A retrospective study of treatment persistence and adherence to α-blocker plus antimuscarinic combination therapies, in men with LUTS/BPH in the Netherlands.

Science.gov (United States)

Drake, Marcus J; Bowditch, Sally; Arbe, Emilio; Hakimi, Zalmai; Guelfucci, Florent; Amri, Ikbel; Nazir, Jameel

2017-05-22

To assess treatment persistence and adherence in men ≥45 years of age with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH), using prescription records from the Netherlands IMS Lifelink™ LRx database. In this retrospective, observational cohort study, we identified men who received combination therapy with an α-blocker plus an antimuscarinic (e.g. solifenacin or tolterodine) between 1 November 2013 and 31 October 2014. Treatment could be received as a fixed-dose combination (FDC) tablet or as two drugs administered together (concomitant therapy), if both combination drugs were prescribed within 30 days. The primary objective was to assess treatment persistence, defined as the time from initiation of combination therapy until first discontinuation of the FDC or at least one of the drugs given concomitantly (i.e. ≥30 days without prescription renewal). Subgroup and sensitivity analyses were conducted to assess persistence by antimuscarinic agent, and with different gap lengths used to define discontinuation (45, 60 and 90 days), respectively. A total of 1891 men received an α-blocker plus an antimuscarinic (FDC, N = 665; concomitant therapy, N = 1226). Median time to discontinuation was significantly longer with FDC versus concomitant therapy (414 vs. 112 days; adjusted hazard ratio [HR] 2.04, 95% confidence interval 1.77, 2.35; p BPH treated with α-blocker plus antimuscarinic combination therapy in the Netherlands showed that treatment persistence was significantly greater in those who received a FDC tablet compared with combination therapy given concomitantly. The study also shows that treatment persistence was extended in men who received combination therapy containing solifenacin compared with other antimuscarinics. Overall, these findings may be useful for prescribers, as improved persistence on-treatment may translate into improved outcomes for men with LUTS/BPH. Further study is warranted to establish the key

Pulse Sign Separation Technique for the Received Bits in Wireless Ultra-Wideband Combination Approach

Directory of Open Access Journals (Sweden)

Rashid A. Fayadh

2014-01-01

Full Text Available When receiving high data rate in ultra-wideband (UWB technology, many users have experienced multiple-user interference and intersymbol interference in the multipath reception technique. Structures have been proposed for implementing rake receivers to enhance their capabilities by reducing the bit error probability (Pe, thereby providing better performances by indoor and outdoor multipath receivers. As a result, several rake structures have been proposed in the past to reduce the number of resolvable paths that must be estimated and combined. To achieve this aim, we suggest two maximal ratio combiners based on the pulse sign separation technique, such as the pulse sign separation selective combiner (PSS-SC and the pulse sign separation partial combiner (PSS-PC to reduce complexity with fewer fingers and to improve the system performance. In the combiners, a comparator was added to compare the positive quantity of positive pulses and negative quantities of negative pulses to decide whether the transmitted bit was 1 or 0. The Pe was driven by simulation for multipath environments for impulse radio time-hopping binary phase shift keying (TH-BPSK modulation, and the results were compared with those of conventional selective combiners (C-SCs and conventional partial combiners (C-PCs.

Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis.

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Chen, Ruey; Chan, Pi-Tuan; Chu, Hsin; Lin, Yu-Cih; Chang, Pi-Chen; Chen, Chien-Yu; Chou, Kuei-Ru

2017-01-01

This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychological symptoms in dementia (BPSD), and global functions. PubMed, Medline, Embase, PsycINFO, and Cochrane databases were used to search for English and non-English articles for inclusion in the meta-analysis to evaluate the effect size and incidence of adverse drug reactions of different treatments. Compared with patients who received donepezil alone, those who received donepezil in combination with memantine exhibited limited improvements in cognitive functions (g = 0.378, p Alzheimer Disease.

Retrospective evaluation of combined modality treatment and prognostic factors in patients with esophageal cancer

International Nuclear Information System (INIS)

Neuhof, Dirk; Neumayer, Florian; Debus, Juergen; Einbeck, Wolfgang; Haschemian, Kai; Mai, Sabine K.; Wenz, Frederik; Hochhaus, Andreas; Willeke, Frank; Rudi, Jochen

2005-01-01

The influence of prognostic factors and combined modality treatment on survival was evaluated retrospectively for 156 patients with esophageal cancer receiving radiotherapy in different modalities between 1991 and 2001 at the Univ. of Heidelberg and the Universitaetsklinikum Mannheim. Forty-six patients (29.5%) were treated with radiotherapy alone, 74 patients (47.4%) had combined radiochemotherapy and 36 patients (23.1%) were operated on after receiving neoadjuvant radiochemotherapy. The median follow-up time was 10 months. Female patients showed a significantly better overall survival compared with male patients (p=0.031), younger patients (age 60 years) (p=0.02). Patients with hemoglobin concentration>13.4 g/dl before therapy (median hemoglobin concentration) had a significantly better overall survival than patients with lower hemoglobin concentration (p=0.044). Patients who received combined radiochemotherapy (with or without operation) had a survival advantage compared with radiotherapy alone. Overall survival after neoadjuvant treatment followed by operation was significantly better than in the two other groups, median survival times were 20 vs. 9 (RCHT) vs. 8 months (RT) (p=0.003). The data presented show for the first time that hemoglobin concentration in addition to gender and age was a prognostic factor for patients with esophageal cancer. A low hemoglobin value was a negative predictor

The effectiveness of RECIST on survival in patients with NSCLC receiving chemotherapy with or without target agents as first-line treatment.

Science.gov (United States)

Zhou, Ting; Zheng, Lie; Hu, Zhihuang; Zhang, Yang; Fang, Wenfeng; Zhao, Yuanyuan; Ge, Jieying; Zhao, Hongyun; Zhang, Li

2015-01-08

We analyzed the correlation between survival and antitumor effect evaluated by RECIST in advanced NSCLC patients with chemotherapy plus target therapy or not as first-line treatment, to examine the applicability of RECIST in this population. The patients were screened from 4 clinical trials (12621, 12006, FASTACT-I, and FASTACT-II), and those who received chemotherapy plus target therapy or chemotherapy alone were eligible. Among the 59 enrolled patients, 29 received combination therapy, while the other 30 received chemotherapy only. In the combination therapy group, patients with PR or SD had longer overall survival (OS) than those with PD (P chemotherapy alone group, compared with PD patients, either PR or SD group had no significant overall survival benefit (P = 0.690 and P = 0.528, respectively). In summary, for advanced NSCLC patients receiving chemotherapy plus target therapy as first-line treatment and evaluated by RECIST criteria, SD has the same overall survival benefit as PR, suggesting that antitumor effective evaluation by RECIST criteria cannot be translated to overall survival benefit especially for this kind of patients. Therefore, developing a more comprehensive evaluation method to perfect RECIST criteria is thus warranted for patients received target therapy in NSCLC.

Abnormal liver stiffness assessed using transient elastography (Fibroscan® in HIV-infected patients without HBV/HCV coinfection receiving combined antiretroviral treatment.

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Sang Hoon Han

Full Text Available BACKGROUND AND AIMS: Liver stiffness measurement (LSM using transient elastography (Fibroscan® can identify individuals with potential underlying liver disease. We evaluated the prevalence of abnormal LSM values as assessed using LSM and its predictors in HIV-infected asymptomatic patients receiving combined antiretroviral treatment (cART without HBV/HCV coinfection. METHODS: We prospectively recruited 93 patients who had consistently been undergoing cART for more than 12 months at Severance Hospital in Seoul, Republic of Korea, from June to December 2010. LSM values >5.3 kPa were defined as abnormal. RESULTS: Thirty-nine (41.9% had abnormal LSM values. On multivariate correlation analysis, the cumulative duration of boosted and unboosted protease inhibitors (PIs were the independent factors which showed a negative and positive correlation to LSM values, respectively (β = -0.234, P = 0.023 and β = 0.430, P<0.001. In multivariate logistic regression analysis, the cumulative exposure duration of boosted-PIs and γ-glutamyltranspeptidase levels were selected as the independent predictors which showed a negative and positive correlation with abnormal LSM values, respectively (odds ratio [OR], 0.941; 95% confidence interval [CI], 0.889-0.997; P = 0.039 and OR, 1.032; 95% CI, 1.004-1.060; P = 0.023. CONCLUSION: The high percentage of HIV-infected asymptomatic patients receiving cART without HBV/HCV coinfection had abnormal LSM values. The cumulative exposure duration of boosted-PIs and γ-GT level were independent predictors which showed a negative and positive correlation with abnormal LSM values, respectively.

Control study of pulmonary surfactant combined with CPAP and BIPAP ventilation modes respectively in treatment of neonatal NRDS

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Yao Liu

2016-04-01

Full Text Available Objective: To analyze the differences in effect of pulmonary surfactant combined with CPAP and BIPAP ventilation modes respectively in treatment of neonatal NRDS. Methods: A total of 50 cases of children with neonatal respiratory distress syndrome (NRDS born and receiving treatment in our hospital from August 2012 to January 2015 were selected as research subjects and randomly divided into observation group and control group, each with 25 cases. Control group received pulmonary surfactant combined with CPAP ventilation mode treatment, observation group received pulmonary surfactant combined with BIPAP ventilation mode treatment, and then differences in blood gas indicators and mechanical ventilation parameters, pulmonary artery pressure, endothelin and nitric oxide levels, blood coagulation and anticoagulation indicators and protein expression levels of CD24, TNF-α, IL-6 and IL-17A of two groups after treatment were compared. Results: PaO2, PH value and oxygenation index of observation group after treatment were higher than those of control group, and PaCO2, positive end-expiratory pressure, peak inspiratory pressure and inspired oxygen concentration were lower than those of control group; pulmonary artery pressure and EF-1 level of observation group after treatment were lower than those of control group, and NO level was higher than that of control group; PC, TPS and AT-Ⅲ levels of observation group after treatment were higher than those of control group, and D-D and vWF levels were lower than those of control group; protein expression of CD24 and IL-6 of observation group after treatment were lower than those of control group, and protein expression of TNF-α and IL-17A were higher than those of control group. Conclusion: Pulmonary surfactant combined with BIPAP ventilation mode treatment of children with NRDS can effectively optimize ventilation function and realize homeostasis, and it has active clinical significance.

Receiver Architectures for MIMO-OFDM Based on a Combined VMP-SP Algorithm

DEFF Research Database (Denmark)

Manchón, Carles Navarro; Kirkelund, Gunvor Elisabeth; Riegler, Erwin

2011-01-01

, such as the sum-product (SP) and variational message passing (VMP) algorithms, have become increasingly popular. In this contribution, we apply a combined VMP-SP message-passing technique to the design of receivers for MIMO-ODFM systems. The message-passing equations of the combined scheme can be obtained from......Iterative information processing, either based on heuristics or analytical frameworks, has been shown to be a very powerful tool for the design of efficient, yet feasible, wireless receiver architectures. Within this context, algorithms performing message-passing on a probabilistic graph...... assessment of our solutions, based on Monte Carlo simulations, corroborates the high performance of the proposed algorithms and their superiority to heuristic approaches....

[Treatment results for different categories of vaginal intraepithelial neoplasia with electrocoagulation, 5-fluorouracil and combined treatment].

Science.gov (United States)

Veloz-Martínez, María Guadalupe; Quintana-Romero, Verónica; Contreras-Morales, María del Rosario Sandra; Jiménez-Vieyra, Carlos Ramón

2015-10-01

Vaginal intraepithelial neoplasia (VAIN) represents a variety of changes that initiate as an intraepithelial squamous lesion with the possibility of resulting in cancer. To compare the results of the treatment for the different categories of VAIN with electrocoagulation, 5-fluorouracil and combined treatment. Observational an analytical study. We stablished groups according to the category of VAIN evaluating and comparing remission, persistence, recurrence, or progression of the disease ac- cording to the received treatment, with a 1-year follow up. The results were compared by chi2 and Kruskal Wallis. The statistics analysis was done with the SPSS program version 20. One hundred thirty seven patients between 20 and 81 years of age (mean age: 52.49 years) were included. Seventy-four percent of the patients had a history of premalignant or malignant cervical lesions. Seventy-four patients had VAIN I, 34 patients had VAIN II, 22 patients had VAIN III and there were seven cases of vaginal carcinoma in situ. Fifty-eight patients were treated with electrocoagulation, 55 patients were treated with 5-FU, 16 patients had combined treatment, and eight patients received expectant management. Sixty three percent of patients had total remission of the lesion, 34% had persistence and 3% showed progression, and there were no cases of recurrence. Results were better in patients with VAIN I treated with 5-FU (bigger percentage of remission P .026), for the remaining categories of VAIN, no treatment showed superior results. The superior response occurs in patients with VAIN I treated with 5-FU. None of the treatments achieves a 100% remission. The VAIN frequency is high, patients with a history of malignant or premalignant cervical pathology should undergo a closer surveillance through cytocolposcopic control with respect to the remaining population.

Combined Kinesiotaoe and Therapeutic Ultrasound in the Treatment of Carpal Tunnel Syndrome

International Nuclear Information System (INIS)

Mohamed, O.G.; Elhafez, H.M.; Alshatoury, H.A.; Refaat, R.

2016-01-01

Background : Carpal tunnel syndrome is the most common neuropathy of the upper limb and a significant contributor to hand functional impairment and disability. Hand is an Accepted November 2016 . important part of body to perform the complex daily living activities. Purpose: To find out effect of combined kinesiotape and therapeutic ultrasound in the treatment of carpal tunnel syndrome. Material and Methods :Thirty Carpal Tunnel Syndrome female patients with positive electro diagnostic findings (MMDL >4.2 ms) participated in this study, their ages ranged between 40 and 50 years. Design of study :They were divided randomly into two equal groups. Group (A) received kinesiotape applicatio n on the affected wrist for 3 days, then day off and then another three days each week for 4 weeks combined with a program of 12 sessions of continuous ultrasound, 3 sessions per week for 5 minute persession in addition nerve and tendon gliding exercise . While, Group (B) received a program of 12 sessions of continuous ultrasound, 3 sessions per week for 5 minute per session in addition tendon and nerve gliding exercise. The treatment program continued for 4 weeks. Boston carpal tunnel questionnaire and median motor distallatency, visual analogue scale and hand grip dynamometer were performed before and after the treatment program for all patients of the two groups. Results : The obtained results showed a highly statistically significant (P< 0.0001) improvement in both groups (A and B) concerning Boston carpal tunnel questionnaire , visual analogue scale and hand grip dynamometer but there was significant improvement in group (A) only concerning median motor distal latency. The improvement was highly significant (P< 0.0001) in group (A) when compared with group (B). Conclusion: It could be concluded that the use of combined kinesiotape and therapeutic ultrasound in the treatment of carpal tunnel syndrome appeared to be effective. Yet the combined effect of kinesiotape with

Combined (radiation and surgery) treatment of laryngeal cancer patients using metronidazole

International Nuclear Information System (INIS)

Andreev, V.G.

1985-01-01

The results of combined treatment of 98 laryngeal cancer patients followed up for 1.5-3 years were analysed. Of them 68 received a preoperative radiotherapy course conbined with the metronidazole. The drug was given in the form of a sugar syrup suspension at a dose of 100-150 mg/kg 2.5-3 hours before irradiation, at 5 Gy twice a week reaching a summary focal dose of 20 Gy. Thirty patients received radiation therapy without metronidazole. Altogether 4 preoperative radiotherapy methods were used. An analysis of the results showed a significant improvement of the cure rates for laryngeal cancer patients using metronidazole. A better healing of postoperative wounds was noted. The author proved the appropriateness of preoperative irradiation by mean fractions up to a summary focal dose of 20 Gy combined with metronidazole and subsequent (on the last or next day of irradiation) radical operation

Gestrinone combined with ultrasound-guided aspiration and ethanol injection for treatment of chocolate cyst of ovary.

Science.gov (United States)

Wu, Xiaoyun; Xu, Yun

2015-05-01

The aim of this study was to determine clinical performance of gestrinone combined with ultrasound-guided aspiration and ethanol injection in treating chocolate cyst of ovary. Sixty-eight patients enrolled in this study were randomly divided into two groups: control group and combination treatment group. In the control group, 34 patients were treated with ultrasound-guided aspiration and ethanol injection. In the combination treatment group, 34 patients received gestrinone p.o. following ultrasound-guided aspiration and ethanol injection. The recurrence rate of chocolate cyst was 10-fold lower in the combination treatment group (2.94%, 1/34) than in the control group (29.4%, 10/34) at 12 months. The effective rate for reduction of chocolate cyst was significantly higher in the combination treatment group (94.12%, 32/34) than in the control group (64.71%, 22/34) (P = 0.009). Gestrinone combined with ultrasound-guided aspiration and ethanol injection therapy is an effective treatment for ovarian chocolate cyst with low recurrence rate. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Pharmacokinetics of combined treatment with praziquantel and albendazole in neurocysticercosis

Science.gov (United States)

Garcia, Hector H; Lescano, Andres G; Lanchote, Vera L; Pretell, E Javier; Gonzales, Isidro; Bustos, Javier A; Takayanagui, Osvaldo M; Bonato, Pierina S; Horton, John; Saavedra, Herbert; Gonzalez, Armando E; Gilman, Robert H

2011-01-01

AIMS Neurocysticercosis is the most common cause of acquired epilepsy in the world. Antiparasitic treatment of viable brain cysts is of clinical benefit, but current antiparasitic regimes provide incomplete parasiticidal efficacy. Combined use of two antiparasitic drugs may improve clearance of brain parasites. Albendazole (ABZ) has been used together with praziquantel (PZQ) before for geohelminths, echinococcosis and cysticercosis, but their combined use is not yet formally recommended and only scarce, discrepant data exist on their pharmacokinetics when given together. We assessed the pharmacokinetics of their combined use for the treatment of neurocysticercosis. METHODS A randomized, double-blind, placebo-controlled phase II evaluation of the pharmacokinetics of ABZ and PZQ in 32 patients with neurocysticercosis was carried out. Patients received their usual concomitant medications including an antiepileptic drug, dexamethasone, and ranitidine. Randomization was stratified by antiepileptic drug (phenytoin or carbamazepine). Subjects had sequential blood samples taken after the first dose of antiparasitic drugs and again after 9 days of treatment, and were followed for 3 months after dosing. RESULTS Twenty-one men and 11 women, aged 16 to 55 (mean age 28) years were included. Albendazole sulfoxide concentrations were increased in the combination group compared with the ABZ alone group, both in patients taking phenytoin and patients taking carbamazepine. PZQ concentrations were also increased by the end of therapy. There were no significant side effects in this study group. CONCLUSIONS Combined ABZ + PZQ is associated with increased albendazole sulfoxide plasma concentrations. These increased concentrations could independently contribute to increased cysticidal efficacy by themselves or in addition to a possible synergistic effect. PMID:21332573

Efficacy of combined orthodontic-periodontic treatment for patients with periodontitis and its effect on inflammatory cytokines: A comparative study.

Science.gov (United States)

Zhang, Jin; Zhang, Ai-Min; Zhang, Zong-Mei; Jia, Jin-Lin; Sui, Xin-Xin; Yu, Lu-Rui; Liu, Hai-Tao

2017-10-01

In this study, we aimed to investigate the efficacy of combined orthodontic-periodontic treatment in the treatment of patients with periodontitis and its effects on the levels of inflammatory cytokines. A total of 117 patients with periodontitis were randomly assigned to the basic group (receiving basic periodontic treatment, n = 58) and the combined group (receiving combined orthodontic-periodontic treatment, n = 59). In addition, 52 healthy people without periodontal disease were selected as the normal group. Probing depth, tooth mobility, plaque index, clinical attachment level, and sulcus bleeding index were recorded. ELISA was applied to detect gingival crevicular fluid (GCF) and serum levels of inflammatory cytokines. A 2-year clinical follow-up was conducted. Before treatment, the periodontal parameters (probing depth, tooth mobility, plaque index, clinical attachement level, and sulcus bleeding index) and GCF and serum levels of inflammatory cytokines (high-sensitivity C-reactive protein, interleukin-1β, interleukin-5, interleukin-6, interleukin-8, tumor necrosis factor-α, and prostaglandin E2) in the combined and basic groups were higher than those in the normal group. After 6 and 18 months of treatment, the periodontal parameters and GCF and serum levels of inflammatory cytokines decreased in the combined and basic groups. The periodontal parameters and the GCF and serum levels of inflammatory cytokines in the combined group were significantly lower than those in the basic group after 18 months of treatment. The combined group had a lower recurrence rate compared with the basic group. Combined orthodontic-periodontic treatment had good clinical efficacy in the treatment of periodontitis and could effectively decrease the levels of inflammatory cytokines. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Laboratory measures of methylphenidate effects in cocaine-dependent patients receiving treatment.

Science.gov (United States)

Roache, J D; Grabowski, J; Schmitz, J M; Creson, D L; Rhoades, H M

2000-02-01

Two experiments examined the effects of methylphenidate in male and female patients enrolled in an outpatient treatment program for primary cocaine dependence. The first study was a component of a double-blind efficacy trial wherein 57 patients were first tested in a human laboratory for their initial responsiveness to medication. Patients were randomly assigned to receive either placebo or methylphenidate treatment and received their first dose in the human laboratory environment before continuing in outpatient treatment. Methylphenidate was given as a 20-mg sustained-release dose (twice daily) plus an additional 5-mg immediate-release dose combined with the morning dose. Methylphenidate increased heart rate and subjective ratings; however, the subjective effects were primarily of a "dysphoric" nature, and significant effects were limited to increases in anxiety, depression, and anger on the Profile of Mood States; shaky/jittery ratings on a visual analog scale; and dysphoria on the lysergic acid diethylamide (LSD) scale of the Addiction Research Center Inventory. Methylphenidate did not increase cocaine craving nor ratings suggesting abuse potential (i.e., Morphine-Benzedrine Group or drug-liking scores, etc.). None of the drug effects observed in the human laboratory was of clinical concern, and no subject was precluded from continuing in the outpatient study. After outpatient treatment completion, 12 patients were brought back into a second double-blind human laboratory study in which three doses (15, 30, and 60 mg) of immediate-release methylphenidate were administered in an ascending series preceded and followed by placebo. Methylphenidate produced dose-related increases in heart rate, subjective ratings of shaky/jittery, and LSD/dysphoria without significantly altering cocaine craving or stimulant euphoria ratings. These results suggest that stimulant substitution-type approaches to the treatment of cocaine dependence are not necessarily contraindicated

Atorvastatin calcium in combination with methylprednisolone for the treatment of multiple sclerosis relapse.

Science.gov (United States)

Li, Xiao-ling; Zhang, Zhen-chang; Zhang, Bo; Jiang, Hua; Yu, Chun-mei; Zhang, Wen-jing; Yan, Xiang; Wang, Man-xia

2014-12-01

This study aimed to investigate the efficacy of combined atorvastatin calcium and methylprednisolone for the treatment of multiple sclerosis relapse. Patients with multiple sclerosis (MS) at the relapse phase were randomized to receive either combined treatment of atorvastatin calcium and methylprednisolone (n = 19) or methylprednisolone alone (n = 19). Expanded Disability Status Scale (EDSS) was administered at baseline, 1 week, 2 weeks, 4 weeks, 3 months, and 6 months after treatment initiation. The number and volume of brain lesions were evaluated using magnetic resonance imaging at baseline and 6 months. The levels of IL-13, IL-35, IFN-γ, and IL-10 in the cerebrospinal fluid were examined using the enzyme-linked immunosorbent assay method. There was no significant difference in EDSS scores at 1, 2, and 4 weeks. At 3 and 6 months, the combined treatment group showed significantly lower EDSS scores than the monotherapy group (P atorvastatin calcium and methylprednisolone can improve the outcomes of MS relapse compared with glucocorticosteroid alone. Copyright © 2014 Elsevier B.V. All rights reserved.

[Combined treatment supported by piracetam and/or acyclovir in idiopathic sudden sensorineural hearing loss: experience with 81 cases].

Science.gov (United States)

Karakurt, Süleyman Emre; Ozkul, Mehmet Doğan; Cukurova, Ibrahim; Demirhan, Erhan; Yiğitbaşi, Orhan Gazi

2009-01-01

To investigate the efficiency of piracetam and acyclovir in treating sudden hearing loss. Eightyone patients (44 males, 37 females; mean age 40.4 year; range 18 to 72 years) who had treatment between January 2002 and December 2006 with diagnosis of idiopathic sudden hearing loss were evaluated retrospectively. These patients were divided into four groups according to the treatment they received. The patients who had combined treatment constituted the first group; those who had combined treatment and piracetam the second; those who had combined treatment and acyclovir the third; those who had combined treatment, acyclovir, and piracetam the fourth group. For the four treatment groups, in the pre-and post-treatment (10th day) evaluation of the treatment efficiency made by calculation of the hearing thresholds in 250-8000 Hz frequencies, no significant difference between the groups was determined (p>0.05). No additional benefit was obtained with acyclovir and piracetam in treatment.

Efficacy of Combined Treatment with Acupuncture and Bee Venom Acupuncture as an Adjunctive Treatment for Parkinson's Disease.

Science.gov (United States)

Cho, Seung-Yeon; Lee, Young-Eun; Doo, Kyeong-Hee; Lee, Ji-Hyun; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Kim, Ho; Rhee, Hak Young; Park, Hi-Joon; Park, Seong-Uk

2018-01-01

The aim of this study was to evaluate the efficacy of acupuncture and bee venom acupuncture (BVA) for idiopathic Parkinson's disease (IPD) through a sham-controlled trial. We also investigated whether there is a sustained therapeutic effect by completing follow-up assessments after treatment completion. A single center, double-blind, three-armed randomized controlled trial. This study was performed at a university hospital in Seoul, Republic of Korea. Seventy-three (73) patients with IPD were the subjects. They were randomly assigned to the active treatment group, sham treatment group, or conventional treatment group. The active treatment group received acupuncture and BVA and the sham group received sham acupuncture and normal saline injections, twice a week for 12 weeks. The conventional treatment group maintained anti-parkinsonian drugs without additional intervention. The Unified Parkinson's Disease Rating Scale (UPDRS) part II and part III score, postural instability and gait disturbance (PIGD) score, gait speed and number, Parkinson's Disease Quality of Life Questionnaire, Beck Depression Inventory, and postural stability at baseline and at 12, 16, and 20 weeks. Sixty-three (63) patients provided a complete data of assessments, including a final follow-up. After 12 weeks of treatment, a significant difference was observed between the active treatment group and the conventional treatment group. After the end of the treatment, the treatment effects were maintained significantly in the active treatment group only. It is suggested that the combined treatment of acupuncture and BVA might be safe and useful adjunctive treatment for patients with IPD.

Effectiveness of medication / auricular therapy / phyto-therapy combination in the treatment of hypertensive patients

Directory of Open Access Journals (Sweden)

José Ramón Martínez Pérez

2015-10-01

Full Text Available Background: hypertension is one of the main cardiovascular risk factors, so its control improves the life expectancy of patients.Objective: to assess the effects of a treatment combining medication with auricular therapy and phyto-therapy in hypertensive patients assisted at the health area of ”Romárico Oro” Polyclinic, in Puerto Padre, Las Tunas province.Methods: an intervention study was carried out in 68 hypertensive patients of the health area of “Romárico Oro” Polyclinic in Puerto Padre from April, 2013 to April, 2014. The patients were distributed at random into two equal groups; the first received medication combined with auricular therapy and phyto-therapy, while the second one received only medication. The statistical analysis was done by means of Statistic system, t-student and Chi-Square tests were used and p< or =0.05 was considered as level of statistical significance.Results: by the end of the intervention, 73, 53% of the patients of the group with the combination of drug treatment and auricular therapy and phyto-therapy were controlled. In this group, the diastolic filling pressure diminished to 2, 2 mm Hg and the systolic gradient to 3, 66 mm, regarding the group treated only with drugs. Only one patient, representing the 2, 94% showed adverse reaction to the natural and traditional treatment.Conclusions: the combination of medication with auricular therapy and phyto-therapy proved to be effective, corroborated by a significant decrease of quantity of crisis, diastolic and systolic filling pressure values and increase of number of patients with their disease controlled; the report of only one complication shows the innocuousness of the auricular therapy and phyto-therapy treatment.

Stereotactic Radiosurgery for Melanoma Brain Metastases in Patients Receiving Ipilimumab: Safety Profile and Efficacy of Combined Treatment

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Kiess, Ana P. [Department of Radiation Oncology, Johns Hopkins University, Baltimore, Maryland (United States); Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Wolchok, Jedd D. [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Barker, Christopher A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Postow, Michael A. [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Tabar, Viviane [Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Huse, Jason T. [Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Chan, Timothy A.; Yamada, Yoshiya [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Beal, Kathryn, E-mail: bealk@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

2015-06-01

Purpose: Ipilimumab (Ipi), a monoclonal antibody against cytotoxic T-lymphocyte antigen-4, has been shown to improve survival in patients with metastatic melanoma. In this single-institution study, we investigated the safety and efficacy of stereotactic radiosurgery (SRS) for patients with melanoma brain metastases (BMs) who also received Ipi. Methods and Materials: From 2005 to 2011, 46 patients with melanoma received Ipi and underwent single-fraction SRS for BMs. A total of 113 BMs (91% intact, 9% postoperative) were treated with a median dose of 21 Gy (range, 15-24 Gy). Ipi was given at 3 mg/kg (54%) or 10 mg/kg (46%) for a median of 4 doses (range, 1-21). Adverse events were recorded with the use of the Common Terminology Criteria for Adverse Events 3.0. Kaplan-Meier methods were used to estimate survival, and Cox regression was used to investigate associations. Results: Fifteen patients received SRS during Ipi, 19 received SRS before Ipi, and 12 received SRS after Ipi. Overall survival (OS) was significantly associated with the timing of SRS/Ipi (P=.035) and melanoma-specific graded prognostic assessment (P=.013). Patients treated with SRS during or before Ipi had better OS and less regional recurrence than did those treated with SRS after Ipi (1-year OS 65% vs 56% vs 40%, P=.008; 1-year regional recurrence 69% vs 64% vs 92%, P=.003). SRS during Ipi also yielded a trend toward less local recurrence than did SRS before or after Ipi (1-year local recurrence 0% vs 13% vs 11%, P=.21). On magnetic resonance imaging, an increase in BM diameter to >150% was seen in 50% of patients treated during or before Ipi but in only 13% of patients treated after Ipi. Grade 3 to 4 toxicities were seen in 20% of patients. Conclusion: Overall, the combination of Ipi and SRS appears to be well tolerated. Concurrent delivery of Ipi and SRS is associated with favorable locoregional control and possibly longer survival. It may also cause a temporary increase in tumor size, possibly

The effect of alcohol treatment on social costs of alcohol dependence: results from the COMBINE study.

Science.gov (United States)

Zarkin, Gary A; Bray, Jeremy W; Aldridge, Arnie; Mills, Michael; Cisler, Ron A; Couper, David; McKay, James R; O'Malley, Stephanie

2010-05-01

The COMBINE (combined pharmacotherapies and behavioral intervention) clinical trial recently evaluated the efficacy of pharmacotherapies, behavioral therapies, and their combinations for the treatment of alcohol dependence. Previously, the cost and cost-effectiveness of COMBINE have been studied. Policy makers, patients, and nonalcohol-dependent individuals may be concerned not only with alcohol treatment costs but also with the effect of alcohol interventions on broader social costs and outcomes. To estimate the sum of treatment costs plus the costs of health care utilization, arrests, and motor vehicle accidents for the 9 treatments in COMBINE 3 years postrandomization. A cost study based on a randomized controlled clinical trial. : The study involved 786 participants 3 years postrandomization. Multivariate results show no significant differences in mean costs between any of the treatment arms as compared with medical management (MM) + placebo for the 3-year postrandomization sample. The median costs of MM + acamprosate, MM + naltrexone, MM + acamprosate + naltrexone, and MM + acamprosate + combined behavioral intervention were significantly lower than the median cost for MM + placebo. The results show that social cost savings are generated relative to MM + placebo by 3 years postrandomization, and the magnitude of these cost savings is greater than the costs of the COMBINE treatment received 3 years prior. Our study suggests that several alcohol treatments may indeed lead to reduced median social costs associated with health care, arrests, and motor vehicle accidents.

Combined treatment: impact of optimal psychotherapy and medication in bipolar disorder.

Science.gov (United States)

Parikh, Sagar V; Hawke, Lisa D; Velyvis, Vytas; Zaretsky, Ari; Beaulieu, Serge; Patelis-Siotis, Irene; MacQueen, Glenda; Young, L Trevor; Yatham, Lakshmi N; Cervantes, Pablo

2015-02-01

The current study investigated the longitudinal course of symptoms in bipolar disorder among individuals receiving optimal treatment combining pharmacotherapy and psychotherapy, as well as predictors of the course of illness. A total of 160 participants with bipolar disorder (bipolar I disorder: n = 115; bipolar II disorder: n = 45) received regular pharmacological treatment, complemented by a manualized, evidence-based psychosocial treatment - that is, cognitive behavioral therapy or psychoeducation. Participants were assessed at baseline and prospectively for 72 weeks using the Longitudinal Interval Follow-up Evaluation (LIFE) scale scores for mania/hypomania and depression, as well as comparison measures (clinicaltrials.gov identifier: NCT00188838). Over a 72-week period, patients spent a clear majority (about 65%) of time euthymic. Symptoms were experienced more than 50% of the time by only a quarter of the sample. Depressive symptoms strongly dominated over (hypo)manic symptoms, while subsyndromal symptoms were more common than full diagnosable episodes for both polarities. Mixed symptoms were rare, but present for a minority of participants. Individuals experienced approximately six significant mood changes per year, with a full relapse on average every 7.5 months. Participants who had fewer depressive symptoms at intake, a later age at onset, and no history of psychotic symptoms spent more weeks well over the course of the study. Combined pharmacological and adjunctive psychosocial treatments appeared to provide an improved course of illness compared to the results of previous studies. Efforts to further improve the course of illness beyond that provided by current optimal treatment regimens will require a substantial focus on both subsyndromal and syndromal depressive symptoms. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Treatment efficacy and methotrexate-related toxicity in patients with rheumatoid arthritis receiving methotrexate in combination with adalimumab.

Science.gov (United States)

Burmester, Gerd R; Kaeley, Gurjit S; Kavanaugh, Arthur F; Gabay, Cem; MacCarter, Daryl K; Nash, Peter; Takeuchi, Tsutomu; Goss, Sandra L; Rodila, Ramona; Chen, Kun; Kupper, Hartmut; Kalabic, Jasmina

2017-01-01

Treatment of rheumatoid arthritis (RA) with a combination of methotrexate (MTX)+adalimumab (ADA) is more effective than ADA monotherapy. We assessed the toxicity of different doses of MTX and treatment efficacy of ADA+MTX in two trials. Data originated from CONCERTO, in patients with early RA initiating ADA+ 2.5, 5, 10 or 20 mg/week MTX for 26 weeks; and MUSICA, in patients with an inadequate response to MTX initiating ADA+ 7.5 or 20 mg/week MTX for 24 weeks. Efficacy was assessed by the American College of Rheumatology 50 (ACR50). Patient-reported MTX-related toxicity information was collected at each visit on 18 prespecified MTX-related adverse events (AE) in the MTX label. In CONCERTO, ACR50 rates increased over time, ranging from 54% to 68% at week 26, while AE rates remained steady, ranging from 2.4% to 17.8% at week 26. Of 395 patients, 113 (28.6%) reported 345 MTX-related AEs, including one serious AE (SAE, excessive fatigue and/or malaise); 10 AEs (in two patients) led to study discontinuation. In MUSICA, ACR50 rates increased over time, and were 32.3% and 37.5% at week 24, while MTX-related AE rates remained steady and were 6.5% at week 24. Of 309 patients, 71 (23%) reported 185 MTX-related AEs, including 5 SAEs (four infections and one fever/chills); six AEs (in four patients) led to study discontinuation. In patients with RA initiating ADA+MTX combination, treatment efficacy was achieved and increased throughout both trials, while rates of MTX-related AEs remained steady. MTX-related AEs were observed in up to 30% of patients and most were mild. MTX was discontinued by 0.5%-1.3% of patients. MUSICA (NCT01185288), CONCERTO (NCT01185301), Post results.

Oral Cryotherapy for Preventing Oral Mucositis in Patients Receiving Cancer Treatment.

Science.gov (United States)

Riley, Philip; McCabe, Martin G; Glenny, Anne-Marie

2016-10-01

In patients receiving treatment for cancer, does oral cryotherapy prevent oral mucositis? Oral cryotherapy is effective for the prevention of oral mucositis in adults receiving fluorouracil-based chemotherapy for solid cancers, and for the prevention of severe oral mucositis in adults receiving high-dose melphalan-based chemotherapy before hematopoietic stem cell transplantation (HSCT).

Combination treatment of neuropathic pain

DEFF Research Database (Denmark)

Holbech, Jakob Vormstrup; Jung, Anne; Jonsson, Torsten

2017-01-01

BACKGROUND: Current Danish treatment algorithms for pharmacological treatment of neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Many patients have insufficient pain relief on monotherapy, but combin...

Randomized comparative trial of efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children

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Falgun Indravadan Vyas

2014-01-01

Full Text Available Objective: Paracetamol and ibuprofen are widely used for fever in children as monotherapy and as combined therapy. None of the treatments is proven clearly superior to others. Hence, the study was planned to compare the efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children. Materials and Methods: This was an investigator blind, randomized, comparative, parallel clinical trial conducted in 99 febrile children, 6 months to 12 years of age, allocated to three groups. First group received paracetamol 15 mg/kg, second group received ibuprofen 10 mg/kg and third group received both paracetamol and ibuprofen, all as a single dose by the oral route. Patients were followed-up at intervals of 1, 2, 3 and 4 h post dose by tympanic thermometry. Results: Mean tympanic temperature after 4 h of drug administration was significantly lower in the combination group compared with paracetamol group (P < 0.05; however, the difference was not clinically significant (<1΀C. The rate of fall of temperature was highest in the combination group. Number of afebrile children any time post dose until 4 h was highest in the combination group. Difference between combination and paracetamol was significant for the 1 st h (P = 0.04. Highest fall of temperature was noted in the 1 st h of drug administration in all the groups. No serious adverse events were observed in any of the groups. Conclusion: Paracetamol and ibuprofen combination caused quicker temperature reduction than either paracetamol or ibuprofen alone. If quicker reduction of body temperature is the desired goal of therapy, the use of combination of paracetamol + ibuprofen may be advocated.

[Considerations about the efficiency of treatment regimens with fixed Rifampicin-Isoniazid combinations in pulmonary tuberculosis].

Science.gov (United States)

Munteanu, Ioana; Husar, Iulia; Didilescu, C; Stoicescu, I P

2004-01-01

Here are presented the results of a prospective, randomized study regarding the efficiency of regimens with fixed drug combination Rifampicin-Isoniazide manufactured by Antibiotics S.A. of Iasi in comparison with single drugs routinely used in treatment of patients with pulmonary tuberculosis. Newly diagnosed (confirmed by smear and culture) pulmonary tuberculosis patients were selected, and those who accepted to be included in the study, were admitted to the National Institute of Pneumology "Marius Nasta" between August 2001 and September 2002. At the time of admission, they were randomized into two groups: 20 patients received fixed drug combination RMP300 HIN150, and 18 patients received RMP and HIN in single drug tablets (2 patients were excluded). The follow-up of the patients was for one year from the date of enclosure. The smear conversion rate was 83,3% for the patients using single drug tablets, and 70% for those using fixed drug combination, motivated with some more severe TB patterns. The success rate was 100% for all TB patients. Although the present study was done for few patients, we can say that it demonstrated the same efficiency of fixed drug combination produced in Romania, with the single drug tablets, and it suggests a better compliance to treatment with a lower price.

Combined treatment with progesterone and magnesium sulfate positively affects traumatic brain injury in immature rats.

Science.gov (United States)

Uysal, Nazan; Baykara, Basak; Kiray, Muge; Cetin, Ferihan; Aksu, Ilkay; Dayi, Ayfer; Gurpinar, Tugba; Ozdemir, Durgul; Arda, M Nuri

2013-01-01

It is well known that head trauma results in damage in hippocampal and cortical areas of the brain and impairs cognitive functions. The aim of this study is to explore the neuroprotective effect of combination therapy with magnesium sulphate (MgSO4) and progesterone in the 7-days-old rat pups subjected to contusion injury. Progesterone (8 mg/kg) and MgSO4 (150 mg/kg) were injected intraperitoneally immediately after induction of traumatic brain injury. Half of groups were evaluated 24 hours later, the remaining animals 3 weeks after trauma or sham surgery. Anxiety levels were assessed with open field activity and elevated plus maze; learning and memory performance were evaluated with Morris Water maze in postnatal 27 days. Combined therapy with progesterone and magnesium sulfate significantly attenuated trauma-induced neuronal death, increased brain VEGF levels and improved spatial memory deficits that appear later in life. Brain VEGF levels were higher in rats that received combined therapy compared to rats that received either medication alone. Moreover, rats that received combined therapy had reduced hipocampus and prefrontal cortex apoptosis in the acute period. These results demonstrate that combination of drugs with different mechanisms of action may be preferred in the treatment of head trauma.

Naltrexone and Bupropion Combination Treatment for Smoking Cessation and Weight Loss in Patients With Schizophrenia

OpenAIRE

Xuechan Lyu; Jiang Du; Guilai Zhan; Yujie Wu; Hang Su; Youwei Zhu; Fredrik Jarskog; Min Zhao; Min Zhao; Xiaoduo Fan

2018-01-01

Objective: The rates of obesity and cigarette smoking are much higher in patients with schizophrenia compared to the general population. This study was to examine whether naltrexone and bupropion combination treatment can help weight loss and smoking cessation in patients with schizophrenia.Methods: Obese male schizophrenia patients with current cigarette smoking were randomized to receive adjunctive naltrexone (25 mg/day) and bupropion (300 mg/day) combination or placebo for 24 weeks. Twenty...

The combination of amoxicillin-clavulanic acid and ketoconazole in the treatment of Madurella mycetomatis eumycetoma and Staphylococcus aureus co-infection.

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Najwa A Mhmoud

2014-06-01

Full Text Available Eumycetoma is a chronic progressive disabling and destructive inflammatory disease which is commonly caused by the fungus Madurella mycetomatis. It is characterized by the formation of multiple discharging sinuses. It is usually treated by antifungal agents but it is assumed that the therapeutic efficiency of these agents is reduced by the co-existence of Staphylococcus aureus co-infection developing in these sinuses. This prospective study was conducted to investigate the safety, efficacy and clinical outcome of combined antibiotic and antifungal therapy in eumycetoma patients with superimposed Staphylococcus aureus infection. The study enrolled 337 patients with confirmed M. mycetomatis eumycetoma and S. aureus co-infection. Patients were allocated into three groups; 142 patients received amoxicillin-clavulanic acid and ketoconazole, 93 patients received ciprofloxacin and ketoconazole and 102 patients received ketoconazole only. The study showed that, patients who received amoxicillin-clavulanic acid and ketoconazole treatment had an overall better clinical outcome compared to those who had combined ciprofloxacin and ketoconazole or to those who received ketoconazole only. In this study, 60.6% of the combined amoxicillin-clavulanic acid/ketoconazole group showed complete or partial clinical response to treatment compared to 30.1% in the ciprofloxacin/ketoconazole group and 36.3% in the ketoconazole only group. The study also showed that 64.5% of the patients in the ciprofloxacin/ketoconazole group and 59.8% in the ketoconazole only group had progressive disease and poor outcome. This study showed that the combination of amoxicillin-clavulanic acid and ketoconazole treatment is safe and offers good clinical outcome and it is therefore recommended to treat eumycetoma patients with Staphylococcus aureus co-infection.

Patient satisfaction after receiving dental treatment among patients ...

African Journals Online (AJOL)

Background: Patient satisfaction is one of the indicators of the quality of care. Therefore it is one of the tools for evaluating the quality of care. Aim: To determine patient satisfaction after receiving dental treatment among patients attending public dental clinics in Dar-Es-Salaam. Material and methods: Five public dental clinics ...

Effect of combined treatment with alendronate and calcitriol on femoral neck strength in osteopenic rats

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Fotovati Abbas

2008-12-01

Full Text Available Abstract Background Hip fracture is associated with pronounced morbidity and excess mortality in elderly women with postmenopausal osteoporosis. Many drugs have been developed to treat osteoporosis and to reduce the risk of osteoporotic fractures. We investigated the effects of combined alendronate and vitamin D3 treatment on bone mass and fracture load at the femoral neck in ovariectomized (OVX rats, and evaluated the relationship between bone mass parameters and femoral neck strength. Methods Thirty 12-week-old female rats underwent either a sham-operation (n = 6 or OVX (n = 24. Twenty weeks later, OVX rats were further divided into four groups and received daily doses of either saline alone, 0.1 mg/kg alendronate, 0.1 μg/kg calcitriol, or a combination of both two drugs by continuous infusion via Alzet mini-osmotic pumps. The sham-control group received saline alone. After 12 weeks of treatment, femoral necks were examined using peripheral quantitative computed tomography (pQCT densitometry and mechanical testing. Results Saline-treated OVX rats showed significant decreases in total bone mineral content (BMC (by 28.1%, total bone mineral density (BMD (by 9.5%, cortical BMC (by 26.3%, cancellous BMC (by 66.3%, cancellous BMD (by 29.0% and total cross-sectional bone area (by 30.4% compared with the sham-control group. The combined alendronate and calcitriol treatments improved bone loss owing to estrogen deficiency. On mechanical testing, although OVX significantly reduced bone strength of the femoral neck (by 29.3% compared with the sham-control group, only the combined treatment significantly improved the fracture load at the femoral neck in OVX rats to the level of the sham-controls. The correlation of total BMC to fracture load was significant, but that of total BMD was not. Conclusion Our results showed that the combined treatment with alendronate and calcitriol significantly improved bone fragility of the femoral neck in OVX osteopenic

[Tamsulosin, oxybutynin or their combination in the treatment of ureteral stent-related symptoms].

Science.gov (United States)

Maldonado-Alcaraz, Efraín; Moreno-Palacios, Jorge; López-Sámano, Virgilio A; Landa-Salas, Jason D; Torres-Mercado, León O; García-Cruz, Carlos

2017-01-01

The aim of this paper is to compare the efficacy of tamsulosin, oxybutynin or their combination for the treatment of symptoms related to double J stent (DJS). Randomized clinical non-blinded trial with three arms (tamsulosin, oxybutynin or combination) to assess the improvement of ureteral related symptoms with DJS with the questionnaire of Ureteral Stent Symptom Questionnaire (USSQ) and the adverse effects of treatment. Evaluations were made at 7 and 21 days after the placement of DJS. The maneuvers were compared using Chi squared test, Kruskall-Wallis, ANOVA and Wilcoxon considering a statistically significant p ≤ 0.05. 170 patients with CJJ were evaluated. A perprotocol analysis was performed in 142 patients, 53 received tamsulosin (37.4%), 42 oxybutynin (29.6%) and 47 the combination of both (33%). At 7 and 21 days the improvement was similar in all three arms. Men with tamsulosin and women with oxybutynin had less general symptoms. Tamsulosin, oxybutynin or its combination similarly improve ureteral stent related symptoms and this improvement becomes more noticeable over time. Men are less symptomatic with tamsulosin and women with oxybutynin.

Combination of Pre-Treatment DWI-Signal Intensity and S-1 Treatment: A Predictor of Survival in Patients with Locally Advanced Pancreatic Cancer Receiving Stereotactic Body Radiation Therapy and Sequential S-1

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Yu Zhang

2018-04-01

Full Text Available OBJECTIVE: To identify whether the combination of pre-treatment radiological and clinical factors can predict the overall survival (OS in patients with locally advanced pancreatic cancer (LAPC treated with stereotactic body radiation and sequential S-1 (a prodrug of 5-FU combined with two modulators therapy with improved accuracy compared with that of established clinical and radiologic risk models. METHODS: Patients admitted with LAPC underwent diffusion weighted imaging (DWI scan at 3.0-T (b = 600 s/mm2. The mean signal intensity (SIb = 600 of region-of-interest (ROI was measured. The Log-rank test was done for tumor location, biliary stent, S-1, and other treatments and the Cox regression analysis was done to identify independent prognostic factors for OS. Prediction error curves (PEC were used to assess potential errors in prediction of survival. The accuracy of prediction was evaluated by Integrated Brier Score (IBS and C index. RESULTS: 41 patients were included in this study. The median OS was 11.7 months (2.8-23.23 months. The 1-year OS was 46%. Multivariate analysis showed that pre-treatment SIb = 600 value and administration of S-1 were independent predictors for OS. The performance of pre-treatment SIb = 600 and S-1 treatment in combination was better than that of SIb = 600 or S-1 treatment alone. CONCLUSION: The combination of pre-treatment SIb = 600 and S-1 treatment could predict the OS in patients with LAPC undergoing SBRT and sequential S-1 therapy with improved accuracy compared with that of established clinical and radiologic risk models.

Combined treatment for complex intracranial aneurysm

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Chiriac A.

2015-06-01

Full Text Available Complex aneurysms often cannot be completely excluded by a single approaches. Today successful treatment of these lesions requires a combination between microsurgical and endovascular techniques. Planning of combined treatment require a very good understanding of aneurysm anatomy and a close collaboration between neurosurgeon and neuroendovascular interventionist. Endovascular coiling can usually be used as early treatment for a partially aneurysm occlusion including the ruptured area and followed by definitive clipping. On the other hand microsurgical clipping also can be used as first treatment for complex aneurysm neck reconstruction, allowing successful secondary placement of coils inside the remnant aneurysm sac

Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment.

Science.gov (United States)

Barrio, Pablo; Miquel, Laia; Moreno-España, Jose; Martínez, Alicia; Ortega, Lluisa; Teixidor, Lidia; Manthey, Jakob; Rehm, Jürgen; Gual, Antoni

2016-03-02

primary health care services for other reasons. The aim of the present study is to describe the differential characteristics of AD patients in primary care, distinguishing between those who receive treatment and those who do not, and their reasons for not seeking it. In a cross-sectional study patients were evaluated by their general practitioner (GP) and interviewed by a member of the research team. Sociodemographic, diagnostic and clinical data were collected. From 1,372 patients interviewed in Catalonia, 118 (8.6%) were diagnosed as AD. These patients showed a lower socioeconomic status (48.3% vs 33.3%, odds ratio 2.02), higher unemployment rates (32.2% vs 19.2 %, odds ratio 2.11), and greater psychological distress and disability. Patients with AD receiving treatment (16.9%), were older (44 vs 36 years of age), reported higher unemployment rates (66% vs 25.5%, odds ratio 6.32) and higher daily alcohol consumption (61.5 vs 23.7 grams), suggesting a more advanced disease. Patients with AD in general showed a higher degree of comorbidity compared to other patients, with patients in treatment showing the most elevated level. The main reasons given for not seeking treatment were shame, fear of giving up drinking and barriers to treatment. Taken together, the data suggest the need to implement earlier strategies for the detection and treatment of AD.

Serious Infections in Patients Receiving Ibrutinib for Treatment of Lymphoid Malignancies.

