitable to address itch. In this review, we describe different psychological interventions shown to be effective in the treatment of chronic itch. We also provide suggestions based on our experience of suitable interventions for patients with different types of itch. PMID:26073701

  12. Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD

    DEFF Research Database (Denmark)

    Galmiche, Jean-Paul; Hatlebakk, Jan; Attwood, Stephen;

    2011-01-01

    Context Gastroesophageal reflux disease (GERD) is a chronic, relapsing disease with symptoms that have negative effects on daily life. Two treatment options are long-term medication or surgery. Objective To evaluate optimized esomeprazole therapy vs standardized laparoscopic antireflux surgery...... (LARS) in patients with GERD. Design, Setting, and Participants The LOTUS trial, a 5-year exploratory randomized, open, parallel-group trial conducted in academic hospitals in 11 European countries between October 2001 and April 2009 among 554 patients with well-established chronic GERD who initially.......6%). Conclusion This multicenter clinical trial demonstrated that with contemporary antireflux therapy for GERD, either by drug-induced acid suppression with esomeprazole or by LARS, most patients achieve and remain in remission at 5 years....

  13. Repression predicts outcome following multidisciplinary treatment of chronic pain.

    Science.gov (United States)

    Burns, J W

    2000-01-01

    This study examined whether repression predicts outcome following multidisciplinary treatment for chronic pain and whether links between anxiety and outcome are obscured by repressors. Ninety-three chronic pain patients completed a 4-week pain program. Lifting capacity, walking endurance, depression, pain severity, and activity were measured at pre- and posttreatment. Low-anxious, repressor, high-anxious, and defensive/high-anxious groups were formed from median splits of Anxiety Content (ACS) and Lie scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Significant ACS x Lie interactions were found for lifting capacity, depression, and pain severity changes. Planned comparisons showed that both repressors and high-anxious patients performed poorly on lifting capacity; repressors alone recovered poorly on depression and pain severity. Results imply that repression may interfere with the process and outcome of pain programs. PMID:10711590

  14. [Osteoporosis treatment for patients with chronic kidney disease].

    Science.gov (United States)

    Konishi, Yoshio

    2015-10-01

    Osteoporosis is defined as a condition of impairment in bone strength and predisposes individuals to an increased risk of fractures. The risk of fragility fracture is shown to be high in patients with chronic kidney disease (CKD). Osteoporosis treatment for patients with CKD G1-3 should not differ from treatment for patients without CKD, as long as there are no accompanying hyperparathyroidism and hyperphosphatemia that indicate the co-existence of CKD -mineral and bone disorder. However, there are few published data on osteoporosis treatment for patients with CKD G4, 5. So, considerations for current pharmacologic therapy (such as bisphosphonate, denosumab, teriparatide, and raloxifene) should be a thoughtful and open discussion with these patients. PMID:26529937

  15. Methylated β-Cyclodextrins

    DEFF Research Database (Denmark)

    Schönbeck, Jens Christian Sidney; Westh, Peter; Madsen, Jens Christian;

    2011-01-01

    groups at O2 promote complexation by extending the hydrophobic cavity. Like in the case of 2-hydroxypropylated cyclodextrins, the methyl substituents cause an increased release of ordered water from the hydration shell of the bile salts, resulting in a strong increase in both the enthalpy and the entropy...

  16. Targeted treatment of chronic myeloid leukemia: role of imatinib

    Directory of Open Access Journals (Sweden)

    Ila Tamascar

    2009-03-01

    Full Text Available Ila Tamascar, Jeyanthi RamanarayananDepartment of Medical Oncology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, USAAbstract: Chronic myeloid leukemia (CML is a myeloproliferative disorder characterized by clonal expansion of pleuripotent hematopoetic stem cells. The incidence of CML is 1 to 2 cases per 100,000 people per year; in the Western Hemisphere, CML accounts for 15% of leukemias in adults. Discovery of the specific karyotypic abnormality of the Philadelphia (Ph chromosome in the pathogenesis of CML has led to a better understanding of the disease and hence to an advancement of targeted therapeutics. Availability of imatinib as an accepted targeted therapy in newly diagnosed patients has changed the treatment paradigm in CML. The majority of CML patients in chronic phase achieve excellent and durable responses with standard-dose imatinib. Mechanisms of primary and secondary resistance to imatinib in CML have been extensively studied and newer tyrosine kinase inhibitors are now being evaluated for clinical use. It is important that at any time the CML treatment and response remain optimal and thus patients on imatinib require continuous monitoring for early detection of resistance. This review will discuss the treatment and guidelines for monitoring CML patients in the imatinib era.Keywords: BCR-ABL, imatinib, tyrosine kinase inhibitors, leukemia, CML

  17. Treatment Preferences for CAM in children with chronic pain.

    Science.gov (United States)

    Tsao, Jennie C I; Meldrum, Marcia; Kim, Su C; Jacob, Margaret C; Zeltzer, Lonnie K

    2007-09-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years +/- 2.4; range = 8-18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80%) were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities. PMID:17965769

  18. Treatment Preferences for CAM in Children with Chronic Pain

    Directory of Open Access Journals (Sweden)

    Jennie C. I. Tsao

    2007-01-01

    Full Text Available CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls (mean age = 14.5 years ± 2.4; range = 8–18 years presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80% were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy, pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

  19. Clinical Study on Treatment of Chronic Renal Failure with Shenshuailing

    Institute of Scientific and Technical Information of China (English)

    鞠建伟; 郭亚玲; 梁延平; 孙世宁; 杨建华; 杨素云

    2001-01-01

    The therapeutic effects of Shenshuailing Kou Fu Ye (SKFY肾衰灵口服液, the Oral Liquid for Renal Failure) and Shenshuailing Guan Chang Ye (SGCY肾衰灵灌肠液, the Enema for Renal Failure) were evaluated in treatment of chronic renal failure, with coateg aldehyde oxystarch as the controls. The changes in the clinical symptoms, serum creatinine, blood urea nitrogen and creatinine clearance rate were observed. The total effective rate in the former was 90.46%, and the latter 60.43%.

  20. Adalimumab treatment for severe recalcitrant chronic plaque psoriasis.

    LENUS (Irish Health Repository)

    Ryan, C

    2012-02-01

    AIM: To assess the efficacy and safety profile of adalimumab in patients with severe, recalcitrant chronic plaque psoriasis, and to assess short-term overlapping of other systemic treatment with adalimumab to prevent flaring of disease. METHODS: This was a retrospective study comprising 39 patients with chronic plaque psoriasis treated with adalimumab between October 2005 and January 2008. All had failed treatment with other systemic agents, including biological therapies in 59% of patients. Patients were started on adalimumab 40 mg weekly or fortnightly, as clinically indicated. Severity of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). Therapeutic response was assessed by 75% improvement on PASI (PASI 75). All adverse events were recorded. RESULTS: Results were analysed separately for those treated with adalimumab only and those on combination treatment. PASI 75 was achieved in 38% (8 of 21 patients at week 16), 62% (13 of 21 patients) at week 24, 69% (9 of 13 patients) at week 48% and 71% (5 of 7 patients) at week 72 in the adalimumab-only group, compared with 56% (5 of 9 patients) at week 16, 50% (4 of 8 patients) at week 24, 80% (4 of 5 patients) at week 48% and 67% (2 of 3 patients) at week 72 in the combined group. Of the 39 patients, 15 (38%) achieved a PASI of 0 at some point in their treatment. Adalimumab was well tolerated; 38% of patients experienced side-effects, which were generally mild. CONCLUSION: Adalimumab was effective in a group of patients with psoriasis refractory to other systemic therapies, including biological treatments, and was well tolerated.

  1. Cyclodextrin induces calcium-dependent lysosomal exocytosis.

    Directory of Open Access Journals (Sweden)

    Fannie W Chen

    Full Text Available Cyclodextrins (CDs have long been used to manipulate cellular cholesterol levels both in vitro and in vivo, but their direct effects at a cellular level are not well characterized. Recently, CDs have garnered much interest because of their ability to clear stored cholesterol from Niemann Pick Type C (NPC cells and markedly prolong the life of NPC1 disease mice. Here, we investigate the hypothesis that treatment with 2-hydroxypropyl- β-cyclodextrin (HPB-CD stimulates lysosomal exocytosis in a calcium-enhanced manner. We propose that this exocytosis is the mechanism by which HPB-CD ameliorates the endolysosomal cholesterol storage phenotype in NPC cells. These findings have significant implications for the use of HPB-CD in biochemical assays and data interpretation as well as for their use for the treatment for NPC and other disorders.

  2. Treatments for chronic myeloid leukemia: a qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Ferdin

    2012-08-01

    Full Text Available Roxanne Ferdinand,1 Stephen A Mitchell,2 Sarah Batson,2 Indra Tumur11Pfizer, Tadworth, UK; 2Abacus International, Bicester, UKBackground: Chronic myeloid leukemia (CML is a myeloproliferative disorder of blood stem cells. The tyrosine kinase inhibitor (TKI imatinib was the first targeted therapy licensed for patients with chronic-phase CML, and its introduction was associated with substantial improvements in response and survival compared with previous therapies. Clinical trial data are now available for the second-generation TKIs (nilotinib, dasatinib, and bosutinib in the first-, second-, and third-line settings. A qualitative systematic review was conducted to qualitatively compare the clinical effectiveness, safety, and effect on quality of life of TKIs for the management of chronic-, accelerated-, or blast-phase CML patients.Methods: Included studies were identified through a search of electronic databases in September 2011, relevant conference proceedings and the grey literature.Results: In the first-line setting, the long-term efficacy (up to 8 years of imatinib has been confirmed in a single randomized controlled trial (International Randomized Study of Interferon [IRIS]. All second-generation TKIs reported lower rates of transformation, and comparable or superior complete cytogenetic response (CCyR, major molecular response (MMR, and complete molecular response rates compared with imatinib by 2-year follow-up. Each of the second-generation TKIs was associated with a distinct adverse-event profile. Bosutinib was the only second-generation TKI to report quality-of-life data (no significant difference compared with imatinib treatment. Data in the second- and third-line setting confirmed the efficacy of the second-generation TKIs in either imatinib-resistant or -intolerant patients, as measured by CCyR and MMR rates.Conclusion: Data from first-line randomized controlled trials reporting up to 2-year follow-up indicate superior response

  3. Attrition and adherence in the online treatment of chronic insomnia.

    Science.gov (United States)

    Hebert, Elizabeth A; Vincent, Norah; Lewycky, Samantha; Walsh, Kaitlyn

    2010-01-01

    This study examined the ability of the Theory of Planned Behavior (TPB; Ajzen, 1985) and the Transtheoretical Model of Behavior Change (TTM; Prochaska & DiClemente, 1983) to explain adherence and attrition in an online treatment program for chronic insomnia. Responses to questionnaire measures of the TPB and TTM were used to predict adherence and dropout over the subsequent 5 weeks of treatment. Results showed that there was a 17% dropout rate and that perceived behavioral control, social support, and intention to complete the program were significantly associated with adherence to sleep hygiene homework. Attrition was predicted only by symptom severity and psychiatric comorbidity. Implications are that these models should be considered to maximize adherence. PMID:20582757

  4. Treatment of Chronic Myelomonocytic Leukemia with 5-Azacytidine: Case Reports

    Directory of Open Access Journals (Sweden)

    Peter Rohon

    2012-01-01

    Full Text Available Epigenetic therapy with hypomethylating agent (5-azacytidine; AZA is common in the management of specific subtypes of myelodysplastic syndrome (MDS, but there are only few studies in chronic myelomonocytic leukemia (CMML patients. In this paper our experience with 3 CMML patients treated with AZA is described. In one patient transfusion independency was observed after 4 treatment cycles; in one case a partial response was recorded, but a progression to acute myeloid leukemia (AML after 13 AZA cycles has appeared. In one patient, AZA in reduced dosage was administered as a bridging treatment before allogeneic stem cell transplantation (ASCT, but in the control bone marrow aspirate (before ASCT a progression to AML was recorded. Future studies are mandatory for evaluation of new molecular and clinical features which could predict the efficiency of hypomethylating agents in CMML therapy with respect to overall survival, event-free survival, quality-adjusted life year, and pharmacoeconomy.

  5. Treatment of Chronic Myelomonocytic Leukemia with 5-Azacytidine: Case Reports

    Science.gov (United States)

    Rohon, Peter; Vondrakova, Jana; Jonasova, Anna; Holzerova, Milena; Jarosova, Marie; Indrak, Karel

    2012-01-01

    Epigenetic therapy with hypomethylating agent (5-azacytidine; AZA) is common in the management of specific subtypes of myelodysplastic syndrome (MDS), but there are only few studies in chronic myelomonocytic leukemia (CMML) patients. In this paper our experience with 3 CMML patients treated with AZA is described. In one patient transfusion independency was observed after 4 treatment cycles; in one case a partial response was recorded, but a progression to acute myeloid leukemia (AML) after 13 AZA cycles has appeared. In one patient, AZA in reduced dosage was administered as a bridging treatment before allogeneic stem cell transplantation (ASCT), but in the control bone marrow aspirate (before ASCT) a progression to AML was recorded. Future studies are mandatory for evaluation of new molecular and clinical features which could predict the efficiency of hypomethylating agents in CMML therapy with respect to overall survival, event-free survival, quality-adjusted life year, and pharmacoeconomy. PMID:22937326

  6. Psychosocial perspectives in the treatment of pediatric chronic pain

    Directory of Open Access Journals (Sweden)

    Carter Bryan D

    2012-06-01

    Full Text Available Abstract Chronic pain in children and adolescents is associated with major disruption to developmental experiences crucial to personal adjustment, quality of life, academic, vocational and social success. Caring for these patients involves understanding cognitive, affective, social and family dynamic factors associated with persistent pain syndromes. Evaluation and treatment necessitate a comprehensive multimodal approach including psychological and behavioral interventions that maximize return to more developmentally appropriate physical, academic and social activities. This article will provide an overview of major psychosocial factors impacting on pediatric pain and disability, propose an explanatory model for conceptualizing the development and maintenance of pain and functional disability in medically difficult-to-explain pain syndromes, and review representative evidence-based cognitive behavioral and systemic treatment approaches for improving functioning in this pediatric population.

  7. Psychosocial perspectives in the treatment of pediatric chronic pain.

    Science.gov (United States)

    Carter, Bryan D; Threlkeld, Brooke M

    2012-01-01

    Chronic pain in children and adolescents is associated with major disruption to developmental experiences crucial to personal adjustment, quality of life, academic, vocational and social success. Caring for these patients involves understanding cognitive, affective, social and family dynamic factors associated with persistent pain syndromes. Evaluation and treatment necessitate a comprehensive multimodal approach including psychological and behavioral interventions that maximize return to more developmentally appropriate physical, academic and social activities. This article will provide an overview of major psychosocial factors impacting on pediatric pain and disability, propose an explanatory model for conceptualizing the development and maintenance of pain and functional disability in medically difficult-to-explain pain syndromes, and review representative evidence-based cognitive behavioral and systemic treatment approaches for improving functioning in this pediatric population. PMID:22676345

  8. Mexiletine for treatment of chronic painful diabetic neuropathy

    DEFF Research Database (Denmark)

    Dejgard, A; Kastrup, J; Petersen, P

    1988-01-01

    Sixteen of nineteen patients completed a randomised double-blind crossover trial to assess the effect of oral mexiletine (10 mg/kg bodyweight daily) on the symptoms and signs of chronic painful diabetic neuropathy. The median age of the sixteen patients was 50 years (range 30-64). Assessment with...... threshold levels, beat-to-beat variation in heart rate during deep breathing, and postural blood pressure response. Mild side-effects were seen in three of the sixteen patients during mexiletine treatment....... with a five-item clinical symptom scale showed significant improvement during the mexiletine phase compared with the placebo phase. Pain was reduced during mexiletine but not during placebo, as assessed by a visual analogue rating scale. Mexiletine treatment had no effect on tendon reflexes, vibration...

  9. Rituximab for the treatment of patients with chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    M Gentile

    2010-03-01

    Full Text Available M Gentile, E Vigna, C Mazzone, E Lucia, AG Recchia, L Morabito2, MG Bisconte, C Gentile, F Morabito1UOC di Ematologia, Azienda Ospedaliera di Cosenza, Italy; 2Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Tenerife, SpainAbstract: Chronic lymphocytic leukemia (CLL is a lymphoproliferative disorder that originates from antigen-experienced B lymphocytes that do not die and hence accumulate due to external survival signals or undergo apoptosis and are replenished by proliferating precursors. These neoplastic lymphocytes exhibit a characteristic immunophenotype of CD5+/CD19+/CD20+/HLA-DR+/CD23+/sIgdim. Thus, the CD20 antigen has been an appealing target for therapy. The introduction of the monoclonal antibody rituximab (anti-CD20 enabled an outstanding advance in CLL treatment. The introduction of this monoclonal antibody into chemotherapy regimens has dramatically improved complete response rates and progression-free survival in patients with both untreated and relapsed CLL. Although only preliminary data from phase III confirmatory trials have been reported, the FCR regimen, which combines fludarabine and cyclophosphamide with rituximab, is currently the most effective treatment regimen for CLL patients, and has also been demonstrated to significantly improve overall survival . The success of rituximab and the identification of other CLL lymphocyte surface antigens have spurred the development of a multitude of monoclonal antibodies targeting distinct proteins and epitopes in an attempt to target CLL cells more effectively.Keywords: rituximab, chronic lymphocytic leukemia, chemotherapy

  10. Effects of cyclodextrins on the structure of LDL and its susceptibility to copper-induced oxidation.

    Science.gov (United States)

    Ao, Meiying; Gan, Chaoye; Shao, Wenxiang; Zhou, Xing; Chen, Yong

    2016-08-25

    Cyclodextrins (CDs) have long been widely used as drug/food carriers and were recently developed as drugs for the treatment of diseases (e.g. Niemann-Pick C1 and cancers). It is unknown whether cyclodextrins may influence the structure of low-density lipoprotein (LDL), its susceptibility to oxidation, and atherogenesis. In this study, four widely used cyclodextrins including α-CD, γ-CD, and two derivatives of β-CD (HPβCD and MβCD) were recruited. Interestingly, agarose gel electrophoresis (staining lipid and protein components of LDL with Sudan Black B and Coomassie brilliant blue, respectively but simultaneously) shows that cyclodextrins at relatively high concentrations caused disappearance of the LDL band and/or appearance of an additional protein-free lipid band, implying that cyclodextrins at relatively high concentrations can induce significant electrophoresis-detectable lipid depletion of LDL. Atomic force microscopy (AFM) detected that MβCD (as a representative of cyclodextrins) induced size decrease of LDL particles in a dose-dependent manner, further confirming the lipid depletion effects of cyclodextrins. Moreover, the data from agarose gel electrophoresis, conjugated diene formation, MDA production, and amino group blockage of copper-oxidized LDL show that cyclodextrins can impair LDL susceptibility to oxidation. It implies that cyclodextrins probably help to inhibit atherogenesis by lowering LDL oxidation. PMID:27140842

  11. Current progress in the treatment of chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Alexandra Alexopoulou; George V Papatheodoridis

    2012-01-01

    Over the last decade,the standard of care for the treatment of chronic hepatitis C has been the combination of pegylated-interferon-alfa (PEG-IFN) and ribavirin (RBV)which results in sustained virological response (SVR)rates of 75%-85% in patients with genotypes 2 or 3 but only of 40%-50% in patients with genotype 1.Currently,there are rapid and continuous developments of numerous new agents against hepatitis C virus (HCV),which are the focus of this review.Boceprevir and telaprevir,two first-generation NS3/4A HCV protease inhibitors,have been recently licensed in several countries around the world to be used in combination with PEGIFN and RBV for the treatment of genotype 1 patients.Boceprevir or telaprevir based triple regimens,compared with the PEG-IFN/RBV combination,improve the SVR rates by 25%-31% in treatment-naive genotype 1 patients,by 40%-64% in prior relapsers,by 33%-45% in prior partial responders and by 24%-28% in prior null responders.At the same time,the application of response-guided treatment algorithms according to the on-treatment virological response results in shortening of the total therapy duration to only 24 wk in 45%-55% of treatment-naive patients.There are,however,several challenges with the use of the new triple combinations in genotype 1 patients,such as the need for immediate results of HCV RNA testing using sensitive quantitative assays,new and more frequent adverse events (anemia and dysgeusia for boceprevir; pruritus,rash and anemia for telaprevir),new drug interactions and increasing difficulties in compliance.Moreover,the SVR rates are still poor in very difficult to treat subgroups of genotype 1 patients,such as null responders with cirrhosis,while there is no benefit for patients who cannot tolerate PEGIFN/RBV or who are infected with non-1 HCV genotype.Many newer anti-HCV agents of different classes and numerous combinations are currently under evaluation with encouraging results.Preliminary data

  12. Profile of omalizumab in the treatment of chronic spontaneous urticaria

    Directory of Open Access Journals (Sweden)

    Labrador-Horrillo M

    2015-08-01

    Full Text Available Moises Labrador-Horrillo,1 Marta Ferrer2 1Allergy Section, Internal Medicine Department, Vall d’Hebron Hospital, Universitat Autònoma de Barcelona, Barcelona, 2Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, IDISNA, Instituto de Investigación de Navarra, Pamplona, Spain Abstract: Chronic spontaneous urticaria (CSU is a disease with significant morbidity and relative prevalence that has important effects on the quality of life (QoL of those who suffer from it. Omalizumab is a recombinant humanized anti-immunoglobulin E (IgE antibody that binds to the Cε3 domain of the IgE heavy chain and prevents it from binding to its high-affinity receptor FcεRI. It has been largely studied in the field of asthma and is currently approved for the treatment of both adult and pediatric (children; >6-year-old patients. In addition, in recent, well-controlled clinical trials in patients with CSU resistant to antihistamines, add-on therapy with subcutaneous omalizumab significantly reduced the severity of itching, and the number and size of hives, and increased patients’ health-related QoL and the proportion of days free from angioedema compared with placebo, with an excellent tolerance. Thus, omalizumab is an effective and well-tolerated add-on therapy for patients with CSU who are symptomatic despite background therapy with H1 antihistamines. In this review, we cover the following points: epidemiology, pathogenesis, assessment of activity, impact on QoL, and treatment of CSU, and finally, we focus on omalizumab in the treatment of CSU including the pharmacokinetic properties and mechanism of action, and use in pregnant women, nursing infants, and children. Keywords: omalizumab, chronic spontaneous urticaria, antihistamines, subcutaneous administration, add-on therapy

  13. Optimal treatment with boceprevir for chronic HCV infection.

    Science.gov (United States)

    Maasoumy, Benjamin; Manns, Michael P

    2013-02-01

    There are 160-170 million people with chronic hepatitis C virus (HCV) infection worldwide. The marketing of protease inhibitors (PIs) has been a milestone in the history of HCV therapy. In phase III studies, up to 75% of the patients achieved a sustained virological response (SVR) after triple therapy with pegylated-interferon (PEG-IFN)-α, ribavirin (RBV) and boceprevir (BOC). However, triple regimens are more expensive and associated with drug-drug interactions (DDIs) and more adverse events (AEs). According to results in 'real-world' settings, safety seems to be limited, in particular in patients with advanced liver disease. To optimize efficacy while minimizing AEs as well as costs, the optimal treatment strategy must be determined for BOC. Optimizing treatment is based on patient selection, the most efficient treatment design, management of side effects and the challenge of DDIs. Therapy-associated risks, treatment urgency and chances of SVR must all be considered for patient selection. In addition, certain differences between the two approved PIs may help identify the ideal candidates for each HCV PI. Optimal treatment design is based on the results of phase II and III studies, in which different approaches have been tested including 'lead-in' and response-guided strategies. Treatment regimens and stopping rules recommended by the FDA and EMA should normally be followed. Still, there are some cases in which more personalized strategies may be more promising. Management of side effects is a major challenge and plays a crucial role in ensuring safety and adherence. PMID:23286841

  14. Endovascular Treatment of Chronic Mesenteric Ischemia: Results in 14 Patients

    International Nuclear Information System (INIS)

    We evaluated immediate and long-term results of percutaneous transluminal angioplasty (PTA) and stent placement to treat stenotic and occluded arteries in patients with chronic mesenteric ischemia. Fourteen patients were treated by 3 exclusive celiac artery (CA) PTAs (2 stentings), 3 cases with both Superior Mesenteric Artery (SMA) and CA angioplasties, and 8 exclusive SMA angioplasties (3 stentings). Eleven patients had atheromatous stenoses with one case of an early onset atheroma in an HIV patient with antiphospholipid syndrome. The other etiologies of mesenteric arterial lesions were Takayashu arteritis (2 cases) and a postradiation stenoses (1 case). Technical success was achieved in all cases. Two major complications were observed: one hematoma and one false aneurysm occurring at the brachial puncture site (14.3%). An immediate clinical success was obtained in all patients. During a follow-up of 1-83 months (mean: 29 months), 11 patients were symptom free; 3 patients had recurrent pain; in one patient with inflammatory syndrome, pain relief was obtained with medical treatment; in 2 patients abdominal pain was due to restenosis 36 and 6 months after PTA, respectively. Restenosis was treated by PTA (postirradiation stenosis), and by surgical bypass (atheromatous stenosis). Percutaneous endovascular techniques are safe and accurate. They are an alternative to surgery in patients with chronic mesenteric ischemia due to short and proximal occlusive lesions of SMA and CA

  15. Chronic disease and recent addiction treatment utilization among alcohol and drug dependent adults

    OpenAIRE

    Samet Jeffrey; Allensworth-Davies Donald; Cheng Debbie M; Larson Mary Jo; Reif Sharon; Saitz Richard

    2011-01-01

    Abstract Background Chronic medical diseases require regular and longitudinal care and self-management for effective treatment. When chronic diseases include substance use disorders, care and treatment of both the medical and addiction disorders may affect access to care and the ability to focus on both conditions. The objective of this paper is to evaluate the association between the presence of chronic medical disease and recent addiction treatment utilization among adults with substance de...

  16. Chronic radiation proctopathy: A practical review of endoscopic treatment.

    Science.gov (United States)

    Lenz, Luciano; Rohr, Rachel; Nakao, Frank; Libera, Ermelindo; Ferrari, Angelo

    2016-02-27

    Chronic radiation proctopathy (CRP) is a troublesome complication of pelvic radiotherapy. The most common presentation is rectal bleeding. CRP symptoms interfere with daily activities and decrease quality of life. Rectal bleeding management in patients with CRP represents a conundrum for practitioners. Medical therapy is ineffective in general and surgical approach has a high morbid-mortality. Endoscopy has a role in the diagnosis, staging and treatment of this disease. Currently available endoscopic modalities are formalin, potassium titanyl phosphate laser, neodymium:yttrium-aluminum-garnet laser, argon laser, bipolar electrocoagulation (BiCAP), heater probe, band ligation, cryotherapy, radiofrequency ablation and argon plasma coagulation (APC). Among these options, APC is the most promising. PMID:26981189

  17. Drug for the treatment of acute lethal or chronic radiolesions

    International Nuclear Information System (INIS)

    The patent claim refers to a drug for total or partial treatment of acute lethal or chronic radiolesions and their harmful effects, marked by the fact that it contains the following components for a daily dose: 103 - 8 x 105 KJU of a Kallikrein-Inhibitor-Polypeptide, 1 mg - 2 x 102 mg thiamine diphosphate, 0.1 mg - 102 mg of an α1-glycoprotein complex, 1 mg - 2 x 102 mg L-Tryptophane, 1 mg - 103 mg Arginin, and 0.1 mg - 102 mg of a lipoprotein complex. The drug is marked by being effective in 60-70% of the cases of Wistar- or R-incest rats after use over at least 30 days. It is also effective in 50-60% of the cases of York-pigs after LD 80-100/30 C060, the foregoing knowledge of the (lethal) moment of radiation being unnecessary. (orig./MG)

  18. Regression of chronic posterior leukoencephalopathy after stop of methotrexate treatment.

    Science.gov (United States)

    Marcon, Gabriella; Giovagnoli, Anna Rita; Mangiapane, Paola; Erbetta, Alessandra; Tagliavini, Fabrizio; Girotti, Floriano

    2009-10-01

    Posterior reversible leukoencephalopathy (PRLE) is a neurological disorder caused by a variety of pathological conditions such as high doses or long-term low-doses of immunosuppressive therapy. PRLE associated with methotrexate (MTX) is well known but it was rarely observed in adult patients submitted to long-term low-dose administration via the oral route. Here we report the case of a patient affected by psoriasis, treated by chronic oral low-dose of MTX, who presented with limb ideomotor apraxia. Magnetic resonance (MRI) of the brain showed, on T2-weighted images, a diffuse hyperintensity involving bilaterally the white matter of the occipital, parietal and frontal lobes. MTX treatment was stopped and, at the 6-month follow-up, the neuropsychological performances was improved. Two years later, the neuropsychological profile was normal and MRI showed a regression of the white matter abnormalities. PMID:19626273

  19. Chronic Melatonin Treatment Prevents Memory Impairment Induced by Chronic Sleep Deprivation.

    Science.gov (United States)

    Alzoubi, Karem H; Mayyas, Fadia A; Khabour, Omar F; Bani Salama, Fatima M; Alhashimi, Farah H; Mhaidat, Nizar M

    2016-07-01

    Sleep deprivation (SD) has been associated with memory impairment through induction of oxidative stress. Melatonin, which promotes the metabolism of many reactive oxygen species (ROS), has antioxidant and neuroprotective properties. In this study, the effect of melatonin on memory impairment induced by 4 weeks of SD was investigated using rat animal model. Animals were sleep deprived using modified multiple platform model. Melatonin was administered via oral gavage (100 mg/kg/day). Spatial learning and memory were assessed using the radial arm water maze (RAWM). Changes in oxidative stress biomarkers in the hippocampus following treatments were measured using ELISA procedure. The result revealed that SD impaired both short- and long-term memory (P sleep-deprived rats (P  0.05). In conclusion, SD induced memory impairment, which was prevented by melatonin. This was correlated with normalizing hippocampus antioxidant mechanisms during chronic SD. PMID:26084441

  20. 慢性咽炎及慢性扁桃体炎的治疗%Treatment of Chronic Pharyngitis and Chronic Tonsillitis

    Institute of Scientific and Technical Information of China (English)

    李健; 吴合

    2003-01-01

    Objective To illustrate the proper treatment of chronic pharyngitis and chronic tonsilli-tis. Methods To recover the immune functions of the patients. Result Chronic pharyngitis and chronictonsillitis could be radically cured by restoring the immune functions of the patients. Conlcusion Thekey etiology of the chronic pharyngitis and chronic tonsillitis is the abnormal immune functions of the patients and the key treatment is to restore the immune functions of the patients.

  1. Modern concepts in the treatment of chronic lymphocytic leukemia.

    Science.gov (United States)

    Smolej, Lukas

    2009-10-01

    There has been considerable progress in the treatment of chronic lymphocytic leukemia (CLL) during last 10 years. Purine analogs and monoclonal antibodies have enabled the shift from purely palliative treatment to intensive regimens aiming at complete remissions and possible prolongation of survival. Many patients have now been shown to achieve molecular responses in addition to their hematological remission. Despite this success, virtually all patients with CLL will eventually relapse and will become refractory to treatment. Allogeneic stem cell transplantation offers a chance of definite cure but is feasible in a minority of patients only. Therefore, considerable effort has been devoted to the further development of more conventional CLL management that is applicable to patient population generally affected by the disease. Emerging treatment concepts include novel combination of well-know agents such as rituximab and chlorambucil, fludarabine, cyclophosphamide and alemtuzumab, FCR with mitoxantrone amongst many. Consolidation regimens using mainly alemtuzumab are also increasingly used but are associated with a major increase in severe infections. High-dose steroids in combination with rituximab or alemtuzumab represent a promising option for refractory patients. Modern chemoimmunotherapy with the FCR regimen has also been tested in early stage patients with unfavourable prognostic factors. Finally, a there are a wide variety of novel drugs including bendamustine, a unique cytostatic with combined properties of an alkylating agent and purine analog, the monoclonal antibodies anti-CD20 ofatumumab and the anti-CD23 lumiliximab, thalidomide and its analog lenalidomide, the semi-synthetic flavonoid flavopiridol and other agents which are currently undergoing clinical trials with promising results. This article reviews the recent advances and future possibilities in the treatment of CLL. PMID:19843378

  2. Outcome of long-term heroin-assisted treatment offered to chronic, treatment-resistant heroin addicts in the Netherlands

    NARCIS (Netherlands)

    P. Blanken; V.M. Hendriks; J.M. van Ree; W. van den Brink

    2010-01-01

    Aims To describe 4-year treatment retention and treatment response among chronic, treatment-resistant heroin-dependent patients offered long-term heroin-assisted treatment (HAT) in the Netherlands. Design Observational cohort study. Setting and intervention Out-patient treatment in specialized heroi

  3. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating neuropathy not responsive to other treatments.

    OpenAIRE

    Nemni, R; Amadio, S; Fazio, R; GALARDI, G; Previtali, S; G. Comi

    1994-01-01

    Nine patients with chronic inflammatory demyelinating poliradiculoneuropathy (CIDP) were treated with intravenous immunoglobulin. All patients had been previously treated with prednisone and/or plasma exchange without effect. Objective improvement in clinical condition occurred in six patients. One patient became refractory after two treatment courses, two patients had no response. The results indicate that intravenous immunoglobulin has beneficial effects in a high percentage of patients wit...

  4. A cognitive deficit induced in rats by chronic intermittent cold stress is reversed by chronic antidepressant treatment

    OpenAIRE

    Danet, M.; Lapiz-Bluhm, S.; Morilak, David A

    2010-01-01

    We have previously reported that 14-days of chronic intermittent cold (CIC) stress induced a cognitive deficit in reversal learning on the rat attentional set-shifting test. This effect may be related to dysregulation of 5-HT function in orbitofrontal cortex, as a model of cognitive dysfunction in depression. To test the ability of chronic antidepressant drug treatment to reverse the cognitive deficit induced by CIC, it was first necessary to assess the temporal characteristics of the CIC-ind...

  5. Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Agostino Cortelezzi

    2012-01-01

    Full Text Available The application of nucleoside analogue-based chemotherapy and immunotherapy with rituximab or alemtuzumab has increased both response rate and survival in patients with Chronic Lymphocytic Leukemia (CLL. However, because none of these therapies is curative, sequential therapeutic regimens are required. The majority of patients with relapsed or refractory CLL carry poor prognostic factors and show shorter overall survival and resistance to standard treatment. Numerous drugs have recently been approved for CLL therapy and many novel agents are under clinical investigation. The role of the tumor microenvironment and of immune dysfunction in CLL have allowed to enlarge the therapeutic armamentarium for CLL patients. This article will provide a comprehensive summary regarding mechanism of action, efficacy and safety of lenalidomide in CLL patients. Relevant clinical trials using lenalidomide alone or in combinations are discussed. Lenalidomide shows good activity also in relapsed/refractory or treatment-naive CLL patients. Definitive data from ongoing studies are needed to validate overall and progression-free survival. The toxicity profile might limit lenalidomide use because it can result in serious side effects, but largely controlled by gradual dose escalation. Further understanding of the exact mechanism of action in CLL will allow more efficacious use of lenalidomide alone or in combination regimens.

  6. Biofeedback treatment of chronic constipation: myths and misconceptions.

    Science.gov (United States)

    Chiarioni, G

    2016-09-01

    Chronic constipation is a prevalent disorder with considerable impact on healthcare costs and quality of life. Most patients would respond to conservative measures in primary care. Patients with refractory constipation are commonly referred to dedicated centers for appropriate investigations and management. After testing, three main subtypes of constipation are commonly identified: normal colon transit, slow transit, and functional defecation disorders. The etiology of functional defecation disorders is consistent with maladaptive behavior, and biofeedback therapy has been considered a valuable treatment option. Being safe and only marginally invasive, retraining has been historically employed to manage all types of refractory constipation. There are a number of strongly held beliefs about biofeedback therapy that are not evidence-based. The aim of this review was to address these beliefs concerning protocols, efficacy, indications, and safety, with a special focus on the relevance of identifying patients with a functional defecation disorder who are ideal candidates for retraining. Randomized controlled trials support the effectiveness of biofeedback therapy for severe, refractory constipation due to functional defecation disorders. Limitations of the treatment are discussed, but biofeedback remains the safest option to successfully manage this hard-to-treat subtype of constipation. PMID:27450533

  7. Prospects for conservative treatment of chronic subdural hematomas

    International Nuclear Information System (INIS)

    111In-DTPA was injected into the hematoma cavity before and after hematoma evacuation and irrigation in 12 cases of chronic subdural hematoma with comparatively mild symptoms. The radioactivity in the head was measure with time using a scintillation counter and the attenuation rate was obtained. The value measured hourly were expressed as ratios of the 1st measured value. Because of the properties of 111In-DTPA, this attenuation rate was considered to be the absorption rate of the liqid components of the hematoma. In 8 of the preoperative cases, the average measured values, were 84.8 +- 12.6% after 3 hours, 77.3 +- 12.1% after six hours, 34.5 +- 13.8% after 24 hours and 13.3 +- 13.5% after 48 hours. In six of the postoperative cases, the values were 70.4 +- 14.3% after 3 hours, 47.8 +- 10.8% after 6 hours, 12.4 +- 6.7% after 24 hours and 3.6 +- 2.0% after 48 hours. In a comparison between the two, the postoperative cases showed clearly advanced absorption with a significant difference at a risk factor of 0.1% or less in each case. This is because the osmotic pressure is the same for the liquid in the hematoma, the blood and the cerebrospinal fluid and an explanation based on this alone is difficult; it is neccessary to consider colloid osmotic pressure. When the radioactivities in the liquid in the hematoma, blood and cerebrospinal fluid were measured, the values for the blood were always higher than those for the cerebrospinal fluid and most of the absorption of the hematoma is considered to originate in the vascular bed in the hematoma cavity (sinusoidal channel layer). Therefore, for the conservative treatment of chronic subdural hematomas, it is necessary to consider methods which promote absorption of the hematoma. (J.P.N.)

  8. Classification of chronic cough by systematic treatment cascade trial starting with beta agonist

    OpenAIRE

    Shimizu, Hideyasu; Hayashi, Masamichi; Saito, Yuji; Mieno, Yuki; Takeuchi, Yasuo; Sasaki, Fumihiko; Sakakibara, Hiroki; Naito, Kensei; Okazawa, Mitsushi

    2013-01-01

    Background Chronic cough is one of the most challenging symptoms to diagnose and treat, not only because of the variety of underlying disorders but also its varying susceptibility to treatments. Etiological studies of chronic cough vary depending on the clinical settings and the particular interests of investigators. Objectives The purposes of this study were first to categorize the etiology of chronic cough by its response to systematic diagnostic treatments starting from the β2 agonist and ...

  9. Craniosacral Therapy for the Treatment of Chronic Neck Pain

    Science.gov (United States)

    Lauche, Romy; Cramer, Holger; Rampp, Thomas; Saha, Felix J.; Ostermann, Thomas; Dobos, Gustav

    2016-01-01

    Objectives: With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients. Materials and Methods: A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20). The primary outcome was the pain intensity on a visual analog scale at week 8; secondary outcomes included pain on movement, pressure pain sensitivity, functional disability, health-related quality of life, well-being, anxiety, depression, stress perception, pain acceptance, body awareness, patients’ global impression of improvement, and safety. Results: In comparison with sham, CST patients reported significant and clinically relevant effects on pain intensity at week 8 (−21 mm group difference; 95% confidence interval, −32.6 to −9.4; P=0.001; d=1.02) and at week 20 (−16.8 mm group difference; 95% confidence interval, −27.5 to −6.1; P=0.003; d=0.88). Minimal clinically important differences in pain intensity at week 20 were reported by 78% within the CST group, whereas 48% even had substantial clinical benefit. Significant between-group differences at week 20 were also found for pain on movement, functional disability, physical quality of life, anxiety and patients’ global improvement. Pressure pain sensitivity and body awareness were significantly improved only at week 8. No serious adverse events were reported. Discussion: CST was both specifically effective and safe in reducing neck pain intensity and may improve functional disability and the quality of life up to 3 months after intervention. PMID:26340656

  10. Sol-Gel Synthesis of Ordered β-Cyclodextrin-Containing Silicas

    Science.gov (United States)

    Trofymchuk, Iryna Mykolaivna; Roik, Nadiia; Belyakova, Lyudmila

    2016-03-01

    New approaches for β-cyclodextrin-containing silicas synthesis were demonstrated. Materials with hexagonally ordered mesoporous structure were prepared by postsynthesis grafting and by co-condensation methods. β-Cyclodextrin activated by a N, N'-carbonyldiimidazole was employed for postsynthesis treatment of 3-aminopropyl-modified MCM-41 support as well as for sol-gel synthesis with β-cyclodextrin-containing organosilane and tetraethyl orthosilicate participation in the presence of cetyltrimethylammonium bromide. The successful incorporation of cyclic oligosaccharide moieties in silica surface layer was verified by means of FT-IR spectroscopy and chemical analysis. Obtained β-cyclodextrin-containing materials were characterized by X-ray diffraction, transmission electron microscopy, and low-temperature adsorption-desorption of nitrogen. In spite of commensurable loading of β-cyclodextrin groups attained by both proposed approaches (up to 0.028 μmol · m-2), it was found that co-condensation procedure provides uniform distribution of β-cyclodextrin functionalities in silica framework, whereas postsynthesis grafting results in modification of external surface of silica surface. Adsorption of benzene from aqueous solutions onto the surface of β-cyclodextrin-containing materials prepared by co-condensation method was studied as the function of time and equilibrium concentration. Langmuir and Freundlich models were used to evaluate adsorption processes and parameters. Adsorption experiments showed that β-cyclodextrin-containing silicas could be promising for the trace amount removal of aromatics from water.

  11. Sol-Gel Synthesis of Ordered β-Cyclodextrin-Containing Silicas.

    Science.gov (United States)

    Trofymchuk, Iryna Mykolaivna; Roik, Nadiia; Belyakova, Lyudmila

    2016-12-01

    New approaches for β-cyclodextrin-containing silicas synthesis were demonstrated. Materials with hexagonally ordered mesoporous structure were prepared by postsynthesis grafting and by co-condensation methods. β-Cyclodextrin activated by a N,N'-carbonyldiimidazole was employed for postsynthesis treatment of 3-aminopropyl-modified MCM-41 support as well as for sol-gel synthesis with β-cyclodextrin-containing organosilane and tetraethyl orthosilicate participation in the presence of cetyltrimethylammonium bromide. The successful incorporation of cyclic oligosaccharide moieties in silica surface layer was verified by means of FT-IR spectroscopy and chemical analysis. Obtained β-cyclodextrin-containing materials were characterized by X-ray diffraction, transmission electron microscopy, and low-temperature adsorption-desorption of nitrogen. In spite of commensurable loading of β-cyclodextrin groups attained by both proposed approaches (up to 0.028 μmol · m(-2)), it was found that co-condensation procedure provides uniform distribution of β-cyclodextrin functionalities in silica framework, whereas postsynthesis grafting results in modification of external surface of silica surface. Adsorption of benzene from aqueous solutions onto the surface of β-cyclodextrin-containing materials prepared by co-condensation method was studied as the function of time and equilibrium concentration. Langmuir and Freundlich models were used to evaluate adsorption processes and parameters. Adsorption experiments showed that β-cyclodextrin-containing silicas could be promising for the trace amount removal of aromatics from water. PMID:27033850

  12. Regulation of brain-derived neurotrophic factor (BDNF) in the chronic unpredictable stress rat model and the effects of chronic antidepressant treatment

    DEFF Research Database (Denmark)

    Larsen, Marianne H; Mikkelsen, Jens D; Hay-Schmidt, Anders;

    2010-01-01

    Chronic unpredictable stress (CUS) is a widely used animal model of depression. The present study was undertaken to investigate behavioral, physiological and molecular effects of CUS and/or chronic antidepressant treatment (venlafaxine or imipramine) in the same set of animals. Anhedonia, a core ...... of the dorsal hippocampus correlated with chronic antidepressant treatment emphasizing a role for BDNF in the mechanisms underlying antidepressant activity....

  13. Correlation between pre-treatment quasispecies complexity and treatment outcome in chronic HCV genotype 3a.

    LENUS (Irish Health Repository)

    Moreau, Isabelle

    2012-02-03

    Pre-treatment HCV quasispecies complexity and diversity may predict response to interferon based anti-viral therapy. The objective of this study was to retrospectively (1) examine temporal changes in quasispecies prior to the start of therapy and (2) investigate extensively quasispecies evolution in a group of 10 chronically infected patients with genotype 3a, treated with pegylated alpha2a-Interferon and ribavirin. The degree of sequence heterogeneity within the hypervariable region 1 was assessed by analyzing 20-30 individual clones in serial serum samples. Genetic parameters, including amino acid Shannon entropy, Hamming distance and genetic distance were calculated for each sample. Treatment outcome was divided into (1) sustained virological responders (SVR) and (2) treatment failure (TF). Our results indicate, (1) quasispecies complexity and diversity are lower in the SVR group, (2) quasispecies vary temporally and (3) genetic heterogeneity at baseline can be use to predict treatment outcome. We discuss the results from the perspective of replicative homeostasis.