Science.gov (United States)

Varughese, Tilly; Taur, Ying; Cohen, Nina; Palomba, M Lia; Seo, Susan K; Hohl, Tobias M; Redelman-Sidi, Gil

2018-03-02

Ibrutinib is a Bruton's tyrosine kinase inhibitor that is used for the treatment of lymphoid malignancies, including chronic lymphocytic leukemia (CLL), Waldenström's macroglobulinemia and mantle cell lymphoma (MCL). Several case series have described opportunistic infections among ibrutinib recipients, but the full extent of these infections is unknown. We sought to determine the spectrum of serious infections associated with ibrutinib treatment. We reviewed the electronic medical records of patients with lymphoid malignancies at Memorial Sloan Kettering Cancer Center who received ibrutinib during a five-year period from January 1, 2012 to December 31, 2016. Serious infections were identified by review of the relevant microbiology, clinical laboratory, and radiology data. Risk factors for infection were determined by univariate and multivariate analyses. 378 patients with lymphoid malignancies who received ibrutinib were analyzed. The most common underlying malignancies were CLL and MCL. 84% of patients received ibrutinib as monotherapy. Serious infection developed in 43 patients (11.4%), primarily during the first year of ibrutinib treatment. Of these, 23 (53.5%) developed invasive bacterial infections, and 16 (37.2%) developed invasive fungal infections (IFI). The majority of those who developed IFI on ibrutinib therapy (62.5%) lacked classical clinical risk factors for fungal infection (i.e., neutropenia, lymphopenia, and receipt of corticosteroids). Infection resulted in death in six of the 43 patients (14%). Patients with lymphoid malignancies receiving ibrutinib treatment are at risk for serious infections, including IFI.

Plaque, caries level and oral hygiene habits in young patients receiving orthodontic treatment

DEFF Research Database (Denmark)

Martignon, S; Ekstrand, K R; Lemos, M I

2010-01-01

To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia.......To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia....

Removal of micropollutants, facultative pathogenic and antibiotic resistant bacteria in a full-scale retention soil filter receiving combined sewer overflow.

Science.gov (United States)

Scheurer, Marco; Heß, Stefanie; Lüddeke, Frauke; Sacher, Frank; Güde, Hans; Löffler, Herbert; Gallert, Claudia

2015-01-01

Combined sewer systems collect surface runoff as well as wastewater of industrial and domestic origin. During periods of heavy rainfall the capacity of the sewer system is exceeded and the overflow is discharged into receiving waters without any treatment. Consequently, combined sewer overflow (CSO) is considered as a major source of water pollution. This study investigates the effectiveness of a retention soil filter (RSF) for the removal of micropollutants as well as facultative pathogenic and antibiotic resistant bacteria from CSO. The removal of organic group parameters like total organic carbon was excellent and the removal efficiency for micropollutants of the RSF and the wastewater treatment plant (WWTP), which treats wastewater of the same origin during dry and normal weather conditions, was comparable. Compounds of high environmental concern like estrogens or certain pharmaceuticals, e.g. diclofenac, were completely eliminated or removed to a high degree during RSF passage. RSF treatment also reduced the number of E. coli, enterococci and staphylococci by 2.7, 2.2 and 2.4 log-units (median values), respectively. Obviously, some Staphylococcus species can better adapt to the conditions of the RSF than others as a shift of the abundance of the different species was observed when comparing the diversity of staphylococci obtained from the RSF influent and effluent. RSF treatment also decreased the absolute number of antibiotic resistant bacteria. The percentage of antibiotic resistant E. coli and staphylococci isolates also decreased during passage of the RSF, whereas the percentage of resistant enterococci did not change. For E. coli ampicillin and for enterococci and staphylococci erythromycin determined the antibiotic resistance level. The results demonstrate that RSFs can be considered as an adequate treatment option for CSO. The performance for the removal of micropollutants is comparable with a medium sized WWTP with conventional activated sludge

Combined Treatment of Residual, Recurrent and Unresectable Gastric Cancer

International Nuclear Information System (INIS)

Bae, Hoon Sik

1990-01-01

A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed INTO 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT-1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT. 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission. 11(50%) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 (64%) received more than 4000 cGy showed partial remission; especially, all 3 patients received more than 5500 cGy achieved partial response. 8 of the 12 patients (67%) who achieved maximal temperature more than 41 .deg. C showed partial response in comparing with 25% (2 of 8 patients, below 41 .deg. C). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients (12%) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months

Treatment of non-small cell lung cancer with intensity-modulated radiation therapy in combination with cetuximab: the NEAR protocol (NCT00115518)

International Nuclear Information System (INIS)

Jensen, AD; Hoess, A; Haberkorn, U; Huber, PE; Steins, M; Thomas, M; Debus, J; Herfarth, KK; Münter, MW; Bischoff, H; Haselmann, R; Timke, C; Krempien, R; Sterzing, F; Nill, S; Heeger, S

2006-01-01

Even today, treatment of Stage III NSCLC still poses a serious challenge. So far, surgical resection is the treatment of choice. Patients whose tumour is not resectable or who are unfit to undergo surgery are usually referred to a combined radio-chemotherapy. However, combined radio-chemotherapeutic treatment is also associated with sometimes marked side effects but has been shown to be more efficient than radiation therapy alone. Nevertheless, there is a significant subset of patients whose overall condition does not permit administration of chemotherapy in a combined-modality treatment. It could be demonstrated though, that NSCLCs often exhibit over-expression of EGF-receptors hence providing an excellent target for the monoclonal EGFR-antagonist cetuximab (Erbitux ® ) which has already been shown to be effective in colorectal as well as head-and-neck tumours with comparatively mild side-effects. The NEAR trial is a prospective phase II feasibility study combining a monoclonal EGF-receptor antibody with loco-regional irradiation in patients with stage III NSCLC. This trial aims at testing the combination's efficacy and rate of development of distant metastases with an accrual of 30 patients. Patients receive weekly infusions of cetuximab (Erbitux ® ) plus loco-regional radiation therapy as intensity-modulated radiation therapy. After conclusion of radiation treatment patients continue to receive weekly cetuximab for 13 more cycles. The primary objective of the NEAR trial is to evaluate toxicities and feasibility of the combined treatment with cetuximab (Erbitux ® ) and IMRT loco-regional irradiation. Secondary objectives are remission rates, 3-year-survival and local/systemic progression-free survival

[Comparison of curative effect of low flow rate plasma exchange combined with hemofiltration for treatment of liver failure].

Science.gov (United States)

Yang, Yong-feng; Huang, Ping; Zhang, Ning; Gai, Xiao-dong; Feng, Xiao-ning; Zhong, Yan-dan; Wang, Li-rong; Yang, Yi-jun; Zhao, Wei

2009-02-01

To investigate the effect of plasma exchange (PE) combined with hemofiltration (HF) on liver failure. Seventy-seven inpatients with liver failure admitted during January 2006 to August 2007 were randomly assigned to receive PE combined with HF (PE+HF group, 38 cases), or PE alone (PE group, 39 cases). Forty-one inpatients with liver failure who had not received artificial liver support treatment were assigned to serve as control group. The survival rates and biochemical parameters of three groups were compared. There was no significant difference in biochemical parameters before treatment among three groups. Compared with pre-treatment values, albumin (Alb), cholinesterase (ChE) and prothrombin activity (PTA) of both PE group and PE+HF group were significantly increased after treatment, and total bilirubin (TBIL), alanine transaminase (ALT), aspartate transaminase (AST) of both PE group and PE+HF group were significantly decreased after treatment (Prate of PE group, PE+HF group and control group was 48.7% (19/39), 68.4% (26/38), and 29.3% (12/41) respectively. The survival rate of PE+HF group was significantly higher than that of control group (chi(2)=12.11, Prate of recovery of consciousness of patients with hepatic encephalopathy in PE+HF group was higher than that of PE group (42.8% vs. 0, P<0.05). Compared with PE alone, the result was better when it was combined with HF in correction of electrolyte disturbance and acid-base imbalance (19/23 vs. 0/21, P<0.05). Treatment of liver failure by PE combined with HF is safe and effective, and its efficacy is higher than PE alone.

Assessment of the tumor load as well as toxic and side effects after herceptin combined with doxorubicin liposome treatment of HER-2 positive breast cance

Directory of Open Access Journals (Sweden)

Guo-Quan Wen

2016-12-01

Full Text Available Objective: To study the effect of herceptin combined with doxorubicin liposome treatment on tumor load as well as toxic and side effects of HER-2 positive breast cancer. Methods: A total of 138 patients with HER-2 positive breast cancer who received chemotherapy in our hospital between July 2014 and December 2015 were selected as the research subjects and randomly divided into two groups, liposome group received herceptin combined with doxorubicin liposome treatment and control group received herceptin combined with doxorubicin treatment. After 8 weeks of treatment, the content of tumor markers, active molecules and myocardial injury markers in serum as well as the expression levels of immune marker molecules in peripheral blood mononuclear cells were detected. Results: After 8 weeks of treatment, CEA, CA199, CA153, CA125, VEGF, nectin-4, TK-1, PF-4, TSGF, CK, CK-MB, cTnI and cTnT content in serum of liposome group were significantly lower than those of control group, and the fluorescence intensity of CD3, CD4, CD8, CD16, CD19 and CD25 on peripheral blood mononuclear cell surface were significantly higher than those of control group. Conclusions: Herceptin combined with doxorubicin liposome treatment of HER-2 positive breast cancer can more effectively reduce the tumor load and cause less toxic and side effects on the heart and the immune system.

Combined Surgical Treatment of Gynecomastia

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Yordanov Y.

2015-05-01

Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

Development of drug resistance in patients receiving combinations of zidovudine, didanosine and nevirapine

NARCIS (Netherlands)

Conway, B.; Wainberg, M. A.; Hall, D.; Harris, M.; Reiss, P.; Cooper, D.; Vella, S.; Curry, R.; Robinson, P.; Lange, J. M.; Montaner, J. S.

2001-01-01

OBJECTIVE: To evaluate the development of phenotypic and genotypic resistance to zidovudine, didanosine and nevirapine as a function of the virologic response to therapy in a group of drug-naive individuals receiving various combinations of these agents. DESIGN: All patients were enrolled in a

Optimal Timing of Bisphosphonate Administration in Combination with Samarium-153 Oxabifore in the Treatment of Painful Metastatic Bone Disease

International Nuclear Information System (INIS)

Rasulova, Nigora; Lyubshin, Vladimir; Arybzhanov, Dauranbek; Sagdullaev, Sh.; Krylov, Valery; Khodjibekov, Marat

2013-01-01

While bisphosphonates are indicated for prevention of skeletal-related events, radionuclide therapy is widely used for treatment of painful bone metastases. Combined radionuclide therapy with bisphosphonates has demonstrated improved effectiveness in achieving bone pain palliation in comparison to mono therapy with radionuclides or bisphosphonates alone. However, there are conflicting reports as to whether bisphosphonates adversely influence skeletal uptake of the bone-seeking radiotracers used for therapy. Recent studies analyzing influence of Zoledronic acid on total bone uptake of Samarium-153 EDTMP (Sm-153 EDTMP) by measuring cumulative urinary activity of Sm-153 on baseline study, as well as in combination with bisphosphonates (administrated 48 hours prior to Sm-153) did not provide any statistically significant difference in urinary excretion of Sm-153 between the two groups. It may be noted that the exact temporal sequence of bisphosphonate administration vis a vis radionuclide therapy has not yet been studied. One of the side effects of bisphosphonates is transient flare effect on bone pain. Radionuclide therapy may also have similar side effect. Keeping in view the above the current study was designed with the main objective of determining the exact timing of bisphosphonate administration in patients receiving combined therapy so as to achieve optimal efficacy of bone pain palliation. Ninety-three patients suffering from metastatic bone pain who received combination therapy with Sm-153 oxabifore (an analog of Sm-153 EDTMP) and Zoledronic acid were divided into three groups according to the timing of Zoledronic acid administration: Group I: 39 patients who received Zoledronic acid 7 or more days prior to Sm-153 oxabifore treatment; Group II: 32 patients who received Zoledronic acid 48-72 hours prior to Sm-153 oxabifore treatment and Group III: 22 patients who received Zoledronic acid 7 days after Sm-153 oxabifore treatment. Sm-153 oxabifore was administered

Macrofilaricidal Activity in Wuchereria bancrofti after 2 Weeks Treatment with a Combination of Rifampicin plus Doxycycline

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Alexander Yaw Debrah

2011-01-01

Full Text Available Infection with the filarial nematode Wuchereria bancrofti can lead to lymphedema, hydrocele, and elephantiasis. Since adult worms cause pathology in lymphatic filariasis (LF, it is imperative to discover macrofilaricidal drugs for the treatment of the infection. Endosymbiotic Wolbachia in filariae have emerged as a new target for antibiotics which can lead to macrofilaricidal effects. In Ghana, a pilot study was carried out with 39 LF-infected men; 12 were treated with 200 mg doxycycline/day for 4 weeks, 16 were treated with a combination of 200 mg doxycycline/day + 10 mg/kg/day rifampicin for 2 weeks, and 11 patients received placebo. Patients were monitored for Wolbachia and microfilaria loads, antigenaemia, and filarial dance sign (FDS. Both 4-week doxycycline and the 2-week combination treatment reduced Wolbachia load significantly. At 18 months posttreatment, four-week doxycycline resulted in 100% adult worm loss, and the 2-week combination treatment resulted in a 50% adult worm loss. In conclusion, this pilot study with a combination of 2-week doxycycline and rifampicin demonstrates moderate macrofilaricidal activity against W. bancrofti.

Effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures.

Science.gov (United States)

Han, L R; Jin, C X; Yan, J; Han, S Z; He, X B; Yang, X F

2015-03-31

This study compared the efficacy between external fixator combined with palmar T-plate internal fixation and simple plate internal fixation for the treatment of comminuted distal radius fractures. A total of 61 patients classified as type C according to the AO/ASIF classification underwent surgery for comminuted distal radius fractures. There were 54 and 7 cases of closed and open fractures, respectively. Moreover, 19 patients received an external fixator combined with T-plate internal fixation, and 42 received simple plate internal fixation. All patients were treated successfully during 12-month postoperative follow-up. The follow-up results show that the palmar flexion and dorsiflexion of the wrist, radial height, and palmar angle were significantly better in those treated with the external fixator combined with T-plate compared to those treated with the simple plate only (P 0.05). Hence, the effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures was satisfactory. Patients sufficiently recovered wrist, forearm, and hand function. In conclusion, compared to the simple T-plate, the external fixator combined with T-plate internal fixation can reduce the possibility of the postoperative re-shifting of broken bones and keep the distraction of fractures to maintain radial height and prevent radial shortening.

[The treatment received by public health services users in Mexico].

Science.gov (United States)

Puentes Rosas, Esteban; Gómez Dantés, Octavio; Garrido Latorre, Francisco

2006-06-01

To document the fact that differences in the treatment received by health services users in Mexico are mainly dependent on the type of provider, regardless of the users' socioeconomic status. The data were obtained by means of a survey of 18 018 users who visited 73 health services in 13 states within Mexico. They were asked to grade the way the institution had performed in seven of the eight domains that define appropriate user treatment (autonomy, confidentiality, communication, respectful manner, condition of basic facilities, access to social assistance networks, and free user choice). The questionnaire included some vignettes to help determine user expectations. A composite ordinal probit model was applied; the perception of quality in connection with each of the appropriate treatment domains was the independent variable, whereas gender, educational level, age, type of provider, and user expectations were used as control variables. The type of provider was the main factor that determined users' perceptions regarding the treatment they received when visiting health services in Mexico. Institutions belonging to the social security system performed the worst, while the services provided under the program targeting the rural population (IMSS Oportunidades) received the highest scores. Overall, the domain that was most highly ranked was respectful manner, whereas the lowest score was given to the ability to choose the provider. Men felt they had been able to communicate better than women, while respectful manner, communication, and social support showed a significant negative association with educational level (P < 0.05). Differences were noted in the way different public health service providers in Mexico treat their users, regardless of the latter's socioeconomic status. Social security system providers showed the greatest deficiencies in this respect. Respectful manner was the domain that received the highest scores in the case of all providers. Organizational

[The combined treatment of dysphonia in the subjects engaged in the voice and speech professions].

Science.gov (United States)

Stepanova, Yu E; Gotovyakhina, T V; Korneenkov, A A; Koren', E E

The objective of the present study was to evaluate the effectiveness of the application of homeovox for the combined treatment of small vocal cord nodules and acute laryngitis in the professional voice users. A total of 40 subjects presenting with dysphonia were examined after they were divided into two study groups and two groups of comparison depending on the nosological form of the pathological condition. The subjects comprising the study groups were given traditional therapy in the combination with the intake of homeovox whereas the patients included in the two groups of comparison received the traditional treatment alone. The outcome of the treatment was evaluated on days 1, 5, and 10 after the initiation of therapy based on the analysis of the changes in the videoendostroboscopic picture of the larynx and the acoustic characteristics obtained by the computer-assisted analysis of the voice. The analysis of the results of the combined treatment has demonstrated the statistically significant differences in some acoustic parameters of the voice between the subjects with small vocal cord nodules and acute laryngitis belonging to the study groups and the groups of comparison. It is concluded that the introduction of homeovox in the combined treatment of the patients presenting with the small nodules in the vocal cords and acute catarrhal laryngitis accelerates the recovery of the acoustic characteristics of the voice within various periods after the onset of the treatment in comparison with the patients treated with the use of traditional therapy alone.

Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics.

Science.gov (United States)

Akarslan, Zühre Zafersoy; Sadik, Burak; Erten, Hüya; Karabulut, Erdem

2009-01-01

The purposes of this research were to investigate factors influencing patients' satisfaction with their present dental esthetic, received previous dental treatments on anterior teeth and basic treatments that they wanted to undergo to improve their dental appearance. A total of 1014 patients who attended a dental school in a major city in Turkey participated in the study. The participants were surveyed with a questionnaire containing questions about gender, age, education level, self-reported tooth appearance, received previous dental treatments on anterior teeth and desired basic esthetic dental treatments. Statistical analysis of the verifying data was made with descriptive statistics, chi2 test and multiple logistic regression analyses. According to the analyses of the verifying data, 55.1% of the patients were dissatisfied with the color of their teeth, 42.7% with dental appearance, 29.9% with crowding of anterior teeth, 23.3% were hiding teeth while smiling, 16.1% had non-esthetic restorations and 11.9% thought that their anterior teeth were protruding. Esthetic restoration was found to be the most-performed treatment recently (29.0%) and whitening of teeth was the most-desired dental treatment (49.0%). Gender, age and education level had an effect on satisfaction and received previous and desired dental treatments for improvement of esthetics. Many of the Turkish patients surveyed in the study were dissatisfied and desired the improvement of dental esthetics. Therefore, dentists should consider this as an important dimension in their practice.

Treatment of non-small cell lung cancer with intensity-modulated radiation therapy in combination with cetuximab: the NEAR protocol (NCT00115518

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Hoess A

2006-05-01

Full Text Available Abstract Background Even today, treatment of Stage III NSCLC still poses a serious challenge. So far, surgical resection is the treatment of choice. Patients whose tumour is not resectable or who are unfit to undergo surgery are usually referred to a combined radio-chemotherapy. However, combined radio-chemotherapeutic treatment is also associated with sometimes marked side effects but has been shown to be more efficient than radiation therapy alone. Nevertheless, there is a significant subset of patients whose overall condition does not permit administration of chemotherapy in a combined-modality treatment. It could be demonstrated though, that NSCLCs often exhibit over-expression of EGF-receptors hence providing an excellent target for the monoclonal EGFR-antagonist cetuximab (Erbitux® which has already been shown to be effective in colorectal as well as head-and-neck tumours with comparatively mild side-effects. Methods/design The NEAR trial is a prospective phase II feasibility study combining a monoclonal EGF-receptor antibody with loco-regional irradiation in patients with stage III NSCLC. This trial aims at testing the combination's efficacy and rate of development of distant metastases with an accrual of 30 patients. Patients receive weekly infusions of cetuximab (Erbitux® plus loco-regional radiation therapy as intensity-modulated radiation therapy. After conclusion of radiation treatment patients continue to receive weekly cetuximab for 13 more cycles. Discussion The primary objective of the NEAR trial is to evaluate toxicities and feasibility of the combined treatment with cetuximab (Erbitux® and IMRT loco-regional irradiation. Secondary objectives are remission rates, 3-year-survival and local/systemic progression-free survival.

A Combined Time Domain Impedance Probe And Plasma Wave Receiver System For Small Satellite Applications.

Science.gov (United States)

Spencer, E. A.; Clark, D. C.; Vadepu, S. K.; Patra, S.

2017-12-01

A Time Domain Impedance Probe (TDIP) measures electron density and electron neutral collision frequencies in the ionosphere. This instrument has been tested on a sounding rocket flight and is now being further developed to fly on a NASA Undergraduate Student Instrument Program (USIP) cubesat to be launched out of the ISS in 2019. Here we report on the development of a new combined TDIP and plasma wave instrument that can be used on cubesat platforms to measure local electron parameters, and also to receive or transmit electron scale waves. This combined instrument can be used to study short time and space scale phenomena in the upper ionosphere using only RF signals. The front end analog circuitry is dual-purposed to perform active or passive probing of the ambient plasma. Two dipole antennas are used, one is optimzed for impedance measurements, while the other is optimized for transmitter-receiver performance. We show our circuit realization, and initial results from laboratory measurements using the TDIP prototype modified for receiver function. We also show Finite Difference Time Domain (FDTD) simulations of an electrically long antenna immersed in a magnetized plasma used to optimize the transmitter receiver performance.

Naltrexone and Bupropion Combination Treatment for Smoking Cessation and Weight Loss in Patients With Schizophrenia.

Science.gov (United States)

Lyu, Xuechan; Du, Jiang; Zhan, Guilai; Wu, Yujie; Su, Hang; Zhu, Youwei; Jarskog, Fredrik; Zhao, Min; Fan, Xiaoduo

2018-01-01

Objective: The rates of obesity and cigarette smoking are much higher in patients with schizophrenia compared to the general population. This study was to examine whether naltrexone and bupropion combination treatment can help weight loss and smoking cessation in patients with schizophrenia. Methods: Obese male schizophrenia patients with current cigarette smoking were randomized to receive adjunctive naltrexone (25 mg/day) and bupropion (300 mg/day) combination or placebo for 24 weeks. Twenty-two patients were enrolled in the study, and 21 patients completed the study (11 in the treatment group, and 10 in the placebo group). Body weight, body mass index (BMI), fasting lipids, smoking urge, expired carbon monoxide (CO) level and cigarettes smoked per week were measured at baseline and week 24. Results: There was no significant difference between two groups in changes in weight, BMI, fasting lipids, or cigarette smoking measures ( p 's > 0.05) Conclusion: Naltrexone and bupropion combination treatment didn't show weight loss or smoking cessation effect in patients with schizophrenia in this pilot study.Implications for future studies were discussed. ClinicalTrials.gov identifier: NCT02736474.

Sexual function in hypertensive patients receiving treatment

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Thorsten Reffelmann

2006-12-01

Full Text Available Thorsten Reffelmann, Robert A KlonerUniversity of Southern California, The Heart Institute, Good Samaritan Hospital, Division of Cardiovascular Medicine, Keck School of Medicine, Los Angeles, CA, USAAbstract: In many forms of erectile dysfunction (ED, cardiovascular risk factors, in particular arterial hypertension, seem to be extremely common. While causes for ED are related to a broad spectrum of diseases, a generalized vascular process seems to be the underlying mechanism in many patients, which in a large portion of clinical cases involves endothelial dysfunction, ie, inadequate vasodilation in response to endothelium-dependent stimuli, both in the systemic vasculature and the penile arteries. Due to this close association of cardiovascular disease and ED, patients with ED should be evaluated as to whether they may suffer from cardiovascular risk factors including hypertension, cardiovascular disease or silent myocardial ischemia. On the other hand, cardiovascular patients, seeking treatment of ED, must be evaluated in order to decide whether treatment of ED or sexual activity can be recommended without significantly increased cardiac risk. The guideline from the first and second Princeton Consensus Conference may be applied in this context. While consequent treatment of cardiovascular risk factors should be accomplished in these patients, many antihypertensive drugs may worsen sexual function as a drug specific side-effect. Importantly, effective treatment for arterial hypertension should not be discontinued as hypertension itself may contribute to altered sexual functioning; to the contrary, alternative antihypertensive regimes should be administered with individually tailored drug regimes with minimal side-effects on sexual function. When phosphodiesterase-5 inhibitors, such as sildenafil, tadalafil and vardenafil, are prescribed to hypertensive patients on antihypertensive drugs, these combinations of antihypertensive drugs and

Evaluation of the malignant degree of primary hepatocellular carcinoma after endostar combined with transcatheter arterial chemoembolization ( TACE treatment

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Yong Zeng

2018-01-01

Full Text Available Objective: To analyze the malignant degree of primary hepatocellular carcinoma after endostar combined with transcatheter arterial chemoembolization (TACE treatment. Methods: A total of 68 cases of patients with primary hepatocellular carcinoma treated in our hospital from September 2011 to December 2014 were enrolled for study and divided into observation group 34 cases and control group 34 cases according to different treatment methods. Control group received transcatheter arterial chemoembolization (TACE treatment, observation group received endostar combined with TACE treatment, and then differences in serum amino acid levels, micro RNA levels, levels of GP73, GPC3, GS, etc as well as levels of ChE, TBA and AFP were compared between two groups after treatment. Results: Serum aspartic acid, leucine and arginine levels of observation group after treatment were higher than those of control group, and αα-aminoadipic acid, methionine, β-alanine and 3-methylhistidine levels were lower than those of control group; relative values of serum miR-106b, miR-222 and miR-21 expression of observation group after treatment were lower than those of control group, and relative values of miR-199a and miR-122 expression were higher than those of control group; GP73, IL-17, IL-6, GPC3, GS and HSP70 levels of observation group after treatment were lower than those of control group, and endostatin level was higher than that of control group; ChE level of observation group after treatment was higher than that of control group, and TBA and AFP levels were lower than those of control group. Conclusion: Endostar combined with TACE treatment for patients with primary hepatocellular carcinoma can effectively inhibit tumor proliferation, invasion and other malignant processes and improve liver function, and it has positive clinical significance.

Sex differences in reinstatement of cocaine-seeking with combination treatments of progesterone and atomoxetine.

Science.gov (United States)

Swalve, Natashia; Smethells, John R; Zlebnik, Natalie E; Carroll, Marilyn E

2016-06-01

Two repurposed medications have been proposed to treat cocaine abuse. Progesterone, a gonadal hormone, and atomoxetine, a medication commonly used to treat attention deficit/hyperactivity disorder, have both been separately shown to reduce cocaine self-administration and reinstatement (i.e., relapse). The goal of the present study was to examine sex differences in the individual effects of PRO and ATO as well as the combination PRO+ATO treatment on cocaine (COC), caffeine (CAF), and/or cue-primed reinstatement of cocaine-seeking. Adult male and female Wistar rats lever-pressed under a FR 1 schedule for cocaine infusions (0.4mg/kg/inf). After 14 sessions of stable responding in daily 2-h sessions, rats underwent a 21-day extinction period when no drug or drug-related stimuli were present. Rats were then separated into four groups that received PRO (0.5mg/kg) alone (PRO+SAL), ATO (1.5mg/kg) alone (VEH+ATO), control (VEH+SAL) or combination (PRO+ATO) treatments prior to the reinstatement condition. Reinstatement of cocaine-seeking to cues and/or drug injections of cocaine or caffeine was tested after extinction. During maintenance, females self-administered more cocaine than males, but no sex differences were seen during extinction. Females showed greater cocaine-seeking than males after a CAF priming injection. Individual treatment with ATO did not decrease reinstatement under any priming condition; however, the combination treatment decreased cocaine-seeking under the COC+CUES priming condition in males, and both PRO alone and the combination treatment decreased cocaine-seeking in the CAF+CUES condition in females. Overall, PRO alone was only effective in reducing reinstatement in females, while the combination treatment was consistently effective in reducing reinstatement in both sexes. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Combined Heat and Preservative Treatment on Storability of Ponkan Fruit (Citrus reticulata Blanco cv. Ponkan during Postharvest Storage

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Dandan Tang

2017-01-01

Full Text Available Heat treatment and preservative application have been widely used during postharvest storage of many fresh products, but the effect of their combination on citrus storage has rarely been investigated. In this study, the optimal heat treatment (HT conditions and HT combined with preservative treatment were investigated for Ponkan fruit (Citrus reticulata Blanco cv. Ponkan storage. Results indicated that HT at 55°C for 20 s can significantly reduce the decay rate of Ponkan fruit, and a combination of HT and 25% of the preservative dosage used in production of iminoctadine tris (albesilate, 2,4-dichlorophenoxyacetic acid, and imazalil significantly reduced the decay rate without affecting fruit quality. In addition, the increased fiber contents in fruit receiving the HT combined with preservative treatments may be a response preventing fungus infection and enhancing fruit storability and resistance. The above results suggested that the combination of HT and 25% of the preservative production dosage was optimal for controlling Ponkan fruit decay during storage.

28 CFR 43.2 - Obligations of persons receiving care and treatment.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Obligations of persons receiving care and treatment. 43.2 Section 43.2 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RECOVERY OF COST OF HOSPITAL AND MEDICAL CARE AND TREATMENT FURNISHED BY THE UNITED STATES § 43.2 Obligations of persons...

Early pain management after periodontal treatment in dogs – comparison of single and combined analgesic protocols

Directory of Open Access Journals (Sweden)

Petr Raušer

2015-01-01

Full Text Available The aim of this study was to assess the analgesic effectiveness of three analgesic protocols in dogs undergoing a periodontal treatment. The study was performed as a prospective, randomized, “double blind” clinical study. A total of 45 client-owned dogs scheduled for periodontal treatment were included. Dogs of Group C received carprofen (4 mg·kg-1, dogs of Group B received bupivacaine (1 mg·kg-1 and dogs of Group CB received a combination of carprofen (4 mg·kg-1 and bupivacaine (1 mg·kg-1. Carprofen was administered subcutaneously 30 min before anaesthesia, bupivacaine was administered by nerve blocks in anaesthetized dogs. Painful periodontal treatment was performed in all patients, lasting up to one hour. Modified University of Melbourne Pain Score (UMPS, Visual Analogue Scale for pain assessment (VAS, plasma glucose and serum cortisol levels were assessed 30 min before administration of analgesics (C-0, B-0, CB‑0 and 2 h after recovery from anaesthesia (C-2, B-2, CB-2. For statistical analysis Friedman test, Mann-Whitney U-test, ANOVA and Fischer exact tests were used (P < 0.05. In CB‑2 compared to CB‑0 significantly decreased modified UMPS values. In CB‑2 UMPS values were significantly lower compared to C‑2 or B‑2. In C‑2 VAS values were significantly increased compared to C‑0, and in B‑2 VAS values were significantly increased compared to B‑0. Visual Analogue Scale values were significantly lower in CB‑2 compared to C‑2 or B‑2. Significantly increased plasma glucose concentrations were found in C‑2 compared to C‑0 and in B‑2 compared to B‑0. No other significant differences were detected. Administration of carprofen, bupivacaine or their combination is sufficient for early postoperative analgesia following periodontal treatment. Carprofen-bupivacaine combination is superior to carprofen or bupivacaine administered separately.

Combined cycle solar central receiver hybrid power system study. Final technical report. Volume II

Energy Technology Data Exchange (ETDEWEB)

None

1979-11-01

This study develops the conceptual design for a commercial-scale (nominal 100 MWe) central receiver solar/fossil fuel hybrid power system with combined cycle energy conversion. A near-term, metallic heat pipe receiver and an advanced ceramic tube receiver hybrid system are defined through parametric and market potential analyses. Comparative evaluations of the cost of power generation, the fuel displacement potential, and the technological readiness of these two systems indicate that the near-term hybrid system has better potential for commercialization by 1990. Based on the assessment of the conceptual design, major cost and performance improvements are projected for the near-term system. Constraints preventing wide-spread use were not identified. Energy storage is not required for this system and analyses show no economic advantages with energy storage provisions. It is concluded that the solar hybrid system is a cost effective alternative to conventional gas turbines and combined cycle generating plants, and has potential for intermediate-load market penetration at 15% annual fuel escalation rate. Due to their flexibility, simple solar/nonsolar interfacing, and short startup cycles, these hybrid plants have significant operating advantages. Utility company comments suggest that hybrid power systems will precede stand-alone solar plants.

Combined local and systemic bleomycin administration in electrochemotherapy to reduce the number of treatment sessions

International Nuclear Information System (INIS)

Maglietti, Felipe; Tellado, Matias; Olaiz, Nahuel; Michinski, Sebastian; Marshall, Guillermo

2016-01-01

Electrochemotherapy (ECT), a medical treatment widely used in human patients for tumor treatment, increases bleomycin toxicity by 1000 fold in the treated area with an objective response rate of around 80%. Despite its high response rate, there are still 20% of cases in which the patients are not responding. This could be ascribed to the fact that bleomycin, when administered systemically, is not reaching the whole tumor mass properly because of the characteristics of tumor vascularization, in which case local administration could cover areas that are unreachable by systemic administration. We propose combined bleomycin administration, both systemic and local, using companion animals as models. We selected 22 canine patients which failed to achieve a complete response after an ECT treatment session. Eleven underwent another standard ECT session (control group), while 11 received a combined local and systemic administration of bleomycin in the second treatment session. According to the WHO criteria, the response rates in the combined administration group were: complete response (CR) 54% (6), partial response (PR) 36% (4), stable disease (SD) 10% (1). In the control group, these were: CR 0% (0), PR 19% (2), SD 63% (7), progressive disease (PD) 18% (2). In the combined group 91% objective responses (CR+PR) were obtained. In the control group 19% objective responses were obtained. The difference in the response rate between the treatment groups was significant (p < 0.01). Combined local and systemic bleomycin administration was effective in previously to ECT non responding canine patients. The results indicate that this approach could be useful and effective in specific population of patients and reduce the number of treatment sessions needed to obtain an objective response

Effects of metformin on body weight in patients with type 2 diabetes mellitus,receiving insulin analogue treatment

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T I Romantsova

2013-03-01

Full Text Available Aims. To study the dynamics of body weight, waist circumference, blood lipid and insulin demand in patients with type 2 diabetes mellitus (T2DM during first year of combined treatment with metformin and insulin analogues, compared with insulin analogue monotherapy.Materials and Methods. We examined 78 patients with T2DM on newly initiated insulin therapy, including 54 females and 24 males. Median age was 56 [51.0; 64.0] years, median disease duration – 9 [6.8;14.0] years. Participants were subdivided in two groups. First group was comprised of 48 subjects (33 females and 15 males, who received monotherapy with insulin analogues (glargine, de- temir, biphasic Aspart 30 and Humalog Mix 25 or rapid-acting lispro and aspart. Second group included 30 patients (18 females and12 males, who were treated with combined therapy (insulin analogues plus metformin. We measured HbA1c, plasma lipid composition, BMI, waist circumference and insulin demand initially and after one year of follow-up.Results. We showed that combined therapy vs. insulin monotherapy allows better glycemic compensation while reducing insulin demand and lowering risks for weight gain.Conclusions. Combined insulin analogue plus metformin treatment delivers better metabolic control in patients with T2DM and is as- sociated with lower risks for body weight gain and increase in insulin demand against monotherapy with insulin analogues.

Effects of metformin on body weight in patients with type 2 diabetes mellitus,receiving insulin analogue treatment

Directory of Open Access Journals (Sweden)

Tatiana Ivanovna Romantsova

2013-03-01

Full Text Available Aims. To study the dynamics of body weight, waist circumference, blood lipid and insulin demand in patients with type 2 diabetes mellitus (T2DM during first year of combined treatment with metformin and insulin analogues, compared with insulin analogue monotherapy. Materials and Methods. We examined 78 patients with T2DM on newly initiated insulin therapy, including 54 females and 24 males. Median age was 56 [51.0; 64.0] years, median disease duration ? 9 [6.8;14.0] years. Participants were subdivided in two groups. First group was comprised of 48 subjects (33 females and 15 males, who received monotherapy with insulin analogues (glargine, de- temir, biphasic Aspart 30 and Humalog Mix 25 or rapid-acting lispro and aspart. Second group included 30 patients (18 females and12 males, who were treated with combined therapy (insulin analogues plus metformin. We measured HbA1c, plasma lipid composition, BMI, waist circumference and insulin demand initially and after one year of follow-up. Results. We showed that combined therapy vs. insulin monotherapy allows better glycemic compensation while reducing insulin demand and lowering risks for weight gain. Conclusions. Combined insulin analogue plus metformin treatment delivers better metabolic control in patients with T2DM and is as- sociated with lower risks for body weight gain and increase in insulin demand against monotherapy with insulin analogues.

Evaluation of RNFL thickness and serum cytokine levels after retinal photocoagulation combined with intravitreous Conbercept injection treatment of diabetic retinopathy

Institute of Scientific and Technical Information of China (English)

Luo Na

2016-01-01

Objective:To evaluate the effect of retinal photocoagulation combined with intravitreous Conbercept injection in RNFL thickness, serum cytokine levels and other aspects of diabetic retinopathy.Methods:A total of 92 patients with diabetic retinopathy (126 eyes) who received inpatient treatment in our hospital from December, 2013 to December 2015 were included in the study and divided into observation group 46 cases (62 eyes) and control group 46 cases (64 eyes) according to random number table, control group received retinal photocoagulation therapy alone, observation group received retinal photocoagulation combined with intravitreous Conbercept injection treatment, and then differences in RNFL thickness, hemodynamic indexes, serum levels of cytokines and others were compared between two groups after treatment.Results: Average RNFL thickness of inner optic disc top, bottom, bitamporal and nasal ring area as well as the average full-cycle 360° RNFL thickness of observation group after treatment was less than those of control group; PSV and EDV values of CRA were higher than those of control group while RI value was lower than that of control group, and PSV, EDV and RI values of CRV were lower than those of control group; serumβ2-GPⅠ, Hcy, VEGF and SDF-1 levels were lower than those of control group while C-peptide and APN levels were higher than those of control group.Conclusion: Retinal photocoagulation combined with intravitreous Conbercept injection can significantly reduce the RNFL thickness of the patients with diabetic retinopathy and optimize the retinal hemodynamic status, and helps to improve patients’ overall conditions.

Efficient FPGA Implementation of a STBC-OFDM Combiner for an IEEE 802.16 Software Radio Receiver

DEFF Research Database (Denmark)

Cattoni, Andrea Fabio; Le Moullec, Yannick; Sacchi, Claudio

2014-01-01

In this paper, an efficient FPGA implementation of a 4x4 Space-Time Block Coding (STBC) combiner for MIMO-OFDM software radio receivers is considered. The proposed combiner is based on a low-complexity algorithm which reduces the interference due to the Quasi-Orthogonality of the STBC decoding...

Evaluation of the efficiency of combination palliative treatment in patients with metastatic clear-cell renal cell carcinoma

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P. S. Borisov

2015-01-01

Full Text Available Background. Experience with combination treatment, i.e. systemic therapy in combination with palliative surgery, in the treatment of metastatic kidney cancer is very rarely described in world literature.Objective: to evaluate the efficiency of combination treatment in combination with palliative cytoreductive surgery and targeted therapy and to define optimal indications for combination treatment.Subjects and methods. Data on 47 patients with metastatic renal cell carcinoma (mRCC who received systemic (targeted therapy in combination or after incomplete cytoreduction (iCR were analyzed in this retrospective study. The proportion of men and women was 72.3 % and 27.7 %, respectively; their ratio was 2.6:1. All the patients (100% underwent surgical treatment as nephrectomy or kidney resection for primary tumor. In the patients who had received radical treatment in different periods, the median relapse-free survival was 25.3 (0-187 months; the mean follow-up duration in the study was 33.2 (27.4–39.0 months. Out of the histological characteristics of a primary tumor, its Fuhrman grade was studied. Prior to initiation of mRCC therapy, Memorial Sloan Kettering Cancer Center (MSKCC prognosis groups were assessed; the patients were divided into good (n = 9 (19.1 %, interim (n = 28 (59.6 %, and bad (n = 10 (21.3 % prognosis groups. Their total somatic status was separately rated using the ECOG scale: 0, (n = 10 (21.3%, 1 (n = 24 (51.1 %, and 2, (n = 13 (27.6 %. The sites of metastases were as follows: the lung (n = 29, bones (n = 18, adrenals (n = 11, recurrence in the removed kidney bed (n = 10, and liver (n = 10. Multiple organ involvements were detected in 22 (46.8 % patients. There were more than 5 metastases in one organ in 18 (40.0 % patients and only 15 (33.3 % were found to have a single focus in one organ. Whether iCR might be used as a separate line treatment was studied. A comparative analysis was made between 2 groups of

Effect of Shenkang injection combined with hemodialysis treatment on renal function, renal anemia and cytokine levels in patients with chronic renal failure

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Rui Liu

2016-10-01

Full Text Available Objective: To study the effect of Shenkang injection combined with hemodialysis treatment on renal function, renal anemia and cytokine levels in patients with chronic renal failure. Methods: A total of 68 patients with chronic renal failure who received hemodialysis treatment in our hospital during between October 2013 and February 2016 were selected and randomly divided into two groups, the observation group received Shenkang injection treatment in the process of dialysis, and the control group only received conventional symptomatic and supportive treatment. 8 weeks after treatment, serum was collected to determine the levels of renal function indexes, nutritional status indexes, anemia indexes and cytokines, and urine was collected to determine renal function indexes. Results: β2-MG, UA, Cr, phosphorus, IL-17, IL-23, CTGF, TGF-β1, FGF-2 and FGF-23 levels in serum as well as NGAL, KIM-1 and RBP levels in urine of observation group were significantly lower than those of control group, and TP, Alb, PA, calcium, Hb, EPO, Fe, TRF and FER levels in serum were significantly higher than those of control group. Conclusion: Shenkang injection combined with hemodialysis treatment helps to improve renal function, nutritional status and renal anemia, and reduce the synthesis of inflammation and renal interstitial fibrosis-related cytokines in patients with chronic renal failure.

Assessment of the degree of oxidative stress injury, renin-angiotensin system activity and podocyte loss after combined treatment of keto acid with low protein diet for patients with diabetic nephropathy

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Yuan-Hua Xu

2016-03-01

Full Text Available Objective: To analyze the degree of oxidative stress injury, RAS activity and podocyte loss after patients with diabetic nephropathy received keto acid combined with low protein diet. Methods: A total of 106 cases of patients with diabetic nephropathy who received hospital treatment in our hospital from September 2012 to July 2015 were selected as research subjects and randomly divided into observation group and control group according to different treatment, each group with 53 cases. Control group received low protein diet treatment alone, observation group received keto acid combined with low protein diet treatment, and then the degree of oxidative stress injury, RAS activity and podocyte loss of two groups were compared. Results: Serum MDA and AOPP levels of observation group after treatment were lower than those of control group, and levels of SOD and T-AOC were higher than those of control group; PRA, Ang栻 and Aldosterone levels of observation group after treatment were lower than those of control group; mRNA expression levels of podocin and synaptopodin in urine sediment of observation group after treatment were lower than those of control group. Conclusion: Keto acid combined with low protein diet treatment for patients with diabetic nephropathy can reduce the degree of oxidative stress injury and RAS activity, decrease podocyte loss and optimize patients’ condition.

IMPLICATION OF THE FIXED COMBINATIONS IN THE HYPERTENSION TREATMENT

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Z. D. Kobalava

2010-01-01

Full Text Available The role of fixed combinations in the hypertension (HT treatment is discussed. Theoretical and practical aspects of combination therapy, principles of rational combination therapy are present. Current guidelines on the use of fixed dose combinations, including start antihypertensive therapy are analyzed. Classification of combinations, advantages and limitations of some of them implementation are also presented. Significance of beta-blocker bisoprolol and thiazide diuretic hydrochlorothiazide fixed combination (Lodoz is shown in HT treatment.

Naltrexone and Bupropion Combination Treatment for Smoking Cessation and Weight Loss in Patients With Schizophrenia

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Xuechan Lyu

2018-03-01

Full Text Available Objective: The rates of obesity and cigarette smoking are much higher in patients with schizophrenia compared to the general population. This study was to examine whether naltrexone and bupropion combination treatment can help weight loss and smoking cessation in patients with schizophrenia.Methods: Obese male schizophrenia patients with current cigarette smoking were randomized to receive adjunctive naltrexone (25 mg/day and bupropion (300 mg/day combination or placebo for 24 weeks. Twenty-two patients were enrolled in the study, and 21 patients completed the study (11 in the treatment group, and 10 in the placebo group. Body weight, body mass index (BMI, fasting lipids, smoking urge, expired carbon monoxide (CO level and cigarettes smoked per week were measured at baseline and week 24.Results: There was no significant difference between two groups in changes in weight, BMI, fasting lipids, or cigarette smoking measures (p's > 0.05Conclusion: Naltrexone and bupropion combination treatment didn't show weight loss or smoking cessation effect in patients with schizophrenia in this pilot study.Implications for future studies were discussed.ClinicalTrials.gov identifier: NCT02736474.

Study on the usefulness of high-frequency analysis of the combined treatment of cancer with hyperthermia

International Nuclear Information System (INIS)

Ji, Youn Sang; Dong, Kyung Rae; Yeo, Hwa Yeon

2016-01-01

In order to understand the usefulness to the high-frequency thermal therapy of cancer staging according to the TNM classification treatment, was to evaluate the effect of high frequency hyperthermia treatment approach through other means and whether other organs, according to the combined presence of transition. Targeted to receive more than a total of 1 cycle high frequency heat treatment at C hospital that performed the high-frequency hyperthermia cancer patients 92 people out stage, depending on the presence or absence of metastasis, combined hyperthermia patients for statistics before and after treatment the therapeutic effect of the therapeutic classification. Out of a total of 92 patients decrease 11 patients, stable 71 patients, with increase 10 patients, the rate of increase is the result of about 11% patients showed a decrease of about 89% is occupied by patients and a stable rate. There is strong evidence for the usefulness as a secondary therapy to maintain the quality of life, while slowing the progression of cancer by a high-frequency heat treatment

Study on the usefulness of high-frequency analysis of the combined treatment of cancer with hyperthermia

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Ji, Youn Sang; Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of); Yeo, Hwa Yeon [Dept. of of Radiology, Nambu University, Gwangju (Korea, Republic of)

2016-11-15

In order to understand the usefulness to the high-frequency thermal therapy of cancer staging according to the TNM classification treatment, was to evaluate the effect of high frequency hyperthermia treatment approach through other means and whether other organs, according to the combined presence of transition. Targeted to receive more than a total of 1 cycle high frequency heat treatment at C hospital that performed the high-frequency hyperthermia cancer patients 92 people out stage, depending on the presence or absence of metastasis, combined hyperthermia patients for statistics before and after treatment the therapeutic effect of the therapeutic classification. Out of a total of 92 patients decrease 11 patients, stable 71 patients, with increase 10 patients, the rate of increase is the result of about 11% patients showed a decrease of about 89% is occupied by patients and a stable rate. There is strong evidence for the usefulness as a secondary therapy to maintain the quality of life, while slowing the progression of cancer by a high-frequency heat treatment.

Intralesional triamcinolone alone and in combination with 5-fluorouracil for the treatment of Keloid and Hypertrophic scars

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Khan, M. A.; Bashir, M. M.; Khan, F. A.

2014-01-01

Objective: To compare the use of intralesional triamcinolone acetonide and its combination with 5 flourouracil in the treatment of keloid and hypertrophic scars in terms of reduction in initial height of the scar. Methods: The randomised controlled trial was conducted at the Department of Plastic Surgery, King Edward Medical University, Lahore, from March 2011 to December 2012. It comprised patients of both genders having keloids or hypertrophic scars (1 cm to 5 cm in size) having no history of treatment for the scars in preceding 6 months. Those who were pregnant, planning pregnancy or lactating were excluded. The subjects were divided into two groups: Group A received intralesional triamcinolone acetonide alone; and Group B received triamcinolone acetonide + 5 flourouracil. Eight injections were given at weekly interval. Scars were assessed 4 weeks after the completion of treatment on a five-point scale. SPSS 16 was used for statistical analysis. Results: The 150 subjects in the study were divided into two equal groups of 75(50%) each. Good to excellent results were seen in 51(68%) cases in Group A compared to 63(84%) in Group B. Frequency of complications was 18(24%) and 6(8%) in Group A and Group B respectively. Conclusion: Combination of triamcinolone acetonide and 5 flourouracil is superior to triamcinolone acetonide therapy in the treatment of keloids and hypertrophic scars. (author)

Results of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) in treatment of obstructive endobronchial non-small cell lung cancer

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Weinberg, Benjamin D.; Allison, Ron R.; Sibata, Claudio; Parent, Teresa; Downie, Gordon

2009-06-01

We reviewed the outcome of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) for patients with symptomatic obstruction from endobronchial non-small cell lung cancer. Methods: Nine patients who received combined PDT and HDR for endobronchial cancers were identified and their charts reviewed. The patients were eight males and one female aged 52-73 at diagnosis, initially presenting with various stages of disease: stage IA (N=1), stage IIA (N=1), stage III (N=6), and stage IV (N=1). Intervention was with HDR (500 cGy to 5 mm once weekly for 3 weeks) and PDT (2 mg/kg Photofrin, followed by 200 J/cm2 illumination 48 hours post infusion). Treatment group 1 (TG-1, N=7) received HDR first; Treatment group 2 (TG-2, N=2) received PDT first. Patients were followed by regular bronchoscopies. Results: Treatments were well tolerated, all patients completed therapy, and none were lost to follow-up. In TG-1, local tumor control was achieved in six of seven patients for: 3 months (until death), 15 months, 2+ years (until death), 2+ years (ongoing), and 5+ years (ongoing, N=2). In TG-2, local control was achieved in only one patient, for 84 days. Morbidities included: stenosis and/or other reversible benign local tissue reactions (N=8); photosensitivity reaction (N=2), and self-limited pleural effusion (N=2). Conclusions: Combined HDR/PDT treatment for endobronchial tumors is well tolerated and can achieve prolonged local control with acceptable morbidity when PDT follows HDR and when the spacing between treatments is one month or less. This treatment regimen should be studied in a larger patient population.

Clinical Observation of Recombinant Human Vascular Endostatin Durative Transfusion Combined with Window Period Arterial Infusion Chemotherapy in the Treatment of 
Advanced Lung Squamous Carcinoma

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Yuan LV

2015-08-01

Full Text Available Background and objective Lung cancer is one of the most common malignant tumors in China. The aim of this study is to observe the efficacy and safety of recombinant human vascular endostatin (endostar durative transfusion combined with window period arterial infusion chemotherapy in the treatment of advanced lung squamous carcinoma. Methods From February 2014 to January 2015, 10 cases of the cytological or histological pathology diagnosed stage IIIb - stage IV lung squamous carcinoma were treated with recombinant human vascular endostatin (30 mg/d durative transfusion combined with window period arterial infusion chemotherapy. Over the same period of 10 cases stage IIIb - stage IV lung squamous carcinoma patients for pure arterial perfusion chemotherapy were compared. Recombinant human vascular endostatin was durative transfused every 24 hours for 7 days in combination group, and in the 4th day of window period, the 10 patients were received artery infusion chemotherapy, using docetaxel combined with cisplatin. Pure treatment group received the same arterial perfusion chemotherapy regimen. 4 weeks was a cycle. 4 weeks after 2 cycles, to evaluate the short-term effects and the adverse drug reactions. Results 2 groups of patients were received 2 cycles treatments. The response rate (RR was 70.0%, and the disease control rate (DCR was 90.0% in the combination group; In the pure treatment group were 50.0%, 70.0% respectively, there were no statistically significant difference (P=0.650, 0.582. The adverse reactions of the treatment were mild, including level 1-2 of gastrointestinal reaction and blood toxicity, there were no statistically significant difference (P=0.999, P=0.628. In the combination group, 1 patient occurred level 1 of cardiac toxicity. Conclusion Recombinant human vascular endostatin durative transfusion combined with window period arterial infusion chemotherapy in the treatment of advanced lung squamous carcinoma could take a

Hypertensive Disorders in Pregnant Women Receiving Fertility Treatments

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Maryam Barekat

2018-05-01

Full Text Available Hypertensive disorders (HDs as the most prevalent medical problem during pregnancy, predispose the patient to a lot of comorbidities and may even cause maternal or fetal death. The rate of infertility has been increasing in recent decades. So, we collected and summarized data about the co-existence of these two entities and found that HDs are somewhat more common in women receiving fertility treatments regardless of pathophysiologic correlation of infer- tility and hypertension or older age and chance of multiple pregnancies.

Combined modality treatment with radiotherapy and chemotherapy

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Tannock, I.F.; Toronto Univ., ON

1989-01-01

The present paper discusses some of the methodological issues which can confound the interpretation of clinical trials of combined modality treatment. It reviews some of the larger randomized trials which have evaluated combined modality treatment in cancers of the head and neck, lung, gastrointestinal tract and bladder. It concludes that adequate trials have yet to be performed in many of thses sites, but that at present, evidence for long-term benefit from adjunctivechemotherapy is meagre. Finally, it suggests some possible mechanisms which might heve limited the benefit of chemotherapy when added to radiation treatment. (Author). 87 refs.; 4 figs.; 4 tabs

Combined Modality Treatment for PET-Positive Non-Hodgkin Lymphoma: Favorable Outcomes of Combined Modality Treatment for Patients With Non-Hodgkin Lymphoma and Positive Interim or Postchemotherapy FDG-PET

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Halasz, Lia M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Jacene, Heather A. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Catalano, Paul J. [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Van den Abbeele, Annick D. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); LaCasce, Ann [Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Mauch, Peter M. [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Ng, Andrea K., E-mail: ang@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States)

2012-08-01

Purpose: To evaluate outcomes of patients treated for aggressive non-Hodgkin lymphoma (NHL) with combined modality therapy based on [{sup 18}F]fluoro-2-deoxy-2-D-glucose positron emission tomography (FDG-PET) response. Methods and Materials: We studied 59 patients with aggressive NHL, who received chemotherapy and radiation therapy (RT) from 2001 to 2008. Among them, 83% of patients had stage I/II disease. Patients with B-cell lymphoma received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy, and 1 patient with anaplastic lymphoma kinase-negative anaplastic T-cell lymphoma received CHOP therapy. Interim and postchemotherapy FDG-PET or FDG-PET/computed tomography (CT) scans were performed for restaging. All patients received consolidated involved-field RT. Median RT dose was 36 Gy (range, 28.8-50 Gy). Progression-free survival (PFS) and local control (LC) rates were calculated with and without a negative interim or postchemotherapy FDG-PET scan. Results: Median follow-up was 46.5 months. Thirty-nine patients had negative FDG-PET results by the end of chemotherapy, including 12 patients who had a negative interim FDG-PET scan and no postchemotherapy PET. Twenty patients were FDG-PET-positive, including 7 patients with positive interim FDG-PET and no postchemotherapy FDG-PET scans. The 3-year actuarial PFS rates for patients with negative versus positive FDG-PET scans were 97% and 90%, respectively. The 3-year actuarial LC rates for patients with negative versus positive FDG-PET scans were 100% and 90%, respectively. Conclusions: Patients who had a positive interim or postchemotherapy FDG-PET had a PFS rate of 90% at 3 years after combined modality treatment, suggesting that a large proportion of these patients can be cured with consolidated RT.

Combination vinblastine, prednisolone and toceranib phosphate for treatment of grade II and III mast cell tumours in dogs.

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Olsen, Jaime A; Thomson, Maurine; O'Connell, Kathleen; Wyatt, Ken

2018-05-24

This retrospective study evaluates the progression-free interval and survival outcomes of 40 canine (Canis familiaris) patients with Patnaik grade II and III mast cell tumours treated with combination vinblastine, prednisolone and toceranib phosphate from 2011 to 2015. Patients were subdivided into three groups; patients who received neoadjuvant therapy for poorly operable lesions, patients who received adjuvant therapy following surgical resection and patients being palliated for gross metastatic disease. Median survival time (MST) for the neoadjuvant group was not reached. Median survival time for the remaining groups was 893 days and 218 days, respectively. This combination demonstrated response in 90% (26/29) patients with measurable disease. The predominant side effects related to this chemotherapy combination were gastrointestinal in origin. Further prospective studies are required to further validate the efficacy of this treatment protocol. © 2018 The Authors Veterinary Medicine and Science Published by John Wiley & Sons Ltd.

Efficacy evaluation of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression

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Chun-Hua Liao

2015-01-01

Objective:To study the efficacy of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression. Methods:120 cases of unstable angina patients with depression were randomly divided into two groups. The anti-depression group received fluoxetine combined with conventional drug therapy; the conventional group received conventional drug therapy. Then contents of monoamine neurotransmitters and their metabolites, antioxidants and inflammatory mediators of both groups were compared. Results:Serum monoamine neurotransmitters NE, 5-HT and HA levels of the anti-depression group were higher than those of the conventional group and metabolites 5-HIAA and HVA contents were lower than those of the conventional group; serum SOD, CAT, GSH and HSP-70 contents of the anti-depression group were higher than those of the conventional group, and hs-CRP, MMP9, MCP1 and HMGB1 contents were lower than those of the conventional group. Conclusion:Fluoxetine combined with conventional drug therapy can increase the contents of monoamine neurotransmitters and antioxidants, and reduce oxidative stress response and inflammatory response; it is an ideal method for treating unstable angina complicated with depression.

Outcome of E1224-Benznidazole Combination Treatment for Infection with a Multidrug-Resistant Trypanosoma cruzi Strain in Mice.

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Diniz, Lívia de Figueiredo; Mazzeti, Ana Lia; Caldas, Ivo Santana; Ribeiro, Isabela; Bahia, Maria Terezinha

2018-06-01

Combination therapy has been proposed as an alternative therapeutic approach for the treatment of Chagas disease. In this study, we evaluated the effect of treatment with benznidazole combined with E1224 (ravuconazole prodrug) in an experimental murine model of acute infection. The first set of experiments assessed the range of E1224 doses required to induce parasitological cure using Trypanosoma cruzi strains with different susceptibilities to benznidazole (Y and Colombian). All E1224 doses were effective in suppressing the parasitemia and preventing death; however, parasitological cure was observed only in mice infected with Y strain. Considering these results, we evaluated the effect of combined treatment against Colombian, a multidrug-resistant T. cruzi strain. After exclusion of antagonistic effects using in vitro assays, infected mice were treated with E1224 and benznidazole in monotherapy or in combination at day 4 or 10 postinoculation. All treatments were well tolerated and effective in suppressing parasitemia; however, parasitological and PCR assays indicated no cure among mice treated with monotherapies. Intriguingly, the outcome of combination therapy was dependent on treatment onset. Early treatment using optimal doses of E1224-benznidazole induced a 100% cure rate, but this association could not eliminate a well-established infection. The beneficial effect of combination therapy was evidenced by further reductions of the patent parasitemia period in the group receiving combined therapy compared with monotherapies. Our results demonstrated a positive interaction between E1224 and benznidazole against murine T. cruzi infection using a multidrug-resistant strain and highlighted the importance of a stringent experimental model in the evaluation of new therapies. Copyright © 2018 Diniz et al.

Diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm

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Chen Huairui; Bai Rulin; Huang Chengguang; Hu Guohan; Luo Chun; Yuan Guoliang; Lu Yicheng

2008-01-01

Objective: To explore the diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Methods: Interventional diagnosed and treated 6 eases of traumatid carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Results: 5 patients presented with recurrent massive epistaxis and symptoms of CCF caused by pseudoaneurysms and fistulas were occluded with detachable balloons and internal carotid arteries were reserved in 2 cases; of which, 1 case also had indirect carotid cavernous fistula in contralateral side, embolizated by trans facial vein approach with microcoil. Complete symptoms resolution was achieved in all cases, without procedure related complications. During the follow-up period, all patients returned to their work. Conclusions: Falling from high speed motorcycle without helmet may be one of the main causes of this disease. The site of strike mostly localize at the frontal and lateral aspects of the orbit. MRI scan is very helpful for the diagnosis before receiving angiography. Detachable balloon occlusion for the pseudoaneurysm and fistula is safe and efficient for the treatment. (authors)

The effects of combined treatment with radiation and bleomycin on the oral carcinoma involving the mandible

International Nuclear Information System (INIS)

Okamoto, Manabu; Ozeki, Satoru; Higuchi, Yoshinori; Tashiro, Hideo

1988-01-01

The effect of concurrent combined treatment with 22.5 Gy of radiation and 110 mg of bleomycin or 55 mg of peplomycin on oral carcinoma involving the mandible was examined histologically. In 14 of 18 patients who had mandibles resected after this combined treatment, bone invasion by carcinoma was observed histologically. According to Shimosato's classification of histological effects, 3 belonged to Grade III/IV, 4 to IIb, 3 to IIa and 4 to I. The formation of new bone that was considered to be reparable was observed in the marked effective patients. In 4 patients the Grade IIb, residual surviving cancer cells were observed in the mandible. Accordingly, excision was needed in the area of radiologic features of mandibular infiltration. But it is considered that although the excision scope for the patient who has received the preoperative treatment is the same as that for the patient who has not, it is advantageous for the former patient that a wider safety region is obtained. (author)

An interactional test of the reformulated helplessness theory of depression in women receiving clinical treatment for eating disorders.

Science.gov (United States)

Rotenberg, Ken J; Costa, Paula; Trueman, Mark; Lattimore, Paul

2012-08-01

The study tested the Reformulated Helplessness model that individuals who show combined internal locus of control, high stability and high globality attributions for negative life events are prone to depression. Thirty-six women (M=29 years-8 months of age) receiving clinical treatment for eating disorders completed: the Attribution Style Questionnaire, the Beck Depression Inventory, and the Stirling Eating Disorder Scales. An HRA yielded a three-way interaction among the attributional dimensions on depressive symptoms. Plotting of the slopes showed that the attribution of negative life events to the combination of internal locus of control, high stability, and a high globality, was associated with the optimal level of depressive symptoms. The findings supported the Reformulated Helplessness as a model of depression. Copyright © 2012 Elsevier Ltd. All rights reserved.

The impact of education on the probability of receiving periodontal treatment. Causal effects measured by using the introduction of a school reform in Norway.

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Grytten, Jostein; Skau, Irene

2017-09-01

The aim of the present study was to estimate the causal effect of education on the probability of receiving periodontal treatment in the adult Norwegian population. In Norway, a substantial part of the cost of periodontal treatment is subsidized by the National Insurance Scheme. In that case, one might expect that the influence of individual resources, such as education, on receiving treatment would be reduced or eliminated. Causal effects were estimated by using data on a school reform in Norway. During the period 1960-1972, all municipalities in Norway were required to increase the number of compulsory years of schooling from seven to nine years. The education reform was used to create exogenous variation in the education variable. The education data were combined with large sets of data from the Norwegian Health Economics Administration and Statistics Norway. Since municipalities implemented the reform at different times, we have both cross-sectional and time-series variation in the reform instrument. Thus we were able to estimate the effect of education on the probability of receiving periodontal treatment by controlling for municipality fixed effects and trend variables. The probability of receiving periodontal treatment increased by 1.4-1.8 percentage points per additional year of schooling. This is a reasonably strong effect, which indicates that policies to increase the level of education in the population can be an effective tool to improve oral health, including periodontal health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Do Women With Breast Cancer Who Choose Adjunctive Integrative Oncology Care Receive Different Standard Oncologic Treatment?

Science.gov (United States)

Standish, Leanna J; Dowd, Fred; Sweet, Erin; Dale, Linda; Andersen, M Robyn

2018-04-01

To determine if women with breast cancer who choose adjunctive naturopathic oncology (NO) specialty care receive different standard oncologic treatment when compared with breast cancer patients who receive only standard care. Women with breast cancer stages 0 to 4, aged 18+ who spoke English and sought care from outpatient naturopathic doctor clinics were enrolled in an observational study of clinical and quality of life outcomes. Women who sought NO care 2 or more times within the first 2 years postdiagnosis were identified as NO cases. A matched comparison group of breast cancer patients were identified using the Western Washington Cancer Surveillance System(CSS). A longitudinal cohort design. In addition to self-report data, the CSS provided data on demographics, stage at the time of diagnosis, and initial treatment. Oncology medical records were abstracted in order to provide additional information on standard oncologic treatment for all participants. Cohorts were well matched with regard to demographic, histologic, and prognostic indicators at the time of diagnosis. Approximately 70% of women in both cohorts received standard oncologic care that met the National Comprehensive Cancer Network guidelines. There were no statistically significant differences between the cohorts in treatment received. Fewer women in the NO cohort with estrogen receptor-positive breast cancer appear to have received antiestrogen therapy. Women in both cohorts appear to receive guideline-concordant care. However, women who receive adjunctive NO care may be less likely to receive antiestrogen therapy.

Treatment of Febrile illness with artemisinin combination therapy: prevalence and predictors in five African household surveys.

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Vialle-Valentin, Catherine E; LeCates, Robert F; Zhang, Fang; Ross-Degnan, Dennis

2015-01-01

To evaluate the determinants of compliance with national policies recommending Artemisinin Combination Therapy (ACT) for the treatment of uncomplicated malaria in the community. We used data from Gambia, Ghana, Kenya, Nigeria, and Uganda national household surveys that were conducted with a standardized World Health Organization (WHO) methodology to measure access to and use of medicines. We analyzed all episodes of acute fever reported in the five surveys. We used logistic regression models accounting for the clustered design of the surveys to identify determinants of seeking care in public healthcare facilities, of being treated with antimalarials, and of receiving ACT. Overall, 92% of individuals with a febrile episode sought care outside the home, 96% received medicines, 67% were treated with antimalarials, and 16% received ACT. The choice of provider was influenced by perceptions about medicines availability and affordability. In addition, seeking care in a public healthcare facility was the single most important predictor of treatment with ACT [odds ratio (OR): 4.64, 95% confidence intervals (CI): 2.98-7.22, P policies recommending ACT for the treatment of uncomplicated malaria depends not only on restricting ACT to confirmed malaria cases, but also on ensuring that ACT is available and affordable for those who need it.

Impact of combination antiretroviral therapy initiation on adherence to antituberculosis treatment

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Marlene Knight

2015-10-01

Full Text Available Background: Healthcare workers are often reluctant to start combination antiretroviral therapy (ART in patients receiving tuberculosis (TB treatment because of the fear of high pill burden, immune reconstitution inflammatory syndrome, and side-effects. Object: To quantify changes in adherence to tuberculosis treatment following ART initiation. Design: A prospective observational cohort study of ART-naïve individuals with baseline CD4 count between 50 cells/mm3 and 350 cells/mm3 at start of TB treatment at a primary care clinic in Johannesburg, South Africa. Adherence to TB treatment was measured by pill count,self-report, and electronic Medication Event Monitoring System (eMEMS before and after initiation of ART. Results: ART tended to negatively affect adherence to TB treatment, with an 8% – 10% decrease in the proportion of patients adherent according to pill count and an 18% – 22% decrease in the proportion of patients adherent according to eMEMS in the first month following ART initiation, independent of the cut-off used to define adherence (90%, 95% or 100%. Reasons for non-adherence were multi factorial, and employment was the only predictor for optimal adherence (adjusted odds ratio 4.11, 95% confidence interval 1.06–16.0. Conclusion: Adherence support in the period immediately following ART initiation could optimise treatment outcomes for people living with TB and HIV.

Effect of combined treatments on viscosity of whey dispersions

International Nuclear Information System (INIS)

Camillo, A.; Sabato, S.F.

2004-01-01

Whey proteins, enriched protein fractions from milk, are of great interest as ingredients due to nutritional value associated with its functional properties. These proteins could have their structural properties improved when some treatments are applied, such as thermal and gamma irradiation or when some compounds are added. The current work aimed to study the viscometer behavior of whey dispersions submitted to two different combined treatments: (1) thermal plus irradiation and (2) thermal plus vacuum and N 2 plus irradiation. Dispersions of whey protein in water (5% and 8% protein (w/v) base) and containing proteins and glycerol at ratios 1:1 and 2:1 (protein:glycerol) were submitted to both combined treatments. The irradiation doses were 0, 5, 15 and 25 kGy. The viscosity of the two combined treatments and for four levels of absorbed doses is presented and the combined effects are discussed. The thermal treatment combined with gamma irradiation contributed to increase the viscosity as irradiation doses increases for both (5% and 8%) concentrations of proteins (p<0.05). For protein and glycerol solutions, the irradiation dose seemed to result in a slightly increase. The vacuum applied before the irradiation showed a small contribution

Effect of combined treatments on viscosity of whey dispersions

Energy Technology Data Exchange (ETDEWEB)

Camillo, A.; Sabato, S.F. E-mail: sfsabato@ipen.br

2004-10-01

Whey proteins, enriched protein fractions from milk, are of great interest as ingredients due to nutritional value associated with its functional properties. These proteins could have their structural properties improved when some treatments are applied, such as thermal and gamma irradiation or when some compounds are added. The current work aimed to study the viscometer behavior of whey dispersions submitted to two different combined treatments: (1) thermal plus irradiation and (2) thermal plus vacuum and N{sub 2} plus irradiation. Dispersions of whey protein in water (5% and 8% protein (w/v) base) and containing proteins and glycerol at ratios 1:1 and 2:1 (protein:glycerol) were submitted to both combined treatments. The irradiation doses were 0, 5, 15 and 25 kGy. The viscosity of the two combined treatments and for four levels of absorbed doses is presented and the combined effects are discussed. The thermal treatment combined with gamma irradiation contributed to increase the viscosity as irradiation doses increases for both (5% and 8%) concentrations of proteins (p<0.05). For protein and glycerol solutions, the irradiation dose seemed to result in a slightly increase. The vacuum applied before the irradiation showed a small contribution.

Acupuncture Treatment for Dyspnea due to Combined Pulmonary Fibrosis and Emphysema: A Case Report.

Science.gov (United States)

Matsumoto-Miyazaki, Jun; Miyazaki, Nagisa; Nishiwaki, Ayuko; Endo, Junki; Ushikoshi, Hiroaki; Ohno, Yasushi; Minatoguchi, Shinya

2015-12-01

Combined idiopathic pulmonary fibrosis with pulmonary emphysema (CPFE) is a syndrome with a characteristic presentation of upper lobe emphysema and lower lobe fibrosis. Dyspnea on exertion (DOE) is a major symptom of CPFE. We report a patient with DOE due to CPFE who was successfully treated with acupuncture. Case report. A 72-year-old Japanese man with a 4-year history of DOE was diagnosed with CPFE 2 years previously in another hospital. He received standard Western medicine treatment, which included bronchodilators. However, his DOE did not improve. Consequently, he visited our hospital for acupuncture treatment and received acupuncture treatment once a week for 1 year. After 10 weeks of acupuncture treatment, the results of the 6-minute walk test (6-minute walking distance, 379 m; lowest oxygen saturation, 86%; modified Borg dyspnea scale score: 2 units) were better than those at baseline (352 m, 84%, 4 units, respectively). These values were sustained at both 30 weeks (470 m, 88%, 1 unit) and 60 weeks (473 m, 85%, 2 units). Serum interstitial biomarkers, Krebs von den Lungen and surfactant protein-D, decreased after commencement of acupuncture therapy. A patient with CPFE showed improvements in dyspnea scores, exercise tolerance, and serum biomarkers during a 1-year course of acupuncture treatment. Use of acupuncture might be an effective adjunct therapy in relieving DOE due to CPFE. A large, well-designed cohort study that includes patients with CPFE treated with acupuncture should be conducted.

Cancer treatment: the combination of vaccination with other therapies

DEFF Research Database (Denmark)

Andersen, M.H.; Sorensen, R.B.; Schrama, D.

2008-01-01

approach to fight cancer, the combination with additional therapy could create a number of synergistic effects. Herein we discuss the possibilities and prospects of vaccination when combined with other treatments. In this regard, cell death upon drug exposure may be immunogenic or non-immunogenic depending...... and endothelial cells. The efficacy of therapeutic vaccination against cancer will over the next few years be studied in settings taking advantage of strategies in which vaccination is combined with other treatment modalities. These combinations should be based on current knowledge not only regarding the biology...... of the cancer cell per se, but also considering how treatment may influence the malignant cell population as well as the immune system Udgivelsesdato: 2008/11...

Clinical effect of systemic chemotherapy combined with transcatheter arterial chemoembolization in treatment of breast cancer with liver metastases

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LI Liye

2016-01-01

Full Text Available ObjectiveTo investigate the clinical effect of systemic chemotherapy combined with transcatheter arterial chemoembolization (TACE in the treatment of breast cancer with liver metastases. MethodsA total of 86 female breast cancer patients with liver metastases who were treated in the Affiliated Hospital of Shandong Academy of Medical Sciences from December 2012 to December 2014 were selected and equally divided into experimental group and control group. The patients in the control group received systemic chemotherapy, and those in the experimental group received systemic chemotherapy combined with TACE. The clinical effect, changes in lesions, and patients′ quality of life (QOL scores after treatment were compared between two groups. The t-test was applied for comparison of continuous data between the two groups, and the chi-square test was applied for comparison of categorical data between the two groups. ResultsThe experimental group had a significantly higher overall response rate than the control group (90.70% vs 58.14%, χ2=13.07, P=0.001. Compared with the control group, the experimental group had significantly smaller diameters of tumors and lymph nodes after treatment (t=4.26 and 4.63, both P＜0.001, as well as significantly higher QOL scores at 3 and 6 months after treatment (t=6.30 and 3.89, both P＜0001. ConclusionSystemic chemotherapy combined with TACE has a significant therapeutic effect in breast cancer patients with liver metastases, and can improve patients′ symptoms, reduce adverse drug reactions, and improve QOL. As a safe and reliable therapeutic method, it is worthy of clinical application.

RadioImmunotherapy for adenoid cystic carcinoma: a single-institution series of combined treatment with cetuximab

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2010-01-01

Background Local control in adjuvant/definitive RT of adenoid cystic carcinoma (ACC) is largely dose-dependent. However, some clinical situations do not allow application of tumouricidal doses (i.e. re-irradiation) hence radiation sensitization by exploitation of high endothelial growth factor receptor (EGFR)-expression in ACC seems beneficial. This is a single-institution experience of combined radioimmunotherapy (RIT) with the EGFR-inhibitor cetuximab. Methods Between 2006 and 2010, 9 pts received RIT for advanced/recurrent ACC, 5/9 pts as re-irradiation. Baseline characteristics as well as treatment parameters were retrieved to evaluate efficacy and toxicity of the combination regimen were evaluated. Control rates (local/distant) and overall survival were calculated using Kaplan-Meier estimation. Results Median dose was 65 Gy, pts received a median of 6 cycles cetuximab. RIT was tolerated well with only one °III mucositis/dysphagia. Overall response/remission rates were high (77,8%); 2-year estimate of local control was 80% hence reaching local control levels comparable to high-dose RT. Progression-free survival (PFS) at 2 years and median overall survival were only 62,5% and 22,2 mo respectively. Conclusion While local control and treatment response in RIT seems promising, PFS and overall survival are still hampered by distant failure. The potential benefit of RIT with cetuximab warrants exploration in a prospective controlled clinical trial. PMID:21047402

RadioImmunotherapy for adenoid cystic carcinoma: a single-institution series of combined treatment with cetuximab

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Weichert Wilko

2010-11-01

Full Text Available Abstract Background Local control in adjuvant/definitive RT of adenoid cystic carcinoma (ACC is largely dose-dependent. However, some clinical situations do not allow application of tumouricidal doses (i.e. re-irradiation hence radiation sensitization by exploitation of high endothelial growth factor receptor (EGFR-expression in ACC seems beneficial. This is a single-institution experience of combined radioimmunotherapy (RIT with the EGFR-inhibitor cetuximab. Methods Between 2006 and 2010, 9 pts received RIT for advanced/recurrent ACC, 5/9 pts as re-irradiation. Baseline characteristics as well as treatment parameters were retrieved to evaluate efficacy and toxicity of the combination regimen were evaluated. Control rates (local/distant and overall survival were calculated using Kaplan-Meier estimation. Results Median dose was 65 Gy, pts received a median of 6 cycles cetuximab. RIT was tolerated well with only one °III mucositis/dysphagia. Overall response/remission rates were high (77,8%; 2-year estimate of local control was 80% hence reaching local control levels comparable to high-dose RT. Progression-free survival (PFS at 2 years and median overall survival were only 62,5% and 22,2 mo respectively. Conclusion While local control and treatment response in RIT seems promising, PFS and overall survival are still hampered by distant failure. The potential benefit of RIT with cetuximab warrants exploration in a prospective controlled clinical trial.

The effect of combined treatment with transcranial direct current stimulation on cerebral blood flow in patients with cerebral palsy

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K. V. Yatsenko

2017-02-01

Full Text Available There is a close link between the activity of the brain and cerebral blood supply. Transcranial direct current stimulation (tDCS modulates the activity of the cerebral cortex and thus affects the cerebral blood flow. The aim of the study was to investigate the effect of combined treatment with tDCS on cerebral blood flow in patients with cerebral palsy (CP. Materials and Methods. 60 patients with various forms of cerebral palsy were examined and received the course of treatment. The comparison group was formed from 30 children who received the course of basic medical and rehabilitation procedures. The main group included 30 children who, in addition to the same therapy, received a course of tDCS. A transcranial Doppler ultrasound examination of head blood vessels was used for the study of cerebral hemodynamics in children with cerebral palsy before and after combined treatment with tDCS. Results. tDCS reduced asymmetry coefficient of blood flow velocity in the middle cerebral arteries (MCA by 12.3 %, whereas in the comparison group only by 2.5 %; in the anterior cerebral artery (ACA – 9.5 %, while in the comparison group – 0.8 %. tDCS significantly reduced the high mean blood flow velocity per cycle (MFV in the basilar artery (BA, MCA and ACA (21.7 %, 18.3 % and 7.8 %, respectively; in the comparison group no statistically significant positive dynamics was observed. tDCS significantly increased the low MVF in the BA, MCA and ACA (29.7 %, 21.2 % and 9.7 % respectively; a statistically significant increase of MVF by 9.9 % was only in the CMA in the comparison group of patients. Conclusions. Our data indicate that the use of tDCS in the combined treatment of CP patients improves cerebral hemodynamics in 87 % of patients, in contrast to 52 % in the comparison group. The addition of transcranial direct current stimulation method to the complex treatment of patients with cerebral palsy improves the effectiveness of treatment and may also

Quality of life in locally advanced prostate cancer patients who underwent hormonal treatment combined with radiotherapy

International Nuclear Information System (INIS)

Koga, Hirofumi; Naito, Seiji; Fukui, Iwao; Tsukamoto, Taiji; Matsuoka, Naoki; Fujimoto, Hiroyuki

2004-01-01

The aim of this study is to estimate the feasibility of quality of life (QOL) research and to evaluate the QOL prospectively in locally advanced prostate cancer patients treated with hormonal treatment combined with radiotherapy. The treatment schedule was that patients with decreasing prostatic specific antigen (PSA) levels below 10 ng/ml after receiving 6 months of neoadjuvant hormonal treatment were randomly divided into two groups; one group was the continuous hormonal treatment group and the other was the intermittent hormonal treatment group. Both groups received a total dose of 72 Gy external beam radiotherapy with concomitant hormonal treatment followed by 6 months of adjuvant hormonal treatment following radiotherapy. At 14 months, patients either underwent continuous or intermittent hormonal treatment according to the random allocation. QOL was assessed at baseline, and at 6, 8, 14, and 20 months after treatment using functional assessment of cancer treatment-general (FACT-G), P with the other 3 items comprising bother of urination, bother of bowel movement, and bother of sexual activity. Between January 2000 and June 2003, a total of 188 patients were enrolled in this study. The rate of collection of baseline QOL sheets was 98.0%. The rate of answer to questions of QOL sheets was 99.0%. At baseline, the average score of FACT-G, P was 120.7 and the maximum score was more than twice the minimum score. Dysfunction of urination and bowel movement was correlated with the bother of urination and bowel movement, respectively. On the other hand, dysfunction of sexual activity was not correlated with the bother of sexual activity. In June 2003, all of the QOL sheets at baseline, and at 6, 8, and 14 months were completely collected from a total of 72 patients. Although QOL at 8 months was significantly affected compared with QOL at baseline and at 6 months, QOL at 14 months was significantly improved compared with that at 8 months and there was no significant

Determinants for receiving acupuncture for LBP and associated treatments: a prospective cohort study

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Baum Erika

2006-11-01

Full Text Available Abstract Background Acupuncture is a frequently used but controversial adjunct to the treatment of chronic low back pain (LBP. Acupuncture is now considered to be effective for chronic LBP and health care systems are pressured to make a decision whether or not acupuncture should be covered. It has been suggested that providing such services might reduce the use of other health care services. Therefore, we explored factors associated with acupuncture treatment for LBP and the relation of acupuncture with other health care services. Methods This is a post hoc analysis of a longitudinal prospective cohort study. General practitioners (GPs recruited consecutive adult patients with LBP. Data on physical function, subjective mood and utilization of health care services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months. Results A total of 179 (13 % out of 1,345 patients received acupuncture treatment. The majority of those (59 % had chronic LBP. Women and elderly patients were more likely to be given acupuncture. Additional determinants of acupuncture therapy were low functional capacity and chronicity of pain. Chronic (vs. acute back pain OR 1.6 (CL 1.4–2.9 was the only significant disease-related factor associated with the treatment. The strongest predictors for receiving acupuncture were consultation with a GP who offers acupuncture OR 3.5 (CL 2.9–4.1 and consultation with a specialist OR 2.1 (CL 1.9–2.3. After adjustment for patient characteristics, acupuncture remained associated with higher consultation rates and an increased use of other health care services like physiotherapy. Conclusion Receiving acupuncture for LBP depends mostly on the availability of the treatment. It is associated with increased use of other health services even after adjustment for patient characteristics. In our study, we found that receiving acupuncture does not offset the use of other health care resources

Determinants for receiving acupuncture for LBP and associated treatments: a prospective cohort study

Science.gov (United States)

Chenot, Jean-François; Becker, Annette; Leonhardt, Corinna; Keller, Stefan; Donner-Banzhoff, Norbert; Baum, Erika; Pfingsten, Michael; Hildebrandt, Jan; Kochen, Michael M; Basler, Heinz-Dieter

2006-01-01

Background Acupuncture is a frequently used but controversial adjunct to the treatment of chronic low back pain (LBP). Acupuncture is now considered to be effective for chronic LBP and health care systems are pressured to make a decision whether or not acupuncture should be covered. It has been suggested that providing such services might reduce the use of other health care services. Therefore, we explored factors associated with acupuncture treatment for LBP and the relation of acupuncture with other health care services. Methods This is a post hoc analysis of a longitudinal prospective cohort study. General practitioners (GPs) recruited consecutive adult patients with LBP. Data on physical function, subjective mood and utilization of health care services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months. Results A total of 179 (13 %) out of 1,345 patients received acupuncture treatment. The majority of those (59 %) had chronic LBP. Women and elderly patients were more likely to be given acupuncture. Additional determinants of acupuncture therapy were low functional capacity and chronicity of pain. Chronic (vs. acute) back pain OR 1.6 (CL 1.4–2.9) was the only significant disease-related factor associated with the treatment. The strongest predictors for receiving acupuncture were consultation with a GP who offers acupuncture OR 3.5 (CL 2.9–4.1) and consultation with a specialist OR 2.1 (CL 1.9–2.3). After adjustment for patient characteristics, acupuncture remained associated with higher consultation rates and an increased use of other health care services like physiotherapy. Conclusion Receiving acupuncture for LBP depends mostly on the availability of the treatment. It is associated with increased use of other health services even after adjustment for patient characteristics. In our study, we found that receiving acupuncture does not offset the use of other health care resources. A significant

LOW POWER BRACHYTHERAPY IN COMBINED TREATMENT IN PATIENTS WITH INTERMEDIATE RISK OF LOCALIZED PROST ATE CANCER

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V. A. Biryukov

2014-01-01

Full Text Available Objective. Estimation of the effectiveness of low power brachytherapy sources I-125 in the combined treatment in group of patients of intermediate risk of localized prostate cancer.Material and methods. The study included 126 patients with prostate cancer of intermediate risk. 104 patients (83,9% were conducted low power brachytherapy I‑125 in combination with hormone therapy by analogues of LHWG. 22 patients (16.1% received external beam irradiation in combination with brachytherapy I‑125 and hormonal treatment. Relapse-free survival of patients was evaluated in accordance with the criteria Phoenix (Nadir PSA + ng/ml. Evaluation of side effects of radiation treatment were carried out according to the RTOG criteria.Results. PSA relapse-free survival in the group of brachytherapy and hormone treatment at the time of observation 5 years amounted to 97.1%. In the group of combined radiation therapy with brachytherapy, and hormonal treatment PSA relapse-free survival rate was 95.5%.In both groups, relapse-free survival was noted in 96,8% of cases. Tumor-specific and overall survival in bothgroups was 100%. The major complications of treatment in both groups were radiation urethritis 1 to 2 degrees in 9.5% of cases (12 patients, urethral stricture in 5 patients (3.9% of cases, acute urinary retention in 1 patient (0.8% of cases and late radiation rectitis of 2 degree in 1.58% of cases (2 patients.Conclusions. It is possible to draw tentative conclusions about the high rate of survival without progression in both treatment groups on the background of the relatively low frequency of adverse reactions. It is necessary further follow-up for patients with estimating of survival for a longer period.

Radiation and combined treatment of Itsenko -Cushing's disease

International Nuclear Information System (INIS)

Barkanov, A.I.; Morozov, A.I.; Pirogov, A.I.; Postnikov, D.A.; Shadyeva, M.M.; Roshchina, V.S.; Devyatykh, Yu.N.

1980-01-01

The authors made observations of 123 patients with the Itsenko - Cushing disease. The mild form of the disease was diagnosed in 27.7 per cent of the patients; moderate in 52 percent, and severe in 20.3 per cent of the patients. A total of 78 patients underwent tele-gamma-therapy in doses of 40-45 Gy, and 45 patients underwent combined treatment consisting in unilateral adrenalectomy and irradiation with the same doses. Protracted remissions with a reverse development of the symptoms of the disease were reached in 69.2 per cent of the patients who had undergone radiation treatment and in 64.4 per cent of the patients who had undergone combined treatment. Radiotherapy was most effective in patients with mild and moderate forms of Itsenko-Cushing's disease, in case of a severe form combined treatment is indicated. Optimal single focal doses are 1.6-1.8 Gy, and cumulative ones 40-45 Gy

Two-year evaluation of Intermittent Preventive Treatment for Children (IPTc) combined with timely home treatment for malaria control in Ghana.

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Ahorlu, Collins K; Koram, Kwadwo A; Seake-Kwawu, Atsu; Weiss, Mitchell G

2011-05-15

Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. Intermittent preventive treatment for children (IPTc) combined with timely treatment of malaria related febrile illness at home to reduce parasite prevalence and malaria morbidity in children aged between six and 60 months in a coastal community in Ghana. This paper reports persistence of reduced parasitaemia two years into the intervention. The baseline and year-one-evaluation findings were published earlier. The main objective in the second year was to demonstrate whether the two interventions would further reduce parasite prevalence and malaria-related febrile illness in the study population. This was an intervention study designed to compare baseline and evaluation findings without a control group. The study combined home-based delivery of intermittent preventive treatment for children (IPTc) aged 6 - 60 months and home treatment of suspected febrile malaria-related illness within 24 hours. All children aged 6-60 months received home-based delivery of intermittent preventive treatment using amodiaquine + artesunate, delivered at home by community assistants every four months (6 times in 24 months). Malaria parasite prevalence surveys were conducted before the first and after the third and sixth IPTc to the children. The evaluation surveys were done four months after the third and sixth IPTc was given. Parasite prevalence which reduced from 25% to 3.0% at year-one evaluation had reduced further from 3% to 1% at year-two-evaluation. At baseline, 13.8% of the children were febrile (axilary temperature of ≥ 37.5 °C) compared to 2.2% at year-one-evaluation while 2.1% were febrile at year-two-evaluation. The year-two-evaluation result indicates that IPTc given three times in a year (every four months) combined with timely treatment of febrile malaria illness, is effective to reduce malaria parasite prevalence in children aged 6 to 60 months

Effect of Ultrasonic Treatment Combined with Peracetic Acid Treatment Reduces Decay and Maintains Quality in Loquat Fruit

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Chen Ling

2018-01-01

Full Text Available The effects of ultrasonic treatment (UT, 400 watts for 6 min combined with peracetic acid (PA, 0.4% (W/W treatment on fruit decay, browning, and quality and physiological changes in loquat fruit stored at 20°C were investigated. The results showed that treatment with UT or PA alone significantly reduced both decay and browning index in loquat fruit compared with the control. The combined treatment was more effective in decreasing decay and browning index and maintaining higher quality parameters than UT or PA treatment alone. Loquat fruits treated with the combined treatment maintained higher activities of polyphenol oxidase (PPO and peroxidase (POD than those treated with other treatments. In addition, UT combined with PA treatment significantly reduced the increase of firmness and increased fruit extractable juice, total soluble solid (TSS, and ascorbic acid content in loquat fruit. Moreover, the contents of total phenolics and total flavonoids were enhanced by the combination of UT and PA treatment. The combination of UT and PA treatment could be a useful method to reduce decay and browning in loquat fruit stored at room temperature, which has potential for application in the loquat industry.

Systemic combination treatment for psoriasis: a review

DEFF Research Database (Denmark)

Jensen, Peter; Skov, Lone; Zachariae, Claus

2010-01-01

Psoriasis is a chronic inflammatory skin disease, which affects approximately 2.6% of the population in Northern Europe and Scandinavia. In order to achieve disease control, combinations of systemic treatments are sometimes needed for variable time periods. However, no evidence-based guidelines...... exist for the use of systemic combination therapy. Therefore, our aim was to review the current literature on systemic anti-psoriatic combination regimens. We searched PubMed and identified 98 papers describing 116 studies (23 randomized) reporting on the effect of various systemic combination...

Combined endoscopic approaches to the cardiac sphincter achalasia treatment

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V. N. Klimenko

2015-12-01

Full Text Available Aim. To assess combined endoscopic approaches to the cardiac sphincter achalasia treatment. Results. There are preliminary results of treatment and methods of carrying out of combined endoscopic pneumocardiodilatation and injections of botulotoxin type A ‘Disport’ at achalasia cardia are described in the article. Aethio-pathogenetic aspects in the development of achalasia cardia, action of botulotoxin type A and balloon pneumocardiodilatation of the esophagus, were described. And modern roentgen-endoscopic classification of achalasia cardia was given. Prognostic estimation scale of possibility to implement further combined endoscopic or surgical treatment is defined and is being in subsequent working out. Conclusion. Described clinical cases most brightly demonstrate variety of clinical achalasia cardia manifestations and also determine of the earlier display of surgical treatment.

Combination of docetaxel and cisplatin in the interventional treatment of advanced non-small cell lung cancer

International Nuclear Information System (INIS)

He Zhijiang; Liu Yunjun; Li Ezhen

2004-01-01

Objective: To evaluate the efficacy and toxicity of the combination of docetaxel and cisplatin in the interventional treatment of patients with advanced non-small cell lung cancer (NSCLC). Methods: Thirty patients with locally advanced (stage III) or metastatic (stage IV) NSCLC were enrolled into the study. The patients received docetaxel 75 mg/m 2 per day by bronchial artery and vein, and cisplatin 40 mg 2 on day 1-3 of a 21-day cycle. Each patient should complete two cycles. Results: An objective response rate was obtained in 46.7% of 30 patients (one complete and 13 partial response), whereas 10 patients had stable disease and 6 patients were progressive. The response rate was 60% (9/15) in the initial patients, and 33.3% (5/15) in the retreated patients. The main toxicities were leukopenia (26.7% in grade III + IV) and thrombocytopenia (10% in grade III + IV). Conclusion: The combination of docetaxel and cisplatin by interventional treatment is a feasible, well-tolerated and active scheme in the treatment of advanced NSCLC. (authors)

Treatment of premature ejaculation: a new combined approach

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Adel Kurkar

2015-01-01

Causes of PE differ considerably. In this paper, we compared the outcomes of two single treatment lines together with a combination of both. The combination therapy was more effective than either line alone.

Combined Aphasia and Apraxia of Speech Treatment (CAAST): effects of a novel therapy.

Science.gov (United States)

Wambaugh, Julie L; Wright, Sandra; Nessler, Christina; Mauszycki, Shannon C

2014-12-01

This investigation was designed to examine the effects of a newly developed treatment for aphasia and acquired apraxia of speech (AOS). Combined Aphasia and Apraxia of Speech Treatment (CAAST) targets language and speech production simultaneously, with treatment techniques derived from Response Elaboration Training (Kearns, 1985) and Sound Production Treatment (Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998). The purpose of this study was to determine whether CAAST was associated with positive changes in verbal language and speech production with speakers with aphasia and AOS. Four participants with chronic aphasia and AOS received CAAST applied sequentially to sets of pictures in the context of multiple baseline designs. CAAST entailed elaboration of participant-initiated utterances, with sound production training applied as needed to the elaborated productions. The dependent variables were (a) production of correct information units (CIUs; Nicholas & Brookshire, 1993) in response to experimental picture stimuli, (b) percentage of consonants correct in sentence repetition, and (c) speech intelligibility. CAAST was associated with increased CIU production in trained and untrained picture sets for all participants. Gains in sound production accuracy and speech intelligibility varied across participants; a modification of CAAST to provide additional speech production treatment may be desirable.

Combinations of drugs in the Treatment of Obesity

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Marcio C. Mancini

2010-07-01

Full Text Available Obesity is a chronic disease associated with excess morbidity and mortality. Clinical treatment, however, currently offers disappointing results, with very high rates of weight loss failure or weight regain cycles, and only two drugs (orlistat and sibutramine approved for long-term use. Drugs combinations can be an option for its treatment but, although widely used in clinical practice, very few data are available in literature for its validation. Our review focuses on the rationale for their use, with advantages and disadvantages; on combinations often used, with or without studies; and on new perspectives of combinations being studied mainly by the pharmaceutical industry.

Combined zero-valent iron and fenton processes for the treatment of Brazilian TNT industry wastewater

International Nuclear Information System (INIS)

Barreto-Rodrigues, Marcio; Silva, Flavio T.; Paiva, Teresa C.B.

2009-01-01

The environmental impact caused by the production of explosives made from nitroaromatic compounds such as 2,4,6-trinitrotoluene (TNT) is currently a major concern, mainly due to their toxic nature, a fact that makes these compounds highly harmful. This work evaluated a continual system treatment reactor (CSTR) consisting of column zero-valent iron and a system to promote a fenton reaction in order to create possible definitive routines for treating effluents originating from the TNT production process. The spectrophotometric results demonstrated that this combination of processes was highly efficient in promoting the removal of all the absorbed species at 290 nm and the visible region of the specter. The results also revealed that the combination of treatments was significantly efficient in terms of correcting the effluent's main parameters of relevance, mainly COD (95.5% reduction) and TNT concentration, whose total was converted into nitrous and phenolic compounds and, additionally, the acute toxicity was also significantly reduced (95%). These results indicate that the strategy can serve as an efficient option for effluent treatment, for release into the receiving body, or eventually for use as industrial reuse water.

Solar power satellite rectenna design study: Directional receiving elements and parallel-series combining analysis

Science.gov (United States)

Gutmann, R. J.; Borrego, J. M.

1978-01-01

Rectenna conversion efficiencies (RF to dc) approximating 85 percent were demonstrated on a small scale, clearly indicating the feasibility and potential of efficiency of microwave power to dc. The overall cost estimates of the solar power satellite indicate that the baseline rectenna subsystem will be between 25 to 40 percent of the system cost. The directional receiving elements and element extensions were studied, along with power combining evaluation and evaluation extensions.

Sewage sludge disintegration by combined treatment of alkaline+high pressure homogenization.

Science.gov (United States)

Zhang, Yuxuan; Zhang, Panyue; Zhang, Guangming; Ma, Weifang; Wu, Hao; Ma, Boqiang

2012-11-01

Alkaline pretreatment combined with high pressure homogenization (HPH) was applied to promote sewage sludge disintegration. For sewage sludge with a total solid content of 1.82%, sludge disintegration degree (DD(COD)) with combined treatment was higher than the sum of DD(COD) with single alkaline and single HPH treatment. NaOH dosage ⩽0.04mol/L, homogenization pressure ⩽60MPa and a single homogenization cycle were the suitable conditions for combined sludge treatment. The combined sludge treatment showed a maximum DD(COD) of 59.26%. By regression analysis, the combined sludge disintegration model was established as 11-DD(COD)=0.713C(0.334)P(0.234)N(0.119), showing that the effect of operating parameters on sludge disintegration followed the order: NaOH dosage>homogenization pressure>number of homogenization cycle. The energy efficiency with combined sludge treatment significantly increased compared with that with single HPH treatment, and the high energy efficiency was achieved at low homogenization pressure with a single homogenization cycle. Copyright © 2012 Elsevier Ltd. All rights reserved.

Evaluation of the Combined Therapy of DA-7218, a New Oxazolidinone, and Trimethoprim/ Sulfamethoxazole in the Treatment of Experimental Actinomycetoma by Nocardia brasiliensis.

Science.gov (United States)

Espinoza-Gonzalez, N A; Welsh, O; Ocampo-Candiani, J; Said-Fernandez, S; Lozano-Garza, G; Choi, S H; Vera-Cabrera, L

2010-07-01

Currently, for actinomycetoma, combined antimicrobial therapy is preferred to the use of a single compound. This is in order to provide a broader-spectrum coverage due to a combinatory or synergistic effect between the drugs, and to decrease the possibility of emergence of natural resistant strains. A new oxazolidinone pro-drug, DA-7218 [(R)-3-(4-(2-(2-methyltetrazol-5-yl)-pyridin-5-yl)-3-fluorophenyl)-2-oxo-5-oxazolidinyl) methyl-disodium-phosphate] (recently re-named TR-701), has shown very good in vitro and in vivo activities against several gram-positive bacteria including Nocardia spp. In the present work we evaluated the effect of DA-7218 at two different doses, alone and combined with trimethoprim/ sulfamethoxazole (SXT), in an experimental Nocardia brasiliensis actinomycetoma murine model. We also included a negative and a positive control group (linezolid and saline solution respectively). At the end of the treatment period, we observed a clinically and statistically significant difference among the drug receiving groups (combined, alone and linezolid) and the control group (P=0.004). The difference was higher (P= 0.004) between the groups receiving DA-7218 (25mg/kg) alone or combined with SXT, and the control group (saline solution). In this work we proved that DA-7218 alone and combined with SXT is effective in the treatment of experimental actinomycetoma by Nocardia brasiliensis and that it could be potentially useful in the treatment of human actinomycetoma.

[Clinical efficacy of high-frequency oscillatory ventilation combined with pulmonary surfactant in treatment of neonatal pulmonary hemorrhage].

Science.gov (United States)

Lin, Xin-Zhu; Lai, Ji-Dong; Lv, Mei; Zhu, Yao; Wang, Lian; Chen, Chao

2015-04-01

To explore the clinical efficacy of high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in the treatment of neonatal pulmonary hemorrhage (NPH). A total of 122 neonates diagnosed with NPH between January 2010 and June 2014 were enrolled. After being stratified by gestational age, the neonates were randomly divided into treatment (HFOV+PS) and control (HFOV alone) groups (n=61 each). Both groups were treated with HFOV after the onset of NPH. After 2-4 hours of HFOV treatment, the treatment group received PS via intratracheal injections, followed by continuous use of HFOV. Dynamic changes in the blood gas, oxygenation index (OI), and PaO2/FiO2 (P/F) values of the neonates were determined before HFOV treatment and after 6, 12, and 24 hours of HFOV treatment. The time to hemostasis, duration of ventilation, incidence of complications, and cure rate were compared between groups. After 6, 12, and 24 hours of HFOV treatment, the treatment group had significantly improved PaO2, PaCO2, O/I, and P/F values compared with the control group (P0.05). HFOV combined with PS is an effective treatment to improve oxygenation, shorten the time to hemostasis and the duration of ventilation, and reduce the incidence of complications in neonates with NPH. However, the dual therapy is unable to reduce the mortality of neonates compared with HFOV monotherapy.

Shorter HBIG administration is not associated to HBV recurrence when receiving combined prophylaxis after liver transplantation.

Science.gov (United States)

Lens, Sabela; García-Eliz, María; Fernández, Inmaculada; Castells, Lluis; Bonacci, Martin; Mas, Antoni; Crespo, Gonzalo; Buti, María; Prieto, Martín; Forns, Xavier

2018-04-16

The combination of hepatitis B immunoglobulin (HBIG) and a nucleos(t)ide analogs (NA) has markedly reduced the rate of hepatitis B (HBV) recurrence after liver transplantation (LT); however, the optimal duration of HBIG has not been clarified. This lack of consensus perpetuates the use of different strategies. The aim of this study was to evaluate the risk factors associated to HBV recurrence after LT in a large cohort of patients under different HBIG regimens. Retrospective multicenter analysis of HBV-related LT recipients receiving combined prophylaxis (HBIG+NA). The strategy of short-term HBIG was compared to life-long administration. HBV recurrence was defined as positive HBsAg after LT. 338 patients were analyzed. After a median follow-up period of 72 months, 37 patients (11%) developed HBV recurrence. Hepatocellular carcinoma (HCC) recurrence and lamivudine resistance after LT were the only factors independently associated to HBV recurrence (HR 5.4[2.3-12] and 9.3[4.2-20], respectively pHBV recurrence was transient (16 patients), persistent (15) or alternant (6). The HBIG regimen did not have an impact on the rate or evolution of HBV recurrence. Overall, patient survival was good and not influenced by HBV recurrence (82% at 5 years). Fulminant liver failure, hepatitis C coinfection or HCC at LT were independent risk factors for lower survival. LT is an effective treatment for HBV-related liver disease. Since the introduction of combined prophylaxis the rate of HBV recurrence is very low. However, life-long HBIG administration does not seem necessary to reduce HBV recurrence. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Effect of Combined Aspirin and Clopidogrel Treatment on Cancer Incidence.