  14. Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement

    Science.gov (United States)

    Ryan, Nicole M; Vertigan, Anne E; Gibson, Peter G

    2009-01-01

    Rationale Chronic persistent cough can be associated with laryngeal dysfunction that leads to symptoms such as dysphonia, sensory hyperresponsiveness to capsaicin, and motor dysfunction with paradoxical vocal fold movement and variable extrathoracic airflow obstruction (reduced inspiratory airflow). Successful therapy of chronic persistent cough improves symptoms and sensory hyperresponsiveness. The effects of treatment for chronic cough on laryngeal dysfunction are not known. Objective The aim of this study was to investigate effects of therapy for chronic cough and paradoxical vocal fold movement. Methods Adults with chronic cough (n = 24) were assessed before and after treatment for chronic persistent cough by measuring quality of life, extrathoracic airway hyperresponsiveness to hypertonic saline provocation, capsaicin cough reflex hypersensitivity and fibreoptic laryngoscopy to observe paradoxical vocal fold movement. Subjects with chronic cough were classified into those with (n = 14) or without (n = 10) paradoxical vocal fold movement based on direct observation at laryngoscopy. Results Following treatment there was a significant improvement in cough related quality of life and cough reflex sensitivity in both groups. Subjects with chronic cough and paradoxical vocal fold movement also had additional improvements in extrathoracic airway hyperresponsiveness and paradoxical vocal fold movement. The degree of improvement in cough reflex sensitivity correlated with the improvement in extrathoracic airway hyperresponsiveness. Conclusion Laryngeal dysfunction is common in chronic persistent cough, where it is manifest as paradoxical vocal fold movement and extrathoracic airway hyperresponsiveness. Successful treatment for chronic persistent cough leads to improvements in these features of laryngeal dysfunction. PMID:19292930

  15. Chronic pain: the burden of disease and treatment innovations

    OpenAIRE

    S. Monti; Caporali, R

    2015-01-01

    Musculoskeletal conditions are the most frequent cause of chronic pain and affect around 1 in 5 adults in Europe. When chronic pain occurs, it becomes disease itself, with substantial clinical, social and economic impact. Effi cacy and tolerability problems are encountered with all therapeutic strategies available to treat musculoskeletal pain. This often limits effective analgesia and patients’ long term compliance, with the result that chronic pain is persistently underestimated and undertr...

  16. Pathophysiology and treatment of inflammatory anorexia in chronic disease

    OpenAIRE

    Braun, Theodore P.; Marks, Daniel L.

    2010-01-01

    Decreased appetite and involuntary weight loss are common occurrences in chronic disease and have a negative impact on both quality of life and eventual mortality. Weight loss in chronic disease comes from both fat and lean mass, and is known as cachexia. Both alterations in appetite and body weight loss occur in a wide variety of diseases, including cancer, heart failure, renal failure, chronic obstructive pulmonary disease and HIV. An increase in circulating inflammatory cytokines has been ...

  17. Diagnosis and treatment of acute and chronic leukemia

    International Nuclear Information System (INIS)

    The Cancergram covers both acute and chronic leukemia in all of its forms (acute lymphocytic, acute monocytic, acute or sub-acute granulocytic, chronic granulocytic, chronic lymphocytic, chronic monocytic, plasma cell, stem cell, and hairy cell). Other neoplastic conditions of the reticuloendothelial system, lymphatic system, spleen, multiple myeloma, macroglobulinemia and other monoclonal gammopathies are excluded, and will be coveted by other Cancergrams now under development. This Cancergram includes abstracts concerning all clinical aspects of the disease, such as diagnosis and staging, supportive care, evaluation, and therapy. Animal models, tissue culture experiments, carcinogenesis and other pre-clinical studies are generally excluded, except for those considered to have direct clinical relevance

  18. Azithromycin buccal patch in treatment of chronic periodontitis

    Science.gov (United States)

    Latif, Sajith Abdul; Vandana, K. L.; Thimmashetty, J.; Dalvi, Priyanka Jairaj

    2016-01-01

    Aim: This study aims to explore the clinical, microbiological, and biochemical impact of azithromycin (AZM) buccal patch in chronic generalized patients as a monotherapy as well as an adjunct to nonsurgical therapy. Materials and Methods: A parallel design was used forty periodontitis patients were randomly allocated into five groups, namely Group 1 scaling root planing (SRP) alone, Group 2 (SRP + AZM patch group), Group 3 (SRP + AZM tablet group), Group 4 (AZM patch monotherapy), and Group 5 (AZM tablet as monotherapy). Plaque index, gingival bleeding index, modified gingival index, probing pocket depth (PPD), and clinical attachment level (CAL) were assessed at baseline and 21 and 90 days. Subgingival pooled plaque sample was collected to assess periodontopathogens like Porphyromonas gingivalis and Prevotella intermedia (Pi) by anaerobic culture method. Tumor necrosis factor alpha (TNF-α) was also evaluated at baseline and 21 days. Periodontal maintenance was performed in Group 1 until 90th day, and clinical parameter was assessed at the end of 90th day. Results: SRP + AZM tablets showed greater reduction in clinical parameters (P periodontal parameters, microbial parameters, and TNF-α level. It is safe to use AZM + SRP as a mode of nonsurgical treatment in periodontitis patients. PMID:27127325

  19. Treatment and Prevention of Common Complications of Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Sheikh Salahuddin Ahmed

    2014-01-01

    Full Text Available Chronic kidney disease (CKD is a worldwide public health problem with an increasing incidence and prevalence. Outcomes of CKD include not only complications of decreased kidney function and cardiovascular disease but also kidney failure causing increased morbidity and mortality. Unfortunately, CKD is often undetected and undertreated because of its insidious onset, variable progression, and length of time to overt kidney failure. Diabetes is now the leading cause of CKD requiring renal replacement therapy in many parts of the world, and its prevalence is increasing disproportionately in the developing countries. This review article outlines the current recommendations from various clinical guidelines and research studies for treatment, prevention and delaying the progression of both CKD and its common complications such as hypertension, anemia, renal osteodystrophy, electrolyte and acid-base imbalance, and hyperlipidemia. Recommendations for nutrition in CKD and measures adopted for early diabetic kidney disease to prevent further progression have also been reviewed. There is strong evidence that early detection and management of CKD can prevent or reduce disease progression, decrease complications and improve outcomes. Evidence supports that achieving optimal glucose control, blood pressure, reduction in albuminuria with a multifactorial intervention slows the progression of CKD. Angiotensin-converting enzyme inhibitors and angiotensin-II receptor antagonists are most effective because of their unique ability to decrease proteinuria, a factor important for the progression of CKD.

  20. A personalized framework for medication treatment management in chronic care.

    Science.gov (United States)

    Koutkias, Vassilis G; Chouvarda, Ioanna; Triantafyllidis, Andreas; Malousi, Andigoni; Giaglis, Georgios D; Maglaveras, Nicos

    2010-03-01

    The ongoing efforts toward continuity of care and the recent advances in information and communication technologies have led to a number of successful personal health systems for the management of chronic care. These systems are mostly focused on monitoring efficiently the patient's medical status at home. This paper aims at extending home care services delivery by introducing a novel framework for monitoring the patient's condition and safety with respect to the medication treatment administered. For this purpose, considering a body area network (BAN) with advanced sensors and a mobile base unit as the central communication hub from the one side, and the clinical environment from the other side, an architecture was developed, offering monitoring patterns definition for the detection of possible adverse drug events and the assessment of medication response, supported by mechanisms enabling bidirectional communication between the BAN and the clinical site. Particular emphasis was given on communication and information flow aspects that have been addressed by defining/adopting appropriate formal information structures as well as the service-oriented architecture paradigm. The proposed framework is illustrated via an application scenario concerning hypertension management. PMID:20007042

  1. [Treatment of Chronic Functional Constipation during Pregnancy and Lactation].

    Science.gov (United States)

    Gharehbaghi, K; Gharehbaghi, D R; Wierrani, F; Sliutz, G

    2016-02-01

    Natural fibres (bulk-forming agents), docusate sodium (stool-softener), mineral oils (lubricant laxatives), macrogol (polyethylene glycol, PEG), sugars and sugar alcohols (osmotic laxatives) and anthraquinones and diphenolic laxatives (stimulant laxatives) seem to be safe medicaments regarding teratogenicity and lactation. The US Food and Drug Administration (FDA) risk categories for these substances taken during pregnancy and lactation are often the result of the lack of studies than of evidence-based information. So risk categories do not help in the decision-making for the right laxative. Alternative solutions such as proposals of the American College of Gastroenterology's Committee on FDA related matters, (ACG-FDA) and the Motherisk Programme try to improve decision-making. For newer compounds such as chloride-channel-activators and procinetics no data regarding safe use in pregnancy and during breast-feeding are available as yet. We suggest the use of macrogol and lactulose as the first-line therapy in treating chronic constipation during pregnancy. Macrogol shows some advantages, such as faster onset of bowel action and fewer flatulences. If this treatment does not work or starts but then stops working, we recommend in the second and third trimenon a second-line treatment with diphenolic laxatives such as bisacodyl and and sodium picosulfate. During pregnancy the decision on the application of these laxatives is largely determined by the side-effects of tenesmus associated with preterm births. During lactation we recommend macrogol (preferable to lactulose due to the lack of data), lactulose, bisacodyl and sodium picosulfate, according to the nature of the conditions. PMID:26866689

  2. Treatment of Chronic Gastritis by Acupuncture: A Review

    Institute of Scientific and Technical Information of China (English)

    HUANG Qin-feng; QI Li-zhen; XIAO Yuan-chun

    2005-01-01

    从<中国现代针灸信息数据库(1970~2002年)收录的40398条信息进行分析,收集93篇针灸治疗胃炎论文,涉及5325例病例中分析,总有效率为94.4%.常采用针刺,灸法,埋藏疗法,水针.常用穴为足三里,中脘,胃俞,脾俞,内关,肝俞,三阴交等,胃痛甚者加梁丘和公孙;腹胀加天枢和气海;腹泻加天枢和上巨虚;呕吐加上脘和太冲.%This paper collects and analyzes 40 398 pieces of information from Chinese Modern Acupuncture Information Database (1970- 2002). It covers 93 articles concerning the treatment of chronic gastritis by acupuncture and 5 325 subjects, the total effective rate being 94.4%. The frequent treatment methods are needling, moxibustion, burial therapy, and hydropuncture. The major acupoints are Zusanli (ST 36), Zhongwan (CV 12), Weishu (BL 21),Pishu (BL20), Neiguan (PC 6), Ganshu (BL 18), Sanyinjiao (SP 6), etc. In the presence of severe stomachache, Liangqiu (ST 34) and Gongsun (SP 4) are added; in the presence of abdominal fullness, Tianshu (ST 25) and Qihai (CV 6) are added; in the presence of diarrhea, Tianshu (ST 25) and Shangjuxu (ST 37) are added; in the presence of vomiting, Shangwan (CV 13) and Taichong (LR 3) are added.

  3. Complexation thermodynamics of modified cyclodextrins

    DEFF Research Database (Denmark)

    Schönbeck, Jens Christian Sidney; Westh, Peter; Holm, Rene

    2014-01-01

    Inclusion complexes between two bile salts and a range of differently methylated β-cyclodextrins were studied in an attempt to rationalize the complexation thermodynamics of modified cyclodextrins. Calorimetric titrations at a range of temperatures provided precise values of the enthalpies (ΔH......°), entropies (ΔS°), and heat capacities (ΔCp) of complexation, while molecular dynamics simulations assisted the interpretation of the obtained thermodynamic parameters. As previously observed for several types of modified cyclodextrins, the substituents at the rims of the cyclodextrin induced large changes in...... strong decrease when the degree of substitution exceeded some threshold. Exactly the same trend was observed for ΔCp. The dehydration of nonpolar surface, as quantified by the simulations, can to a large extent explain the variation in the thermodynamic parameters. The methyl substituents form additional...

  4. Recognizing Family Dynamics in the Treatment of Chronic Fatigue Syndrome

    Science.gov (United States)

    Sperry, Len

    2012-01-01

    Chronic fatigue syndrome (CFS) is an increasingly common chronic medical condition that affects not only patients but also their families. Because family dynamics, particularly the family life cycle, can and does influence the disease process, those providing counseling to CFS patients and their families would do well to recognize these dynamics.…

  5. Diagnosis and Treatment of Infective Endocarditis in Chronic Hemodialysis Patients

    Institute of Scientific and Technical Information of China (English)

    Jian-ling Tao; Xue-mei Li; Xue-wang Li; Jie Ma; Guang-li Ge; Li-meng Chen; Hang Li; Bao-tong Zhou; Yang Sun; Wen-ling Ye; Qi Miao

    2010-01-01

    Objective To analyze the clinical features of hemodialysis patients complicated by infective endo-carditis.Methods The clinical features of six such patients admitted to Peking Union Medical College Hos-pital during the year 1990 to 2009 were analyzed. All of them were diagnosed based on Chinese Children Diagnostic Criteria for Infective Endocarditis.Results The average age of the six patients was 52.3±19.3 years old. Four were males. Vascular ac-cesses at the onset of infective endocarditis were as follows: permanent catheters in three, temporary cathe-ters in two, and arteriovenous fistula in one. Three were found with mitral valve involvement, two with aor-tic valve involvement, and one with both. Five vegetations were found by transthoraeic echocardiography, and one by transesophageal echocardiography. Four had positive blood culture results. The catheters were all removed. Four of the patients were improved by antibiotics treatment, in which two were still on hemodialy-sis in the following 14-24 months and the other two were lost to follow-up. One patient received surgery, but died of heart failure after further hemodialysis for three months. One was well on maintenance hemodi-alysis for three months after surgery.Conclusions Infective endocarditis should be suspected when hemodialysis patients suffer from long-term fever, for which prompt blood culture and transthoracic echocardiography confirmation could be performed. Transesophageal echocardiography could be considered even when transthoracic echocardiogra-phy produces negative findings. With catheters removed, full course of appropriate sensitive antibiotics and surgery if indicated could improve the outcome of chronic hemodialysis patients complicated by infective endocarditis.

  6. Nutrition treatment of deficiency and malnutrition in chronic pancreatitis: a review.

    LENUS (Irish Health Repository)

    Duggan, SN

    2010-08-01

    Chronic pancreatitis results in exocrine and endocrine dysfunction, affecting normal digestion and absorption of nutrients. In individuals with chronic pancreatitis, nutrition status may be further affected by poor dietary intake, often related to alcoholism. However, some deficiencies may be overlooked, potentially leading to nutrition-related problems with bone health and fatigue. The aim of this article is to describe the deficiencies that occur and to propose an evidence-based algorithm for the nutrition assessment and treatment of patients with chronic pancreatitis.

  7. Processing polymers with cyclodextrins

    Science.gov (United States)

    Williamson, Brandon Robert

    Cyclodextrins (CDs) are cyclic starch molecules that have the unique ability to include a variety of small molecules and polymers inside their cavities, forming "Inclusion Complexes" (ICs). While much work has been done to understand the formation and behavior of these ICs, far less is known about the fundamental property changes that can occur when CD is used to alter polymer chain morphology. The goal of my graduate research has been to discover different ways to improve upon existing polymer properties through CD processing, as well as explore the possibility of creating a novel type of IC using non-traditional forms of cyclodextrin. Poly(ε-caprolactone) (PCL) was processed with alpha-CD to form an IC. The cyclodextrin was then stripped away to yield a PCL with elongated, unentangled, and constrained polymer chains, a process referred to as coalescence. The physical and rheological property changes resulting from this coalescence were then examined. It was found that reorganizing PCL in this manner resulted in an increase in the melt crystallization temperature of up to 25°C. Coalescence also decreased the tan delta of the material and increased the average hardness and Young's modulus by 33 and 53%, respectively. Non-stoichiometric ICs (NS-ICs), or ICs with at least parts of some polymer chains uncovered, were formed between poly (methyl methacrylate) (PMMA) and gamma-CD as well as a synthesized poly(ε-caprolactone)-poly(propylene glycol)-poly(ε-caprolactone) (PCL-PPG-PCL) triblock copolymer and beta-CD. The property changes of the non-complexed polymer chains were then studied. The PMMA/gamma-CD NS-IC samples were determined to be extremely heterogeneous, however glass transition temperature increases of up to 27°C above that of as-received PMMA were observed. Diffraction data for the PMMA NS-ICs suggests slight crystallinity at partial coverage, with a similar crystal structure to that of the fully covered IC. XRD, DSC and FTIR data revealed an almost

  8. TCM Treatment for Two Cases of Chronic and Intractable Eczema

    Institute of Scientific and Technical Information of China (English)

    He Kuanqi; Zhu Hanting

    2008-01-01

    @@ The author treated 2 cases of chronic and intractable eczema,who were once treated by western drugs without good results,with Chinese medicine and obtained satisfactory therapeutic effects.Now it is reported as follows.

  9. CYCLODEXTRINS – FIELDS OF APPLICATION. PART I

    Directory of Open Access Journals (Sweden)

    Gheorghe Duca

    2008-12-01

    Full Text Available This review is dedicated to different fields of use of cyclodextrins, a family of three cyclic natural oligosaccharides and their derivatives. The first part of the review gives a brief description of the main and the most recent developed applications of cyclodextrins in food, cosmetic industry, environmental protection technologies and agriculture. Different products based on inclusion complexes with cyclodextrins and technologies with different use of cyclodextrins and inclusion complexes are described.

  10. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis

    OpenAIRE

    2013-01-01

    Diabetes secondary to pancreatic diseases is commonly referred to as pancreatogenic diabetes or type 3c diabetes mellitus. It is a clinically relevant condition with a prevalence of 5%-10% among all diabetic subjects in Western populations. In nearly 80% of all type 3c diabetes mellitus cases, chronic pancreatitis seems to be the underlying disease. The prevalence and clinical importance of diabetes secondary to chronic pancreatitis has certainly been underestimated and underappreciated so fa...

  11. Selectively Modified Cyclodextrins as Artificial Glycosidases

    DEFF Research Database (Denmark)

    Bjerre, Jeannette; Bols, Mikael

    I proceedingen beskrives forfatterens og gruppens arbejde med at skabe kunstige glycosidaser baseret på beta-cyclodextrin. Vha. selektiv modificering af 1-2 alkohol-grupper på den primære rand af beta-cyclodextrin, er syntetiseret en række kunstige glycosidaser. Disse cyclodextrin-baserede glycos...

  12. Melatonin Treatment in Individuals with Intellectual Disability and Chronic Insomnia: A Randomized Placebo-Controlled Study

    Science.gov (United States)

    Braam, W.; Didden, R.; Smits, M.; Curfs, L.

    2008-01-01

    Background: While several small-number or open-label studies suggest that melatonin improves sleep in individuals with intellectual disabilities (ID) with chronic sleep disturbance, a larger randomized control trial is necessary to validate these promising results. Methods: The effectiveness of melatonin for the treatment of chronic sleep…

  13. Screening and Early Treatment of Migrants for Chronic Hepatitis B Virus Infection Is Cost-Effective

    NARCIS (Netherlands)

    Veldhuijzen, Irene K.; Toy, Mehlika; Hahne, Susan J. M.; de Wit, G. Ardine; Schalm, Solko W.; de Man, Robert A.; Richardus, Jan Hendrik

    2010-01-01

    BACKGROUND & AIMS: Persons with chronic hepatitis B virus (HBV) infection are at risk of developing cirrhosis and hepatocellular carcinoma. Early detection of chronic HBV infection through screening and treatment of eligible patients has the potential to prevent these sequelae. We assessed the cost-

  14. Chronic pain relief after the exposure of nitrous oxide during dental treatment: longitudinal retrospective study

    Directory of Open Access Journals (Sweden)

    Francisco Moreira Mattos Júnior

    2015-07-01

    Full Text Available The objective was to investigate the effect of nitrous/oxygen in chronic pain. Seventy-seven chronic pain patients referred to dental treatment with conscious sedation with nitrous oxide/oxygen had their records included in this research. Data were collected regarding the location and intensity of pain by the visual analogue scale before and after the treatment. Statistical analysis was performed comparing pre- and post-treatment findings. It was observed a remarkable decrease in the prevalence of pain in this sample (only 18 patients still had chronic pain, p < 0.001 and in its intensity (p < 0.001. Patients that needed fewer sessions received higher proportions of nitrous oxide/oxygen. Nitrous oxide may be a tool to be used in the treatment of chronic pain, and future prospective studies are necessary to understand the underlying mechanisms and the effect of nitrous oxide/oxygen in patients according to the pain diagnosis and other characteristics.

  15. Chronic systemic treatment with epidermal growth factor induces hypergastrinaemia in Goettingen minipigs

    DEFF Research Database (Denmark)

    Vinter-Jensen, Lars; Juhl, C O; Rehfeld, J F; Poulsen, Steen Seier; Dajani, E Z; Nexø, Ebba

    1995-01-01

    Epidermal growth factor (EGF) is an inhibitor of gastric acid secretion. The impact of chronic systemic treatment with EGF on intragastric pH and serum gastrin concentrations has not been investigated previously....

  16. Chronic Urticaria: Indian Context—Challenges and Treatment Options

    Directory of Open Access Journals (Sweden)

    Sujoy Khan

    2013-01-01

    Full Text Available Urticaria is a common condition that occurs in both children and adults. Most cases have no specific allergic trigger and the aetiology of urticaria remains idiopathic and occasionally spontaneous in nature. Inappropriate advice such as avoidance of foods (milk, egg, prawn, and brinjal is common place in certain sections of India mostly by nonspecialists that should not be routinely recommended. It is important to look for physical urticarias such as pressure urticaria in chronic cases, which may be present either alone or in combination with other causes. Autoimmune causes for chronic urticaria have been found to play an important role in a significant proportion of patients. Long-acting nonsedating antihistamines at higher than the standard doses is safe and effective. Quality of life is affected adversely in patients with chronic symptomatic urticaria and some may require multidisciplinary management.

  17. Comparison of Operant Behavioral and Cognitive-Behavioral Group Treatment for Chronic Low Back Pain.

    Science.gov (United States)

    Turner, Judith A.; Clancy, Steve

    1988-01-01

    Assigned chronic low back pain patients to operant behavioral (OB) treatment, cognitive-behavioral (CB) treatment, or waiting-list (WL) condition. Both treatments resulted in decreased physical and psychosocial disability. OB patients' greater improvement leveled off at followup; CB patients continued to improve over the 12 months following…

  18. Treatment of Chronic Phantom Limb Pain Using a Trauma-Focused Psychological Approach

    OpenAIRE

    Roos, C; Veenstra, AC; Jongh, A. de; den Hollander-Gijsman, ME; van der Wee, NJA; Zitman, FG; van Rood, YR

    2010-01-01

    BACKGROUND: Chronic phantom limb pain (PLP) is a disabling chronic pain syndrome for which regular pain treatment is seldom effective. Pain memories resulting from long-lasting preamputation pain or pain flashbacks, which are part of a traumatic memory, are reported to be powerful elicitors of PLP.OBJECTIVE: To investigate whether a psychological treatment directed at processing the emotional and somatosensory memories associated with amputation reduces PLP.METHODS: Ten consecutive participan...

  19. Experience of using immuno-therapy in treatment of chronic generalized periodontitis

    OpenAIRE

    Verechagina E.A.; Kobzeva U.A.; Ostrovskaya L.U.; Lukina L.V.; Bulkina N.V.

    2011-01-01

    The application of immunomodulator Gepon in the treatment of chronic generalized periodontitis can improve the quality of care, reduce the time of preoperative preparation of up to 10 days (in the traditional treatment 14-16 days), rapid postoperative rehabilitation of patients and to achieve stable remission in 82% of patients with chronic periodontitis easy degree and 77% with moderate periodontitis after 6 months of observation

  20. Experience of using immuno-therapy in treatment of chronic generalized periodontitis

    Directory of Open Access Journals (Sweden)

    Verechagina E.A.

    2011-03-01

    Full Text Available The application of immunomodulator Gepon in the treatment of chronic generalized periodontitis can improve the quality of care, reduce the time of preoperative preparation of up to 10 days (in the traditional treatment 14-16 days, rapid postoperative rehabilitation of patients and to achieve stable remission in 82% of patients with chronic periodontitis easy degree and 77% with moderate periodontitis after 6 months of observation

  1. Bisoprolol in the treatment of chronic heart failure: from pathophysiology to clinical pharmacology and trial results

    OpenAIRE

    Metra, Marco; NODARI, SAVINA; Bordonali, Tania; Milani, Patrizia; Lombardi, Carlo; Bugatti, Silvia; Fontanella, Benedetta; VERZURA, GIULIA; Danesi, Rossella; DEI CAS, LIVIO

    2007-01-01

    Clinical trials have consistently shown the benefits of beta-blocker treatment in patients with chronic heart failure (HF). As a result, bisoprolol, carvedilol, and metoprolol succinate are now indicated for the treatment of all patients with chronic HF who do not have major contraindications. Bisoprolol is the first beta-blocker shown to improve survival in an outcome trial. In the Cardiac Insufficiency Bisoprolol Study II (CIBIS-II), all-cause mortality and sudden death were reduced in pati...

  2. The classic: Chapter XVIII. Operative treatment in chronic articular ostitis. 1884.

    Science.gov (United States)

    Gibney, Virgil P

    2010-02-01

    This Classic article is a reprint of the original work by Virgil P. Gibney, Chapter XVIII. Operative Treatment in Chronic Articular Ostitis. An accompanying biographical sketch of Virgil P. Gibney, MD, is available at DOI 10.1007/s11999-009-1166-2 . The Classic Article is (c)1884 and is abridged from Gibney VP. Operative treatment in chronic articular ostitis. In: The Hip and Its Diseases. New York, NY, London, UK: Bermingham & Co; 1884:388-402. PMID:19936860

  3. Randomised trial of mycophenolate mofetil versus azathioprine for treatment of chronic active Crohn's disease

    OpenAIRE

    Neurath, M; Wanitschke, R; Peters, M.; Krummenauer, F; zum, B; Schlaak, J.

    1999-01-01

    BACKGROUND—Crohn's disease is a chronic inflammatory disease of the alimentary tract. Azathioprine is an effective agent in the management of chronic active Crohn's disease leading to long term remission of disease activity. Such treatment leads to limited efficacy or side effects in a small subset of patients. 
AIMS—To compare efficacy and side effects of treatment with azathioprine plus corticosteroids versus mycophenolate mofetil (MMF) plus corticosteroids in patients wit...

  4. HSV gene transfer in the treatment of chronic pain

    Institute of Scientific and Technical Information of China (English)

    David J. Fink; Marina Mata

    2008-01-01

    It has proven difficult to use systemic administration of small molecules to selectively modulate nociception. Over the past decade, we and others have developed non-replicating herpes simplex virus (HSV)-based vectors to treat chronic pain. Subcutaneous inoculation of an HSV vector effectively transduces sensory neurons in the dorsal root ganglion; release of transgene-coded inhibitory neurotransmitters or anti-inflammatory peptides reduces pain-related behaviors in rodent models of chronic inflammatory and neuro-pathic pain. A phase 1 trial of this therapy in patients is set to begin soon.

  5. OBSERVATION ON THE THERAPEUTIC EFFECT OF ELECTROACUPUNCTURE TREATMENT FOR SIMPLE CHRONIC RHINITIS

    Institute of Scientific and Technical Information of China (English)

    WEN Biling; ZHOU Shuang; YANG Yihong

    2002-01-01

    @@ Simple chronic rhinitis is a reversible chronic inflammatory disorder of nasal mucosa caused by various factors, it is a frequently encountered disorder with clinical manifestations of increased nasal secretion, intermittent alternative nasal obstruction, frequent ( respiratory ) anosmia and rhinophonia while speaking. In severe cases, it may manifest as hypocathexis, hypomnesis, fatigue, headache, head distress, insomnia, etc.that considerably hinder the patient's work or study. In the last 10 years, the authors have chiefly applied electroacupuncture (EA) to treatment of 38 cases of chronic rhinitis and the therapeutic effects are satisfactory. The following is the report of the treatment.

  6. Chronic Fatigue Syndrome: Searching for the Cause and Treatment.

    Science.gov (United States)

    Eichner, Edward R.

    1989-01-01

    Chronic fatigue syndrome became known nationally in l985 with a pseudoepidemic in a Nevada resort community. Initially and erroneously linked to the Epstein-Barr virus, the cause of this puzzling syndrome and the mind-body connection are areas of controversy and research. (Author/SM)

  7. Clinical Experience in TCM Treatment of Chronic Cervicitis

    Institute of Scientific and Technical Information of China (English)

    周宜强; 范宏宇

    2002-01-01

    @@ Chronic cervicitis is a common disease in the female reproductive system, which may be the inducing factor for carcinoma of uterine cervix. It is clinically manifested by sticky and foul leukorrhagia, contact hemorrhage, pain in the lower limbs or lumbosacral region, dysmenorrhea and infertility.

  8. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2008-01-01

    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of an

  9. Diagnostic efficiency and treatment strategy in chronic axonal polyneuropathy

    NARCIS (Netherlands)

    Vrancken, A.F.J.E.

    2007-01-01

    Polyneuropathy is a common peripheral nerve disorder that often has a well known cause such as diabetes, chronic renal disease, alcohol abuse, vitamin deficiency, hypothyroidism, or use of toxic medication. Elderly people are more often affected, but the differentiation from signs of normal ageing c

  10. Chronic pain treatment : from psychological predictors to implementation

    NARCIS (Netherlands)

    Samwel, J.J.A.

    2008-01-01

    In this thesis, cognitive-behavioural factors were studied based on the Fear-avoidance model (catastrophizing, fear of pain and avoidance behaviour) and, based on recent literature, helplessness and acceptance. All were studied as predictors of chronic pain outcomes (pain intensity, functional disab

  11. Pathogenetic approaches to the treatment of children with chronic pneumonia

    OpenAIRE

    Rano Musajanova

    2011-01-01

    We observed 60 children with chronic pneumonia aged from 3 to 14 years compared with 20 healthy children of the same age. Analysis of the biochemical data in children who received thiotriazoline showed reliable reduce of malondialdehyde and dien conjugates in comparison with control group. The levels of superoxidismutase and catalase increased. The results of immunological investigations showed that in children who took thiotriazoline noted reliable increase of T-lymphocytes, T-helpers, T-sup...

  12. Experience in Endovascular Treatment of Recurrent Chronic Subdural Hematoma

    OpenAIRE

    Ishihara, H.; Ishihara, S.; Kohyama, S.; Yamane, F.; Ogawa, M.; A. Sato; Matsutani, M.

    2007-01-01

    Most cases with chronic subdural hematoma (CSDH) are treated by simple irrigation and drainage, then more than eighty percent of them result in good recovery. But we sometimes encounter intractable cases with hematoma re-collection, which is considered of repeated bleeding from macrocapillary in the hematoma capsule. Embolization of the middle meningeal artery (MMA) is considered to be useful to eliminate the blood supply to this structure. The authors experienced seven cases of intractable C...

  13. Targeted treatment of chronic myeloid leukemia: role of imatinib

    OpenAIRE

    Ila Tamascar; Jeyanthi Ramanarayanan

    2009-01-01

    Ila Tamascar, Jeyanthi RamanarayananDepartment of Medical Oncology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, USAAbstract: Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by clonal expansion of pleuripotent hematopoetic stem cells. The incidence of CML is 1 to 2 cases per 100,000 people per year; in the Western Hemisphere, CML accounts for 15% of leukemias in adults. Discovery of the specific karyotypic abnormality of the Philadelphia (...

  14. Is exercise an alternative treatment for chronic insomnia?

    OpenAIRE

    Giselle Soares Passos; Dalva Lucia Rollemberg Poyares; Marcos Gonçalves de Santana; Sergio Tufik; Marco Túlio de Mello

    2012-01-01

    The purposes of this systematic/critical review are: 1) to identify studies on the effects of exercise on chronic insomnia and sleep complaints in middle-aged and older adults and to compare the results of exercise with those obtained with hypnotic medications and 2) to discuss potential mechanisms by which exercise could promote sleep in insomniac patients. We identified studies from 1983 through 2011 using MEDLINE, SCOPUS and Web of Science. For systematic analyses, only studies assessing t...

  15. Autografting as first line treatment for chronic myeloid leukaemia.

    OpenAIRE

    Singer, I O; Franklin, I M

    1998-01-01

    Interest in autografting for chronic myeloid leukaemia and its clinical relevance has revived in recent years. This followed observations that with various chemotherapeutic regimens it was possible to achieve, temporarily at least, peripheral blood and bone marrow that were Philadelphia negative. Bone marrow or peripheral blood progenitor cells could then be harvested and reinfused following a high dose procedure, hopefully eliminating any residual disease, and resulting in prolonged disease ...

  16. Mitochondrial Dysfunction and Chronic Disease: Treatment With Natural Supplements

    OpenAIRE

    Nicolson, Garth L.

    2014-01-01

    Loss of function in mitochondria, the key organelle responsible for cellular energy production, can result in the excess fatigue and other symptoms that are common complaints in almost every chronic disease. At the molecular level, a reduction in mitochondrial function occurs as a result of the following changes: (1) a loss of maintenance of the electrical and chemical transmembrane potential of the inner mitochondrial membrane, (2) alterations in the function of the electron transport chain,...

  17. Pathophysiology and treatment of inflammatory anorexia in chronic disease.

    Science.gov (United States)

    Braun, Theodore P; Marks, Daniel L

    2010-12-01

    Decreased appetite and involuntary weight loss are common occurrences in chronic disease and have a negative impact on both quality of life and eventual mortality. Weight loss in chronic disease comes from both fat and lean mass, and is known as cachexia. Both alterations in appetite and body weight loss occur in a wide variety of diseases, including cancer, heart failure, renal failure, chronic obstructive pulmonary disease and HIV. An increase in circulating inflammatory cytokines has been implicated as a uniting pathogenic mechanism of cachexia and associated anorexia. One of the targets of inflammatory mediators is the central nervous system, and in particular feeding centers in the hypothalamus located in the ventral diencephalon. Current research has begun to elucidate the mechanisms by which inflammation reaches the hypothalamus, and the neural substrates underlying inflammatory anorexia. Research into these neural mechanisms has suggested new therapeutic possibilities, which have produced promising results in preclinical and clinical trials. This review will discuss inflammatory signaling in the hypothalamus that mediates anorexia, and the opportunities for therapeutic intervention that these mechanisms present. PMID:21475703

  18. Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain.

    Science.gov (United States)

    Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter

    2015-12-01

    The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = -0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increase in pain volatility was associated with a 44% reduction in the probability of endpoint abstinence. The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain. PMID:26302337

  19. Two novel ternary albendazole-cyclodextrin-polymer systems: dissolution, bioavailability and efficacy against Taenia crassiceps cysts.

    Science.gov (United States)

    Palomares-Alonso, Francisca; González, Cesar Rivas; Bernad-Bernad, Ma Josefa; Montiel, María Dolores Castillo; Hernández, Guadalupe Palencia; González-Hernández, Iliana; Castro-Torres, Nelly; Estrada, Enrique Pinzón; Jung-Cook, Helgi

    2010-01-01

    The effect of two water-soluble polymers: pectin and polyvinylpyrrolidone in combination with beta-cyclodextrin, on the dissolution, bioavailability and cysticidal efficacy of albendazole was evaluated using a commercial suspension as reference product. The dissolution of the albendazole-beta-cyclodextrin-pectin formulation was slow and incomplete (44.7%). No statistical differences in C(max) and AUC were found between this formulation and the reference. Also its cysticidal efficacy (33%) was similar to the reference (38%). The albendazole-beta-cyclodextrin-polyvinylpyrrolidone formulation exhibited the highest dissolution rate (78.5%) and its bioavailability was also significantly increased (2.3-fold). In addition, the cysticidal activity of this formulation (83%) was greater than a commercial suspension. Our results suggest that the ternary system of albendazole-beta-cyclodextrin-polyvinylpyrrolidone could be a potential alternative for the treatment of systemic helmintic diseases and it is worth to continue its preclinical evaluation. PMID:19769931

  20. Erythropoietin treatment does not compromise cardiovascular function in chronic renal failure

    DEFF Research Database (Denmark)

    Haedersdal, C; Mehlsen, J; Stenver, Doris Irene;

    1994-01-01

    The anemia in patients with chronic renal failure can be corrected through treatment with recombinant human erythropoietin treatment. This correction is associated with changes in the rheologic variables, which could explain the changes in hemodynamics found by many investigators. The authors have...... followed up 11 patients with chronic renal failure on hemodialysis before and during six months of therapy with erythropoietin. The measurements were made before treatment, after four months of therapy, and after six months of therapy. The measurements included hematocrit, osmotic resistance of the red...

  1. Modern wound care - practical aspects of non-interventional topical treatment of patients with chronic wounds.

    Science.gov (United States)

    Dissemond, Joachim; Augustin, Matthias; Eming, Sabine A; Goerge, Tobias; Horn, Thomas; Karrer, Sigrid; Schumann, Hauke; Stücker, Markus

    2014-07-01

    The treatment of patients with chronic wounds is becoming increasingly complex. It was therefore the aim of the members of the working group for wound healing (AGW) of the German Society of Dermatology (DDG) to report on the currently relevant aspects of non-interventional, topical wound treatment for daily practice. -Beside necessary procedures, such as wound cleansing and débridement, we describe commonly used wound dressings, their indications and practical use. Modern antiseptics, which are currently used in wound therapy, usually contain polyhexanide or octenidine. Physical methods, such as negative-pressure treatment, are also interesting options. It is always important to objectify and adequately treat pain symptoms which often affect these patients. Modern moist wound therapy may promote healing, reduce complications, and improve the quality of life in patients with chronic wounds. Together with the improvement of the underlying causes, modern wound therapy is an important aspect in the overall treatment regime for patients with chronic wounds. PMID:24813380

  2. Erythropoietin treatment does not compromise cardiovascular function in chronic renal failure

    DEFF Research Database (Denmark)

    Haedersdal, C; Mehlsen, J; Stenver, Doris Irene;

    1994-01-01

    The anemia in patients with chronic renal failure can be corrected through treatment with recombinant human erythropoietin treatment. This correction is associated with changes in the rheologic variables, which could explain the changes in hemodynamics found by many investigators. The authors have...... followed up 11 patients with chronic renal failure on hemodialysis before and during six months of therapy with erythropoietin. The measurements were made before treatment, after four months of therapy, and after six months of therapy. The measurements included hematocrit, osmotic resistance of the red...... were unchanged. The conclude that, in spite of changes in rheologic variables, increasing viscosity of the blood and thus possibly increasing the peripheral resistance, these had no effect on the cardiovascular state. Erythropoietin treatment improves the subjective well-being in patients on chronic...

  3. Clinical Studies on Treatment of Chronic Prostatitis with Acupuncture and Mild Moxibustion

    Institute of Scientific and Technical Information of China (English)

    Yu Yang; Kang Jingli; Duan Shumin

    2005-01-01

    To observe the therapeutic effect of acupuncture and mild moxibustion on chronic prostatitis and to probe into the mechanism of the therapy. Two hundred patients with chronic prostatitis were randomly divided into two groups so as to observe respectively the changes in clinical symptoms, count of WBC and lecithin corpuscles in succus prostaticus, prostatic capcules and internal echo, tenderness and elasticity of prostate by palpation before and after treatment. After treatment, a remarkable improvement was found in clinical symptoms, succus prostaticus test and ultrasonic examination in the treatment group with a statistically significant difference (P<0.05) as compared to the control group. The treatment of chronic prostatitis with acupuncture and mild moxibustion can remove the stagnation of succus prostaticus, improve the blood circulation in prostate, inhibit or kill the pathogenic micro-organisms, strengthen or regulate the immune function of the patients, improve local blood circulation, eliminate the accumulation of secretion and relieve the obstruction of the prostatic ducts.

  4. Cocaine abstinence following chronic treatment alters cerebral metabolism in dopaminergic reward regions. Bromocriptine enhances recovery

    International Nuclear Information System (INIS)

    2-[14C]deoxyglucose autoradiography was used to determine local cerebral glucose utilization (lCGU) in rats following chronic cocaine treatment and subsequent abstinence. lCGU was examined in 43 discrete brain regions in animals which had received daily injections of cocaine for 14 days (10 mg/kg) followed by 3 days of saline or bromocriptine (10 mg/kg) treatment. Cocaine abstinence following chronic treatment significantly reduced lCGU in several regions including mesocorticolimbic structures such as ventral tegmental area, medial prefrontal cortex, and nucleus accumbens (NAc). Within the NAc, however, only the rostral pole showed significant reduction. In contrast, when bromocriptine treatment accompanied abstinence, lCGU was no longer reduced in mesocorticolimbic and most other regions, implying that metabolic recovery was enhanced by bromocriptine treatment during early abstinence following chronic cocaine treatment. These data suggest that cerebral metabolism is decreased during cocaine abstinence following chronic treatment in critical brain regions, and that this alteration can be prevented by treatment with direct-acting dopamine agonists such as bromocriptine

  5. Prolonged Exposure Treatment of Chronic PTSD in Juvenile Sex Offenders: Promising Results from Two Case Studies

    Science.gov (United States)

    Hunter, John A.

    2010-01-01

    Prolonged exposure (PE) was used to treat chronic PTSD secondary to severe developmental trauma in two adolescent male sex offenders referred for residential sex offender treatment. Both youth were treatment resistant prior to initiation of PE and showed evidence of long-standing irritability and depression/anxiety. Clinical observation and…

  6. Laboratory recommendations for scoring deep molecular responses following treatment for chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Cross, N. C. P.; White, H. E.; Colomer, D.;

    2015-01-01

    Treatment of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors has advanced to a stage where many patients achieve very low or undetectable levels of disease. Remarkably, some of these patients remain in sustained remission when treatment is withdrawn, suggesting that they may be at ...

  7. Sofosbuvir and Simeprevir Treatment of a Stem Cell Transplanted Teenager With Chronic Hepatitis C Infection.

    Science.gov (United States)

    Fischler, Björn; Priftakis, Peter; Sundin, Mikael

    2016-06-01

    There have been no previous reports on the use of interferon-free combinations in pediatric patients with chronic hepatitis C infection. An infected adolescent with severe sickle cell disease underwent stem cell transplantation and subsequent treatment with sofosbuvir and simeprevir during ongoing immunosuppression. Despite the emergence of peripheral edema as a side effect, treatment was continued with sustained antiviral response. PMID:26928522

  8. Virtual reality hypnosis in the treatment of chronic neuropathic pain: a case report.

    Science.gov (United States)

    Oneal, Brent J; Patterson, David R; Soltani, Maryam; Teeley, Aubriana; Jensen, Mark P

    2008-10-01

    This case report evaluates virtual reality hypnosis (VRH) in treating chronic neuropathic pain in a patient with a 5-year history of failed treatments. The patient participated in a 6-month trial of VRH, and her pain ratings of intensity and unpleasantness dropped on average 36% and 33%, respectively, over the course of 33 sessions. In addition, she reported both no pain and a reduction of pain for an average of 3.86 and 12.21 hours, respectively, after treatment sessions throughout the course of the VRH treatment. These reductions and the duration of treatment effects following VRH treatment were superior to those following a trial of standard hypnosis (non-VR) treatment. However, the pain reductions with VRH did not persist over long periods of time. The findings support the potential of VRH treatment for helping individuals with refractory chronic pain conditions. PMID:18726807

  9. Pancreaticoduodenectomy (Whipple resection) in the treatment of chronic pancreatitis.

    Science.gov (United States)

    Howard, J M; Zhang, Z

    1990-01-01

    The armamentarium of the pancreatic surgeon must include multiple operative techniques, to be adapted to the clinical and anatomical findings in the patient with chronic pancreatitis. Pancreaticoduodenectomy is an essential component of this armamentarium. Its indications and limitations require continued refinement. Pancreaticoduodenectomy (Whipple operation) provides excellent results in the relief of the pain of chronic pancreatitis. The incidence of reoperation for control of pain after this procedure is less than after drainage procedures. The postoperative mortality rate in recent report is less than 2%. Whereas resection of pancreatic tissue diminishes pancreatic function, the metabolic deficits are partially compensated by the better nutritional status resulting from pain relief and discontinuation of narcotics. In experienced hands, pancreaticoduodenectomy would appear to be the procedure of choice in patients with small pancreatic ducts. In selected patients, it appears to be a good procedure and, possibly, the operation of choice when the disease is predominantly present in the head of the pancreas and/or the uncinate process, especially when strictures involve the common bile duct and duodenum. The authors prefer the procedure when a hard, chronically-inflamed mass is present in the head of the pancreas. In our experience, if the suspicion of malignancy of the head of the pancreas persists at operation, pancreaticoduodenectomy is the procedure of choice. Before undertaking resection, the individual surgeon must assess his/her own experience; a low risk is essential. The continuing alcoholic is not a candidate for pancreaticoduodenectomy. Those who will not stop drinking should seldom be accepted for resection. The same limitation exists for the narcotic addict, but few such patients are encountered today. In the authors' experience, the operation is excellent for the relief of pain. It is the lifestyle of the continuing alcoholic that poses the more

  10. Karyotypic findings in chronic myeloid leukemia cases undergoing treatment

    Directory of Open Access Journals (Sweden)

    Anupam Kaur

    2012-01-01

    Full Text Available Background: Chronic myeloid leukemia (CML is a clonal myeloproliferative expansion of primitive hematopoietic progenitor cells. Materials and Methods: In the present study, CML samples were collected from various hospitals in Amritsar, Jalandhar and Ludhiana. Results: Chromosomal alterations seen in peripheral blood lymphocytes of these treated and untreated cases of CML were satellite associations, double minutes, random loss, gain of C group chromosomes and presence of marker chromosome. No aberrations were observed in control samples. Karyotypic abnormalities have also been noted in the Ph-negative cells of some patients in disease remission. Conclusion: This is a novel phenomenon whose prognostic implications require thorough and systematic evaluation.