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Leader, Avi; Zelikson-Saporta, Ravit; Pereg, David; Spectre, Galia; Rozovski, Uri; Raanani, Pia; Hermoni, Doron; Lishner, Michael

2017-07-01

Multiple studies have shown an association between aspirin treatment and a reduction in newly diagnosed cancer. Conversely, there are conflicting clinical and laboratory data on the effect of combined clopidogrel and aspirin therapy on cancer incidence, including analyses suggesting an increased cancer risk. No large-scale cohort study has been performed to address this issue in a heterogeneous real-world scenario. We investigated the effect of clopidogrel and aspirin on cancer incidence compared with aspirin alone and no antiplatelet therapy. A population-based historical cohort study of subjects aged ≥50 years covered by Clalit Health Services, an Israeli health maintenance organization, was performed. Patients treated with the newer antiplatelet drugs, prasugrel or ticagrelor, which, like clopidogrel, inhibit adenosine diphosphate receptors, and those with prior cancer were excluded. Prescription records of antiplatelet medication were retrieved. The cohort included 183,912 subjects diagnosed with 21,974 cancer cases based upon the International Classification of Diseases, Ninth Revision. Dual aspirin and clopidogrel was prescribed in 9.6%, while 49% received aspirin alone and 41% used neither. Compared with nonusers, there was a lower risk of cancer in subjects exposed to aspirin with (hazard ratio [HR] 0.46; 95% confidence interval [CI], 0.44-0.49) or without clopidogrel (HR 0.54; 95% CI, 0.52-0.56), on long-term follow-up. Combined treatment was associated with a lower cancer risk than the aspirin-only group (HR 0.92; 95% CI, 0.86-0.97). Dual clopidogrel and aspirin treatment is safe regarding the cancer risk. This study generates the hypothesis that clopidogrel may reduce cancer incidence. Copyright © 2017 Elsevier Inc. All rights reserved.

Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy.

Science.gov (United States)

Boljanovic, S; Axelsson, C K; Elberg, J J

2003-01-01

The purpose of the present work has been to evaluate surgical treatment of gynecomastia performed by liposuction combined with subcutaneous mastectomy. It was designed as a prospective consecutive registration of 21 patients (28 breasts) operated in a four month period. Treatment was done in local anaesthesia in the out-patient clinic. Treatment was in one patient complicated with a haematoma. In 86% of cases the patients were satisfied with the postoperative result. Liposuction combined with surgical excision of the gland performed as an out-patient treatment in local anaesthesia is followed by few complications and good cosmetic results.

Health-related quality of life of HIV-infected adults receiving combination antiretroviral therapy in Addis Ababa

NARCIS (Netherlands)

Mekuria, Legese A.; Sprangers, Mirjam A. G.; Prins, Jan M.; Yalew, Alemayehu W.; Nieuwkerk, Pythia T.

2015-01-01

Health-related quality of life (HRQoL) is an important outcome measure among HIV-infected patients receiving combination antiretroviral therapy (cART), but has not been studied extensively in resource-limited settings. Insight in the predictors or correlates of poor HRQoL may be helpful to identify

Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison In 60 cases

Institute of Scientific and Technical Information of China (English)

Lixiong Wu; Haibo Yu; Yongfeng Liu

2008-01-01

BACKGROUND: The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE: To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure (GMFM) of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING: Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS: All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups: 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS: Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES: The comprehensive functional evaluation scale of cerebral palsy and

Effect of Er, Cr: YSGG laser combined with oral basic treatment on inflammatory injury and apoptosis in patients with periodontitis

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Wei-Xing Jin

2017-09-01

Full Text Available Objective: To study the effect of Er, Cr: YSGG laser combined with oral basic treatment on inflammatory injury and apoptosis in patients with periodontitis. Methods: Patients with chronic periodontitis who were treated in dental clinic of our hospital between February 2015 and March 2017 were selected as the research subjects and randomly divided into the group A who accepted ultrasonic dental cleaning, hand scaling combined with Er, Cr: YSGG laser treatment and the group B who received ultrasonic dental cleaning and hand scaling treatment. The contents of inflammatory response cytokines, protease molecules and apoptosis molecules in gingival crevicular fluid were detected before treatment and 1 week after treatment. Results: TNF-α, hs-CRP, IL-1β, IL-6, IL-8, EMMPRIN, CyPA, MMP2, MMP9, Smac, Bax, Fas and FasL contents in gingival crevicular fluid of both groups of patients 1 week after treatment were significantly lower than those before treatment, and TNF-α, hs-CRP, IL-1β, IL-6, IL-8, EMMPRIN, CyPA, MMP2, MMP9, Smac, Bax, Fas and FasL contents of group A 1 week after treatment were significantly lower than those of group B. Conclusion: Er, Cr: YSGG laser combined with oral basic treatment can inhibit the inflammatory injury and apoptosis in periodontal tissue of patients with periodontitis.

Retrospective evaluation of doxorubicin-piroxicam combination for the treatment of transitional cell carcinoma in dogs.

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Robat, C; Burton, J; Thamm, D; Vail, D

2013-02-01

To determine whether doxorubicin-piroxicam combination is safe and has activity against transitional cell carcinoma in dogs. Data was collected retrospectively from 34 dogs from two institutions over a 6-year period. Signalment, clinical presentation, treatment specifics, adverse events, response, progression-free survival and overall survival time were evaluated. Dogs received doxorubicin every 3 weeks and daily piroxicam; 17 dogs (50%) had surgery. Clinical presentations were those typically reported for transitional cell carcinoma. Mean number of doses administered was 3·5. Of the 23 dogs with measurable disease, 14 (60·5%) had stable disease, 7 (30·5%) had progressive disease and 2 (9%) a partial response. Adverse events were generally manageable, and gastrointestinal in origin; one dog died of treatment-related complications. Overall median progression-free survival and overall survival were 103 and 168 days, respectively. Cytoreductive surgery did not result in prolongation of progression-free survival, but significantly prolonged overall survival. All dogs but one died as a result of disease progression. Doxorubicin-piroxicam combination therapy is well-tolerated in dogs with transitional cell carcinoma although progression-free survival, overall survival and biological response rates appear modest. Combination with surgery appears to offer a survival advantage; however, this may reflect tumour location and volume. Prospective studies are necessary to compare activity of combination doxorubicin-piroxicam to currently applied therapies. © 2013 British Small Animal Veterinary Association.

Influence of one-year neurologic outcome of treatment on newborns with moderate and severe hypoxic-ischemic encephalopathy by rhuEP0 combined with ganglioside (GM1).

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Zhu, X-Y; Ye, M-Y; Zhang, A-M; Wang, W-D; Zeng, F; Li, J-L; Fang, F

2015-10-01

To observe the one-year neurologic prognostic outcome of newborns with moderate and severe hypoxic-ischemic encephalopathy (HIE) who received recombinant human erythropoietin (rhuEPO) combined with exogenous monosialotetrahexosylganglioside (GM1) treatment to provide new guidelines for clinical treatment. Seventy-six newborns with moderate and severe HIE were selected from February 2011 to February 2014 in our hospital. This study received the informed consent of our hospital's Ethics Committee and the newborns' guardians. The newborns were divided to an observation group (n = 34 cases) and a control group (n = 42 cases). All newborns underwent hypothermia and conventional treatment for their conditions. The control group received GMl treatment and observation group received rhuEPO combined with GMl treatment. The curative differences and neural behavior from these two groups were compared. The excellent, efficient proportion and total effective rate of the newborns from the observation group were higher than the control group. The death rate, cerebral palsy and the invalid ratio of the newborns from the observation group were lower than that of the control group. Awareness, muscle tension, primitive reflex and increased intracranial pressure recovery time of the newborns in the observation group were less than those of the control group. The Neonatal Behavior Neurological Assessment (NBNA) score of both groups after the treatment of 7, 14 and 28 days were significantly higher and increased with time (p newborns from the two groups all increased after treatment of 3, 6 and 12 months than those of before, which increased with time (p newborns with HIE improves short-term clinical effects and long-term neurological symptoms.

Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

DEFF Research Database (Denmark)

Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

2016-01-01

Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...... the sensitive fraction of the commensal flora.Growth parameters for competing bacterial strains were estimated from the combined in vitro pharmacodynamic effect of two antimicrobials using the relationship between concentration and net bacterial growth rate. Predictions of in vivo bacterial growth were...... (how frequently antibiotics are alternated in a sequential treatment) of the two drugs was dependent upon the order in which the two drugs were used.Conclusion: Sequential treatment was more effective in preventing the growth of resistant strains when compared to the combination treatment. The cycling...

Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria

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Adebimpe Wasiu Olalekan

2015-09-01

Conclusion: Hyponatraemia, hyperkalaemia, and hypochloremia characterized some of the electrolyte imbalance among TB patients receiving treatments. The raised level of bicarbonate may be attributed to overcorrection of respiratory acidosis often found in patients with tuberculosis. Monitoring electrolytes is therefore an important component of TB management.

Specie – treatment – adhesive combinations for glulam purpose

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Carlito Calil Neto

2016-12-01

Full Text Available Glued laminated timber is an engineered product that requires precision manufacturing in all its stages. The finished product can only be tested in laboratory conditions. However, it is necessary to have quality control in the production to ensure that the properties of the glulam are appropriate to the product specified requirements in accordance with the standards. In Brazil is still no specific standard of qualification for the manufactures of Glulam. In this context, different kinds of wood, adhesives and preservative treatments in the composition of Glulam can be used. This paper aims to evaluate the proposed trials conducted with combinations of four Brazilian reforestation species, three adhesives and three types of preservative treatment. As a result was observed that combinations, which showed the best performance, were pine and parica wood, with any type of adhesive or treatment investigated, which can be used in exterior applications. Lyptus® wood for any combination of treatments falls into the internal use class. Teak wood can be used indoors (adhesive polyurethane and all kinds of treatment or external (phenol resorcinol formaldehyde adhesive and all kinds of treatment.

Safety and pharmacokinetics of motesanib in combination with gemcitabine and erlotinib for the treatment of solid tumors: a phase 1b study

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Sun Yu-Nien

2011-07-01

Full Text Available Abstract Background This phase 1b study assessed the maximum tolerated dose (MTD, safety, and pharmacokinetics of motesanib (a small-molecule antagonist of VEGF receptors 1, 2, and 3; platelet-derived growth factor receptor; and Kit administered once daily (QD or twice daily (BID in combination with erlotinib and gemcitabine in patients with solid tumors. Methods Patients received weekly intravenous gemcitabine (1000 mg/m2 and erlotinib (100 mg QD alone (control cohort or in combination with motesanib (50 mg QD, 75 mg BID, 125 mg QD, or 100 mg QD; cohorts 1-4; or erlotinib (150 mg QD in combination with motesanib (100 or 125 mg QD; cohorts 5 and 6. Results Fifty-six patients were enrolled and received protocol-specified treatment. Dose-limiting toxicities occurred in 11 patients in cohorts 1 (n = 2, 2 (n = 4, 3 (n = 3, and 6 (n = 2. The MTD of motesanib in combination with gemcitabine and erlotinib was 100 mg QD. Motesanib 125 mg QD was tolerable only in combination with erlotinib alone. Frequently occurring motesanib-related adverse events included diarrhea (n = 19, nausea (n = 18, vomiting (n = 13, and fatigue (n = 12, which were mostly of worst grade Conclusions Treatment with motesanib 100 mg QD plus erlotinib and gemcitabine was tolerable. Motesanib 125 mg QD was tolerable only in combination with erlotinib alone. Trial Registration ClinicalTrials.gov NCT01235416

Combined diabetic foot infections treatment, complicated by foot phlegmon

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Yavruyan O.A.

2017-01-01

Full Text Available the article shows the analysis of treatment results of 163 patients with diabetic foot infections, complicated by foot phlegmon. Patients were divided into 2 groups. The control group received traditional treatment and had an autopsy deep plantar space done and then, during the second phase, cytokine-rich autoplatelet concentrate had been applied. The research results confirmed a significant decrease in the duration of treatment and hospitalization of patients in the hospital.

Chemotherapy in combined and multimodality treatment

International Nuclear Information System (INIS)

Anon.

1989-01-01

It is shown that chemotherapy of tumors of various localizations developes intensively in the last few years. It is connected with discovery and adoption of new active antitumoral preparations, such as alkylating preparations, antimetabolites, antitumoral antibiotics, hormonal preparations. To create the rational effective conditions of chemotherapy a study was made on kinetics of tumor gowth, molecular mechanisms of interaction of cytostatics and cells of malignant tumor. Main factors of chemotherapy combination with radiotherapy when treating numerous malignant tumors were considered. Effectiveness of using chemotherapy in combination with other methods of treatment was shown

Fixed Dose Combination for TB treatment

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Tjandra Y. Aditama

2003-06-01

Full Text Available According to the World Health Organization, a third of the world’s population is infected with tuberculosis. The disease is responsible for nearly 2 million deaths each year and over 8 million were developing active diseases. Moreover, according to WHO (2000, tuberculosis deaths are estimated to increase to 35 million between 2000-2020. The majority of tuberculosis patients worldwide are still treated with single drugs, or with 2-drug fixed-dose combinations (FDCs. To improve tuberculosis treatment, 2- and 3-drug FDCs were recommended by the World Health Organization (WHO as part of the DOTS strategy. Since 1999 a 4-drug FDC was included on the WHO Model List of Essential Drugs. Today, FDCs are important tools to further improve the quality of care for people with TB, and accelerate DOTS expansion to reach the global TB control targets. Fixed dose combination TB drugs could simplifies both treatment and management of drug supply, and may prevent the emergence of drug resistance .Prevention of drug resistance is just one of the potential benefits of the use of FDCs. FDCs simplify administration of drugs by reducing the number of pills a patient takes each day and decreasing the risk of incorrect prescriptions. Most tuberculosis patients need only take 3–4 FDCs tablets per day during the intensive phase of treatment, instead of the 15–16 tablets per day that is common with single-drug formulations It is much simpler to explain to patients that they need to take four tablets of the same type and colour, rather than a mixture of tablets of different shapes, colours and sizes. Also, the chance of taking an incomplete combination of drugs is eliminated, since the four essential drugs are combined into one tablet. FDCs are also simpler for care-givers as they minimize the risk of confusion. Finally, drug procurement, in all its components (stock management, shipping, distribution, is simplified by FDCs. Adverse reactions to drugs are not more

Two-year evaluation of Intermittent Preventive Treatment for Children (IPTc combined with timely home treatment for malaria control in Ghana

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Seake-Kwawu Atsu

2011-05-01

Full Text Available Abstract Background Intermittent preventive treatment (IPT has recently been accepted as an important component of the malaria control strategy. Intermittent preventive treatment for children (IPTc combined with timely treatment of malaria related febrile illness at home to reduce parasite prevalence and malaria morbidity in children aged between six and 60 months in a coastal community in Ghana. This paper reports persistence of reduced parasitaemia two years into the intervention. The baseline and year-one-evaluation findings were published earlier. Objective The main objective in the second year was to demonstrate whether the two interventions would further reduce parasite prevalence and malaria-related febrile illness in the study population. Methods This was an intervention study designed to compare baseline and evaluation findings without a control group. The study combined home-based delivery of intermittent preventive treatment for children (IPTc aged 6 - 60 months and home treatment of suspected febrile malaria-related illness within 24 hours. All children aged 6 - 60 months received home-based delivery of intermittent preventive treatment using amodiaquine + artesunate, delivered at home by community assistants every four months (6 times in 24 months. Malaria parasite prevalence surveys were conducted before the first and after the third and sixth IPTc to the children. The evaluation surveys were done four months after the third and sixth IPTc was given. Results Parasite prevalence which reduced from 25% to 3.0% at year-one evaluation had reduced further from 3% to 1% at year-two-evaluation. At baseline, 13.8% of the children were febrile (axilary temperature of ≥37.5°C compared to 2.2% at year-one-evaluation while 2.1% were febrile at year-two-evaluation. Conclusion The year-two-evaluation result indicates that IPTc given three times in a year (every four months combined with timely treatment of febrile malaria illness, is

Impact of palbociclib combinations on treatment of advanced estrogen receptor-positive/human epidermal growth factor 2-negative breast cancer

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Boér K

2016-10-01

Full Text Available Katalin Boér Department of Medical Oncology, Szent Margit Hospital, Budapest, Hungary Abstract: Breast cancer is a heterogeneous disease with multiple subgroups based on clinical and molecular characteristics. For the largest subgroup of breast cancers, hormone receptor-positive/human epidermal growth factor 2 (HER2-negative tumors, hormone treatment is the mainstay of therapy and is likely to result in significant improvement in disease outcomes. However, some of these cancers demonstrate de novo or acquired resistance to endocrine therapy. Despite intensive research to develop new strategies to enhance the efficacy of currently available treatment options for hormone receptor-positive breast cancer, progress has been slow, and there were few advances for a period of 10 years. In 2012, a new molecularly targeted therapeutic strategy, inhibition of mammalian target of rapamycin with everolimus, was introduced into clinical practice. Everolimus, in combination with a steroidal aromatase inhibitor, exemestane, resulted in an increase in progression-free survival, but not overall survival in patients with estrogen receptor (ER+ve advanced disease who had progressed on hormone therapy. In 2015, the first cyclin-dependent kinases 4/6 (CDK4/6 inhibitor, palbociclib, received accelerated US Food and Drug Administration approval for use in combination with letrozole for the treatment of postmenopausal ER+ve/HER2-ve advanced breast cancer as initial, endocrine-based therapy. The addition of palbociclib to endocrine therapy resulted in longer progression-free survival than letrozole alone. One year later, palbociclib received a new indication, use in combination with fulvestrant, in both premenopausal and postmenopausal females with advanced breast cancer of the same subtype with disease progression following endocrine therapy. Adding palbociclib to fulvestrant resulted in a significantly increased median progression-free survival compared to fulvestrant

Biological black water treatment combined with membrane separation

NARCIS (Netherlands)

van Voorthuizen, E.M.; Zwijnenburg, A.; van der Meer, Walterus Gijsbertus Joseph; Temmink, Hardy

2008-01-01

Separate treatment of black (toilet) water offers the possibility to recover energy and nutrients. In this study three combinations of biological treatment and membrane filtration were compared for their biological and membrane performance and nutrient conservation: a UASB followed by effluent

Combined aspirin and cilostazol treatment is associated with reduced platelet aggregation and prevention of exercise-induced platelet activation.

Science.gov (United States)

Cleanthis, M; Bhattacharya, V; Smout, J; Ashour, H; Stansby, G

2009-05-01

Cilostazol has proven efficacy in increasing walking distance in claudicants, but it has not been demonstrated to be more effective than placebo in secondary cardiovascular prevention. The direct effect of exercise on platelet function remains less well defined. We have investigated the effect of combination treatment with aspirin and cilostazol on platelet activity in claudicants subjected to repeated treadmill exercise. Nineteen claudicants completed a double-blind, randomised, controlled, cross-over trial. Each subject received a 2-week course of aspirin (75mg) and placebo and aspirin and cilostazol (100mg twice daily). Following each 2-week treatment period, patients participated in a standardised treadmill test (3.2kmh(-1), 10 degrees incline) walking to maximal claudication distance. The exercise was repeated thrice in total, and blood was sampled before and after exercise. Platelet activation was measured using free platelet counting aggregation, flow cytometry for surface markers of platelet activation and soluble P-selectin assay. Compared to aspirin and placebo, combination treatment with aspirin and cilostazol was associated with reduced arachidonic-acid-induced platelet aggregation (pWilcoxon signed-rank test). Aspirin and placebo treatment were associated with elevated P-selectin expression, platelet-monocyte aggregation and reduced CD42b expression (pWilcoxon signed-rank test) post-exercise. No difference was seen in spontaneous platelet aggregation whilst soluble P-selectin was reduced post-exercise with combination treatment with aspirin and cilostazol (pWilcoxon signed-rank test). Combination treatment with aspirin and cilostazol results in suppression of platelet activation and reduces the effect of exercise on platelets. The benefit seen may be a result of cilostazol enhancing the inhibitory effect of aspirin on the cyclo-oxygenase pathway.

An angiotensin-converting enzyme inhibitor in the combination treatment of rheumatoid arthritis

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E. B. Komarova

2017-01-01

Full Text Available Angiotensin-converting enzyme (ACE inhibitors have anti-inflammatory and antiproliferative properties and can affect the processes of angiogenesis, by reducing the effects of angiotensin II (ATII. The use of ACE inhibitors in the combination therapy of rheumatoid arthritis (RA can be also effective for monitoring disease activity and for reducing a cardiovascular risk.Objective: to evaluate the efficacy of an ACE inhibitor in the combination therapy of RA.Patients and methods. Eighty-four patients with RA and endothelial dysfunction were examined; the mean age was 40.12±10.2 years; the mean disease duration was 4.22±3.43 years. All the patients had a blood level of ATII of >9 pg/ml. Enzyme immunoassay was used to measure the levels of tumor necrosis factor-α (TNF-α (Vector-Best, Russia, intercellular adhesion molecules 1 (ICAM-1 (Diaclone, France, vascular endothelial growth factor (VEGF and ATII (Diagnostic, Canada. Wrist ultrasonography using the Doppler ultrasound apparatus ESAOTE MyLAB40 was carried out to assess synovial vascularization. The patients were divided into two groups. Group 1 included 43 patients who were assigned to receive standard therapy for RA according to the rheumatic disease treatment protocols; Group 2 comprised 41 patients who received the standard therapy plus ACE inhibitors 2.5–5 mg/day.Results. The use of ACE inhibitors in the 12-month combination therapy of RA patients led to an improvement in the endothelial regulation of vascular tone, to a decrease in the blood concentration of ICAM-1, to a reduction in the intensity of synovial angiogenesis and in the blood level of VEGF by 39%, and a more significant drop in the levels of CRP and TNF-? and in DAS28 by 1.2 scores as compared to those in the standard therapy.

[Effect of treatment in 39 patients with diabetic nephropathy by safflor yellow and benazepril in combination].

Science.gov (United States)

Guo, Deng-Zhou; Wang, Yue-Hua; Chen, Zhi-Qiang

2008-04-01

To observe the clinical effect of combined treatment with safflor yellow powder injection and benazepril in treating patients with diabetic nephropathy (DN). Seventy-six patients with DN were randomly assigned to the treatment group (39 cases) and the control group (37 cases). Conventional treatment for lowering blood glucose was given to both groups, but to the control group 10 mg benazepril was given orally once a day additionally, while to those in the treatment group the same dosage of benazepril po. and 150 mg/d of safflor yellow powder injection by adding in 250 mL 0.9% normal saline for intravenous dripping. The therapeutic course for them all was 15 days, and all patients received two courses with an interval of 5 days. Changes of clinical symptoms, urinary albumin excretion rate (UAER), blood and urinary levels of beta2 -microglobulin (beta2 -MG), urinary level of alpha1-microglobulin (alpha1 -MG), D-dimer (D-D) and plasma fibrinogen (FIB) were observed. The total effective rate in the treatment group was higher than that in the control group (84.62% vs 59.45 %, P benazepril is superior to benazepril alone in reducing urinary albumin, improving renal function and blood hyperviscosity manner for patients with DN, suggesting the combination of the two could play their respective superiorities and act in cooperation for retarding the progression of DN.

Received View of Addiction, Relapse and Treatment.

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Ndasauka, Yamikani; Wei, Zhengde; Zhang, Xiaochu

2017-01-01

It is important to highlight that attempts at understanding and explaining addiction have been made for centuries. It is, however, just five decades ago, with the growth of science and technology that more interest has been observed in this field. This chapter examines different views and theories that have been posited to understand and explain addiction. More attention will be given to prominent views that seem to draw consensus among researchers and medical practitioners. The first section of the chapter introduces the addiction debate, the different theories that have been provided to explain it from different perspectives and disciplines such as neurosciences, philosophy and psychology. Then, the chapter discusses different views on the role of relapse and what it entails in understanding addiction. The second section discusses different proposed and used forms of treating addiction. Thus, the chapter discusses the received view of addiction, the understanding of relapse as a critical element in addiction and treatments.

COMBINATION OF MOLECULAR ADSORBENT RECIRCULATING SYSTEM AND RADIOIODINE FOR THE TREATMENT OF CONCURRENT HYPERTHYROIDISM AND SEVERE LIVER DYSFUNCTION: A RETROSPECTIVE COHORT STUDY.

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Zhang, Qing; Guan, Yanxing; Xiang, Tianxin; Liu, Shaozheng; Chen, Qingjie; Zhang, Qing

2017-02-01

The treatment of hyperthyroidism associated with severe liver dysfunction (LD) is a clinical challenge, and there has been no unified examination of this problem. The objective of this study was to assess the efficacy and safety of radioiodine ( 131 I) in combination with a molecular adsorbent recirculating system (MARS) for the treatment of hyperthyroidism complicated by severe liver LD. A total of 116 hyperthyroidism patients with concomitant LD who received MARS treatment were studied retrospectively. The patients were grouped according to whether or not they also received 131 I treatment: Group 1 (59 patients) received 131 I following MARS treatment, while Group 2 (57 cases) received only MARS. Clinical outcomes, including thyroid hormone levels, liver function parameters, and therapeutic efficacy were calculated. The overall response rate was significantly greater in Group 1 than in Group 2 (Ptreatment compared with before treatment (Ptreatments (Ptreatment of hyperthyroidism complicated by severe LD was effective and safe. The use of this system could rapidly improve liver function and metabolism, allowing 131 I therapy to be applied as early as possible with a shortened recovery time of liver function. ALSS = artificial liver support system ALT = alanine transaminase AST = aspartate transaminase ATD = antithyroid drugs DBil = direct bilirubin FT3 = free tri-iodothyronine FT4 = free thyroxine 131 I = radioiodine INR = international normalized ratio LD = liver dysfunction MARS = molecular adsorbent recirculating system MELD = model for end-stage liver disease PT = prothrombin time TBil = total bilirubin TSH = thyroid-stimulating hormone.

Cognitive adaptation training combined with assertive community treatment

DEFF Research Database (Denmark)

Hansen, Jens Peter; Østergaard, Birte; Nordentoft, Merete

2012-01-01

Cognitive adaptation training (CAT) targets the adaptive behaviour of patients with schizophrenia and has shown promising results regarding the social aspects of psychosocial treatment. As yet, no reports have appeared on the use of CAT in combination with assertive community treatment (ACT). Our...

The Efficacy of Synchronous Combination of Chemotherapy and EGFR TKIs for the First-Line Treatment of NSCLC: A Systematic Analysis.

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Han Yan

Full Text Available The combination of chemotherapy and epidermal growth factor receptor (EGFR tyrosine kinase inhibitors (TKIs currently has become the hotspot issue in the treatment of non-small lung cancer (NSCLC. This systematic review was conducted to compare the efficacy and safety of the synchronous combination of these two treatments with EGFR TKIs or chemotherapy alone in advanced NSCLC.EMBASE, PubMed, the Central Registry of Controlled Trials in the Cochrane Library (CENTRAL, Chinese biomedical literature database (CNKI and meeting summaries were searched. The Phase II/III randomized controlled trials were selected by which patients with advanced NSCLC were randomized to receive a combination of EGFR TKIs and chemotherapy by synchronous mode vs. EGFR TKIs or chemotherapy alone.A total of six randomized controlled trials (RCTs including 4675 patients were enrolled in the systematic review. The meta-analysis demonstrated that the synchronous combination group of chemotherapy and EGFR TKIs did not reach satisfactory results; there was no significant difference in overall survival (OS, time to progression (TTP and objective response rate (ORR, compared with monotherapy (OS: HR = 1.05, 95%CI = 0.98-1.12; TTP: HR = 0.94, 95%CI = 0.89-1.00; ORR: RR = 1.07, 95%CI = 0.98-1.17, and no significant difference in OS and progression-free survival (PFS, compared with EGFR TKIs alone (OS: HR = 1.10, 95% CI = 0.83-1.46; PFS: HR = 0.86, 95% CI = 0.67-1.10. The patients who received synchronous combined therapy presented with increased incidences of grade 3/4 anemia (RR = 1.40, 95% CI = 1.10-1.79 and rash (RR = 7.43, 95% CI = 4.56-12.09, compared with chemotherapy, grade 3/4 anemia (RR = 6.71, 95% CI = 1.25-35.93 and fatigue (RR = 9.60, 95% CI = 2.28-40.86 compared with EGFR TKI monotherapy.The synchronous combination of chemotherapy and TKIs is not superior to chemotherapy or EGFR TKIs alone for the first-line treatment of NSCLC.

The Efficacy and Safety of the Combination of Total Glucosides of Peony and Leflunomide for the Treatment of Rheumatoid Arthritis: A Systemic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Zhitao Feng

2016-01-01

Full Text Available Objective. To evaluate the efficacy and safety of the total glucosides of peony (TGP and leflunomide (LEF for the treatment of rheumatoid arthritis (RA. Methods. Randomized controlled trials (RCTs on the efficacy and safety of the combination of TGP and LEF versus LEF alone for the treatment of RA were retrieved by searching PubMed, EMBASE, Cochrane Library, the China National Knowledge Infrastructure database, and Wanfang database. Results. Eight RCTs including 643 RA patients were included in the present meta-analysis. The quality of included studies was poor. The levels of ESR (P<0.0001, CRP (P<0.0001, and RF (P<0.0001 in RA patients who received the combination of TGP and LEF were significantly lower than RA patients who received LEF therapy alone. The pooled results suggest that the combination of TGP and LEF caused less abnormal liver function than LEF alone (P=0.02. No significant difference in the gastrointestinal discomfort was identified between the combination of TGP and LEF and LEF alone groups (P=0.18. Conclusion. The combination of TGP and LEF in treatment of RA presented the characteristics of notably decreasing the levels of laboratory indexes and higher safety in terms of liver function. However, this conclusion should be further investigated based on a larger sample size.

Effects of combined electron-beam irradiation and sous-vide treatments on microbiological and other qualities of chicken breast meat

International Nuclear Information System (INIS)

Shamsuzzaman, K.; Lucht, L.; Chuaqui-Offermanns, N.

1994-01-01

The microbiological safety, refrigeration shelf-life, and nutritional quality of chicken breast meat were investigated following combined electron-beam irradiation and cooking under vacuum (sous-vide). Chicken breast meat inoculated with 10 6 CFU/g of Listeria monocytogenes was irradiated with an electron beam at doses up to 3.1 kGy under vacuum in barrier bags, cooked in a boiling water bath for 3 min 45 s (previously determined to achieve an internal temperature of 71.1 o C), and stored at 8 o C for up to 5 weeks. Listeria was undetectable in samples treated with combined sous-vide and irradiation at 3.1 kGy, but the organism survived the sous-vide treatment without irradiation and multiplied during storage. A similar study, conducted with uninoculated chicken breast meat, revealed that the product which received both irradiation (3 kGy) and sous-vide treatment had a shelf-life of at least 8 weeks at 8 o C, whereas the unirradiated samples treated sous-vide spoiled in 16 days. Listeria was undetectable in combination treated samples, but some of the unirradiated sous-vide samples tested after long storage showed high levels of Listeria. Some loss of thiamine occurred with the combined treatments. (author)

Treatment of B-cells non-Hodgkin lymphomas with combined immunochemotherapy: ability to treatment optimization

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N. V. Smirnova

2015-01-01

Full Text Available The results of two consecutive multicenter clinical trials enrolled 241 patient with childhood mature B-cells non-Hodgkin lymphomas/leukemia are presented. Patients received treatment according B-NHL 2004mab protocol (n = 83 and B-NHL 2010M (n = 158 with combined immunochemotherapy (ICT in Russian and Belarus pediatric clinics from 2004 to 2015 years. Primary patients with different mature B-NHL (Burkitt lymphoma/leukemia, diffuse large B-cell lymphoma and primary mediastinal B-cell lymphoma (DLBCL and PMBCL aged from 2 to 18 years are included in the studies.Protocol B-NHL 2004mab for treatment of children and adolescents with B-NHL/B-AL, stage III and IV, includes a combination of chemotherapy (PCT and rituximab – an antibody against the B-cells receptor CD20. PCT courses similar to those in the B-NHL BFM90 protocol (group III with the exception of methotrexate dose in induction courses, reduced to 1 g/m2 /24 h in order to reduce toxicity. Rituximab (Mabthera, 375 mg/m2 /h used for the first time in the treatment of children and adolescents with B-NHL. Of the 83 patients included, clinical remission was achieved in 77 (92.8 %. With a median follow time of 51.6 months, remission continued in 23 (85.2 % patients with B-AL, in 32 (88.9 % patients with LB and 19 (95.0 % patients – with DLBCL. With median follow time of 65.2 months, event-free and overall survival was 84 ± 6 and 82 ± 8 %, respectively.Based on previous experience in order to further optimize B-NHL treatment, new protocol B-NHL 2010M with effect-adapted therapy and improvement of stratification risk group criteria was proposed. Overall survival in patients of 1st and 2nd risk groups with full implementation of diagnosis and treatment is approaching 100 %. In interim analysis of 3rd risk group patients, pOS was 88 ± 3 %. The incidence of induction death (infections, metabolic complications remains within 2.7 % (n = 4; refractory cases (n = 2; 1.3 % and relapses (n = 4; 2

Irradiation in combined treatments and food safety

International Nuclear Information System (INIS)

Lacroix Monique; Dussault Dominic; Turgis Melanie; Salmieri Stephane; Perlette Takala; Vu Dang Khanh; Ayari Samia

2013-01-01

Irradiation combined with other processes can contribute to insuring food safety to consumers and controlling severe losses during transportation and commercialisation. We have demonstrated that using in synergy with other treatments; a lower dose could be used to eliminate pathogenic bacteria and permit a better protection of the sensorial quality and to prolong the shelf life of foods. Results indicated that some bacteria are more sensitive to irradiation under modified atmosphere (MAP) and the presence of active compound can increase the bacterial radiosensitivity by more than 4 times under air and by more than 10 times under MAP. Mild heat treatment or addition of natural antimicrobial compounds before irradiation treatment has also permitted an increase of Bacillus cereus radiosensitization. An increase of the bacterial radiosensitization of 1.5 and 1.56 was respectively observed. The effectiveness of the use of edible coating containing natural antimicrobial compounds, modified atmosphere packaging (MAP) or mild treatment before irradiation treatment was demonstrated in order to inactivate Listeria monocytogenes, Salmonella typhimurium, Escherichia coli and Bacillus cereus growth or B. cereus spore germination, to increase the bacterial sensitivity to irradiation, to reduce the water loss and to extend the shelf life of the food when stored at 4 deg C. Also, the use of edible coating previously crosslinked by irradiation have permitted a better control of the active compounds release. Studies of combined treatments were used in ready to eat vegetables, fruits and meat products. (author)

Smoking Cessation Treatment for Patients With Mental Disorders Using CBT and Combined Pharmacotherapy.

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Loreto, Aline Rodrigues; Carvalho, Carlos Felipe Cavalcanti; Frallonardo, Fernanda Piotto; Ismael, Flavia; Andrade, Arthur Guerra de; Castaldelli-Maia, João Maurício

2017-01-01

The aim of this study was to investigate smoking treatment effectiveness and retention in a population with and without mental disorders (MD). Participants received cognitive behavioral therapy (CBT) plus nicotine patch alone or in combination with other medications (i.e., gum, bupropion, or nortriptyline) for smoking cessation treatment in a Brazilian Psychosocial Care Center unit (CAPS), taking into account sociodemographics and smoking profile covariates. The study involved comparison of treatment success (seven-day point prevalence abstinence at the end of the treatment) and retention (presence of the individual in all of the four medical consultations and six group sessions) in two subsamples of patients with MD (n = 267) and without MD (n = 397) who were included in a six-week treatment provided by a CAPS from 2007 to 2013. The treatment protocol comprised group CBT and pharmacotherapy (nicotine patches, nicotine gums, and bupropion and nortriptyline available, prescribed by psychiatrists). Within patients with MD, CBT plus nicotine patch plus bupropion (aOR = 2.00, 95% CI [1.14, 3.50], p = .015) and CBT plus nicotine patch plus gum (aOR = 2.10, 95% CI [1.04, 4.23], p = .036) were associated with treatment success. Within patients without MD, female gender (aOR = 0.60, 95% CI [0.37, 0.95], p = .031) and lower Heaviness of Smoking Index score (aOR = 0.80, 95% CI [0.65, 0.99], p = .048) were associated with treatment success. No variable was associated with dropout or retention within patients with or without MD. Our findings support the use of CBT plus nicotine patch plus bupropion as well as CBT plus nicotine patch plus gum in samples with high rates of medical, psychiatric, and addiction disorders. These findings support those of previous studies in the general population. Pharmacological treatment associated with group CBT based on cognitive-behavioral concepts and combined with ongoing MD treatment seems to be the best option for smoking cessation

Nonstent Combination Interventional Therapy for Treatment of Benign Cicatricial Airway Stenosis.

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Qiu, Xiao-Jian; Zhang, Jie; Wang, Ting; Pei, Ying-Hua; Xu, Min

2015-08-20

Benign cicatricial airway stenosis (BCAS) is a life-threatening disease. While there are numerous therapies, all have their defects, and stenosis can easily become recurrent. This study aimed to investigate the efficacy and complications of nonstent combination interventional therapy (NSCIT) when used for the treatment of BCAS of different causes and types. This study enrolled a cohort of patients with BCAS resulting from tuberculosis, intubation, tracheotomy, and other origins. The patients were assigned to three groups determined by their type of stenosis: Web-like stenosis, granulation stenosis, and complex stenosis, and all patients received NSCIT. The efficacy and complications of treatment in each group of patients were observed. The Chi-square test, one-factor analysis of variance (ANOVA), and the paired t -test were used to analyze different parameters. The 10 patients with web-like stenosis and six patients with granulation stenosis exhibited durable remission rates of 100%. Among 41 patients with complex stenosis, 36 cases (88%) experienced remission and 29 cases (71%) experienced durable remission. When five patients with airway collapse were eliminated from the analysis, the overall remission rate was 97%. The average treatment durations for patients with web-like stenosis, granulation stenosis, and complex stenosis were 101, 21, and 110 days, respectively, and the average number of treatments was five, two, and five, respectively. NSCIT demonstrated good therapeutic efficacy and was associated with few complications. However, this approach was ineffective for treating patients with airway collapse or malacia.

Radical treatment of stage Ⅳ pancreatic cancer by the combination of cryosurgery and iodine-125 seed implantation

Institute of Scientific and Technical Information of China (English)

Ji-Bing Chen; Jia-Liang Li; Li-Hua He; Wei-Qun Liu; Fei Yao; Jian-Ying Zeng; Yi Zhang

2012-01-01

AIM:To investigate the therapeutic effect of radical treatment and palliative treatment in stage Ⅳ pancreatic cancer patients.METHODS:81 patients were enrolled in the study.Radical treatment was performed on 51 patients,while 30 patients were put under palliative treatment.The procedural safety and interval survival for stage Ⅳ pancreatic cancer (IS-Ⅳ) was assessed by almost 2.5 years of follow-ups.The IS-Ⅳ of patients under the two kinds of treatment,and the effects of treatment timing and frequency on IS-Ⅳ,were compared.RESULTS:The IS-Ⅳ of patients who received radical treatment was significantly longer than those who received palliative treatment (P ＜ 0.001).The IS-Ⅳ of patients who received delayed radical or palliative treatment was longer than those who received accordingly timely treatment (P =0.0034 and 0.0415,respectively).Multiple treatments can play an important role in improving the IS-Ⅳ of patients who received radical treatment (P =0.0389),but not for those who received palliative treatment (P =0.99).CONCLUSION:The effect of radical treatment was significantly more obvious than that of palliative treatment,and multiple radical treatments may contribute more to patients than a single radical treatment.

The Results of the Combine Treatment of Patients with Liver Bilobar Metastases from Colorectal Cancer Using Radiofrequency Ablation.

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Kaganov, Oleg Igorevich; Kozlov, Sergei Vasilevich; Orlov, Andrei Evgenyevich; Blinov, Nikita Vyacheslavovich

2018-06-01

Colorectal cancer (CRC) is the third most common cancer worldwide. The mortality from CRC remains very high. The main cause of such a high mortality is a disseminate process with the appearance of distant metastases. In this regard, the treatment of metastatic lesions is recognized as an important trend in modern oncology. The program of study included 176 patients with colorectal cancer after primary tumor removal with the malignant progression-multiple (more than 4) bilobar liver metastases. The research was organized in Samara Regional Oncology Centre from 2001 to 2014. By the treatment method, patients were divided into two groups. Main group got the combined (chemotherapy + radiofrequency ablation (RFA)) treatment ( n  = 98). In control group, only chemotherapy was applied ( n  = 78). One-, two-, and three-year OS were 73.5, 25.1, and 7.2% in the main group and 39.6, 6.3, and 2.1% in the control group. The RFA application allowed us to reach the index of 4-year survival 1.8% in the main group, while we received only 2.1 of 3-year survival in the control group. The OS median reached 18 months in the main group and 11 months in the control group. So, the OS curves in two comparing groups were significantly different according to statistics (log-rank test 3.77, р  = 0.000). The application of RFA in combination with chemotherapy in the treatment of bilobar metastasis colorectal cancer allows to improve the performance of disease-free survival and overall survival significantly, compared with the group of patients who received only chemotherapy.

Combined treatment of acute deep vein thrombosis of the lower limbs

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Vasylij Rusin

2017-06-01

Full Text Available The article represents the combined treatment results analysis of 50 patients with deep vein thromboses of inferior vena cava system. The complex clinical and instrumental examination of patients included duplex ultrasound scan, X-ray phlebography, multislice computed tomography with intravenous contrast and radionuclide fleboscintigrahpy. All patients were performed the regional thrombolytic therapy, combined with an open palliative thrombectomy in 19 (38% patients and endovascular implantation of a temporary or constant cava-filter in 31 (62% patients. In postoperative period for 12 months’ monitoring the local and general complications after combined treatment were found in 4 (8.0% out of 50 patients, who were performed the combined treatment.

Assessment of the degree of oxidative stress injury, renin-angiotensin system activity and podocyte loss after combined treatment of keto acid with low protein diet for patients with diabetic nephropathy

OpenAIRE

Yuan-Hua Xu; Mei Wang

2016-01-01

Objective: To analyze the degree of oxidative stress injury, RAS activity and podocyte loss after patients with diabetic nephropathy received keto acid combined with low protein diet. Methods: A total of 106 cases of patients with diabetic nephropathy who received hospital treatment in our hospital from September 2012 to July 2015 were selected as research subjects and randomly divided into observation group and control group according to different treatment, each group with 53...

Efficacy of combined pranoprofen eye drops and artificial tears on the treatment of mild to moderate dry eye syndrome after trabbeculectomy

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Guang-Ming Zhao

2015-02-01

Full Text Available AIM:To evaluate the efficacy of combined pranoprofen eye drops and artificial tears on the treatment of mild to moderate dry eye syndrome after trabbeculectomy. METHODS: This prospective case control study included 63 cases(63 eyesof patients with mild to moderate dry eye syndrome after trabbeculectomy in our hospital from November 2013 to June 2013. All subjects were randomly divided into two groups. Observation group was treated with combined pranoprofen eye drops and artificial tears and control group received simple artificial tears marking the eyes at 1, 2, 4wk. The patient's symptoms, signs, BUT, SⅠt, and FL were observed before treatment and 1, 2, 4wk after treatment. RESULTS:After 2wk, the symptoms of observation group were improved, there was statistically significant difference(PPPPCONCLUSION: Artificial tears joint pranoprofen eye drops has good curative effect in the treatment of mild to moderate dry eye syndrome after trabbeculectomy.

Artemether-Lumefantrine Combination Therapy for Treatment of Uncomplicated Malaria: The Potential for Complex Interactions with Antiretroviral Drugs in HIV-Infected Individuals

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Pauline Byakika-Kibwika

2011-01-01

Full Text Available Treatment of malaria in HIV-infected individuals receiving antiretroviral therapy (ART poses significant challenges. Artemether-lumefantrine (AL is one of the artemisisnin-based combination therapies recommended for treatment of malaria. The drug combination is highly efficacious against sensitive and multidrug resistant falciparum malaria. Both artemether and lumefantrine are metabolized by hepatic cytochrome P450 (CYP450 enzymes which metabolize the protease inhibitors (PIs and nonnucleoside reverse transcriptase inhibitors (NNRTIs used for HIV treatment. Coadministration of NNRTIs and PIs with AL could potentially cause complex pharmacokinetic drug interactions. NNRTI by inducing CYP450 3A4 enzyme and PIs by inhibiting CYP450 3A4 enzymes could influence both artemether and lumefantrine concentrations and their active metabolites dihydroartemisinin and desbutyl-lumefantrine, predisposing patients to poor treatment response, toxicity, and risk for development of resistance. There are scanty data on these interactions and their consequences. Pharmacokinetic studies to evaluate these interactions in the target populations are urgently needed.

Estimate of neutron secondary doses received by patients in proton therapy: cases of ophthalmologic treatments

International Nuclear Information System (INIS)

Martinetti, F.

2009-12-01

This research thesis aims at assessing doses due to secondary neutrons and received by the organs of a patient which are located outside of the treatment field. The study focused on ophthalmological treatments performed at the Orsay proton therapy centre. A 75 eV beam line model has first been developed with the MCNPX Monte Carlo code. Several experimental validations of this model have been performed: proton dose distribution in a water phantom, ambient equivalent dose due to secondary neutrons and neutron spectra in the treatment room, and doses deposited by secondary neutrons in an anthropomorphous phantom. Simulations and measurements are in correct agreement. Then, a numeric assessment of secondary doses received by the patient's organs has been performed by using a MIRD-type mathematical phantom. These doses have been computed for several organs: the non-treated eye, the brain, the thyroid, and other parts of the body situated either in the front part of the body (the one directly exposed to neutrons generated in the treatment line) or deeper and further from the treatment field

Recent advances in delivery of drug-nucleic acid combinations for cancer treatment.

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Li, Jing; Wang, Yan; Zhu, Yu; Oupický, David

2013-12-10

Cancer treatment that uses a combination of approaches with the ability to affect multiple disease pathways has been proven highly effective in the treatment of many cancers. Combination therapy can include multiple chemotherapeutics or combinations of chemotherapeutics with other treatment modalities like surgery or radiation. However, despite the widespread clinical use of combination therapies, relatively little attention has been given to the potential of modern nanocarrier delivery methods, like liposomes, micelles, and nanoparticles, to enhance the efficacy of combination treatments. This lack of knowledge is particularly notable in the limited success of vectors for the delivery of combinations of nucleic acids with traditional small molecule drugs. The delivery of drug-nucleic acid combinations is particularly challenging due to differences in the physicochemical properties of the two types of agents. This review discusses recent advances in the development of delivery methods using combinations of small molecule drugs and nucleic acid therapeutics to treat cancer. This review primarily focuses on the rationale used for selecting appropriate drug-nucleic acid combinations as well as progress in the development of nanocarriers suitable for simultaneous delivery of drug-nucleic acid combinations. Copyright © 2013 Elsevier B.V. All rights reserved.

Hospital of Diagnosis Influences the Probability of Receiving Curative Treatment for Esophageal Cancer.

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van Putten, Margreet; Koëter, Marijn; van Laarhoven, Hanneke W M; Lemmens, Valery E P P; Siersema, Peter D; Hulshof, Maarten C C M; Verhoeven, Rob H A; Nieuwenhuijzen, Grard A P

2018-02-01

The aim of this article was to study the influence of hospital of diagnosis on the probability of receiving curative treatment and its impact on survival among patients with esophageal cancer (EC). Although EC surgery is centralized in the Netherlands, the disease is often diagnosed in hospitals that do not perform this procedure. Patients with potentially curable esophageal or gastroesophageal junction tumors diagnosed between 2005 and 2013 who were potentially curable (cT1-3,X, any N, M0,X) were selected from the Netherlands Cancer Registry. Multilevel logistic regression was performed to examine the probability to undergo curative treatment (resection with or without neoadjuvant treatment, definitive chemoradiotherapy, or local tumor excision) according to hospital of diagnosis. Effects of variation in probability of undergoing curative treatment among these hospitals on survival were investigated by Cox regression. All 13,017 patients with potentially curable EC, diagnosed in 91 hospitals, were included. The proportion of patients receiving curative treatment ranged from 37% to 83% and from 45% to 86% in the periods 2005-2009 and 2010-2013, respectively, depending on hospital of diagnosis. After adjustment for patient- and hospital-related characteristics these proportions ranged from 41% to 77% and from 50% to 82%, respectively (both P < 0.001). Multivariable survival analyses showed that patients diagnosed in hospitals with a low probability of undergoing curative treatment had a worse overall survival (hazard ratio = 1.13, 95% confidence interval 1.06-1.20; hazard ratio = 1.15, 95% confidence interval 1.07-1.24). The variation in probability of undergoing potentially curative treatment for EC between hospitals of diagnosis and its impact on survival indicates that treatment decision making in EC may be improved.

Cysticidal Efficacy of Combined Treatment With Praziquantel and Albendazole for Parenchymal Brain Cysticercosis.

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Garcia, Hector H; Lescano, Andres G; Gonzales, Isidro; Bustos, Javier A; Pretell, E Javier; Horton, John; Saavedra, Herbert; Gonzalez, Armando E; Gilman, Robert H

2016-06-01

The efficacy of current antiparasitic treatment for cerebral Taenia solium cysticercosis with either albendazole (ABZ) or praziquantel (PZQ) is suboptimal. A recent study demonstrated that combining these 2 antiparasitic drugs improves antiparasitic efficacy. We present here the parasiticidal efficacy data obtained during a previous phase II pharmacokinetic study that compared combined ABZ plus PZQ with ABZ alone. The study was a randomized, double-blinded, placebo-controlled phase II evaluation of the pharmacokinetics of ABZ (15 mg/k/d, for 10 days) and PZQ (50 mg/k/d, for 10 days) in intraparenchymal brain cysticercosis. Patients received the usual concomitant medications, including an antiepileptic drug (phenytoin or carbamazepine), dexamethasone, and ranitidine. Randomization was stratified by antiepileptic drug. Patients underwent safety laboratory evaluations at days 4, 7, and 11, as well as magnetic resonance (MR) imaging at 6 months to assess parasiticidal efficacy. Thirty-two patients were included, 16 in each arm. All of them completed antiparasitic treatment and underwent follow-up brain MR imaging. Cysticidal efficacy was strikingly higher in the combined ABZ-plus-PZQ group than in the ABZ-alone group (proportion of cysts resolved, 78 of 82 [95%] vs 23 of 77 [30%] [relative risk {RR}, 3.18; 95% confidence interval {CI}, 2.08-4.88; P < .001]; patients with complete cyst clearance, 12 of 16 [75%] vs 4 of 16 [25%] [RR, 3.00; 95% CI, 1.23-7.34; P = .005]). The combination of ABZ plus PZQ is more effective in destroying viable brain cysticercosis cysts than ABZ alone. NCT00441285. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

An OFDM Receiver with Frequency Domain Diversity Combined Impulsive Noise Canceller for Underwater Network

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Saotome, Rie; Hai, Tran Minh; Matsuda, Yasuto; Suzuki, Taisaku; Wada, Tomohisa

2015-01-01

In order to explore marine natural resources using remote robotic sensor or to enable rapid information exchange between ROV (remotely operated vehicles), AUV (autonomous underwater vehicle), divers, and ships, ultrasonic underwater communication systems are used. However, if the communication system is applied to rich living creature marine environment such as shallow sea, it suffers from generated Impulsive Noise so-called Shrimp Noise, which is randomly generated in time domain and seriously degrades communication performance in underwater acoustic network. With the purpose of supporting high performance underwater communication, a robust digital communication method for Impulsive Noise environments is necessary. In this paper, we propose OFDM ultrasonic communication system with diversity receiver. The main feature of the receiver is a newly proposed Frequency Domain Diversity Combined Impulsive Noise Canceller. The OFDM receiver utilizes 20–28 KHz ultrasonic channel and subcarrier spacing of 46.875 Hz (MODE3) and 93.750 Hz (MODE2) OFDM modulations. In addition, the paper shows Impulsive Noise distribution data measured at a fishing port in Okinawa and at a barge in Shizuoka prefectures and then proposed diversity OFDM transceivers architecture and experimental results are described. By the proposed Impulsive Noise Canceller, frame bit error rate has been decreased by 20–30%. PMID:26351656

An OFDM Receiver with Frequency Domain Diversity Combined Impulsive Noise Canceller for Underwater Network.