  11. Ibrutinib treatment ameliorates murine chronic graft-versus-host disease

    OpenAIRE

    Dubovsky, Jason A.; Flynn, Ryan; Du, Jing; Harrington, Bonnie K.; Zhong, Yiming; Kaffenberger, Benjamin; Yang, Carrie; Towns, William H; Lehman, Amy; Johnson, Amy J.; Muthusamy, Natarajan; Devine, Steven M.; Jaglowski, Samantha; Serody, Jonathan S.; Murphy, William J.

    2014-01-01

    Chronic graft-versus-host disease (cGVHD) is a life-threatening impediment to allogeneic hematopoietic stem cell transplantation, and current therapies do not completely prevent and/or treat cGVHD. CD4+ T cells and B cells mediate cGVHD; therefore, targeting these populations may inhibit cGVHD pathogenesis. Ibrutinib is an FDA-approved irreversible inhibitor of Bruton’s tyrosine kinase (BTK) and IL-2 inducible T cell kinase (ITK) that targets Th2 cells and B cells and produces durable remissi...

  12. 'You say treatment, I say hard work': treatment burden among people with chronic illness and their carers in Australia.

    Science.gov (United States)

    Sav, Adem; Kendall, Elizabeth; McMillan, Sara S; Kelly, Fiona; Whitty, Jennifer A; King, Michelle A; Wheeler, Amanda J

    2013-11-01

    The aim of this study was to explore treatment burden among people with a variety of chronic conditions and comorbidities and their unpaid carers. The burden of living with ongoing chronic illness has been well established. However, the burden associated with proactively treating and managing chronic illness, commonly referred to as 'treatment burden', is less understood. This study helps to bridge this gap in our understanding by providing an in-depth analysis of qualitative data collected from a large sample of adults from diverse backgrounds and with various chronic conditions. Using semi-structured in-depth interviews, data were collected with a large sample of 97 participants that included a high representation of people from culturally and linguistically diverse backgrounds and indigenous populations across four regions of Australia. Interviews were conducted during May-October 2012, either face to face (n = 49) or over the telephone (n = 48) depending on the participant's preference and location. Data were analysed using an iterative thematic approach and the constant comparison method. The findings revealed four interrelated components of treatment burden: financial burden, time and travel burden, medication burden and healthcare access burden. However, financial burden was the most problematic component with the cost of treatment being significant for most people. Financial burden had a detrimental impact on a person's use of medication and also exacerbated other types of burden such as access to healthcare services and the time and travel associated with treatment. The four components of treatment burden operated in a cyclical manner and although treatment burden was objective in some ways (number of medications, and time to access treatment), it was also a subjective experience. Overall, this study underscores the urgent need for healthcare professionals to identify patients overwhelmed by their treatment and develop 'individualised' treatment

  13. Immunogenicity of recombinant hepatitis B vaccine in treatment-naïve and treatment-experienced chronic hepatitis C patients: The effect of pegylated interferon plus ribavirin treatment

    OpenAIRE

    Elefsiniotis, Ioannis S; Vezali, Elena; Kamposioras, Konstantinos; Pantazis, Konstantinos D.; Tontorova, Radostina; Ketikoglou, Ioannis; Moulakakis, Antonios; Saroglou, George

    2006-01-01

    AIM: To retrospectively evaluate the vaccination-induced anti-HBs seroconversion rates in treatment-naïve and treatment-experienced chronic hepatitis C (CHC) patients. Also to prospectively evaluate the seroconversion rates in CHC patients during pegylated interferon (PEG) plus ribavirin (RIB) treatment.

  14. Diagnosis and treatment of chronic cough in China: an insight into the status quo

    OpenAIRE

    Lai, Kefang; Luo, Wei; Zeng, Guangqiao; Zhong, Nanshan

    2012-01-01

    Chronic cough is a very common complaint in clinics throughout China. Clinical and basic science research on chronic cough started late, but in recent years the effort has yielded promising findings regarding the etiological diagnosis, treatment and pathogenesis. We found that inflammation in nonasthmatic eosinophilic bronchitis has some similarities to cough variant asthma but also a number of distinct differences. Recent evidence has also suggested a mechanistic link between airway neurogen...

  15. Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety?

    OpenAIRE

    Kissin I

    2013-01-01

    Igor Kissin Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Background: For the past 30 years, opioids have been used to treat chronic nonmalignant pain. This study tests the following hypotheses: (1) there is no strong evidence-based foundation for the conclusion that long-term opioid treatment of chronic nonmalignant pain is effective; and (2) the main problem associated with the safety of such treatme...

  16. Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

    OpenAIRE

    Wiegand, Cornelia; Hipler,Uta-Christina; Elsner, Peter; Tittelbach,Jörg

    2015-01-01

    Cornelia Wiegand, Jörg Tittelbach, Uta-Christina Hipler, Peter Elsner Department of Dermatology, University Hospital Jena, Jena, Germany Abstract: The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of us...

  17. Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

    OpenAIRE

    Wieg; C.; Tittelbach J; Hipler UC; Elsner P

    2015-01-01

    Cornelia Wiegand, Jörg Tittelbach, Uta-Christina Hipler, Peter Elsner Department of Dermatology, University Hospital Jena, Jena, Germany Abstract: The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of using ...

  18. A new generation of topical chronic wound treatments containing specific MMP inhibitors

    OpenAIRE

    Shrivastava R; Cucuat N; Rousse M; Weig; T; Neto P; Janicot C; Shrivastava C

    2014-01-01

    Ravi Shrivastava, Nathalie Cucuat, Monika Rousse, Thomas Weigand, Pedro Neto, Claire Janicot, Christiane Shrivastava VITROBIO Research Institute, Issoire, France Purpose: Incidence of chronic wounds is constantly rising worldwide, but all currently available treatments are intended either to provide symptomatic relief or to assist cicatrization to some extent, but not to directly stimulate cellular growth. Physiologically, chronic wound healing simply requires cell growth to fill the injured...

  19. Chronic ACE inhibitor treatment increases angiotensin type 1 receptor binding in vivo in the dog kidney

    Energy Technology Data Exchange (ETDEWEB)

    Zober, Tamas G. [Johns Hopkins University, Departments of Radiology and Surgery, Baltimore, MD (United States); Semmelweis University, Department of Pathophysiology, Budapest (Hungary); Fabucci, Maria E.; Zheng, Wei; Sandberg, Kathryn [Georgetown University, Department of Medicine, Washington, DC (United States); Brown, Phillip R.; Seckin, Esen; Mathews, William B. [Johns Hopkins University, Departments of Radiology and Surgery, Baltimore, MD (United States); Szabo, Zsolt [Johns Hopkins University, Departments of Radiology and Surgery, Baltimore, MD (United States); Johns Hopkins Outpatient Center, Division of Nuclear Medicine, Baltimore, MD (United States)

    2008-06-15

    PET imaging has been recently introduced for investigating the type 1 angiotensin II receptor (AT{sub 1}R) in vivo. The goal of the present study was to investigate the effects of acute and chronic exposure to angiotensin converting enzyme inhibitors (ACEI) on the AT{sub 1}R in the dog kidney. Animals were imaged at baseline, after acute intravenous ACEI treatment and after a chronic 2-week exposure to an oral ACEI. Control animals were imaged at identical time points in the absence of ACEI treatment. In vivo AT{sub 1}R binding expressed by K{sub i} was increased in the renal cortex by chronic ACEI treatment (p < 0.05). In vitro measurements of AT{sub 1}R density (B{sub max}) also revealed significant increases in AT{sub 1}R in isolated glomeruli (p < 0.05). Plasma renin activity was increased, but angiotensin II (Ang II) and the Ang II/Ang I ratio showed a weak correlation with chronic ACEI treatment, consistent with an Ang II escape phenomenon. This study reveals, for the first time, that chronic ACEI treatment increases AT{sub 1}R binding in vivo in the dog renal cortex. (orig.)

  20. An autoradiographic analysis of cholinergic receptors in mouse brain after chronic nicotine treatment

    International Nuclear Information System (INIS)

    Quantitative autoradiographic procedures were used to examine the effects of chronic nicotine infusion on the number of central nervous system nicotinic cholinergic receptors. Female DBA mice were implanted with jugular cannulas and infused with saline or various doses of nicotine (0.25, 0.5, 1.0 or 2.0 mg/kg/hr) for 10 days. The animals were then sacrificed and the brains were removed and frozen in isopentane. Cryostat sections were collected and prepared for autoradiographic procedures as previously described. Nicotinic cholinergic receptors were labeled with L-[3H]nicotine or alpha-[125I]bungarotoxin; [3H]quinuclidinyl benzilate was used to measure muscarinic cholinergic receptor binding. Chronic nicotine infusion increased the number of sites labeled by [3H]nicotine in most brain areas. However, the extent of the increase in binding as well as the dose-response curves for the increase were widely different among brain regions. After the highest treatment dose, binding was increased in 67 of 86 regions measured. Septal and thalamic regions were most resistant to change. Nicotinic binding measured by alpha-[125I]bungarotoxin also increased after chronic treatment, but in a less robust fashion. At the highest treatment dose, only 26 of 80 regions were significantly changes. Muscarinic binding was not altered after chronic nicotine treatment. These data suggest that brain regions are not equivalent in the mechanisms that regulate alterations in nicotinic cholinergic receptor binding after chronic nicotine treatment

  1. Successful medical treatment of emphysematous pyelonephritis in chronic hemodialysis.

    Science.gov (United States)

    Vlachopanos, Georgios; Kassimatis, Theodoros; Zerva, Adamantia; Kokkona, Anastasia; Stavroulaki, Eirini; Zacharogiannis, Charilaos; Agrafiotis, Athanasios

    2015-10-01

    Emphysematous pyelonephritis (EPN) is a life-threatening renal infection caused by gas-producing bacteria and fungi. It usually occurs in patients with diabetes and patients with urinary tract obstruction. A combination of systemic antibiotics, percutaneous catheter drainage, or open nephrectomy is typically required to achieve cure. Because of grim prognosis, resorting to interventional methods is frequently inevitable. We report the case of a 77-year-old woman with diabetes and end-stage renal disease on chronic hemodialysis that presented with fever and left flank pain. A bubbly gas pattern inside the left kidney was demonstrated on abdominal computed tomography scan and blood cultures grew Escherichia coli. She was successfully treated solely with systemic antibiotics. This highlights the fact that prompt recognition of imaging findings associated with benign prognosis is essential for a favorable outcome. It allows for an effective management avoiding high-risk interventions, especially in frail patients with multiple comorbidities. Finally, we review all published cases of EPN in chronic dialysis patients. PMID:25643771

  2. Effect of a pre-freezing treatment with cholesterol-loaded cyclodextrins on boar sperm longevity, capacitation dynamics, ability to adhere to porcine oviductal epithelial cells in vitro and DNA fragmentation dynamics.

    Science.gov (United States)

    Tomás, C; Blanch, E; Fazeli, A; Mocé, E

    2013-01-01

    The aim of this work was to examine how a pre-freezing treatment with cholesterol-loaded cyclodextrins (CLC) affects boar sperm longevity, capacitation dynamics, ability to bind to a porcine telomerase-immortalised oviductal epithelial cell line (TERT-OPEC) in vitro and DNA integrity dynamics after freeze-thawing. Although the samples treated with CLC exhibited lower sperm quality than the control samples (P0.05) after long-term incubation (26h at 37 or 16°C). Additionally, the CLC-treated spermatozoa underwent similar capacitation and DNA fragmentation dynamics as the control spermatozoa (P>0.05). However, CLC-treated spermatozoa were better able to bind to TERT-OPEC in vitro (POPEC in vitro, which could have an effect on the establishment of the sperm reservoir in the ampullary--isthmic junction in vivo. Additionally, frozen-thawed spermatozoa can be stored at 16°C for at least 6h without a significant observable decline in sperm quality, which could be beneficial for the transport of thawed diluted doses of spermatozoa from the laboratory to the farm. PMID:23036662

  3. [Opinions on the prevention and treatment of chronic critical illness].

    Science.gov (United States)

    An, Youzhong

    2016-07-01

    Chronic critical illness (CCI) is an inevitable result of overpopulation and aging, as well as the development of medicine. The number of CCI patients will constantly increase and become an unaffordable economic burden for families, societies and countries. CCI could be prevented by multiple measures. Firstly, doctors must know about the pathophysiology and etiology of the disease. When providing organ function support for CCI patient, we have to know and treat the cause of the disease as early as possible. Secondly, we need to precisely monitor the insults caused by the disease and/or improper host response to the disease, evaluate the organ reserve function, and predict the outcomes and life quality after discharging from hospital. In addition, it is necessary to strengthen the humanity training of health care workers, publicize the correct thanatopsis in the whole society that every life is "born to die", and define the core role of medicine as "to comfort always". PMID:27452750

  4. Neuropsychological consequences of chronic drug use: relevance to treatment approaches

    Directory of Open Access Journals (Sweden)

    Jean Lud eCadet

    2016-01-01

    Full Text Available Heavy use of drugs impacts of the daily activities of individuals in these activities. Several groups of investigators have indeed documented changes in cognitive performance by individuals who have a long history of chronic drug use. In the case of marijuana, a wealth of information suggests that heavy long-term use of the drug may have neurobehavioral consequences in some individuals. In humans, heavy cocaine use is accompanied by neuropathological changes that might serve as substrates for cognitive dysfunctions. Similarly, methamphetamine users suffer from cognitive abnormalities that may be consequent to alterations in structures and functions. Here, we detail the evidence for these neuropsychological consequences. The review suggests that improving the care of our patients will necessarily depend on the better characterization of drug-induced cognitive phenotypes because they might inform the development of better pharmacological and behavioral interventions, with the goal of improving cognitive functions in these subsets of drug users.

  5. Neuropsychological Consequences of Chronic Drug Use: Relevance to Treatment Approaches.

    Science.gov (United States)

    Cadet, Jean Lud; Bisagno, Veronica

    2015-01-01

    Heavy use of drugs impacts of the daily activities of individuals in these activities. Several groups of investigators have indeed documented changes in cognitive performance by individuals who have a long history of chronic drug use. In the case of marijuana, a wealth of information suggests that heavy long-term use of the drug may have neurobehavioral consequences in some individuals. In humans, heavy cocaine use is accompanied by neuropathological changes that might serve as substrates for cognitive dysfunctions. Similarly, methamphetamine users suffer from cognitive abnormalities that may be consequent to alterations in structures and functions. Here, we detail the evidence for these neuropsychological consequences. The review suggests that improving the care of our patients will necessarily depend on the better characterization of drug-induced cognitive phenotypes because they might inform the development of better pharmacological and behavioral interventions, with the goal of improving cognitive functions in these subsets of drug users. PMID:26834649

  6. Influence of late treatment on how chronic myeloid leukemia responds to imatinib

    Directory of Open Access Journals (Sweden)

    Ana Carolina Costa Scerni

    2009-01-01

    Full Text Available INTRODUCTION: In Brazil, patients with chronic myeloid leukemia (CML in the chronic phase were not given first-line imatinib treatment until 2008. Therefore, there was a long period of time between diagnosis and the initiation of imatinib therapy for many patients. This study aims to compare the major molecular remission (MMR rates of early versus late imatinib therapy in chronic phase CML patients. METHODS: Between May 2002 and November 2007, 44 patients with chronic phase CML were treated with second-line imatinib therapy at the Hematology Unit of the Ophir Loyola Hospital (Belém, Pará, Brazil. BCR-ABL transcript levels were measured at approximately six-month intervals using quantitative polymerase chain reaction. RESULTS: The early treatment group presented a 60% probability of achieving MMR, while the probability for those patients who received late treatment was 40%. The probability of either not achieving MMR within one year of the initiation of imatinib therapy or losing MMR was higher in patients who received late treatment (79%, compared with patients who received early treatment (21%, odds ratio=5.75, P=0.012. The probability of maintaining MMR at 30 months of treatment was 80% in the early treatment group and 44% in the late treatment group (P=0.0005. CONCLUSIONS: For CML patients in the chronic phase who were treated with second-line imatinib therapy, the probability of achieving and maintaining MMR was higher in patients who received early treatment compared with those patients for whom the time interval between diagnosis and initiation of imatinib therapy was longer than one year.

  7. Treatment satisfaction and dissatisfaction in patients with chronic low back pain

    OpenAIRE

    Rofail, Diana

    2010-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. This thesis explores treatment satisfaction and dissatisfaction in patients with chronic low back pain (CLBP). Chapters 1 and 2 provide background on CLBP, and treatment satisfaction and dissatisfaction. Chapter 3 presents study 1, the systematic review which identified research concerning treatment satisfaction and dissatisfaction in patients with CLBP. Findings indicated a need to def...

  8. Stochastic modelling to evaluate the economic efficiency of treatment of chronic subclinical mastitis

    OpenAIRE

    Steeneveld, W.; Hogeveen, H; Borne, van den, D Dirk; Swinkels, J.M.

    2006-01-01

    Treatment of subclinical mastitis is traditionally no common practice. However, some veterinarians regard treatment of some types of subclinical mastitis to be effective. The goal of this research was to develop a stochastic Monte Carlo simulation model to support decisions around treatment of chronic subclinical mastitis caused by Streptococcus uberis. Factors in the model include, amongst others, the probability of spontaneous cure, probability of the cow becoming clinically diseased, trans...

  9. Treatment of Pediatric Chronic Pain with Tramadol Hydrochloride: Siblings with Ehlers-Danlos Syndrome - Hypermobility Type

    OpenAIRE

    Brown, Stephen C; Jennifer Stinson

    2004-01-01

    OBJECTIVE: To evaluate the effectiveness of tramadol hydrochloride for the treatment of chronic pain refractory to previous treatment in two pediatric patients.METHODS: Tramadol hydrochloride was administered (50 mg/day to 150 mg/day) to two siblings with Ehlers-Danlos syndrome -- Hypermobility type refractory to previous pharmacological treatments, and changes in pain intensity and physical activity were assessed.RESULTS: Pain intensity decreased and physical activity improved within days of...

  10. Azithromycin buccal patch in treatment of chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Sajith Abdul Latif

    2016-01-01

    Conclusion: The monotherapy resulted in no improvement of periodontal parameters, microbial parameters, and TNF-α level. It is safe to use AZM + SRP as a mode of nonsurgical treatment in periodontitis patients.

  11. Chronic ACE inhibitor treatment increases angiotensin type 1 receptor binding in vivo in the dog kidney

    International Nuclear Information System (INIS)

    PET imaging has been recently introduced for investigating the type 1 angiotensin II receptor (AT1R) in vivo. The goal of the present study was to investigate the effects of acute and chronic exposure to angiotensin converting enzyme inhibitors (ACEI) on the AT1R in the dog kidney. Animals were imaged at baseline, after acute intravenous ACEI treatment and after a chronic 2-week exposure to an oral ACEI. Control animals were imaged at identical time points in the absence of ACEI treatment. In vivo AT1R binding expressed by Ki was increased in the renal cortex by chronic ACEI treatment (p 1R density (Bmax) also revealed significant increases in AT1R in isolated glomeruli (p 1R binding in vivo in the dog renal cortex. (orig.)

  12. Cognitive-behavioral treatment of panic attacks in chronic schizophrenia

    OpenAIRE

    Arlow, PB; Moran, ME; Bermanzohn, PC; Stronger, R; Siris, SG

    1997-01-01

    Although panic attacks have been described as relatively common in schizophrenia, few studies have examined treatments for this problem. Because cognitive-behavioral therapy (CBT) has demonstrated efficacy for panic disorder without schizophrenia, the authors conducted an open clinical trial of CBT for the treatment of panic attacks in schizophrenic patients. Eight patients meeting DSM-III-R criteria for schizophrenia and panic disorder were given a 16-week clinical trial of...

  13. Multi-centre retrospective analysis of clinical diagnosis and treatment for chronic cough

    Directory of Open Access Journals (Sweden)

    Xiao-ming CHENG

    2011-02-01

    Full Text Available Objective To explore the clinical characteristics and the present status of diagnosis and treatment of chronic cough.Methods The clinical data of 238 in-patients and out-patients of Departments of Respiratory Diseases from 4 teaching hospitals of Chongqing Municipality were collected from Oct.2008 to Dec.2009,and their clinical characteristics,diagnosis and therapeutic effects were retrospectively analyzed.Results A total of 238 patients were enrolled,most of them complained of dry cough and night cough.Throat symptoms were most common,including itching or foreign body sensation,throat discomfort and gastro-oesophageal reflux.Congestion of pharynx and cobblestone like changes in posterior pharyngeal wall were the most common signs in patients with chronic cough.Among all the supplementary examinations,bronchial provocation test resulted in highest positive rate.Etiological diagnosis was done in a total of 254 case-times for diseases leading to chronic cough,among them upper airway cough syndrome(UACS was suspected in 115 case-times.cough variant asthma(CVA in 42 case-times,and cough due to gastroesophageal reflux(GERC in 53 case-times.After the specific treatment targeting UACS,CVA and GERC,in 152 case-times improvement was found after follow-up,including 56,27 and 21 case-times,respectively,with an effective rate of 68.4%(104/152.The final diagnosis for the other 44 case-times with chronic cough was chronic tonsillitis,chronic bronchitis,eosinophilic bronchitis and angiotensin converting enzyme inhibitor(ACEI induced cough.A definite diagnosis was finally made in 148 out of a total of 254 casses,with a diagnostic rate of 58.3%(148/254.Conclusion The final diagnostic rate in etiology of chronic cough is still poor nowadays in our country,and empirical treatment is still the main practice for chronic cough.

  14. [EFFICACY OF CYCLOFERON LINIMENT IN THE COMBINED TREATMENT OF CHRONIC GINGIVITIS IN PATIENTS WITH CHRONIC INFECTIOUS DISEASES].

    Science.gov (United States)

    Soboleva, L A; Shul'dyakov, A A; Bulkina, N V

    2015-01-01

    In order to study the clinical-pathogenetic efficacy of using cycloferon liniment in the combined therapy of patients with gingivitis on the background of chronic infectious diseases (HIV infection, hepatitis C, brucellosis), medical examination and treatment of 42 patients with this diagnosis has been carried out. It is established, that the use of cycloferon liniment in the combined therapy decreases the infection load in periodontal recess and manifestation of local inflammation, normalizes the immunity indices, and reduces the level of endogenous intoxication. All these factors provide acceleration of the recuperation processes and decrease the frequency of recidivating. PMID:26591207

  15. The number of granule cells in rat hippocampus is reduced after chronic mild stress and re-established after chronic escitalopram treatment

    DEFF Research Database (Denmark)

    Jayatissa, Magdalena N; Bisgaard, Christina; West, Mark J;

    2008-01-01

    Stress and depression cause structural changes in the hippocampal formation. Some of these can be reversed by chronic antidepressant treatment. In the present study, we examined the changes in the total number of granule cells and the volume of the granule cell layer after exposing rats to chronic...... mild stress and chronic escitalopram treatment. Furthermore, we investigated which classes of immature granule cells are affected by stress and targeted by escitalopram. Rats were initially exposed to 2weeks of CMS and 4weeks of escitalopram treatment with concurrent exposure to stress. The behavioral...

  16. Chronic treatment with antidepressant drugs and the analgesia induced by 5-methoxy-N,N-dimethyltryptamine: attenuation by desipramine.

    Science.gov (United States)

    Danysz, W; Minor, B G; Post, C; Archer, T

    1986-08-01

    The effect of chronic and acute oral or intraperitoneal treatment with the antidepressant drugs, desipramine, amitriptyline, alaproclate and iprindole, upon pain thresholds in the tail flick, hot plate and shock titration tests of nociception in saline- and 5-MeODMT-treated rats was studied. Chronic desipramine treatment increased the pre-test tail flick latencies. In the saline-treated rats, chronic oral desipramine treatment increased tail flick latencies, whereas chronic oral amitriptyline treatment decreased tail flick latencies. In 5-MeODMT-treated rats, chronic oral desipramine treatment attenuated the effects of 5-MeODMT (1 mg/kg) in all three tests of nociception, whereas chronic amitriptyline caused a potentiation in the tail flick and hot plate tests. Chronic oral iprindole treatment attenuated 5-MeODMT-induced analgesia in the hot plate test. Chronic intraperitoneal desipramine treatment attenuated 5-MeODMT analgesia in the tail flick and shock titration tests. In a different chronic treatment experiment, oral desipramine treatment attenuated 5-MeODMT analgesia in the tail flick test and zimeldine did for both the tail flick and hot plate tests, whereas mianserin potentiated 5-MeODMT-induced analgesia in both the tail flick and hot plate tests. In the saline-treated rats, acute treatment with all four drugs, desipramine, amitriptyline, iprindole and alaproclate, elevated the shock thresholds, whereas in 5-MeODMT-treated rats, desipramine and amitriptyline elevated shock thresholds. Two main conclusions can be drawn: chronic desipramine caused a quite consistent attenuation of 5-MeODMT-induced analgesia and the effects of acute treatment differed strongly from that of the chronic treatment. The effects of chronic administration with these antidepressants were compared with other findings using different measures of behavioural and receptor function. PMID:3776549

  17. Chronic myelogenous leukemia in chronic phase transforming into acute leukemia under treatment with dasatinib 4 months after diagnosis.

    Science.gov (United States)

    Nakamura, Yukitsugu; Tokita, Katsuya; Nagasawa, Fusako; Takahashi, Wataru; Nakamura, Yuko; Sasaki, Ko; Ichikawa, Motoshi; Mitani, Kinuko

    2016-03-01

    We report a 64-year-old woman morphologically diagnosed with chronic myelogenous leukemia in the chronic phase. Despite having achieved a complete hematological response following treatment with dasatinib, she developed lymphoblastic crisis 4 months later. Blastic cells were in a CD45-negative and SSC-low fraction, and positive for CD10, CD19, CD34, and HLA-DR expression and rearrangement in the immunoglobulin heavy chain gene. Chemotherapy using the HyperCVAD/MA regimen led to a complete cytogenetic response, and after cord blood transplantation, she obtained a complete molecular remission. However, the crisis recurred 6 months later. Another salvage therapy using L-AdVP regimen followed by nilotinib led to a complete molecular remission. Retrospective analyses using flow cytometry and polymerase chain reaction revealed a minimal blastic crisis clone present in the initial marrow in chronic phase. This case is informative as it suggests that sudden blastic crisis may occur from an undetectable blastic clone present at initial diagnosis and that leukemic stem cells may survive cytotoxic chemotherapy that eliminates most of the blastic cells. PMID:26662559

  18. USAGE OF PASTE FOR TEMPORARY PLACEMENT IN THE TREATMENT OF CHRONIC APICAL PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    A.V. Borysenko

    2012-03-01

    Full Text Available Summary: The aim of the present investigation was usage of medicamental paste with antibacterial and regeneration action for temporary placement in the treatment of chronic apical periodontitis. Materials and method: The medicamental paste for temporary placement of root canals consists of a mixture of metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania. Thë paste was used for the treatment of 30 teeth with chronic apical periodontitis. Final obturation of the root canals was performed with gutta percha cones and sealer. The efficiency of the treatment was appreciated after examination on the basis of clinical and radiographic findings. Results: During the treatment of the 30 teeth, no exacerbations of the pathological process were recorded. Pain after obturation of the root canals was revealed in only 6 (20% of the treated teeth. No pain, pathologic changes of gingiva, good mastication efficiency in all teeth after treatment were revealed. Conclusions: The high clinical efficiency of the medicamental paste with antibacterial and regeneration action at the level of temporary root canals placement in the treatment of chronic apical periodontitis was shown. Keywords: chronic apical periodontitis, medicamental paste for temporary root canals placement, metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania

  19. Clinical Research on Acupuncture and Moxibustion Treatment of Chronic Atrophic Gastritis

    Institute of Scientific and Technical Information of China (English)

    Gao Xiyan; Yuan Jing; Li Huijuan; Ren Shan

    2007-01-01

    Objective: To observe the clinical therapeutic effects of acupuncture and moxibustion in treating chronic atrophic gastritis. Methods: Patients who met the criteria were randomly divided into the treatment groups consisting of the acupuncture group (30 cases) and the acupuncture-moxibustion group (30 cases), and the control group (28 cases). After two months of treatment, observed were safety and the curative effects,through general physical check ups, routine examinations of blood, urine and feces, and symptoms,pathology and gastrin before, during and after the treatment. Results: 1) The treatment groups showed significant superiorities in the improvement of symptoms, with the acupuncture-moxibustion group showing the best therapeutic effects. 2) The acupuncture-moxibustion group showed marked differences before and after the treatment in the improvement of glandular atrophy and intestinal metaplasia, with a total effective rate of 66.67%. 3) After the treatment, the three groups all showed marked improvement in the level of serum gastrin, with the acupuncture-moxibustion group showing the best effects. Conclusion: Acupuncture and moxibustion have definite therapeutic effects for chronic atrophic gastritis, especially in improving the symptoms. Acupuncture or acupuncture combined with moxibustion can provide possibilities in reversing the pathologic changes of glandular atrophy and intestinal metaplasia for patients with chronic atrophic gastritis. Acupuncture-moxibustion is really an effective and safe therapy for chronic atrophic gastritis.

  20. Effect of non-surgical periodontal treatment on chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Hilana Paula Carillo Artese

    2010-12-01

    Full Text Available Chronic kidney disease (CKD is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1 and 19 individuals without clinical evidence of kidney disease (group 2 with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated at baseline and 3 months after treatment. Both groups showed significant and similar post-treatment improvements in all periodontal parameters examined. Most interestingly, periodontal treatment had a statistically significant positive effect on the glomerular filtration rate of each individual (group 1, p = 0.04; group 2, p = 0.002. Our results indicate that chronic periodontitis in predialysis kidney disease patients improved similarly in patients with chronic periodontitis and no history of CKD after receiving non-surgical periodontal therapy. This study demonstrates that CKD predialysis patients show a good response to non-surgical periodontal treatment.

  1. [Treatment of chronic alcoholic pancreatitis with a new acid-resistant pancreatin product].

    Science.gov (United States)

    Kempelen, I; Szilárd, M

    1995-09-17

    The authors summarised pathophysiology and therapy possibility of the chronic alcoholic pancreatitis. They introduce a new product of pancreatin use for treatment of chronic alcoholic pancreatitis. The aim of this prospective study was to asses the efficacy of this new drug in the treatment of chronic alcoholic pancreatitis. The treatment was carried out by new pancreatin product containing 10,000 FIP U lipase, 9000 FIP U amylase, and 500 FIP E protease. During the study 30 patients--suffering from alcoholic pancreatitis--were treated. They received, two tablets three times daily in a period of two weeks. The following parameters were observed and compared before and after the period of treatment: complaints of the patients, the characteristics of the stool (daily weight, frequency, fat contents, consistency) the change of the body weight and degree of abdominal pain. These parameters were compared using a score-system, before and after the period of treatment. The authors could analyse the data of 21 patients. It was proved that there was a significant decrease in frequency, daily weight and fat contents of the stool and in abdominal pain. There was not significant change in the body weight. The authors concluded that this new product is a good pancreatin preparation which is useful and suitable for effective treatment of chronic alcoholic pancreatitis, if the patient keeps abstinence. PMID:7566938

  2. CYCLODEXTRINS - FIELFS OF APPLICATION. PART II

    Directory of Open Access Journals (Sweden)

    Gh. Duca

    2012-12-01

    Full Text Available This paper represents an analysis of potential and current applications of cyclodextrins as biologically active substances in medicine. The main applications described here include use of cyclodextrins as agents that form inclusion complexes with endogenous substances (membrane lipids, cellular cholesterol, agents that form inclusion complexes with exogenous substances with their man role as guest molecules (sugammadex, FBCx, agents that block endogenous and exogenous macromolecules (ion channels, anthrax toxin, α-hemolysin, and agents which activity is based on the chemical nature of them and of their derivatives (cyclodextrin polysulphate derivatives. The fi rst classifi cation for medically important biological activity of cyclodextrins has been proposed.

  3. Cyclodextrins in Asymmetric and Stereospecific Synthesis

    Directory of Open Access Journals (Sweden)

    Fliur Macaev

    2015-09-01

    Full Text Available Since their discovery, cyclodextrins have widely been used as green and easily available alternatives to promoters or catalysts of different chemical reactions in water. This review covers the research and application of cyclodextrins and their derivatives in asymmetric and stereospecific syntheses, with their division into three main groups: (1 cyclodextrins promoting asymmetric and stereospecific catalysis in water; (2 cyclodextrins’ complexes with transition metals as asymmetric and stereospecific catalysts; and (3 cyclodextrins’ non-metallic derivatives as asymmetric and stereospecific catalysts. The scope of this review is to systematize existing information on the contribution of cyclodextrins to asymmetric and stereospecific synthesis and, thus, to facilitate further development in this direction.

  4. Chronic disease and recent addiction treatment utilization among alcohol and drug dependent adults

    Directory of Open Access Journals (Sweden)

    Samet Jeffrey

    2011-10-01

    Full Text Available Abstract Background Chronic medical diseases require regular and longitudinal care and self-management for effective treatment. When chronic diseases include substance use disorders, care and treatment of both the medical and addiction disorders may affect access to care and the ability to focus on both conditions. The objective of this paper is to evaluate the association between the presence of chronic medical disease and recent addiction treatment utilization among adults with substance dependence. Methods Cross-sectional secondary data analysis of self-reported baseline data from alcohol and/or drug-dependent adults enrolled in a randomized clinical trial of a disease management program for substance dependence in primary care. The main independent variable was chronic medical disease status, categorized using the Katz Comorbidity Score as none, single condition of lower severity, or higher severity (multiple conditions or single higher severity condition, based on comorbidity scores determined from self-report. Asthma was also examined in secondary analyses. The primary outcome was any self-reported addiction treatment utilization (excluding detoxification in the 3 months prior to study entry, including receipt of any addiction-focused counseling or addiction medication from any healthcare provider. Logistic regression models were adjusted for sociodemographics, type of substance dependence, recruitment site, current smoking, and recent anxiety severity. Results Of 563 subjects, 184 (33% reported any chronic disease (20% low severity; 13% higher severity and 111 (20% reported asthma; 157 (28% reported any addiction treatment utilization in the past 3 months. In multivariate regression analyses, no significant effect was detected for chronic disease on addiction treatment utilization (adjusted odds ratio [AOR] 0.88 lower severity vs. none, 95% confidence interval (CI: 0.60, 1.28; AOR 1.29 higher severity vs. none, 95% CI: 0.89, 1.88 nor for

  5. FORMULATION AND EVALUATION OF FAST DISSOLVING TABLETS OF CYCLODEXTRIN INCLUSION COMPLEXED WATER INSOLUBLE DRUG: GLIMIPIRIDE

    Directory of Open Access Journals (Sweden)

    Shirse Prabhakar

    2012-06-01

    Full Text Available Glimepiride (GMP is a Third Generation Sulphonylureas used for treatment of type 2 diabetes. Poor water solubility is the main constraint for its oral bioavailability. The rationale of this study was to enhance the solubility and dissolution of the drug by preparing its complex with β-cyclodextrin and Hydroxypropyl Betacyclodextrin-β-cyclodextrin. In the present study attempt has been made to prepare, formulate and characterize inclusion complexes of Glimepiride with β-cyclodextrin and Hydroxypropyl Betacyclodextrin-β-cyclodextrin. The inclusion complexes were prepared by three different methods viz. Physical, Kneading and Co-precipitation method. The inclusion complex containing Glimepiride: β-cyclodextrin and Hydroxypropyl Betacyclodextrin-β-cyclodextrin was further formulated into Fast Dissolving Tablets (FDT by Direct Compression Technique using Super-disintegrants like Crosscarmelose Sodium, Crospovidone and Sodium Starch Glycolate were used. The prepared Complexes were characterized using FT-IR and Differential Scanning Calorimetry and finally the prepared Fast Dissolving Tablets were Evaluated for various pharmaceutical characteristics viz. Hardness, % Friability, Weight Variation, Wetting Time, Drug Content and In-vitro Dissolution profiles. The results of stability studies revealed no change in physical appearance, hardness, drug content and in-vitro dissolution profiles, thus indicating that formulation was stable.

  6. Patient phenotyping in clinical trials of chronic pain treatments

    DEFF Research Database (Denmark)

    Edwards, Robert R.; Dworkin, Robert H.; Turk, Dennis C.;

    2016-01-01

    that determine the optimal treatments, or treatment combinations, for individual patients) that would presumably improve both the clinical care of patients with pain and the success rates for putative analgesic drugs in phase 2 and 3 clinical trials. However, before implementing this approach, the......There is tremendous interpatient variability in the response to analgesic therapy (even for efficacious treatments), which can be the source of great frustration in clinical practice. This has led to calls for "precision medicine" or personalized pain therapeutics (ie, empirically based algorithms...... stimulation, endogenous pain-modulatory processes, and response to pharmacologic challenge. We provide evidence-based recommendations for core phenotyping domains and recommend measures of each domain....

  7. EMDR: a new treatment for trauma and chronic pain.

    Science.gov (United States)

    Grant, M

    2000-05-01

    EMDR (eye movement desensitization and reprocessing) is a new psychological treatment for trauma that is capable of facilitating rapid and permanent reduction in distressing thoughts and feelings (Carlson et al. 1998,Wilson et al. 1995). In addition to reduction of psychological distress, the method leads to more adaptive attitudes and functioning. The utility of the method also appears to extend beyond trauma with positive results reported in the treatment of addictions, phobias, and pain (Henry 1996, Goldstein & Feske 1994, Grant 1986). As a treatment for pain EMDR offers a method of facilitating permanent changes in how pain is experienced somatically and emotionally. Knowledge and understanding of the principles underlying EMDR can also provide a guide for more effective interventions by pain specialists. PMID:10844748

  8. Do Patients with Chronic Noncancer Pain Accept Treatment of Questionable Benefit More Readily that those Who Are Pain Free?

    Directory of Open Access Journals (Sweden)

    Mark K Simmonds

    2004-01-01

    Full Text Available BACKGROUND: The efficacy of some common, questionable chronic pain interventions has been debated and it is unclear why sufferers of chronic noncancer pain agree to receive them. This study attempts to determine if chronic pain sufferers characteristically more readily accept treatment with questionable benefit.

  9. Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Marcelo Henrique da Silva

    2014-08-01

    Full Text Available Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions.

  10. Changes in the anti-inflammatory activity of soy isoflavonoid genistein versus genistein incorporated in two types of cyclodextrin derivatives

    Directory of Open Access Journals (Sweden)

    Danciu CorinaTiulea

    2012-06-01

    Full Text Available Abstract Background The isoflavonoid genistein represents the major active compound from soybean, the vegetal product from Glycine max (Fabaceae. The aim of this study is to prove that genistein was incorporated in two semisynthetic cyclodextrins, beta-cyclodextrin derivatives: hydroxypropyl-beta-cyclodextrin and randomly-methylated-beta-cyclodextrin as well as to compare the anti-inflammatory activity of genistein with that of genistein incorporated in these two types of semisynthetic cyclodextrins. Results The animal studies were conducted on 8-week old C57BL/6 J female mice. Inflammation was induced in both ears of each mouse by topical application of 10 micrograms 12-O-tetradecanoylphorbol-3-acetate dissolved in 0.1 ml solvent (acetone : dimethylsulfoxide in a molar ratio 9:1. Thirty minutes later treatment was applied. The inflammatory reaction was correlated with increased values in ear thickness. Treatment with genistein and genistein incorporated in the two cyclodextrins led to decreased values for ear thickness. Better anti-inflammatory action was found for the complexes of genistein. Both haematoxylin-eosin analysis and CD45 marker expression are in agreement with these findings. Conclusions Results allow concluding that genistein is an active anti-inflammatory phytocompound and its complexation with hydrophilic beta-cyclodextrin derivatives leads to a stronger anti-inflammatory activity.

  11. Treatment of chronic diarrhoea: loperamide versus ispaghula husk and calcium

    DEFF Research Database (Denmark)

    Qvitzau, S; Matzen, Peter; Madsen, P

    1988-01-01

    loose in all, and urgency was present in 16 out of 19 patients. Both treatments halved stool frequency, but with regard to urgency and stool consistency ispaghula and calcium was significantly better. A combination of ispaghula and calcium seems to be a cheap and effective alternative to conventional...

  12. Anagrelide treatment in 52 patients with chronic myeloproliferative diseases

    DEFF Research Database (Denmark)

    Penninga, E; Jensen, B A; Hansen, P B;

    2004-01-01

    -term treatment with anagrelide. Furthermore, a total of 13 events were recorded. More than 25% of these events occurred in patients with platelet counts between 400 and 600 x 10(9)/l and almost 40% of all events occurred in patients with platelet counts above 400 x 10(9)/l. This observation supports the...

  13. Sofa dermatitis presenting as a chronic treatment resistant dermatitis.

    LENUS (Irish Health Repository)

    Lynch, M

    2010-04-01

    There is now a well publicised increase in cases of sofa dermatitis since 2007. These have been linked to allergic contact sensitization to dimethlylfumarate, a novel contact allergen. We report on a case associated with a two year history of a treatment resistant dermatitis.

  14. Collaborative decision-making and promoting treatment adherence in pediatric chronic illness

    Directory of Open Access Journals (Sweden)

    Dennis Drotar

    2010-03-01

    Full Text Available Dennis Drotar, Peggy Crawford, Margaret BonnerCincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USAAbstract: Collaborative or shared decision-making between health care providers and families can facilitate treatment adherence, health outcomes, and satisfaction with care in the management of pediatric chronic illness, but raises special challenges. Barriers such as authoritarian models of medical care as well as absence of time and opportunity for dialogue limit collaborative decision making and can disrupt treatment adherence. However, models of provider-family communication that emphasize communication and shared goal-setting inform an anticipatory guidance model of collaborative decision-making that can enhance treatment adherence. Salient challenges and strategies involved in implementing collaborative decision-making in pediatric chronic illness care are described. Research is needed to: 1 describe the communication and decision-making process in the management of pediatric chronic illness; and 2 evaluate the impact of interventions that enhance collaborative decision-making on provider-family communication, illness management, and treatment adherence.Keywords: collaborative decision-making, shared decision-making, treatment adherence, pediatric chronic illness

  15. Clinical heterogeneity of dominant chronic mucocutaneous candidiasis disease: presenting as treatment-resistant candidiasis and chronic lung disease.

    Science.gov (United States)

    Dotta, Laura; Scomodon, Omar; Padoan, Rita; Timpano, Silviana; Plebani, Alessandro; Soresina, Annarosa; Lougaris, Vassilios; Concolino, Daniela; Nicoletti, Angela; Giardino, Giuliana; Licari, Amelia; Marseglia, Gianluigi; Pignata, Claudio; Tamassia, Nicola; Facchetti, Fabio; Vairo, Donatella; Badolato, Raffaele

    2016-03-01

    In gain-of-function STAT1 mutations, chronic mucocutaneous candidiasis disease (CMCD) represents the phenotypic manifestation of a complex immunodeficiency characterized by clinical and immunological heterogeneity. We aimed to study clinical manifestations, long-term complications, molecular basis, and immune profile of patients with dominant CMCD. We identified nine patients with heterozygous mutations in STAT1, including novel amino acid substitutions (L283M, L351F, L400V). High risk of azole-resistance was observed, particularly when intermittent regimens of antifungal treatment or use of suboptimal dosage occurs. We report a case of Cryptococcosis and various bacterial and viral infections. Risk of developing bronchiectasis in early childhood or gradually evolving to chronic lung disease in adolescent or adult ages emerges. Lymphopenia is variable, likely progressing by adulthood. We conclude that continuous antifungal prophylaxis associated to drug monitoring might prevent resistance to treatment; prompt diagnosis and therapy of lung disease might control long-term progression; careful monitoring of lymphopenia-related infections might improve prognosis. PMID:26732859

  16. The dynamics of histamine level in patients with chronic urticaria under the influence of different methods of treatment.

    OpenAIRE

    Dytyatkovska Ye.M.

    2014-01-01

    There was studied the efficiency of different methods of chronic urticaria treatment. All patients were divided into 2 groups depending on treatment scteme. The paper shows the dynamics of histamine level in blood plasma, intestine disbiosis in patients with chronic urticaria under the influence of different treatment complexes. It was proved that there exists the correlation between the serum histamine level and method of treatment. Intro¬ducing bionorm into the treatment allows to decrease ...

  17. XPC genetic polymorphisms correlate with the response to imatinib treatment in patients with chronic phase chronic myeloid leukemia.