Science.gov (United States)

Saotome, Rie; Hai, Tran Minh; Matsuda, Yasuto; Suzuki, Taisaku; Wada, Tomohisa

2015-01-01

In order to explore marine natural resources using remote robotic sensor or to enable rapid information exchange between ROV (remotely operated vehicles), AUV (autonomous underwater vehicle), divers, and ships, ultrasonic underwater communication systems are used. However, if the communication system is applied to rich living creature marine environment such as shallow sea, it suffers from generated Impulsive Noise so-called Shrimp Noise, which is randomly generated in time domain and seriously degrades communication performance in underwater acoustic network. With the purpose of supporting high performance underwater communication, a robust digital communication method for Impulsive Noise environments is necessary. In this paper, we propose OFDM ultrasonic communication system with diversity receiver. The main feature of the receiver is a newly proposed Frequency Domain Diversity Combined Impulsive Noise Canceller. The OFDM receiver utilizes 20-28 KHz ultrasonic channel and subcarrier spacing of 46.875 Hz (MODE3) and 93.750 Hz (MODE2) OFDM modulations. In addition, the paper shows Impulsive Noise distribution data measured at a fishing port in Okinawa and at a barge in Shizuoka prefectures and then proposed diversity OFDM transceivers architecture and experimental results are described. By the proposed Impulsive Noise Canceller, frame bit error rate has been decreased by 20-30%.

An OFDM Receiver with Frequency Domain Diversity Combined Impulsive Noise Canceller for Underwater Network

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Rie Saotome

2015-01-01

Full Text Available In order to explore marine natural resources using remote robotic sensor or to enable rapid information exchange between ROV (remotely operated vehicles, AUV (autonomous underwater vehicle, divers, and ships, ultrasonic underwater communication systems are used. However, if the communication system is applied to rich living creature marine environment such as shallow sea, it suffers from generated Impulsive Noise so-called Shrimp Noise, which is randomly generated in time domain and seriously degrades communication performance in underwater acoustic network. With the purpose of supporting high performance underwater communication, a robust digital communication method for Impulsive Noise environments is necessary. In this paper, we propose OFDM ultrasonic communication system with diversity receiver. The main feature of the receiver is a newly proposed Frequency Domain Diversity Combined Impulsive Noise Canceller. The OFDM receiver utilizes 20–28 KHz ultrasonic channel and subcarrier spacing of 46.875 Hz (MODE3 and 93.750 Hz (MODE2 OFDM modulations. In addition, the paper shows Impulsive Noise distribution data measured at a fishing port in Okinawa and at a barge in Shizuoka prefectures and then proposed diversity OFDM transceivers architecture and experimental results are described. By the proposed Impulsive Noise Canceller, frame bit error rate has been decreased by 20–30%.

Anticonvulsants or Antidepressants in Combination Pharmacotherapy for Treatment of Neuropathic Pain in Cancer Patients: A Systematic Review and Meta-analysis.

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Guan, Jia; Tanaka, Shiro; Kawakami, Koji

2016-08-01

To investigate the efficacy of anticonvulsants or antidepressants in combination pharmacotherapy for treatment of neuropathic pain in cancer patients. We systematically searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and the metaRegister of Controlled Trials for randomized controlled trials that compared anticonvulsants or antidepressants in combination pharmacotherapy (experimental group) with treatments without anticonvulsants or antidepressants (control group) for neuropathic pain in cancer patients. Risk of bias was evaluated in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The primary outcome was a mean difference (MD) in change in global pain analyzed by a random-effects model. Eight trials met the inclusion criteria with a total of 1359 participants of whom 698 received an experimental intervention. The MD in change in global pain suggested a favorable association with anticonvulsants or antidepressants in combination pharmacotherapy compared with control groups (MD, -0.41; 95% confidence interval, -0.70 to -0.12) with no heterogeneity across trials (I=0%). The MD in change estimated in all sensitivity analyses ranged from -0.36 to -0.47, suggesting that these effects were consistent across different study designs and statistical assumptions. Anticonvulsants or antidepressants in combination pharmacotherapy reduce neuropathic pain in cancer patients compared with treatments without anticonvulsants or antidepressants. Limited evidence precludes a recommendation on specific adjuvants in combination pharmacotherapy.

Mosapride combined with probiotics on gastrointestinal function and growth in premature infants

OpenAIRE

Zhang, Ai-Mei; Sun, Zhi-Qun; Zhang, Li-Ming

2017-01-01

The aim of this study was to investigate the effects of mosapride combined with probiotics on gastrointestinal function and growth and development in premature infants. A total of 240 premature infants treated at Weifang People's Hospital between June 2012 and May 2015 who matched our criteria were randomly divided into three groups of 80 cases each. Group A received routine treatment, group B received routine treatment combined with live B. subtilis and E. faecium granules with multivitamins...

Power and Efficiency Analysis of a Solar Central Receiver Combined Cycle Plant with a Small Particle Heat Exchanger Receiver

Science.gov (United States)

Virgen, Matthew Miguel

Two significant goals in solar plant operation are lower cost and higher efficiencies. To achieve those goals, a combined cycle gas turbine (CCGT) system, which uses the hot gas turbine exhaust to produce superheated steam for a bottoming Rankine cycle by way of a heat recovery steam generator (HRSG), is investigated in this work. Building off of a previous gas turbine model created at the Combustion and Solar Energy Laboratory at SDSU, here are added the HRSG and steam turbine model, which had to handle significant change in the mass flow and temperature of air exiting the gas turbine due to varying solar input. A wide range of cases were run to explore options for maximizing both power and efficiency from the proposed CSP CCGT plant. Variable guide vanes (VGVs) were found in the earlier model to be an effective tool in providing operational flexibility to address the variable nature of solar input. Combined cycle efficiencies in the range of 50% were found to result from this plant configuration. However, a combustor inlet temperature (CIT) limit leads to two distinct Modes of operation, with a sharp drop in both plant efficiency and power occurring when the air flow through the receiver exceeded the CIT limit. This drawback can be partially addressed through strategic use of the VGVs. Since system response is fully established for the relevant range of solar input and variable guide vane angles, the System Advisor Model (SAM) from NREL can be used to find what the actual expected solar input would be over the course of the day, and plan accordingly. While the SAM software is not yet equipped to model a Brayton cycle cavity receiver, appropriate approximations were made in order to produce a suitable heliostat field to fit this system. Since the SPHER uses carbon nano-particles as the solar absorbers, questions of particle longevity and how the particles might affect the flame behavior in the combustor were addressed using the chemical kinetics software Chemkin

Effect of combination of fractional CO2 laser and narrow-band ultraviolet B versus narrow-band ultraviolet B in the treatment of non-segmental vitiligo.

Science.gov (United States)

El-Zawahry, Mohamed Bakr; Zaki, Naglaa Sameh; Wissa, Marian Youssry; Saleh, Marwah Adly

2017-12-01

The present study was designed to evaluate the effect of combining fractional CO 2 laser with narrow-band ultraviolet B (NB-UVB) versus NB-UVB in the treatment of non-segmental vitiligo. The study included 20 patients with non-segmental stable vitiligo. They were divided into two groups. Group I received a single session of fractional CO 2 laser therapy on the right side of the body followed by NB-UVB phototherapy twice per week for 8 weeks. Group II received a second session of fractional CO 2 laser therapy after 4 weeks from starting treatment with NB-UVB. The vitiligo lesions were assessed before treatment and after 8 weeks of treatment by VASI. At the end of the study period, the vitiligo area score index (VASI) in group I decreased insignificantly on both the right (-2.6%) and left (-16.4%) sides. In group II, VASI increased insignificantly on the right (+14.4%) and left (+2.5%) sides. Using Adobe Photoshop CS6 extended program to measure the area of vitiligo lesions, group I showed a decrease of -1.02 and -6.12% in the mean area percentage change of vitiligo lesions on the right and left sides, respectively. In group II the change was +9.84 and +9.13% on the right and left sides, respectively. In conclusion, combining fractional CO 2 laser with NB-UVB for the treatment of non-segmental vitiligo did not show any significant advantage over treatment with NB-UVB alone. Further study of this combination for longer durations in the treatment of vitiligo is recommended.

[The long-term results of the application of the combined rehabilitative treatment in the patients presenting with knee osteoarthrosis].

Science.gov (United States)

Razumov, A N; Purigа, A O; Yurova, O V

2015-01-01

The rehabilitative treatment of the patients suffering from knee osteoarthrosis (OA) up-to-date remains one of the most important medical and social problems of modern medicine due to the high prevalence of this disease, heavy morbidity, and the significant deterioration of the quality of the patients' life. The objective of the present study was to evaluate the long-term results of the combined application of radon and extracorporeal shock-wave therapy for the rehabilitation of the patients presenting with knee OA. The study involved 75 patients at the age from 35 to 62 years with the confirmed diagnosis of stage II and III knee osteoarthrosis. They were divided into 3 groups. Those comprising the main group received extracorporeal shock-wave therapy in combination with the treatment based on the use of radon baths. The patients included in the group of comparison were given a course of radon therapy alone while the patients of the control group received the standard treatment including physiotherapy, magnetic therapy, and the use of non-steroidal anti-inflammatory drugs (NSAIDs). The study has demonstrated the high effectiveness of the combined application of the radon baths and extracorporeal shock-wave therapy that was manifested as the substantial decrease of pain intensity, the increased range of motion in the knee joints, and the improvement of the general quality of life. These beneficial effects persisted during a period of up to 12 months. The stable remission was documented in 82% of the patients comprising the main group. The data obtained give reason to recommend the method employed in the present study for the extensive practical application at different stages of medical rehabilitation of the patients presenting with knee osteoarthrosis.

Experience on treatment of acute head injury combined with optic nerve damage

International Nuclear Information System (INIS)

Gao Heng; Feng Dongxia; Ma Yuanpin; Chen Jinqing

2000-01-01

Objective: To investigate the therapeutic principle for the management of acute head injury combined with optic nerve damage. Method: the clinical data of treatment and prognosis from 24 patients, in which 15 received operative and 9 conservative measures were collected and analyzed. Results: In 15 operated cases, the vision of 10 cases including one with blindness before operation was improved obviously, while those of other 5 did not get any improvement. In 9 conservatively treated cases, the vision was improved in 4 cases, deteriorated in 4 case and no change in 1 case with blindness after injury. Conclusion: One the optic nerve damage has been manifested by clinical or radiological evidences in acute head injury patients, despite it was primary or secondary reason, surgical optic nerve bone canal decompression should be done as soon as possible

Experience in the Use of Psychocorrection Therapy in the Comprehensive Treatment of Patients with Gastroesophageal Reflux Disease Combined with Dysfunction of the Biliary System

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L.V. Demeshkina

2016-09-01

Full Text Available Nowadays, due to the rapid increase in the number of stress factors, it is especially important to use psychotherapy and psychopharmacotherapy in the combination treatment of patients with diseases of the gastrointestinal tract. Psychogenic overlaying plays a leading role in the clinical picture of the disease and determines the decreased performance in patients. Objective. To evaluate the effectiveness of therapy with psychocorrective agents in patients with gastroesophageal reflux disease (GERD associated with dysfunction of the biliary system, if they have depressive and anxiety symptoms. Materials and methods. All patients were divided into 2 groups: group I consisted of 27 patients, who received only basic combination treatment, group II — of 25 patients, who in addition to the basic treatment received thioridazine, which is a piperidine derivative of phenothiazine and belongs to the group of neuroleptics. Both groups were representative by the age, duration and course of the disease. All patients demonstrate anxiety and depressive symptoms on the HADS scale. Questionnaire SF‑36 was used to analyze the quality of life. Treatment efficacy was assessed 14 days after. Results. As a result of the treatment, an improvement in overall well-being was observed in both groups against the background of reduction in the pain and dyspeptic syndromes. Additional prescription of psychocorrectives (thioridazine to the basic therapy results in greater positive changes in the intensity of anxiety and depressive symptoms. The distribution of patients by the level of anxiety and depression after treatment showed that these indicators were absent more often in group II (by 2.6 and 1.5 times, respectively. However, cases of clinically significant anxiety and depression were 4.6 and 3.7 times more often in patients, who did not receive thioridazine. The difference in points between the level of anxiety and depression before and after the treatment was 4

A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia

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Pridgen WL

2017-02-01

Full Text Available William L Pridgen,1 Carol Duffy,2 Judy F Gendreau,3 R Michael Gendreau3 1Innovative Med Concepts, LLC, 2Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, 3Gendreau Consulting, LLC, Poway, CA, USA Objective: Infections and other stressors have been implicated in the development of fibromyalgia. We hypothesized that these stressors could result in recurrent reactivations of latent herpes virus infections, which could lead to the development of fibromyalgia. This study evaluated a famciclovir + celecoxib drug combination (IMC-1, active against suspected herpes virus reactivation and infection, for the treatment of fibromyalgia.Methods: A total of 143 fibromyalgia patients were enrolled at 12 sites in a 16-week, double-blinded, placebo-controlled proof-of-concept trial. Randomized patients received either IMC-1 or placebo in a 1:1 ratio. Outcome measures included a 24-hour recall pain Numerical Rating Scale, the Revised Fibromyalgia Impact Questionnaire (FIQ-R, the Patient’s Global Impression of Change (PGIC questionnaire, the Multidimensional Fatigue Inventory, the NIH Patient-Reported Outcomes Measurement Information System (PROMIS, and the Beck Depression Inventory-II conducted at baseline and weeks 6, 12, and 16 of the study.Results: A significant decrease in fibromyalgia-related pain was observed for patients on IMC-1 treatment versus placebo. PGIC response rates were significantly improved with IMC-1 treatment. Overall, patient self-reported functioning, as measured by the FIQ-R, was significantly improved. Fatigue was also significantly improved as measured by the PROMIS fatigue inventory. The safety profile was encouraging. Despite the celecoxib component of IMC-1, gastrointestinal and nervous system treatment emergent adverse events were reported less frequently in the IMC-1 group, and study completion rates favored IMC-1 treatment.Conclusion: IMC-1 was efficacious and safe in treating symptoms of fibromyalgia

Current concepts in combination therapy for the treatment of hypertension: combined calcium channel blockers and RAAS inhibitors

Directory of Open Access Journals (Sweden)

Alberto F Rubio-Guerra

2009-11-01

Full Text Available Alberto F Rubio-Guerra1, David Castro-Serna2, Cesar I Elizalde Barrera2, Luz M Ramos-Brizuela21Metabolic and Research Clinic, 2Internal Medicine Department, Hospital General de Ticomán SS DF, MéxicoAbstract: Recent guidelines for the management of hypertension recommend target blood pressures <140/90 mmHg in hypertensive patients, or <130/80 mmHg in subjects with diabetes, chronic kidney disease, or coronary artery disease. Despite the availability and efficacy of antihypertensive drugs, most hypertensive patients do not reach the recommended treatment targets with monotherapy, making combination therapy necessary to achieve the therapeutic goal. Combination therapy with 2 or more agents is the most effective method for achieving strict blood pressure goals. Fixed-dose combination simplifies treatment, reduces costs, and improves adherence. There are many drug choices for combination therapy, but few data are available about the efficacy and safety of some specific combinations. Combination therapy of calcium antagonists and inhibitors of the renin-angiotensin-aldosterone system (RAAS are efficacious and safe, and have been considered rational by both the JNC 7 and the 2007 European Society of Hypertension – European Society of Cardiology guidelines for the management of arterial hypertension. The aim of this review is to discuss some relevant issues about the use of combinations with calcium channel blockers and RAAS inhibitors in the treatment of hypertension.Keywords: hypertension, calcium channel blockers, renin-angiotensin-aldosterone system inhibitors, fixed-dose combination, adherence

Clinicopathological studies on preoperative three combined treatments with hyperthermo-chemo-radiotherapy for rectal cancer

Energy Technology Data Exchange (ETDEWEB)

Yoshioka, Yuji [Kyoto Prefectural Univ. of Medicine (Japan)

1995-08-01

To prevent local recurrence of rectal cancer postoperatively, we treated patients using preoperative hyperthermia (5-6 times), irradiation (total 30 Gy) and a 5-Fluorouracil suppository (2000-2500 mg). The subjects were 31 patients given combined preoperative treatments and 28 patients given surgery alone. The results were as follows: Histologically, therapeutic effects were recognized in 80.6% of the combined treatments group. The mean distance from the adventitia to the site of cancer infiltration was 6.44 mm in the combined treatments group and 3.35 mm in the surgery alone group. The difference between the two was significant (p<0.05). The combined treatments produced a reduced tumor infiltration into the anal side, and resulted in making a safe margin for anastomosis. The rate of local recurrence in the combined treatments group was less than that of the surgery alone group. No systematic side effects or severe complications were observed during hospitalization in the combined treatments group. The survival rate of the combined treatments group was higher than that of the surgery alone group. It was considered that combined preoperative treatments for rectal cancer is beneficial to expand indications of super low anterior resection. (author).

Clinicopathological studies on preoperative three combined treatments with hyperthermo-chemo-radiotherapy for rectal cancer

International Nuclear Information System (INIS)

Yoshioka, Yuji

1995-01-01

To prevent local recurrence of rectal cancer postoperatively, we treated patients using preoperative hyperthermia (5-6 times), irradiation (total 30 Gy) and a 5-Fluorouracil suppository (2000-2500 mg). The subjects were 31 patients given combined preoperative treatments and 28 patients given surgery alone. The results were as follows: Histologically, therapeutic effects were recognized in 80.6% of the combined treatments group. The mean distance from the adventitia to the site of cancer infiltration was 6.44 mm in the combined treatments group and 3.35 mm in the surgery alone group. The difference between the two was significant (p<0.05). The combined treatments produced a reduced tumor infiltration into the anal side, and resulted in making a safe margin for anastomosis. The rate of local recurrence in the combined treatments group was less than that of the surgery alone group. No systematic side effects or severe complications were observed during hospitalization in the combined treatments group. The survival rate of the combined treatments group was higher than that of the surgery alone group. It was considered that combined preoperative treatments for rectal cancer is beneficial to expand indications of super low anterior resection. (author)

Adaptive Jamming Suppression in Coherent FFH System Using Weighted Equal Gain Combining Receiver over Fading Channels with Imperfect CSI

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Yishan He

2015-01-01

Full Text Available Fast frequency hopping (FFH is commonly used as an antijamming communication method. In this paper, we propose efficient adaptive jamming suppression schemes for binary phase shift keying (BPSK based coherent FFH system, namely, weighted equal gain combining (W-EGC with the optimum and suboptimum weighting coefficient. We analyze the bit error ratio (BER of EGC and W-EGC receivers with partial band noise jamming (PBNJ, frequency selective Rayleigh fading, and channel estimation errors. Particularly, closed-form BER expressions are presented with diversity order two. Our analysis is verified by simulations. It is shown that W-EGC receivers significantly outperform EGC. As compared to the maximum likelihood (ML receiver in conventional noncoherent frequency shift keying (FSK based FFH, coherent FFH/BPSK W-EGC receivers also show significant advantages in terms of BER. Moreover, W-EGC receivers greatly reduce the hostile jammers’ jamming efficiency.

Psychotropic medication in a randomly selected group of citizens receiving residential or home care

DEFF Research Database (Denmark)

Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

2014-01-01

INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...

A flexible WLAN receiver

NARCIS (Netherlands)

Schiphorst, Roelof; Hoeksema, F.W.; Slump, Cornelis H.

2003-01-01

Flexible radio receivers are also called Software Defined Radios (SDRs) [1], [2]. The focus of our SDR project [3] is on designing the front end, from antenna to demodulation in bits, of a °exible, multi-standard WLAN receiver. We try to combine an instance of a (G)FSK receiver (Bluetooth) with an

Effects of Combining Medication and Pivotal Response Treatment on Aberrant Behavior in Children with Autism Spectrum Disorder

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Mohammad Rezaei

2018-01-01

Full Text Available Abstract: The purpose of this study was to investigate the effects of combined risperidone (RIS and pivotal response treatment (PRT on children with autism spectrum disorder (ASD. A total of 34 children diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V (mean age of 12.36 years were randomly assigned to either of two groups; the first group (n = 17 received combined PRT–RIS while the second group (n = 17 received RIS only. Behavioral problems were evaluated with the Aberrant Behavior Checklist (ABC, whereas global improvement (GI was measured with the Clinical Global Impressions (CGI. Assessment of ABC was performed before intervention, after intervention (12 weeks, and following 3 months of the intervention (follow-up. Total ABC scores were seen to decrease in both groups after 3 months, as compared with the scores prior to the interventions. Also, in both groups, mean scores of behavioral problems after the intervention were not significantly different from those prior to the intervention, in all subscales but the inappropriate speech (p < 0.001. However, both groups showed significant differences in mean scores of ABC subscales in both of the post-intervention evaluation stages. It was concluded that the combination of behavioral and drug interventions can further improve behavioral problems, ultimately improving patient’s communication and social skills.

Vincristine, cisplatin, teniposide, and cyclophosphamide combination in the treatment of recurrent or metastatic adrenocortical cancer.

Science.gov (United States)

Khan, Tanweera S; Sundin, Anders; Juhlin, Claes; Wilander, Erik; Oberg, Kjell; Eriksson, Barbro

2004-01-01

The efficacy and tolerability of a combination of vincristine, cisplatin, teniposide, and cyclophosphamide (OPEC) in 11 patients (median age, 45 yr) with recurrent and/or metastatic adrenocortical cancer (ACC) (seven functional and four nonfunctional) were evaluated. All patients received this regimen after the failure of streptozocin and o,p'-DDD (SO) combination therapy. The regimen comprised cyclophosphamide, 600 mg/m2, and vincristine, 1.5 mg/m2, maximum dose 2.0 mg (d 1); cisplatin, 100 mg/m2 (d 2) and teniposide, 150 mg/m2 (d 4). Cycles were repeated every 4 wk. One to eight cycles (median, six cycles) of OPEC were administered to each patient. The median duration of treatment was 6 mo. The overall 2-yr survival rate was 82% and the median survival since diagnosis was 44 mo while it was 21 mo since start of OPEC therapy. Responses were obtained in nine patients: partial response in two patients, and stable disease in seven patients. The median duration of response was 6.75 mo. A total of 60 cycles of chemotherapy were given to all patients; grade 1-2 toxicity occurred in 57 cycles, while grade 3 toxicity was observed only in two cycles, according to NCI's Common Toxicity Criteria. We conclude that the OPEC regimen may be considered in recurrent or metastatic ACC as a second-line medical treatment. However, the combination is accompanied by considerable side effects and dose modifications are necessary in order to be able to recommend the treatment. This regimen needs further evaluation compared with SO therapy preferably in a randomized multicenter trial.

Malignant peritoneal pseudomyxona: Combined treatment

International Nuclear Information System (INIS)

Martin, A.; Alvarado, E.; Marcos, A.; Palacios, E.; Gomez, A.

1993-01-01

We describe a special treatment for the malignant peritoneal pseudomyxoma as suggested by Sugarbaker. Shortly, it is a combination of surgical cytoreduction with a curative aim, completed with inmediate postoperative intraperitoneal chemotherapy. Having in mind the lack of metastasic danger of these tumours, as well as its lack of infiltrative character, by this surgical technique which consists in five different ''peritonectomies'', one may be able to free the patient of macroscopic tumour. The additional intraperitoneal chemotherapy might contribute to increase the survival of these patients and, perhaps, even to cure them. (Author) 12 refs

Radial shock wave treatment alone is less efficient than radial shock wave treatment combined with tissue-specific plantar fascia-stretching in patients with chronic plantar heel pain.

Science.gov (United States)

Rompe, Jan D; Furia, John; Cacchio, Angelo; Schmitz, Christoph; Maffulli, Nicola

2015-12-01

Whether shock wave therapy or shock wave therapy combined with plantar fascia-specific stretching is more efficient in treating chronic plantar heel pain remains unclear. The aim of the study was to test the null hypothesis of no difference of these two forms of management for patients who had unilateral plantar fasciopathy for a minimum duration of twelve months and which had failed at least three other forms of treatment. One hundred and fifty-two patients with chronic plantar fasciopathy were assigned to receive repetitive low-energy radial shock-wave therapy without local anesthesia, administered weekly for three weeks (Group 1, n = 73) or to receive the identical shock wave treatment and to perform an eight-week plantar fascia-specific stretching program (Group 2, n = 79). All patients completed the nine-item pain subscale of the validated Foot Function Index and a subject-relevant outcome questionnaire. Patients were evaluated at baseline, and at two, four, and twenty-four months after baseline. The primary outcome measures were a mean change in the Foot Function Index sum score at two months after baseline, a mean change in item 2 (pain during the first steps of walking in the morning) on this Index, and satisfaction with treatment. No difference in mean age, sex, weight or duration of symptoms was found between the groups at baseline. At two months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients managed with shock-wave therapy plus plantar fascia-specific stretching than those managed with shock-wave therapy alone (p plantar fascia in combination with repetitive low-energy radial shock-wave therapy is more efficient than repetitive low-energy radial shock-wave therapy alone for the treatment of chronic symptoms of proximal plantar fasciopathy. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Model evaluation of faecal contamination in coastal areas affected by urban rivers receiving combined sewer overflows.

Science.gov (United States)

Shibata, T; Kojima, K; Lee, S A; Furumai, H

2014-01-01

Odaiba seaside park is one of the most popular waterfronts in Tokyo Bay, but is easily affected by wet weather pollutant loads through combined sewer overflows (CSOs). The monitoring data of Escherichia coli clearly showed high faecal contamination after a rainfall event on 9-11 November 2007. We estimated the amounts of discharge volume and E. coli pollutant loads of urban rivers receiving CSO from rainfall chambers as well as pumping stations and primary effluent discharge. The result suggested that Sumida River and Meguro River were more influential to the Odaiba coastal area than other sources including the nearest wastewater treatment plant. Subsequently, we simulated the dynamic behaviour of E. coli by a three-dimensional (3D) hydro-dynamic and water quality model. The model simulation reproduced that E. coli concentration after the rainfall event increased rapidly at first and later gradually decreased. The simulations with and without inflow pollutant loads from urban rivers suggested that the E. coli concentration can be influenced by the Meguro River just after the rainfall event and Sumida River about 1 week later. From the spatial and temporal distribution of surface E. coli concentration, after at least 6 days from the rainfall event, high faecal contamination spread to the whole of the coastal area.

Preventive treatment of combined radiation injuries

International Nuclear Information System (INIS)

Boudagov, R.; Uljanova, L.; Makarov, G.

1996-01-01

The risk of sepsis development increases when thermal burns and other trauma occur in combination with exposure to radiation. Only surgical correction of the life-threatening state recommends within 48 hours after irradiation. All other arrangements have to carry out when hemopoiesis recovery will complete. However exposed patients with combined injuries (CI) die during the first two or three weeks mainly due to sepsis. Therefore prophylaxis and preventive therapy of infectious complications are need early. Actual difficulties in choice of valid treatment procedure for acute radiation syndrome (ARS) exhibit additional aggravation under CI. The available facts prove decreasing early therapy efficiency for rather high dose exposure and wound trauma occurrence. The own results showed that bacterial polysaccharide pyrogenal, glycopin (synthetic analogue of muramil-dipeptide), thymus preparations (thymozin, thymotropin, thymogen), tuftsin, heterologic human and bovine immunoglobulins did not modify the low values of 30-day survival under CI (irradiation + thermal burn). Single injection of prodigiozan, zymozan and some other yeast polysaccharides in 1 hr after CI resulted at moderate increasing of survival. The main purpose of this study, which bases upon our understanding of CI pathogenesis, was search more effective means for preventive treatment of combined radiation injuries. Two groups of remedies were under study. The first group included so called 'biological response modifiers' (BRM). These agents may increase host defences to infection, macrophage's activity and hemopoietic growth factor's secretion. The second group included antibiotics that should be directed against the potential gram-negative as well as gram-positive pathogens and simultaneously be useful for selective decontamination of gastrointestinal tract. (author)

Indications for and results of combined modality treatment of colorectal cancer

International Nuclear Information System (INIS)

Gunderson, L.L.

1999-01-01

Combined modality chemoirradiation is commonly used as a component of treatment in combination with maximum resection for both high-risk resectable and locally advanced primary or recurrent rectal cancers. With surgically resected but high-risk rectal cancers, postoperative chemoirradiation has been shown to improve both disease control (local and distant) and survival (disease-free and overall) and was recommended as standard adjuvant treatment at the 1990 National Institute of Health (NIH) Consensus Conference on Adjuvant treatment for patients with rectal and colon cancers. Subsequent intergroup trials are being conducted to help define optimal combinations of postoperative chemoirradiation for resected high-risk rectal cancers and to test sequencing issues of preoperative versus postoperative chemoirradiation. With locally unresectable primary or recurrent colorectal cancers, standard therapy with surgery, external beam irradiation (EBRT) and chemotherapy is often unsuccessful. When intraoperative electron irradiation (IOERT) is combined with standard treatment, local control and survival appear to be improved in separate analyses from the Mayo Clinic and the Massachusetts General Hospital (MGH). However, routine use of systemic therapy is also needed as a component of treatment, in view of high rates of systemic failure. (orig.)

Indications for and results of combined modality treatment of colorectal cancer

Energy Technology Data Exchange (ETDEWEB)

Gunderson, L.L. [Mayo Medical School and Mayo Clinic, Rochester, MN (United States)

1999-05-01

Combined modality chemoirradiation is commonly used as a component of treatment in combination with maximum resection for both high-risk resectable and locally advanced primary or recurrent rectal cancers. With surgically resected but high-risk rectal cancers, postoperative chemoirradiation has been shown to improve both disease control (local and distant) and survival (disease-free and overall) and was recommended as standard adjuvant treatment at the 1990 National Institute of Health (NIH) Consensus Conference on Adjuvant treatment for patients with rectal and colon cancers. Subsequent intergroup trials are being conducted to help define optimal combinations of postoperative chemoirradiation for resected high-risk rectal cancers and to test sequencing issues of preoperative versus postoperative chemoirradiation. With locally unresectable primary or recurrent colorectal cancers, standard therapy with surgery, external beam irradiation (EBRT) and chemotherapy is often unsuccessful. When intraoperative electron irradiation (IOERT) is combined with standard treatment, local control and survival appear to be improved in separate analyses from the Mayo Clinic and the Massachusetts General Hospital (MGH). However, routine use of systemic therapy is also needed as a component of treatment, in view of high rates of systemic failure. (orig.)

Plasma metabolic changes in Chinese HIV-infected patients receiving lopinavir/ritonavir based treatment: Implications for HIV precision therapy.

Science.gov (United States)

Li, Xiaolin; Wu, Tong; Jiang, Yongjun; Zhang, Zining; Han, Xiaoxu; Geng, Wenqing; Ding, Haibo; Kang, Jing; Wang, Qi; Shang, Hong

2018-05-16

The goal of this study is to profile the metabolic changes in the plasma of HIV patients receiving lopinavir/ritonavir (LPV/r)-based highly active antiretroviral therapy (HAART) relative to their treatment-naïve phase, aimed to identify precision therapy for HIV for improving prognosis and predicting dyslipidemia caused by LPV/r. 38 longitudinal plasma samples were collected from 19 HIV-infected patients both before and after antiretroviral therapy, and 18 samples from healthy individuals were used as controls. Untargeted metabolomics profiling of these plasma samples was performed using liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS). A total of 331 compounds of known identity were detected among these metabolites, a 67-metabolite signature mainly mapping to tryptophan, histidine, acyl carnitine, ketone bodies and fatty acid metabolism distinguished HIV patients from healthy controls. The levels of 19 out of the 67 altered metabolites including histidine, kynurenine, and 3-hydroxybutyrate (BHBA), recovered after LPV/r-based antiretroviral therapy, and histidine was positively correlated with the presence of CD4 + T lymphocytes. Furthermore, using receiver operating characteristic (ROC) analyses, we discovered that butyrylcarnitine in combination with myristic acid from plasma in treatment-naïve patients could predict dyslipidemia caused by LPV/r with 87% accuracy. Metabolites alterations in treatment-naïve HIV patients may indicate an inflammatory, oxidative state and mitochondrial dysfunction that is permissive for disease progression. Histidine may provide a specific protective function for HIV patients. Besides, elevated fatty acids levels including butyrylcarnitine and myristic acid after infection may indicate patients at risk of suffering from dyslipidemia after LPV/r-based HAART. Copyright © 2018 Elsevier Ltd. All rights reserved.

The role of combination medical therapy in the treatment of acromegaly.

Science.gov (United States)

Lim, Dawn Shao Ting; Fleseriu, Maria

2017-02-01

Uncontrolled acromegaly results in approximately 2-fold excess mortality. Pituitary surgery is first-line therapy, and medical treatment is indicated for persistent disease. While cabergoline and pegvisomant are used in select patients, somatostatin receptor ligands (SRLs) remain the cornerstone of medical treatment. Management of patients poorly responsive to SRLs is therefore, challenging. The purpose of this review is to highlight the options for combination medical therapy in the treatment of acromegaly, with an emphasis on efficacy and safety. All original articles/abstracts detailing combination medical therapy in acromegaly were identified from a PubMed search. Studies reviewed included retrospective and open-label prospective studies. While the combination of SRL and cabergoline was generally well tolerated, a lower baseline insulin-like growth factor-1 (IGF-1) level was the best predictor of efficacy; this combination may be most effective in patients with mildly elevated IGF-1. SRL-pegvisomant combination normalized IGF-1 in the majority of patients; continued efficacy despite individual drug dosing reduction was also reported. The risk of significant liver enzyme elevation was, however, higher than that reported with SRL monotherapy; close monitoring is recommended. Data on pegvisomant-cabergoline combination is limited, but this may be an option in the setting of SRL intolerance. Reports on temozolomide used in combination with other medical therapies in patients with aggressive GH-secreting tumors are also summarized. While more prospective, randomized controlled trials on long-term efficacy and safety are needed, combination medical therapy remains a treatment strategy that should be considered for acromegaly patients poorly responsive to SRLs.

Combined effects of myofeedback and isokinetic training on hand ...

African Journals Online (AJOL)

Combined effects of myofeedback and isokinetic training on hand function in spastic hemiplegic children. ... Both groups received a designed physical therapy program with isokinetic training for the triceps brachii muscle for 60 min, in addition group B received myofeedback training. Results: The post treatment results ...

Combination treatment with excimer laser and narrowband UVB light in vitiligo patients.

Science.gov (United States)

Shin, Sungsik; Hann, Seung-Kyung; Oh, Sang Ho

2016-01-01

For the treatment of vitiligo, narrowband UVB (NBUVB) light is considered the most effective for nonsegmental vitiligo, while excimer laser treatment is commonly used for localized vitiligo. However, treatment areas may potentially be missed with excimer laser treatment. We aimed to evaluate the effect of combinational treatment with NBUVB light and excimer laser on vitiligo. All patients were first treated with NBUVB; excimer laser was then applied in conjunction with NBUVB phototherapy due to a slow response or no further improvement with continuous NBUVB treatment alone. To minimize adverse effects, a fixed dose of NBUVB was administered, and the dose of excimer laser was increased based on patient response. Among 80 patients, 54 patients showed responses after combination with excimer laser; however, 26 patients (32.5%) showed no remarkable change after combination therapy. Of the 26 patients who showed no further response, 12 patients (46.1%) presented with vitiligo on the acral areas, which are known to the least responsive sites. Our study suggests that combined treatment of NBUVB and excimer laser in vitiligo may enhance the treatment response without remarkable side effects, therefore might also increase the compliance of the patients to the treatment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of mortality rate and predictors of outcome in dogs receiving outpatient treatment for parvoviral enteritis.

Science.gov (United States)

Sarpong, Kathryn J; Lukowski, Jennifer M; Knapp, Cassandra G

2017-11-01

OBJECTIVE To determine mortality rates and prognostic factors for dogs with parvoviral enteritis receiving outpatient treatment. DESIGN Retrospective case series and case-control study. ANIMALS 130 client-owned dogs with a diagnosis of parvoviral enteritis between August 1, 2012, and January 31, 2015, that were treated with outpatient care. PROCEDURES Medical records were reviewed and data extracted regarding dog age, body weight, breed, and vaccination history; treatments administered; and short-term (≥ 3 day) outcome (determined via telephone call with owner). Treatments were administered according to clinician preference. Mortality rates were calculated overall and for various signalment and treatment groupings and compared. RESULTS 97 (75%) dogs survived and 33 (25%) dogs failed to survive for ≥ 3 days after initial diagnosis of parvoviral enteritis. Compared with distributions in the general hospital population, Chihuahuas, German Shepherd Dogs, pit bull-type dogs, and males were overrepresented. No significant difference was identified between survivors and nonsurvivors regarding age, body weight, or sex. Dogs prescribed a caloric supplement fed every 2 to 4 hours had a mortality rate of 19% (16/85). Most of these dogs had also received fluids administered SC, an antiemetic, and antimicrobials. CONCLUSIONS AND CLINICAL RELEVANCE Clinicians should note the 25% mortality rate of the dogs with parvoviral enteritis that received outpatient care in this study setting when discussing treatment options with owners of affected dogs who are financially unable to pursue hospitalization.

Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

DEFF Research Database (Denmark)

Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

2016-01-01

generated by a mathematical model of the competitive growth of multiple strains of Escherichia coli.Results: Simulation studies showed that sequential use of tetracycline and ampicillin reduced the level of double resistance, when compared to the combination treatment. The effect of the cycling frequency...... frequency did not play a role in suppressing the growth of resistant strains, but the specific order of the two antimicrobials did. Predictions made from the study could be used to redesign multidrug treatment strategies not only for intramuscular treatment in pigs, but also for other dosing routes.......Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...

Efficiency of a Combination of Pharmacological Treatment and Nondrug Interventions in Childhood Narcolepsy.

Science.gov (United States)

Kacar Bayram, Ayşe; Per, Hüseyin; Ismailoğullari, Sevda; Canpolat, Mehmet; Gumus, Hakan; Aksu, Murat

2016-12-01

Objective  Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic and/or hypnopompic hallucinations, and sleep paralysis. It is one of the most important causes of excessive daytime sleepiness in the pediatric population. The aim of this study is to present the clinical and laboratory findings, and treatment results of pediatric patients with narcolepsy. Materials and Methods  We studied five unrelated consecutive children with narcolepsy, focusing on clinical and laboratory features, the therapy and outcome over the 33-month follow-up period. Results  The study subjects included two boys and three girls. The mean age at diagnosis was 11.8 ± 3.3 years (range: 8-16 years). Three patients had cataplexy. There were no hypnagogic hallucinations and/or sleep paralysis in any patients. All patients were educated about sleep hygiene, appropriate nutrition, and regular exercise. Three patients were treated with modafinil, while two patients received methylphenidate. Sodium oxybate was added to existing treatment in patients with cataplexy. Cataplexy attacks did not respond well to the treatment in one patient; therefore intravenous immunoglobulin therapy was given. Conclusions  Early diagnosis is important to help narcoleptic patients in improving their quality of life. A combination of pharmacological treatment and nondrug interventions can greatly improve children's clinical symptoms. Georg Thieme Verlag KG Stuttgart · New York.

The role of antimicrobial drops Okomistin® in combined chronic blepharoconjunctivitis treatment

Directory of Open Access Journals (Sweden)

Igor Anatilevich Makarov

2015-12-01

Full Text Available Purpose. The evaluation of antimicrobial drops Okomistin® efficacy in combined treatment of chronic blepharoconjunctivitis. Material and methods. 80 patients (160 eyes with chronic blepharoconjunctivitis were monitored. Demodex acne was found in eyelids of 72 eyes, the growth of saprophytic microflora in 28 cases. The complex of treatment and prevention measures consisted of daily compresses of Сalendula aqueous solution, instillations of Okomistin® eye drops, artificial tears. In the research group, the ultrasound eyelid margin micromassage was performed, and eyelid D’Arsonval therapy in demodex acne cases. Results. More rapid acute illness relief was observed in the eyes of patients in whom physiotherapy treatment was performed. Okomistin® instillations allow achieving sterile conjunctival culture in 3-5 days. Combined therapy helps to restore meibomian gland function, to achieve long-term disease remission. Conclusions. Combined use of the Okomistin®, physiotherapy, hygiene procedures, artificial tears is an effective and safe treatment method for chronic blepharoconjunctivitis combined treatment.

Evaluation of the efficacy and safety of lanreotide in combination with targeted therapies in patients with neuroendocrine tumours in clinical practice: a retrospective cross-sectional analysis

International Nuclear Information System (INIS)

Capdevila, Jaume; Sevilla, Isabel; Alonso, Vicente; Antón Aparicio, Luís; Jiménez Fonseca, Paula; Grande, Enrique; Reina, Juan José; Manzano, José Luís; Alonso Lájara, Juan Domingo; Barriuso, Jorge; Castellano, Daniel; Medina, Javier; López, Carlos; Segura, Ángel; Carrera, Sergio; Crespo, Guillermo; Fuster, José; Munarriz, Javier; García Alfonso, Pilar

2015-01-01

Based on the mechanism of action, combining somatostatin analogues (SSAs) with mTOR inhibitors or antiangiogenic agents may provide synergistic effects for the treatment of patients with neuroendocrine tumours (NETs). Herein, we investigate the use of these treatment combinations in clinical practice. This retrospective cross-sectional analysis of patients with NETs treated with the SSA lanreotide and targeted therapies at 35 Spanish hospitals evaluated the efficacy and safety of lanreotide treatment combinations in clinical practice. The data of 159 treatment combinations with lanreotide in 133 patients was retrospectively collected. Of the 133 patients, with a median age of 59.4 (16–83) years, 70 (52.6 %) patients were male, 64 (48.1 %) had pancreatic NET, 23 (17.3 %) had ECOG PS ≥2, 41 (30.8 %) had functioning tumours, 63 (47.7 %) underwent surgery of the primary tumour, 45 (33.8 %) had received prior chemotherapy, and 115 (86.5 %) had received prior SSAs. 115 patients received 1 lanreotide treatment combination and 18 patients received between 2 and 5 combinations. Lanreotide was mainly administered in combination with everolimus (73 combinations) or sunitinib (61 combinations). The probability of being progression-free was 78.5 % (6 months), 68.6 % (12 months) and 57.0 % (18 months) for patients who only received everolimus plus lanreotide (n = 57) and 89.3 % (6 months), 73.0 % (12 months), and 67.4 % (18 months) for patients who only received sunitinib and lanreotide (n = 50). In patients who only received everolimus plus lanreotide the median time-to-progression from the initiation of lanreotide combination treatment was 25.8 months (95 % CI, 11.3, 40.3) and it had not yet been reached among the subgroup of patients only receiving sunitinib plus lanreotide. The safety profile of the combination treatment was comparable to that of the targeted agent alone. The combination of lanreotide and targeted therapies, mainly everolimus and sunitinib, is widely

[Clinical effect of triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori infection in children].

Science.gov (United States)

Zhao, Hong-Mei; Ou-Yang, Hong-Juan; Duan, Bo-Ping; Xu, Bin; Chen, Zhi-Yong; Tang, Juan; You, Jie-Yu

2014-03-01

To evaluate the clinical effect of proton pump inhibitor-based triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori (Hp) infection among children in terms of Hp eradication rate and incidence of adverse events. A prospective randomised controlled study was conducted on 240 children with a confirmed diagnosis of Hp infection. These patients were randomized into triple therapy (n=120) and probiotics groups (n=120). The triple therapy group received amoxicillin [40 mg/(kg·d), Tid], clarithromycin [15 mg/(kg·d), Bid] and omeprazole [0.7-0.8 mg/(kg·d), Qd], while the probiotics group received Saccharomyces boulardii (250 mg, Bid) in addition to triple therapy. The course of treatment was 14 days in both groups. The adverse events in subjects were recorded by their parents during treatment. Hp eradiation was evaluated by (13)C breath test at 4 weeks after treatment, and the eradication rate and incidence of adverse events were compared between the two groups. The Hp eradication rates were 75.8% (91/120) in the triple therapy group and 85% (102/120) in the probiotics group (P>0.05). Compared with the triple therapy group, the probiotics group had nonsignificantly lower incidence of nausea, vomiting, and abdominal pain (P>0.05) and significantly lower incidence of stomatitis, constipation and diarrhea (PSaccharomyces boulardii cannot significantly increase Hp eradication rate, but can significantly reduce the incidence of stomatitis, constipation, and diarrhea during treatment.

Social networks and their influence on drinking behaviors: differences related to cognitive impairment in clients receiving alcoholism treatment.

Science.gov (United States)

Buckman, Jennifer F; Bates, Marsha E; Cisler, Ron A

2007-09-01

Mechanisms of behavioral change that support positive addiction treatment outcomes in individuals with co-occurring alcohol-use disorders and cognitive impairment remain largely unknown. This article combines person- and variable-centered approaches to examine the interrelated influence of cognitive impairment and social support on stability of and changes in drinking behaviors of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) outpatients and aftercare clients (N = 1,726) during the first year after their entry into treatment. Latent class analysis identified homogeneous groups of clients based on the nature and extent of social support for abstinence or drinking at treatment entry. Cognitive impairment and drinking outcomes were compared across latent classes, and the interaction between impairment and social support on drinking outcomes was examined using mixture probit regression. Three independent social support classes (frequent positive, limited positive, and negative) were identified. In the outpatient sample, the frequent positive support class had greater cognitive impairment at treatment entry versus other classes, and extent of impairment significantly predicted improved drinking outcomes in this class. In the aftercare sample, the frequent positive and negative support classes had heightened impairment, yet cognitive impairment significantly predicted relatively poorer drinking outcomes in the negative support class only. Cognitive impairment may increase the influence of the social network on the drinking outcomes of persons receiving treatment for alcohol-use disorders, but more research is needed to understand client characteristics that determine whether this influence is more likely to be manifest as increased salience of helping agents or of hindering agents in the social network.

Evaluation on the Clinical Efficacy of Dendritic Cell-Activated Cytokine-Induced Killer Cells Combined with Conventional Therapy in the Treatment of Malignant Tumors

Directory of Open Access Journals (Sweden)

Hong WEI

2016-06-01

Full Text Available Objective: To evaluate the clinical efficacy of dendritic cell-activated cytokine-induced killer (DC-CIK cells combined with conventional therapy in the treatment of malignant tumors.Methods: A total of 100 patients with malignant tumors were randomly divided into two groups. Treatment group received conventional therapy combined with DC-CIK while control group received conventional therapy alone. The short-term efficacy, adverse reactions and changes of lymphocyte subpopulation were all compared between two groups after treatment.Results: The overall response rate (ORR was higher in treatment group (86.00% than in control group (54.00%, the difference was statistically significant (P<0.05. White blood cell count (WBC reduced after treatment when compared with treatment before (P=0.001, but liver and kidney function had no obvious change in treatment group (P>0.05. WBC reduced markedly, but the level of alanine aminotransferase (ALT increased obviously after treatment in control group (P<0.001. WBC was higher, but the level of ALT was lower in treatment group than in control group (P<0.001. However, there was no difference between two groups regarding serum creatinine (Scr and blood urea nitrogen (BUN (P>0.05. In treatment group, the levels of CD3+, CD3+CD4+, CD3+CD8+, and CD3+CD56+ increased (P<0.05, but the level of CD4+/CD8+ had no significant change (P>0.05. In control group, the levels of CD3+ and CD3+CD4+ reduced (P<0.05, while the levels of CD3+CD8+, CD3+CD56+ and CD4+/CD8+ had no significant change (P>0.05. The levels of CD3+, CD3+CD4+, CD3+CD8+ and CD3+CD56+ in treatment group were higher than those in control group (P<0.01, whereas CD4+/CD8+ was lower than that in control group (P<0.01.Conclusion: DC-CIK combined with conventional therapy, safe and effective, is capable of promoting the recovery of leukocytes and liver and kidney function, and improving the cellular immune function, which may provide a new therapeutic regimen for

Sludge disinfection by combined treatment of bleaching powder and irradiation

International Nuclear Information System (INIS)

Harsoyo

1987-01-01

Sludge disinfection by combined treatment of bleaching powder and irradiation. Disinfection of sludge by combined treatment of bleaching powder and irradiation has been investigated. Sludge were obtained from water and waste sanitation department (Dinas Kebersihan) DKI located at Kebon Nanas, Jakarta. Sludge were mixed with bleaching powder at the concentration of 0, 10 and 20 mg/l and then irradiated in multipurpose panoramic batch irradiator (PANBIT) with doses of 2, 4, 6, 8, and 10 kGy and a dose rate 9 kGy/h. The reducing colony form unit caused by the combined treatment depend on type bacteria observed in sludge. Pathogenic bacteria as Clostridium still survive at a dose of 10 kGy on sludge containing 20 mg/l bleaching powder, but Salmonella, Shigella, and Vibrio were not detected in this experiment, neither in the control nor in the irradiated samples. (author). 14 refs.; 4 figs

Ivabradine in combination with beta-blocker therapy for the treatment of stable angina pectoris in every day clinical practice.

Science.gov (United States)

Koester, Ralf; Kaehler, Jan; Ebelt, Henning; Soeffker, Gerold; Werdan, Karl; Meinertz, Thomas

2010-10-01

The anti-anginal efficacy of the selective I(f) inhibitor ivabradine has been demonstrated in controlled clinical trials. However, there is limited information about the safety and efficacy of a combined treatment of ivabradine with beta-blockers, particularly outside of clinical trials in every day practice. This analysis from the REDUCTION study evaluated the safety and efficacy of a combined therapy of beta-blockers and ivabradine in every day practice. In this multi-center study 4,954 patients with stable angina pectoris were treated with ivabradine in every day routine practice and underwent a clinical follow-up for 4 months. 344 of these patients received a co-medication with beta-blockers. Heart rate (HR), angina pectoris episodes, nitrate consumption, overall efficacy and tolerance were analyzed. After 4 months of treatment with ivabradine HR was reduced by 12.4 ± 11.6 bpm from 84.3 ± 14.6 to 72.0 ± 9.9 bpm, p every day practice.

Combination of chemotherapy, radiotherapy and surgery in the treatment of oral cancer

International Nuclear Information System (INIS)

Ayyagiri, S.; Gupta, B.D.; Dutta, T.K.

1980-01-01

In locally advanced oral cancer, the main modalities of treatment, e.g. surgery and radiotherapy, most often fail to control the disease when used singly. A combination policy of surgery and radiotherapy achieves adequate control of the disease. In order to improve the results in advanced oral cancer, chemotherapy given prior to and during radiation treatment and judicious combination of surgery offer the best possible approach in the management. The experience in the combination policy in the treatment of oral cancer in Northern India is dealt with. (auth.)