    Science.gov (United States)

    Guillem, Vicent M; Cervantes, Francisco; Martínez, Jesús; Alvarez-Larrán, Alberto; Collado, María; Camós, Mireia; Sureda, Anna; Maffioli, Margherita; Marugán, Isabel; Hernández-Boluda, Juan-Carlos

    2010-07-01

    Chronic myeloid leukemia (CML) is driven by the BCR-ABL protein, which promotes the proliferation and viability of the leukemic cells. Moreover, BCR-ABL induces genomic instability that can contribute to the emergence of resistant clones to the ABL kinase inhibitors. It is currently unknown whether the inherited individual capability to repair DNA damage could affect the treatment results. To address this, a comprehensive analysis of single nucleotide polymorphisms (SNPs) on the nucleotide excision repair (NER) genes (ERCC2-ERCC8, RPA1-RPA3, LIG1, RAD23B, XPA, XPC) was performed in 92 chronic phase CML patients treated with imatinib upfront. ERCC5 and XPC SNPs correlated with the response to imatinib. Haplotype analysis of XPC showed that the wild-type haplotype (499C-939A) was associated with a better response to imatinib. Moreover, the 5-year failure free survival for CA carriers was significantly better than that of the non-CA carriers (98% vs. 73%; P = 0.02). In the multivariate logistic model with genetic data and clinical covariates, the hemoglobin (Hb) level and the XPC haplotype were independently associated with the treatment response, with patients having a Hb < or =11 g/dl (Odds ratio [OR] = 5.0, 95% confidence interval [CI] = 1.5-16.1) or a non-CA XPC haplotype (OR = 4.1, 95% CI = 1.6-10.6) being at higher risk of suboptimal response/treatment failure. Our findings suggest that genetic polymorphisms in the NER pathway may influence the results to imatinib treatment in CML. PMID:20575039

  18. Ginseng treatment reduces bacterial load and lung pathology in chronic Pseudomonas aeruginosa pneumonia in rats

    DEFF Research Database (Denmark)

    Song, Z; Johansen, H K; Faber, V;

    1997-01-01

    The predominant pathogen in patients with cystic fibrosis (CF) is Pseudomonas aeruginosa, which results in a chronic lung infection associated with progressive pulmonary insufficiency. In a rat model of chronic P. aeruginosa pneumonia mimicking that in patients with CF, we studied whether the...... inflammation and antibody responses could be changed by treatment with the Chinese herbal medicine ginseng. An aqueous extract of ginseng was injected subcutaneously, and cortisone and saline were used as controls. Two weeks after challenge with P. aeruginosa, the ginseng-treated group showed a significantly...... against P. aeruginosa sonicate and a shift from an acute type to a chronic type of lung inflammation compared to those in the control and cortisone-treated groups were observed. These findings indicate that ginseng treatment of an experimental P. aeruginosa pneumonia in rats promotes a cellular response...

  19. [Novel treatments for hepatitis C virus infection in chronic kidney disease].

    Science.gov (United States)

    Fabrizi, Fabrizio; Messa, Piergiorgio

    2016-01-01

    Recent evidence has been accumulated showing a negative impact of chronic hepatitis C virus infection on survival in patients with chronic kidney disease. Moreover, it appears that anti-HCV positive status has been associated with an increased risk of developing chronic kidney disease in the adult general population. These reports have emphasized the need for safe and effective therapies for hepatitis C virus infection in the chronic kidney disease population. Treatment of HCV has made considerable progress with the approval of interferon-free, direct-acting antiviral drug-based combination therapies among patients with intact kidneys; but a paucity of information exists regarding chronic kidney disease patients. The first published report on the antiviral treatment of hepatitis C among patients with chronic kidney disease (stage 4-5) and HCV genotype 1 concerns the combination of grazoprevir (NS3/4A protease inhibitor) and elbasvir (NS5A inhibitor); excellent safety and efficacy (sustained viral response, 94.3% 115/122) have been reached. In another study, the 3-D regimen (ombitasvir/ paritaprevir/ ritonavir/ dasabuvir with or without ribavirin) has been administered to CKD (stage 4-5) patients with genotype 1 (n=20); the rate of sustained viral response was excellent (90%, 18/20) and no patients discontinued treatment due to adverse events. Preliminary data on the combined treatment of sofosbuvir (NS5B inhibitor) and simeprevir (NS3/4A inhibitor) has given a viral response of 89% (34/38), but the size of the study group (n=38 patients with end-stage renal disease) was small. Thus, the evidence in the medical literature concerning use of DAAs in CKD population is encouraging even if it has a preliminary nature. Also, several points need to be addressed regarding the use of DAAs in CKD population including their impact on survival, costs, and drug-drug interactions. PMID:27545640

  20. EFFECTS OF MICROWAVE TREATMENT ON THE LYMPHOCYTESUBSETS IN CASES OF CHRONIC LYMPHEDEMA OF EXTREMITIES

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To determine the immune status of T lymphocyte subsets of patients with chronic lymphedema of extremities and the effects of microwave treatment. Methods Patients with lymphedema of extremities (n=20) and normal volunteers (n=10) were studied by fluorescein isothiocyanate (FITC) or phycoerythrin (PE)-conjugated monoclonal antibo dies (MoAbs) and dual color flow cytometry to examine the changes of lymphocyte phenotypes in them before and after treat ment. Results The percentage of CD4+ T lymphocytes and CD4+ /CD8+ T cell ratios in lymphedema group were less than those in control group before treatment. They increased significantly and restored to nearly normal level after microwave treatment. The percentage of CD8+ and HLA-DR + T lymphocytes in lymphedema group also demonstrated significant decline after treat ment. Conclusion Disorder of T lymphocyte subsets existed in patients with chronic lymphedema of extremities, and mi crowave treatment can improve the states and enhance the cellular immunity of the patients.

  1. Treatment of Chronic Renal Failure by Supplementing the Kidney and Invigorating Blood Flow

    Institute of Scientific and Technical Information of China (English)

    张勉之; 张大宁; 张文柱; 刘树松; 张敏英

    2004-01-01

    Objective: To evaluate the effectiveness of treatment of chronic renal failure by supplementing the kidney and invigorating blood flow. Method: The eligible patients were assigned to a treatment group (N =120)treated with the above principle and a control group (N = 128) treated with western drugs, and the effectiveness was evaluated when the study was completed in one year. Results: The total effective rate of 92.5% was achieved in the treatment group, better than that in the control group (49.2%); the difference was significant (P<0.01), especially in patients of stage Ⅰ and Ⅱ. Conclusion: The treatment of chronic renal failure by supplementing the kidney and invigorating blood flow proved to be very effective.

  2. Chronic oleoylethanolamide treatment improves spatial cognitive deficits through enhancing hippocampal neurogenesis after transient focal cerebral ischemia.

    Science.gov (United States)

    Yang, Li-Chao; Guo, Han; Zhou, Hao; Suo, Da-Qin; Li, Wen-Jun; Zhou, Yu; Zhao, Yun; Yang, Wu-Shuang; Jin, Xin

    2015-04-15

    Oleoylethanolamide (OEA) has been shown to have neuroprotective effects after acute cerebral ischemic injury. The aim of this study was to investigate the effects of chronic OEA treatment on ischemia-induced spatial cognitive impairments, electrophysiology behavior and hippocampal neurogenesis. Daily treatments of 30 mg/kg OEA significantly ameliorated spatial cognitive deficits and attenuated the inhibition of long-term potentiation (LTP) in the middle cerebral artery occlusion (MCAO) rat model. Moreover, OEA administration improved cognitive function in a manner associated with enhanced neurogenesis in the hippocampus. Further study demonstrated that treatment with OEA markedly increased the expressions of brain-derived neurotrophic factor (BDNF) and peroxisome proliferator-activated receptors α (PPARα). Our data suggest that chronic OEA treatment can exert functional recovery of cognitive impairments and neuroprotective effects against cerebral ischemic insult in rats via triggering of neurogenesis in the hippocampus, which supports the therapeutic use of OEA for cerebral ischemia. PMID:25748831

  3. Studies on treatment of chronic hepatitis B, C and D

    OpenAIRE

    Berk, Luuk

    1991-01-01

    textabstractTsji Pa, physician to the Chinese emperor Hoang Ti (2674-2575 B.C.), described the syndrome of jaundice with fatigue, arthralgia and malaise as related to diseases of the liver. At that t"1me the treatment varied from administering herbs to restoring the yinyang balance with acupuncture (1 }. Two thousand years later Hippocrates described the same syndrome and differentiated liver disease due to the abuse of wine, a fulminant form of hepatitis and a third form that rendered the pa...

  4. CHELT therapy in the treatment of chronic insertional Achilles tendinopathy.

    Science.gov (United States)

    Notarnicola, Angela; Maccagnano, Giuseppe; Tafuri, Silvio; Forcignanò, Maria Immacolata; Panella, Antonio; Moretti, Biagio

    2014-05-01

    The application of laser therapy on soft tissue is used for pain relief, anti-inflammation action and biostimulation. The efficiency of High Energy Laser Therapy has not yet been studied on Achilles tendinopathy. The aim of the study is to evaluate the effectiveness of a flow of Cold air and High Energy Laser Therapy (CHELT) versus Extracorporeal Shock Waves Therapy (ESWT) in the treatment of Achilles tendinopathy. In this prospective, clinical trial, 60 subjects affected by insertional Achilles tendinopathy were enrolled and randomized to CHELT (30 subjects) or to ESWT (30 subjects). In CHELT group the patients received ten daily sessions of 1,200 J and 12 W of laser therapy (wavelength of 1,084, 810 and 980 nm) added to a flow of cold air at -30 °C. In the ESWT group, the patients received three sessions at 3- to 4-day intervals of 1,600 impulses with an energy flux density (EFD) of 0.05-0.07 mJ/mm(2). Both groups of participants performed stretching and eccentric exercises over a 2-month period. The visual analogue scale (VAS), the Ankle-Hindfoot Scale, and the Roles and Maudsley Score were measured before treatment (T0), and at end of the treatment session (T1) and 2 (T2) and 6 months (T3) after treatment during the follow-up examinations. In both groups, we found a statistically significant improvement of the VAS at T1, T2 and T3 (p < 0.01). The difference between the two groups was statistically significant in favour of the CHELT group (p < 0.001). At 2 months, the CHELT group was statistically better for Ankle-Hindfoot Scale and the Roles and Maudsley Score (p < 0.05) and at 6 months only for the Roles and Maudsley Score (p < 0.001). High Energy Laser Therapy gave quicker and better pain relief. It also gave the patient a full functional recovery and greater satisfaction. PMID:24352875

  5. Nebivolol: Its role in the treatment of hypertension and chronic heart failure

    NARCIS (Netherlands)

    Voors, Adriaan; Van Veldhuisen, D.J.

    2006-01-01

    (beta)-blockers are standard therapy in patients with cardiovascular disease, and have become a cornerstone in the treatment of both hypertension and chronic heart failure. However, two meta-analyses have recently raised doubts about the use of (beta)-blockers in patients with essential hypertension

  6. Chronic Hepatitis C and Antiviral Treatment Regimens: Where Can Psychology Contribute?

    Science.gov (United States)

    Evon, Donna M.; Golin, Carol E.; Fried, Michael W.; Keefe, Francis J.

    2013-01-01

    Objective: Our goal was to evaluate the existing literature on psychological, social, and behavioral aspects of chronic hepatitis C viral (HCV) infection and antiviral treatment; provide the state of the behavioral science in areas that presently hinder HCV-related health outcomes; and make recommendations for areas in which clinical psychology…

  7. Treating Chronic Pain in Veterans Presenting to an Addictions Treatment Program

    Science.gov (United States)

    Ilgen, Mark A.; Haas, Elizabeth; Czyz, Ewa; Webster, Linda; Sorrell, John T.; Chermack, Stephen

    2011-01-01

    Chronic pain and substance use disorders frequently co-occur. The pharmacological treatment of pain is complicated in individuals with substance use disorders because of the potential for abuse and diversion of many prescription pain medications. One potential approach is to use a combination of cognitive-behavioral and acceptance-based strategies…

  8. Clinical Observation The Thoughts and Methods for Clinical Research on Acupuncture Treatment of Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The general situation of chronic fatigue syndrome (CFS) and the criteria for its diagnosis are discussed, and it is put forward that making qi and blood of the zang-fu organs balanced is the key to acupuncture treatment of the disease. Such aspects as case selection, point selection and therapeutic assessment are also discussed in the present paper.

  9. Chronic Treatment with Haloperidol Induces Deficits in Working Memory and Feedback Effects of Interval Timing

    Science.gov (United States)

    Lustig, C.; Meck, W.H.

    2005-01-01

    Normal participants (n=5) having no experience with antipsychotic drugs and medicated participants (n=5) with clinical experience with chronic low doses of haloperidol (3-10mg/day for 2-4 months) in the treatment of neuroses were evaluated for the effects of inter-trial interval (ITI) feedback on a discrete-trials peak-interval timing procedure.…

  10. Treatment of Chronic Pain in Older People Evidence-Based Choice of Strong-Acting Opioids

    NARCIS (Netherlands)

    van Ojik, Annette L.; Jansen, Paul A. F.; Brouwers, Jacobus R. B. J.; van Roon, Eric N.

    2012-01-01

    In the treatment of chronic malignant and non-malignant pain, opioids are used as strong analgesics. Frail elderly patients often have multiple comorbidities and use multiple medicines, leading to an increased risk of clinically relevant drug-drug and drug-disease interactions. Age-related changes a

  11. Differential Effects of Treatments for Chronic Depression: A Latent Growth Model Reanalysis

    Science.gov (United States)

    Stulz, Niklaus; Thase, Michael E.; Klein, Daniel N.; Manber, Rachel; Crits-Christoph, Paul

    2010-01-01

    Objective: Psychotherapy-pharmacotherapy combinations are frequently recommended for the treatment of chronic depressive disorders. Our aim in this novel reanalysis of archival data was to identify patient subgroups on the basis of symptom trajectories and examine the clinical significance of the resultant classification on basis of differential…

  12. Individualizing Opioid Use Disorder (OUD Treatment: Time to Fully Embrace a Chronic Disease Model

    Directory of Open Access Journals (Sweden)

    Richard Gustin

    2015-02-01

    Full Text Available The current opioid epidemic in the United States is changing our perceptions of the face of addiction. Opioid Use Disorder (OUD has become pervasive and is affecting all ethnicities, races, socioeconomic classes, the young and the old. In 2015, 46 people will lose their life each day to a chronic brain disease that is going unnoticed and undertreated. Over the last five decades, numerous scientific and clinical breakthroughs have allowed for a better understanding of the mechanisms underlying addiction, and the development of medications that can help support a patient’s long-term recovery. All of those that have contributed to these advancements have aided in redefining addiction as a primary, chronic disease of the brain reward, motivation, memory and related circuitry; however, our treatment strategies have not necessarily advanced to the same extent as our current understanding of the disease. This commentary will explore how personal philosophies can bias treatments strategies and definitions of treatment success, and prevent adoption of chronic disease treatment models that would significantly improve the quality of life of those suffering with OUD. This is a challenge to consider how our views and stigma can impact a patient’s recovery. We are currently losing a battle with a disease that is taking the lives of 46 individuals daily; it is time to fully embrace a chronic disease model which comprises an integrated pharmacopsychosocial approach for treating the biopsychosocial disorder that is addiction to reverse these trends.

  13. Treatment options for chronic idiopathic (immune) thrombocytopenic purpura.

    Science.gov (United States)

    George, J N

    2000-01-01

    The goal of treatment for idiopathic (immune) thrombocytopenic purpura (ITP) is to prevent serious bleeding. Traditionally, corticosteroids have been used as first-line therapy followed by splenectomy. Experience with splenectomy over 60 years shows that approximately two thirds of patients achieve normal platelet counts during the initial observation, but that thrombocytopenia often recurs with longer follow-up. We know that long-term use of corticosteroids can lead to significant morbidities; there is no consensus regarding the appropriate timing or indications for splenectomy. To address the Issue of appropriate use of splenectomy, we designed a multicenter clinical trial that will randomize patients to either standard care, involving prednisone followed by splenectomy, or to a novel regimen of limited prednisone treatment followed by WinRho SDF (Nabi, Boca Raton, FL) (anti-D) therapy to maintain the platelet count in a safe range for 1 year. Anti-D can be administered easily in an outpatient setting with few side effects and can provide predictable, transient increases in platelet count. The hypothesis is that prolonged maintenance therapy with a nontoxic regimen may increase the percentage of patients who will experience a spontaneous remission from thrombocytopenia, thereby avoiding an invasive and permanent surgical procedure, splenectomy, and its potentially life-threatening sequelae. PMID:10676922

  14. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy: a double blind, placebo controlled study.

    OpenAIRE

    Vermeulen, M.; van Doorn, P. A.; Brand, A; Strengers, P F; Jennekens, F G; Busch, H F

    1993-01-01

    Patients with a clinical diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) were randomised in a double-blind, placebo-controlled multicentre trial to investigate whether high-dose intravenous immunoglobulin treatment (IVIg) for 5 consecutive days has a beneficial effect. Fifteen patients were randomised to IVIg and 13 to placebo. In the IVIg treatment group 4 patients improved and 3 patients in the placebo group. The degree of improvement of the patients in the IVIg treatm...

  15. Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults

    OpenAIRE

    Eberhard, J.; Jepsen, S.; Jervøe-Storm, P. M.; Needleman, I.; Worthington, H. V.

    2015-01-01

    Periodontitis is chronic inflammation that causes damage to the soft tissues and bones supporting the teeth. Mild to moderate periodontitis affects up to 50% of adults. Conventional treatment is quadrant scaling and root planing. In an attempt to enhance treatment outcomes, alternative protocols for anti-infective periodontal therapy have been introduced: full-mouth scaling (FMS) and full-mouth disinfection (FMD), which is scaling plus use of an antiseptic. This review updates our previous re...

  16. Neurobiologically informed treatment for adults with anorexia nervosa: a novel approach to a chronic disorder

    OpenAIRE

    Knatz, Stephanie; Wierenga, Christina E.; Murray, Stuart B.; Hill, Laura; Kaye, Walter H.

    2015-01-01

    Anorexia nervosa (AN) is a severe and debilitating disorder with significant medical and psychological sequelae. To date, there are no effective treatments for adults, resulting in high rates of chronicity, morbidity, and mortality. Recent advances in brain imaging research have led to an improved understanding of etiology and specific neurobiological mechanisms underlying symptoms. Despite this, there are no treatments focused on targeting symptoms using this empirically supported mechanisti...

  17. The place of subfascial endoscopic perforator vein surgery (SEPS) in advanced chronic venous insufficiency treatment

    OpenAIRE

    2011-01-01

    In spite of medical science development and initiation of new technologies in minimally invasive surgery, treatment of advanced chronic venous insufficiency at the 5th and 6th degree of CEAP classification is still a great clinical challenge. In case of no satisfactory results of non-surgical treatment of recurrent venous ulcers, scientists search for alternative therapeutic methods which could be more effective and lasting. Subfascial endoscopic perforator vein surgery (SEPS) as a method of ...

  18. Diagnosis and control for treatment of chronic arthritis and arthrosis of temporomandibular joint

    International Nuclear Information System (INIS)

    A study was made of anatomy and functions of temperomandibular joint in age aspect in patients with chronic arthritis and arthrosis using comprehensive clinicoroentgenological investigations. Such methods as X-ray examination, electromyography and diplography were important. The verification of results of treatment was also conducted on the base of clinicoroentgenological methods. It was shown that it was expedient to individual approach to treatment of petints with arthritis and arthrosis taking into account age-associated features

  19. Methadone: applied pharmacology and use as adjunctive treatment in chronic pain

    OpenAIRE

    Brown, R.; C. Kraus; Fleming, M.; Reddy, S.

    2004-01-01

    This article reviews the unique pharmacological properties of methadone and outlines its appropriate clinical application, with focus upon its use in the treatment of chronic pain. Although methadone is most widely known for its use in the treatment of opioid dependence, methadone also provides effective analgesia. Patients who experience inadequate pain relief or intolerable side effects with other opioids or who suffer from neuropathic pain may benefit from a transition to methadone as thei...

  20. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    OpenAIRE

    Juliana Serraillier; Jamison, Robert N.; Edward Michna

    2011-01-01

    Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patie...

  1. Yoga as a treatment for chronic low back pain: A systematic review of the literature

    OpenAIRE

    Chang, Douglas G.; Holt, Jacquelyn A.; Sklar, Marisa; Groessl, Erik J.

    2016-01-01

    Objectives Chronic low back pain (CLBP) affects millions of people worldwide, and appears to be increasing in prevalence. It is associated not only with pain, but also with increased disability, psychological symptoms, and reduced quality of life. There are various treatment options for CLBP, but no single therapy stands out as being the most effective. In the past 10 years, yoga interventions have been studied as a CLBP treatment approach. The objective of this paper is to review the current...

  2. Classification and targeted treatment of patients with Non Specific Chronic Low Back Pain

    OpenAIRE

    Fersum, Kjartan Vibe

    2011-01-01

    Non-specific chronic low back pain (NSCLBP) disorders have proven highly resistant to change in spite of enormous resources directed at them. There is lack of evidence for single treatment interventions for patients with NSCLBP despite the substantial amount of Randomised Controlled Trials (RCT) evaluating treatment outcome for this disorder. It has been hypothesised that this vacuum of evidence is caused by the lack of sub-classifying the heterogeneous population of patient...

  3. On-treatment platelet reactivity in patients with chronic obstructive pulmonary disease undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Campo, Gianluca; Pavasini, Rita; Pollina, Alberto; Tebaldi, Matteo; Ferrari, Roberto

    2014-01-01

    Patients with chronic obstructive pulmonary disease (COPD) show a poor prognosis after myocardial infarction (MI) and percutaneous coronary intervention (PCI). We evaluated on-treatment platelet reactivity (PR) and several gene polymorphisms related to PR in 130 patients undergoing PCI with and without COPD. Those with concomitant COPD showed higher on-treatment PR values both at the time of PCI and 1 month after. This finding may contribute to explain the poor prognosis of COPD patients after MI and PCI. PMID:23878160

  4. Evidence for the endothelin system as an emerging therapeutic target for the treatment of chronic pain

    Directory of Open Access Journals (Sweden)

    Smith TP

    2014-08-01

    Full Text Available Terika P Smith,1 Tami Haymond,1 Sherika N Smith,1 Sarah M Sweitzer1,2 1Department of Pharmacology, Physiology and Neuroscience, University of South Carolina, Columbia, SC, USA; 2Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, USA Abstract: Many people worldwide suffer from pain and a portion of these sufferers are diagnosed with a chronic pain condition. The management of chronic pain continues to be a challenge, and despite taking prescribed medication for pain, patients continue to have pain of moderate severity. Current pain therapies are often inadequate, with side effects that limit medication adherence. There is a need to identify novel therapeutic targets for the management of chronic pain. One potential candidate for the treatment of chronic pain is therapies aimed at modulating the vasoactive peptide endothelin-1. In addition to vasoactive properties, endothelin-1 has been implicated in pain transmission in both humans and animal models of nociception. Endothelin-1 directly activates nociceptors and potentiates the effect of other algogens, including capsaicin, formalin, and arachidonic acid. In addition, endothelin-1 has been shown to be involved in inflammatory pain, cancer pain, neuropathic pain, diabetic neuropathy, and pain associated with sickle cell disease. Therefore, endothelin-1 may prove a novel therapeutic target for the relief of many types of chronic pain. Keywords: endothelin-1, acute pain, chronic pain, endothelin receptor antagonists

  5. Chronic bacterial prostatitis and irritable bowel syndrome: effectiveness of treatment with rifaximin followed by the probiotic VSL#3

    OpenAIRE

    Enzo Vicari; Sandro La Vignera; Roberto Castiglione; Rosita A. Condorelli; Vicari, Lucia O; Calogero, Aldo E.

    2014-01-01

    This study was undertaken to evaluate the influence of treatment with rifaximin followed by the probiotic VSL#3 versus no treatment on the progression of chronic prostatitis toward chronic microbial prostate-vesiculitis (PV) or prostate-vesiculo-epididymitis (PVE). A total of 106 selected infertile male patients with bacteriologically cured chronic bacterial prostatitis (CBP) and irritable bowel syndrome (IBS) were randomly prescribed rifaximin (200 mg, 2 tablets bid, for 7 days monthly for 1...

  6. Chronic Pruritus in the Absence of Skin Disease: Pathophysiology, Diagnosis and Treatment.

    Science.gov (United States)

    Pereira, Manuel P; Kremer, Andreas E; Mettang, Thomas; Ständer, Sonja

    2016-08-01

    Chronic pruritus arises not only from dermatoses, but also, in up to half of cases, from extracutaneous origins. A multitude of systemic, neurological, psychiatric, and somatoform conditions are associated with pruritus in the absence of skin disease. Moreover, pruritus is a frequently observed side effect of many drugs. It is therefore difficult for physicians to make a correct diagnosis. Chronic pruritus patients frequently present to the dermatologist with skin lesions secondary to a long-lasting scratching behavior, such as lichenification and prurigo nodularis. A structured clinical history and physical examination are essential in order to evaluate the pruritus, along with systematic, medical history-adapted laboratory and radiological tests carried out according to the differential diagnosis. For therapeutic reasons, a symptomatic therapy should be promptly initiated parallel to the diagnostic procedures. Once the underlying factor(s) leading to the pruritus are identified, a targeted therapy should be implemented. Importantly, the treatment of accompanying disorders such as sleep disturbances or mental symptoms should be taken into consideration. Even after successful treatment of the underlying cause, pruritus may persist, likely due to chronicity processes including peripheral and central sensitization or impaired inhibition at spinal level. A vast arsenal of topical and systemic agents targeting these pathophysiological mechanisms has been used to deter further chronicity. The therapeutic options currently available are, however, still insufficient for many patients. Thus, future studies aiming to unveil the complex mechanisms underlying chronic pruritus and develop new therapeutic agents are urgently needed. PMID:27216284

  7. CYCLODEXTRINS - FIELFS OF APPLICATION. PART II

    OpenAIRE

    Gh. Duca; A. Ivancic; V. Boldescu

    2012-01-01

    This paper represents an analysis of potential and current applications of cyclodextrins as biologically active substances in medicine. The main applications described here include use of cyclodextrins as agents that form inclusion complexes with endogenous substances (membrane lipids, cellular cholesterol), agents that form inclusion complexes with exogenous substances with their man role as guest molecules (sugammadex, FBCx), agents that block endogenous and exogenous macromolec...

  8. Preparation of ferrofluid from cyclodextrin and magnetite

    International Nuclear Information System (INIS)

    A ferrofluid was obtained from magnetite and β-cyclodextrin. The results evidence the inclusion of magnetite into β-cyclodextrin. This is the first inclusion complex of a metal oxide reported. The physical-chemical characterization was performed by X-ray diffraction, transmission electron microscopy, atomic absorption spectroscopy, electron microprobe with an energy dispersive spectrometer, and magnetometry

  9. Psoralen plus ultraviolet A (PUVA soaks and UVB TL01 treatment for chronic hand dermatoses

    Directory of Open Access Journals (Sweden)

    Lisbeth Jensen

    2012-02-01

    Full Text Available Chronic eczematous hand dermatoses with and without contact allergies are complex diseases, which makes it a challenge to select the best treatment and obtain an optimal patient experience and a satisfactory treatment result. The aim of this study was to evaluate retrospectively the clinical effect and patient experience of local treatment with psoralen plus ultraviolet A (PUVA soaks and TL01 phototherapy for severe chronic hand dermatoses, and also to evaluate the quality of life for the subgroup of patients with allergic contact dermatitis including Compositae allergy. A retrospective evaluation of results for 94 consecutive patients having received a total of 121 treatment courses with local PUVA soaks or TL01 phototherapy for one of the following diagnoses (n=number of treatment courses: psoriasis (n=19, hyperkeratotic hand eczema (n=27, Pustulosis Palmoplantaris (PPP (n=22, vesicular eczema (n=16, Compositae dermatitis (n=24, and allergic contact dermatitis (n=13. Moreover, semi-structured interviews with 6 selected patients having multiple contact allergies including Compositae allergy were used to evaluate quality of life. As a result, we found that PUVA soaks has good effect in patients with psoriasis and hyperkeratotic hand eczema and local phototherapy for chronic hand dermatoses is a useful treatment option in selected cases.

  10. Serum pharmacodynamic biomarkers for chronic corticosteroid treatment of children.

    Science.gov (United States)

    Hathout, Yetrib; Conklin, Laurie S; Seol, Haeri; Gordish-Dressman, Heather; Brown, Kristy J; Morgenroth, Lauren P; Nagaraju, Kanneboyina; Heier, Christopher R; Damsker, Jesse M; van den Anker, John N; Henricson, Erik; Clemens, Paula R; Mah, Jean K; McDonald, Craig; Hoffman, Eric P

    2016-01-01

    Corticosteroids are extensively used in pediatrics, yet the burden of side effects is significant. Availability of a simple, fast, and reliable biochemical read out of steroidal drug pharmacodynamics could enable a rapid and objective assessment of safety and efficacy of corticosteroids and aid development of corticosteroid replacement drugs. To identify potential corticosteroid responsive biomarkers we performed proteome profiling of serum samples from DMD and IBD patients with and without corticosteroid treatment using SOMAscan aptamer panel testing 1,129 proteins in leptin, afamin), stunting of growth (growth hormone binding protein), and connective tissue remodeling (MMP3). Significant suppression of multiple adrenal steroid hormones was also seen in treated children (reductions of 17-hydroxyprogesterone, corticosterone, 11-deoxycortisol and testosterone). A panel of new pharmacodynamic biomarkers for corticosteroids in children was defined. Future studies will need to bridge specific biomarkers to mechanism of drug action, and specific clinical outcomes. PMID:27530235

  11. Hypericum perforatum treatment: effect on behaviour and neurogenesis in a chronic stress model in mice

    Directory of Open Access Journals (Sweden)

    Cuzzocrea Salvatore

    2011-01-01

    Full Text Available Abstract Background Extracts of Hypericum perforatum (St. John's wort have been traditionally recommended for a wide range of medical conditions, in particular mild-to-moderate depression. The present study was designed to investigate the effect of Hypericum perforatum treatment in a mouse model of anxiety/depressive-like behavior, induced by chronic corticosterone administration. Methods CD1 mice were submitted to 7 weeks corticosterone administration and then behavioral tests as Open Field (OF, Novelty-Suppressed Feeding (NSF, Forced Swim Test (FST were performed. Cell proliferation in hippocampal dentate gyrus (DG was investigated by both 5-bromo-2'-deoxyuridine (BrdU and doublecortin (DCX immunohistochemistry techniques and stereological procedure was used to quantify labeled cells. Golgi-impregnation method was used to evaluate changes in dendritic spines in DG. Hypericum perforatum (30 mg/Kg has been administered for 3 weeks and then neural development in the adult hippocampus and behavioral changes have been examined. Results The anxiety/depressive-like state due to chronic corticosterone treatment was reversed by exogenous administration of Hypericum perforatum; the proliferation of progenitor cells in mice hippocampus was significantly reduced under chronic corticosterone treatment, whereas a long term treatment with Hypericum perforatum prevented the corticosterone-induced decrease in hippocampal cell proliferation. Corticosterone-treated mice exhibited a reduced spine density that was ameliorated by Hypericum perforatum administration. Conclusion These results provide evidence of morphological adaptations occurring in mature hippocampal neurons that might underlie resilient responses to chronic stress and contribute to the therapeutic effects of chronic Hypericum perforatum treatment.

  12. A new generation of topical chronic wound treatments containing specific MMP inhibitors

    Directory of Open Access Journals (Sweden)

    Shrivastava R

    2014-09-01

    Full Text Available Ravi Shrivastava, Nathalie Cucuat, Monika Rousse, Thomas Weigand, Pedro Neto, Claire Janicot, Christiane Shrivastava VITROBIO Research Institute, Issoire, France Purpose: Incidence of chronic wounds is constantly rising worldwide, but all currently available treatments are intended either to provide symptomatic relief or to assist cicatrization to some extent, but not to directly stimulate cellular growth. Physiologically, chronic wound healing simply requires cell growth to fill the injured cavity. To grow, our cells need to attach onto a cushion, called extracellular matrix (ECM, secreted by the mother cells and composed of multiple proteins. Recent scientific works prove that the concentration of certain matrix metalloproteinases (MMPs is extremely high in all chronic wounds and, because of their proteolytic nature, some MMPs completely degrade the ECM, hindering cell attachment and cell growth. The aim of this study was to identify, neutralize, and eliminate these MMPs from the wound surface so as to design an effective treatment for chronic wounds. Methods: Acute and chronic models of human epithelial and fibroblast cells were prepared on a defined ECM cushion in vitro and MMPs were added in the culture medium to identify the MMPs causing ECM disintegration for each cell type. ECM-degrading MMPs were then incubated with selected procyanidin-rich plant extracts (PCDs and cell growth was reanalyzed. Results: It was observed that: 1 multiple MMPs are involved in cellular matrix destruction; 2 ECM-destroying MMPs are specific with respect to cell type; and 3 specific PCDs may bind and neutralize selected MMPs. Conclusion: Topical application of specific plant PCDs to selectively neutralize ECM-destroying MMPs in acute and chronic wounds represents a novel approach for the treatment of superficial and deep skin wounds. Keywords: extra cellular matrix (ECM, matrix metalloproteinases, procyanidins (PCDs, tannins, ulcers

  13. Treatment with Benznidazole during the Chronic Phase of Experimental Chagas' Disease Decreases Cardiac Alterations

    Science.gov (United States)

    Garcia, Simone; Ramos, Carolina O.; Senra, Juliana F. V.; Vilas-Boas, Fabio; Rodrigues, Maurício M.; Campos-de-Carvalho, Antonio C.; Ribeiro-dos-Santos, Ricardo; Soares, Milena B. P.

    2005-01-01

    Chagas' disease, caused by Trypanosoma cruzi infection, is one of the main causes of death due to heart failure in Latin American countries. Benznidazole, the chemotherapeutic agent most often used for the treatment of chagasic patients, is highly toxic and has limited efficacy, especially in the chronic phase of the disease. In the present study we used a mouse model of chronic Chagas' disease to investigate the effects of benznidazole treatment during the chronic phase on disease progression. The hearts of benznidazole-treated mice had decreased parasitism and myocarditis compared to the hearts of untreated chagasic mice. Both groups of Trypanosoma cruzi-infected mice had significant alterations in their electrocardiograms compared to those of the healthy mice. However, untreated mice had significantly higher cardiac conduction disturbances than benznidazole-treated mice, including intraventricular conduction disturbances, atrioventricular blocks, and extrasystoles. The levels of antibodies against T. cruzi antigens (epimastigote extract, P2β, and trans-sialidase) as well as antibodies against peptides of the second extracellular loops of β1-adrenergic and M2-muscarinic cardiac receptors were also lower in the sera from benznidazole-treated mice than in the sera from untreated mice. These results demonstrate that treatment with benznidazole in the chronic phase of infection prevents the development of severe chronic cardiomyopathy, despite the lack of complete parasite eradication. In addition, our data highlight the role of parasite persistence in the development of chronic Chagas' disease and reinforce the importance of T. cruzi elimination in order to decrease or prevent the development of severe chagasic cardiomyopathy. PMID:15793134

  14. New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant.

    Science.gov (United States)

    Fabrizi, Fabrizio; Martin, Paul; Messa, Piergiorgio

    2016-05-01

    The evidence that chronic hepatitis C plays a detrimental role in survival among patients on maintenance dialysis or renal transplant recipients promotes the antiviral treatment of hepatitis C virus (HCV) among chronic kidney disease patients. Also, it seems that HCV infection is associated with an increased risk of developing chronic kidney disease in the adult general population. Interferon-based regimens have provided limited efficacy and safety among chronic kidney disease patients, whereas the advent of the new direct-acting antivirals for the treatment of hepatitis C (launched over the past 5 years) has given the opportunity to reach sustained virologic response rates of 90% for many patient groups. Unfortunately, poor information exists regarding the antiviral treatment of hepatitis C in the chronic kidney disease population. The first published data on the treatment of hepatitis C among patients with chronic kidney disease (stage 4-5) and HCV genotype 1 regard the grazoprevir (NS3/4A protease inhibitor) and elbasvir (NS5A inhibitor) combination; excellent efficacy (sustained viral response, 94.3%; 115/122) and safety have been achieved. Preliminary evidence on the combined treatment of sofosbuvir (NS5B inhibitor) and simeprevir (NS3/4A inhibitor) has given a viral response of 89%, but the size of the study group (n = 38 patients with end-stage renal disease) was small. Some phase 2 and 3 clinical trials based on other antiviral combinations (3D regimen, sofosbuvir/ledipasvir, or other sofosbuvir-containing approaches) are ongoing. Thus, the antiviral regimens based on direct-acting antivirals promise to play a pivotal role in the eradication of hepatitis C among kidney disease patients. Direct-acting antivirals are very expensive; in an era of cost containment this is a crucial point either in developed and developing countries. Adverse drug reactions resulting from concomitantly administered medications are another ongoing concern for patients

  15. Efficient Biocatalytic Production of Cyclodextrins by Combined Action of Amylosucrase and Cyclodextrin Glucanotransferase.

    Science.gov (United States)

    Koh, Dong-Wan; Park, Min-Oh; Choi, Seong-Won; Lee, Byung-Hoo; Yoo, Sang-Ho

    2016-06-01

    A novel enzymatic process for cyclodextrin (CD) production was developed by utilizing sucrose as raw material instead of corn starch. Cyclodextrin glucanotransferase (CGTase) from Bacillus macerans was applied to produce the CDs from linear α-(1,4)-glucans, which were obtained by Neisseria polysaccharea amylosucrase (NpAS) treatment on sucrose. The greatest CD yield (21.1%, w/w) was achieved from a one-pot dual enzyme reaction at 40 °C for 24 h. The maximum level of CD production (15.1 mg/mL) was achieved with 0.5 M sucrose in a simultaneous mode of dual enzyme reaction, whereas the reaction with 0.1 M sucrose was the most efficient with regard to conversion yield. Consequently, dual enzyme synthesis of CDs was successfully carried out with no need of starch material. This result can be applied as a novel efficient bioconversion process that does not require the high temperature necessary for starch liquefaction by thermostable α-amylase in conventional industrial processing. PMID:27169988

  16. Part 2: Treatments for Chronic Gastrointestinal Disease and Gut Dysbiosis.

    Science.gov (United States)

    Bull, Matthew J; Plummer, Nigel T

    2015-02-01

    Part 1 of this review discussed the connection between the human gut microbiota and health. Manipulation of the intestinal microbiota holds promise as a prospective therapy for gut dysbiosis, ameliorating symptoms of gastrointestinal and systemic diseases and restoring health. The concept of probiotics has existed for more than 100 y, and modern research methods have established sound scientific support for the perceived benefits of probiotic bacteria, which mainly include Lactobacillus and Bifidobacterium genera. On the basis of these evidence-based functional approaches, dietary interventions that supplement the normal diet with probiotics or prebiotics are now considered as potentially viable alternatives or adjuncts to the use of steroids, immunosuppressants, and/or surgical interventions. Studies investigating the impact on gastrointestinal disorders, such as diarrhea, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS); and systemic metabolic diseases, such as type 2 diabetes and obesity, in response to the use of probiotics and prebiotics are reviewed. Further, fecal microbial transplantation (FMT) is discussed as an exciting development in the treatment of gut dysbiosis using microbes. PMID:26770128

  17. Balloon pulmonary angioplasty: a treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Aiko eOgawa

    2015-02-01

    Full Text Available In chronic thromboembolic pulmonary hypertension, stenoses or obstructions of the pulmonary arteries due to organized thrombi can cause an elevation in pulmonary artery resistance, which in turn can result in pulmonary hypertension. Chronic thromboembolic pulmonary hypertension can be cured surgically by pulmonary endarterectomy; however, patients deemed unsuitable for pulmonary endarterectomy due to lesion, advanced age, or comorbidities have a poor prognosis and limited treatment options. Recently, advances have been made in balloon pulmonary angioplasty for these patients, and this review highlights this recent progress.

  18. Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

    Science.gov (United States)

    Shin, Jeong Eun; Jung, Hye-Kyung; Lee, Tae Hee; Jo, Yunju; Lee, Hyuk; Song, Kyung Ho; Hong, Sung Noh; Lim, Hyun Chul; Lee, Soon Jin; Chung, Soon Sup; Lee, Joon Seong; Rhee, Poong-Lyul; Lee, Kwang Jae; Choi, Suck Chei; Shin, Ein Soon

    2016-01-01

    The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods. PMID:27226437

  19. Therapeutic vaccination and immunomodulation in the treatment of chronic hepatitis B: preclinical studies in the woodchuck.

    Science.gov (United States)

    Kosinska, Anna D; Liu, Jia; Lu, Mengji; Roggendorf, Michael

    2015-02-01

    Infection with hepatitis B virus (HBV) may lead to subclinical, acute or chronic hepatitis. In the prevaccination era, HBV infections were endemic due to frequent mother to child transmission in large regions of the world. However, there are still estimated 240 million chronic HBV carriers today and ca. 620,000 patients die per year due to HBV-related liver diseases. Recommended treatment of chronic hepatitis B with interferon-α and/or nucleos(t)ide analogues does not lead to satisfactory results. Induction of HBV-specific T cells by therapeutic vaccination or immunomodulation may be an innovative strategy to overcome virus persistence. Vaccination with commercially available HBV vaccines in patients with or without therapeutic reduction of viral load did not result in effective immune control of HBV infection, suggesting that combination of antiviral treatment with new formulations of therapeutic vaccines is needed. The woodchuck (Marmota monax) and its HBV-like woodchuck hepatitis virus are a useful preclinical animal model for developing new therapeutic approaches in chronic hepadnaviral infections. Several innovative approaches combining antiviral treatments using nucleos(t)ide analogues, with prime-boost vaccination using DNA vaccines, new hepadnaviral antigens or recombinant adenoviral vectors were tested in the woodchuck model. In this review, we summarize these encouraging results obtained with these therapeutic vaccines. In addition, we present potential innovations in immunostimulatory strategies by blocking the interaction of the inhibitory programmed death receptor 1 with its ligand in this animal model. PMID:25535101

  20. Single Drug Treatment for Chronic Kidney Disease – A Case Study

    Directory of Open Access Journals (Sweden)

    D. M. Padavi

    2014-10-01

    Full Text Available Punarnava matured whole plant of Boerhaavia diffusa Linn. (Fam Nyctaginaceae, trailing herb found throughout India and collected after rainy season, herb is diffusely branched with stout root stock and many long slender, prostrate or ascending branches. The name says “pun-nava” means new again; Punarnava can rejuvenates the dying cells and helps to revive the dying organs of the body. Kidneys are the organs that have numerous biological roles. They maintain the homeostatic balance of body fluids by removing waste out of body. Chronic Kidney disease (CKD or Chronic Renal Failure (CRF refers to an irreversible deterioration in renal function, which develops over a period of years. The conventional approach of management includes dialysis and renal transplantation, which are involving the high costs and complexity so very few patients are able to obtain adequate treatment for kidney disorders because of financial limitation. Therefore, exploration of a safe and alternative therapy is needed, which proves to be helpful in reducing the requirement of dialysis and in postponing the renal transplantation. The use of herbal drugs for the prevention and treatment of various diseases is constantly developing throughout the world. In present study a case was taken of chronic kidney disease with chronic nephritis. He was Punarnava swaras daily with orally. This treatment approach has significantly improved condition of patient eliminating dialysis requirement.

  1. Overview of the pathogenesis and treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulins

    Directory of Open Access Journals (Sweden)

    Mohamed Mahdi-Rogers

    2010-03-01

    Full Text Available Mohamed Mahdi-Rogers, Yusuf A RajaballyNeuromuscular Clinic, Department of Neurology, University Hospitals of Leicester, Leicester, UKAbstract: Chronic inflammatory demyelinating polyneuropathy (CIDP is an acquired heterogeneous disorder of immune origin affecting the peripheral nerves, causing motor weakness and sensory symptoms and signs. The precise pathophysiology of CIDP remains uncertain although B and T cell mechanisms are believed to be implicated. Intravenous immunoglobulins (IVIg have been shown in a number of trials to be an effective treatment for CIDP. IVIg is thought to exert its immunomodulatory effects by affecting several components of the immune system including B-cells, T-cells, macrophages and complement. This article provides an overview of the pathogenesis of CIDP and of its treatment with IVIg.Keywords: chronic inflammatory demyelinating polyneuropathy, intravenous immunoglobulin, pathogenesis, treatment

  2. Subcutaneous immunoglobulins in the treatment of chronic immune-mediated neuropathies.

    Science.gov (United States)

    Leussink, Verena I; Hartung, Hans-Peter; Kieseier, Bernd C; Stettner, Mark

    2016-07-01

    Intravenous immunoglobulins represent an established therapy for the treatment of chronic immune-mediated neuropathies, specifically chronic inflammatory demyelinating polyradiculoneuropathies (CIDPs) as well as multifocal motor neuropathies (MMNs). For the treatment of antibody deficiency syndromes, subcutaneous immunoglobulins (SCIgs) have represented a mainstay for decades. An emerging body of evidence suggests that SCIg might also exhibit clinical efficacy in CIDP and MMN. This article reviews the current evidence for clinical effectiveness, as well as safety of SCIg for the treatment of immune-mediated neuropathies, and addresses remaining open questions in this context. We conclude that despite the need for controlled long-term studies to demonstrate long-term efficacy of SCIg in immune-mediated neuropathies, SCIg may already represent a potential therapeutic alternative for selected patients. PMID:27366241

  3. THE EFFECT OF MICROWAVE AND BANDAGING TREATMENT ON SKIN IMMUNOLOGICAL CELLS IN CHRONIC LIMB LYMPHEDEMA

    Institute of Scientific and Technical Information of China (English)

    曹卫刚; 张涤生; 干季良

    2000-01-01

    Objective To clarify the characteristics of immunological reactions in skin tissues of non - filarial lymphedema patients with or without skin bacterial infection. Methods Avidin-biotin peroxidase (ABC)immunohistochemical method was used to examine the local skin tissue infiltrating inflammatory cells in 16chronic limb lymphedema patients before and after two courses of microwave and bandaging treatment. Results There was a significant increase of T lymphocyte infiltration in lymphedematous skin tissues; after two courses of microwave treatment, T lymphocyte infiltration was greatly resolved whereas the number of macrophages, which can lyse the stagnant proteins in lymphedematous tissues through proteolysis increased. Conclusion Microwave and bandaging treatment can promote regression of extremity edema by reducing chronic inflammation and enhancing the stagnant protein lysis capability in lymphedematous skin tissues.