Dapsone gel 5% in combination with adapalene gel 0.1%, benzoyl peroxide gel 4% or moisturizer for the treatment of acne vulgaris: a 12-week, randomized, double-blind study.

Science.gov (United States)

Fleischer, Alan B; Shalita, Alan; Eichenfield, Lawrence F; Abramovits, William; Lucky, Anne; Garrett, Steven

2010-01-01

To evaluate the safety and efficacy of dapsone gel 5% in the treatment of acne when used in combination with adapalene gel 0.1%, benzoyl peroxide gel 4% or moisturizer. This was a twelve-week, randomized, double-blind study. Patients aged 12 years and older (n=301) applied dapsone gel twice daily and were randomly assigned (1:1:1) to one of three additional treatments, applied once daily. By week 12, dapsone gel combined with any of the three additional treatments reduced the mean number of inflammatory lesions. However, the authors did not detect a significant difference in the reduction of inflammatory lesions when dapsone was used in combination with adapalene gel or with benzoyl peroxide gel compared to the dapsone plus moisturizer combination group (P=0.052 for both versus moisturizer combination). Patients treated with dapsone gel combined with adapalene showed a significantly better response in reduction in non-inflammatory and total acne lesion count than those who received the moisturizer combination. Local adverse reactions in all three treatment groups were minimal and generally mild in severity. Dapsone gel in combination with adapalene gel or benzoyl peroxide gel is safe and well tolerated for the treatment of acne vulgaris.

Oral combination therapy: repaglinide plus metformin for treatment of type 2 diabetes.

Science.gov (United States)

Raskin, P

2008-12-01

Type 2 diabetes is characterized by decreases in insulin secretion and insulin sensitivity. Several classes of oral antidiabetic medications are currently approved for the treatment of type 2 diabetes. A stepwise treatment approach from monotherapy to combination therapy is traditionally used; however, the frequency of treatment failure with monotherapy has resulted in a move towards earlier treatment with combination therapies that target the two principal defects in glycaemic control. One such combination regimen is repaglinide (a prandial glucose regulator that increases insulin release) plus metformin (an insulin sensitizer that inhibits hepatic glucose output, increases peripheral glucose uptake and utilization and minimizes weight gain). Findings from several clinical trials have shown that combination therapy with repaglinide plus metformin is well tolerated and results in greater reductions of haemoglobin A(1c) and fasting plasma glucose values compared with either monotherapy. Repaglinide may also provide a more suitable alternative to combination therapy with sulphonylureas and metformin because of its reduced propensity for hypoglycaemia. The combination regimen of repaglinide plus metformin should therefore be considered as a valuable option in the management of patients with type 2 diabetes when monotherapy is no longer adequate.

The use of a combined regimen of GnRH agonist plus a low-dose oral contraceptive improves the spontaneous pulsatile LH secretory characteristics in patients with polycycstic ovary disease after discontinuation of treatment.

Science.gov (United States)

Genazzani, A D; Battaglia, C; Gamba, O; Petraglia, F; Malavasi, B; Genazzani, A R

2000-05-01

The fertility rate in women with polycystic ovary disease (PCOD) is influenced by the type of treatment received. The present study evaluated the possible correlation between treatment and pulsatile release of gonadotropins. Spontaneous episodic secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and hormonal parameters were monitored before and after 1, 3, and 6 months after treatments suspension. Twenty-four PCOD patients were randomly divided into two groups of 12 subjects. Group A was treated with gonadotropin-releasing hormone (GnRH)-analogue plus oral contraceptive (OC). Group B was treated only with OC. Both groups were treated for 6 months and followed up for 6 months. In all subjects the therapeutic regimens reduced the androgenic milieau and the gonadotropin plasma levels. Spontaneous pulsatile secretion of LH and FSH was significantly modified in both groups, but patients who received the combined regimen showed a significantly greater reduction of LH plasma levels and a significantly greater decrease of LH pulse amplitude throughout the 6 months after treatment suspension. Ferriman-Gallway score and ovarian volumes were significantly reduced in patients who received the combined treatment than in the OC-treated patients. These data support the evidence of a higher efficacy of the combination of GnRH-a + OC than OC alone in restoring a normal and adequate spontaneous episodic gonadotropin discharge and in decreasing Ferriman-Gallway score and ovarian volumes in patients with PCOD.

Why more boys than girls with ADHD receive treatment: a study of Dutch twins

NARCIS (Netherlands)

Derks, Eske M.; Hudziak, James J.; Boomsma, Dorret I.

2007-01-01

More boys than girls with attention deficit hyperactivity disorder (ADHD) receive treatment. One explanation for this bias may be that boys score higher on disruptive behavior scales than girls. Although this was supported by findings in clinical samples, recent studies in nonreferred samples showed

Factors associated with contingency management adoption among opioid treatment providers receiving a comprehensive implementation strategy.

Science.gov (United States)

Becker, Sara J; Kelly, Lourah M; Kang, Augustine W; Escobar, Katherine I; Squires, Daniel D

2018-03-29

Contingency management (CM) is an evidence-based behavioral intervention for opioid use disorders (OUDs); however, CM adoption in OUD treatment centers remains low due to barriers at patient, provider, and organizational levels. In a recent trial, OUD treatment providers who received the Science to Service Laboratory (SSL), a multilevel implementation strategy developed by a federally funded addiction training center, had significantly greater odds of CM adoption than providers who received training as usual. This study examined whether CM adoption frequency varied as a function of provider sociodemographic characteristics (i.e., age, race/ethnicity, licensure) and perceived barriers to adoption (i.e., patient-, provider-, organization-level) among providers receiving the SSL in an opioid treatment program. Thirty-nine providers (67% female, 77% non-Hispanic white, 72% with specialty licensure, M age = 42 [SD = 11.46]) received the SSL, which consisted of didactic training, performance feedback, specialized training of internal change champions, and external coaching. Providers completed a comprehensive baseline assessment and reported on their adoption of CM biweekly for 52 weeks. Providers reported using CM an average of nine 2-week intervals (SD = 6.35). Hierarchical multiple regression found that providers identifying as younger, non-Hispanic white, and without addiction-related licensure all had higher levels of CM adoption frequency. Higher perceived patient-level barriers predicted lower levels of CM adoption frequency, whereas provider- and organization-level barriers were not significant predictors. The significant effect of age on CM adoption frequency was consistent with prior research on predictors of evidence-based practice adoption, whereas the effect of licensure was counter to prior research. The finding that CM adoption frequency was lower among racially/ethnically diverse providers was not expected and suggests that the SSL may require adaptation

Irradiation in combination of heat treatment of mango puree

International Nuclear Information System (INIS)

Noomhorm, A.; Apintanapong, M.

1996-01-01

The effect of irradiation with heat combination treatment on the shelf life and quality of mango puree was studied. Thermal inactivation of polyphenol oxidase enzyme at 80 degree C and 15 min. was used as a measure of adequacy of pre-heat treatment. Irradiation of mango puree after heat treatment at dosage of 0, 2, 4, 6 and 8 kGy showed no change in mc, pH, acidity, and TSS but during storage, growth of microorganisms brought changes in these values. Irradiation in combination with low temperature (5 degree C) reduced discoloration and darkening rate during storage. Irradiation dose from 0 to 8 kGy resulted in log linear reductions in microorganism levels but at 6 and 8 kGy, there was no growth of microorganisms. Products irradiated at 8 kGy showed no microorganism growth at both temperatures

Pharmacodynamically optimized erythropoietin treatment combined with phlebotomy reduction predicted to eliminate blood transfusions in selected preterm infants.

Science.gov (United States)

Rosebraugh, Matthew R; Widness, John A; Nalbant, Demet; Cress, Gretchen; Veng-Pedersen, Peter

2014-02-01

Preterm very-low-birth-weight (VLBW) infants weighing eliminated by reducing laboratory blood loss in combination with pharmacodynamically optimized erythropoietin (Epo) treatment. Twenty-six VLBW ventilated infants receiving RBCTx were studied during the first month of life. RBCTx simulations were based on previously published RBCTx criteria and data-driven Epo pharmacodynamic optimization of literature-derived RBC life span and blood volume data corrected for phlebotomy loss. Simulated pharmacodynamic optimization of Epo administration and reduction in phlebotomy by ≥ 55% predicted a complete elimination of RBCTx in 1.0-1.5 kg infants. In infants 1.0 kg.

Design of mobile receiving and treatment equipment for radioactive liquid waste

International Nuclear Information System (INIS)

Kong Jinsong; Guo Weiqun; Lu Jingbin

2012-01-01

The advantage and disadvantage of radioactive liquid waste treatment technology are analyzed in this paper. The experimental disposal equipment for radioactive liquid waste with complicated sources is designed by combining the far infrared calcification technology with evaporation technology. It has advantages of low energy consuming and high decontamination efficiency. The frothy and dirt appear rarely in this equipment. (authors)

Combined photo-Fenton-SBR process for antibiotic wastewater treatment

International Nuclear Information System (INIS)

Elmolla, Emad S.; Chaudhuri, Malay

2011-01-01

Highlights: · The work focused on hazardous wastewater (antibiotic wastewater) treatment. · Complete degradation of the antibiotics achieved by the treatment process. · The SBR performance was found to be very sensitive to BOD 5 /COD ratio below 0.40. · Combined photo-Fenton-SBR process is a feasible treatment process for the antibiotic wastewater. - Abstract: The study examined combined photo-Fenton-SBR treatment of an antibiotic wastewater containing amoxicillin and cloxacillin. Optimum H 2 O 2 /COD and H 2 O 2 /Fe 2+ molar ratio of the photo-Fenton pretreatment were observed to be 2.5 and 20, respectively. Complete degradation of the antibiotics occurred in one min. The sequencing batch reactor (SBR) was operated at different hydraulic retention times (HRTs) with the wastewater treated under different photo-Fenton operating conditions (H 2 O 2 /COD and H 2 O 2 /Fe 2+ molar ratio). The SBR performance was found to be very sensitive to BOD 5 /COD ratio of the photo-Fenton treated wastewater. Statistical analysis of the results indicated that it was possible to reduce the Fe 2+ dose and increase the irradiation time of the photo-Fenton pretreatment. The best operating conditions of the combined photo-Fenton-SBR treatment were observed to be H 2 O 2 /COD molar ratio 2, H 2 O 2 /Fe 2+ molar ratio 150, irradiation time 90 min and HRT of 12 h. Under the best operating conditions, 89% removal of sCOD with complete nitrification was achieved and the SBR effluent met the discharge standards.

Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial

OpenAIRE

Gita Faghihi; Shima Keyvan; Ali Asilian; Saeid Nouraei; Shadi Behfar; Mohamad Ali Nilforoushzadeh

2016-01-01

Background: Autologous platelet-rich plasma has recently attracted significant attention throughout the medical field for its wound-healing ability. Aims: This study was conducted to investigate the potential of platelet-rich plasma combined with fractional laser therapy in the treatment of acne scarring. Methods: Sixteen patients (12 women and 4 men) who underwent split-face therapy were analyzed in this study. They received ablative fractional carbon dioxide laser combined with intradermal ...

Is the residential combined (psychotherapy plus medication) treatment of patients with severe personality disorder effective in terms of suicidality and impulsivity?

Science.gov (United States)

Vaslamatzis, Grigorios; Theodoropoulos, Panayiotis; Vondikaki, Stamatia; Karamanolaki, Hara; MiliaTsanira, Myrto; Gourounti, Kleanthi

2014-02-01

The aim of this study was to compare the effectiveness of combined treatment-medication plus psychodynamic psychotherapy-and psychodynamic psychotherapy alone on the outcome variables of suicidality and impulsivity in a population of adult inpatients with severe personality disorder (SPD). This is a naturalistic-empirical (observational) study under the conditions of clinical practice (an intensive specialized inpatient psychotherapeutic program [SIPP]). The sample consisted of 33 inpatients with SPD who were allocated to two subgroups (groups A and B). The patients in group A received psychodynamic psychotherapy and adjunctive pharmacotherapy, whereas the patients in group B received multimodal psychodynamic psychotherapy only. A statistically significant reduction in suicidality score was observed in the patients in group A, whereas a tendency for significant reduction in impulsivity score was observed in group B after the SIPP termination. Pharmacotherapy combined with multimodal psychodynamic psychotherapy, always within the SIPP, seems more effective in the case of suicidality rather than impulsivity.

Combination antibiotic therapy for the treatment of infective endocarditis due to enterococci.

Science.gov (United States)

Leone, Sebastiano; Noviello, Silvana; Esposito, Silvano

2016-06-01

Enterococci are common causes of infective endocarditis (IE) in both health care and community-based setting. Enterococcal IE requires bactericidal therapy for an optimal outcome. For decades, cell-wall-active antimicrobial agents (penicillins or vancomycin) in combination with aminoglycosides were the cornerstone of the treatment; however, the emergence of antibiotic resistance has significantly reduced the efficacy of these regimens. Data for this review were identified by searches of MEDLINE and references from relevant articles on antibiotic combination regimens for the treatment of enterococcal IE. Abstracts presented in scientific conferences were not searched for. New effective and safe combination treatments, including double-β-lactam and daptomycin/β-lactam combination, are proving useful for the management of IE due to enterococci.

Targeting Strategies for the Combination Treatment of Cancer Using Drug Delivery Systems

Science.gov (United States)

Kydd, Janel; Jadia, Rahul; Velpurisiva, Praveena; Gad, Aniket; Paliwal, Shailee; Rai, Prakash

2017-01-01

Cancer cells have characteristics of acquired and intrinsic resistances to chemotherapy treatment—due to the hostile tumor microenvironment—that create a significant challenge for effective therapeutic regimens. Multidrug resistance, collateral toxicity to normal cells, and detrimental systemic side effects present significant obstacles, necessitating alternative and safer treatment strategies. Traditional administration of chemotherapeutics has demonstrated minimal success due to the non-specificity of action, uptake and rapid clearance by the immune system, and subsequent metabolic alteration and poor tumor penetration. Nanomedicine can provide a more effective approach to targeting cancer by focusing on the vascular, tissue, and cellular characteristics that are unique to solid tumors. Targeted methods of treatment using nanoparticles can decrease the likelihood of resistant clonal populations of cancerous cells. Dual encapsulation of chemotherapeutic drug allows simultaneous targeting of more than one characteristic of the tumor. Several first-generation, non-targeted nanomedicines have received clinical approval starting with Doxil® in 1995. However, more than two decades later, second-generation or targeted nanomedicines have yet to be approved for treatment despite promising results in pre-clinical studies. This review highlights recent studies using targeted nanoparticles for cancer treatment focusing on approaches that target either the tumor vasculature (referred to as ‘vascular targeting’), the tumor microenvironment (‘tissue targeting’) or the individual cancer cells (‘cellular targeting’). Recent studies combining these different targeting methods are also discussed in this review. Finally, this review summarizes some of the reasons for the lack of clinical success in the field of targeted nanomedicines. PMID:29036899

Targeting Strategies for the Combination Treatment of Cancer Using Drug Delivery Systems

Directory of Open Access Journals (Sweden)

Janel Kydd

2017-10-01

Full Text Available Cancer cells have characteristics of acquired and intrinsic resistances to chemotherapy treatment—due to the hostile tumor microenvironment—that create a significant challenge for effective therapeutic regimens. Multidrug resistance, collateral toxicity to normal cells, and detrimental systemic side effects present significant obstacles, necessitating alternative and safer treatment strategies. Traditional administration of chemotherapeutics has demonstrated minimal success due to the non-specificity of action, uptake and rapid clearance by the immune system, and subsequent metabolic alteration and poor tumor penetration. Nanomedicine can provide a more effective approach to targeting cancer by focusing on the vascular, tissue, and cellular characteristics that are unique to solid tumors. Targeted methods of treatment using nanoparticles can decrease the likelihood of resistant clonal populations of cancerous cells. Dual encapsulation of chemotherapeutic drug allows simultaneous targeting of more than one characteristic of the tumor. Several first-generation, non-targeted nanomedicines have received clinical approval starting with Doxil® in 1995. However, more than two decades later, second-generation or targeted nanomedicines have yet to be approved for treatment despite promising results in pre-clinical studies. This review highlights recent studies using targeted nanoparticles for cancer treatment focusing on approaches that target either the tumor vasculature (referred to as ‘vascular targeting’, the tumor microenvironment (‘tissue targeting’ or the individual cancer cells (‘cellular targeting’. Recent studies combining these different targeting methods are also discussed in this review. Finally, this review summarizes some of the reasons for the lack of clinical success in the field of targeted nanomedicines.

Secondary neutron doses received by patients of different ages during intracranial proton therapy treatments

International Nuclear Information System (INIS)

Sayah, R.

2012-01-01

Proton therapy is an advanced radiation therapy technique that allows delivering high doses to the tumor while saving the healthy surrounding tissues due to the protons' ballistic properties. However, secondary particles, especially neutrons, are created during protons' nuclear reactions in the beam-line and the treatment room components, as well as inside the patient. Those secondary neutrons lead to unwanted dose deposition to the healthy tissues located at distance from the target, which may increase the secondary cancer risks to the patients, especially the pediatric ones. The aim of this work was to calculate the neutron secondary doses received by patients of different ages treated at the Institut Curie-centre de Protontherapie d'Orsay (ICPO) for intracranial tumors, using a 178 MeV proton beam. The treatments are undertaken at the new ICPO room equipped with an IBA gantry. The treatment room and the beam-line components, as well as the proton source were modeled using the Monte Carlo code MCNPX. The obtained model was then validated by a series of comparisons between model calculations and experimental measurements. The comparisons concerned: a) depth and lateral proton dose distributions in a water phantom, b) neutron spectrometry at one position in the treatment room, c) ambient dose equivalents at different positions in the treatment room and d) secondary absorbed doses inside a physical anthropomorphic phantom. A general good agreement was found between calculations and measurements, thus our model was considered as validated. The University of Florida hybrid voxelized phantoms of different ages were introduced into the MCNPX validated model, and secondary neutron doses were calculated to many of these phantoms' organs. The calculated doses were found to decrease as the organ's distance to the treatment field increases and as the patient's age increases. The secondary doses received by a one year-old patient may be two times higher than the doses

Combined treatment of UV and gamma radiation of papaya for decay control

International Nuclear Information System (INIS)

Moy, J.H.; McElhaney, T.; Matsuzaki, C.; Piedrahita, C.

1978-01-01

An exploratory study was made to determine if combining u.v. and gamma radiation treatment at selective doses would decrease the fungal decay incidence in papaya (Carica papaya L. var. Solo), and thereby increase the marketable life of the fruit. Also studied was the effect of the combined treatment on the spores of Aschochyta spp., Colletotrichium spp. and Phytophthora spp., which are commonly found on papaya grown in Hawaii. This was to test the postulate that the combined treatment would prevent photoreactivation of the disrupted nuclei in microorganisms and lead to eventual death. Experimental results did not indicate a conclusive trend to effectiveness but suggested a number of problems to be resolved before the treatment can become useful in fungal decay control of fruits. (author)

Evaluation of the combination of radio frequency, infrared energy and mechanical rollers with suction to improve skin surface irregularities (cellulite) in a limited treatment area.

Science.gov (United States)

Kulick, Michael

2006-12-01

This IRB-approved (Institutional Review Board) study evaluated the efficacy of a device that combines radio frequency, infrared energy and mechanical rollers/suction (ELOS technology) to reduce skin surface irregularities in a limited treatment zone. Sixteen patients were enrolled and received two treatments per week for 4 consecutive weeks. Treatments were limited to a 20.53 cm x 33.02 cm area of the posterior or lateral thigh and lasted for 15 minutes. Maximum machine settings were used for all but one individual at every treatment. Evaluations consisted of a patient questionnaire and photographic assessment of skin contour by three physicians at 3 and 6 months after the last session who were blind to the treatment each patient received. Physician evaluators determined that all patients were improved at both post-treatment periods. The average improvement at 3 and 6 months was 62% and 50%, respectively. All patients felt they were improved. One patient described the treatment as painful and required reduced treatment parameters after the initial treatment. Bruising within the treatment area was observed in five patients following the initial sessions but this did not alter the treatment protocol and did not occur in subsequent treatments. One patient had a superficial skin burn due to poor electrode contact that did not require corrective treatment.

Can diet combined with treatment scheduling achieve consistency of rectal filling in patients receiving radiotherapy to the prostate?

International Nuclear Information System (INIS)

McNair, Helen A.; Wedlake, Linda; McVey, Gerard P.; Thomas, Karen; Andreyev, Jervoise; Dearnaley, David P.

2011-01-01

Background and purpose: This pilot study investigates whether an individualized fluid and fibre prescription combined with a constant treatment can improve rectal filling consistency during radiotherapy. Methods and materials: Fibre, fluid intake and bowel function were assessed in 22 patients at a standard planning scan (SCT) and individualized dietary advice was prescribed to regularize bowel habit. Patients were requested to record frequency and type of bowel movements, fibre and fluid intake daily. Two subsequent CT scans were acquired at 7 (CCT1) and 10 days (CCT2) after SCT at a similar time. Rectal volume and gas were measured planning CT’s and ‘on treatment’ cone beam CT scans. We hypothesised that the difference in volume between CCT1 and CCT2 would be less than the difference between SCT and CCT1. Results: The mean (SD) change in volume between SCT to CCT1 and CCT1 to CCT2 was 5.68 cm 3 (26.2) and −8.6 cm 3 (40.1), respectively (p = 0.292). Of the 22 patients scanned 20 provided a complete record of dietary intake and bowel motion. The majority of patients either achieved or exceeded prescription. Change in rectal gas was the only correlation with change in rectal volume. Conclusion: Patient self reporting of bowel motion, fibre, fluid intake was achievable but consistency of rectal filling was not improved. Improved understanding of the aetiology and management of rectal gas is indicated.

Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia.

Science.gov (United States)

Bao, Linlin; Gong, Lin; Guo, Menger; Liu, Taoming; Shi, Anyu; Zong, Haifeng; Xu, Xuegang; Chen, Hongduo; Gao, Xinghua; Li, Yuanhong

2017-10-13

In treating androgenetic alopecia, 5% minoxidil is a commonly used topical drug. By using electrodynamic microneedle at the same time may increase absorption of minoxidil and further stimulate hair growth. A 24-week, randomized, evaluator blinded, comparative study was performed to evaluate the efficacy of treating Chinese male androgenetic alopecia using microneedle combined with 5% minoxidil topical solution. Randomized subjects received topical 5% minoxidil (group 1, n = 20), local electrodynamic microneedle treatments (group 2, n = 20), or local electrodynamic microneedle treatments plus topical 5% minoxidil (group 3, n = 20). A total of 12 microneedle treatments were performed every 2 weeks with 2ml 5% minoxidil delivery in group 3 during each microneedle treatment. Patient receiving topical 5% minoxidil applied 1 ml of the solution twice daily over the course of the study. A total of 60 Chinese male subjects with Norwood-Hamilton type III-VI androgenetic alopecia were treated. The mean improvement in total hair density from baseline to 24 weeks was 18.8/cm 2 in group 1, 23.4/cm 2 in group 2, and 38.3/cm 2 in group 3. The hair growth in the 3 groups was significantly different (P = 0.002), but there were no significant differences in toxicity found between the 3 groups. Treatment with microneedle plus topical 5% minoxidil was associated with the best hair growth.

Combined photo-Fenton-SBR process for antibiotic wastewater treatment

Energy Technology Data Exchange (ETDEWEB)

Elmolla, Emad S., E-mail: em_civil@yahoo.com [Department of Civil Engineering, Faculty of Engineering, Al-Azhar University, Cairo (Egypt); Chaudhuri, Malay [Department of Civil Engineering, Universiti Teknologi PETRONAS, Bandar Seri Iskandar, 31750 Tronoh, Perak (Malaysia)

2011-09-15

Highlights: {center_dot} The work focused on hazardous wastewater (antibiotic wastewater) treatment. {center_dot} Complete degradation of the antibiotics achieved by the treatment process. {center_dot} The SBR performance was found to be very sensitive to BOD{sub 5}/COD ratio below 0.40. {center_dot} Combined photo-Fenton-SBR process is a feasible treatment process for the antibiotic wastewater. - Abstract: The study examined combined photo-Fenton-SBR treatment of an antibiotic wastewater containing amoxicillin and cloxacillin. Optimum H{sub 2}O{sub 2}/COD and H{sub 2}O{sub 2}/Fe{sup 2+} molar ratio of the photo-Fenton pretreatment were observed to be 2.5 and 20, respectively. Complete degradation of the antibiotics occurred in one min. The sequencing batch reactor (SBR) was operated at different hydraulic retention times (HRTs) with the wastewater treated under different photo-Fenton operating conditions (H{sub 2}O{sub 2}/COD and H{sub 2}O{sub 2}/Fe{sup 2+} molar ratio). The SBR performance was found to be very sensitive to BOD{sub 5}/COD ratio of the photo-Fenton treated wastewater. Statistical analysis of the results indicated that it was possible to reduce the Fe{sup 2+} dose and increase the irradiation time of the photo-Fenton pretreatment. The best operating conditions of the combined photo-Fenton-SBR treatment were observed to be H{sub 2}O{sub 2}/COD molar ratio 2, H{sub 2}O{sub 2}/Fe{sup 2+} molar ratio 150, irradiation time 90 min and HRT of 12 h. Under the best operating conditions, 89% removal of sCOD with complete nitrification was achieved and the SBR effluent met the discharge standards.

The efficacy of fractional carbon dioxide (CO2) laser combined with terbinafine hydrochloride 1% cream for the treatment of onychomycosis.

Science.gov (United States)

Shi, Jian; Li, Jin; Huang, He; Permatasari, Felicia; Liu, Juan; Xu, Yang; Wu, Di; Zhou, Bing-Rong; Luo, Dan

2017-10-01

Although systemic and topical antifungal agents are widely used to treat onychomycosis, oral medications can cause adverse effects and the efficacy of topical agents is not satisfying. Currently, laser treatment has been studied for its efficacy in the treatment of onychomycosis. Our study was aimed to evaluate the efficacy of fractional carbon dioxide (CO 2 ) laser treatment combined with terbinafine cream for 6 months in the treatment of onychomycosis and to analyze the influencing factors. A total of 30 participants (124 nails) with clinical and mycological diagnosis of onychomycosis received fractional CO 2 laser treatment at 2-week interval combined with terbinafine cream once daily for 6 months. The clinical efficacy rate (CER) was assessed from the percentage of fully normal-appearing nails or nails with ≤5% abnormal appearance, and the mycological clearance rate (MCR) was assessed from the percentage of nails with negative fungal microscopy. The CER was evaluated at 3 time points: at the end of treatment (58.9%), at 1 month after the last treatment (63.5%), and at 3 months after the last treatment (68.5%). The MCRs at 1 month and 3 months after the last treatment were 77.4 and 74.2%, respectively. The evaluation of influencing factors showed significantly higher CER (p terbinafine cream for 6 months was an effective and safe method for the treatment of onychomycosis. There were 5 factors that positively influenced the treatment outcome: age, clinical type of onychomycosis, nail thickness, involved nail, and species of fungus.

MR-based conductivity imaging using multiple receiver coils.

Science.gov (United States)

Lee, Joonsung; Shin, Jaewook; Kim, Dong-Hyun

2016-08-01

To propose a signal combination method for MR-based tissue conductivity mapping using a standard clinical scanner with multiple receiver coils. The theory of the proposed method is presented with two practical approaches, a coil-specific approach and a subject-specific approach. Conductivity maps were reconstructed using the transceive phase of the combined signal. The sensitivities of the coefficients used for signal combination were analyzed and the method was compared with other signal combination methods. For validation, multiple receiver brain coils and multiple receiver breast coils were used in phantom, in vivo brain, and in vivo breast studies. The variation among the conductivity estimates was conductivity estimates. MR-based tissue conductivity mapping is feasible when using a standard clinical MR scanner with multiple receiver coils. The proposed method reduces systematic errors in phase-based conductivity mapping that can occur due to the inhomogeneous magnitude of the combined receive profile. Magn Reson Med 76:530-539, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Suicidal Behavior Among People Living with HIV (PLHIV) in Medical Care in Estonia and Factors Associated with Receiving Psychological Treatment.

Science.gov (United States)

Lemsalu, Liis; Rüütel, Kristi; Laisaar, Kaja-Triin; Lõhmus, Liilia; Raidvee, Aire; Uusküla, Anneli

2017-06-01

People living with HIV (PLHIV) have higher rates of suicidal behavior than the general population. This study assessed suicidal behavior (ideation and/or attempts, ever and in the past 12 months) among PLHIV receiving outpatient HIV medical care in Estonia and associations between suicidal behavior and psychological treatment. The cross-sectional study collected data from January to November 2013 using a self-report questionnaire. Eight hundred PLHIV participated, 39 % (n = 306) of whom had been suicidal. Lifetime prevalence was 36 % for suicidal ideation and 20 % for attempts. Younger age, incarceration, having ever abused alcohol and also injected drugs, having lived with HIV for more than 10 years, and being depressed were associated with lifetime suicidal behavior. Suicidal behavior within the past 12 months was reported by 20 % (n = 156) of respondents. Of these, 27 % received psychological treatment (counseling and/or psychotherapy), 20 % had taken antidepressants, and 49 % sedatives. Individuals perceiving a need for treatment were significantly more likely to receive psychological treatment when experiencing suicidal behavior (OR 25.65, 95 % CI 2.92-225.47). In conclusion, suicidal behavior is frequent among PLHIV but psychological treatment is not often received. One of the barriers to treatment is patients' lack of perceived need for help.

Sample size requirements for separating out the effects of combination treatments: randomised controlled trials of combination therapy vs. standard treatment compared to factorial designs for patients with tuberculous meningitis.

Science.gov (United States)

Wolbers, Marcel; Heemskerk, Dorothee; Chau, Tran Thi Hong; Yen, Nguyen Thi Bich; Caws, Maxine; Farrar, Jeremy; Day, Jeremy

2011-02-02

In certain diseases clinical experts may judge that the intervention with the best prospects is the addition of two treatments to the standard of care. This can either be tested with a simple randomized trial of combination versus standard treatment or with a 2 x 2 factorial design. We compared the two approaches using the design of a new trial in tuberculous meningitis as an example. In that trial the combination of 2 drugs added to standard treatment is assumed to reduce the hazard of death by 30% and the sample size of the combination trial to achieve 80% power is 750 patients. We calculated the power of corresponding factorial designs with one- to sixteen-fold the sample size of the combination trial depending on the contribution of each individual drug to the combination treatment effect and the strength of an interaction between the two. In the absence of an interaction, an eight-fold increase in sample size for the factorial design as compared to the combination trial is required to get 80% power to jointly detect effects of both drugs if the contribution of the less potent treatment to the total effect is at least 35%. An eight-fold sample size increase also provides a power of 76% to detect a qualitative interaction at the one-sided 10% significance level if the individual effects of both drugs are equal. Factorial designs with a lower sample size have a high chance to be underpowered, to show significance of only one drug even if both are equally effective, and to miss important interactions. Pragmatic combination trials of multiple interventions versus standard therapy are valuable in diseases with a limited patient pool if all interventions test the same treatment concept, it is considered likely that either both or none of the individual interventions are effective, and only moderate drug interactions are suspected. An adequately powered 2 x 2 factorial design to detect effects of individual drugs would require at least 8-fold the sample size of the

Combination Antifungal Therapy in the Treatment of Scedosporium apiospermum Central Nervous System Infections

Directory of Open Access Journals (Sweden)

Andrés F. Henao-Martínez

2013-01-01

Full Text Available Treatment of Scedosporium apiospermum central nervous system (CNS infection typically consists of an azole in combination with surgical debridement. This approach requires prolonged treatment and carries a high associated mortality. We present two cases of the successful treatment of S. apiospermum CNS infections with the combination of voriconazole and terbinafine.

[Combination drug therapy in patients with BPH].

Science.gov (United States)

Kuzmenko, A V; Kuzmenko, V V; Gyaurgiev, T A

2018-03-01

Introuction. One of the risk factors for LUTS is an infravesical obstruction, which is most often caused by benign prostatic hyperplasia (BPH). BPH symptoms are formed due to three components: static (mechanical), dynamic, and impaired functional capacity of the bladder. Medical treatment with 1-blockers decreases the outflow obstruction. 5-alpha reductase inhibitors are used to inhibit the static component of BPH. To investigate the effectiveness of various modifications of medical therapy of BPH using -blockers and 5-reductase inhibitors and combinations thereof. The study comprised 90 BPH patients who were divided into three groups, with each group containing 30 people. Patients of group I, II and III received monotherapy with -blockers, a combination of 5-reductase and -blockers, and fixed-dose combination drug Duodart, respectively. Evaluation of the treatment effectiveness included filling out voiding diaries, completing the I-PSS and QL questionnaires, uroflowmetry, transrectal ultrasonography of the prostate and estimation of the incidence of adverse effects. Also, compliance with the treatment was evaluated, and the number of patients who had episodes of acute urinary retention and required surgical treatment during the 12 month treatment course was registered. Compared to monotherapy, combination therapy with -blockers and 5-reductase inhibitors more effectively reduces the LUTS, increases Qmax and prevents the disease progression, which manifests in a lower incidence of AUR and fewer surgical interventions in groups II and III. However, the combination therapy can be associated with some side effects. Patients who received fixed-dose combination drug Duodart had a greater compliance rate than patients on the combination of drugs, which, in our opinion, is associated with fewer cases of AUR and surgical interventions. The use of Duodart in patients with BPH effectively alleviates LUTS and reduces the risk of the disease progression, which manifests itself

Combination chemotherapy versus single-agent therapy as first- and second-line treatment in metastatic breast cancer

DEFF Research Database (Denmark)

Joensuu, H; Holli, K; Heikkinen, M

1998-01-01

PURPOSE: We report results of a randomized prospective study that compared single agents of low toxicity given both as the first-line and second-line chemotherapy with combination chemotherapy in advanced breast cancer with distant metastases. PATIENTS AND METHODS: Patients in the single-agent arm...... (n = 153) received weekly epirubicin (E) 20 mg/m2 until progression or until the cumulative dose of 1,000 mg/m2, followed by mitomycin (M) 8 mg/m2 every 4 weeks, and those in the combination chemotherapy arm (n = 150) were first given cyclophosphamide 500 mg/m2, E 60 mg/m2, and fluorouracil 500 mg/m2...... younger than 50. RESULTS: An objective response (complete [CR] or partial [PR]) was obtained in 55%, 48%, 16%, and 7% of patients treated with CEF, E, M, and MV, respectively. A response to CEF tended to last longer than a response to E (median, 12 v 10.5 months; P = .07). Treatment-related toxicity...

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

Science.gov (United States)

Chin, Helen B; Howards, Penelope P; Kramer, Michael R; Mertens, Ann C; Spencer, Jessica B

2016-12-01

To assess which characteristics are associated with failure to receive fertility counseling among a cohort of young women diagnosed with cancer. Population-based cohort study. Not applicable. A total of 1,282 cancer survivors, of whom 1,116 met the inclusion criteria for the analysis. None. The main outcome in this study was whether or not women reported receiving any information at the time of their cancer diagnosis on how cancer treatment might affect their ability to become pregnant. Forty percent of cancer survivors reported that they did not receive fertility counseling at the time of cancer diagnosis. Women were more likely to fail to receive counseling if they had only a high school education or less or if they had given birth. Cancer-related variables that were associated with a lack of counseling included not receiving chemotherapy as part of treatment and diagnosis with certain cancer types. Counseling about the risk of infertility and available fertility preservation options is important to cancer patients. Additionally, counseling can make women aware of other adverse reproductive outcomes, such as early menopause and its associated symptoms. Less-educated women and parous women are at particular risk of not getting fertility-related information. Programs that focus on training not just the oncologist, but also other health care providers involved with cancer care, to provide fertility counseling may help to expand access. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Protein loss in human hair from combination straightening and coloring treatments.

Science.gov (United States)

França-Stefoni, Simone Aparecida; Dario, Michelli Ferrera; Sá-Dias, Tânia Cristina; Bedin, Valcinir; de Almeida, Adriano José; Baby, André Rolim; Velasco, Maria Valéria R

2015-09-01

Hair chemical treatments, such as dyeing and straightening products, are known to cause damage that can be assessed by protein loss. The aim of this study was to evaluate the hair protein loss caused by combined chemical treatments (dye and relaxer) using the validated bicinchoninic acid (BCA) method. Three kinds of straighteners, based on ammonium thioglycolate, guanidine hydroxide and sodium hydroxide, were evaluated and the least harmful combination indicated. Caucasian virgin dark brown hair tresses were treated with developed natural brown color oxidative hair dyeing and/or straightening commercial products based on ammonium thioglycolate, sodium hydroxide, or guanidine hydroxide. Protein loss quantification was assessed by the validated BCA method which has several advantages for quantifying protein loss in chemically treated hair. When both treatments (straightening and dyeing) were combined, a higher negative effect was observed, particularly for dyed hair treated with sodium hydroxide. In this case, a 356% increase in protein loss relative to virgin hair was observed and 208% in relation to only dyed hair. The combination of dying and relaxers based on ammonium thioglycolate or guanidine hydroxide caused a small increase in protein loss, suggesting that these straightening products could be the best alternatives for individuals wishing to combine both treatments. These results indicated that when application of both types of products is desired, ammonium thioglycolate or guanidine hydroxide should be chosen for the straightening process. © 2015 Wiley Periodicals, Inc.

Combined treatment of Pseudomonas aeruginosa biofilms with bacteriophages and chlorine.

Science.gov (United States)

Zhang, Yanyan; Hu, Zhiqiang

2013-01-01

Bacterial biofilms are a growing concern in a broad range of areas. In this study, a mixture of RNA bacteriophages isolated from municipal wastewater was used to control and remove biofilms. At the concentrations of 400 and 4 × 10(7) PFU/mL, the phages inhibited Pseudomonas aeruginosa biofilm formation by 45 ± 15% and 73 ± 8%, respectively. At the concentrations of 6,000 and 6 × 10(7) PFU/mL, the phages removed 45 ± 9% and 75 ± 5% of pre-existing P. aeruginosa biofilms, respectively. Chlorine reduced biofilm growth by 86 ± 3% at the concentration of 210 mg/L, but it did not remove pre-existing biofilms. However, a combination of phages (3 × 10(7) PFU/mL) and chlorine at this concentration reduced biofilm growth by 94 ± 2% and removed 88 ± 6% of existing biofilms. In a continuous flow system with continued biofilm growth, a combination of phages (a one-time treatment at the concentration of 1.9 × 10(8) PFU/mL for 1 h first) with chlorine removed 97 ± 1% of biofilms after Day 5 while phage and chlorine treatment alone removed 89 ± 1% and 40 ± 5%, respectively. For existing biofilms, a combined use of a lower phage concentration (3.8 × 10(5) PFU/mL) and chlorination with a shorter time duration (12 h) followed by continuous water flushing removed 96 ± 1% of biofilms in less than 2 days. Laser scanning confocal microscopy supplemented with electron microscopy indicated that the combination treatment resulted in biofilms with lowest cell density and viability. These results suggest that the combination treatment of phages and chlorine is a promising method to control and remove bacterial biofilms from various surfaces. Copyright © 2012 Wiley Periodicals, Inc.

Combination of Advanced Oxidation Processes and biological treatments for wastewater decontamination-A review

International Nuclear Information System (INIS)

Oller, I.; Malato, S.; Sanchez-Perez, J.A.

2011-01-01

Nowadays there is a continuously increasing worldwide concern for development of alternative water reuse technologies, mainly focused on agriculture and industry. In this context, Advanced Oxidation Processes (AOPs) are considered a highly competitive water treatment technology for the removal of those organic pollutants not treatable by conventional techniques due to their high chemical stability and/or low biodegradability. Although chemical oxidation for complete mineralization is usually expensive, its combination with a biological treatment is widely reported to reduce operating costs. This paper reviews recent research combining AOPs (as a pre-treatment or post-treatment stage) and bioremediation technologies for the decontamination of a wide range of synthetic and real industrial wastewater. Special emphasis is also placed on recent studies and large-scale combination schemes developed in Mediterranean countries for non-biodegradable wastewater treatment and reuse. The main conclusions arrived at from the overall assessment of the literature are that more work needs to be done on degradation kinetics and reactor modeling of the combined process, and also dynamics of the initial attack on primary contaminants and intermediate species generation. Furthermore, better economic models must be developed to estimate how the cost of this combined process varies with specific industrial wastewater characteristics, the overall decontamination efficiency and the relative cost of the AOP versus biological treatment.

Assessing the outcomes of HIV-infected persons receiving treatment for Kaposi sarcoma in Conakry-Guinea.

Science.gov (United States)

Bekolo, Cavin E; Soumah, Mohamed M; Tiemtore, Ousseni W; Diallo, Abdourahimi; Yuma, Joseph-Desire; Di Stefano, Letizia; Metcalf, Carol; Cisse, Mohamed

2017-12-02

Médecins Sans Frontières is supporting comprehensive HIV care and treatment for Kaposi Sarcoma (KS) in Guinea, where antiretroviral coverage is low and access to KS treatment is very limited. We aimed to evaluate treatment response and survival outcomes of epidemic KS in this setting. Retrospective survival analysis of routinely collected clinical data of HIV-infected patients with clinically diagnosed KS, receiving ART and chemotherapy consisting of a combination of bleomycin and vincristine at the Donka National Hospital in Conakry between 2012 and 2015. A total of 225 patients were enrolled for KS treatment within the three-year period. Late presentation with stage T1 disease was common (82.7%). At the end of a median of 8 cycles of chemotherapy (IQR: 2-12), complete remission was observed in 65 (28.9%), partial remission in 53 (23.6%), stable disease in 15 (6.7%) and unknown response for all 92 (40.9%) patients who dropped out of care. The chances of achieving complete remission doubled after each additional cycle of chemotherapy (aOR = 2.09 95% CI: 1.44-3.01) but were reduced by about two-thirds for each additional month delay between treatment and onset of KS (aOR = 0.31, 95% CI: 0.11-0.86). Treatment response was seriously compromised in patients with woody skin oedema (aOR = 0.05, 95% CI: 0.01-0.38) and those with prior chemotherapy (aOR = 0.21, 95% CI: 0.05-0.80). The median survival time was 7.6 months (95% CI: 5.9-9.8). Attrition from care was reduced by 22% for every additional cycle of chemotherapy administered (aH0R = 0.78, 95% CI: 0.71-0.84) and was lower in those with complete remission compared with those with partial or no response (aHR = 0.05, 95% CI: 0.007-0.43). There has been an increased access to KS treatment. The overall response rate is 52.4%, which is considered a satisfactory result. Poor outcomes were common and were largely due to late presentation and defaulting on treatment. Efforts towards early HIV

Health status, food insecurity, and time allocation patterns of patients with AIDS receiving antiretroviral treatment in South Africa.

Science.gov (United States)

Bhargava, Alok; Booysen, Frederik Le Roux; Walsh, Corinna M

2018-03-01

For patients with AIDS receiving antiretroviral treatment (ART) in South Africa via public clinics, improvements in nutritional status and economic productivity are likely to depend on adherence to drug regimen and quality of diet reflected in protein and micronutrient intakes. This study randomized 643 patients receiving ART from public clinics in the Free State Province into a Control group, a treatment group receiving adherence support, and a treatment group receiving adherence support and a nutritious food supplement. The data on food insecurity levels and time spent on various activities were analyzed for assessing the impact of the intervention programs. The main results were, first, changes between survey rounds 1 and 3 were significant at the 5% level for outcomes such as food insecurity levels and CD4 cell counts. Moreover, there was a significant reduction in food insecurity levels of patients with BMI less than 25 who received the nutritious food supplement. Second, the estimated parameters from models for patients' food insecurity levels showed that household incomes were significantly associated with lower food insecurity levels. Third, patients' BMI was a significant predictor of time spent on sedentary, moderate and overall activity levels, and it was important to separately evaluate the effects of BMI for under-weight and over-weight patients. Overall, the results indicated the need for reducing food insecurity levels, and for designing different interventions for under-weight and over-weight patients with AIDS for enhancing their labor productivity.

Effects of A Combined Treatment Protocol in Chronic Regional Pain Syndrome

Directory of Open Access Journals (Sweden)

Ali Asghar Jameh-Bozorgi

2011-01-01

Full Text Available Objective: Chronic regional pain syndrome (CRPS is one of the most important and worst types of peripheral nervous system, especially in upper extremity. The aim of this study was determination of the effect of a combined rehabilitation program in the treatment of patients with CRPS type I. Materials & Methods: In this quasi-experimental and before-after study, 20 patients with chronic regional pain syndrome were selected simply and their pain, range of motion, edema and muscular strength were examined and recorded before intervention. Then, patients under went a combined treatment programs included some modalities from physical and occupation therapy. Patients attended at clinic for 20 therapeutic sessions with one day intervals. Finally, data were analyzed using paired–t test. Results: Post operatively, pain and edema were decreased and range of motion and grip strength was increased significantly (P>0.05. Conclusion: Current study demonstrated that early and combined physical and occupational therapy efficient in the treatment of patients suffering from CRPS type I. This combined program can relieve pain and edema and increase ROM and grip strength.

Assessment of blood gas parameters and the degree of inflammation in noninvasive positive pressure ventilation combined with aminophylline treatment of COPD complicated with type II respiratory failure

Directory of Open Access Journals (Sweden)

Jin-Ru Zhang

2016-10-01

Full Text Available Objective: To analyze the effect of noninvasive positive pressure ventilation combined with aminophylline therapy on blood gas parameters and the degree of inflammation in patients with COPD and type II respiratory failure. Methods: A total of 80 patients with COPD and type Ⅱ respiratory failure were randomly divided into observation group and control group (n=40, control group received symptomatic treatment + aminophylline treatment, observation group received symptomatic treatment + aminophylline + noninvasive positive pressure ventilation treatment, and then differences in blood gas parameters, pulmonary function parameters, hemorheology parameters and inflammatory factor levels were compared between two groups of patients after treatment. Results: Radial artery pH and PO2 values of observation group after treatment were higher than those of control group while PCO2, Cl- and CO2CP values were lower than those of control group; pulmonary function parameters FVC, FEV1, FEF25-75, MMF, PEF and FRC values of observation group after treatment were higher than those of control group; whole blood viscosity (150 s- and 10 s-, plasma viscosity, fibrinogen, erythrocyte aggregation index and erythrocyte rigidity index values in peripheral venous blood of observation group after treatment were lower than those of control group; serum IL-17, IL-33, TREM-1, sICAM-1 and PGE2 levels of observation group after treatment were lower than those of control group. Conclusion: Noninvasive positive pressure ventilation combined with aminophylline can optimize the respiratory function of patients with COPD and type II respiratory failure and improve blood gas parameters and the degree of inflammation.

Multicenter Evaluation of the Tolerability of Combined Treatment With PD-1 and CTLA-4 Immune Checkpoint Inhibitors and Palliative Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Bang, Andrew [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Division of Radiation Oncology, University of Ottawa, Ottawa, Ontario (Canada); Wilhite, Tyler J. [Harvard Medical School, Boston, Massachusetts (United States); Pike, Luke R.G. [Harvard Radiation Oncology Program, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Cagney, Daniel N.; Aizer, Ayal A.; Taylor, Allison; Spektor, Alexander; Krishnan, Monica [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Ott, Patrick A. [Department of Medical Oncology and Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Balboni, Tracy A. [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Hodi, F. Stephen [Department of Medical Oncology and Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Schoenfeld, Jonathan D., E-mail: jdschoenfeld@partners.org [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

2017-06-01

Purpose: To analyze immune-related adverse events (ir-AEs) in patients treated with radiation and immune checkpoint blockade. Methods and Materials: We retrospectively reviewed records from patients with metastatic non-small cell lung cancer, melanoma, or renal cell cancer who received at least 1 cycle of a CTLA-4 or PD-1 inhibitor and radiation. Immune-related adverse events, defined using Common Terminology Criteria for Adverse Events version 4.0, were tabulated in relation to treatment variables, and associations with sequencing and timing were assessed. Results: We identified 133 patients, of whom 28 received a CTLA-4 inhibitor alone, 88 received a PD-1 inhibitor alone, and 17 received both classes of inhibitors either sequentially (n=13) or concurrently (n=4). Fifty-six patients received radiation within 14 days of an immune checkpoint inhibitor. Forty-six patients experienced at least 1 ir-AE (34.6%). Patients receiving both CTLA-4 and PD-1 inhibitors experienced more any-grade ir-AEs as compared with either individually (71% vs 29%, P=.0008). Any-grade ir-AEs occurred in 39% of patients in whom radiation was administered within 14 days of immunotherapy, compared with 23% of other patients (P=.06) and more often in patients who received higher equivalent dose in 2-Gy fractions (EQD2) EQD2 (P=.01). However, most toxicities were mild. There were no associations between site irradiated and specific ir-AEs. Conclusions: Our data suggest the combination of focal palliative radiation and CTLA-4 and/or PD-1 inhibitors is well tolerated, with manageable ir-AEs that did not seem to be associated with the particular site irradiated. Although conclusions are limited by the heterogeneity of patients and treatments, and future confirmatory studies are needed, this information can help guide clinical practice for patients receiving immune checkpoint therapy who require palliative radiation therapy.

Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients.

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Hu, Ruiming; Xu, Feng; Sheng, Youyu; Qi, Sisi; Han, Yumei; Miao, Ying; Rui, Wenlong; Yang, Qinping

2015-01-01

Finasteride at 1 mg/day and 5% topical minoxidil are effective in male androgenetic alopecia (MAGA). However, studies describing their effects in Chinese individuals are scarce. 450 Chinese MAGA patients were randomly assigned to receive finasteride (n = 160), minoxidil (n = 130) and combined medication (n = 160) for 12 months. The patients returned to the clinic every 3 months for efficacy evaluation. And efficacy was evaluated in 428 men at treatment end, including 154, 122, and 152 in the finasteride, 5% minoxidil, and combination groups, respectively. All groups showed similar baseline characteristics, including age at enrollment, and duration and severity of alopecia (p > 0.05). At 12 months, 80.5, 59, and 94.1% men treated with finasteride, 5% minoxidil and the combination therapy showed improvement, respectively. Adverse reactions were rare (finasteride, 1.8%; minoxidil, 6.1%), and disappeared right after drug withdrawal. In conclusion, finasteride is superior to 5% minoxidil, while the combined medication showed the best efficacy. © 2015 Wiley Periodicals, Inc.

Quality indicators for prostate radiotherapy: are patients disadvantaged by receiving treatment in a 'generalist' centre?

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Freeman, Amanda R; Roos, Daniel E; Kim, Laurence

2015-04-01

The purpose of this retrospective review was to evaluate concordance with evidence-based quality indicator guidelines for prostate cancer patients treated radically in a 'generalist' (as distinct from 'sub-specialist') centre. We were concerned that the quality of treatment may be lower in a generalist centre. If so, the findings could have relevance for many radiotherapy departments that treat prostate cancer. Two hundred fifteen consecutive patients received external beam radiotherapy (EBRT) and/or brachytherapy between 1.10.11 and 30.9.12. Treatment was deemed to be in line with evidence-based guidelines if the dose was: (i) 73.8-81 Gy at 1.8-2.0 Gy/fraction for EBRT alone (eviQ guidelines); (ii) 40-50 Gy (EBRT) for EBRT plus high-dose rate (HDR) brachytherapy boost (National Comprehensive Cancer Network (NCCN) guidelines); and (iii) 145 Gy for low dose rate (LDR) I-125 monotherapy (NCCN). Additionally, EBRT beam energy should be ≥6 MV using three-dimensional conformal RT (3D-CRT) or intensity-modulated RT (IMRT), and high-risk patients should receive neo-adjuvant androgen-deprivation therapy (ADT) (eviQ/NCCN). Treatment of pelvic nodes was also assessed. One hundred four high-risk, 84 intermediate-risk and 27 low-risk patients (NCCN criteria) were managed by eight of nine radiation oncologists. Concordance with guideline doses was confirmed in: (i) 125 of 136 patients (92%) treated with EBRT alone; (ii) 32 of 34 patients (94%) treated with EBRT + HDR BRT boost; and (iii) 45 of 45 patients (100%) treated with LDR BRT alone. All EBRT patients were treated with ≥6 MV beams using 3D-CRT (78%) or IMRT (22%). 84%, 21% and 0% of high-risk, intermediate-risk and low-risk patients received ADT, respectively. Overall treatment modality choice (including ADT use and duration where assessable) was concordant with guidelines for 176/207 (85%) of patients. The vast majority of patients were treated concordant with evidence-based guidelines suggesting that

Apoptosis induced by piroxicam plus cisplatin combined treatment is triggered by p21 in mesothelioma.

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Alfonso Baldi

Full Text Available BACKGROUND: Malignant mesothelioma (MM is a rare, highly aggressive tumor, associated to asbestos exposure. To date no chemotherapy regimen for MM has proven to be definitively curative, and new therapies for MM treatment need to be developed. We have previously shown in vivo that piroxicam/cisplatin combined treatment in MM, specifically acts on cell cycle regulation triggering apoptosis, with survival increase. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed, at molecular level, the apoptotic increase caused by piroxicam/cisplatin treatment in MM cell lines. By means of genome wide analyses, we analyzed transcriptional gene deregulation both after the single piroxicam or cisplatin and the combined treatment. Here we show that apoptotic increase following combined treatment is mediated by p21, since apoptotic increase in piroxicam/cisplatin combined treatment is abolished upon p21 silencing. CONCLUSIONS/SIGNIFICANCE: Piroxicam/cisplatin combined treatment determines an apoptosis increase in MM cells, which is dependent on the p21 expression. The results provided suggest that piroxicam/cisplatin combination might be tested in clinical settings in tumor specimens that express p21.

Apoptosis Induced by Piroxicam plus Cisplatin Combined Treatment Is Triggered by p21 in Mesothelioma

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Baldi, Alfonso; Piccolo, Maria Teresa; Boccellino, Maria Rosaria; Donizetti, Aldo; Cardillo, Irene; La Porta, Raffaele; Quagliuolo, Lucio; Spugnini, Enrico P.; Cordero, Francesca; Citro, Gennaro; Menegozzo, Massimo; Calogero, Raffaele A.; Crispi, Stefania

2011-01-01

Background Malignant mesothelioma (MM) is a rare, highly aggressive tumor, associated to asbestos exposure. To date no chemotherapy regimen for MM has proven to be definitively curative, and new therapies for MM treatment need to be developed. We have previously shown in vivo that piroxicam/cisplatin combined treatment in MM, specifically acts on cell cycle regulation triggering apoptosis, with survival increase. Methodology/Principal Findings We analyzed, at molecular level, the apoptotic increase caused by piroxicam/cisplatin treatment in MM cell lines. By means of genome wide analyses, we analyzed transcriptional gene deregulation both after the single piroxicam or cisplatin and the combined treatment. Here we show that apoptotic increase following combined treatment is mediated by p21, since apoptotic increase in piroxicam/cisplatin combined treatment is abolished upon p21 silencing. Conclusions/Significance Piroxicam/cisplatin combined treatment determines an apoptosis increase in MM cells, which is dependent on the p21 expression. The results provided suggest that piroxicam/cisplatin combination might be tested in clinical settings in tumor specimens that express p21. PMID:21858171

Treatment-refractory anxiety; definition, risk factors, and treatment challenges.

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Roy-Byrne, Peter

2015-06-01

A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to "pseudo-resistance" (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true "treatment resistance." Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to unrecognized exogenous anxiogenic factors (eg, caffeine overuse, sleep deprivation, use of alcohol or marijuana) or an incorrect diagnosis (eg, atypical bipolar illness, occult substance abuse, attention deficit-hyperactivity disorder). Once the above factors are eliminated, treatment should focus on combining effective medications and cognitive behavioral therapy, combining several medications (augmentation), or employing novel medications or psychotherapies not typically indicated as first-line evidence-based anxiety treatments.

Evaluation of Therapy Management and Patient Compliance in Postmenopausal Patients with Hormone Receptor-positive Breast Cancer Receiving Letrozole Treatment: The EvaluateTM Study

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Fasching, P. A.; Fehm, T.; Kellner, S.; de Waal, J.; Rezai, M.; Baier, B.; Baake, G.; Kolberg, H.-C.; Guggenberger, M.; Warm, M.; Harbeck, N.; Würstlein, R.; Deuker, J.-U.; Dall, P.; Richter, B.; Wachsmann, G.; Brucker, C.; Siebers, J. W.; Fersis, N.; Kuhn, T.; Wolf, C.; Vollert, H.-W.; Breitbach, G.-P.; Janni, W.; Landthaler, R.; Kohls, A.; Rezek, D.; Noesslet, T.; Fischer, G.; Henschen, S.; Praetz, T.; Heyl, V.; Kühn, T.; Krauß, T.; Thomssen, C.; Kümmel, S.; Hohn, A.; Tesch, H.; Mundhenke, C.; Hein, A.; Rauh, C.; Bayer, C. M.; Jacob, A.; Schmidt, K.; Belleville, E.; Hadji, P.; Wallwiener, D.; Grischke, E.-M.; Beckmann, M. W.; Brucker, S. Y.

2014-01-01

Introduction: The EvaluateTM study (Evaluation of therapy management and patient compliance in postmenopausal hormone receptor-positive breast cancer patients receiving letrozole treatment) is a prospective, non-interventional study for the assessment of therapy management and compliance in the routine care of postmenopausal women with invasive hormone receptor-positive breast cancer receiving letrozole. The parameters for inclusion in the study are presented and discussed here. Material and Methods: Between January 2008 and December 2009 a total of 5045 patients in 310 study centers were recruited to the EvaluateTM study. Inclusion criteria were hormone receptor-positive breast cancer and adjuvant treatment or metastasis. 373 patients were excluded from the analysis for various reasons. Results: A total of 4420 patients receiving adjuvant treatment and 252 patients with metastasis receiving palliative treatment were included in the study. For 4181 patients receiving adjuvant treatment, treatment with the aromatase inhibitor letrozole commenced immediately after surgery (upfront). Two hundred patients had initially received tamoxifen and started aromatase inhibitor treatment with letrozole at 1–5 years after diagnosis (switch), und 39 patients only commenced letrozole treatment 5–10 years after diagnosis (extended endocrine therapy). Patient and tumor characteristics were within expected ranges, as were comorbidities and concurrent medication. Conclusion: The data from the EvaluateTM study will offer a good overview of therapy management in the routine care of postmenopausal women with hormone receptor-positive breast cancer. Planned analyses will look at therapy compliance and patient satisfaction with how information is conveyed and the contents of the conveyed information. PMID:25568468

Protective specific immunity induced by cyclophosphamide plus tumor necrosis factor alpha combination treatment of EL4-lymphoma-bearing C57BL/6 mice.

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Krawczyk, C M; Verstovsek, S; Ujházy, P; Maccubbin, D; Ehrke, M J

1995-06-01

A combination treatment protocol initiated 12 days after tumor injection, when the tumor was large, by administering cyclophosphamide (CY, 150 or 250 mg/kg) intraperitoneally followed by intravenous tumor necrosis factor alpha (TNF alpha, 1000 units injection) on days 13, 16, 18, 21, and 23, resulted in about 60% long-term survival (i.e., survival for at least 60 days) in the syngeneic C57BL/6 mouse/EL4 lymphoma model system. The establishment of a specific antitumor immune memory and its possible therapeutic relevance was verified by reinjecting 60-day survivors with EL4 cells; all 60-day survivors that had received the combination treatments rejected the implants and survived for a further 60 days. Thymic cellularity was reduced during treatment and its recovery appeared to correlate with long-term survival and immunity. Thymocytes from mice treated with the combination were found to express significant levels of specific anti-EL4 cytolytic activity following a 4-day stimulation culture with X-irradiated EL4 cells and low concentrations of interleukin-2. This response could not be generated with thymocytes from naive animals. In each case the effect seen with the combination of a moderate CY dose (150 mg/kg) with TNF alpha was better than that seen with either dose of CY alone and equal to or better than that seen with the higher dose of CY combined with TNF alpha. These results indicate that treatment with a single moderate dose of CY in combination with TNF alpha is effective against a large, established tumor in this murine model. Furthermore, all the long-term survivors induced by this treatment developed protective immunity against reimplanted tumor and demonstrated a long-term specific immune memory in the thymus.

Combined chemotherapy and radiotherapy in the treatment of lung cancer

International Nuclear Information System (INIS)

Wolf, M.

1992-01-01

In the past decade the prognosis of patients with locally advanced lung cancer has not been altered significantly. In both small and non-small cell lung cancer cure rates are poor and 5-year survival rate still has not exceeded the 5% borderline. Despite of initially high response rates, a vast majority of patients suffered from tumor progression within 2 years after the start of treatment. Sites of tumor progression are either the primary tumor or the occurrence of distant metastases. Therefore, improvements of both local and systemic tumor control are necessary to increase long-term survival rate in lung cancer. Combined chemo- and radiotherapy may be an appropriate treatment approach to reach these aims. In patients with locally advanced lung cancer combined chemo-radiotherapy aims at overcoming radio- and chemo-therapy resistance as a cause of local treatment failure and at early eradication of distant micrometastases as a cause of systemic treatment failure. (author). 29 refs., 2 figs., 6 tabs

Combination pharmacotherapy for the treatment of fibromyalgia in adults.

Science.gov (United States)

Thorpe, Joelle; Shum, Bonnie; Moore, R Andrew; Wiffen, Philip J; Gilron, Ian

2018-02-19

Fibromyalgia is a chronic widespread pain condition affecting millions of people worldwide. Current pharmacotherapies are often ineffective and poorly tolerated. Combining different agents could provide superior pain relief and possibly also fewer side effects. To assess the efficacy, safety, and tolerability of combination pharmacotherapy compared to monotherapy or placebo, or both, for the treatment of fibromyalgia pain in adults. We searched CENTRAL, MEDLINE, and Embase to September 2017. We also searched reference lists of other reviews and trials registries. Double-blind, randomised controlled trials comparing combinations of two or more drugs to placebo or other comparators, or both, for the treatment of fibromyalgia pain. From all studies, we extracted data on: participant-reported pain relief of 30% or 50% or greater; patient global impression of clinical change (PGIC) much or very much improved or very much improved; any other pain-related outcome of improvement; withdrawals (lack of efficacy, adverse events), participants experiencing any adverse event, serious adverse events, and specific adverse events (e.g. somnolence and dizziness). The primary comparison was between combination and one or all single-agent comparators. We also assessed the evidence using GRADE and created a 'Summary of findings' table. We identified 16 studies with 1474 participants. Three studies combined a non-steroidal anti-inflammatory drug (NSAID) with a benzodiazepine (306 participants); two combined amitriptyline with fluoxetine (89 participants); two combined amitriptyline with a different agent (92 participants); two combined melatonin with an antidepressant (164 participants); one combined carisoprodol, paracetamol (acetaminophen), and caffeine (58 participants); one combined tramadol and paracetamol (acetaminophen) (315 participants); one combined malic acid and magnesium (24 participants); one combined a monoamine oxidase inhibitor with 5-hydroxytryptophan (200

Development of a Multicomponent Prediction Model for Acute Esophagitis in Lung Cancer Patients Receiving Chemoradiotherapy

International Nuclear Information System (INIS)

De Ruyck, Kim; Sabbe, Nick; Oberije, Cary; Vandecasteele, Katrien; Thas, Olivier; De Ruysscher, Dirk; Lambin, Phillipe; Van Meerbeeck, Jan; De Neve, Wilfried; Thierens, Hubert

2011-01-01

Purpose: To construct a model for the prediction of acute esophagitis in lung cancer patients receiving chemoradiotherapy by combining clinical data, treatment parameters, and genotyping profile. Patients and Methods: Data were available for 273 lung cancer patients treated with curative chemoradiotherapy. Clinical data included gender, age, World Health Organization performance score, nicotine use, diabetes, chronic disease, tumor type, tumor stage, lymph node stage, tumor location, and medical center. Treatment parameters included chemotherapy, surgery, radiotherapy technique, tumor dose, mean fractionation size, mean and maximal esophageal dose, and overall treatment time. A total of 332 genetic polymorphisms were considered in 112 candidate genes. The predicting model was achieved by lasso logistic regression for predictor selection, followed by classic logistic regression for unbiased estimation of the coefficients. Performance of the model was expressed as the area under the curve of the receiver operating characteristic and as the false-negative rate in the optimal point on the receiver operating characteristic curve. Results: A total of 110 patients (40%) developed acute esophagitis Grade ≥2 (Common Terminology Criteria for Adverse Events v3.0). The final model contained chemotherapy treatment, lymph node stage, mean esophageal dose, gender, overall treatment time, radiotherapy technique, rs2302535 (EGFR), rs16930129 (ENG), rs1131877 (TRAF3), and rs2230528 (ITGB2). The area under the curve was 0.87, and the false-negative rate was 16%. Conclusion: Prediction of acute esophagitis can be improved by combining clinical, treatment, and genetic factors. A multicomponent prediction model for acute esophagitis with a sensitivity of 84% was constructed with two clinical parameters, four treatment parameters, and four genetic polymorphisms.

Comparison of a long-pulse Nd:YAG laser and a combined 585/1,064-nm laser for the treatment of acne scars: a randomized split-face clinical study.

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Min, Seong U K; Choi, Yu Sung; Lee, Dong Hun; Yoon, Mi Young; Suh, Dae Hun

2009-11-01

Nonablative laser is gaining popularity because of the low risk of complications, especially in patients with darker skin. To compare the efficacy and safety of a long-pulse neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and a combined 585/1,064-nm laser for the treatment of acne scars. Nineteen patients with mild to moderate atrophic acne scars received four long-pulse Nd:YAG laser or combined 585/1,064-nm laser treatment sessions at fortnightly intervals. Treatments were administered randomly in a split-face manner. Acne scars showed mild to moderate improvement, with significant Echelle d'évaluation clinique des cicatrices d'acné (ECCA) score reductions, after both treatments. Although intermodality differences were not significant, combined 585/1,064-nm laser was more effective for deep boxcar scars. In patients with combined 585/1,064-nm laser-treated sides that improved more than long-pulse Nd:YAG laser-treated sides, ECCA scores were significantly lower for combined 585/1,064-nm laser treatment. Histologic evaluations revealed significantly greater collagen deposition, although there was no significant difference between the two modalities. Patient satisfaction scores concurred with physicians' evaluations. Both lasers ameliorated acne scarring with minimal downtime. In light of this finding, optimal outcomes might be achieved when laser treatment types are chosen after considering individual scar type and response.

Novel low fluence combination laser treatment of solar lentigines in type III Asian skin

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Brian Wei Cheng Anthony Tian

2015-01-01

Full Text Available Objective: To demonstrate a novel low fluence combination laser technique [Erbium-doped yttrium aluminum garnet (Erb:YAG and neodymium-doped yttrium aluminum garnet (Nd:YAG] to effectively treat solar lentigines in type III Asian skin in a single session. Design: A prospective study. Setting: A Singapore-based clinic. Participants: Five patients (all females were enrolled into the study. The ages ranged 35-60 years; all patients had Fitzpatrick skin type III. Measurements: Photographs were taken at baseline and at 1-month follow-up. These were reviewed by two independent physicians who were blinded to the study. Changes in pigment severity were assessed by a 5-point scale (1: Aggravation of pigment, 2: No change, 3: 25-50% improvement, 4: 51-75% improvement, and 5: 76-100% improvement. Results: All patients received a single treatment session. At 1-month follow-up, a reduction in pigment was observed in all patients. Both physicians′ reports were independently agreeable. All patients scored 5, having >90% improvement in pigment severity. No hypopigmentation, postinflammatory hyperpigmentation (PIH, or recurrence was seen. Conclusion: Low fluence combination laser is effective and safe for clearance of solar lentigines in type III Asian skin.

Treatment of Osteoarthritis of the Knee with a Combination of Autologous Conditioned Serum and Physiotherapy: A Two-Year Observational Study.

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Baselga García-Escudero, Jaime; Miguel Hernández Trillos, Pedro

2015-01-01

Autologous conditioned serum (ACS) is an autologous blood product that has shown efficacy against knee osteoarthritis (OA) in randomized controlled trials. However, there are few reports of its effectiveness in everyday practice. Here, we report clinical efficacy results from a two-year prospective observational study of patients with highly symptomatic knee OA who received ACS in conjunction with physiotherapy. 118 patients with unilateral knee OA (Kellgren-Lawrence grades I-IV), who were candidates for surgery but instead chose conservative treatment, were treated with a combination of four intra-articular injections of ACS (2 mL each) once weekly over four weeks and subsequent physiotherapy applied 4 weeks after ACS injection. Main endpoints of the study were pain (Numeric Rating Scale [NRS]) assessed at 0, 3, 6, 12 and 24 months, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) global score, assessed at 0 and 24 months. The effect size (Cohen's d) was calculated for pain and WOMAC outcomes, with effect sizes >0.8 considered large. By 3 months, there were significant improvements in pain (NRS) from baseline (-63.0%, p5) and WOMAC improvement (8.0-13.6) were very large. Only one patient received total knee joint replacement during the study. Clinical improvement did not correlate with gender, age, Kellgren-Lawrence grade, or body mass index. Treatment with ACS and physiotherapy produced a rapid decline in pain, which was sustained for the entire two years of the study. This was accompanied by a large improvement in WOMAC scores at two years. These results confirm that ACS combined with physiotherapy is an effective treatment for OA of the knee.

Treatment of Osteoarthritis of the Knee with a Combination of Autologous Conditioned Serum and Physiotherapy: A Two-Year Observational Study.

Directory of Open Access Journals (Sweden)

Jaime Baselga García-Escudero

Full Text Available Autologous conditioned serum (ACS is an autologous blood product that has shown efficacy against knee osteoarthritis (OA in randomized controlled trials. However, there are few reports of its effectiveness in everyday practice. Here, we report clinical efficacy results from a two-year prospective observational study of patients with highly symptomatic knee OA who received ACS in conjunction with physiotherapy.118 patients with unilateral knee OA (Kellgren-Lawrence grades I-IV, who were candidates for surgery but instead chose conservative treatment, were treated with a combination of four intra-articular injections of ACS (2 mL each once weekly over four weeks and subsequent physiotherapy applied 4 weeks after ACS injection. Main endpoints of the study were pain (Numeric Rating Scale [NRS] assessed at 0, 3, 6, 12 and 24 months, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC global score, assessed at 0 and 24 months. The effect size (Cohen's d was calculated for pain and WOMAC outcomes, with effect sizes >0.8 considered large.By 3 months, there were significant improvements in pain (NRS from baseline (-63.0%, p5 and WOMAC improvement (8.0-13.6 were very large. Only one patient received total knee joint replacement during the study. Clinical improvement did not correlate with gender, age, Kellgren-Lawrence grade, or body mass index.Treatment with ACS and physiotherapy produced a rapid decline in pain, which was sustained for the entire two years of the study. This was accompanied by a large improvement in WOMAC scores at two years. These results confirm that ACS combined with physiotherapy is an effective treatment for OA of the knee.

Combined treatment of ionizing radiation with genistein on cervical cancer HeLa cells

International Nuclear Information System (INIS)

Zhang Bei; Liu Jiayin; Han Suping; Pan Jinshun; Yin Xiaoxing; Wang Bing; Hu Gang

2006-01-01

The anticancer agent genistein inhibits cell growth of tumor cell lines from various malignancies. In our study, we investigated the effectiveness of combined treatment of ionizing radiation (IR) with genistein on cervical HeLa cells and its possible mechanism. It was found that the inhibitory rate in cells with combined treatment was significantly higher than that of the cells treated with IR or genistein alone. After treatments of IR (4 Gy) combined with genistein (40 μmol/L), the apoptotic index of the cells was significantly increased and the cells were arrested in the G2/M phase. Survivin mRNA expression increased after IR (4 Gy), while it significantly decreased after combined treatment. These findings indicated that genistein enhanced the radiosensitivity of cervical cancer HeLa cells, and the mechanisms for this action might include increase of apoptosis, decrease of survivin expression, and prolongation of cell cycle arrest. (author)

Sample size requirements for separating out the effects of combination treatments: Randomised controlled trials of combination therapy vs. standard treatment compared to factorial designs for patients with tuberculous meningitis

Directory of Open Access Journals (Sweden)

Farrar Jeremy

2011-02-01

Full Text Available Abstract Background In certain diseases clinical experts may judge that the intervention with the best prospects is the addition of two treatments to the standard of care. This can either be tested with a simple randomized trial of combination versus standard treatment or with a 2 × 2 factorial design. Methods We compared the two approaches using the design of a new trial in tuberculous meningitis as an example. In that trial the combination of 2 drugs added to standard treatment is assumed to reduce the hazard of death by 30% and the sample size of the combination trial to achieve 80% power is 750 patients. We calculated the power of corresponding factorial designs with one- to sixteen-fold the sample size of the combination trial depending on the contribution of each individual drug to the combination treatment effect and the strength of an interaction between the two. Results In the absence of an interaction, an eight-fold increase in sample size for the factorial design as compared to the combination trial is required to get 80% power to jointly detect effects of both drugs if the contribution of the less potent treatment to the total effect is at least 35%. An eight-fold sample size increase also provides a power of 76% to detect a qualitative interaction at the one-sided 10% significance level if the individual effects of both drugs are equal. Factorial designs with a lower sample size have a high chance to be underpowered, to show significance of only one drug even if both are equally effective, and to miss important interactions. Conclusions Pragmatic combination trials of multiple interventions versus standard therapy are valuable in diseases with a limited patient pool if all interventions test the same treatment concept, it is considered likely that either both or none of the individual interventions are effective, and only moderate drug interactions are suspected. An adequately powered 2 × 2 factorial design to detect effects of

Experimental Study of Advanced Treatment of Coking Wastewater Using MBR-RO Combined Process

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Zhang, Lei; Hwang, Jiannyang; Leng, Ting; Xue, Gaifeng; Chang, Hongbing

A membrane bioreactor-reverse osmosis (MBR-RO) combined process was used for advanced treatment of coking wastewater from secondary biological treatment. MBR and RO units' treatment efficiency for the pollution removal were conducted, and effects of raw water conductivity and trans-membrane pressure on water yield and desalination rate in RO unit were investigated in detail. The experimental results proved that MBR-RO combined process ran steadily with good treatment effect, which could obtain stable effluent water quality and met the requirement of "Design Criterion of the Industrial Circulating Cooling Water Treatment" (GB 50050-2007).

[The assessment of the effectiveness of fenspiride (erespal) for the combined treatment of the patients presenting with exudative otitis media].

Science.gov (United States)

Mel'chinskiĭ, A N; Vasilenko, D Iu; Kiseleva, G V

2013-01-01

The objective of the present work was to estimate the effectiveness and safety of combined anti-inflammatory therapy of exudative otitis media with the use of fenspiride (erespal). The study included 75 patients of whom 35 (group 1) were given standard therapy supplemented by erespal (80 mg thrice daily); the remaining patients receiving standard therapy alone formed group 2 (control). The patients treated with erespal reported the subjective improvement of hearing and reduced congestion on days 7 - 8. Similar changes in group 2 occurred on day 10. It is concluded that the use of erespal for the combined treatment of the patients presenting with exudative otitis media reduces the duration of hospital stay, accelerates recovery, and promotes rapid normalization of hearing.

Assessment of the doses received by patients with pacemakers who have received treatment of external radiotherapy; Evaluacion de la dosis recibida por pacientes con marcapasos que han recibido tratamiento de radioterapia externa

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Rodriguez Alarcon, C.; Carrasco Herrera, M. A.; Vicent Grandado, D.; Gutierrez Ramos, S. M.; Herrador Cordoba, M.

2013-07-01

The objective of this study is to estimate with system planning, TPS the dose that would receive the pacemaker and its comparison with the dose received during the treatment a film radiochromic EBT2 located in the area where it is located. (Author)

Treatment selection for stage IIIA Hodgkin's disease patients

International Nuclear Information System (INIS)

Prosnitz, L.R.; Cooper, D.; Cox, E.B.; Kapp, D.S.; Farber, L.R.

1985-01-01

Two treatment policies for the therapy of patients with Stage IIIA Hodgkin's disease are compared. From 1969-1976, 49 newly diagnosed and pathologically staged IIIA patients received total nodal irradiation (TNI) alone (no liver irradiation). Although actuarial survival was 80% at 5 years and 68% at 10 years, actuarial freedom from relapse was only 38% at 5 years. Accordingly, a new treatment policy was instituted in 1976. Patients with either CS IIIA disease, multiple splenic nodules, IIIA with a large mediastinal mass or III 2 , received combined modality therapy (combination chemotherapy and irradiation). All others received TNI. Thirty-six patients have been treated under the new program. The actuarial survival is 90% at 5 years and the relapse-free survival is 87%, suggesting the superiority of this approach. Complications from the treatments are discussed

Cerebral tuberculoma in a patient receiving anti-TNF alpha (adalimumab) treatment.

LENUS (Irish Health Repository)

Lynch, Karen

2010-10-01

We report a case of a cerebral tuberculoma in a 60-year-old woman with rheumatoid arthritis while receiving the anti-tumor necrosis factor alpha monoclonal antibody, adalimumab (Humira), for active disease. MR brain imaging for dyspraxia revealed a left parietal ring-enhancing lesion, which on resection was shown to be a necrotizing granuloma. There were no associated pulmonary lesions, and the patient was systemically well. Sputum and urine cultures were negative for tuberculosis. The patient was treated with anti-tuberculous medications and made an excellent recovery. We consider this to be the first documented case of tuberculosis involving the central nervous system occurring in the setting of adalimumab treatment.

Successful treatment of a large oral verrucous hyperplasia with photodynamic therapy combined with cryotherapy

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Yu-Chao Chang

2013-03-01

Full Text Available Studies have shown that topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT can be used successfully for the treatment of oral verrucous hyperplasia (OVH. Studies have also demonstrated that cryotherapy could be used as a treatment modality for OVH lesions. In this case report, we tested the efficacy of topical ALA-PDT, combined with cryogun cryotherapy, for an extensive OVH lesion on the right buccal mucosa of a 65-year-old male areca quid chewer. The tumor was cleared after six treatments of combined topical ALA-PDT and cryogun cryotherapy. No recurrence of the lesion was found after a follow-up period of 18 months. We suggest that our combined treatment protocol may be effective in treating OVH lesions. The treatment course may be slightly shortened with this combined protocol and was well tolerated by the patient.

Association between Gastrointestinal Illness and Precipitation in Areas Impacted by Combined Sewer Systems: Utilizing a Distributed Lag Model

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Combined sewer systems collect rainwater runoff, sewage, and industrial wastewater for transit to treatment facilities. With heavy precipitation, volumes can exceed capacity of treatment facilities, and wastewater discharges directly to receiving waters. These combined sewer over...

Early postoperative magnet application combined with hydrocolloid dressing for the treatment of earlobe keloids.

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Park, Tae Hwan; Chang, Choong Hyun

2013-04-01

To prevent the recurrence of earlobe keloids after surgical removal, a reliable and safe postoperative treatment method is critical. To the authors' knowledge, no studies have elucidated the most effective postoperative dressing method for preventing the recurrence of earlobe keloids. This study aimed to compare keloid recurrence rates in patients whose keloids were dressed using conventional methods (plain gauze or a polyvinyl alcohol sponge) with those of a matched cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials. This observational case-control study compared a retrospective cohort of patients whose keloids were dressed using conventional methods with a matched prospective cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials. The study included patients with pathologically confirmed earlobe keloids that were surgically excised with primary closure. Patients 8 years of age or older underwent adjuvant pressure therapy with magnets at the study hospital. Patients were excluded from the study if they were unavailable for follow-up evaluation, if they had received additional adjuvant therapy during treatment, or if histologic confirmation of a keloid was not obtained. Matched-pair analysis was performed using the McNemar test. Treatment outcome was evaluated as recurrence or nonrecurrence. Overall, 9 (11.2%) of the 80 study patients experienced recurrence. The recurrence rate was significantly lower in the matched case group (2 of 40, 5%) than in the matched control group (7 of 40, 17.5%) during the follow-up period of 18 months (p=0.0253). The authors' novel dressing of magnets and hydrocolloid materials appears to be effective in reducing earlobe keloid recurrence. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to

Comparative evaluation of combined irradiation and hyperthermia versus irradiation alone

International Nuclear Information System (INIS)

Sawas-Dimopoulou, C.; Iordanou, I.; Uzunoglu, N.; Dardoufas, K.; Kouloulias, V.; Maris, T.; Kotaridis, S.

1994-01-01

Controvesy remains as to the treatment schedule producing better results in combined hyperthermia and X-ray therapy. Our experience concerning combined therapy of the solid tumour Walker carcinoma is reported. Male Wistar rats were submitted to treatment on the ninth day after transplantation of the tumour. Two groups of rats received either a therapeutic X-ray dose of 800 cGy by a 6-MeV linear accelerator (Mevatron, Siemens) or treatment by 432 MHz of microwaves with continuous control of tumour tissue temperature to 44±1 C for 45 min. Another group of rats was submitted to a combined treatment, with X-ray therapy preceding hyperthermia by 24 h. The last group of animals constituted the control rats. Greater tumour regression and longer survival times were obtained with the combined treatment. The gain factor for survival time was equal to 1.85 after combined treatment compared with 1.30 after X-ray therapy and 1.05 after hyperthermia. In conclusion, the results suggest that in the above schedule of combined treatment, hyperthermia applied to a solid tumour 24 h after a single dose of X-rays enhances the beneficial effect of therapy. (orig.)

Transarterial chemoembolization combined with sorafenib for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

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Zhang YF

2016-07-01

Full Text Available Yong-Fa Zhang,1–3,* Wei Wei,1–3,* Jia-Hong Wang,1–3,* Li Xu,1–3 Pei-En Jian,1–3 Cheng-Zuo Xiao,4 Xiao-Ping Zhong,1–3 Ming Shi,1–3 Rong-Ping Guo1–3 1Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, 2State Key Laboratory of Oncology in South China, 3Collaborative Innovation Center for Cancer Medicine, Guangzhou, 4Department of General Surgery, Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University, Shenzhen, People’s Republic of China *These authors contributed equally to this work Objective: To compare the treatment outcomes of sorafenib plus transarterial chemoembolization (TACE vs TACE alone in patients with hepatocellular carcinoma (HCC and hepatic vein tumor thrombus (HVTT.Methods: Twenty patients who were initially diagnosed with HCC and HVTT and received TACE combined with sorafenib during February 2009 to October 2013 were included in the study. To minimize selection bias, these patients were compared with 60 case-matched controls selected from a pool of 81 patients (in a 1:3 ratio who received TACE alone during the same period. The primary end point was overall survival (OS. The secondary end points were time to progression, disease control rate, and adverse events.Results: After a median follow-up period of 12.5 months (range, 1.03–44.23 months, the OS of the combined group was found to be significantly higher compared with the monotherapy group (14.9 vs 6.1 months, P=0.010. The time to progression was found to be significantly longer in the combined group (4.9 vs 2.4 months, P=0.016. Univariate and multivariate analyses revealed that the treatment allocation was an independent predictor of OS.Conclusion: Sorafenib plus TACE was well tolerated and was more effective in treating patients with advanced HCC and HVTT. Future trials with prospective larger samples are required to validate these results. Keywords: hepatocellular carcinoma, hepatic vein tumor thrombus, prognosis

Effect of Short-term Quercetin, Caloric Restriction and Combined Treatment on Age-related Oxidative Stress Markers in the Rat Cerebral Cortex

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Alugoju, Phaniendra; Swamy, Vkd Krishan; Periyasamy, Latha

2018-03-14

Aging is characterized by gradual accumulation of macromolecular damage leading to progressive loss of physiological function and increased susceptibility to diverse diseases. Effective anti-aging strategies involving caloric restriction or antioxidant supplementation are receiving growing attention to attenuate macromolecular damage in age associated pathology. In the present study, we for the first time investigated the effect of quercetin, caloric restriction and combined treatment (caloric restriction with quercetin) on oxidative stress parameters, acetylcholinesterase and ATPases enzyme activities in the cerebral cortex of aged male Wistar rats. 21 months aged rats were divided into four groups (n=6-8) such as group 1-fed ad libitum (AL); group 2-quercetin supplementation of 50 mg/kg b.w/day for 45 days fed ad libitum (QUER); group 3: caloric restricted (CR) (fed 40% reduced AL for 45 days); group 4-fed 40% CR and 50 mg/kg b.w/day QUER for 45 days (CR + QUER). Group 5-three month age old rats served as young control (YOUNG). Our results demonstrate that combined treatment of caloric restriction and quercetin significantly improved the age associated decline in the activities of endogenous antioxidant enzymes [such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)] and glutathione (GSH) content and attenuated elevated levels of protein carbonyl content (PCC), lipid peroxidation, lipofuscin, reactive oxygen species (ROS), and nitric oxide (NO). Furthermore, it is also observed that combined treatment ameliorated age associated alterations in acetylcholine esterase (AChE) and adenosine triphosphatases (ATPases) such as Na+/K+-ATPase and Ca+2-ATPase (but not Mg+2- ATPase) enzyme activities. Finally, we conclude that combined treatment of caloric restriction and quercetin (but not either treatment alone) in late life is an effective anti-aging therapy to counteract the age related accumulation of oxidative macromolecular damage

Hodgkin Illness in the childhood. Results with combined treatment of OPPA with radiotherapy

International Nuclear Information System (INIS)

Terselich z, Gretti

1999-01-01

A retrospective revision was made (not randomized) among the years 1988 and 1997, of patients histories that had entered the INC for treatment for the Hodgkin illness. All the cases, patient smaller than 16 years were studied, that had not been treated in other centers neither it had received another oncospecific treatment. The sheets or the anatomy-pathology study were revised, being remarkable that for but of 10 years the histology study is in charge of oneself pathologists' group. In total 144 patients were recruited; 29 were excluded: 2 for treatments in other centers, 17 to only have received radiotherapy, 9 to receive other outlines of treatment chemo therapeutic and a patient to reject the treatment; finally 115 patients were studied. To all they were made complete analysis of hematology with erythro sedimentation and serology for hepatitis study B and C. Biopsy of bony marrow was not made in the I and II states; echography and thorax X rays, was made to all patients but the TAC it could not be carried out to all for logistical difficulties; in some patients the corporal journey was made with gammagraphy, using gallium. The final results showed a complete answer in 100 patients (87%). There were 7 deaths: 2 for causes different to the illness, one for sepsis for klebsiella, one for cardio toxicity for anthracycline, 2 for abandonment of the treatment and 3 patients got lost. 13 patients were presented with neutropenia, 3 patients with pneumonia, 1 with chicken pox and 2 with sepsis. The global survival is of 90%

Clinical utility and development of the fluticasone/formoterol combination formulation (Flutiform® for the treatment of asthma

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Tan RA

2014-09-01

Full Text Available Ricardo Antonio Tan,1 Jonathan Corren2 1California Allergy and Asthma Medical Group, 2David Geffen School of Medicine at UCLA, Los Angeles, CA, USAAbstract: Pharmacologic treatment of asthma should be done with a stepwise approach recommended in treatment guidelines. If inhaled corticosteroids (ICSs alone are not adequate, ICSs in combination with long-acting β-agonists (LABAs are now established and widely used as the next step in effective controller therapy. Fixed-dose ICS/LABA combinations in a single device are the preferred form of delivery and improve compliance by enabling patients to get symptom relief from the LABA while receiving the anti-inflammatory benefits of ICSs. Fluticasone propionate/formoterol fumarate is one of the newest fixed-dose combinations. It has been in use in Europe in 2012, but is still under regulatory review in the US. Fluticasone is a synthetic ICS with potent anti-inflammatory effects, while formoterol is a selective β2-adrenergic receptor agonist with a rapid onset of bronchodilation within 5–10 minutes and a 12-hour duration of action. Fluticasone/formoterol has shown superior efficacy when compared to fluticasone or formoterol alone in multiple well-designed studies. The combination has shown comparable or “noninferior” benefits in lung function, clinical symptoms, and asthma control when compared with fluticasone and formoterol administered concurrently in separate inhalers. Fluticasone/formoterol provides similar efficacy with fluticasone/salmeterol, but with more rapid symptom relief. It has been compared directly with budesonide/formoterol with comparable results. Fluticasone/formoterol is well tolerated, with no unusual or increased safety concerns versus each individual component or other available ICS/LABA combinations. Fluticasone/formoterol is the latest entry into a relatively crowded market of branded fixed-dose preparations. Upcoming generic fixed-dose combinations and once-daily agents

Treatment-refractory anxiety; definition, risk factors, and treatment challenges

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Roy-Byrne, Peter

2015-01-01

A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to “pseudo-resistance” (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true “treatment resistance.” Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to unrecognized exogenous anxiogenic factors (eg, caffeine overuse, sleep deprivation, use of alcohol or marijuana) or an incorrect diagnosis (eg, atypical bipolar illness, occult substance abuse, attention deficit-hyperactivity disorder). Once the above factors are eliminated, treatment should focus on combining effective medications and cognitive behavioral therapy, combining several medications (augmentation), or employing novel medications or psychotherapies not typically indicated as first-line evidence-based anxiety treatments. PMID:26246793

Inhibition of SIRT1 combined with gemcitabine therapy for pancreatic carcinoma

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Gong DJ

2013-07-01

Full Text Available Dao-Jun Gong,1 Jia-Min Zhang,1 Min Yu,1 Bo Zhuang,1 Qing-Qu Guo21Department of Hepatobiliary-Pancreatic Surgery, Jinhua Hospital of Zhejiang University, Jinhua, People's Republic of China; 2Department of Surgery, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, People's Republic of ChinaBackground: Pancreatic carcinoma possesses one of the highest lethality rates, highest drug-resistance, and highest incidence rates. The objective of this research was to enhance the efficacy and drug-resistance for pancreatic carcinoma by using inhibition of SIRT1 combined with gemcitabine therapy methods.Methods: Three pancreatic carcinoma cells (PANC-1 cells, BxPC-3 cells, and SW1990 cells received treatment with physiological saline, inhibition of SIRT1, gemcitabine, and combination therapy with inhibition of SIRT1 and gemcitabine in vitro; then BxPC-3 pancreatic cancer xenogeneic mice also received treatment with physiological saline, inhibition of SIRT1, gemcitabine, and combination therapy with inhibition of SIRT1 and gemcitabine in vivo.Results: The cleaved poly ADP ribose polymerase (PARP-1 effect of drug in pancreatic carcinoma cells was significantly different (P < 0.05 and the efficacy in descending order was the combination therapy with inhibition of SIRT1 and gemcitabine, inhibition of SIRT1, and gemcitabine. The BxPC-3 pancreatic cancer xenogeneic mice model received treatment with physiological saline, inhibition of SIRT1, gemcitabine, and combination therapy with inhibition of SIRT1 and gemcitabine in vivo and the results showed that the tumor volumes decreased and the survival rate within 45 days increased according to the order of the given drugs and the difference was significant (P < 0.05.Conclusion: Combination therapy with inhibition of SIRT1 and gemcitabine could improve efficacy and survival time in a BxPC-3 pancreatic cancer xenogeneic mice model, compared with single inhibition of SIRT1, or single

Trazodone plus pregabalin combination in the treatment of fibromyalgia: a two-phase, 24-week, open-label uncontrolled study

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Rodriguez-Lopez Carmen M

2011-05-01

Full Text Available Abstract Background Although trazodone is frequently used by fibromyalgia patients, its efficacy on this disease has not been adequately studied. If effective, pregabalin, whose beneficial effects on pain and sleep quality in fibromyalgia have been demonstrated, could complement the antidepressant and anxiolytic effects of trazodone. The aim of the present study was to assess the effectiveness of trazodone alone and in combination with pregabalin in the treatment of fibromyalgia. Methods This was an open-label uncontrolled study. Trazodone, flexibly dosed (50-300 mg/day, was administered to 66 fibromyalgia patients during 12 weeks; 41 patients who completed the treatment accepted to receive pregabalin, also flexibly dosed (75-450 mg/day, added to trazodone treatment for an additional 12-week period. Outcome measures included the Fibromyalgia Impact Questionnaire (FIQ, the Pittsburgh Sleep Quality Index (PSQI, the Beck Depression Inventory (BDI, the Hospital Anxiety and Depression Scale (HADS, the Brief Pain Inventory (BPI, the Short-Form Health Survey (SF-36, and the Patients' Global Improvement scale (PGI. Emergent adverse reactions were recorded. Data were analyzed with repeated measures one-way ANOVA and paired Student's t test. Results Treatment with trazodone significantly improved global fibromyalgia severity, sleep quality, and depression, as well as pain interference with daily activities although without showing a direct effect on bodily pain. After pregabalin combination additional and significant improvements were seen on fibromyalgia severity, depression and pain interference with daily activities, and a decrease in bodily pain was also apparent. During the second phase of the study, only two patients dropped out due to side effects. Conclusions Trazodone significantly improved fibromyalgia severity and associated symptomatology. Its combination with pregabalin potentiated this improvement and the tolerability of the drugs in

Comparison of intelligence quotient in children surviving leukemia who received different prophylactic central nervous system treatments

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Reisi Nahid

2012-01-01

Conclusion: We can that reveal that CNS prophylaxis treatment, especially the combined treatment, is associated with IQ score decline in ALL survivors. Therefore,a baseline and an annual assessment of their educational progress are suggested.

Therapeutic effects of ciprofloxacin/bushenhuazhuo combination on ...

African Journals Online (AJOL)

Purpose: To evaluate the clinical effect of bushenhuazhuo (a Chinese traditional medicine) in combination with ciprofloxacin (an orthodox medicine) in chronic prostatitis (CP) therapy. Methods: A total of 160 patients who suffered from CP and received treatment in the People's Hospital of Zhengzhou between April 2012 ...

A Multicenter Study To Evaluate The Safety And Efficacy Of Heber On (Interferon Alfa-2b In Combination With Ribavirin For The Treatment Of Chronic Hepatitis C In Iran

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H. Mirmomen

2005-05-01

Full Text Available Combination therapy with interferon and ribavirin is the most effective treatment for chronic hepatitis C today. The aim of this study was to evaluate the efficacy and safety of thrice-weekly Heberon (interferon alfa-2b in combination with ribavirin as first -line treatment of chronic hepatitis C. Methods: A total of97 treatment-naive patients received Heberon three million units thrice-weekly subcutaneously in combination with ribavirin for 12 months. Serum HCV RNA levels were measured before and during therapy and 6 months after the end of therapy. End-of-treatment and sustained virological responses was defmed as an undetectable HCV-RNA level at the end of treatment, and 6 months after treatment was completed (end of follow-up, respectively. Results: In an intent-to-treat analysis, HCV-RNA was undetectable at the end of treatment in 49.5% of patients. At the end of follow-up, sustained virological response was 36.1 %. Combination treatment was generally well tolerated. Six patients stopped therapy because of side effects: severe cytopenia (n=4, depression (n=1, and hyperthyroidism (n= 1 . Common side effects of therapy include: Flu-like syndrome (85.6%, generalized alopecia (41.2% , injection site inflammation (37.1% , mood changes (36% , anorexia (34% and weight loss (32% . Conclusion: Heberon as an IFN product in combination with ribavirin for treat-ment of patients with chronic hepatitis Cis relatively safe, feasible, and potentially efficacious. It has comparable results in achieving end-of-treatment and sustained virological responses in chronic hepatitis C.

The Efficacy and Safety of the Combination of Total Glucosides of Peony and Leflunomide for the Treatment of Rheumatoid Arthritis: A Systemic Review and Meta-Analysis.

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Feng, Zhitao; Xu, Juan; He, Guochao; Cao, Meiqun; Duan, Lihong; Chen, Liguo; Wu, Zhengzhi

2016-01-01

Objective. To evaluate the efficacy and safety of the total glucosides of peony (TGP) and leflunomide (LEF) for the treatment of rheumatoid arthritis (RA). Methods. Randomized controlled trials (RCTs) on the efficacy and safety of the combination of TGP and LEF versus LEF alone for the treatment of RA were retrieved by searching PubMed, EMBASE, Cochrane Library, the China National Knowledge Infrastructure database, and Wanfang database. Results. Eight RCTs including 643 RA patients were included in the present meta-analysis. The quality of included studies was poor. The levels of ESR (P TGP and LEF were significantly lower than RA patients who received LEF therapy alone. The pooled results suggest that the combination of TGP and LEF caused less abnormal liver function than LEF alone (P = 0.02). No significant difference in the gastrointestinal discomfort was identified between the combination of TGP and LEF and LEF alone groups (P = 0.18). Conclusion. The combination of TGP and LEF in treatment of RA presented the characteristics of notably decreasing the levels of laboratory indexes and higher safety in terms of liver function. However, this conclusion should be further investigated based on a larger sample size.

Combination of capecitabine and oxaliplatin is an effective treatment option for advanced neuroendocrine tumors

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Renata Ferrarotto

2013-09-01

Full Text Available The role of chemotherapy in well differentiated neuroendocrine tumors (NET has been questioned. It was recently demonstrated that everolimus and sunitinib have activity in low and intermediate grade pancreatic NET. The aim of this study was to evaluate the activity of capecitabine and oxaliplatin (CapOx combination in treating NET in an unselected population. In this regard, we retrospectively evaluated 24 patients diagnosed with metastatic NET treated with CapOx at two Brazilian institutes that are reference centers in cancer care. Tumor response was measured by RECIST criteria. Median age at diagnosis was 56 years, 71% had ECOG 0 or 1, the majority of tumors were primary from pancreas (67% followed by lung (17%, and 29% were functional. According to WHO classification criteria, 25% were grade 1, 37.5% grade 2 and 37.5% grade 3. Most patients received CapOx as second-line therapy, with a median of 6 cycles. Twenty-nine percent of patients had partial response by RECIST criteria. No association was observed between response rate and tumor grade, primary site or line of CapOx. The median time to progression was 9.8 months and median time to treatment failure was 12.1 months. Seventy-five percent of patients are alive at the time of this analysis; therefore, median overall survival was not reached. The CapOx combination was shown to be active in an unselected population with metastatic NET and may be a good platform for the incorporation of the newer molecular targeted agents being investigated for the treatment of this entity.

Induced polygenic variability using combination treatment of gamma ...

African Journals Online (AJOL)

Induced mutation in plant improvement has been proven to be one of the alternative ways to generate new sources of genetic variation in blackgram. In this study, dry seeds of VBN 4 blackgram were treated with combination treatment of both gamma rays (400, 500 and 600 Gy) and ethyl methane sulphonate (EMS) (50, ...

Combined and surgical treatment of cervix uteri cancer

International Nuclear Information System (INIS)

Shuvaeva, N.I.; Kundukhova, E.M.; Vekhova, L.I.; Volkova, M.A.; Falileeva, E.P.; Troitskaya, I.B.

1980-01-01

The many-year experience with the treatment of the cervix uteri cancer has indicated that a combined method in case of the appropriate indications provides for high and persistant delayed results. The five-year recovery of patients at all stages was noted in 78.7% (1 stage-87.3%; 2 stage-71.6 %, 3 stage-41.7%). Improvement of therapeutic and diagnostic methods, strict adherence to the principles of a differential approach to selecting the type of therapy enabled increasing the per cent of a five-year cure from 68.9%' (1945-46) to 91.8% in 1965-69. The clinical features of microinvasive cervix uteri canner (stage 1a) made it possible to reduce the extent of the treatment applied on account of excluding a radiation component and lessening the extent of surgical intervention. A five-year cure by the surgical method in patients with cancer of stage 1a made up 97%. The results of the combined therapy in patients cervix uteri with stage 1b within the same period yielded 94%

Low Non-structured Antiretroviral Therapy Interruptions in HIV-Infected Persons Who Inject Drugs Receiving Multidisciplinary Comprehensive HIV Care at an Outpatient Drug Abuse Treatment Center.

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Vallecillo, Gabriel; Mojal, Sergio; Roquer, Albert; Samos, Pilar; Luque, Sonia; Martinez, Diana; Martires, Paula Karen; Torrens, Marta

2016-05-01

Continuous HIV treatment is necessary to ensure successful combined antiretroviral therapy (cART). The aim of this study was to evaluate the incidence of patient-initiated non-structured treatment interruptions in HIV-infected persons who inject drugs and who received a multidisciplinary comprehensive program, including medical HIV care, drug-dependence treatment and psychosocial support, at a drug outpatient addiction center. Non-structured treatment interruptions were defined as ≥30 consecutive days off cART without medical indication. During a median follow-up of 53.8 months, 37/132 (28 %) patients experienced the first non-structured treatment interruptions. The cumulative probability of cART interruption at 5 years was 31.2 % (95 % CI 22.4-40.0). Current drug use injection ≥1/day (HR 14.77; 95 % CI 5.90-36.96) and cART naive patients (HR 0.35, 95 % CI 0.14-0.93) were predictive factors for non-structured treatment interruptions. HIV care provided at a drug addiction center is a useful strategy to sustain continuous cART, however, drug abstinence is essential for the long-term maintenance of cART.

Combination irradiation treatments for food safety and phytosanitary uses

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Combination of irradiation treatment with other preservation techniques is of potential importance in enhancing the effectiveness and reducing the energy or dose requirement for destroying food borne illness and spoilage organisms while retaining or improving product quality. Phytosanitary irradiati...

Neoadjuvant polychemotherapy in combined treatment for oral cavity mucosa carcinoma patients

International Nuclear Information System (INIS)

Protsyk, V.S.; Trembach, A.M.; Korobko, E.V.; Garbar, L.I.

2007-01-01

Neoadjuvant polychemotherapy and radiotherapy as a pre surgeon combined treatment was applied to 144 patients with cancer of oral cavity mucosa. That method of treatment permit to obtain maximum destroy of tumoral parenchyma and clinical effect to all patients. (authors)

Hormonal homeostasis in lung cancer patients under combined and radiation treatment

International Nuclear Information System (INIS)

Zotova, I.A.; Firsova, P.P.; Matveenko, E.G.