  4. Clinical Observation on Abdominal Cluster-Needling for Treatment of Chronic Annexitis

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Chronic annexitis is a frequently encountered disease at clinic. According to clinical experience in acupuncture treatment of annexitis, the author has developed an effective acupuncture method called abdominal cluster-needling, with quite good therapeutic results as reported in the following. Clinical Data There were altogether 66 cases of chronic annexitis in this series, which were divided randomly into the treatment group and control group. The treatment group consisted of 36 cases, ranging in age from 20-40 years, and duration of illness from 0.5-9 years. The control group consisted of 30 cases, ranging in age from 21-38 years, and duration of illness from 1-8 years.

  5. Azithromycin 1.5% ophthalmic solution: efficacy and treatment modalities in chronic blepharitis

    Directory of Open Access Journals (Sweden)

    Ali Fadlallah

    2012-06-01

    Full Text Available PURPOSE: To assess the efficacy of topical 1.5% azithromycin in the treatment of moderate to severe chronic blepharitis and to compare the efficacy of two different treatment modalities. METHODS: A randomized clinical trial included 67 patients with chronic anterior and/or posterior blepharitis, followed-up for 3 months. Signs and symptoms were graded according to severity. Patients were randomized into two groups: 33 patients in group I and 34 patients in group II. Group I patients were treated with topical 1.5% azithromycin twice a day for three days, and Group II patients were treated with topical 1.5% azithromycin twice a day for three days then at bedtime for the rest of the month. All patients were instructed to apply warm compresses and an eye-friendly soap twice daily. RESULTS: Patients in both groups tolerated the treatment with minimal irritation. A significant improvement in signs and symptoms was noted at the one week follow-up visit. Group II showed a more pronounced and longer-lasting improvement that persisted after three months of follow-up. CONCLUSION: Topical 1.5% azithromycin ophthalmic solution is an effective treatment option for chronic blepharitis. In moderate to severe blepharitis, a one month treatment is safe and shows better improvement than the three-day protocol with no significant relapse until three months of follow-up.

  6. Chronic pramipexole treatment increases tolerance for sucrose in normal and ventral tegmental lesioned rats.

    Directory of Open Access Journals (Sweden)

    David eDARDOU

    2015-01-01

    Full Text Available The loss of dopamine neurons observed in Parkinson’s disease (PD elicits severe motor control deficits which are reduced by the use of dopamine agonists. However, recent works have indicated that D3-preferential agonists such as pramipexole can induce impulse control disorders such as food craving or compulsive eating. In the present study, we performed an intermittent daily feeding experiment to assess the effect of chronic treatment by pramipexole and VTA bilateral lesion on tolerance for sucrose solution. The impact of such chronic treatment on spontaneous locomotion and spatial memory was also examined. Changes in sucrose tolerance could indicate the potential development of a change in food compulsion or addiction related to the action of pramipexole. Neither the bilateral lesion of the VTA nor chronic treatment with pramipexole altered the spontaneous locomotion or spatial memory in rats. Rats without pramipexole treatment quickly developed a stable intake of sucrose solution in the 12h access phase. On the contrary, when under daily pramipexole treatment, rats developed a stronger and ongoing escalation of their sucrose solution intakes. In addition, we noted that the change in sucrose consumption was sustained by an increase of the expression of the dopamine 3 receptor in the core and the shell regions of the nucleus accumbens. The present results may suggest that long term stimulation of the dopamine 3 receptor in animals induces a strong increase in sucrose consumption, indicating an effect of this receptor on certain pathological aspects of food eating.

  7. Chronic pramipexole treatment increases tolerance for sucrose in normal and ventral tegmental lesioned rats.

    Science.gov (United States)

    Dardou, David; Chassain, Carine; Durif, Franck

    2014-01-01

    The loss of dopamine neurons observed in Parkinson's disease (PD) elicits severe motor control deficits which are reduced by the use of dopamine agonists. However, recent works have indicated that D3-preferential agonists such as pramipexole can induce impulse control disorders (ICDs) such as food craving or compulsive eating. In the present study, we performed an intermittent daily feeding experiment to assess the effect of chronic treatment by pramipexole and VTA bilateral lesion on tolerance for sucrose solution. The impact of such chronic treatment on spontaneous locomotion and spatial memory was also examined. Changes in sucrose tolerance could indicate the potential development of a change in food compulsion or addiction related to the action of pramipexole. Neither the bilateral lesion of the VTA nor chronic treatment with pramipexole altered the spontaneous locomotion or spatial memory in rats. Rats without pramipexole treatment quickly developed a stable intake of sucrose solution in the 12 h access phase. On the contrary, when under daily pramipexole treatment, rats developed a stronger and ongoing escalation of their sucrose solution intakes. In addition, we noted that the change in sucrose consumption was sustained by an increase of the expression of the Dopamine D3 receptor in the core and the shell regions of the nucleus accumbens. The present results may suggest that long-term stimulation of the Dopamine D3 receptor in animals induces a strong increase in sucrose consumption, indicating an effect of this receptor on certain pathological aspects of food eating. PMID:25610366

  8. Profile of bosutinib and its clinical potential in the treatment of chronic myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Keller-von Amsberg G

    2013-03-01

    Full Text Available Gunhild Keller-von Amsberg,1 Steffen Koschmieder21Department of Hematology and Oncology, University Cancer Center Hamburg, University Hospital Hamburg Eppendorf, 2Department of Medicine (Hematology, Oncology, and Stem Cell Transplantation, University Medical Center of Aachen and RWTH Aachen University, Aachen, GermanyAbstract: Bosutinib (SKI-606 is an orally available, once-daily, dual Src and Abl kinase inhibitor with promising clinical potential in first-, second-, and third-line treatment of chronic myeloid leukemia (CML. Bosutinib effectively inhibits wild-type BCR-ABL and most imatinib-resistant BCR-ABL mutations except for V299L and T315I. Low hematologic toxicity is a remarkable characteristic of this novel second-generation tyrosine kinase inhibitor, and this has been ascribed to its minimal activity against the platelet-derived growth factor receptor and KIT. Low-grade, typically self-limiting diarrhea, which usually appears within the first few weeks after treatment initiation, represents the predominant toxicity of bosutinib. Other treatment-associated adverse events are mostly mild to moderate. Bosutinib has been approved by the US Food and Drug Administration for the treatment of chronic, accelerated, or blast phase Philadelphia chromosome-positive CML in adult patients with resistance or intolerance to prior therapy. This review summarizes the main properties of bosutinib and the currently available data on its clinical potential in the treatment of CML.Keywords: bosutinib, chronic myeloid leukemia, BCR-ABL, Src/Abl kinase inhibitor, point mutation, imatinib resistance

  9. Chronic lithium treatment increased intracellular S100ß levels in rat primary neuronal culture.

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    Masoumeh Emamghoreishi

    2015-02-01

    Full Text Available S100ß a neurotrophic factor mainly released by astrocytes, has been implicated in the pathogenesis of bipolar disorder. Thus, lithium may exert its neuroprotective effects to some extent through S100ß. Furthermore, the possible effects of lithium on astrocytes as well as on interactions between neurons and astrocytes as a part of its mechanisms of actions are unknown. This study was undertaken to determine the effect of lithium on S100β in neurons, astrocytes and a mixture of neurons and astrocytes. Rat primary astrocyte, neuronal and mixed neuro-astroglia cultures were prepared from cortices of 18-day's embryos. Cell cultures were exposed to lithium (1mM or vehicle for 1day (acute or 7 days (chronic. RT-PCR and ELISA determined S100β mRNA and intra- and extracellular protein levels. Chronic lithium treatment significantly increased intracellular S100β in neuronal and neuro-astroglia cultures in comparison to control cultures (P<0.05. Acute and chronic lithium treatments exerted no significant effects on intracellular S100β protein levels in astrocytes, and extracellular S100β protein levels in three studied cultures as compared to control cultures. Acute and chronic lithium treatments did not significantly alter S100β mRNA levels in three studied cultures, compared to control cultures. Chronic lithium treatment increased intracellular S100ß protein levels in a cell-type specific manner which may favor its neuroprotective action. The findings of this study suggest that lithium may exert its neuroprotective action, at least partly, by increasing neuronal S100ß level, with no effect on astrocytes or interaction between neurons and astrocytes.

  10. Molecular Signatures of Psychosocial Stress and Cognition Are Modulated by Chronic Lithium Treatment.

    Science.gov (United States)

    Brzózka, Magdalena M; Havemann-Reinecke, Ursula; Wichert, Sven P; Falkai, Peter; Rossner, Moritz J

    2016-07-01

    Chronic psychosocial stress is an important environmental risk factor of psychiatric diseases such as schizophrenia. Social defeat in rodents has been shown to be associated with maladaptive cellular and behavioral consequences including cognitive impairments. Although gene expression changes upon psychosocial stress have been described, a comprehensive transcriptome profiling study at the global level in precisely defined hippocampal subregions which are associated with learning has been lacking. In this study, we exposed adult C57Bl/6N mice for 3 weeks to "resident-intruder" paradigm and combined laser capture microdissection with microarray analyses to identify transcriptomic signatures of chronic psychosocial stress in dentate gyrus and CA3 subregion of the dorsal hippocampus. At the individual transcript level, we detected subregion specific stress responses whereas gene set enrichment analyses (GSEA) identified several common pathways upregulated upon chronic psychosocial stress related to proteasomal function and energy supply. Behavioral profiling revealed stress-associated impairments most prominent in fear memory formation which was prevented by chronic lithium treatment. Thus, we again microdissected the CA3 region and performed global transcriptome analysis to search for molecular signatures altered by lithium treatment in stressed animals. By combining GSEA with unsupervised clustering, we detected pathways that are regulated by stress and lithium in the CA3 region of the hippocampus including proteasomal components, oxidative phosphorylation, and anti-oxidative mechanisms. Our study thus provides insight into hidden molecular phenotypes of chronic psychosocial stress and lithium treatment and proves a beneficial role for lithium treatment as an agent attenuating negative effects of psychosocial stress on cognition. PMID:26714764

  11. Neuroendoscopic treatment of idiopathic occlusion of unilateral foramen of Monro presenting as chronic headache

    Directory of Open Access Journals (Sweden)

    Dhaval Shukla

    2016-01-01

    Full Text Available Asymmetric ventriculomegly due to idiopathic occlusion of the foramen of Monro is rare. Such patients present with clinical features of raised intracranial pressure (ICP. Presentation as chronic headache has not been previously described. In the absence of raised ICP, pursuing surgical treatment raises a clinical dilemma as the headache may be a primary headache with no improvement after surgery. A 21-year-old woman presented with chronic headache. She was found to have asymmetric ventriculomegaly due to the occlusion of the foramen of Monro. She underwent endoscopic septostomy and widening of the foramen of Monro. Her headache subsided after surgery. At 15 months of follow-up, she was free from headache without medications. Unilateral occlusion of the foramen of Monro can present with asymmetric ventriculomegaly resulting in chronic headache. Though the symptoms of raised ICP may not be present, still endoscopic relief of ventriculomegaly leads to cure of headache.

  12. Nationwide Experience of Treatment with Protease Inhibitors in Chronic Hepatitis C Patients in Denmark

    DEFF Research Database (Denmark)

    Sølund, Christina; Krarup, Henrik; Ramirez, Santseharay; Thielsen, Peter; Røge, Birgit T; Lunding, Suzanne; Barfod, Toke S; Madsen, Lone G; Tarp, Britta; Christensen, Peer B; Gerstoft, Jan; Laursen, Alex L; Bukh, Jens; Weis, Nina

    2014-01-01

    patients. Thus, treatment response and development of viral resistance during triple therapy in a routine clinical setting needs to be determined. The aims of this study were to investigate treatment outcome and identify sequence variations after triple therapy in patients with chronic HCV genotype 1...... infection in a routine clinical setting. METHODS: 80 patients, who initiated and completed triple therapy in Denmark between May 2011 and November 2012, were included. Demographic data and treatment response were obtained from the Danish Database for Hepatitis B and C. Direct sequencing and clonal analysis...

  13. Early signaling, referral, and treatment of adolescent chronic pain: a study protocol

    Directory of Open Access Journals (Sweden)

    Voerman Jessica S

    2012-06-01

    Full Text Available Abstract Background Chronic pain is prevalent among young people and negatively influences their quality of life. Furthermore, chronic pain in adolescence may persist into adulthood. Therefore, it is important early on to promote the self-management skills of adolescents with chronic pain by improving signaling, referral, and treatment of these youngsters. In this study protocol we describe the designs of two complementary studies: a signaling study and an intervention study. Methods and design The signaling study evaluates the Pain Barometer, a self-assessed signaling instrument for chronic pain in adolescents. To evaluate the feasibility of the Pain Barometer, the experiences of youth-health care nurses will be evaluated in semi-structured interviews. Also, we will explore the frequencies of referral per health-care provider. The intervention study evaluates Move It Now, a guided self-help intervention via the Internet for teenagers with chronic pain. This intervention uses cognitive behavioural techniques, including relaxation exercises and positive thinking. The objective of the intervention is to improve the ability of adolescents to cope with pain. The efficacy of Move It Now will be examined in a randomized controlled trial, in which 60 adolescents will be randomly assigned to an experimental condition or a waiting list control condition. Discussion If the Pain Barometer is proven to be feasible and Move It Now appears to be efficacious, a health care pathway can be created to provide the best tailored treatment promptly to adolescents with chronic pain. Move It Now can be easily implemented throughout the Netherlands, as the intervention is Internet based. Trial registration Dutch Trial Register NTR1926

  14. [Chronification of chronic patients from the viewpoint of interaction in the medical treatment system].

    Science.gov (United States)

    Schindler, R

    1980-01-01

    Though chronicity in psychiatry seems to have undergone a favorable modification, it has, nevertheless, increased and evolved so to adopte itself to a more liberal society (group techniques having no doubt contributed to this modification). Chronicity is no longer the end result of the asylum and solitude. Stades of chronicity are found in each and every branch of medicine, its development being parallel to the expressive of medicine itself. Due to intensification of preventive medicine and post-cure, chronicity touches not only patients undergoing long-term treatment, but also those attending ambulatories and post-cure institutions, and individuals who are considered ill in their environmental interactions, living recluded lives in order to avoid contact, friction and treatment. Chronification, deriving from the interaction with the therapeutic system, can be avoided if the patient and his milieu, in a common effort, give up the idea of illness and allow confrontation to the aggressive stimuli of society. The lack of understanding on the therapist's side, concerning the above-mentioned effort, in the demonstration that the therapist has a preconceived position in the system. This fact is not surprising since chronification is a target in medicine which defines health as a sort of negative of the illness it treats. On the other hand Freudian psychology should enable us to renounce all absolute idealization and help us seek health conceived as a libidinal blend of Eros and Thanatos. The question is not, therefore, how to avoid chronicity, but how to find a chronicity adapted to the patients biography and not to our own. PMID:7455615

  15. Neurobiologically informed treatment for adults with anorexia nervosa: a novel approach to a chronic disorder

    Science.gov (United States)

    Knatz, Stephanie; Wierenga, Christina E.; Murray, Stuart B.; Hill, Laura; Kaye, Walter H.

    2015-01-01

    Anorexia nervosa (AN) is a severe and debilitating disorder with significant medical and psychological sequelae. To date, there are no effective treatments for adults, resulting in high rates of chronicity, morbidity, and mortality. Recent advances in brain imaging research have led to an improved understanding of etiology and specific neurobiological mechanisms underlying symptoms. Despite this, there are no treatments focused on targeting symptoms using this empirically supported mechanistic understanding of the illness. Updated treatment approaches focused on targeting neurobiological mechanisms underlying core AN symptomatology are necessary to improve treatment out-comes for this population. Neurobiologically Enhanced With Family Eating Disorder Trait Response Treatment (NEW FED TR) is a neurobiologically informed treatment targeting key temperament constructs associated with the illness through the delivery of psychoeducation and skills training to patients and nominated carers. PMID:26246796

  16. Treatment of chronic idiopathic urticaria with levamisole: a multicentre, randomized, double-blind, controlled trial.

    Science.gov (United States)

    Zhang, H; Shan, C; Hua, Z; Zhao, P; Zhang, H

    2009-01-01

    The objective of this study was to evaluate the efficacy of treating chronic idiopathic urticaria (CIU) with levamisole in combination with levocetirizine. This was a multicentre, randomized, double-blind, controlled trial that included 132 patients with active CIU who were treated for 6 weeks with either levocetirizine alone (control group; n = 65) or levamisole plus levocetirizine (treatment group; n = 67). Response to therapy was evaluated by measuring the efficacy rate. After 2 weeks of treatment, there was no significant difference in the efficacy rate between the treatment and control groups (54.84% and 42.37%, respectively). After 6 weeks of treatment, a statistically significant difference in the efficacy rate was observed between the groups (76.27% and 54.39% for the treatment and control groups, respectively). This study demonstrated that a combination of levamisole plus levocetirizine is more effective than levocetirizine alone and potentially provides a new, promising approach to the treatment of CIU. PMID:19761700

  17. Rapid removal of organic micropollutants from water by a porous β-cyclodextrin polymer

    Science.gov (United States)

    Alsbaiee, Alaaeddin; Smith, Brian J.; Xiao, Leilei; Ling, Yuhan; Helbling, Damian E.; Dichtel, William R.

    2016-01-01

    The global occurrence in water resources of organic micropollutants, such as pesticides and pharmaceuticals, has raised concerns about potential negative effects on aquatic ecosystems and human health. Activated carbons are the most widespread adsorbent materials used to remove organic pollutants from water but they have several deficiencies, including slow pollutant uptake (of the order of hours) and poor removal of many relatively hydrophilic micropollutants. Furthermore, regenerating spent activated carbon is energy intensive (requiring heating to 500-900 degrees Celsius) and does not fully restore performance. Insoluble polymers of β-cyclodextrin, an inexpensive, sustainably produced macrocycle of glucose, are likewise of interest for removing micropollutants from water by means of adsorption. β-cyclodextrin is known to encapsulate pollutants to form well-defined host-guest complexes, but until now cross-linked β-cyclodextrin polymers have had low surface areas and poor removal performance compared to conventional activated carbons. Here we crosslink β-cyclodextrin with rigid aromatic groups, providing a high-surface-area, mesoporous polymer of β-cyclodextrin. It rapidly sequesters a variety of organic micropollutants with adsorption rate constants 15 to 200 times greater than those of activated carbons and non-porous β-cyclodextrin adsorbent materials. In addition, the polymer can be regenerated several times using a mild washing procedure with no loss in performance. Finally, the polymer outperformed a leading activated carbon for the rapid removal of a complex mixture of organic micropollutants at environmentally relevant concentrations. These findings demonstrate the promise of porous cyclodextrin-based polymers for rapid, flow-through water treatment.

  18. Rapid removal of organic micropollutants from water by a porous β-cyclodextrin polymer.

    Science.gov (United States)

    Alsbaiee, Alaaeddin; Smith, Brian J; Xiao, Leilei; Ling, Yuhan; Helbling, Damian E; Dichtel, William R

    2016-01-14

    The global occurrence in water resources of organic micropollutants, such as pesticides and pharmaceuticals, has raised concerns about potential negative effects on aquatic ecosystems and human health. Activated carbons are the most widespread adsorbent materials used to remove organic pollutants from water but they have several deficiencies, including slow pollutant uptake (of the order of hours) and poor removal of many relatively hydrophilic micropollutants. Furthermore, regenerating spent activated carbon is energy intensive (requiring heating to 500-900 degrees Celsius) and does not fully restore performance. Insoluble polymers of β-cyclodextrin, an inexpensive, sustainably produced macrocycle of glucose, are likewise of interest for removing micropollutants from water by means of adsorption. β-cyclodextrin is known to encapsulate pollutants to form well-defined host-guest complexes, but until now cross-linked β-cyclodextrin polymers have had low surface areas and poor removal performance compared to conventional activated carbons. Here we crosslink β-cyclodextrin with rigid aromatic groups, providing a high-surface-area, mesoporous polymer of β-cyclodextrin. It rapidly sequesters a variety of organic micropollutants with adsorption rate constants 15 to 200 times greater than those of activated carbons and non-porous β-cyclodextrin adsorbent materials. In addition, the polymer can be regenerated several times using a mild washing procedure with no loss in performance. Finally, the polymer outperformed a leading activated carbon for the rapid removal of a complex mixture of organic micropollutants at environmentally relevant concentrations. These findings demonstrate the promise of porous cyclodextrin-based polymers for rapid, flow-through water treatment. PMID:26689365

  19. Montelukast versus Dexamethasone Treatment in a Guinea Pig Model of Chronic Pulmonary Neutrophilic Inflammation.

    Science.gov (United States)

    Abdel Kawy, Hala S

    2016-08-01

    Airway inflammation in chronic obstructive pulmonary disease (COPD) is refractory to corticosteroids and hence COPD treatment is hindered and insufficient. This study assessed the effects of oral treatment with Montelukast (10 and 30 mg/kg) or dexamethasone (20 mg/kg) for 20 days on COPD model induced by chronic exposure to lipopolysaccharide (LPS). Six groups of male guinea pigs were studied. Group 1: naïve group, group 2: exposed to saline nebulization. Groups 3, 4, 5, and 6: exposed to 9 nebulizations of LPS (30 μg/ml) for 1 hour, 48 hours apart with or without treatment with Montelukast or dexamethasone. Airway hyperreactivity (AHR) to methacholine (MCh), histopathological study and bronchoalveolar lavage fluid (BALF) as well as lung tissue analyses were performed 48 hours after the final exposure to LPS (day 20). LPS-induced pulmonary dysfunction was associated with increased neutrophil count, leukotriene (LT) B4, and tumor necrosis factor (TNF)-α in BALF. Moreover, there was an increase in malondialdehyde (MDA) level and a decrease in histone deacetylases(HDAC) activity in the lung tissue. Both Montelukast (10 or 30 mg /kg) and dexamethasone significantly reduced neutrophil count in BALF and inflammatory cells in lung parenchyma as well as TNF-α, and MDA levels. However, dexamethasone was more effective (p dexamethasone. These results suggest that treatment with Montelukast can be useful in chronic airway inflammatory diseases including COPD poorly responsive to glucocorticoids. PMID:26751767

  20. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    Directory of Open Access Journals (Sweden)

    Robert N. Jamison

    2011-01-01

    Full Text Available Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no “gold standard” for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management.

  1. Treatment Expectations for CAM Interventions in Pediatric Chronic Pain Patients and their Parents

    Directory of Open Access Journals (Sweden)

    Jennie C. I. Tsao

    2005-01-01

    Full Text Available Patient expectations regarding complementary and alternative medicine (CAM interventions have important implications for treatment adherence, attrition and clinical outcome. Little is known, however, about parent and child treatment expectations regarding CAM approaches for pediatric chronic pain problems. The present study examined ratings of the expected benefits of CAM (i.e. hypnosis, massage, acupuncture, yoga and relaxation and conventional medicine (i.e. medications, surgery interventions in 45 children (32 girls; mean age = 13.8 years ± 2.5 and parents (39 mothers presenting for treatment at a specialty clinic for chronic pediatric pain. Among children, medications and relaxation were expected to be significantly more helpful than the remaining approaches (P < 0.01. However, children expected the three lowest rated interventions, acupuncture, surgery and hypnosis, to be of equal benefit. Results among parents were similar to those found in children but there were fewer significant differences between ratings of the various interventions. Only surgery was expected by parents to be significantly less helpful than the other approaches (P < 0.01. When parent and child perceptions were compared, parents expected hypnosis, acupuncture and yoga, to be more beneficial than did children, whereas children expected surgery to be more helpful than did parents (P < 0.01. Overall, children expected the benefits of CAM to be fairly low with parents' expectations only somewhat more positive. The current findings suggest that educational efforts directed at enhancing treatment expectations regarding CAM, particularly among children with chronic pain, are warranted.

  2. Expression changes of hippocampal energy metabolism enzymes contribute to behavioural abnormalities during chronic morphine treatment

    Institute of Scientific and Technical Information of China (English)

    Xiao-Lan Chen; Jing-Gen Liu; Gang Lu; Ying-Xia Gong; Liang-Cai Zhao; Jie Chen; Zhi-Qiang Chi; Yi-Ming Yang; Zhong Chen; Qing-lin Li

    2007-01-01

    Dependence and impairment of learning and memory are two well-established features caused by abused drugs such as opioids. The hippocampus is an important region associated with both drug dependence and learning and memory. However, the molecular events in hippocampus following exposure to abused drugs such as opioids are not well understood. Here we examined the effect of chronic morphine treatment on hippocampal protein expression by proteomic analyses. We found that chronic exposure of mice to morphine for 10 days produced robust morphine withdrawal jumping and memory impairment, and also resulted in a significant downregulation of hippocampal protein levels of three metabolic enzymes, including Fe-S protein 1 of NADH dehydrogenase, dihydrolipoamide acetyltransferase or E2 component of the pyruvate dehydrogenase complex and lactate dehydrogenase 2. Further real-time quantitative PCR analyses confirmed that the levels of the corresponding mRNAs were also remarkably reduced. Consistent with these findings, lower ATP levels and an impaired ability to convert glucose into ATP were also observed in the hippocampus of chronically treated mice. Opioid antagonist naltrexone administrated concomitantly with morphine significantly suppressed morphine withdrawal jumping and reversed the downregulation of these proteins. Acute exposure to morphine also produced robust morphine withdrawal jumping and significant memory impairment, but failed to decrease the expression of these three proteins. Intrahippocampal injection of D-glucose before morphine administration significantly enhanced ATP levels and suppressed morphine withdrawal jumping and memory impairment in acute morphine-treated but not in chronic morphine-treated mice. Intraperitoneal injection of high dose of D-glucose shows a similar effect on morphine-induced withdrawal jumping as the central treatment. Taken together, our results suggest that reduced expression of the three metabolic enzymes in the hippocampus as

  3. A critical appraisal of lubiprostone in the treatment of chronic constipation in the elderly

    Directory of Open Access Journals (Sweden)

    Gras-Miralles B

    2013-02-01

    Full Text Available Beatriz Gras-Miralles,1 Filippo Cremonini1,21Gastroenterology Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 2Southern Nevada VA Healthcare System, Las Vegas, NV, USAAbstract: Chronic constipation is a common disorder in the general population, with higher prevalence in the elderly, and is associated with worse quality of life and with greater health care utilization. Lubiprostone is an intestinal type-2 chloride channel activator that increases intestinal fluid secretion, small intestinal transit, and stool passage. Lubiprostone is currently approved by the US Food and Drug Administration for the treatment of chronic idiopathic constipation and of irritable bowel syndrome with predominant constipation. This review outlines current approaches and limitations in the treatment of chronic constipation in the elderly and discusses the results, limitations, and applicability of randomized, controlled trials of lubiprostone that have been conducted in the general and elderly population, with additional focus on the use of lubiprostone in constipation in Parkinson's disease and in opioid-induced constipation, two clinical entities that can be comorbid in elderly patients.Keywords: irritable bowel syndrome, Parkinson's disease, opioid-induced constipation, chronic constipation

  4. Factor analysis for the adoption of nuclear technology in diagnosis and treatment of chronic diseases

    International Nuclear Information System (INIS)

    To identify and evaluate latent variables (variables that are not directly observed) for adopting and using nuclear technologies in diagnosis and treatment of chronic diseases. The measurement and management of these latent factors are important for health care due to complexities of the sector. Methods: An exploratory factor analysis study was conducted among 52 physicians practicing in the areas of Cardiology, Neurology and Oncology in the State of Sao Paulo who agreed to participate in the study between 2009 and 2010. Data were collected using an attitude measurement questionnaire, and analyzed according to the principal component method with Varimax rotation. Results: The component matrix after factor rotation showed three elucidative groups arranged according to demand for nuclear technology: clinical factors, structural factors, and technological factors. Clinical factors included questionnaire answers referring to medical history, previous interventions, complexity and chronicity of the disease. Structural factors included patient age, physician's practice area, and payment ability. Technological factors included prospective growth in the use of nuclear technology and availability of services. Conclusions: The clinical factors group dimension identified in the study included patient history, prior interventions, and complexity and chronicity of the disease. This dimension is the main motivating for adopting nuclear technology in diagnosis and treatment of chronic diseases. (author)

  5. Treatment of chronic viral hepatitis with nitazoxanide and second generation thiazolides

    Institute of Scientific and Technical Information of China (English)

    Emmet B Keeffe; Jean-Francois Rossignol

    2009-01-01

    Nitazoxanide, the first thiazolide, was originally developed for the treatment of Cryptosporidium parvum. More recently, antiviral activity of nitazoxanide against hepatitis B virus (HBV) and hepatitis C virus was recognized in in vitro systems. These basic studies led to phase Ⅱ clinical trials that demonstrated the safety and efficacy of nitazoxanide in combination with peginterferon, with or without ribavirin, in the treatment of chronic hepatitis C genotype 4. The sustained virologic response rate was 79% and 80% in two studies, which was higher than the response rate of 50% with the standard of care with peginterferon plus ribavirin. In very preliminary studies of patients with chronic hepatitis B, nitazoxanide suppressed serum HBV DNA and led to loss of hepatitis B e antigen in the majority of patients and hepatitis B surface antigen in approximately a quarter of patients. Randomized controlled studies of naive and nonresponder patients with chronic hepatitis C genotype 1 are underway, new second generation and controlled release thiazolides are being developed, and future studies of patients with chronic hepatitis B are planned.

  6. Diseases of the small bowel in chronic diarrhea: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    M. Simadibrata

    2002-09-01

    Full Text Available The incidence of chronic diarrhea in Asia is between 0.8-1.0%. The diseases and abnormalities according to the location, which can cause chronic diarrhea, are divided into three locations: the small bowel, the large bowel and extraintestinal. The small bowel diseases include infectious and non-infectious diseases. The infectious diseases are bacterial infections, parasitic infections etc. The non-infectious diseases include of Crohn’s disease, Celiac sprue, NSAID enteropathy, lactose intolerance, benign tumor, carcinoid tumor, carcinoma, post surgery complications, laxative etc. The approaches to diagnosis include good anamnesis, careful physical examination, supporting laboratory tests, more specialized supporting examinations including X-ray of the colon, esophagogastroduodenum follow-through, enteroclysis, ileo-colonoscopy and endoscopy on the upper portion of the digestive tract including the small intestine with biopsy for histopathology examinations. The treatment for chronic diarrhea is divided into supportive and causal therapy. (Med J Indones 2002; 11: 179-89 Keywords: small bowel, chronic diarrhea, approaches to diagnosis, treatment

  7. Self-assembly of cyclodextrins

    DEFF Research Database (Denmark)

    Fülöp, Z.; Kurkov, S.V.; Nielsen, T.T.;

    2012-01-01

    The design of functional cyclodextrin (CD) nanoparticles is a developing area in the field of nanomedicine. CDs can not only help in the formation of drug carriers but also increase the local concentration of drugs at the site of action. CD monomers form aggregates by self-assembly, a tendency that...... increases upon formation of inclusion complexes with lipophilic drugs. However, the stability of such aggregates is not sufficient for parenteral administration. In this review CD polymers and CD containing nanoparticles are categorized, with focus on self-assembled CD nanoparticles. It is described how the...

  8. Auricular point acupressure for chronic pain: a feasibility study of a 4-week treatment protocol.

    Science.gov (United States)

    Yeh, Chao Hsing; Chien, Lung-Chang; Huang, Li Chun; Suen, Lorna Kwai-Ping

    2014-01-01

    This 1-group, 4-week observational study aimed to (1) assess the feasibility of recruiting, retention, and completion of a 4-week auricular point acupressure (APA) treatment protocol for chronic pain in adult patients and (2) assess the effects of APA in pain reduction (pain severity and pain interference) among these patients. The participants received a 4-week APA treatment protocol in weekly cycles. Each weekly cycle included 5 days with APA seeds taped onto the ear and 2 days without. Each participant was called every day to monitor adherence to the treatment protocol (the actual times the participant pressed the seeds each day and the duration of applied pressure), to answer analgesic use, and to answer the pain intensity questionnaire. Thirty participants were initially enrolled in this study, but 5 did not continue. The retention rate was 83% (n = 25). Approximately 60% of the participants (n = 15) adhered to the 4-week APA and completed all data assessments. At baseline assessment, only 40% of all participants (n = 12 of 30) were confident that APA would reduce and eliminate pain; nonetheless, all participants reported fewer episodes of pain occurrences and pain intensity with the APA treatment. For the participants who completed the 4-week APA protocol (n = 15), 96% (n = 14) decreased analgesic medication intake and 88% (n = 13) felt "much better" after the APA treatment. Participants reported an average reduction of 63% in the worst pain intensity at day 7. By the end of the 4-week APA protocol, an even greater reduction in pain intensity was reported (66%, n = 10, at day 28). The participants who did not complete the treatment protocol reported an average pain reduction of 29%, which fluctuated to 22% before they dropped out. Auricular point acupressure is feasible for patients with chronic pain. The preliminary findings of this feasibility study show a reduction in pain intensity and improvement in physical function, which demonstrate the potential for

  9. Aqueous dispersions of oxide nanoparticles as a treatment for pyoinflammatory diseases with chronic component

    International Nuclear Information System (INIS)

    Promising direction of surgery related to the treatment of acute purulent wounds with chronic component could be utilization of aqueous dispersions of nanostructures (ADN) produced by pulsed electric discharge in water. The investigation is addressed to finding out the opportunity of usage of an ADN for treatment of purulent wounds with a chronic component and comparison of its efficiency with the widespread antiseptics. For realization of investigation was used ADN, which has maximal share of 'small' nanostructures (<100 nm) with the greatest surface electric charge. High activity of reparative processes is established at use of ADN and subsequent moderate changes of the further healing. The attributes of cellular atypia and preternatural representations about inflammatory reactions are not revealed at local use of ADN.

  10. Chronic Inflammatory Demyelinating Polyneuropathy in Children: A Review of Clinical Characteristics and Recommendations for Treatment

    Directory of Open Access Journals (Sweden)

    Narges Karimi

    2015-07-01

    Full Text Available Context: Chronic inflammatory demyelinating polyradiculopathy (CIDP is an acquired and autoimmune neuropathy, characterized by a chronic, rapidly progressive, symmetric weakness. In children, abnormal gait is as a first symptom of muscle weakness. Evidence Acquisition: The diagnosis of CIDP is on the basis of clinical characteristics, electrodiagnostic that shows the severity of the disease, lumbar puncture and spine magnetic resonance imaging (MRI. Results: The first-line treatments in childhood CIDP are intravenous immunoglobulin (IVIG, corticosteroids, and plasmapheresis. Response to first-line therapies is usually satisfactory; nevertheless, recommendations regarding the choice of second-line therapy can only be prepared on the basis of the existing practice described in some of the case reports. Conclusions: This review demonstrated the clinical presentation, diagnosis, and treatment of childhood CIDP.

  11. Enhanced sensitivity of muscarinic cholinergic receptor associated with dopaminergic receptor subsensitivity after chronic antidepressant treatment

    International Nuclear Information System (INIS)

    The chronic effects of antidepressant treatment on striatal dopaminergic (DA) and muscarinic cholinergic (mACh) receptors of the rat brain have been examined comparatively in this study using 3H-spiroperidol (3H-SPD) and 3H-quinuclidinyl benzilate (3H-QNB) as the respective radioactive ligands. Imipramine and desipramine were used as prototype antidepressants. Although a single administration of imipramine or desipramine did not affect each receptor sensitivity, chronic treatment with each drug caused a supersensitivity of mACh receptor subsequent to DA receptor subsensitivity. Furthermore, it has been suggested that anti-mACh properties of imipramine or desipramine may not necessarily be related to the manifestation of mACh receptor supersensitivity and that sustained DA receptor subsensitivity may play some role in the alterations of mACh receptor sensitivity

  12. Aqueous dispersions of oxide nanoparticles as a treatment for pyoinflammatory diseases with chronic component

    Science.gov (United States)

    Rutberg, Ph; Kolikov, V.; Moshkin, A.; Snetov, V.; Stogov, A.; Khalilov, M.

    2011-04-01

    Promising direction of surgery related to the treatment of acute purulent wounds with chronic component could be utilization of aqueous dispersions of nanostructures (ADN) produced by pulsed electric discharge in water. The investigation is addressed to finding out the opportunity of usage of an ADN for treatment of purulent wounds with a chronic component and comparison of its efficiency with the widespread antiseptics. For realization of investigation was used ADN, which has maximal share of "small" nanostructures (<100 nm) with the greatest surface electric charge. High activity of reparative processes is established at use of ADN and subsequent moderate changes of the further healing. The attributes of cellular atypia and preternatural representations about inflammatory reactions are not revealed at local use of ADN.

  13. Aqueous dispersions of oxide nanoparticles as a treatment for pyoinflammatory diseases with chronic component

    Energy Technology Data Exchange (ETDEWEB)

    Rutberg, Ph; Kolikov, V; Snetov, V; Stogov, A [Institute for Electrophysics and Electric Power Russian Academy of Sciences, 18 Dvortsovaya nab., St.-Petersburg, 191186 (Russian Federation); Moshkin, A; Khalilov, M, E-mail: Stogov2007@yandex.ru [Oryol State University, Medical Institute, October st. 25, Oryol, 302028 (Russian Federation)

    2011-04-01

    Promising direction of surgery related to the treatment of acute purulent wounds with chronic component could be utilization of aqueous dispersions of nanostructures (ADN) produced by pulsed electric discharge in water. The investigation is addressed to finding out the opportunity of usage of an ADN for treatment of purulent wounds with a chronic component and comparison of its efficiency with the widespread antiseptics. For realization of investigation was used ADN, which has maximal share of 'small' nanostructures (<100 nm) with the greatest surface electric charge. High activity of reparative processes is established at use of ADN and subsequent moderate changes of the further healing. The attributes of cellular atypia and preternatural representations about inflammatory reactions are not revealed at local use of ADN.

  14. Effects of chronic delta-9-THC treatment on cardiac beta-adrenoceptors in rats

    Energy Technology Data Exchange (ETDEWEB)

    Evans, E.B.; Seifen, E.; Kennedy, R.H.; Kafiluddi, R.; Paule, M.G.; Scallet, A.C.; Ali, S.F.; Slikker, W. Jr.

    1987-10-01

    This study was designed to determine if chronic treatment with delta-9-tetrahydrocannabinol (THC) alters cardiac beta-adrenoceptors in the rat. Following daily oral administration of 10 or 20 mg/kg THC or an equivalent volume of control solvent for 90 days, rats were sacrificed, and sarcolemmal membranes were prepared from ventricular myocardium. Beta-adrenoceptor density and binding affinity estimated with (-)(/sup 3/H)dihydroalprenolol; a beta-adrenergic antagonist, were not significantly affected by treatment with THC when compared to vehicle controls. These results suggest that the tolerance to cardiovascular effects of THC which develops during chronic exposure in the rat is not associated with alterations in cardiac beta-adrenoceptors as monitored by radiolabeled antagonist binding.

  15. Treatment of chronic radiation enteritis and colitis with salicylazosulfapyridine and systemic corticosteroids

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, F.; Khoury, J.; Thornton, J.J.

    1976-03-01

    Four patients with severe chronic radiation enteritis and/or colitis were treated with anti-inflammatory drugs that are used conventionally in the treatment of idiopathic inflammatory bowel disease. Salicylazosulfapyridine (SASP) was used in the treatment of all four patients, while one patient received oral prednisone together with SASP. All four patients were treated and observed for over one year, with follow-up observations now extending to over three years. The four patients showed striking clinical improvement, accompanied by improvement in the radiographic appearance of affected bowel, complete or almost complete in three and incomplete in the fourth patient. The results of this pilot investigation are encouraging and call for wider clinical trials of the same and related drugs in larger groups of patients with chronic radiation enterocolitis, a serious condition that has until now not been successfully treated with drugs.

  16. Cyclodextrin promotes atherosclerosis regression via macrophage reprogramming.

    Science.gov (United States)

    Zimmer, Sebastian; Grebe, Alena; Bakke, Siril S; Bode, Niklas; Halvorsen, Bente; Ulas, Thomas; Skjelland, Mona; De Nardo, Dominic; Labzin, Larisa I; Kerksiek, Anja; Hempel, Chris; Heneka, Michael T; Hawxhurst, Victoria; Fitzgerald, Michael L; Trebicka, Jonel; Björkhem, Ingemar; Gustafsson, Jan-Åke; Westerterp, Marit; Tall, Alan R; Wright, Samuel D; Espevik, Terje; Schultze, Joachim L; Nickenig, Georg; Lütjohann, Dieter; Latz, Eicke

    2016-04-01

    Atherosclerosis is an inflammatory disease linked to elevated blood cholesterol concentrations. Despite ongoing advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains the leading cause of death worldwide. Continuous retention of apolipoprotein B-containing lipoproteins in the subendothelial space causes a local overabundance of free cholesterol. Because cholesterol accumulation and deposition of cholesterol crystals (CCs) trigger a complex inflammatory response, we tested the efficacy of the cyclic oligosaccharide 2-hydroxypropyl-β-cyclodextrin (CD), a compound that increases cholesterol solubility in preventing and reversing atherosclerosis. We showed that CD treatment of murine atherosclerosis reduced atherosclerotic plaque size and CC load and promoted plaque regression even with a continued cholesterol-rich diet. Mechanistically, CD increased oxysterol production in both macrophages and human atherosclerotic plaques and promoted liver X receptor (LXR)-mediated transcriptional reprogramming to improve cholesterol efflux and exert anti-inflammatory effects. In vivo, this CD-mediated LXR agonism was required for the antiatherosclerotic and anti-inflammatory effects of CD as well as for augmented reverse cholesterol transport. Because CD treatment in humans is safe and CD beneficially affects key mechanisms of atherogenesis, it may therefore be used clinically to prevent or treat human atherosclerosis. PMID:27053774

  17. Chronic morphine treatment decreases acoustic startle response and prepulse inhibition in rats

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The reward-related effects of addictive drugs primarily act via the dopamine system, which also plays an important role in sensorimotor gating. The mesolimbic dopamine system is the common pathway of drug addiction and sensorimotor gating. However, the way in which addictive drugs affect sensorimotor gating is currently unclear. In previous studies, we examined the effects of morphine treatment on sensory gating in the hippocampus. The present study investigated the effects of morphine on sensorimotor gating in rats during chronic morphine treatment and withdrawal. Rats were examined during treatment with morphine for 10 successive days, followed by a withdrawal period. Acoustic startle responses to a single startle stimulus (115 dB SPL) and prepulse inhibition responses were recorded. The results showed that acoustic startle responses were attenuated during morphine treatment, but not during withdrawal. PPI was impaired in the last 2 morphine treatment days, but returned to a normal level during withdrawal.

  18. Pivmecillinam and amoxycillin as combined treatment in purulent exacerbations of chronic bronchitis.

    Science.gov (United States)

    Pines, A; Nandi, A R; Raafat, H; Rahman, M

    1977-07-01

    One hundred and thirty-two patients with purulent exacerbations of chronic bronchitis were randomly allotted to treatment in three groups. They received (a) amoxycillin 250 mg and pivmecillinam 200 mg; or (b) amoxycillin 500 mg; or (c) amoxycillin 500 mg and pivmecillinam 400 mg: three times daily for 10 days. By the 7th day of treatment there was significant improvement over amoxycillin alone for both groups given combined chemotherapy in conversion of sputum to mucoid and in general improvement; at the end of treatment results in patients given the higher doses of both antibiotics were still superior to amoxycillin alone. Patients were observed 2 to 4 weeks later, when those given amoxycillin alone relapsed much more frequently. The three treatments were well tolerated and succeeded equally in clearing potential pathogens from the sputum. Combined treatment may be superior due to synergy against Haemophilus influenzae or to the elimination of beta-lactamase producing organisms and should be investigated further. PMID:330483

  19. The outcome of tuberculosis treatment in subjects with chronic kidney disease in Brazil: a multinomial analysis

    Directory of Open Access Journals (Sweden)

    Barbara Reis-Santos

    2013-09-01

    Full Text Available OBJECTIVE: To analyze the association between clinical/epidemiological characteristics and outcomes of tuberculosis treatment in patients with concomitant tuberculosis and chronic kidney disease (CKD in Brazil. METHODS: We used the Brazilian Ministry of Health National Case Registry Database to identify patients with tuberculosis and CKD, treated between 2007 and 2011. The tuberculosis treatment outcomes were compared with epidemiological and clinical characteristics of the subjects using a hierarchical multinomial logistic regression model, in which cure was the reference outcome. RESULTS: The prevalence of CKD among patients with tuberculosis was 0.4% (95% CI: 0.37-0.42%. The sample comprised 1,077 subjects. The outcomes were cure, in 58%; treatment abandonment, in 7%; death from tuberculosis, in 13%; and death from other causes, in 22%. The characteristics that differentiated the ORs for treatment abandonment or death were age; alcoholism; AIDS; previous noncompliance with treatment; transfer to another facility; suspected tuberculosis on chest X-ray; positive results in the first smear microscopy; and indications for/use of directly observed treatment, short-course strategy. CONCLUSIONS: Our data indicate the importance of sociodemographic characteristics for the diagnosis of tuberculosis in patients with CKD and underscore the need for tuberculosis control strategies targeting patients with chronic noncommunicable diseases, such as CKD.

  20. Enhanced Chiral Recognition by Cyclodextrin Dimers

    Directory of Open Access Journals (Sweden)

    Bart Jan Ravoo

    2011-07-01

    Full Text Available In this article we investigate the effect of multivalency in chiral recognition. To this end, we measured the host-guest interaction of a β-cyclodextrin dimer with divalent chiral guests. We report the synthesis of carbohydrate-based water soluble chiral guests functionalized with two borneol, menthol, or isopinocampheol units in either (+ or (– configuration. We determined the interaction of these divalent guests with a β-cyclodextrin dimer using isothermal titration calorimetry. It was found that—in spite of a highly unfavorable conformation—the cyclodextrin dimer binds to guest dimers with an increased enantioselectivity, which clearly reflects the effect of multivalency.

  1. Molecular Recognition Studies on Modified Cyclodextrins

    Institute of Scientific and Technical Information of China (English)

    LIU,Yu; YOU,Chang-Cheng

    2001-01-01

    This account deacribes our research progress in recent years in the areas of the molecular recognition studies on modified cy clodextrins, including positively charged cyclodextrins, cy clodextrin derivatives with hydrophobic substituent, and dimeric cyclodextrins. Calorimetric titration and various spec trometric techniques were employed to determine the complex stability constants, as well as the thermodynamic parameters, for their inclusion complexation with diverse guest molecules. The results obtained have heen discussed from the viewpoint of size/shape-matching, induced-fit, geometric compensation, and multiple recognition. Thermodynamically, the compen satory relationship between △H and T△S was found to be ex hibited in the inclusion complexation of modified cyclodextrin.

  2. CHARACTERIZATION OF RUTIN-CYCLODEXTRIN INCLUSION COMPOUNDS

    Directory of Open Access Journals (Sweden)

    Andreia Corciovă

    2011-12-01

    Full Text Available The objectives of this study were to examine the potential of beta-cyclodextrin to improve the solubility of rutin and obtain inclusion compounds that were analyzed by different techniques: UV-Vis, IR spectroscopy, thermal analysis. The presence of β-cyclodextrin raises the content of rutin in water. The inclusion compounds were prepared by dry mixing, complexation in semisolid and liquid medium in 1:2 molar ratio rutin - β-cyclodextrin. The UV-Vis and IR analysis demonstrated the obtaining of inclusion compounds and the thermal analysis show that these compounds are more stable than the parent substance.

  3. Electroacupuncture in the treatment of chronic lameness in horses and ponies: a controlled clinical trial.

    OpenAIRE

    Steiss, J E; White, N A; Bowen, J. M.

    1989-01-01

    Electroacupuncture was used to treat lameness in horses and ponies with chronic laminitis (n = 10) or navicular disease (n = 10). A clinical trial was conducted with random allocation of equal numbers of animals to control and treatment groups. Acupuncture was performed three times per week for four consecutive weeks. The degree of lameness was assessed by 1) a grading scheme, 2) measurement of stride lengths and 3) analysis of weight distribution using a force plate. Although seven out of te...

  4. Effects of chronic crocin treatment on desoxycorticosterone acetate (doca)-salt hypertensive rats

    OpenAIRE

    Mohsen Imenshahidi; Bibi Marjan Razavi; Ayyoob Faal; Ali Gholampoor; Seyed Mehran Mousavi; Hossein Hosseinzadeh

    2014-01-01

      Objective(s): In this study, the effects of chronic administration of crocin, an active constituent of saffron, on blood pressures of normotensive and desoxycorticosterone acetate (DOCA) - salt induced hypertensive rats, were investigated.   Materials and Methods: Five week administration of three doses of crocin (50, 100 and 200 mg/kg/day) and spironolactone (50 mg/kg/day) in different groups of normotensive and hypertensive rats (at the end of 4 weeks treatment by DOC...

  5. Investigation of Neurokinin‐1 Receptor Antagonism as a Novel Treatment for Chronic Bronchitis in Dogs

    OpenAIRE

    Grobman, M.; Reinero, C.

    2016-01-01

    Background Canine chronic bronchitis (CCB) results in cough lasting ≥2 months and airway inflammation. Adverse effects include risk of secondary infection associated with lifelong corticosteroid administration and prompt investigation into alternative therapies. Neurogenic pathways mediated by tachykinins that bind neurokinin (NK) 1 receptors may induce cough and airway inflammation. Maropitant,1 a NK‐1 receptor antagonist, has been advocated for treatment of CCB based on anecdotal improvemen...

  6. Comparison of Two Aerosolized Bronchodilators in the Treatment of Severe Equine Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Friday, Philippa Anne

    2000-01-01

    Aerosolized bronchodilator drugs are commonly used for treatment of horses with chronic obstructive pulmonary disease. Relative efficacy of sympathomimetic and parasympatholytic bronchodilators for relief of acute airway obstruction and improvement of pulmonary gas exchange was compared in 6 horses with COPD. Physical examination, arterial and venous blood gas analysis and measurement of end-tidal CO2 tension were performed at time zero, 30 minutes, 1, 2, 3 and 4 hours after administration of...

  7. Exploring Robust Methods for Evaluating Treatment and Comparison Groups in Chronic Care Management Programs

    OpenAIRE

    Wells, Aaron R.; Hamar, Brent; Bradley, Chastity; Gandy, William M.; Harrison, Patricia L.; Sidney, James A.; Coberley, Carter R.; Rula, Elizabeth Y.; Pope, James E

    2013-01-01

    Evaluation of chronic care management (CCM) programs is necessary to determine the behavioral, clinical, and financial value of the programs. Financial outcomes of members who are exposed to interventions (treatment group) typically are compared to those not exposed (comparison group) in a quasi-experimental study design. However, because member assignment is not randomized, outcomes reported from these designs may be biased or inefficient if study groups are not comparable or balanced prior ...

  8. Collaborative decision-making and promoting treatment adherence in pediatric chronic illness

    OpenAIRE

    Dennis Drotar, Dennis

    2010-01-01

    Dennis Drotar, Peggy Crawford, Margaret BonnerCincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USAAbstract: Collaborative or shared decision-making between health care providers and families can facilitate treatment adherence, health outcomes, and satisfaction with care in the management of pediatric chronic illness, but raises special challenges. Barriers such as authoritarian models of medical care as well as absence of time and opportunity for dialogue limit colla...

  9. The Biopsychosocial Model of Treatment the Patients with Inflammatory Chronic Bowel Disease

    OpenAIRE

    Rakovec-Felser, Zlatka

    2011-01-01

    We present the organised psychological group interventions for persons with inflammatory bowel disease (ulcerose colitis, Morbus Crohn). The actual bio-psychosocial model of health and illness is used to explain the situation of chronically ill patient as stressful life position and their ways of coping with such, health-related problems. Considering that numerous psychological factors can lead to insufficient illness adaptation and (non) adherence to treatment – and all those – t...

  10. Anemia treatment and left ventricular hypertrophy in non-dialysis chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    Robert N. Foley; Peter A. McCullough

    2005-01-01

    @@ To this day, the target hemoglobin level that minimizes cardiovascular risk in chronic kidney disease (CKD) patients remains unclear. When one examines the many randomized trials of epoetin therapy in aggregate, enhanced quality of life provides the most cogent argument for hemoglobin levels above 110 g/L. It remains unclear whether treatment of anemia improves longevity, or even a surrogate marker (such as left ventricular [LV] mass index), especially when applied at earlier phases of CKD.

  11. CURRENT STATE OF CHRONIC WOUND CARE IN KAZAKHSTAN: FOCUS ON TOPICAL TREATMENTS

    OpenAIRE

    Alma Akhmetova; Timur Saliev; Gulsim Kulsharova; Talgat Nurgozhin; Sergey Mikhalovsky

    2015-01-01

    Background — The presence of chronic hard-to-heal wounds significantly affects patients’ quality of life causing pain, discomfort, decrease of mobility and consequently leads to social isolation and depression. This type of wound is more prevalent among older population. It has been estimated that up to 1-2% of the world population have this condition. The treatment of hard-to-heal wounds is expensive and long-term process, and, stresses healthcare systems of every country. Unfortunately, lim...

  12. Biomarkers of Disease and Treatment in Murine and Cynomolgus Models of Chronic Asthma

    OpenAIRE

    Jennifer Louten,; Mattson, Jeanine D.; Maria-Christina Malinao; Ying Li; Claire Emson; Felix Vega; Robert L. Wardle; Scott, Michael R.; Fick, Robert B.; McClanahan, Terrill K.; Rene de Waal Malefyt; Maribel Beaumont

    2012-01-01

    Background Biomarkers facilitate early detection of disease and measurement of therapeutic efficacy, both at clinical and experimental levels. Recent advances in analytics and disease models allow comprehensive screening for biomarkers in complex diseases, such as asthma, that was previously not feasible. Objective Using murine and nonhuman primate (NHP) models of asthma, identify biomarkers associated with early and chronic stages of asthma and responses to steroid treatment. Methods The tot...

  13. Preventive non–pharmacological treatment and nitric oxide in chronic migraine

    OpenAIRE

    Ciancarelli, I.; Tozzi–Ciancarelli, M. G.; Di Massimo, C.; Olivieri, L; Carolei, A.

    2005-01-01

    In chronic migraine the central sensitisation and the changes of regional cerebral blood flow are mediated by nitric oxide (NO) and oxygen free radicals. Biofeedback is considered a preventive non–pharmacological treatment decreasing migraine attacks. We investigated whether biofeedback effectiveness is related to relaxation processes and its influence on oxidative stress. The Migraine Disability Assessment Score (MIDAS) and serum NO stable metabolites (NO x ) were evaluated in 20 patients wi...

  14. Serotonergic neurotransmission in the ventral hippocampus is enhanced by corticosterone and altered by chronic amphetamine treatment

    OpenAIRE

    Barr, Jeffrey L.; Forster, Gina L.

    2011-01-01

    The ventral hippocampus modulates anxiety-like behavior in rats, and serotonergic transmission within the hippocampus facilitates adaptation to stress. Chronic amphetamine treatment results in anxiety-like behavior in rats and reduced monoamine concentrations in the ventral hippocampus. Since reduced hippocampal serotonergic transmission in response to stress is observed in rats that display high anxiety-like behavior, anxiety states in amphetamine-treated rats may be associated with reduced ...

  15. Methylene blue laser therapy for the treatment of chronic maxillary sinusitis

    Science.gov (United States)

    Bashkatov, Alexey N.; Genina, Elina A.; Tuchin, Valery V.; Chikina, Elena E.; Knyazev, Anatoly B.; Mareev, Oleg V.

    2005-08-01

    The clinical results of photodynamic therapy of chronic maxillary sinusitis have been demonstrated. Obtained results show that the photodynamic therapy is effective in comparison with conservative methods of treatment of the disease. Diffusion of Methylene Blue in the mucous tissue has been studied in vitro and value of the diffusion coefficient of Methylene Blue in the tissue has been estimated at 20°C as (4.8+/-2.9)×10-7 cm2/sec.

  16. Acupuncture for the treatment of chronic obstructive pulmonary disease: a protocol of a systematic review

    OpenAIRE

    Choi, Tae-Young; Jun, Ji Hee; Choi, Jun-Young; Kim, Jong-In; Lee, Myeong Soo; Ernst, Edzard

    2014-01-01

    Introduction This review aims to evaluate the efficacy of acupuncture in the treatment of chronic obstructive pulmonary disease (COPD). Methods and analysis 14 databases will be searched from their inception. These include PubMed, AMED, EMBASE, the Cochrane Library, seven Korean medical databases (Korean Studies Information Service System, DBPIA, Oriental Medicine Advanced Searching Integrated System, Research Information Service System, KoreaMed, The Town Society of Science Technology and th...

  17. Safety and Efficacy of Ranolazine for the Treatment of Chronic Angina Pectoris

    OpenAIRE

    Mohammed Aldakkak; Stowe, David F; Camara, Amadou K.S.

    2013-01-01

    Coronary heart disease is a global malady and it is the leading cause of death in the United States. Chronic stable angina is the most common manifestation of coronary heart disease and it results from the imbalance between myocardial oxygen supply and demand due to reduction in coronary blood flow. Therefore, in addition to lifestyle changes, commonly used pharmaceutical treatments for angina (nitrates, β-blockers, Ca2+ channel blockers) are aimed at increasing blood flow or decreasing O2 de...

  18. A critical appraisal of ibrutinib in the treatment of mantle cell lymphoma and chronic lymphocytic leukemia

    OpenAIRE

    Tucker DL; Rule SA

    2015-01-01

    David L Tucker, Simon A Rule Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK Abstract: Although chemo-immunotherapy remains at the forefront of first-line treatment for mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL), small molecules, such as ibrutinib, are beginning to play a significant role, particularly in patients with multiply relapsed or chemotherapy-refractory disease and where toxicity is an overriding concern. Ibrutinib is a first-in-class, ...

  19. Effects of chronic fluoxetine treatment on neurogenesis and tryptophan hydroxylase expression in adolescent and adult rats

    OpenAIRE

    Klomp, A.; Václavů, L.; Meerhoff, G.F.; Reneman, L.; Lucassen, P J

    2014-01-01

    The antidepressant drug fluoxetine (Prozac) has been increasingly prescribed to children and adolescents with depressive disorders despite a lack of thorough understanding of its therapeutic effects in the paediatric population and of its putative neurodevelopmental effects. Within the framework of PRIOMEDCHILD ERA-NET, we investigated; a) effects of chronic fluoxetine treatment on adult hippocampal neurogenesis, a structural readout relevant for antidepressant action and hippocampal developm...

  20. Compliance to treatment in patients with chronic illness: A concept exploration

    OpenAIRE

    Rafii, Forough; Fatemi, Naima Seyed; Danielson, Ella; Johansson, Christina Melin; Modanloo, Mahnaz

    2014-01-01

    Background: Patients’ compliance to treatment is an important indicator for evaluating the successful management in chronic illnesses. Despite the fact an applicable definition of compliance is required to suitable intervention and research, this concept is not clear and there is no consensus concerning its meaning, definition, and measurement. The aim of this study was to explore the concept of compliance and to formulate a working definition. Materials and Methods: Theoretical phase of Schw...

  1. Hypnosis as a treatment of chronic widespread pain in general practice: A randomized controlled pilot trial

    Directory of Open Access Journals (Sweden)

    Grøndahl Jan

    2008-09-01

    Full Text Available Abstract Background Hypnosis treatment in general practice is a rather new concept. This pilot study was performed to evaluate the effect of a standardized hypnosis treatment used in general practice for patients with chronic widespread pain (CWP. Methods The study was designed as a randomized control group-controlled study. Sixteen patients were randomized into a treatment group or a control group, each constituting eight patients. Seven patients in the treatment group completed the schedule. After the control period, five of the patients in the control group also received treatment, making a total of 12 patients having completed the treatment sessions. The intervention group went through a standardized hypnosis treatment with ten consecutive therapeutic sessions once a week, each lasting for about 30 minutes, focusing on ego-strengthening, relaxation, releasing muscular tension and increasing self-efficacy. A questionnaire was developed in order to calibrate the symptoms before and after the 10 weeks period, and the results were interpolated into a scale from 0 to 100, increasing numbers representing increasing suffering. Data were analyzed by means of T-tests. Results The treatment group improved from their symptoms, (change from 62.5 to 55.4, while the control group deteriorated, (change from 37.2 to 45.1, (p = 0,045. The 12 patients who completed the treatment showed a mean improvement from 51.5 to 41.6. (p = 0,046. One year later the corresponding result was 41.3, indicating a persisting improvement. Conclusion The study indicates that hypnosis treatment may have a positive effect on pain and quality of life for patients with chronic muscular pain. Considering the limited number of patients, more studies should be conducted to confirm the results. Trial Registration The study was registered in ClinicalTrials.gov and released 27.08.07 Reg nr NCT00521807 Approval Number: 05032001.

  2. Aquolab ® ozone-therapy is an efficient adjuvant in the treatment of chronic periodontitis: A case-control study

    OpenAIRE

    Francesco Carinci; Annalisa Palmieri; Ambra Girardi; Francesca Cura; Dorina Lauritano

    2015-01-01

    Aim: The objective of this study was to compare the efficacy of supportive periodontal therapy (i.e., scaling and root planning [SRP]) alone versus Aquolab ® ozone therapy used in association with SRP in the treatment of chronic periodontitis in adult patients. Materials and Methods: A total of 20 patients with a diagnosis of chronic periodontitis (40 localized chronic periodontitis sites) were enrolled. None of these patients have previously received any surgical or nonsurgical periodontal t...

  3. Assessing Temperature-Controlled Radiofrequency Tonsil Ablation for Treatment of Halitosis Caused by Chronic Tonsillitis with Caseum

    OpenAIRE

    F Hashemian; H. Jafari Moez; F. Farahani; M.A. Seifrabei

    2015-01-01

    Introduction & Objective: Chronic tonsillitis with caseum has been proven to be the cause of halitosis. The objective of this study was to evaluate the efficacy and safety of temperature-controlled radiofrequency tonsil ablation in the treatment of halitosis caused by chronic tonsil-litis with caseum. Materials & Methods: In this clinical trial study 28 adult patients with halitosis due to chronic tonsillitis with caseum were treated by temperature-controlled radiofrequency tonsil ablation an...

  4. Clostridium difficile Infection: A Rarity in Patients Receiving Chronic Antibiotic Treatment for Crohn’s Disease

    Science.gov (United States)

    Roy, Abhik; Lichtiger, Simon

    2016-01-01

    Background Prolonged antibiotic use is limited by several adverse effects, one of which is Clostridium difficile infection (CDI). The aim of this study was to determine the incidence of CDI in patients receiving chronic antibiotic treatment for Crohn’s disease (CD). Methods We conducted a retrospective review of 100 patients with CD for which ≥6 months of outpatient antibiotic therapy was prescribed. Data were collected regarding demographics, CD phenotype, treatment history, and CDI. The incidence of CDI in our patient population was calculated and compared with historical controls. Results 100 patients were studied—60% of men, mean age 23.9 years at CD diagnosis. Eighty-two percent had disease involving the ileum, and 33% had disease involving the colon. The mean duration of antibiotic therapy was 39.6 months (range, 6–217 months). The most commonly prescribed classes of antibiotics were fluoroquinolones (84%), penicillins (57%), and cephalosporins (32%). Forty-nine percent of patients were treated with concomitant thiopurines, 45% with budesonide, and 41% with biologics. The overall incidence of CDI was 2%. This incidence of CDI was lower than previously reported for non-CD patients receiving chronic antibiotics for continuous-flow left ventricular assist device infections (12.5%) and orthopedic prosthesis infections (22.2%). Conclusions The incidence of CDI is rare in patients receiving chronic antibiotic treatment for CD, and it seems significantly lower than for non-CD populations reported in the literature. PMID:26650148

  5. THERAPEUTIC EFFECT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN DIABETIC CHINESE

    Institute of Scientific and Technical Information of China (English)

    YANG Yun-zhu(杨芸珠); SUN Zhe(孙喆); HU Chun-zhen(胡纯贞); YANG Yu-guo(杨裕国); JIN Li-jian(金力坚); LEUNG Hui-qiang(梁惠强); Esmond F Corbet

    2004-01-01

    Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese with chronic periodontitis. Methods Moderate to advanced chronic periodontitis (CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fiuctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PH), gingival index (Gl), bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (AL)of all patients were recorded at 6 sites on each tooth at the baseline and 1,3 and 6 months after oral hygiene instruction ( OHI) , scaling and root planing. Results It was found that the short-term effect of non-surgical periodontal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.

  6. Application of aqueous dispersions of silver nanostructures for treatment of pyoinflammatory diseases with a chronic component

    International Nuclear Information System (INIS)

    Bactericidal properties of aqueous dispersions of oxide silver nanostructures (ADSN) produced by means of pulsed electric discharges (PED) in water can use in surgery for treatment of upper purulent wounds with a chronic component. The patients with such wounds are of large number and differ on etiology of diseases but their mutual feature is long treatment without marked positive changes. Thus long application of antibiotics leads to abnormality of immune processes and antibacterial resistance of microbial flora. Moreover, local antiseptics are frequently toxic and one can oppress processes of reparation in a wound. The investigation is addressed to finding out the opportunity of usage of an ADSN for treatment of purulent wounds with a chronic component and comparison of its efficiency with the sodium hypochlorite. At investigation, the ADSN formed at PED of 5 - 10 μs duration, with highest share of 'small' (hydrodynamic diameter ≤ 100 nm) nanostructures and greatest surface electric charge we used. It was found that the usage of ADSN during the first 5 days characterized by high active reparative processes with their maximum at 3rd - 4th days and subsequent moderate further healing. At local use of ADSN, there were no cellular atypia and preternatural representations about inflammatory reactions. It is possible to assume that usage of ADSN will allow in prospect to correct the practice of out-patient therapy of chronic and slow pyoinflammatory diseases.

  7. The Needle-Rolling Therapy for Treatment of Non-organic Chronic Insomnia in 90 Cases

    Institute of Scientific and Technical Information of China (English)

    HUANG Li-sha; WANG Dan-lin; WANG Cheng-wei; HU You-ping; ZHOU Jian-wei; LI Ning

    2009-01-01

    To evaluate the therapeutic effects of needle-rolling therapy for chronic insomnia. Methods: In the present multi-central randomly controlled clinical study, 180 cases of chronic insomnia were randomly divided into the following two groups, a treatment group (90 cases) treated by the needle-rolling therapy and a control group (90 cases) treated with clonopin. The treatment course for both the two groups was 4 weeks. The therapeutic effects were evaluated based on improvement of the TCM symptoms and the Pittsburgs's sleep-quality index (PSQI). Results: After treatment, there were significant differences between the two groups in the effective rate (P<0.05), and in the total score of PSQI and in the scores of the 4 sub-items, i.e. sleep-quality, sleep-efficiency, hypnotic and daytime function (P<0.05). Although there was no significant difference between the two groups in the effective rate after a 3-month follow-up period, significant differences still existed in the 3 sub-items of sleep-efficiency, hypnotic, and daytime function of the PSQI (P<0.05). Conclusion: As compared with hypnotics of the second generation, the needle-rolling therapy may show better therapeutic effects for chronic insomnia patients.

  8. Dose-response curve to salbutamol during acute and chronic treatment with formoterol in COPD

    Directory of Open Access Journals (Sweden)

    La Piana GE

    2011-07-01

    Full Text Available Giuseppe Emanuele La Piana¹, Luciano Corda², Enrica Bertella¹, Luigi Taranto Montemurro¹, Laura Pini¹, Claudio Tantucci¹¹Cattedra di Malattie dell'Apparato Respiratorio, Università di Brescia, ²Prima Divisione di Medicina Interna, Spedali Civili, Brescia, ItalyBackground: Use of short-acting ß2-agonists in chronic obstructive pulmonary disease (COPD during treatment with long-acting ß2-agonists is recommended as needed, but its effectiveness is unclear. The purpose of this study was to assess the additional bronchodilating effect of increasing doses of salbutamol during acute and chronic treatment with formoterol in patients with COPD.Methods: Ten patients with COPD underwent a dose-response curve to salbutamol (until 800 µg of cumulative dose after a 1-week washout (baseline, 8 hours after the first administration of formoterol 12 µg (day 1, and after a 12-week and 24-week period of treatment with formoterol (12 µg twice daily by dry powder inhaler. Peak expiratory flow, forced expiratory volume in one second (FEV1, forced vital capacity, and inspiratory capacity were measured at the different periods of treatment and at different steps of the dose-response curve.Results: Despite acute or chronic administration of formoterol, maximal values of peak expiratory flow, FEV1, and forced vital capacity after 800 µg of salbutamol were unchanged compared with baseline. The baseline FEV1 dose-response curve was steeper than that at day 1, week 12, or week 24 (P < 0.0001. Within each dose-response curve, FEV1 was different only at baseline and at day 1 (P < 0.001, when FEV1 was still greater at 800 µg than at 0 µg (P < 0.02. In contrast, the forced vital capacity dose-response curves were similar at the different periods, while within each dose-response curve, forced vital capacity was different in all instances (P < 0.001, always being higher at 800 µg than at 0 µg (P < 0.05.Conclusion: In patients with stable COPD, the maximal effect

  9. The Results of Intraosseous Drilling and Decompression in the Treatment of Chronic Anterior Knee Pain

    Directory of Open Access Journals (Sweden)

    Saberi S

    2012-01-01

    Full Text Available Background: Anterior knee pain is one of the most common complaints of patients in orthopedic clinics. The first step in the treatment of this problem is conservative treatment which includes administration of anti-inflammatory drugs, exercise and changes in life style. Many patients respond well to these measures in about six months, but a small number of patients may not respond to the conservative treatment; therefore, surgical procedures such as Maquet osteotomy or lateral retinacular release may be needed in these cases. The aim of this study was to determine the efficacy of intraosseous drilling and decompression of patella in the treatment of chronic anterior knee pain.Methods : This study was performed as a case series on ten patients with chronic anterior knee pain attending the Orthopedic Clinic of Imam Khomeini Hospital, in Tehran, Iran in 2009-2010. Eight of the patients were male and the rest were female. The patients met the inclusion criteria and were followed up for at least 12 months after the surgery. Results : The mean age of the patients was 27.8±4.66 yr and their mean BMI was 22.5±1.71 kg/m2. The mean pain severity before the interventions was 8.2±0.78 based on VAS but it decreased to 2.5±1.26 post-surgically. An average reduction of 5.7 scores were noticed in pain severity depicting a significant reduction of pain (P<0.0001.Conclusion: It may be concluded that intraosseous drilling and decompression of patella is a safe and effective method in the treatment of chronic anterior knee pain not responding to conservative treatment.

  10. Comparison of botox and lateral internal sphincterotomy treatment outcomes in chronic anal fissures

    Directory of Open Access Journals (Sweden)

    Tolga Dinç

    2014-03-01

    Full Text Available Objective: Both botox and lateral internal sfinkterotomi are treatment technics used in chronic anal fissure; provide the relaxation of anal sphincter and as a result of this, healing occurs. Aim of this study is to compare efficacy of botox and LIS treatment in chronic anal fissure and discussing with the literature. Methods: 60 of 66 patients who has chronic anal fissure, that we reached, treated but not healed with medical therapy, appealed to the Dr. Sami Ulus Hospital included the study. Gender, age, fissure localization, complaints (pain, bleeding, itching, constipation, complaint length, recurrences after treatment, continence conditions and complications of patients were registered. Results: Sixty patients were enrolled the study. Of the 60 patients; 38(63.3% were male and 22 (27.7% were female. Mean age of all patients was 35.93 ± 11.45 (21 -60. Pain was the common complaint of the all patients. 10 (32.3% recurrence were detected in botox treatment group (Group-I, only 1 (3.4% recurrence was in LIS group (Group-II. There was no complication as an incontinence in group-I but 3 cases with incontinence (10.39% were obtained in group-II. In the evaluation of these 3 cases by Cleveland Clinic Continence Scoring System, 2 cases classified as gas incontinence and 1 case as moderate fecal incontinence. Conclusion: Although botulinum toxin injection seen as an alternative treatment method with low complication rates such as incontinence, high recurrence is an important shortcoming of this technic. LIS performed by experienced surgeons remained the most popular treatment modality with low complication rates and great deal of healing success.

  11. Potential role of ustekinumab in the treatment of chronic plaque psoriasis

    Directory of Open Access Journals (Sweden)

    Santo Raffaele Mercuri

    2010-05-01

    Full Text Available Santo Raffaele Mercuri1, Luigi Naldi21Unità di Dermatologia, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Università Vita-Salute, Milano, Italy; 2Centro Studi GISED, Fondazione per la Ricerca Ospedale Maggiore, Unità di Dermatologia, Ospedali Riuniti, Bergamo, ItalyAbstract: Psoriasis is a relatively common, chronic and disabling skin disease, with an immune-related pathogenesis and a genetic background which may be triggered by several environmental factors including smoking and infections. There is no cure but several treatment options are available. The treatment of psoriasis is far from being satisfactory due to impractical modalities of topical treatment and suboptimal safety profile of the systemic treatments available. In the last few years, parallel to an improved understanding of the disease pathogenesis, there has been a boost in research on new agents for the treatment of psoriasis. Ustekinumab, a monoclonal antibody targeting the p40 subunit of interleukin (IL-12 and IL-23, is one such new agent. Psoriasis and its management are briefly reviewed before focusing on the evidence for ustekinumab in the treatment of chronic plaque psoriasis through a systematic search of the main registries of ongoing trials up to December 2009. Ustekinumab proved to be very effective short term in the control of clinical manifestations in psoriasis compared with placebo and with etanercept. Long-term and comparative data are still limited. There is a need for continuing research on the long-term effectiveness and safety of the drug.Keywords: ustekinumab, chronic plaque psoriasis

  12. β-Cyclodextrins enhance artemisinin production in Artemisia annua suspension cell cultures.

    Science.gov (United States)

    Durante, Miriana; Caretto, Sofia; Quarta, Angela; De Paolis, Angelo; Nisi, Rossella; Mita, Giovanni

    2011-06-01

    Artemisinin is a sesquiterpene antimalarial compound produced, though at low levels (0.1-1% dry weight), in Artemisia annua in which it accumulates in the glandular trichomes of the plant. Due to its antimalarial properties and short supply, efforts are being made to improve our understanding of artemisinin biosynthesis and its production. Native β-cyclodextrins, as well as the chemically modified heptakis(2,6-di-O-methyl)-β-cyclodextrin (DIMEB) and 2-hydroxypropyl-β-cyclodextrins, were added to the culture medium of A. annua suspension cultures, and their effects on artemisinin production were analysed. The effects of a joint cyclodextrin and methyl jasmonate treatment were also investigated. Fifty millimolar DIMEB, as well as a combination of 50 mM DIMEB and 100 μM methyl jasmonate, was highly effective in increasing the artemisinin levels in the culture medium. The observed artemisinin level (27 μmol g(-1) dry weight) was about 300-fold higher than that observed in untreated suspensions. The influence of β-cyclodextrins and methyl jasmonate on the expression of artemisinin biosynthetic genes was also investigated. PMID:21468706

  13. [Pathophysiology, diagnosis and treatment of asthma: focusing on a chronic disease].

    Science.gov (United States)

    Wäsche, Anja; Schreiber, Jens

    2016-06-01

    Bronchial asthma is one of the most common chronic diseases. Its pathogenesis is still not fully understood and its progression is still not predictable. There are individual differences in frequency, severity and duration of symptoms and progression as well as in the response to therapy. The diagnosis is based on a detailed medical history and physical examination, on lung function tests and allergy tests. In recent years great improvements in medical treatment and patient care have been achieved. This article summarizes the pathogenesis, clinical picture, diagnosis and treatment of bronchial asthma. PMID:27359238

  14. Improving the treatment outcome of patients with chronic lymphocytic leukemia through targeted antibody therapy.

    Science.gov (United States)

    Stephens, Deborah M; Byrd, John C

    2013-04-01

    Therapy for chronic lymphocytic leukemia (CLL) has evolved dramatically throughout the years. In 1997, rituximab (Rituxan), a CD20 monoclonal antibody (mAb), became the first mAb approved by the Food and Drug Administration for marketing in the treatment of cancer, specifically targeting B-cell malignancies. Over the last 10 years, rituximab or other mAbs including alemtuzumab and ofatumumab have become an integral part of the standard of care for CLL patients as single agents or in combination with chemotherapy or other immunotherapy. This review discusses the currently approved and novel mAbs for the treatment of CLL. PMID:23561475

  15. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Woods JA

    2014-05-01

    Full Text Available J Andrew Woods,1 James S Wheeler,1 Christopher K Finch,2 Nathan A Pinner3 1School of Pharmacy, Wingate University, Wingate, NC, USA; 2Department of Pharmacy, Methodist University Hospital, Memphis, TN, USA; 3Harrison School of Pharmacy, Auburn University, Auburn, AL, USA Background: Chronic obstructive pulmonary disease (COPD is a chronic and progressive disease that affects an estimated 10% of the world's population over the age of 40 years. Worldwide, COPD ranks in the top ten for causes of disability and death. Given the significant impact of this disease, it is important to note that acute exacerbations of COPD (AECOPD are by far the most costly and devastating aspect of disease management. Systemic steroids have long been a standard for the treatment of AECOPD; however, the optimal strategy for dosing and administration of these medications continues to be debated. Objective: To review the use of corticosteroids in the treatment of acute exacerbations of COPD. Materials and methods: Literature was identified through PubMed Medline (1950–February 2014 and Embase (1950–February 2014 utilizing the search terms corticosteroids, COPD, chronic bronchitis, emphysema, and exacerbation. All reference citations from identified publications were reviewed for possible inclusion. All identified randomized, placebo-controlled trials, meta-analyses, and systematic reviews evaluating the efficacy of systemic corticosteroids in the treatment of AECOPD were reviewed and summarized. Results: The administration of corticosteroids in the treatment of AECOPD was assessed. In comparison to placebo, systemic corticosteroids improve airflow, decrease the rate of treatment failure and risk of relapse, and may improve symptoms and decrease the length of hospital stay. Therefore, corticosteroids are recommended by all major guidelines in the treatment of AECOPD. Existing literature suggests that low-dose oral corticosteroids are as efficacious as high

  16. Gene therapy by electroporation for the treatment of chronic renal failure in companion animals

    OpenAIRE

    Pope Melissa A; Bodles-Brakhop Angela M; Brown Patricia A; Draghia-Akli Ruxandra

    2009-01-01

    Abstract Background Growth hormone-releasing hormone (GHRH) plasmid-based therapy for the treatment of chronic renal failure and its complications was examined. Companion dogs (13.1 ± 0.8 years, 29.4 ± 5.01 kg) and cats (13.2 ± 0.9 years, 8.5 ± 0.37 kg) received a single 0.4 mg or 0.1 mg species-specific plasmid injection, respectively, intramuscularly followed by electroporation, and analyzed up to 75 days post-treatment; controls underwent electroporation without plasmid administration. Res...

  17. Medicinal Herbs Used in Pairs for Treatment of 98 Cases of Chronic Gastritis

    Institute of Scientific and Technical Information of China (English)

    夏建忠

    2004-01-01

    Objective: Chronic gastritis was treated with herbal pairs in order to reduce the side effects and raise the therapeutic effects. Method: The outpatients were randomly divided into a treatment group treated with herbal pairs and a control group treated with Banxia Xiexin Tang (Pinellia Decoction for Purging the Stomach-fire). Result: The total effective rate in the treatment group was 96%, higher than that in the control group (P<0.05). Conclusion: With the basic theory of traditional Chinese medicine as guiding principles, herbal pairs have two-way regulatory effects, that is, reducing the side effects and raising the therapeutic effects.

  18. [Treatment of anemia in patients with chronic renal insufficiency with recombinant human erythropoietin].

    Science.gov (United States)

    Djukanović, Lj; Lezaić, V

    1996-01-01

    The discovery of recombinant human erythropoietin has enabled treatment of anaemia in patients whose anaemia was primarily caused by the lack of erythropoietin. This agent was most widely used in the treatment of anaemia in chronic renal failure patients. Non-regulated hypertension is considered to be the only absolute contraindication for recombinant human erythropoietin application, but thrombocytosis, predisposition to thromboses of arterio-venous fistulae, and convulsions are regarded as relative contraindications. Recombinant human erythropoietin may be administered intravenously, but the subcutaneous route is considered more rational. The treatment is initiated by low doses with gradual dose increase, what enables gradual anaemia correction and prevents the appearance of adverse effects. Haemoglobin level of around 100 g/l is considered the target haemoglobin level. The majority of patients respond well to treatment by human recombinant erythropoietin and the absence of anaemia improvement may be the result of iron deficiency, occult haemorrhages, chronic infection, inadequate dialysis, secondary hyperparathyroidism, aluminium intoxication. Anaemia improvement during the treatment with recombinant erythropoietin leads to the improvement of function of most organs and the quality of life in general as well as avoidance of blood transfusions and their adverse effects. The most frequent adverse effect of recombinant erythropoietin is the development of iron deficiency or hypertension aggravation. PMID:9102827

  19. Behavioural and neuroplastic properties of chronic lurasidone treatment in serotonin transporter knockout rats.

    Science.gov (United States)

    Luoni, Alessia; Hulsken, Sjoerd; Cazzaniga, Greta; Racagni, Giorgio; Homberg, Judith R; Riva, Marco A

    2013-07-01

    Second-generation antipsychotics (SGA) are multi-target agents widely used for the treatment of schizophrenia and bipolar disorder that also hold potential for the treatment of impaired emotional control, thanks to their diverse receptor profiles as well as their potential in modulating neuroadaptive changes in key brain regions. The aim of this study was thus to establish the ability of lurasidone, a novel SGA characterized by a multi-receptor signature, to modulate behavioural and molecular defects associated with a genetic model of impaired emotional control, namely serotonin transporter knockout (SERT KO) rats. At behavioural level, we found that chronic lurasidone treatment significantly increased fear extinction in SERT KO rats, but not in wild-type control animals. Moreover, at molecular level, lurasidone was able to normalize the reduced expression of the neurotrophin brain-derived neurotrophic factor in the prefrontal cortex of SERT KO rats, an effect that occurred through the regulation of specific neurotrophin transcripts (primarily exon VI). Furthermore, chronic lurasidone treatment was also able to restore the reduced expression of different GABAergic markers that is present in these animals. Our results show that lurasidone can improve emotional control in SERT KO rats, with a primary impact on the prefrontal cortex. The adaptive changes set in motion by repeated treatment with lurasidone may in fact contribute to the amelioration of functional capacities, closely associated with neuronal plasticity, which are deteriorated in patients with schizophrenia, bipolar disease and major depression. PMID:23164505

  20. Evaluation of the Quality of Life after Surgical Treatment of Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    Philipp Hildebrand

    2011-07-01

    Full Text Available Objective Pain is the main symptom of chronic pancreatitis. However, in addition to an improvement in pain symptoms, an increase in the quality of life also influences therapeutic success. The present paper evaluates the influence of surgery on chronic pancreatitis, and the early and late postoperative quality of life. Patients From March 2000 until April 2005, 51 patients underwent surgical treatment for chronic pancreatitis at our institution. Intervention Thirty-nine (76.5% patients were operated on according to the Frey procedure and, in 12 (23.5% patients, a Whipple procedure was performed. Study design Patient data were documented throughout the duration of the hospital stay. Postoperative follow-up data were recorded retrospectively. Main outcome measures Postoperative follow-up with postoperative pain scores and quality of life were carried out using a standardized questionnaire. Results During a median follow-up period of 50 months, an improvement in pain scores was observed in 92.3% of the patients in the Frey group and in 66.7% in the Whipple group. The indices for global quality of life and for physical and emotional status increased in both surgical groups. Conclusion For patients with chronic pancreatitis, the decisive factor is the quality of life, particularly concerning pain and metabolic changes. The Frey procedure seems to offer advantages with respect to long-term freedom of pain and low risk of surgery-induced pancreatic insufficiency.

  1. Tapentadol extended-release for treatment of chronic pain: a review

    Directory of Open Access Journals (Sweden)

    Vadivelu N

    2011-08-01

    Full Text Available Nalini Vadivelu1, Alexander Timchenko1, Yili Huang2, Raymond Sinatra11Department of Anesthesiology, Yale University School of Medicine, New Haven, CT; 2Internal Medicine, North Shore-LIJ Plainview Hospital, Plainview, NY, USAAbstract: Tapentadol is a centrally acting analgesic with a dual mechanism of action of mu receptor agonism and norepinephrine reuptake inhibition. Tapentadol immediate-release is approved by the US Food and Drug Administration for the management of moderate-to-severe acute pain. It was developed to decrease the intolerability issue associated with opioids. Tapentadol extended-release has a 12-hour duration of effect, and has recently been evaluated for pain in patients with chronic osteoarthritis, low back pain, and pain associated with diabetic peripheral neuropathy. Tapentadol extended-release was found to provide safe and highly effective analgesia for the treatment of chronic pain conditions, including moderate-to-severe chronic osteoarthritis pain and low back pain. Initial trials demonstrating efficacy in neuropathic pain suggest that tapentadol has comparable analgesic effectiveness and better gastrointestinal tolerability than opioid comparators, and demonstrates effectiveness in settings of inflammatory, somatic, and neuropathic pain. Gastrointestinal intolerance and central nervous system effects were the major adverse events noted. Tapentadol will need to be rigorously tested in chronic neuropathic pain, cancer-related pain, and cancer-related neuropathic pain.Keywords: osteoarthritis, neuropathic pain, analgesic, opioids, norepinephrine

  2. Alpha9 alpha10 nicotinic acetylcholine receptors as target for the treatment of chronic pain.

    Science.gov (United States)

    Del Bufalo, Alessandra; Cesario, Alfredo; Salinaro, Gianluca; Fini, Massimo; Russo, Patrizia

    2014-01-01

    Chronic pain is a widespread healthcare problem affecting not only the patient but in many ways all the society. Chronic pain is a disease itself that endures for a long period of time and it is resistant to the majority of medical treatments that provide modest improvements in pain and minimum improvements in physical and emotional functioning. More co-existing chronic pain conditions may be present in the same individual (patient). The α9α10 nicotinic acetylcholine receptor (nAChR) may be a potential target in the pathophysiology of chronic pain, as well in the development of breast and lung cancers. α-conotoxins (α-CNT) are small peptides used offensively by carnivorous marine snails known as Conus that target nAChR. Among α-CNT there are potent and selective antagonists of α9α10 nAChR such as RgIA and Vc1.1 that produces both acute and long lasting analgesia. Moreover, these peptides accelerate the recovery of nerve function after injury, likely through immune/inflammatory-mediated mechanisms. We review the background, findings, implications and problems in using compounds that act on α9α10 nAChR. PMID:24641230

  3. A retrospective analysis of a human cellular repair matrix for the treatment of chronic wounds.

    Science.gov (United States)

    Regulski, Matthew; Jacobstein, Douglas A; Petranto, Russell D; Migliori, Vincent J; Nair, Girish; Pfeiffer, Darelle

    2013-12-01

    Despite the introduction of advanced wound care modalities over the last 15 years, chronic wounds are an increasing problem. Few single options are available for clinicians to treat recalcitrant wounds such as diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). A retrospective, single-center study was conducted at an outpatient wound care center to evaluate the clinical effect of a human cellular repair matrix (h-CRM) on chronic wounds that had failed to heal. Data from all patients who had received this treatment modality during a period of 2 years were abstracted. Standard care included weekly visits, regular debridement, offloading DFUs, compression for VLUs, and h-CRM for wounds >4 weeks duration. A total of 66 patients (30 male, 36 female, mean age 71.1 [± 8.8] years) received h-CRM treatment for 67 wounds (34 VLUs, 27 DFUs, and six other chronic wounds). The average wound size at baseline was 6.65 (± 9.68) cm2, and the average wound duration before h-CRM treatment was 38 (±70.8) weeks. Fifty (50) patients (74.6%) had failed to heal using other advanced therapies. After 12 weeks of care, 51 of the 67 wounds (76.1%) were healed: 23 of 34 (67.6%) VLUs and 23 of 27 (85.2%) DFUs. Average time to closure in these wounds was 5.8 (±2.5) weeks. No significant differences were found between proportions of VLUs and DFUs healed. No adverse events or recurrences occurred during an average follow-up time of 20.4 months (range 11 to 32 months). Overall, patients received an average of 3.8 applications of h-CRM, and 3.2 applications were used among patients that healed. The study results suggest h-CRM may benefit patients with chronic wounds. Prospective, randomized clinical studies are warranted. PMID:24334364

  4. Nucleos(tide analogues treatment outcome in genotype B and C chronic hepatitis B

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    Myo Nyein Aung

    2010-01-01

    Full Text Available Background : Hepatitis B genotypes influence the course and severity of the disease. Aim: To compare the treatment outcome of chronic hepatitis B genotype B and C patients after treating with nucleos(tide analogues for six months. Patients and Methods: Forty chronic hepatitis B patients attending the liver clinic of Hospital for Tropical diseases, Bangkok, were studied in retrospective cohort design. Six genotype B patients (15% and thirty-four genotype C patients (85% were treated. Serum hepatitis B viral load , serum alanine amino transferase level, HBeAg status and alpha-feto protein level were measured at the time of starting nucleos(t analogues therapy, and six months later. Besides, achievement of undetectable viral load was assessed in patients with normal serum alanine amino transferase compared to patients with high serum alanine amino transferase level. Results: After six months of nucleos (t analogues treatment, achievement of undetectable hepatitis B viral load was higher in genotype B patients (66.7% than in genotype C patients (42.4% (Relative Risk=1.57, 0.79-3.14. Biochemical remission, HBeAg seroconversion and tumor marker levels between the two groups were not significantly different. Moreover, achievement of undetectable hepatitis B viral load was significantly higher in normal alanine amino transferase level (75% than in patients with high serum alanine amino transferase level (33.3% on nucleos(tide analogue treatment (Relative Risk=2.25, 1.20- 4.20. Conclusion: Chronic hepatitis B treatment outcome between genotype B and C were not significantly different. Patients with normalized serum alanine amino transferase level tend to achieve undetectable viral load after nucleoside analogues treatment.

  5. Efficacy of H, antihistamine, corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria

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    Kumar Rajesh

    2002-01-01

    Full Text Available H, antihistamines relieve urticaria by blocking the action of histamine on the target tissue, while demonstration of autoantibodies in the sera of a proportion of the patients having chronic idiopathic urticaria, use of immunosuppressive drugs for the treatment of these patients has acquired the greater rationality. We evaluated the role of corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria. Twenty-five patients, 13 males and 12 females, between 18-53 years in age, having chronic dermographic urticaria were taken up for this study. The patients were divided into three groups. Group I patients (n=9 were treated with cetirizine hydrochloride 10 mg per day orally, group II patients (n=7 were treated with betamethasone 2 mg along with cyclophosphamide 50 mg along with cetirizine 10 mg per day for a total period of 4 weeks. The patients were evaluated every week to record the therapeutic response and side effects, and then followed up without treatment for a period of 6 months to look for recurrence of the urticaria, if any. Six patients in group I and all the patients in group II and group III had complete remission while the remaining patients in group I had partial relief. The side effects included drowsiness in 4 patients. All the patients in group II had weight gain, 4 patients had acne and 2 patients developed cushingoid features. Majority of the patients relapsed within 3 days after stopping the treatment. Supplementation of the treatment with oral corticosteroids or cyclophosphamide was more effective in controlling the symptoms as compared to cetirizine alone. But a four weeks supplementation was not adequate for preventing the relapses when the drugs were withdrawn.

  6. Immobilization and stabilization of cyclodextrin glucanotransferase

    Czech Academy of Sciences Publication Activity Database

    Ivanova, V.; Šafaříková, Miroslava

    VII, - (2008), s. 80-83. ISSN N R&D Projects: GA MPO(CZ) 2A-1TP1/094 Institutional research plan: CEZ:AV0Z60870520 Keywords : cyclodextrin glucanotransferase * immobilization Subject RIV: CE - Biochemistry

  7. Effect of chronic Maluoling treatment on plasma contents of ET in patients with COPD

    International Nuclear Information System (INIS)

    Objective: To study the effect of maluoling treatment on plasma ET contents in patients with COPD. Methods: Plasma ET contents were measured with RIA at admission one year later in (1) 45 patients with COPD treated with 4 courses of maluoling and (2) 82 patients with COPD without maluoling treatment. Results: The plasma ET contents in the two groups of COPD patients were not much different at admission (80.49 ± 29.67pg/ml vs 78.28±24.38pg/ml, P>0.05). One year later, the plasma ET contents in the 45 patients with maluoling treatment were significantly lower than those in the 32 patients without maluoling treatment (64.38±24. 52pg/ml vs 77.49±30.63pg/ml, P<0.05). Conclusion: Chronic use of maluoling could markedly decrease the plasma ET contents in patients with COPD. (authors)

  8. The current understanding of the treatment chronic non-bacterial prostatitis with inflammatory component

    Directory of Open Access Journals (Sweden)

    Yu. Yu. Vinnik

    2015-01-01

    Full Text Available A literature review is dedicated to one of the most urgent problems of modern andrology – the treatment of chronic non-bacterial prostatitis (CP with inflammatory component. Over the past decades, despite numerous methods of prevention and treatment offered by the Russian and foreign urologists, the incidence of CP has been steadily progressing. Treatment of patients with CP should be comprehensive and be sure to include the effects on all the links in the pathogenesis of the disease. It is different depending on the age of the patient and the presence and nature of CP manifestations, including changes in mental status, especially disease progression, stage and phase inflammatory activity in the prostate, the degree of involvement in the disease process nearby organs, immune status and other factors. The proposed scientific review covers the basic techniques of therapeutic effect on patients with CP. Given in article data allows a more rational approach to the treatment of these patients.

  9. The dynamics of histamine level in patients with chronic urticaria under the influence of different methods of treatment.

    Directory of Open Access Journals (Sweden)

    Dytyatkovska Ye.M.

    2014-11-01

    Full Text Available There was studied the efficiency of different methods of chronic urticaria treatment. All patients were divided into 2 groups depending on treatment scteme. The paper shows the dynamics of histamine level in blood plasma, intestine disbiosis in patients with chronic urticaria under the influence of different treatment complexes. It was proved that there exists the correlation between the serum histamine level and method of treatment. Intro¬ducing bionorm into the treatment allows to decrease histamine level and correspondingly to significantly improve clinical effect and patients’ life quality.

  10. Evaluation of Treatment Results of Patients with Chronic Hepatitis B Followed for Five Years

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    Sıla Akhan

    2009-12-01

    Full Text Available Objective: Interferon-alpha has been used in the treatment of chronic hepatitis B (CHB for two decades. Diagnosis and treatment of CHB have improved in recent years with the introduction of new oral antiviral drugs. In this study, treatment results of patients with CHB followed for five years were evaluated.Methods: Between January 2004 and December 2009, 583 patients were treated in the Out-Patient Clinic of Infectious Diseases and Clinical Microbiology. Of these, 167 patients were included in the study. The remaining patients were excluded due to the short span of treatment (less than one year.Results: 27 (16% of the patients were HBeAg-positive and 140 (84% of them were HBeAg-negative. All of the patients were found to be of genotype D. The study group consisted of 40 (24% patients who received only interferon and had not yet relapsed at least in one-year follow-up, 70 (42% patients who used oral antiviral drugs due to relapses after completion of interferon therapy and 57 (34% patients who used only oral antivirals due to contraindications for interferon treatment. Drug resistance to lamivudine was found in 18 of 55 (32% patients and to adefovir in 4 of 53 (8% patients. Lamivudine resistance was observed in only 2 of the patients, who received interferon before lamivudine therapy. We found that, of 27 (16% HBeAg-positive patients, 4 showed anti-HBe seroconversion. Of the entire study group of 167 patients, 2 (1% developed anti-HBs seroconversion. Conclusions: We conclude that chronic hepatitis B requires life-long follow-up and treatment and the treatment schedule should be individualized. When appropriate, the treatment should begin with interferon, and if necessary, proceed with the use of oral antivirals. We believe this regimen may help delay the development of antiviral resistance.

  11. CYCLODEXTRIN A GIFT TO PHARMACEUTICAL WORLD REVIEW

    OpenAIRE

    Katageri Akshay R; Sheikh Mohsin A.

    2012-01-01

    The macrocyclic cyclodextrins (enzymatic conversion products of starch) were discovered in 1891, and the structures were elucidated in the mid-1930s. Their industrial significance become obvious in the 1970s, and by now thousands of tons of the three cyclodextrins (α-, β-, and γCD) and of their chemical derivatives and inclusion complexes are produced industrially. The paper highlights important CD applications in drug solubility and dissolution, bioavailability, safety, and stability, their ...

  12. Nilotinib for the treatment of chronic myeloid leukemia: An evidence-based review

    Directory of Open Access Journals (Sweden)

    Elias Jabbour

    2009-10-01

    Full Text Available Elias Jabbour, Jorge Cortes, Hagop KantarjianDepartment of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USAIntroduction: Chronic myelogenous leukemia (CML is a progressive and often fatal hematopoietic neoplasm. The Bcr-Abl tyrosine kinase inhibitor imatinib mesylate represented a major therapeutic advance over conventional CML therapy, with more than 90% of patients obtaining complete hematologic response, and 70%–80% of patients achieving a complete cytogenetic response. Despite the high efficacy of imatinib, a minority of patients in chronic phase CML and more patients in advanced phases are resistant to imatinib, or develop resistance during treatment. This is attributed, in 40% to 50% of cases, to the development of mutations in the Bcr-Abl tyrosine kinase domain that impair imatinib binding. Attempts to circumvent resistance led to the discovery of nilotinib (Tasigna, a novel, potent and selective oral Bcr-Abl kinase inhibitor.Aims: To review the evidence for the use of nilotinib in the management of CML.Evidence review: Preclinical and clinical investigations demonstrate that nilotinib effectively overcomes imatinib resistance, and has further improved the treatment of CML.Place in therapy: Nilotinib is currently indicated for patients with CML in chronic and accelerated phases following imatinib failure. Randomized studies are ongoing to assess the efficacy of nilotinib in patients with newly diagnosed CML.Keywords: CML, tyrosine kinase inhibitors, nilotinib, imatinib-resistance, imatinibintolerance.

  13. Effect of Interventions for Premature Ejaculation in the Treatment of Chronic Prostatitis with Secondary Premature Ejaculation.

    Science.gov (United States)

    Chen, Chang-Qing; Yi, Qing-Tong; Chen, Chu-Hong; Gong, Min

    2016-08-01

    Objective To evaluate the effect of interventions for premature ejaculation (PE) in the management of patients with chronic prostatitis and secondary premature ejaculation. Methods Totally 90 patients diagnosed as chronic prostatitis with PE were randomly divided into control group (n=45) and interventional group (n=45). Control group received a conventional therapy consisted of oral administration of antibiotics,α-receptor blocker,and proprietary Chinese medicine for clearing away heat and promoting diuresis. Interventional group received a conventional therapy combined with treatment for ameliorating the PE symptom (oral dapoxetine on-demand and ejaculation control exercise).National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI),Chinese Index of Sexual Function for Premature Ejaculation (CIPE)-5 questionnaires,intravaginal ejaculatory latency time,and the number of coituses per week were applied for evaluating the treatment outcomes. Results Follow-up was accomplished in 35 and 38 patients in the control and interventional group.The CIPE-5 score,intravaginal ejaculatory latency time,and the number of coituses per week were significantly improved in both two groups but more significantly in interventional group (all Pmanagement of CP.p. PMID:27594150

  14. Prognostic factors determining the outcome of treatment in chronic hepatitis C.

    Science.gov (United States)

    Hadziyannis, S J

    2000-01-01

    After a brief introduction in terminology and a distinction between predictors and determinants or response to therapy in chronic hepatitis C, a review of the wide literature on this topic is presented. None of the pretreatment variables or combination of them can be used as an absolute predictor of response in individual patients. Prognostic factors can help in clinical practice for informing and counseling patients of the likelihood of response. Information on pretreatment HCV RNA levels and HCV genotype can improve the cost benefit of therapy. Predictors of response should be properly evaluated in terms of positive predictive value, negative predictive value and accuracy. The strongest hitherto predictor of sustained response to any therapeutic regimen in chronic hepatitis is the clearance of HCV RNA during treatment. Recent data suggest that sequencing of several regions of the HCV genome may provide important prognostic information on the outcome of therapy. In complex and difficult to treat subsets of patients with chronic HCV infection, available data on predictors and determinants of the outcome of treatment are limited. PMID:10925467

  15. Vitamin E treatment for children with chronic hepatitis B: A randomized placebo controlled trial

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To evaluate the safety and efficacy of vitamin E in children with chronic hepatitis B. METHODS: We randomly assigned patients with chronic hepatitis B, positive for hepatitis B e antigen (HBeAg), to receive either vitamin E or placebo once daily for 6 mo in a 3:1 ratio and double-blind manner. The primary end point was HBeAg seroconversion, defined as the loss of HBeAg, undetectable levels of serum hepatitis B virus DNA, and the appearance of antibodies against HBeAg 12 rno after therapy. RESULTS: At baseline visit, 49 patients had normal and 43 had increased serum aminotransferase levels. Twenty-nine patients did not respond to previous treatment with interferon-α or lamivudine. Seventy-six children completed the study; 16 were non-compliant (n = 7), lost to follow-up (n = 7), or started another antiviral treatment (n = 3). Intention-to-treat analysis showed HBeAg seroconversion in 16 children (23.2%) treated with vitamin E and two (8.7%) in the placebo group (P = 0.13). Vitamin E was well tolerated. CONCLUSION: There is only a tendency that vitamin E may promote HBeAg seroconversion. Erefore larger studies are needed to clarify the role of antioxidants in the therapy of chronic hepatitis B.

  16. Duloxetine in the treatment of chronic pain due to fibromyalgia and diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Alan Wright

    2010-12-01

    Full Text Available Alan Wright, Kyle E Luedtke, Chad VanDenBergCenter for Clinical Research, Mercer University, Atlanta, Georgia, USAAbstract: Duloxetine is a serotonin-norepinephrine reuptake inhibitor approved by the US Food and Drug Administration for the treatment of fibromyalgia and painful diabetic neuropathy at doses of 60 mg daily. Duloxetine has been shown to significantly improve the symptoms of chronic pain associated with these disorders, as measured by the Fibromyalgia Impact Questionnaire, Brief Pain Inventory scores, the Clinical Global Impressions Scale, and other various outcome measures in several placebo-controlled, randomized, double-blind, multicenter studies. Symptom improvement generally began within the first few weeks, and continued for the duration of the study. In addition, the efficacy of duloxetine was found to be due to direct effects on pain symptoms rather than secondary to improvements in depression or anxiety. Adverse events including nausea, constipation, dry mouth, and insomnia, were mild and transient and occurred at relatively low rates. In conclusion, duloxetine, a selective inhibitor for the serotonin and norepinephrine transporters, is efficacious in the treatment of chronic pain associated with fibromyalgia or diabetic neuropathy, and has a predictable tolerability profile, with adverse events generally being mild to moderate.Keywords: duloxetine, chronic pain, neuropathic pain, fibromyalgia, efficacy, safety

  17. Pulmonary thromboendarterectomy after treatment with treprostenil in a chronic thromboembolic pulmonary hypertension patient: a case report

    Directory of Open Access Journals (Sweden)

    Porpodis K

    2011-11-01

    Full Text Available Konstantinos Porpodis1, Maria Konoglou2, Paul Zarogoulidis1, Evangelos Kaimakamis2, Theodoros Kontakiotis1, Despoina Papakosta1, Vasilis Zervas1, Nikolaos Katsikogiannis3, Nikolaos Courcoutsakis4, Alexandros Mitrakas5, Panagiotis Touzopoulos5, Michael Karanikas5, Konstantinos Zarogoulidis1, Aikaterini Markopoulou2 1Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece; 2First Pulmonary Clinic, "G Papanikolaou" General Hospital, Thessaloniki, Greece; 3Surgery Department (NHS, University Hospital of Alexandroupolis, Greece; 4Radiology Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 5First University Surgery Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Greece Abstract: In recent years, there has been a major advance in the treatment of pulmonary hypertension. New medications are continually added to the therapeutic arsenal. The prostanoids are among the first agents used to treat pulmonary hypertension and are currently considered the most effective. This case study describes a 63-year-old man who was diagnosed with chronic thromboembolic pulmonary hypertension and successfully treated with subcutaneously administered treprostenil for 6 months before a successful pulmonary thromboendarterectomy. Treatment of chronic thromboembolic pulmonary hypertension often requires a multidisciplinary approach before surgery. Further evaluation of prostanoids is needed to define their role and time of initiation of medical therapy in these patients. Keywords: chronic thromboembolic pulmonary hypertension, prostanoids, treprostenil sodium, pulmonary thromboendarterectomy

  18. Spiral ganglion neuron survival and function in the deafened cochlea following chronic neurotrophic treatment.

    Science.gov (United States)

    Landry, Thomas G; Wise, Andrew K; Fallon, James B; Shepherd, Robert K

    2011-12-01

    Cochlear implants electrically stimulate residual spiral ganglion neurons (SGNs) to provide auditory cues for the severe-profoundly deaf. However, SGNs gradually degenerate following cochlear hair cell loss, leaving fewer neurons available for stimulation. Providing an exogenous supply of neurotrophins (NTs) has been shown to prevent SGN degeneration, and when combined with chronic intracochlear electrical stimulation (ES) following a short period of deafness (5 days), may also promote the formation of new neurons. The present study assessed the histopathological response of guinea pig cochleae treated with NTs (brain-derived neurotrophic factor and neurotrophin-3) with and without ES over a four week period, initiated two weeks after deafening. Results were compared to both NT alone and artificial perilymph (AP) treated animals. AP/ES treated animals exhibited no evidence of SGN rescue compared with untreated deafened controls. In contrast, NT administration showed a significant SGN rescue effect in the lower and middle cochlear turns (two-way ANOVA, p evoked auditory brainstem response (EABR) thresholds. EABR thresholds following NT treatment were significantly lower than animals treated with AP (two-way ANOVA, p = 0.033). Finally, the potential for induced neurogenesis following the combined treatment was investigated using a marker of DNA synthesis. However, no evidence of neurogenesis was observed in the SGN population. The results indicate that chronic NT delivery to the cochlea may be beneficial to cochlear implant patients by increasing the number of viable SGNs and decreasing activation thresholds compared to chronic ES alone. PMID:21762764

  19. Efficacy of tepronone and folic acid in the treatment of chronic atrophic gastritis evaluated by the marking targeting biopsy

    Institute of Scientific and Technical Information of China (English)

    裘力锋

    2013-01-01

    Objective To explore the efficacy of tepronone and folic acid in the treatment of chronic atrophic gastritis(CAG) evaluated by the marking targeting biopsy(MTB).Methods A total of 224 H.pylori negative

  20. Antinociception induced by chronic glucocorticoid treatment is correlated to local modulation of spinal neurotransmitter content

    Directory of Open Access Journals (Sweden)

    Almeida Armando

    2009-07-01

    Full Text Available Abstract Background While acute effects of stress on pain are well described, those produced by chronic stress are still a matter of dispute. Previously we demonstrated that chronic unpredictable stress results in antinociception in the tail-flick test, an effect that is mediated by increased levels of corticosteroids. In the present study, we evaluated nociception in rats after chronic treatment with corticosterone (CORT and dexamethasone (DEX in order to discriminate the role of each type of corticosteroid receptors in antinociception. Results Both experimental groups exhibited a pronounced antinociceptive effect after three weeks of treatment when compared to controls (CONT; however, at four weeks the pain threshold in CORT-treated animals returned to basal levels whereas in DEX-treated rats antinociception was maintained. In order to assess if these differences are associated with altered expression of neuropeptides involved in nociceptive transmission we evaluated the density of substance P (SP, calcitonin gene-related peptide (CGRP, somatostatin (SS and B2-γ-aminobutiric acid receptors (GABAB2 expression in the spinal dorsal horn using light density measurements and stereological techniques. After three weeks of treatment the expression of CGRP in the superficial dorsal horn was significantly decreased in both CORT and DEX groups, while GABAB2 was significantly increased; the levels of SP for both experimental groups remained unchanged at this point. At 4 weeks, CGRP and SP are reduced in DEX-treated animals and GABAB2 unchanged, but all changes were restored to CONT levels in CORT-treated animals. The expression of SS remained unaltered throughout the experimental period. Conclusion These data indicate that corticosteroids modulate nociception since chronic corticosteroid treatment alters the expression of neuropeptides involved in nociceptive transmission at the spinal cord level. As previously observed in some supraspinal areas, the

  1. Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers

    Directory of Open Access Journals (Sweden)

    Shwetha Suryanarayan

    2014-09-01

    Full Text Available Aim: The aim was to evaluate the efficacy of platelet-rich plasma (PRP in the treatment of chronic nonhealing ulcers. Methods: A nonrandomized, uncontrolled study was performed on 24 patients with 33 nonhealing ulcers of various etiologies. All patients were treated with PRP at weekly intervals for a maximum of 6 treatments. At the end of the 6-week period, reduction in size of the ulcers (area and volume was assessed. Results: The mean age of the patients was 42.5 years (standard deviation [SD] 12.48. Of 33 ulcers, there were 19 venous ulcers, 7 traumatic ulcers, 2 ulcers secondary to pyoderma gangrenosum, 2 diabetic ulcers, 2 trophic ulcers, and 1 vasculitic ulcer. The mean duration of healing of the ulcers was 5.6 weeks (SD 3.23. The mean percentage of reduction in area and volume of the ulcers was 91.7% (SD 18.4% and 95% (SD 14%, respectively. About 100% resolution in the area was seen in 25 (76% of the ulcers and 100% reduction in volume was seen in 24 (73% of the ulcers at the end of the 6th treatment. Conclusion: Conventional therapies do not provide satisfactory healing for chronic nonhealing ulcers as they are not able to provide the necessary growth factors (GFs (platelet-derived GF, epidermal GF, vascular endothelial GF, etc. which are essential for the healing process. PRP is a safe, affordable, biocompatible, and simple office-based procedure for the treatment of nonhealing ulcers.

  2. Superficially, longer, intermittent ozone theraphy in the treatment of the chronic, infected wounds.

    Science.gov (United States)

    Białoszewski, Dariusz; Kowalewski, Michał

    2003-10-30

    Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc. Material and methods. In the Department of Phisiotherapy of the Medical Faculty and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical University of Warsaw in the period from January 2001 until November 2002, 23 patients with heavy,chronic, antibiotic resistants septic complications after trauma, surgical procedures and secundary skin infetions were treated with ozone. The ozone therapy was administered using an authorial technique of superficially, longer, intermittent ozone application. Results. In the wounds of the all experienced patients the inhibition of septic processes and wound healing was much faster than normal. Conclusions. Our data confirm the advantages wich result from the technique of superficially, longer, intermittent ozone theraphy in combined treatment for septic complications in the soft tissue, especially in the locomotor system. These technique makes posttraumatic infections and promotes quicker healing of post-surgical and post-traumal complications - chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures. PMID:17679848

  3. [Progress of different drug delivery route of vancomycin for the treatment of chronic osteomyelitis].

    Science.gov (United States)

    Long, Y Z; Zhu, Z X; Yu, Y; Zhang, S M

    2016-09-01

    Chronic osteomyelitis (COM) is an infectious disease caused by methicillin-resistant Staphylococcus aureus (MRSA), the main characteristics of COM including local dead bone formation, soft tissue infection, and repeatedly attacks. As a sensitive antibiotic, vancomycin plays an important role in the therapy of COM caused by MRSA. Currently, drug treatment is divided into systemic and topical, systemic medication is given priority to intravenous drug delivery; local drug application including local delivery device and local antibiotics lavage and regional arterial perfusion. In practice, its validity depends on whether free drug concentration of vancomycin has riched the effective concentration in the organization. Nevertheless, low concentration lead to treatment failure and even induce drug-resistance bacteria, meanwhile high concentration may cause acute renal failure. So when using vancomycin for the treatment of chronic osteomyelitis, both drug resistance and renal toxicity is as the same important as the effectiveness. Systemic administration is a targeting weak way and has many complications; topical medicate effect on the lesion can be targeted, it would be an effective way in the future treatment of COM. Different methods of delivering vancomycin have great influence on local drug concentration, which makes it become the most important factor on local drug concentration of COM. PMID:27587217

  4. Effects of chronic treatment with methylphenidate on oxidative stress and inflammation in hippocampus of adult rats.

    Science.gov (United States)

    Motaghinejad, Majid; Motevalian, Manijeh; Shabab, Behnaz

    2016-04-21

    Methylphenidate (MPH) is a central stimulant, prescribed for the treatment of attention deficit/hyperactivity disorder. The long-term behavioral consequences of MPH treatment are unknown. In this study, the oxidative stress and neuroinflammation induced by various doses of MPH were investigated. Forty adult male rats were divided into 5 groups; and treated with different doses of MPH for 21 days. Twenty four hours after drug treatment, Open Field Test (OFT) was performed in all animals. At the end of the study, blood cortisol level (BCL) was measured and hippocampus was isolated and oxidative stress and inflammation parameters and histological changes were analyzed. Chronic MPH at all doses decreased central square entries, number of rearing, ambulation distance and time spent in central square in OFT. BCL increased in doses 10 and 20mg/kg of MPH. Furthermore, MPH in all doses markedly increased lipid peroxidation, mitochondrial oxidized glutathione (GSSG) level, Interleukin 1β (IL-1β) and Tumor Necrosis Factor α (TNF-α) in isolated hippocampus. MPH (10 and 20mg/kg) treated groups had decreased mitochondrial reduced glutathione (GSH) content, and reduced superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GRx) activities. 10 and 20mg/kg of MPH change cell density and morphology of cells in Dentate Gyrus (DG) and CA1 areas of hippocampus. Chronic treatment with high doses of MPH can cause oxidative stress, neuroinflammation and neurodegeneration in hippocampus of adult rats. PMID:26687276

  5. Medical therapies for chronic thromboembolic pulmonary hypertension: an evolving treatment paradigm.

    Science.gov (United States)

    Bresser, Paul; Pepke-Zaba, Joanna; Jaïs, Xavier; Humbert, Marc; Hoeper, Marius M

    2006-09-01

    Pulmonary endarterectomy (PEA) is recommended as the treatment of choice for eligible patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, only a proportion of patients fulfill the criteria for surgical intervention. In addition, operated patients with CTEPH may experience a gradual hemodynamic and symptomatic decline related to a secondary hypertensive arteriopathy in the small precapillary pulmonary vessels. It has also been questioned what can be done to reduce risks from PEA surgery to improve outcome in "high risk" patients with CTEPH with substantial impairment of pulmonary hemodynamics before surgery. Such patients may benefit from preoperative reduction of pulmonary vascular resistance by means of medical therapy. Conventional medical treatments, such as anticoagulation, diuretics, digitalis, and chronic oxygen therapy, show low efficacy in the treatment of CTEPH as they do not affect underlying disease processes. Over the last decade, several novel therapies have been developed for pulmonary arterial hypertension (PAH), including prostacyclin analogs (epoprostenol, beraprost, iloprost), endothelin receptor antagonists (bosentan, sitaxsentan, ambrisentan), and phosphodiesterase-5 inhibitors (sildenafil). Evidence of efficacy in PAH, coupled with studies showing histopathologic similarities between CTEPH and PAH, provides a rationale to extend the use of some of these medications to the treatment of CTEPH. However, direct evidence from clinical trials in CTEPH is limited to date. This article reviews evidence supporting, and issues surrounding, the possible use of novel PAH medications in CTEPH. PMID:16963540

  6. The effects of cyclodextrins on drug release from fatty suppository bases : III. Application of cyclodextrin derivatives

    NARCIS (Netherlands)

    Frijlink, H.W.; Paiotti, S.; Eissens, Anko; Lerk, C.F.

    1992-01-01

    The complexation of both n-butyl-4-aminobenzoate and diazepam with dimethyl-beta-cyclodextrin and hydroxypropyl-beta-cyclodextrin, respectively, was studied. Solid complexes were prepared by freeze-drying. The complexes were incorporated in fatty suppositories and drug release was studied, both in v

  7. A novel preparation of methyl-β-cyclodextrin from dimethyl carbonate and β-cyclodextrin

    DEFF Research Database (Denmark)

    Gan, Yongjiang; Zhang, Yimin; Xiao, Chuanhao;

    2011-01-01

    A novel green synthesis process about methyl-β-cyclodextrin has been investigated through the reaction between β-cyclodextrin and dimethyl carbonate by anhydrous potassium carbonate as catalyst in DMF. The influence of experimental factors including the molar ratio of dimethyl carbonate to β...

  8. Covalent modification of carbon surfaces with cyclodextrins by mediated oxidation of β-cyclodextrin monoanions

    International Nuclear Information System (INIS)

    Graphical abstract: - Highlights: • >Covalent grafting of carbon surfaces by mediated oxidation of cyclodextrin monoanions > The use of ferrocene as redox catalyst to prepare electrochemically modified electrodes. • EPR spectrum of electrochemically generated cyclodextrin radicals. • Electrochemical polymerization of cyclodextrine over glassy carbon surfaces. • Formation of inclusion complexes between ferrocene and β-cyclodextrin in dimethylsulfoxide. - Abstract: The covalent grafting of glassy carbon and highly oriented pyrolytic graphite with cyclodextrins is reported in this work. The modification procedure is based in the concept that oxidation of organic anions generates radicals which react with carbon surfaces. These radical species are generated through a redox catalysis mechanism involving the formation of ferrocenium ion, which in turn oxidizes the cyclodextrin monoanion to afford an oxygen-centered free radical that ultimately reacts either in solution or with the surface, affording a strong attachment of cyclodextrin molecules to the carbon surface. The intervention of this radical was established from spectroelectrochemical EPR experiments. Atomic force microscopy imaging showed that the attached organic layer is thick while cyclic voltammetry experiments confirmed that this modified surface behaves as an ultramicroelectrode array. This kind of modification allows incorporate cyclodextrin to an electrode surface without a binder, making the modified electrode useful to be tested in forthcoming sensor studies

  9. BOTULINUM TOXIN: FOR SAFE AND EFFECTIVE NON-SURGICAL TREATMENT IN ACUTE AND CHRONIC ANAL FISSURES

    Directory of Open Access Journals (Sweden)

    Rehan Sabir

    2015-12-01

    Full Text Available BACKGROUND Fissure in ano is a common painful anorectal condition with high recurrence rates. It is commonly seen due to sedentary lifestyle, which involves prolonged sitting posture, mental stress, low fiber diet and lack of physical activity which causes chronic constipation. Irrespective to whichever modality of existing therapies that are used, the recurrences are common. The traditional surgical option like lateral internal sphincterotomy, which has been into practice since long time carries risk of incontinence. It is a need of an hour to rely on a treatment modality which should be simple, safe, effective and reversible with no permanent sequelae. In this study chemical sphincterotomy using injection, Botulinum toxin gives an alternative modality and proved to be the most safe and reliable non-operative option for treating both acute and chronic fissure in ano. AIM AND OBJECTIVE This present study clinically assesses the role of injection Botulinum Toxin A in the management of acute and chronic anal fissure. METHODS A total of 50 patients including both acute and chronic fissure-in-ano were treated with injection Botulinum toxin as first line of management. RESULT All patients were found to get symptomatic relief with high rates of fissure healing eventually. The lack of complications and simplicity in its administration makes it a reliable alternative to the currently practiced therapies. CONCLUSION Botulinum toxin offers a simple outpatient procedure for fissure-in-ano, which is safe without any significant complications. It carries the potential of being used as a first line of management in acute and chronic fissure-in-ano.

  10. Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

    Directory of Open Access Journals (Sweden)

    Wieg

    2015-06-01

    Full Text Available Cornelia Wiegand, Jörg Tittelbach, Uta-Christina Hipler, Peter Elsner Department of Dermatology, University Hospital Jena, Jena, Germany Abstract: The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of using the same wound dressing during the entire healing period is no longer reasonable. Instead, multiple types of dressings may be needed for a single wound over its healing trajectory. Selection of the most appropriate dressing should be based on wound phase, depth, signs of infection, and level of exudate. Moisture balance is critical in wound care; dryness will hamper epithelial cell migration while excessive generation of fluid causes maceration at the wound margins. Hence, exudate management is a key issue in chronic wound therapy, particularly given that exudate from chronic wounds has a composition different from that of acute wound fluid. Several studies have shown that exudates from non-healing wounds contain significantly elevated levels of protease activity, increased formation of free radicals, and abundant amounts of proinflammatory cytokines, while concentrations of growth factors and protease inhibitors are markedly decreased. Application of dressings that remove and sequester excess amounts of wound fluid may not only help in restoring the correct balance of moisture, but also support the wound healing process by preventing tissue deterioration caused by abundant protease activity. Several types of dressings, such as hydrogels, hydrocolloids, alginates, hydrofibers, foams, and superabsorbent dressings, are reviewed here and evaluated with regard to their efficacy for highly exuding wounds. Keywords: chronic wounds, exuding, dressings, clinical efficacy 

  11. Introduction of dermatome shaving as first line treatment of chronic tattoo reactions

    DEFF Research Database (Denmark)

    Sepehri, Mitra; Jørgensen, Bo; Serup, Jørgen

    2015-01-01

    BACKGROUND/AIMS: Chronic tattoo reactions requiring treatment have increased. Laser removal is not ideal for removal of allergic reactions. Surgical removal of culprit pigment situated in the outer dermis by dermatome shaving is rational and need to be revisited. MATERIALS/METHODS: Fifty four...... tattoos with chronic reactions in 50 patients were treated with dermatome shaving. Tattoos with red/red nuances dominated the material. In total, 52 operations were performed in infiltration and 2 in general anaesthesia. Shaving was performed to the level in the dermis free of tattoo pigment as assessed...... visually by the surgeon. RESULTS: Operative complications were few. Healing occurred over weeks as normal for this procedure. On a rating scale from 0 to 4, 4 as most severe, the patient's severity rating of symptoms in their tattoo declined from 3.2 pre-operatively to 1.0, 0.8 and 0.7 after 3, 6 and 12...

  12. [Consensus document on treatment of type 2 diabetes in patients with chronic kidney disease].

    Science.gov (United States)

    Gómez-Huelgas, Ricardo; Martínez-Castelao, Alberto; Artola, Sara; Górriz, José L; Menéndez, Edelmiro

    2014-01-01

    Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic diseases that represent a significant public health problem and require multidisciplinary management. T2DM is the main cause of CKD in our setting and it is also a major comorbidity of non-diabetic nephropathy. Patients with diabetes and renal failure represent a special risk group as they have higher morbidity and mortality and are at a higher risk of hypoglycaemia than diabetic individuals with normal renal function. Treatment of T2DM in patients with CKD is controversial because of the scarcity of evidence available. This consensus document aims to facilitate the appropriate selection and dosage of anti-diabetic drugs as well as establishing glycaemic control safety targets in patients with CKD. PMID:24611186

  13. Clinical commentary of the evolution of the treatment for chronic painful mid-portion Achilles tendinopathy

    Directory of Open Access Journals (Sweden)

    Håkan Alfredson

    2015-10-01

    Full Text Available ABSTRACTThe chronic painful Achilles tendon mid-portion was for many years, and still is in many countries, treated with intratendinous revision surgery. However, by coincidence, painful eccentric calf muscle training was tried, and it showed very good clinical results. This finding was unexpected and led to research into the pain mechanisms involved in this condition. Today we know that there are very few nerves inside, but multiple nerves outside, the ventral side of the chronic painful Achilles tendon mid-portion. These research findings have resulted in new treatment methods targeting the regions with nerves outside the tendon, methods that allow for a rapid rehabilitation and fast return to sports.

  14. A Review of the Use of Methadone for the Treatment of Chronic Noncancer Pain

    Directory of Open Access Journals (Sweden)

    Mary E Lynch

    2005-01-01

    Full Text Available Methadone, although having been available for approximately half a century, is now receiving increasing attention in the management of chronic pain. This is due to recent research showing that methadone exhibits at least three different mechanisms of action including potent opioid agonism, N-methyl-D-aspartate antagonism and monoaminergic effects. This, along with methadone's excellent oral and rectal absorption, high bioavailability, long duration of action and low cost, make it a very attractive option for the treatment of chronic pain. The disadvantages of significant interindividual variation in pharmacokinetics, graduated dose equivalency ratios based on prerotation opioid dose when switching from another opioid, and the requirement for special exemption for prescribing methadone make it more complicated to use. The present review is intended to educate physicians interested in adding methadone to their armamentarium for assisting patients with moderate to severe pain.

  15. Pros and cons of peginterferon versus nucleos(t)ide analogues for treatment of chronic hepatitis B

    NARCIS (Netherlands)

    M.J. Sonneveld (Milan); H.L.A. Janssen (Harry)

    2010-01-01

    textabstractThe emergence of new and more potent treatment options has markedly changed the treatment landscape of chronic hepatitis B. Both peginterferon and nucleos(t)ide analogues have considerable advantages and limitations, and current treatment guidelines refrain from clearly suggesting a firs

  16. Effects of Ginseng Treatment on Neutrophil Chemiluminescence and Immunoglobulin G Subclasses in a Rat Model of Chronic Pseudomonas aeruginosa Pneumonia

    OpenAIRE

    Song, Zhijun; Kharazmi, Arsalan; Wu,Hong; Faber, Viggo; Moser, Claus; Krogh Johansen, Helle; Rygaard, Jørgen; Høiby, Niels

    1998-01-01

    Chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients is almost impossible to eradicate with antibiotic treatment. In the present study, the effects of treatment with the Chinese herbal medicine ginseng on blood polymorphonuclear leukocyte (PMN) chemiluminescence and serum specific antibody responses were studied in a rat model of chronic P. aeruginosa pneumonia mimicking CF. An aqueous extract of ginseng was administered by subcutaneous injection at a dosage of 25 mg...

  17. Use of Platelet-Rich Plasma (PRP) for the Treatment of Chronic Persistent Jumper’s Knee

    OpenAIRE

    Enginsu, Müjdat; Lokmaoğlu, Recep; Selimoğlu, Şafak; Korkmaz, Erol

    2014-01-01

    Objectives: The aim of this study was to evaluate the efficacy of multiple PRP injections on the healing of chronic persistent patellar tendinopathy, after previous classical treatment have failed. Methods: We treated 30 patients affected by chronic jumper’s knee, who had failed previous nonsurgical treatments, with multiple PRP injections and physiotherapy. We also compared the clinical outcome with a homogeneous group of 15 patients primarily treated with the physiotherapy approach. Tegner,...

  18. Chronic and treatment-resistant depression: a study using arterial spin labeling perfusion MRI at 3Tesla.

    OpenAIRE

    Duhameau, Bérengère; Ferré, Jean-Christophe; Jannin, Pierre; Gauvrit, Jean-Yves; Vérin, Marc; Millet, Bruno; Drapier, Dominique

    2010-01-01

    International audience The aim of the present study was to compare patients displaying chronic and treatment-resistant depression with healthy controls, using the resting-state perfusion with arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) technique at 3T. The study focused on the subgenual anterior cingulate cortex (sACC), which is a key component in the pathophysiology of depression. Six patients with chronic and treatment-resistant depression and six healthy cont...

  19. Potential of activated carbon to recover randomly-methylated-β-cyclodextrin solution from washing water originating from in situ soil flushing

    OpenAIRE

    Sniegowski, Kristel; Vanhecke, Marina; D'Huys, P-J; Braeken, Leen

    2014-01-01

    Despite the overall high efficacy of cyclodextrins to accelerate the treatment of soil aquifer remediation by in-situ soil flushing, the use in practice remains limited because of the high costs of cyclodextrin and high concentrations needed to significantly reduce the treatment time. The current study tested the potential of activated carbon to treat washing water originating from soil flushing in order to selectively separate hydrocarbon contaminants from washing water containing cyclodextr...

  20. The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease

    Science.gov (United States)

    Yarnoff, Benjamin O.; Hoerger, Thomas J.; Simpson, Siobhan A.; Pavkov, Meda E.; Burrows, Nilka R.; Shrestha, Sundar S.; Williams, Desmond E.; Zhuo, Xiaohui

    2016-01-01

    Background Although major guidelines uniformly recommend iron supplementation and erythropoietin stimulating agents (ESAs) for managing chronic anemia in persons with chronic kidney disease (CKD), there are differences in the recommended hemoglobin (Hb) treatment target and no guidelines consider the costs or cost-effectiveness of treatment. In this study, we explored the most cost-effective Hb target for anemia treatment in persons with CKD stages 3–4. Methods and Findings The CKD Health Policy Model was populated with a synthetic cohort of persons over age 30 with prevalent CKD stages 3–4 (i.e., not on dialysis) and anemia created from the 1999–2010 National Health and Nutrition Examination Survey. Incremental cost-effectiveness ratios (ICERs), computed as incremental cost divided by incremental quality adjusted life years (QALYs), were assessed for Hb targets of 10 g/dl to 13 g/dl at 0.5 g/dl increments. Targeting a Hb of 10 g/dl resulted in an ICER of $32,111 compared with no treatment and targeting a Hb of 10.5 g/dl resulted in an ICER of $32,475 compared with a Hb target of 10 g/dl. QALYs increased to 4.63 for a Hb target of 10 g/dl and to 4.75 for a target of 10.5 g/dl or 11 g/dl. Any treatment target above 11 g/dl increased medical costs and decreased QALYs. Conclusions In persons over age 30 with CKD stages 3–4, anemia treatment is most cost-effective when targeting a Hb level of 10.5 g/dl. This study provides important information for framing guidelines related to treatment of anemia in persons with CKD. PMID:27404556

  1. The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease.

    Directory of Open Access Journals (Sweden)

    Benjamin O Yarnoff

    Full Text Available Although major guidelines uniformly recommend iron supplementation and erythropoietin stimulating agents (ESAs for managing chronic anemia in persons with chronic kidney disease (CKD, there are differences in the recommended hemoglobin (Hb treatment target and no guidelines consider the costs or cost-effectiveness of treatment. In this study, we explored the most cost-effective Hb target for anemia treatment in persons with CKD stages 3-4.The CKD Health Policy Model was populated with a synthetic cohort of persons over age 30 with prevalent CKD stages 3-4 (i.e., not on dialysis and anemia created from the 1999-2010 National Health and Nutrition Examination Survey. Incremental cost-effectiveness ratios (ICERs, computed as incremental cost divided by incremental quality adjusted life years (QALYs, were assessed for Hb targets of 10 g/dl to 13 g/dl at 0.5 g/dl increments. Targeting a Hb of 10 g/dl resulted in an ICER of $32,111 compared with no treatment and targeting a Hb of 10.5 g/dl resulted in an ICER of $32,475 compared with a Hb target of 10 g/dl. QALYs increased to 4.63 for a Hb target of 10 g/dl and to 4.75 for a target of 10.5 g/dl or 11 g/dl. Any treatment target above 11 g/dl increased medical costs and decreased QALYs.In persons over age 30 with CKD stages 3-4, anemia treatment is most cost-effective when targeting a Hb level of 10.5 g/dl. This study provides important information for framing guidelines related to treatment of anemia in persons with CKD.

  2. Dasatinib: the emerging evidence of its potential in the treatment of chronic myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Sonya Haslam

    2005-03-01

    Full Text Available Sonya HaslamCore Medical Publishing, Mere House, Brook Street, Knutsford, Cheshire WA16 8GP, UKIntroduction: Current therapy options for chronic myeloid leukemia (CML include conventional chemotherapy, allogeneic stem cell transplant, interferon-alfa, and imatinib mesylate, which has recently achieved gold standard status. Although the majority of patients initially respond well to treatment with imatinib, wider clinical experience with this drug has resulted in the development of imatinib resistance being increasingly documented. There is therefore an unmet medical need for novel therapies to override imatinib resistance in CML.Aims: This review summarizes the emerging evidence for the potential use of dasatinib in the treatment of imatinib-resistant CML. Disease and treatment: Dasatinib is a novel small molecule that has shown potent antileukemic activity in imatinib-resistant cell lines, malignant marrow cells isolated from patients with imatinib-resistant CML, and in mouse xenograft models of imatinib-resistant CML. Preliminary data from an initial phase I dose escalation trial have been encouraging, indicating that dasatinib is generally well tolerated and produces hematologic and cytogenetic responses in patients with imatinib-resistant CML in all phases of the disease. The maximum tolerated dose (MTD has not yet been reached, and dose escalation continues to determine the dose range that yields optimal results.Profile: Although dasatinib is still in the early stages of development, the potential impact of this molecule on the treatment of CML could be revolutionary, not only providing a much needed treatment option for patients with imatinib-resistant CML, but also, combined with imatinib, could possibly prove useful in delaying the onset of resistance to treatment. Furthermore, combined with other agents active in CML, dasatinib could have potential utility in purging residual leukemic cells in patients whose disease is controlled by

  3. Effect of Polyvinylpyrrolidone on Complexation and Dissolution Rate of Beta Cyclodextrin and Hydroxypropyl Beta Cyclodextrin Complexes of Piroxicam

    Directory of Open Access Journals (Sweden)

    Otra Kumar

    2012-05-01

    Full Text Available Complexation of Piroxicam with β-Cyclodextrin and hydroxypropyl-β-Cyclodextrin in the presence and absence of polyvinylpyrrolidone and the effect of polyvinylpyrrrolidone on the solubilizing efficiency of Cyclodextrins and on the dissolution rate of Piroxicam from the Cyclodextrin complexes were investigated. The phase solubility studies indicated the formation of Piroxicam-β-Cyclodextrin and Piroxicam-hydroxypropyl-β-Cyclodextrin inclusion complexes at a 1:1 M ratio in solution, both in the presence and absence of polyvinylpyrrolidone. The complexes formed were quite stable. The solubility and dissolution rate of Piroxicam were markedly enhanced by complexation with β-Cyclodextrin and hydroxypropyl- β-Cyclodextrin. Piroxicamhydroxypropyl-β-Cyclodextrin(1:2 inclusion complex gave a 36.52-fold increase in the dissolution rate of Piroxicam. Addition of polyvinylpyrrolidone resulted in higher complexation efficiency and markedly enhanced solubilizing efficiency of β-Cyclodextrin and hydroxypropyl-β-Cyclodextrin. Solid inclusion complexes of Cyclodextrins with polyvinylpyrrolidone gave several times higher rates of dissolution than those of Piroxicam and its complexes with Cyclodextrins alone.

  4. Optimal treatment of chronic angina in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kaur H

    2014-07-01

    Full Text Available Harjinder Kaur,1 Kully Sandhu,2 Awais Jabbar,3 Azfar G Zaman3,4 1City Hospitals Sunderland, Sunderland, UK; 2University Hospital of North Staffordshire, Stoke-on-Trent, UK; 3Freeman Hospital, Newcastle-upon-Tyne, UK; 4Institute of Cellular Medicine, Newcastle University, Newcastle, UK Abstract: Type 2 diabetes mellitus (T2DM trebles the risk of developing coronary artery disease (CAD; once CAD has developed, the risk of acute coronary syndromes (ACS and clinical risk associated with a coronary event, both double in diabetic patients. Patients with T2DM have more extensive CAD and present at a younger age; therefore, identification and management of chronic angina in these patients presents an opportunity to limit both cardiovascular symptoms and adverse outcomes. This article reviews the role of screening and treatment for chronic angina in patients with T2DM. There is a strong evidence base for modifying lifestyle as a way of reducing adverse cardiovascular outcomes in the diabetic population and this article reviews evidence of lifestyle modification as an important and necessary adjunct to pharmacologic intervention. Management of chronic stable angina is addressed by looking at treatments that reduce ischemic symptoms and those that reduce adverse cardiovascular outcomes. Trials specific to the diabetic population are limited, with information largely obtained from the diabetic subgroup analysis of large intervention trials. The growing diabetic population with increased propensity to cardiovascular disease mandates trials specifically in this patient population. Revascularization in patients with diabetes is associated with more complications than in the non-diabetic population. Recent trials specific to this population suggest surgical revascularization to be associated with better long-term outcomes and therefore, this article reviews the evidence for the optimal mode of revascularization in this population. Keywords: type 2 diabetes

  5. Clinical Characteristics and Treatment for Patients with Occult Chronic hepatitis B

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To observe the clinical manifestations and assess direct antiviral effect for patients with occult hepatitis B in China. Methods The study includes 15 patients with occult hepatitis B and their medical history, family history, ifrst-diagnosis time, conifrmed-diagnosis time, laboratory report, anti-viral therapy and outcomes were analyzed. Results The average age of the patients is 38.67-year old (6 males and 9 females), 2 with acute hepatitis B (2/15, 13.3%), 13 with no hepatitis history (13/15, 86.6%), 8 with family history (8/15, 53.3%), 6 with no family history (6/15, 40%), 1 with unknown family history (1/15, 6.6%). Eight patients were treated with entecavir (0.5 mg/day, taken orally), with effective results and steady conditions;3 patients were treated with lamivudine (0.1 g/day, taken orally), 2 of them were prescribed to take adefovir dipivoxil additionally due to drug-resistance, the other one was treated with lamivudine continuously without drug-resistance;4 cases refused anti-viral therapy. One patient’s condition remained steady, 1 patient died of cirrhosis with portal hypertension and liver failure 5 years after ifrst-diagnosis, 1 patient progressed to hepatocellular carcinoma and accepted surgery operation treatment 5 years after ifrst-diagnosis, the other 1 patient progressed to compensatory cirrhosis 2 years after ifrst-diagnosis and is steady from then, which indicates that occult chronic hepatitis B can progress to cirrhosis and hepatocellular carcinoma without therapy in time. Conclusions The clinical characteristics of 15 cases with occult chronic hepatitis B showed that these patients with short latency, younger age when being-struck, and light damage to liver function. The efifcacy and drug-resistance of nucleos(t)ide-analogue (entecavir, lamivudine, adefovir dipivoxil) in treatment of patients with occult chronic hepatitis B are similar to chronic hepatitis B.

  6. IL-1, IL-4 production and IgE levels in acute and chronic fasciolosis before and after triclabendazole treatment.

    Science.gov (United States)

    Allam, A F; Osman, M M; el-Sayed, M H; Demian, S R

    2000-12-01

    IL-1 generation by mononuclear phagocytes, IL-4 production by Th2 lymphocytes and IgE levels in serum were measured in eight patients with acute fasciolosis and seven patients in the chronic stage of the disease before and after triclabendazole treatment. Results were compared with those of a control group of ten individuals. The monocytes and lymphocytes from patients with acute and chronic fasciolosis produced significantly lower levels of IL-1 and IL-4 respectively, particularly in the chronic phase of the disease, as compared to the control. A significant increase in IgE level in both acute and chronic fasciolosis was observed. The level was significantly higher in acute as compared to chronic cases. After treatment with triclabendazole IL-1, IL-4 and IgE levels moved towards the control indicating obvious improvement in the immunological responses of the patients. PMID:11198376

  7. Catastrophizing and internal pain control as mediators of outcome in the multidisciplinary treatment of chronic low back pain.

    OpenAIRE

    Spinhoven, P.; Kuile, M. ter; Kole-Snijders, A.M.J.; Hutten Mansfeld, M.; Ouden, D.J. den; Vlaeyen, J. W. S.

    2004-01-01

    The aim of the present study was to examine (a) whether a cognitive-behavioral treatment (differentially) affects pain coping and cognition; and (b) whether changes in pain coping and cognition during treatment mediate treatment outcome. Participants in this randomized clinical trial were 148 patients with chronic low back pain attending a multidisciplinary treatment program consisting of operant-behavioral treatment plus cognitive coping skills training (N = 59) or group discussion (N = 58) ...

  8. Internet-based adherence interventions for treatment of chronic disorders in adolescents

    Directory of Open Access Journals (Sweden)

    Bass AM

    2015-05-01

    Full Text Available Alexandria M Bass,1 Michael E Farhangian,1 Steven R Feldman1–3 1Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA; 2Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA; 3Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA Background: Treatment adherence is a ubiquitous challenge in medicine, particularly in the adolescent population with chronic disorders. Web-based adherence interventions may be particularly useful in adolescents, due to their familiarity with and frequent use of the Internet. Objective: To review web-based interventions used to improve adherence to medication in adolescent patients with chronic disorders. Methods: A PubMed search was performed for full-text, English, clinical trials in adolescents using keywords “adherence” or “compliance”, “Internet” or “web”, and “treatment” from inception until November 2014. Articles were selected if they involved using the Internet to provide support to adolescents to help improve their adherence to treatment, excluding those focused on solely providing medical services through the Internet and articles focusing on preventative care, rather than treatment of an illness. Results: Fourteen studies were found concentrating on chronic adolescent disorders. Interventions included online surveys, physician chat lines, monitoring programs, and interactive programs. All interventions experienced either greater improvement in adherence or another disease control measure or no statistically significant difference compared with the control group (in-clinic visits. Limitations: Few clinical trials studying web-based interventions to improve adherence in adolescents were found. Due to not having one standard outcome measured in all of the studies, it was also difficult comparing the effectiveness of the interventions. Conclusion: Web

  9. Treatment of pediatric chronic inflammatory demyelinating polyneuropathy: Challenges, controversies, and questions

    Directory of Open Access Journals (Sweden)

    Jay Desai

    2015-01-01

    Full Text Available Pediatric chronic inflammatory demyelinating polyneuropathy (CIDP is an uncommon acquired disorder of unknown cause, presumed to have an immunological basis. We report 20 patients seen at Children′s Hospital Los Angeles over a period of 10 years. The outcome of our patients was favorable in a vast majority with good response to various treatments instituted. However, residual neurologic deficit was common. The choice of treatment modality was empirical and selected by the treating neurologist. Intravenous immunoglobulin (IVIG and corticosteroids were most commonly utilized for treatment. Plasmapheresis, mycophenolate mofetil, rituximab, cyclophosphamide, azathioprine, and abatacept were added if the patients were refractory to IVIG or became corticosteroid dependent. The spectrum of disease severity ranged from a single monophasic episode, to multiphasic with infrequent relapses with good response to IVIG, to progressive disease refractory to multiple therapies.

  10. Novel agents in the treatment of chronic lymphocytic leukemia: a review about the future.

    Science.gov (United States)

    Desai, Anjali Varma; El-Bakkar, Hassan; Abdul-Hay, Maher

    2015-06-01

    Half of a century ago, physicians managing chronic lymphocytic leukemia (CLL) recognized some of its presenting features such as lymphocytosis, lymphadenopathy, and splenomegaly. Subsequently, an enhanced understanding of the disease mechanisms involved in CLL led to new, more targeted treatments. There is now a plethora of treatments available for CLL. In this review article we discuss in detail several of the novel agents that are being studied or approved for the treatment of CLL including: phosphatidylinositol 3-kinase inhibitors (idelalisib and IPI-145), Bruton tyrosine kinase inhibitors (ibrutinib), B cell lymphoma 2 inhibitors (ABT-263 and ABT-199), new anti-CD20 monoclonal antibodies (obinutuzumab), cyclin-dependent kinase inhibitors (flavopiridol and dinaciclib), immunomodulators (lenalidomide) and chimeric antigen receptor T-cell therapy. PMID:25445466

  11. Periodontal Treatment Reduces Risk of Adverse Respiratory Events in Patients With Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Shen, Te-Chun; Chang, Pei-Ying; Lin, Cheng-Li; Chen, Chia-Hung; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang; Kao, Chia-Hung

    2016-01-01

    Abstract Treatment of periodontal diseases has been associated with benefit outcomes for patients with chronic obstructive pulmonary disease (COPD). However, no population-based cohort study has been conducted. We evaluated this relationship by retrospective cohort study using a large population data. Using the National Health Insurance claims data of Taiwan, we identified 5562 COPD patients with periodontal diseases who had received periodontal treatment as the treatment group. The comparison group was selected at a 1:1 ratio matched by the propensity score estimated with age, sex, date of COPD diagnosis and periodontal treatment, and comorbidities. Both groups were followed up for 5 years to compare risks of acute exacerbation, pneumonia, and acute respiratory failure. The incidence rates of adverse respiratory events were significantly lower in the treatment group than in the comparison group: 3.79 versus 4.21 per 100 person-years for emergency room visits, 2.75 versus 3.65 per 100 person-years for hospitalizations, and 0.66 versus 0.75 per 100 person-years for intensive care unit admissions. The treatment group also had a 37% reduced risk of deaths (1.81 vs 2.87 per 100 person-years), with an adjusted hazard ratio of 0.57 (95% confidence interval 0.52–0.62). Periodontal treatment for COPD patients could reduce the risk of adverse respiratory events and mortality. The adequate periodontal health care is important for COPD patients with periodontal diseases. PMID:27196497

  12. Changes in p-wave amplitude and axis after treatment of chronic obstructive pulmonary disease exacerbation

    International Nuclear Information System (INIS)

    To compare the change in P-wave amplitude and axis before and after 24 hours of the treatment of chronic obstructive pulmonary disease exacerbation. Study Design: Quasi-experimental study. Place and Duration of Study: Department of medicine, PNS Shifa Karachi from Dec-2010 to June-2011 (six months). Material and Methods: A total of 93 subjects were included in the study. Their pre-treatment and post treatment ECGs were evaluated by measuring P-wave amplitudes in leads II and aVF and P-wave axes were calculated. The differences in terms of changes in P-wave amplitude and axis were compared. Results: Mean age of patients was 53.09 ± 7.20 years. Before treatment P-wave amplitude in lead II was 2.36 ± 0.34 mm and after treatment it was 1.73 ± 0.29 mm (p < 0.001). P-wave amplitude in lead aVF before treatment was 2.446 ± 0.334 mm while after treatment it was 1.556 ± 0.329 mm (p < 0.001). P-wave axis before treatment was 72.670 ± 4.670 and after 24 hours of treatment it was 63.750 ± 3.950 (p < 0.001). Conclusion: Significant changes in terms of reduction of P-wave amplitude and left ward rotation of P-wave axis occur after effective treatment of acute exacerbation of COPD. These findings provide valuable objective evidence in evaluating patient's response to treatment and recommended to be used in clinical practice. (author)

  13. The outcome of treatment of chronic osteomyelitis according to an integrated approach.

    Science.gov (United States)

    Marais, Leonard C; Ferreira, Nando; Aldous, Colleen; Le Roux, Theo L B

    2016-08-01

    Previous classification systems of chronic osteomyelitis have failed to provide objective and pragmatic guidelines for selection of the appropriate treatment strategy. In this study, we assessed the short-term treatment outcome in adult patients with long-bone chronic osteomyelitis prospectively where a modified host classification system was integrated with treatment strategy selection through a novel management algorithm. Twenty-six of the 28 enrolled patients were available for follow-up at a minimum of 12 months. The median patient age of was 36.5 years (range 18-72 years). Fourteen patients (54 %) were managed palliatively, and 11 patients (42 %) were managed through the implementation of a curative treatment strategy. One patient required alternative treatment in the form of an amputation. The overall success rate was 96.2 % (95 % CI 80.4-99.9 %) at a minimum of 12-months follow-up. Remission was achieved in all [11/11] patients treated curatively (one-sided 95 % CI 73.5-100.0 %). Palliative treatment was successful in 92.9 % [13/14] of cases (95 % CI 66.1-99.9 %). In patients with lower limb involvement, there was a statistically significant improvement of 28.3 (95 % CI 21.0-35.7; SD 17.0) in the AAOS Lower Limb Outcomes Instrument score (p value osteomyelitis of long bones in adult patients in the developing world. Further investigation is required to validate the approach, and additional development of the algorithm may be required in order to render it useful in other clinical environments. PMID:27369868

  14. Current treatment options and response rates in children with chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Stefan Wirth

    2012-01-01

    Vertical transmission has become the most common mode of transmission of hepatitis C virus (HCV) in children. The rate of perinatal transmission from an HCVinfected mother to her child ranges from 2% to 5% and the prevalence of HCV in children in developed countries ranges between 0.1% and 0.4%. Spontaneous viral clearance seems to be dependent on the genotype and has been reported between 2.4%-25%. For chronically infected patients, treatment with recombinant polyethylene glycol (PEG)-interferon α-2b and daily ribavirin has now been approved as standard treatment for children 2-17 years of age. In five large prospective studies, a total of 318 children and adolescents aged 3-17 years were treated either with subcutaneous PEG-interferon α-2b at a dose of 1-1.5 μg/kg or 60 μg/m2 once a week in combination with oral ribavirin (15 mg/kg per day) or PEG-interferon α-2a with ribavirin. Subjects with genotype 1 and 4 received the medication for 48 wk and individuals with genotype 2 and 3 mainly for 24 wk. Overall sustained viral response (SVR) was achieved in 193/318 (60.7%) of treated patients. Stratified for genotype; 120/234 (51%) with genotype 1, 68/73 (93%) with genotype 2/3, and 6/11 (55%) with genotype 4 showed SVR. Relapse rate was between 7.7% and 17%. Overall, treatment was well tolerated; however,notable side effects were present in approximately 20%. According to recent experiences in the treatment of chronic hepatitis C in children and adolescents, a combination of PEG-interferon α with ribavirin has been found to be well tolerated and highly efficacious, particularly in individuals with genotype 2/3. Thus, this treatment can be recommended as standard of care until more effective treatment options will become available for genotype 1 patients.

  15. The Effect of Topical Nifedipine in Treatment of Chronic Anal Fissure

    Directory of Open Access Journals (Sweden)

    Farzaneh Golfam

    2010-10-01

    Full Text Available Chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. Reduction of hypertonocity is a special treatment for fissure healing. For this purpose chronic anal fissures were conventionally treated by anal dilatation or by lateral sphincterotomy. However, both of these methods may cause a degree of incontinence in some patients. The uptake of medical therapies that create a reversible chemical sphincterotomy has recently become widespread. The aim of this prospective clinical trial study was to assess the effectiveness of nifedipine in healing anal fissure, a calcium channel blocker that reduces sphincter pressure. A single-blind randomized comparative trial was setup to compare traditional treatment with stool softeners and 2% lidocaine cream against 0.5% nifedipine cream for 4 weeks. 110 patients were included in this study, 60 patients in the nifedipine group and 50 patients in the control group and the therapeutic outcome and side effects were recorded. Healing had occurred in 70% of patients in the nifedipine group and in 12% of patients in the control group after 4 weeks treatment (P

  16. In vivo imaging of nicotinic receptor upregulation following chronic (-)-nicotine treatment in baboon using SPECT

    International Nuclear Information System (INIS)

    To quantify changes in neuronal nAChR binding in vivo, quantitative dynamic SPECT studies were performed with 5-[123I]-iodo-A-85380 in baboons pre and post chronic treatment with (-)-nicotine or saline control. Infusion of (-)-nicotine at a dose of 2.0 mg/kg/24h for 14 days resulted in plasma (-)-nicotine levels of 27.3 ng/mL. This is equivalent to that found in an average human smoker (20 cigarettes a day). In the baboon brain the regional distribution of 5-[123I]-iodo-A-85380 was consistent with the known densities of nAChRs (thalamus > frontal cortex > cerebellum). Changes in nAChR binding were estimated from the volume of distribution (Vd ) and binding potential (BP) derived from 3-compartment model fits. In the (-)-nicotine treated animal Vd was significantly increased in the thalamus (52%) and cerebellum (50%) seven days post cessation of (-)-nicotine treatment, suggesting upregulation of nAChRs. The observed 33% increase in the frontal cortex failed to reach significance. A significant increase in BP was seen in the thalamus. In the saline control animal no changes were observed in Vd or BP under any experimental conditions. In this preliminary study, we have demonstrated for the first time in vivo upregulation of neuronal nAChR binding following chronic (-)-nicotine treatment

  17. The Administration and Effect of Sodium Nitroprusside in the Treatment of Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Sun Ming; Wang Wenmeng; Wu Qiong

    2000-01-01

    To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12.5 -75mg/24hrs);Group C was treated continuously with SNP (continuous infusion of 100-300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group.The results showed that the highly effective rates of the three groups were 46.9% (15/32), 90.5% (19/21)and 100% (12/12) respectively. The effective rates were 81.3% (26/32), 100% (21/21), 100%(12/12) respectively. The highly effective rates of group B and C were much higher than that of group A (P<0.005, P< 0.005) . The reduction of blood pressure of group B and C was greater than that of group A ( P < 0. 025) . Among the patients we studied, no body had severe side effects. We concluded that the use of SNP in the treatment of chronic congestive heart failure is safe, with better effect than routine treatment,and continous infusion of SNP is the best choice.

  18. Menopause in women with chronic immunosuppressive treatment - how to help those patients.

    Science.gov (United States)

    Cyganek, Anna; Pietrzak, Bronisława; Wielgoś, Mirosław; Grzechocińska, Barbara

    2016-03-01

    Women after organ transplantation with chronic immunosuppressive therapy or after bone marrow transplantation without such therapy are a growing group of patients. Although their problems in the peri- and postmenopausal period are the same as in healthy women, due to the primary disease and treatment applied they represent a huge challenge from the point of view of their hormonal treatment of menopause. Transplanted women have no particular contraindications for hormonal therapy use. General contraindications, however, such as arterial hypertension, thrombosis in medical history, diabetes, endometriosis, myomas, or active neoplastic disease, have a higher incidence in this group of patients than in healthy women, which significantly influences the possibility of using hormonal therapy. On the other hand, taking into consideration the predisposition for premature menopause in this group, in combination with chronic immunosuppression, it predisposes these patients for higher cardiovascular disease incidence and bone density loss, so hormonal therapy would be highly advisable. Therapy management in transplanted patients requires special care and close monitoring of the transplanted organ. Saving lives with organ transplantation is one of the greatest achievements of contemporary medicine. For long-term improvement of their quality of life, emphasis should be put on regular diagnostic examinations, early detection of abnormalities, and introduction of effective treatment. PMID:27095951

  19. Buprenorphine – an attractive opioid with underutilized potential in treatment of chronic pain

    Directory of Open Access Journals (Sweden)

    Khanna IK

    2015-12-01

    Full Text Available Ish K Khanna, Sivaram PillarisettiNeuroPn Therapeutics, Alpharetta, GA, USAAbstract: Despite proven clinical utility, buprenorphine has not been used widely for the treatment of chronic pain. Questions about “ceiling effect” or bell-shaped curve observed for analgesia in preclinical studies and potential withdrawal issues on combining with marketed µ-agonists continue to hinder progress in expanding full potential of buprenorphine in the treatment of cancer and noncancer pain. Mounting evidence from clinical studies and conclusions drawn by a panel of experts strongly support superior safety and efficacy profile of buprenorphine vs marketed opioids. No ceiling on analgesic effect has been reported in clinical studies. The receptor pharmacology and pharmacokinetics profile of buprenorphine is complex but unique and contributes to its distinct safety and efficacy. The buprenorphine pharmacology also allows it to be combined with other µ-receptor opioids for additivity in efficacy. Transdermal delivery products of buprenorphine have been preferred choices for the management of pain but new delivery options are under investigation for the treatment of both opioid dependence and chronic pain.Keywords: buprenorphine, opioids, opioid dependence, partial agonist, hyperalgesia, neuropathic pain

  20. AIR: Advances in Respiration - Music therapy in the treatment of chronic pulmonary disease.

    Science.gov (United States)

    Canga, Bernardo; Azoulay, Ronit; Raskin, Jonathan; Loewy, Joanne

    2015-12-01

    The aim of this randomized control study is to examine the effect of a multimodal psycho-music therapy intervention on respiratory symptoms, psychological well-being and quality of life of patients with Chronic Obstructive Pulmonary Disease and other lung diseases as adjunct to Pulmonary Rehabilitation with a design of music therapy plus PR compared to Pulmonary Rehabilitation alone. Music therapy group treatment including music visualization, wind playing and singing was provided weekly. This was compared with standard care treatment. Adults ages 48 to 88 (mean 70.1) with moderate to severe GOLD stage II-IV lung disease as well as other diseases processes that lead to chronic airflow limitations were included (n = 98). Participants in both conditions were followed from baseline enrollment to six weeks post control/treatment. Outcome measures included the Beck Depression Inventory Scale 2nd edition-Fast Screen (BDI-FS), Chronic Respiratory Questionnaire Self-Reported (CRQ-SR), and Dyspnea Visual Analog Scale (VAS). Results showed improvement in symptoms of depression (LS mean -0.2) in the music therapy group with statistical divergence between groups (p = 0.007). The CRQ-SR demonstrated improvement in dyspnea (p = 0.01 LS mean 0.5) and mastery (p = 0.06 LS mean 0.5) in the music therapy group and fatigue (p = 0.01 LS mean 0.3). VAS demonstrated highly significant effect in the music therapy group between weeks 5 and 6 (p music therapy combined with standard PR may prove to be an effective modality in the management of pulmonary disease. PMID:26522499

  1. [Application of modern wound dressings in the treatment of chronic wounds].

    Science.gov (United States)

    Triller, Ciril; Huljev, Dubravko; Smrke, Dragica Maja

    2012-10-01

    Chronic and acute infected wounds can pose a major clinical problem because of associated complications and slow healing. In addition to classic preparations for wound treatment, an array of modern dressings for chronic wound care are currently available on the market. These dressings are intended for the wounds due to intralesional physiological, pathophysiological and pathological causes and which failed to heal as expected upon the use of standard procedures. Classic materials such as gauze and bandage are now considered obsolete and of just historical relevance because modern materials employed in wound treatment, such as moisture, warmth and appropriate pH are known to ensure optimal conditions for wound healing. Modern wound dressings absorb wound discharge, reduce bacterial contamination, while protecting wound surrounding from secondary infection and preventing transfer of infection from the surrounding area onto the wound surface. The use of modern wound dressings is only justified when the cause of wound development has been established or chronic wound due to the underlying disease has been diagnosed. Wound dressing is chosen according to wound characteristics and by experience. We believe that the main advantages of modern wound dressings versus classic materials include more efficient wound cleaning, simpler placement of the dressing, reduced pain to touch, decreased sticking to the wound surface, and increased capacity of absorbing wound exudate. Modern wound dressings accelerate the formation of granulation tissue, reduce the length of possible hospital stay and facilitate personnel work. Thus, the overall cost of treatment is reduced, although the price of modern wound dressings is higher than that of classic materials. All types of modern wound dressings, their characteristics and indications for use are described. PMID:23193824

  2. Multiple spots of photodynamic therapy for the treatment of severe chronic central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Tsakonas GD

    2012-10-01

    Full Text Available George D Tsakonas, Athanasios I Kotsolis, Chrysanthi Koutsandrea, Ilias Georgalas, Dimitrios Papakonstantinou, Ioannis D LadasFirst Department of Ophthalmology, Medical School of Athens University, Athens, GreecePurpose: To evaluate the efficacy and safety of fluorescein angiography (FA-guided photodynamic therapy (PDT for the treatment of severe chronic central serous chorioretinopathy (CSC.Methods: Patients presenting with chronic CSC with multiple areas of retinal pigment epithelium decompensation, with or without focal leaks, were treated with FA-guided full-fluence PDT. Best-corrected visual acuity (BCVA, optical coherence tomography (OCT, FA, indocyanine green angiography, and fundus autofluorescence were used to determine functional and anatomic outcomes.Results: Twenty-one eyes (17 patients were treated with PDT and followed for a median of 24 months (range, 12–73. In fourteen eyes (66.66%, two PDT spots were performed within the same session. In three eyes (14.28%, three PDT spots were performed, in two eyes (9.52% four spots, and in two eyes (9.52% five spots. In 17 eyes (80.95%, the leakage in FA and the subretinal fluid in OCT disappeared after only one session of PDT. In four eyes (19.05%, a second session – with only one spot – of PDT was required due to persistent or recurrent leakage and subfoveal SRF. Median BCVA improved significantly from 20/63 at baseline to 20/40 at 3 months (P = 0.0002 and 20/32 at 6 months (P < 0.0001, and remained improved until the last examination (20/25, P < 0.0001. Two patients complained of a transient central scotoma after the treatment.Conclusion: FA-guided full-fluence PDT with multiple PDT spots within the same session seems to be effective and safe for the treatment of chronic CSC cases with multiple areas of retinal pigment epithelium decompensation.Keywords: central serous chorioretinopathy, photodynamic therapy

  3. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Stegenga Boudewijn

    2011-01-01

    Full Text Available Abstract Background Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effectiveness of multimodal treatment of MTrPs in patients with chronic shoulder pain. Methods A single-assessor, blinded, randomized, controlled trial was conducted. The intervention group received comprehensive treatment once weekly consisting of manual compression of the MTrPs, manual stretching of the muscles and intermittent cold application with stretching. Patients were instructed to perform muscle-stretching and relaxation exercises at home and received ergonomic recommendations and advice to assume and maintain good posture. The control group remained on the waiting list for 3 months. The Disabilities of Arm, Shoulder and Hand (DASH questionnaire score (primary outcome, Visual Analogue Scale for Pain (VAS-P, Global Perceived Effect (GPE scale and the number of muscles with MTrPs were assessed at 6 and 12 weeks in the intervention group and compared with those of a control group. Results Compared with the control group, the intervention group showed significant improvement (P Conclusions The results of this study show that 12-week comprehensive treatment of MTrPs in shoulder muscles reduces the number of muscles with active MTrPs and is effective in reducing symptoms and improving shoulder function in patients with chronic shoulder pain. Trial registration number ISRCTN: ISRCTN75722066

  4. The influence of chronic nicotine treatment on proteins expressed in the mouse hippocampus and cortex.

    Science.gov (United States)

    Matsuura, Kenji; Otani, Mieko; Takano, Masaoki; Kadoyama, Keiichi; Matsuyama, Shogo

    2016-06-01

    Chronic treatment with nicotine, the primary psychoactive substance in tobacco smoke, affects central nervous system functions, such as synaptic plasticity. Here, to clarify the effects of chronic nicotine treatment on the higher brain functions, proteomic analysis of the hippocampus and cortex of mice treated for 6 months with nicotine was performed using two-dimensional gel electrophoresis (2-DE) followed by mass spectrometry. There was significant change in the expression of 16 proteins and one phosphoprotein in the hippocampus (increased tubulin β-5, atp5b, MDH1, cytochrome b-c1 complex subunit 1, Hsc70, dynamin, profilin-2, 4-aminobutyrate aminotransferase, mitochondrial isoform 1 precursor, calpain small subunit 1, and vacuolar adenosine triphosphatase subunit B and decreased γ-actin, α-tubulin isotype M-α-2, putative β-actin, tubulin β-2A, NDUFA10, and G6PD) and 24 proteins and two phosphoproteins in the cortex (increased spectrin α chain, non-erythrocytic 1 isoform 1, tubulin β-5, γ-actin, creatine kinase B-type, LDH-B, secernin-1, UCH-L1, 14-3-3 γ, type II peroxiredoxin 1, PEBP-1, and unnamed protein product and decreased tubulin α-1C, α-internexin, γ-enolase, PDHE1-B, DPYL2, vacuolar adenosine triphosphatase subunit A, vacuolar adenosine triphosphatase subunit B, TCTP, NADH dehydrogenase Fe-S protein 1, protein disulfide-isomerase A3, hnRNP H2, γ-actin, atp5b, and unnamed protein product). Additionally, Western blotting validated the changes in dynamin, Hsc70, MDH1, NDUFA10, α-internexin, tubulin β-5 chain, and secernin-1. Thus, these findings indicate that chronic nicotine treatment changes the expression of proteins and phosphoproteins in the hippocampus and cortex. We propose that effect of smoking on higher brain functions could be mediated by alterations in expression levels of these proteins. PMID:26988295

  5. Challenges with current inhaled treatments for chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis.

    LENUS (Irish Health Repository)

    Greally, Peter

    2012-06-01

    Pseudomonas aeruginosa (Pa) is the predominant pathogen infecting the airways of patients with cystic fibrosis (CF). Initial colonization is usually transient and associated with non-mucoid strains, which can be eradicated if identified early. This strategy can prevent, or at least delay, chronic Pa infection, which eventually develops in the majority of patients by their late teens or early adulthood. This article discusses the management and latest treatment developments of Pa lung infection in patients with CF, with a focus on nebulized antibiotic therapy.

  6. [THE PLACE OF PANCREATICODUODENAL RESECTION IN SURGICAL TREATMENT OF COMPLICATED FORMS OF CHRONIC PANCREATITIS].

    Science.gov (United States)

    Pylypchuk, V I; Shevchuk, I M; Yavorskiy, A M; Dyriv, O L

    2015-11-01

    Results of surgical treatment of 120 patients, suffering complicated forms of chronic pancreatitis, were analyzed. In 5 patients pancreaticoduodenal resection in accordance to Whipple method have constituted the operation of choice. The indications for operation were: impossibility to exclude completely the malignant process inside pancreatic head; enhancement of the pancreatic head, causing duodenal, common biliary duct and the pancreatoduodenal zone vessels compression; cystic changes of pancreatic head with several episodes of hemorrhage inside the cyst and duodenum. The immediate, short-term and intermediate results of the operation were estimated as good and satisfactory. PMID:26939425

  7. The efficacy and tolerability of voriconazole in the treatment of chronic cavitary pulmonary aspergillosis.

    OpenAIRE

    Jain L, Denning DW.

    2006-01-01

    Voriconazole is the second oral drug licensed for the treatment of aspergillosis.A retrospective non-comparative study was conducted in 16 patients with chronic cavitary pulmonary aspergillosis (CCPA) treated with voriconazole.All patients had failed or were intolerant of itraconazole.The duration of therapy varied from 3 days to 16.5 months.Eleven patients received at least 3 months of therapy with no significant adverse events.Overall seven (64%) patients had a response at 3 months as asses...

  8. Investing in Obesity Treatment: Kaiser Permanente's Approach to Chronic Disease Management.

    Science.gov (United States)

    Tsai, Adam G; Histon, Trina; Donahoo, W Troy; Hashmi, Shahid; Murali, Sameer; Latare, Peggy; Oliver, Lajune; Slovis, Jennifer; Grall, Sarah; Fisher, David; Solomon, Loel

    2016-09-01

    Kaiser Permanente, an integrated health care delivery system in the USA, takes a "whole systems" approach to the chronic disease of obesity that begins with efforts to prevent it by modifying the environment in communities and schools. Aggressive case-finding and substantial investment in intensive lifestyle modification programs target individuals at high risk of diabetes and other weight-related conditions. Kaiser Permanente regions are increasingly standardizing their approach when patients with obesity require treatment intensification using medically supervised diets, prescription medication to treat obesity, or weight loss surgery. PMID:27342446

  9. Prucalopride: the evidence for its use in the treatment of chronic constipation

    Directory of Open Access Journals (Sweden)

    Georges Coremans

    2008-12-01

    Full Text Available Georges CoremansDivision of Gastroenterology, University Hospital Gasthuisberg, University of Leuven, Leuven, BelgiumIntroduction: Chronic constipation is a common condition that is difficult to treat. Existing options for the treatment of patients with different subgroups of constipation are limited. A new efficacious and safe drug is needed to limit the frequently observed adverse effects induced by laxatives, to improve general wellbeing and quality of life, and to provide an alternative for enemas or even resectional surgery in patients in whom stimulant laxatives cause disabling adverse effects or fail to increase bowel movement frequency. Aims: The purpose of this article is to assess the current evidence supporting the use of the selective and high affinity serotonin-4 (5-HT4 receptor agonist prucalopride in the management of chronic constipation.Evidence review: There are now convincing data from phase II and multicenter phase III randomized, double-blind, placebo-controlled trials that prucalopride treatment results in a clinically meaningful increase in the number of spontaneous complete bowel movements, a reduction of perceived severity of symptoms and improved disease-related quality of life in a significant proportion of patients. There is a rapid onset of the effect and the improvement is maintained for at least 12 weeks. Prucalopride in a dose of up to 4 mg per day appeared generally well tolerated and devoid of serious cardiac events. Adverse events, most frequently headache and nausea, are usually mild or moderate and occur mainly during the first days of treatment. Prucalopride should be used with prudence and with careful assessment of the benefit-risk ratio until more clinical and electrophysiologic data become available, because relatively few patients have been exposed to the drug for long periods of time.Place in therapy: Prucalopride 1–2 mg once daily may be given to patients suffering from chronic constipation for whom

  10. Chronic morphine treatment up-regulates mu opioid receptor binding in cells lacking Filamin A

    OpenAIRE

    Onoprishvili, Irma; Simon, Eric J.

    2007-01-01

    We investigated the effects of morphine and other agonists on the human mu opioid receptor (MOP) expressed in M2 melanoma cells, lacking the actin cytoskeleton protein filamin A and in A7, a sub clone of the M2 melanoma cells, stably transfected with filamin A cDNA. The results of binding experiments showed, that after chronic morphine treatment (24 hr) of A7 cells, MOP binding sites were down-regulated to 63% of control, whereas, unexpectedly, in M2 cells, MOP binding was up-regulated to 188...

  11. The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2015-10-01

    Full Text Available Bruno Bordoni,1–3 F Marelli2,3 1Don Carlo Gnocchi Foundation, Department of Cardiology, IRCCS Santa Maria Nascente, Milan, Italy; 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, AN, Italy; 3School CRESO, Osteopathic Centre for Research and Studies, Castellanza, VA, Italy Abstract: Chronic heart failure is a progressive, debilitating disease, resulting in a decline in the quality of life of the patient and incurring very high social economic costs. Chronic heart failure is defined as the inability of the heart to meet the demands of oxygen from the peripheral area. It is a multi-aspect complex disease which impacts negatively on all of the body systems. Presently, there are no texts in the modern literature that associate the symptoms of exercise intolerance of the patient with a dysfunction of the fascial system. In the first part of this article, we will discuss the significance of the disease, its causes, and epidemiology. The second part will explain the pathological adaptations of the myofascial system. The last section will outline a possible osteopathic treatment for patients with heart failure in order to encourage research and improve the general curative approach for the patient. Keywords: manual therapy, fatigue, chronic heart failure, osteopathic

  12. [Long-term results of the surgical treatment of chronic pancreatitis].

    Science.gov (United States)

    Padillo Ruiz, F J; Rufián, S; Varo, E; Solorzano, G; Miño, G; Pera Madrazo, C

    1994-08-01

    We analized the long-term results after surgical treatment in 41 patients with chronic pancreatitis. Twenty one of them underwent resection: 19 pancreaticoduodenectomy (11 Whipple procedure and 8 Traverso Longmire); total pancreatectomy (1) and near-total pancreatectomy (1). In the remaining 20 patients a drainage procedure was carried out: Puestow-Duval (5); Partington (7); double derivation: pancreatic and biliar (5); triple derivation: pancreatic, biliar, gastric (2) and Nardi procedure+quisteduodenostomy in one patient. The following were evaluated: persistent pain; chronic alcoholism; nutrition status; exocrine function (syntomatic steatorrea, use of pancreatic enzyme preparation and fecal determination of glucide, protids and lipids) and endocrine function (glucose and insulin levels and glucose oral test). Surgery failed to relieve pain in 15.6% of the patients; failures were associated chronic alcoholism (p < 0.05); 18 patients (44%) required oral pancreatic enzymes. There weren't significant differences between resection and drainage procedures regarding the exocrine function. However, endocrine function was significantly worse (p < 0.05) after pancreaticoduodenectomy than after drainages procedures. Among the late, the endocrine function was better after Partington operation than after the Puestow-Duval. PMID:7946606

  13. [Mucolytics in acute and chronic respiratory tract disorders. II. Uses for treatment and antioxidant properties].

    Science.gov (United States)

    Kupczyk, Maciej; Kuna, Piotr

    2002-03-01

    In the first part of our editorial we reviewed the possible factors responsible for mucus hypersecretion in acute and chronic pulmonary diseases. The present paper presents the results of studies proving, that mucolytics are useful in adjunctive therapy of respiratory tract disorders. Mucolytic agents such as Ambroxol and N-acetylcysteine are able to alter the secretion of mucus and its physical properties which results in improvement of mucociliary clearance. Current evidence indicate, that these drugs are effective, especially in chronic obstructive pulmonary disease, asthma and acute bronchitis. They produce a modest improvement in symptom control and lung function. It has been demonstrated that there is a synergism between mucolytics and antibiotics in the treatment of exacerbation of chronic bronchitis. Moreover, they act as scavengers of reactive oxygen species. Ambroxol is able to inhibit mediator release involved in the pathogenesis of allergic inflammation. As mucolytics are cheap and well-tolerated they are beneficial in the therapy of patients suffering from respiratory tract disorders. PMID:12053601

  14. Microbubble mediated thrombus dissolution with diagnostic ultrasound for the treatment of chronic venous thrombi.

    Directory of Open Access Journals (Sweden)

    Shelby Kutty

    Full Text Available BACKGROUND: Central venous catheter (CVC thrombi result in significant morbidity in children, and currently available treatments are associated with significant risk. We sought to investigate the therapeutic efficacy of microbubble (MB enhanced sonothrombolysis for aged CVC associated thrombi in vivo. METHODS AND RESULTS: A model of chronic indwelling CVC in the low superior vena cava with thrombus in situ was established after feasibility and safety testing in 7 pigs; and subsequently applied for repeated, sonothrombolytic treatments in 9 pigs (total 24 treatments. Baseline intracardiac echocardiography (ICE, 10.5F, Siemens, fluoroscopy and saline flushing confirmed the absence of any pre-existing CVC thrombus. A thrombus was then allowed to form and age over 24 hours. The created thrombus was localized and measured by ICE, and transthoracic image guided high mechanical index (MI two-dimensional US treatments (1.1-1.7 MI; iE33, Philips applied intermittently whenever intravenously infused MBs (3% MRX-801; NuVox were visualized near the thrombus (n = 10; Group A. Control pigs (n = 10; Group B received US without MB. All treatments were randomized. Post-treatment thrombus area by ICE planimetry was compared with pre-treatment measurements. Thrombus area measurements before and after treatment were 0.22 and 0.10 cm(2 respectively in Group A; compared to 0.24 and 0.21 cm(2 in Group B (p  = 0.0003. Effectiveness of longer duration US and MB thrombolytic treatments were studied (n = 4, which suggested that near complete thrombus dissolution is possible. No pulmonary emboli, alterations in oxygen saturation, or hemodynamics occurred with either treatment. CONCLUSIONS: Guided high MI diagnostic US+systemic MB facilitates reduction of aged CVC associated thrombi in vivo. MB enhanced sonothrombolytic therapy may be a non-invasive safe alternative to thrombolytic agents in treating thrombotic CVC occlusions.

  15. Improving compliance with iron infusion therapy in the treatment of chronic anemia in haemodialysis patients with chronic kidney disease

    OpenAIRE

    Nuti, Amith

    2015-01-01

    This quality improvement project was conducted at the haemodialysis unit in the paediatric nephrology department at Noah's Ark Children's Hospital, Cardiff. Stakeholders involved were the medical and nursing staff at the haemodialysis unit, responsible for the care of children with chronic kidney disease CKD. Anaemia is prevalent among children with CKD. Iron infusion is administered to such children with chronic anaemia. Children on haemodialysis attending the Children's Kidney Center receiv...

  16. Influence of a cyclodextrin on soil wettability

    Directory of Open Access Journals (Sweden)

    Muranyi A.

    2002-06-01

    Full Text Available The effect of various doses of the randomly methylated b-cyclodextrin on changes in surface free energy and wettability of a natural, and a humic acid enriched, loessial soil Orthic Luvisol was studied. A thin column wicking technique was used to determine the horizontal migration velocity vs. time depen- dence in the sample beds for a range of liquids of various surface tensions (surface free energies. From the latter dependencies the surface free energy and its components (water contact angles, works of adhesion and force of interparticle interaction via water layer were estimated for the studied materials. The dispersive component of the surface free energy was least affected by the added cyclodextrin, however for the natural soil this markedly increased after the highest (2.5%w/w cyclodextrin addition. The polar, acid-base component decreased in general with the cyclodextrin dose increase. The contribution of the electron-donor interactions to the polar surface free energy com- ponent decreased after low cyclodextrin doses (0.1 and 0.5% and increased after the highest (2.5% dose. Generally, the opposite tendency was noted for the electron-acceptor contribution. The wettability of the soil decreased at low cyclodextrin concentration and increased again at the highest load. The increase in the cyclodextrin concentration decreased the effective radius of the soil bed which caused an increase in the average force of in- teraction between soil particles via water layer, despite the simul- taneous decrease of adhesion forces of water to the soil.

  17. Cardiovascular complications following chronic treatment with cocaine and testosterone in adolescent rats.

    Directory of Open Access Journals (Sweden)

    Sheila A Engi

    Full Text Available Concomitant use of anabolic androgenic steroids and cocaine has increased in the last years. However, the effects of chronic exposure to these substances during adolescence on cardiovascular function are unknown. Here, we investigated the effects of treatment for 10 consecutive days with testosterone and cocaine alone or in combination on basal cardiovascular parameters, baroreflex activity, hemodynamic responses to vasoactive agents, and cardiac morphology in adolescent rats. Administration of testosterone alone increased arterial pressure, reduced heart rate (HR, and exacerbated the tachycardiac baroreflex response. Cocaine-treated animals showed resting bradycardia without changes in arterial pressure and baroreflex activity. Combined treatment with testosterone and cocaine did not affect baseline arterial pressure and HR, but reduced baroreflex-mediated tachycardia. None of the treatments affected arterial pressure response to either vasoconstrictor or vasodilator agents. Also, heart to body ratio and left and right ventricular wall thickness were not modified by drug treatments. However, histological analysis of left ventricular sections of animals subjected to treatment with testosterone and cocaine alone and combined showed a greater spacing between cardiac muscle fibers, dilated blood vessels, and fibrosis. These data show important cardiovascular changes following treatment with testosterone in adolescent rats. However, the results suggest that exposure to cocaine alone or combined with testosterone during adolescence minimally affect cardiovascular function.

  18. The effect of L-thyroxine treatment on chronic idiopathic urticaria and autoimmune thyroiditis.

    Science.gov (United States)

    Magen, Eli; Mishal, Joseph

    2012-01-01

    Autoimmune thyroiditis (AT) is more prevalent in patients with chronic idiopathic urticaria CIU) than in the general population. Previous small studies without any controlled comparison reported that CIU remits in patients with CIU and AT treated with L-thyroxine. To determine whether l-thyroxine treatment can improve the clinical course of CIU in patients with the co-occurrence of AT and CIU. A total of 749 patients with CIU were retrospectively studied. Clinical and laboratory evaluation and classification of chronic urticaria were performed according to the EAACI/GA(2)LEN/EDF/WAO guidelines. After L-thyroxine treatment for 53 ± 19 days, euthyroidism was restored in all subjects. Urticaria activity score (UAS) was evaluated at baseline and after three and six months. The control group consisted of matched 44 euthyroid subjects with CIU. A total of 44 (5.9%) patients were diagnosed to have hypothyroidism related to AT. Autologous serum skin test (ASST) was found to be positive in 17 (38.6%) of them. There was no statistically significant difference in baseline UAS, between the ASST+ (3.94 ± 1.52) and the ASST- (3.63 ± 1.42; P = 0.27) hypothyroid subjects and the euthyroid CIU controls (3.73 ± 1.74). During the L-thyroxine treatment, a significant reduction of UAS was observed in both hypothyroid ASST+ and ASST- subjects. However, the mean UAS after three and six months of L-thyroxine treatment remained not significantly different from that in control euthyroid subjects with CIU. L-Thyroxine treatment has no effect on the course of CIU in patients with CIU and AT. PMID:22182385

  19. Effect of chronic treatment with a cyclooxygenase inhibitor on reproductive parameters in male rat

    International Nuclear Information System (INIS)

    Indomethacin is a member of non-steroidal anti-inflammatory drugs (NSAIDs) commonly used for treatment of gout, arthritis, and other inflammatory conditions. It has been shown to inhibit ovarian prostaglandins synthesis in mammals, birds, fish and reptiles. However, the effects of its chronic administration on male reproductive functions remain largely unknown. Using rat as a model, we studied the effect of chronic treatment with indomethacin on the male reproductive system. Methods: Testosterone was measured in the serum, testicular tissue, and testicular interstitial fluid by radioimmunoassay. Moreover, we also studied the direct effect of indomethacin in vitro on luteinizing hormone stimulated testosterone secretion from the Leydig cells isolated from various treatment groups. Results: Indomethacin treatment for 50 days caused a significant but reversible decrease in prostate weight, epididymal sperm reserves and sperm motility score compared with control rats (p<0.05). In vitro stimulation of Leydig cells isolated from treated rat's testes with luteinizing hormone (250 mu IU) produced significantly reduced testosterone compared with cells from control groups (p<0.05). Furthermore, stimulatory effect of luteinizing hormone on the control Leydig cells was significantly reduced when these cells were challenged with luteinizing hormone in the presence of indomethacin, (p<0.05). Testosterone concentration in the testicular tissue and testicular interstitial fluid reduced after indomethacin treatment (p<0.05). Conclusion: Due to its significant inhibition of key reproductive hormones, indomethacin effectively inhibits reproductive functions if used on a long-term basis. In his study, we have identified potential risks in the long-term use of cyclooxygenase inhibitors. (author)

  20. Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes

    Directory of Open Access Journals (Sweden)

    Aryal S

    2014-10-01

    Full Text Available Shambhu Aryal,1 Enrique Diaz-Guzman,2 David M Mannino3 1Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, 2Division of Pulmonary, Allergy and Critical Care, University of Alabama, Birmingham, AL, 3Department of Preventive Medicine and Environmental Health, University of Kentucky, Lexington, KY, USA Abstract: Chronic obstructive pulmonary disease (COPD, one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research. Keywords: chronic obstructive lung disease, sex, smoking, comorbidity, sex bias