1984-01-01

Radioimmunoassay of hormonal homeostasis was performed in 200 lung cancer patients before and after combined and radiation treatment and in 25 healthy subjects (controls). The study showed an increase in the basal level of hormones of pituitary - adrenal system matched by a decline in thyroid function. Adequate combined and radiation treatment brought hormone levels to normal. Hormonal disorders accompanying recurrence were identical to those registered at disease onset. In some cases, changes in hormonal homeostasis developed as early as 3-6 months prior to clinically manifest recurrences or dissemination

Hypofractionated Proton Boost Combined with External Beam Radiotherapy for Treatment of Localized Prostate Cancer

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Johansson, Silvia; Åström, Lennart; Sandin, Fredrik; Isacsson, Ulf; Montelius, Anders; Turesson, Ingela

2012-01-01

Proton boost of 20 Gy in daily 5 Gy fractions followed by external beam radiotherapy (EBRT) of 50 Gy in daily 2 Gy fractions were given to 278 patients with prostate cancer with T1b to T4N0M0 disease. Fifty-three percent of the patients received neoadjuvant androgen deprivation therapy (N-ADT). The medium followup was 57 months. The 5-year PSA progression-free survival was 100%, 95%, and 74% for low-, intermediate-, and high-risk patients, respectively. The toxicity evaluation was supported by a patient-reported questionnaire before every consultant visit. Cumulative probability and actuarial prevalence of genitourinary (GU) and gastrointestinal (GI) toxicities are presented according to the RTOG classification. N-ADT did not influence curability. Mild pretreatment GU-symptoms were found to be a strong predictive factor for GU-toxicity attributable to treatment. The actuarial prevalence declined over 3 to 5 years for both GU and GI toxicities, indicating slow resolution of epithelial damage to the genitourinary and gastrointestinal tract. Bladder toxicities rather than gastrointestinal toxicities seem to be dose limiting. More than 5-year followup is necessary to reveal any sign of true progressive late side effects of the given treatment. Hypofractionated proton-boost combined with EBRT is associated with excellent curability of localized PC and acceptable frequencies of treatment toxicity. PMID:22848840

Hypofractionated Proton Boost Combined with External Beam Radiotherapy for Treatment of Localized Prostate Cancer

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Silvia Johansson

2012-01-01

Full Text Available Proton boost of 20 Gy in daily 5 Gy fractions followed by external beam radiotherapy (EBRT of 50 Gy in daily 2 Gy fractions were given to 278 patients with prostate cancer with T1b to T4N0M0 disease. Fifty-three percent of the patients received neoadjuvant androgen deprivation therapy (N-ADT. The medium followup was 57 months. The 5-year PSA progression-free survival was 100%, 95%, and 74% for low-, intermediate-, and high-risk patients, respectively. The toxicity evaluation was supported by a patient-reported questionnaire before every consultant visit. Cumulative probability and actuarial prevalence of genitourinary (GU and gastrointestinal (GI toxicities are presented according to the RTOG classification. N-ADT did not influence curability. Mild pretreatment GU-symptoms were found to be a strong predictive factor for GU-toxicity attributable to treatment. The actuarial prevalence declined over 3 to 5 years for both GU and GI toxicities, indicating slow resolution of epithelial damage to the genitourinary and gastrointestinal tract. Bladder toxicities rather than gastrointestinal toxicities seem to be dose limiting. More than 5-year followup is necessary to reveal any sign of true progressive late side effects of the given treatment. Hypofractionated proton-boost combined with EBRT is associated with excellent curability of localized PC and acceptable frequencies of treatment toxicity.

Effect of heat treatment oanas irradiation, and combined treatment on the shelf of fresh avocados (Persea americana L)

International Nuclear Information System (INIS)

Purwanto, Z.I.; Maha, Munsiah

1987-01-01

Effects of heat treatment, gamma irradiation, and combined treatments on the shelf-life of fresh avocados (Persea americana L.). Experiments to determine the effective irradiation conditions to prolong the shelf-life of fresh avocados were conducted at the centre for the Application of Isotopes washed and dried, then divided into 4 groups, namely for control (A), dipped in hot water at 40 0 C for 20 minutes (heat treatment, B), irradiated at a dose of 25 Gy (C), and combination of hot water dipping (40 0 C for 20 minutes) and irradiation at a 25 Gy (D). The samples were stored at room temperature. Evaluation on physical and chemical properties of the samples was done daily up to 10 days' storage. Parameters observed were texture, moisture and fat contents, percentage of weight loss, percentage of mature fruit, and subjective organoleptic evaluation. It was found that treated samples with and without combination treatment were still in good condition until 10 days of storage. It could be concluded that dipping in hot water, either alone or in combination with irradiation at a dose of 25 Gy could extend the shelf-life of fresh avocado up to 10 days at room temperature compared to only 5 days of the control. (author). 2 figs, 8 refs

Combining biologic and phototherapy treatments for psoriasis: safety, efficacy, and patient acceptability

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Farahnik B

2016-07-01

Full Text Available Benjamin Farahnik,1 Viraat Patel,2 Kourosh Beroukhim,3 Tian Hao Zhu,4 Michael Abrouk,2 Mio Nakamura,5 Rasnik Singh,3 Kristina Lee,5 Tina Bhutani,5 John Koo5 1University of Vermont College of Medicine, Burlington, VT; 2School of Medicine, University of California, Irvine, 3David Geffen School of Medicine, University of California, Los Angeles, 4University of Southern California Keck School of Medicine, Los Angeles, 5Department of Dermatology, Psoriasis and Skin Treatment Center, University of California, San Francisco, CA, USA Background: The efficacy and safety of biologic and phototherapy in treating moderate-to-severe psoriasis is well known. However, some patients may not respond well to biologic agents or phototherapy on their own and may require combination therapy. Skillfully combining a biologic agent and phototherapy may provide an additive improvement without much increase in risks.Objective: To summarize the current state of evidence for the efficacy and safety of combining biologics with phototherapy in the treatment of moderate-to-severe plaque psoriasis.Methods: We conducted an extensive search on Pubmed database for English language literature that evaluated the use of a combination of biologic and phototherapy for the treatment of moderate-to-severe psoriasis through January 2016. The search included the following keywords: psoriasis, etanercept, adalimumab, infliximab, ustekinumab, biologics, phototherapy, and combination therapy.Results: The primary literature included randomized controlled trials, a head-to-head study, open-label controlled and uncontrolled trials, case series, and case reports. Etanercept was used in over half of the reported cases, but other biologic agents used included ustekinumab, adalimumab, and infliximab. The vast majority of phototherapy was narrowband ultraviolet B (NBUVB radiation. Most cases reported enhanced improvement with combination therapy. Serious adverse events throughout the study duration

[Treatment of Occipital Neuralgia by Electroacupuncture Combined with Neural Mobilization].

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Wang, Yan; Guo, Zi-Nan; Yang, Zhen; Wang, Shun

2018-03-25

To observe the effect of electroacupuncture (EA) combined with neural mobilization (NM) in the treatment of occipital neuralgia. A total of 62 occipital neuralgia patients were randomized into EA group (19 cases), NM group (22 cases) and EA＋NM group (21 cases). EA was applied at acupoint-pairs as Yuzhen (BL 9)- Tianzhu (BL 10), Fengchi (GB 20)- Wangu (GB 12), etc. NM intervention consisted of occipital muscle group mobilization, C 2 spinous process mobilization, cervical joint passive movement management mobilization, etc., was performed at the impaired cervical spine segment. The two methods were used in combination for patients in the EA＋NM group. All the treatment was given once a day for 2 weeks. Before and after treatment, the visual analogue scale (VAS) and the 6-point (1－6 points) behavioral rating scale (BRS-6) of headache were used to assess the severity of pain. The therapeutic effect was evaluated according to the "Criteria for Diagnosis and Cure-Improvement of Clinical Conditions" formulated by State Administration of Traditional Chinese Medicine of the People's Republic of China in 1994. After treatment, both VAS and BRS-6 scores were significantly lower than those before treatment in each of the three groups ( P occipital neuralgia, and EA＋NM has a synergic analgesic effect for occipital neuralgia.

Treatment of burn scars in Fitzpatrick phototype III patients with a combination of pulsed dye laser and non-ablative fractional resurfacing 1550 nm erbium:glass/1927 nm thulium laser devices.

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Tao, Joy; Champlain, Amanda; Weddington, Charles; Moy, Lauren; Tung, Rebecca

2018-01-01

Burn scars cause cosmetic disfigurement and psychosocial distress. We present two Fitzpatrick phototype (FP) III patients with burn scars successfully treated with combination pulsed dye laser (PDL) and non-ablative fractional lasers (NAFL). A 30-year-old, FP III woman with a history of a second-degree burn injury to the bilateral arms and legs affecting 30% body surface area (BSA) presented for cosmetic treatment. The patient received three treatments with 595 nm PDL (7 mm, 8 J, 6 ms), six with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4-8 passes) and five with the 1927 nm thulium laser (10 mJ, 30% density, 4-8 passes). Treated burn scars improved significantly in thickness, texture and colour. A 33-year-old, FP III man with a history of a second-degree burn injury of the left neck and arm affecting 7% BSA presented for cosmetic treatment. The patient received two treatments with 595 nm PDL (5 mm, 7.5 J, 6 ms), four with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4-8 passes) and two with the 1927 nm thulium laser (10 mJ, 30% density, 4-8 passes). The burn scars became thinner, smoother and more normal in pigmentation and appearance. Our patients' burn scars were treated with a combination of PDL and NAFL (two wavelengths). The PDL targets scar hypervascularity, the 1550 nm erbium:glass stimulates collagen remodelling and the 1927 nm thulium targets epidermal processes, particularly hyperpigmentation. This combination addresses scar thickness, texture and colour with a low side effect profile and is particularly advantageous in patients at higher risk of post-procedure hyperpigmentation. Our cases suggest the combination of 595nm PDL plus NAFL 1550 nm erbium:glass/1927 nm thulium device is effective and well-tolerated for burn scar treatment in skin of colour.

Combined Therapies of Modified Taiyi Miraculous Moxa Roll and Cupping for Patients with Lumbar Intervertebral Disc Herniation

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Chunyue Cai

2018-01-01

Full Text Available Lumbar intervertebral disc herniation is a kind of syndrome caused by stimulation or pressure of nerve root and cauda equina due to intervertebral disc disorder, fibrous ring rupture, and pulpiform nucleus protrusion. Application of traditional Chinese medicine (TCM including acupuncture therapy and cupping therapy is unique and effective treatment for lumbar intervertebral disc herniation in China. Hence, we try to investigate the combined clinical efficacy of modified Taiyi miraculous moxa roll and cupping therapy on patients with lumbar intervertebral disc herniation. Seventy patients were randomly assigned into combined treatment group (n=35 and control group (n=35. The treatment group received combined therapy of modified Taiyi miraculous moxa roll and cupping therapy, while control group received acupuncture therapy alone. Diagnostic criteria of TCM syndrome, Japanese Orthopedic Association (JOA score, and simplified McGill pain questionnaire (MPQ were used to evaluate the therapy. 11 and 13 out of 35 subjects in the combined treatment group had improvement > 75% and between 50% and 75%, respectively. The corresponding number was 2 and 22 of 35 subjects in the acupuncture group. There was significant difference in the clinical efficacy between the treatment group and control group (P=0.036. The scores of JOA and MPQ detected in the patients of the two groups (P<0.05 also showed statistically significant differences. Moreover, no serious adverse events occurred in the patients, who received cupping therapy or acupuncture. The combined or alone therapies can effectively improve the treatment efficacy in the patients with lumbar intervertebral disc herniation, while the combined therapies show more comparative effectiveness. Furthermore, the combined therapies are potentially safe and cost-effective and also benefit the improvement of short-term pain. Therefore, the combined therapies of the two ancient TCM deserve further clinical

Assessment of single and combined X-ray and colchicine treatment on Trichosanthes anguina L

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Datta, S.K.

1992-01-01

The results of the present experiment on combined treatment with 18 kR X-rays followed by treatment with 0.25, 0.50 and 1.00 per cent aqueous solution of colchicine on white fruit colour variety of T. anguina have been found to be very interesting. The treatments have led to an increase in surviving plants till maturity, reduction in percentage of pollen mother cells with chromosomal aberrations and increase in pollen fertility. Analysis of root tip mitosis has shown that treatment with X-rays produces dicentric bridge and fragment while only polyploid cells were observed after treatment with colchicine. Combined treatment with X-rays and colchicine, produces both chromosomal aberrations and polyploid cells. Simultaneously, it reduces the percentage of cells with chromosomal aberrations and those with polyploid chromosome numbers. Desirable variability in seed number, seed weight and size, seed oil and punicic acid content were observed in both combined and individual treatment. (author). 6 refs., 3 tabs

Randomized Controlled Trial to Compare the Safety and Efficacy of Tamsulosin, Solifenacin, and Combination of Both in Treatment of Double-J Stent-Related Lower Urinary Symptoms

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Essam Shalaby

2013-01-01

Full Text Available Purpose. We evaluated the effectiveness and safety of tamsulosin, solifenacin, and combination of both in reducing double-J stent-related lower urinary symptoms. Materials and Methods. A total of 338 patients with double-J ureteral stenting were randomly divided, postoperatively, into 4 groups. In group I (, no treatment was given (control group, group II ( received tamsulosin 0.4 mg daily, group III ( received solifenacin 10 mg daily, and group IV ( received a combination of both medications. Before insertion and 2 weeks after, all patients completed the International Prostate Symptom Score (IPSS, quality of life component of the IPSS (IPSS/Qol, Overactive Bladder Questionnaire (OAB-q, and Visual Analogue Pain Scale (VAPS questionnaire. Results. The demographics and preoperative questionnaires scores of all groups were comparable. There were statistically significant differences in all scores in favour of groups II, III, and IV as compared to control group ( value < 0.005. Group IV showed statistically significant differences in total IPSS, QoL score, and OAB-q score as compared to groups II and III ( value < 0.001. Conclusions. Combined therapy of tamsulosin and solifenacin significantly alleviated lower urinary symptoms associated with double-J stents as compared to either medication alone.

Visualizing the Comorbidity Burden in Children with Autism Spectrum Disorder Receiving Dental Treatment Under General Anesthesia.

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Mathu-Muju, Kavita R; Li, Hsin-Fang; Nam, Lisa H; Bush, Heather M

2016-01-01

The purposes of this study were to: (1) describe the comorbidity burden in children with autism spectrum disorder (ASD) receiving dental treatment under general anesthesia (GA); and (2) characterize the complexity of these concurrent comorbidities. A retrospective chart review was completed of 303 children with ASD who received dental treatment under GA. All comorbidities, in addition to the primary diagnosis of ASD, were categorized using the International Classification of Diseases-10 codes. The interconnectedness of the comorbidities was graphically displayed using a network plot. Network indices (degree centrality, betweenness centrality, closeness centrality) were used to characterize the comorbidities that exhibited the highest connectedness to ASD. The network plot of medical diagnoses for children with ASD was highly complex, with multiple connected comorbidities. Developmental delay, speech delay, intellectual disability, and seizure disorders exhibited the highest connectedness to ASD. Children with autism spectrum disorder may have a significant comorbidity burden of closely related neurodevelopmental disorders. The medical history review should assess the severity of these concurrent disorders to evaluate a patient's potential ability to cooperate for dental treatment and to determine appropriate behavior guidance techniques to facilitate the delivery of dental care.

Combined orthodontic and periodontic treatment in a child with Papillon Lefèvre syndrome.

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AlSarheed, Maha A; Al-Sehaibany, Fares S

2015-08-01

A 9-year-old girl with Papillon-Lefèvre syndrome (PLS) was treated orthodontically 24 months after the start of mechanical and antibiotic therapy in adjunct with periodontal treatment every 6 weeks. After achieving stable periodontal conditions, orthodontic treatment was commenced to correct the teeth position, facial profile, and maxillary protraction. Following the combination therapy and a failure to detect Actinobacillus actinomycetemcomitans from any site in the oral cavity, orthodontic treatment with a fixed appliance was performed aside from creating space for eruption of permanent teeth. We found that combined periodontal and orthodontic treatment of PLS may be successful with a complex interdisciplinary regimen and close follow up. This is a 2-year follow-up case report of a girl with PLS. Orthodontic and periodontic therapy were offered using combined treatments of orthodontic and periodontal with the benefit of prosthodontic consultation, resulting in a treatment plan.

Clinical efficacy and safety of vitrectomy combined with cyclophotocoagulation in treatment of traumatic glaucoma

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Guo-Ning Ye

2018-02-01

Full Text Available AIM: To analyze the clinical efficacy and safety of vitrectomy combined with cyclophotocoagulation in the treatment of traumatic glaucoma, and to provide an effective treatment for improving the quality of life of patients with traumatic glaucoma.METHODS: Totally 90 patients(90 eyeswith traumatic glaucoma admitted in our hospital from January 2011 to July 2016 were divided into two groups(45 patients in each groupaccording to different treatment methods. The patients in the observation group underwent vitrectomy combined with cyclophotocoagulation under direct vision; the control group underwent vitrectomy combined with trans-scleral cyclophotocoagulation. We observed the effect of different treatment on visual acuity, intraocular pressure and complication of the two groups. RESULTS: The visual acuity of the observation group was significantly better than that of the control group after treatment(Z=-5.689, PP>0.05. The change of decreased intraocular pressure in the observation group was less than that in the contral group after operation(PP>0.05. The complications of the two groups after treatment were vitreous hemorrhage, choroidal detachment, low intraocular pressure, increased intraocular pressure and other complications, but the complication rate of two groups were no different(χ2=1.553, P=0.213. CONCLUSION: Vitrectomy combined with cyclophotocoagulation under direct vision brings patients better visual acuity than that combined with trans-scleral cyclophotocoagulation.

Treatment Outcomes Based on Patients' Self-Reported Measures after Receiving New Clasp or Precision Attachment-Retained Removable Partial Dentures.

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Peršić, Sanja; Kranjčić, Josip; Pavičić, Daniela Kovačević; Mikić, Vlatka Lajnert; Čelebić, Asja

2017-02-01

To evaluate effects of a treatment taking into consideration esthetics, chewing, and oral health-related quality of life (OHRQoL) of two tooth replacement strategies for maxillary partially edentulous patients with clasp (C-RPD) and precision attachment (PA-RPD) retained removable partial dentures (RPD). The study included 150 patients (72 men, 78 women) who received maxillary RPDs; 88 patients received clasp and 62 patients received precision attachment retained RPDs. Patients completed three questionnaires before treatment and again 3 months after treatment: the Orofacial Esthetic Scale (OES), the Oral Health Impact Profile (OHIP-14), and the Chewing Function Questionnaire (CFQ). Statistical analysis comprised descriptive statistics, paired t-test, and two-factor ANOVA. Both RPD treatments yielded better after-treatment summary scores when compared with the baseline scores (p < 0.01); however, better results were obtained in the PA-RPD group. Gender, as a single factor, did not yield significant effects; mutual interaction of retention type and gender yielded significant effects. The PA-RPD female group assessed esthetics, chewing function, and OHRQoL significantly better than males, and significantly worse than males in the C-RPD group. The covariate baseline scores yielded statistically significant effects; patients with worse pretreatment condition benefited more from both therapies. Treatment outcomes were better in the PA-RPD group than the C-RPDs. Women showed greater concern for the treatment outcomes; their rates were significantly better than in male patients in the PA-RPD group; however, when their satisfaction was lower, their rates were significantly worse than in male patients (in the C-RPD group). © 2015 by the American College of Prosthodontists.

Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

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Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

2016-07-01

The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cryotherapy combined with chemoembolization for the treatment of advanced hepatic carcinoma: a clinical study

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Zhou Yiting; Cao Jianming; Xu Jian; Hu Xiaobo; Shi Donghong; Kong Weidong; Gao Dazhi

2009-01-01

Objective: To discuss the technique, efficacy and clinical significance of cryoablation combined with transcatheter arterial chemoembolization(TACE) for the treatment of advanced hepatic carcinoma. Methods: One hundred and ninety-two patients, who accorded with the selected criterion, were divided into TACE group (n=100) and combination group (cryotherapy combined with TACE, n=92). Pre-and post-treatment AFP level, recurrence rate and life span between two groups were compared. Results: The complete necrosis rate of the tumor and the recurrence rate in TACE group were 29% and 42%, which were 88.04% and 24% in combination group, respectively. The serum AFP level was significantly decreased after treatment in both groups (P<0.05), and the reduction in AFP level was significantly greater in combination group than that in TACE group (P<0.05). During a follow-up of 30 months the survival rate at each evaluation period of combination group was higher than that of TACE group without exception. Conclusion: As an effective and safe technique, cryoablation combined with chemoembolization is far superior to simple TACE in treating advanced hepatic carcinoma. (authors)

Radioiodine treatment of non-toxic multinodular goitre: effects of combination with lithium

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Vannucchi, Guia; Mannavola, Deborah; Dazzi, Davide; Beck-Peccoz, Paolo; Fugazzola, Laura [Ospedale Maggiore IRCCS (Pad. Granelli), Institute of Endocrine Sciences, Milan (Italy); Chiti, Arturo; Rodari, Marcello; Tadayyon, Sara [Istituto Clinico Humanitas, Nuclear Medicine Unit, Milan (Italy)

2005-09-01

This study aimed to evaluate the effects of radioiodine ({sup 131}I), alone or in combination with lithium, on thyroid volume and the prevention of radioiodine-induced thyrotoxicosis. This is the first clinical trial including only patients with multinodular goitre, normal TSH values and negative anti-thyroid auto-antibodies at baseline. Eighty consecutive patients were randomised to receive {sup 131}I plus lithium (group I+L) or {sup 131}I alone (group I). Thyroid ultrasonography and biochemical analyses were performed at baseline and at 1, 3, 6, 12 and 24 months after treatment. At 1-4 weeks after treatment, {sup 131}I-induced hyperthyroidism was observed in 58.8% of patients and was prevented by lithium administration. A low incidence of hypothyroidism (19%) was recorded at 24 months, whereas up to 44% of patients developed anti-thyroid antibodies. A significant reduction in thyroid volume was observed after {sup 131}I, with a mean decrease of 47.2% (median 48.2%) at 24 months, without differences between the groups. Moreover, it was shown that the decrease in thyroid volume after {sup 131}I was also due to the significant shrinkage of thyroid nodules. This demonstrates that adjunctive lithium is able to reduce radioiodine-induced hyperthyroidism. Therefore, such treatment appears to be safe in older patients and those with underlying cardiovascular disease. In the present large series, {sup 131}I therapy was demonstrated to be highly effective in reducing thyroid and nodular volume even in patients treated with low {sup 131}I doses (2.5 MBq/ml of thyroid tissue), further supporting the view that radioiodine therapy represents a real alternative to surgery. (orig.)

Radioiodine treatment of non-toxic multinodular goitre: effects of combination with lithium

International Nuclear Information System (INIS)

Vannucchi, Guia; Mannavola, Deborah; Dazzi, Davide; Beck-Peccoz, Paolo; Fugazzola, Laura; Chiti, Arturo; Rodari, Marcello; Tadayyon, Sara

2005-01-01

This study aimed to evaluate the effects of radioiodine ( 131 I), alone or in combination with lithium, on thyroid volume and the prevention of radioiodine-induced thyrotoxicosis. This is the first clinical trial including only patients with multinodular goitre, normal TSH values and negative anti-thyroid auto-antibodies at baseline. Eighty consecutive patients were randomised to receive 131 I plus lithium (group I+L) or 131 I alone (group I). Thyroid ultrasonography and biochemical analyses were performed at baseline and at 1, 3, 6, 12 and 24 months after treatment. At 1-4 weeks after treatment, 131 I-induced hyperthyroidism was observed in 58.8% of patients and was prevented by lithium administration. A low incidence of hypothyroidism (19%) was recorded at 24 months, whereas up to 44% of patients developed anti-thyroid antibodies. A significant reduction in thyroid volume was observed after 131 I, with a mean decrease of 47.2% (median 48.2%) at 24 months, without differences between the groups. Moreover, it was shown that the decrease in thyroid volume after 131 I was also due to the significant shrinkage of thyroid nodules. This demonstrates that adjunctive lithium is able to reduce radioiodine-induced hyperthyroidism. Therefore, such treatment appears to be safe in older patients and those with underlying cardiovascular disease. In the present large series, 131 I therapy was demonstrated to be highly effective in reducing thyroid and nodular volume even in patients treated with low 131 I doses (2.5 MBq/ml of thyroid tissue), further supporting the view that radioiodine therapy represents a real alternative to surgery. (orig.)

The Strategy of Combining Antidepressants in the Treatment of Major Depression: Clinical Experience in Spanish Outpatients

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Luis M. Martín-López

2011-01-01

The most frequent combinations are SSRIs and tricyclic antidepressants. The active principle most widely combined is fluoxetine. Conclusions. The prevalence of use of antidepressant combination therapy is 2.2% of the global sample and 8.3% of treated patients. Other than duration of the depressive episode, no clinical characteristics exclusive to patients who received combination rather than monotherapy were found. Our study found that the most frequent combination is SSRIs + TCAs, also being the most studied.

Efficacy of combination treatment with anti-IgE plus specific immunotherapy in polysensitized children and adolescents with seasonal allergic rhinitis.

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Kuehr, Joachim; Brauburger, Jens; Zielen, Stefan; Schauer, Uwe; Kamin, Wolfgang; Von Berg, Andrea; Leupold, Wolfgang; Bergmann, Karl-Christian; Rolinck-Werninghaus, Claudia; Gräve, Michael; Hultsch, Thomas; Wahn, Ulrich

2002-02-01

Specific immunotherapy (SIT) and treatment with monoclonal anti-IgE antibody have complementary modes of action. The purpose of this study was to determine whether combined therapy could provide better efficacy than either treatment alone. We conducted a randomized, double-blinded trial to assess the efficacy and safety of subcutaneously administered anti-IgE (omalizumab) or placebo in children and adolescents with seasonal allergic rhinitis in both a birch pollen season and a grass pollen season (sequential seasons together lasting an average of 84 days). There were 4 treatment arms. Each subject was started on SIT-birch or SIT-grass, and anti-IgE or placebo was started before and maintained during the anticipated pollen seasons (a total of 24 weeks). The primary efficacy variable was symptom load, the sum of daily symptom severity score plus rescue medication use. A total of 221 subjects (intent-to-treat population) aged 6 to 17 years were analyzed for efficacy. Combination therapy reduced symptom load over the 2 pollen seasons by 48% (P <.001) over SIT alone. When analyzed separately by season, the 2 groups receiving unrelated SIT were considered placebo controls. In the grass season, symptom loads were as follows: unrelated (birch) SIT + placebo, 0.89 (reference value); unrelated (birch) SIT + anti-IgE, 0.49 (-45%); SIT-grass + placebo, 0.61 (-32%); SIT-grass + anti-IgE, 0.26 (-71%). Anti-IgE therapy conferred a protective effect independent of the type of allergen. Additional clinical benefit was demonstrated in both pollen seasons, whether there was coverage by SIT or not. This combination might prove useful for the treatment of allergic rhinitis, particularly for polysensitized patients.

Treatment of selective mutism based on cognitive behavioural therapy, psychopharmacology and combination therapy - a systematic review.

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Østergaard, Kasper Rud

2018-02-15

Selective mutism (SM) is a debilitating childhood anxiety disorder characterized by a persistent lack of speech in certain social settings and is considered hard to treat. Cognitive behavioral therapy (CBT) and pharmacological treatments are the best described treatments in the literature. To test whether there is evidence on treatment based on CBT, medication or a combination of these. Systematic and critical review of the literature on CBT and/or pharmacological treatments of SM. Literature was sought on PubMed, Embase and Psycinfo in March 2017. Of the included studies, six examined CBT, seven pharmacologic treatment and two a combination of these. Using CBT 53/60 children improved symptomatically whilst respectively 55/67 and 6/7 improved using pharmacologic- and combination-treatment. Pharmacologic treatment and especially CBT showed promising results supported by some degree of evidence, which combination treatment lacks. Yet small numbers, few RCTs, heterogeneous study designs, lack of consistent measures, short treatment and follow-up periods, generally limits the evidence. This needs focus in future research.

Effect of Qianggan Pills combined with antiviral treatment on the fibrosis indexes, immune and inflammatory response in patients with compensated hepatitis b cirrhosis

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Hong-Gang Huang

2017-04-01

Full Text Available Objective: To study the effect of Qianggan Pills combined with antiviral treatment on the fibrosis indexes, immune and inflammatory response in patients with compensated hepatitis b cirrhosis. Methods: A total of 88 patients with compensated hepatitis b cirrhosis treated in our hospital between April 2013 and March 2016 were collected and divided into observation group and control group according to single blind randomized control. Observation group of patients accepted Qianggan Pills combined with antiviral treatment and control group of patients received antiviral treatment alone. After 6 months of treatment, chemiluminescence method was used to detect serum fibrosis indexes, flow cytometer was used to detect peripheral blood T lymphocyte subset levels, and enzyme-linked immunosorbent assay (ELISA was used to detect serum levels of inflammatory factors. Results: Before treatment, differences in fibrosis indexes, immune and inflammatory response indexes were not statistically significant between two groups of patients; after 6 months of treatment, serum LN, HA and Ⅳ-C levels of observation group were lower than those of control group, peripheral blood CD3+ and CD4+ T lymphocyte levels as well as CD4+/CD8+ ratio were higher than those of control group, and CD8+ T lymphocyte level was lower than that of control group; serum PCT and CRP levels were lower than those of control group while IL-10 and IL-13 levels were higher than those of control group. Conclusion: Qianggan Pills combined with antiviral treatment can inhibit the fibrosis process, strengthen the body's immune function and also relieve systemic inflammatory response in patients with compensated hepatitis b cirrhosis.

Effect of combined gliclazide/metformin treatment on oxidative stress, lipid profile, and hepatorenal functions in type 2 diabetic patients

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Mansour Alsharidah

2018-01-01

Full Text Available Background: Type 2 diabetes is a chronic condition that requires pharmacotherapy interventions. Metformin and gliclazide are widely used drugs in monotherapy. However, their complementary action made utilization of the combination of these drugs an appealing approach. Aims: The study compared major therapeutic potentials of combined metformin/gliclazide treatment over metformin monotherapy based on the following parameters: oxidative stress, lipid profile, and hepatorenal functions. Subjects and methods: This is a comparative study was conducted from March 2015 to March 2016. The study screened 80 type 2 diabetic patients, of which 40 patients underwent combined metformin + gliclazide therapy (500 mg BD + 80 mg OD, respectively. The other 40 were matched for age and duration of diabetes mellitus with the previous group and received metformin monotherapy (500 mg BD. The levels of fasting blood glucose (FBG, total glycated hemoglobin (HbA1c, lipid peroxidation, total antioxidant capacity, serum creatinine, aspartate and alanine transaminases, total cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins were measured according to the standard methods. Results: Oxidative stress, lipid profile, and hepatorenal functions were comparable in patients of both groups. However, patients on metformin treatment showed significantly lower levels of FBG [7.61 (6.70–8.89 mmol/L vs. 9.00 (7.30–10.68 mmol/L; P = .022] and HBA1c [7.00 (6.40–7.65% vs. 8.20 (7.20–9.75%; P < .001] compared to those on combined therapy. Conclusion: Oxidative stress, lipids profile, and hepatorenal functions were not different in patients who were on combined metformin/gliclazide therapy and compared to those metformin alone. In contrast, glycemic control was poor in the diabetic patients undergoing combined therapy. Keywords: Diabetes mellitus, Gliclazide, Glucose, Lipids, Metformin, Oxidative stress

Recovery of immunological indices after reflexotherapy in combined treatment of upper limb radiation edema

International Nuclear Information System (INIS)

Kuz'mina, E.G.; Degtyareva, A.A.

1987-01-01

A study was made of the effect of combined treatment (routine drug therapy, massage, application of DMSO) alone and in combination with acupuncture and laser puncture on a degree of secondary (radiation) edema and immunological indices in 36 patients treated for breast cancer 2-15 years ago. These methods were shown to decrease effectively a degree of edema by 22-37%. The highest effect was achieved using laser puncture against a background of the main treatment. All types of combined modality treatment promoted the return of the patients' immunological status to normal (an increase in low and a decrease in high values)

Combined treatment of uveal melanoma liver metastases

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Brasiuniene B

2011-02-01

Full Text Available Abstract Uveal melanoma (UM is the most prevalent intraocular malignant tumor in the Western world. The prognosis of survival in the presence of metastatic disease is 2-7 months, depending on the treatment applied. This article presents a case of metastatic UM with successful complex treatment of liver metastases. A 49-year old female, underwent removal of the right eyeball in 1996 due to a histologically confirmed uveal melanoma. After 11 years, CT revealed a mass in the left kidney and multiple metastases in the liver. After left nephrectomy, 6 chemotherapy courses with dacarbazine were performed. The increasing liver metastases were observed. Additional 4 intraarterial (i/a chemotherapy courses were administered using cisplatin, doxorubicin, fluorouracil, and interferon alfa. After few courses increase in CTC Grade 4 liver transaminases was seen. A partial response was observed, and in December 2008 the patient underwent surgery removing all liver metastases by 7 wedge or atypical resections. All margins were tumor-free. 21 months after liver resections and 14 years since diagnosis, the patient is alive without evidence of disease. Successful treatment of metastatic uveal melanoma was due to a timely application of a combination of several treatment methods and good prognostic factors of the patient.

BiRD (Biaxin [clarithromycin]/Revlimid [lenalidomide]/dexamethasone) combination therapy results in high complete- and overall-response rates in treatment-naive symptomatic multiple myeloma.

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Niesvizky, Ruben; Jayabalan, David S; Christos, Paul J; Furst, Jessica R; Naib, Tara; Ely, Scott; Jalbrzikowski, Jessica; Pearse, Roger N; Zafar, Faiza; Pekle, Karen; Larow, April; Lent, Richard; Mark, Tomer; Cho, Hearn J; Shore, Tsiporah; Tepler, Jeffrey; Harpel, John; Schuster, Michael W; Mathew, Susan; Leonard, John P; Mazumdar, Madhu; Chen-Kiang, Selina; Coleman, Morton

2008-02-01

This trial determined the safety and efficacy of the combination regimen clarithromycin (Biaxin), lenalidomide (Revlimid), and dexamethasone (BiRD) as first-line therapy for multiple myeloma. Patients received BiRD in 28-day cycles. Dexamethasone (40 mg) was given orally once weekly, clarithromycin (500 mg) was given orally twice daily, and lenalidomide (25 mg) was given orally daily on days 1 to 21. Objective response was defined by standard criteria (ie, decrease in serum monoclonal protein [M-protein] by at least 50%, and a decrease in urine M-protein by at least 90%). Of the 72 patients enrolled, 65 had an objective response (90.3%). A combined stringent and conventional complete response rate of 38.9% was achieved, and 73.6% of the patients achieved at least a 90% decrease in M-protein levels. This regimen did not interfere with hematopoietic stem-cell harvest. Fifty-two patients who did not go on to receive transplants received continued therapy (complete response, 37%; very good partial response, 33%). The major adverse events were thromboembolic events, corticosteroid-related morbidity, and cytopenias. BiRD is an effective regimen with manageable side effects in the treatment of symptomatic, newly diagnosed multiple myeloma. This trial was registered at www.clinicaltrials.gov as #NCT00151203.

Simultaneous Response in Several Domains in Patients with Psoriatic Disease Treated with Etanercept as Monotherapy or in Combination with Conventional Synthetic Disease-modifying Antirheumatic Drugs.

Science.gov (United States)

Behrens, Frank; Meier, Lothar; Prinz, Jörg C; Jobst, Jürgen; Lippe, Ralph; Löschmann, Peter-Andreas; Lorenz, Hanns-Martin

2018-04-01

To evaluate patients with psoriatic arthritis (PsA) receiving etanercept (ETN) monotherapy or ETN plus conventional synthetic disease-modifying antirheumatic drugs (csDMARD) to determine the proportion achieving a clinically meaningful response in arthritis, psoriasis, and quality of life simultaneously. A prospective, multicenter, 52-week observational study in patients with active PsA evaluated treatment with ETN in clinical practice (ClinicalTrials.gov: NCT00293722). This analysis assessed simultaneous achievement of 3 treatment targets: low disease activity (LDA) based on 28-joint count Disease Activity Score (DAS28); body surface area (BSA) involvement ≤ 3%; and a score > 45 on the Medical Outcomes Study Short Form-12 (SF-12) physical component summary. Of 579 patients, 380 received ETN monotherapy and 199 received combination ETN plus csDMARD. At 52 weeks, data for all 3 disease domains were available for 251 patients receiving monotherapy and 151 receiving combination therapy. In the monotherapy and combination therapy groups, 61 (24.3%) and 37 (24.5%) patients, respectively, achieved all 3 treatment targets simultaneously. A significantly greater proportion of patients receiving monotherapy versus combination therapy achieved SF-12 > 45 (43.0% vs 31.8%; p < 0.05) and DAS28 LDA (72.5% vs 62.3%; p < 0.05). Conversely, BSA ≤ 3% was reached by a significantly greater proportion receiving combination therapy (75.5% vs 56.6%; p < 0.001). However, baseline BSA involvement was higher for the monotherapy group. While nearly half the patients achieved arthritis and psoriasis treatment targets simultaneously and one-fourth reached all 3 treatment targets, combining ETN and csDMARD did not substantially improve clinical response compared with ETN monotherapy in this real-world PsA patient population.

Fewer acute respiratory infection episodes among patients receiving treatment for gastroesophageal reflux disease.

Directory of Open Access Journals (Sweden)

Herng-Ching Lin

Full Text Available Patients with gastroesophageal reflux disease (GERD present with comorbid complications with implications for healthcare utilization. To date, little is known about the effects of GERD treatment with a proton-pump inhibitor (PPI on patients' subsequent healthcare utilization for acute respiratory infections (ARIs. This population-based study compared ARI episodes captured through outpatient visits, one year before and one year after GERD patients received PPI treatment. We used retrospective data from the Longitudinal Health Insurance Database 2005 in Taiwan, comparing 21,486 patients diagnosed with GERD from 2010 to 2012 with 21,486 age-sex matched comparison patients without GERD. Annual ARI episodes represented by ambulatory care visits for ARI (visits during a 7-day period bundled into one episode, were compared between the patient groups during the 1-year period before and after the index date (date of GERD diagnosis for study patients, first ambulatory visit in the same year for their matched comparison counterpart. Multiple regression analysis using a difference-in-difference approach was performed to estimate the adjusted association between GERD treatment and the subsequent annual ARI rate. We found that the mean annual ARI episode rate among GERD patients reduced by 11.4%, from 4.39 before PPI treatment, to 3.89 following treatment (mean change = -0.5 visit, 95% confidence interval (CI = (-0.64, -0.36. In Poisson regression analysis, GERD treatment showed an independent association with the annual ARI rate, showing a negative estimate (with p<0.001. The study suggests that GERD treatment with PPIs may help reduce healthcare visits for ARIs, highlighting the importance of treatment-seeking by GERD patients and compliance with treatment.

Hyperbolastic modeling of tumor growth with a combined treatment of iodoacetate and dimethylsulphoxide

International Nuclear Information System (INIS)

Eby, Wayne M; Tabatabai, Mohammad A; Bursac, Zoran

2010-01-01

An understanding of growth dynamics of tumors is important in understanding progression of cancer and designing appropriate treatment strategies. We perform a comparative study of the hyperbolastic growth models with the Weibull and Gompertz models, which are prevalently used in the field of tumor growth. The hyperbolastic growth models H1, H2, and H3 are applied to growth of solid Ehrlich carcinoma under several different treatments. These are compared with results from Gompertz and Weibull models for the combined treatment. The growth dynamics of the solid Ehrlich carcinoma with the combined treatment are studied using models H1, H2, and H3, and the models are highly accurate in representing the growth. The growth dynamics are also compared with the untreated tumor, the tumor treated with only iodoacetate, and the tumor treated with only dimethylsulfoxide, and the combined treatment. The hyperbolastic models prove to be effective in representing and analyzing the growth dynamics of the solid Ehrlich carcinoma. These models are more precise than Gompertz and Weibull and show less error for this data set. The precision of H3 allows for its use in a comparative analysis of tumor growth rates between the various treatments

[Efficacy of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation].

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Li, Jian-xin; Lu, Qing-ge

2015-05-01

To observe the clinical effectiveness of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation (PE). A total of 120 patients with secondary non-consolidated kidney qi PE were randomly assigned to groups A (aged [35.5 ± 5.4] yr), B (aged [36.2 ± 5.7] yr), and C (aged [35.2 ± 5.3] yr) in the ratio of 1:1:1 to receive Qilin Pills (once 6 g, bid), sertraline (once 50 mg, qd), and Qilin Pills plus sertraline, respectively, all for 4 weeks. The intravaginal ejaculatory latency time (IELT) and PE diagnostic tool (PEDT) scores were obtained before and after medication and at 1 month after drug withdrawal, and comparative analyses were made among the three groups of patients. The IELT was dramatically prolonged in groups A, B, and C after treatment ([3.23 ± 1.84], [3.87 ± 2.43], and [5.92 ± 3.11] min) and at 1 month after drug withdrawal ([1.85 ± 1.27], [1.52 ± 1.06], and [ 4.26 ± 1.88 ] min) as compared with the baseline ([0.88 ± 0.45], [0.84 ± 0.47], and [0.85 ± 0.50] min) (P Pills combined with sertraline has a definite efficacy in the treatment of secondary non-consolidated kidney qi PE and therefore deserves wide clinical application.

Treatment of lymphatic nodes metastasis in advanced cancer with interventional chemotherapy combined radiotherapy

International Nuclear Information System (INIS)

Xia Shian; Guo Weijian; Wu Guohua; Lin Qing; Jiang Mawei; Yao Yuan

2000-01-01

Objective: To evaluate the clinical effects of treatment with interventional chemotherapy combined radiotherapy for lymphatic nodes metastasis in advanced cancer. Methods: Treated with interventional chemotherapy for 27 cases of lymphatic rode metastasis once a month with average 2-3 times totally. Simultaneously treated with linear accelerator radiotherapy with average dose of 40-50 Gy/20-25 times/4-5 weeks. Results: To evaluate the clinical effects after finished the whole treatment program two months later. CR + PR reached 77.8% (24/27). All patients showed tolerance to accept the treatment. Conclusion: Treatment for lymphatic node metastasis in advanced cancer with interventional chemotherapy combined radiation therapy seems to be a valuable way

Effect of non-specific prophylaxis of thrombogenic complications on delayed results of combined treatment of bladder carcinoma

International Nuclear Information System (INIS)

Popov, A.I.

1987-01-01

Altogether 106 patients with bladder carcinoma (Stage T 3 N x M 0 ) after combined treatment were followed-up for 5 yrs. Nicotonic acid and aspirin at common doses were adminstrated to 51 patients (the 1st group) during pre- and postoperative radiation therapy. The other 55 patients (the 2nd group) did not receive these drugs. Relapses were noted in 33.3% of the patients of the 1st group and in 76.3% of the patients of the 2nd group. The 5-year survival in the 1st group was 72.5% and in the 2nd group 27.4%. The administration of nicotonic acid and aspirin to patients during pre- and postoperative γ-beam therapy was shown to raise the body antitumor resistance

Combination use of atomoxetine hydrochloride and olanzapine in the treatment of attention-deficit/hyperactivity disorder with comorbid disruptive behavior disorder in children and adolescents 10-18 years of age.

Science.gov (United States)

Holzer, Barry; Lopes, Vasco; Lehman, Robert

2013-08-01

The aim of this study was to assess the use of atomoxetine and olanzapine in combination to treat attention-deficit/hyperactivity disorder (ADHD) and comorbid disruptive behaviors in children and adolescents 10-18 years of age. Eleven subjects ages 10-18 received open-label atomoxetine and olanzapine for a 10 week treatment period. Patients were assessed at baseline, 2 weeks, 4 weeks, 6 weeks, and 10 weeks (posttreatment). ADHD improvement was measured through the ADHD Rating Scale (ADHD-RS) (Investigator and Parent ratings). Aggression was measured through the Modified Overt Aggression Scale (MOAS). The combined use of atomoxetine and olanzapine resulted in statistically significant improvement in ADHD symptoms and overt aggression from baseline to posttreatment. As evidenced by a 33% reduction in symptoms on the ADHD-RS-I and the MOAS, 73% of patients were considered responders to ADHD treatment, whereas 55% responded to treatment for aggression. Both medications were generally well tolerated. Olanzapine treatment was associated with significant weight gain. Patients gained, on average, 3.9 kg. throughout the treatment period. These data provide initial evidence that combination use of atomoxetine and olanzapine for the treatment of ADHD and comorbid disruptive behaviors was effective in reducing ADHD symptoms and aggressive behavior in a 10 week treatment period.

Effect of combined gliclazide/metformin treatment on oxidative stress, lipid profile, and hepatorenal functions in type 2 diabetic patients.

Science.gov (United States)

Alsharidah, Mansour; Algeffari, Metab; Abdel-Moneim, Abdel-Moneim Hafez; Lutfi, Mohamed Faisal; Alshelowi, Haila

2018-01-01

Type 2 diabetes is a chronic condition that requires pharmacotherapy interventions. Metformin and gliclazide are widely used drugs in monotherapy. However, their complementary action made utilization of the combination of these drugs an appealing approach. The study compared major therapeutic potentials of combined metformin/gliclazide treatment over metformin monotherapy based on the following parameters: oxidative stress, lipid profile, and hepatorenal functions. This is a comparative study was conducted from March 2015 to March 2016. The study screened 80 type 2 diabetic patients, of which 40 patients underwent combined metformin + gliclazide therapy (500 mg BD + 80 mg OD, respectively). The other 40 were matched for age and duration of diabetes mellitus with the previous group and received metformin monotherapy (500 mg BD). The levels of fasting blood glucose (FBG), total glycated hemoglobin (HbA1c), lipid peroxidation, total antioxidant capacity, serum creatinine, aspartate and alanine transaminases, total cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins were measured according to the standard methods. Oxidative stress, lipid profile, and hepatorenal functions were comparable in patients of both groups. However, patients on metformin treatment showed significantly lower levels of FBG [7.61 (6.70-8.89) mmol/L vs. 9.00 (7.30-10.68) mmol/L; P = .022] and HBA1c [7.00 (6.40-7.65)% vs. 8.20 (7.20-9.75)%; P metformin/gliclazide therapy and compared to those metformin alone. In contrast, glycemic control was poor in the diabetic patients undergoing combined therapy.

Combining biological agents and chemotherapy in the treatment of cholangiocarcinoma

DEFF Research Database (Denmark)

Jensen, Lars Henrik; Jakobsen, Anders

2011-01-01

is not always possible. Chemotherapy is effective and the combination of cisplatin and gemcitabine is considered a standard treatment of inoperable cholangiocarcinoma. Biological targeted treatment to date has minor effect when given as monotherapy, but some of the drugs hold promise as an adjunct...... to chemotherapy. It should, however, be noted that most of the trials are based on few patients, and thus far the literature does not allow for a conclusion as to the role of biological treatment on cholangiocarcinoma. This situation calls for well-designed randomized trials, and international cooperation as well...

Effect of combined treatment of angiotensin converting enzyme inhibitors and diuretics on serum creatinine levels among elderly patients

International Nuclear Information System (INIS)

Sweileh, Waleed M.

2006-01-01

The adverse effects of angiotensin converting enzyme inhibitors (ACE-I) and diuretics when given together need extensive research and attention. We performed a cross-sectional study of patients admitted to the internal department of a general medical hospital to investigate the effect of drug combinations on serum creatinine level and creatinine clearance upon admission. Age, sex, disease, status and prior consumption of the target drugs: diuretics and ACE-I were correlated with creatnine and creatinine clearance on admission. The levels of serum creatinine for groups receiving the target combination in both sexes were significantly higher than groups who were not receiving the target combination. Computing an estimate of creatinine clearance based on Cockroft equation yields similar results to that for serum level creatinine. The levels of creatinine clearance in both sexes were significantly higher in the control group compared to those receiving the target combinations. Low dose aspirin seems to have a synergistic negative effect on renal function when given in combination with the target medications. Taking ACE-I/diuretic combination was associated with significant changes in creatinine levels and creatinine clearance. Attention should be made to balance positive effects of theses medications against their negative effect on renal function. (author)

Magnetic resonance imaging findings as predictors of clinical outcome in patients with sciatica receiving active conservative treatment

DEFF Research Database (Denmark)

Jensen, Tue Secher; Albert, Hanne B; Sorensen, Joan S

2007-01-01

OBJECTIVE: The aims of this study were to investigate the possible prognostic value of disk-related magnetic resonance imaging (MRI) findings in relation to recovery at 14 months in patients with severe sciatica, and whether improvement of disk herniation and/or nerve root compromise is concurrent...... with recovery. METHODS: All patients included in this prospective observational study of patients with sciatica receiving active conservative treatment were scanned at baseline and at 14 months' follow-up. Definite recovery at follow-up was defined as an absence of sciatic leg pain and a Roland Morris...... in that the prevalence of disk-related MRI findings was different for men and women, and they had different recovery rates. Improvement of disk herniations and nerve root compromise over time did not coincide with definite recovery. CONCLUSIONS: In patients with sciatica receiving active conservative treatment, broad...

[Rasagiline in daily clinical use. Results of a treatment study of Parkinson patients with a combination treatment].

Science.gov (United States)

Jost, W H; Klasser, M; Reichmann, H

2008-10-01

, rigidity, bradykinesia) the total score was reduced from 6.2 to 4.8, within the other items from 14.7 to 11.5. The proportion of patients without OFF-periods increased from 33.3% to 49.5%. Determined from "24-hours" home diaries, time spend in the OFF-state during wake time decreased from 120 minutes to 45 minutes. In all 8 aspects of quality of life rated by the patients an reduction of the disability could be documented. The PDQ-39 total score was reduced from 36.4 by 7.3 points (20.1%). In total, 29 of the 545 patients who received rasagiline as combination therapy had switched directly from previous combination therapy with selegiline. In this subgroup CURS total score improved from 17.0 to 12.9 points during treatment. The proportion of patients without OFF-periods increased from 36% to 48% and the daily time spent in the OFF-state was reduced from 45 minutes to 30 minutes. The PDQ-39 total score improved by 6.5 points (22.2%). All in all, adverse events were reported by 8.4% of the patients. In conclusion this post-marketing observational study has shown that in patients with pre-existing combination therapy the add-on medication of rasagiline resulted in improvements of motor and non-motor functions. Furthermore, motor complications were significantly reduced and led to an improved quality of life in the self-estimation of the patients. This also applies to those patients with selegiline pre-treatment.

A comparative consecutive case series of 20 children with a diagnosis of ADHD receiving homeopathic treatment, compared with 10 children receiving usual care.

Science.gov (United States)

Fibert, Philippa; Relton, Clare; Heirs, Morag; Bowden, Deborah

2016-05-01

20 consecutively enrolled children age 5-16 with Attention Deficit Hyperactivity Disorder (ADHD) received treatment by a homeopath (8 consultations and individualized remedies) for one year. Ten subsequently enrolled children received similar time and attention for 4 months. The study explored optimum treatment protocols; the effectiveness, deliverability and acceptability of treatment; and the feasibility of outcome measurement and recruitment. Parents completed Conners' Parent Rating Scale, Revised Long Version ( L) every 4 months, from which DSMIV total scores were extracted; and Measure Your Own Medical Outcome Profile (MYMOP) every consultation. An interaction between time (baseline/4 months) and group (treatment/non-treatment) was found .756 F (1,28)=9.06, p=0.005. The intervention was associated with statistically significant improvements in treated children over the year: L (t (18)=4.529, p≤0.000); MYMOP (t (18)=6.938, p≤0.000). Mean DSMIV total t scores decreased at each time point: baseline: 85 (SD 5.1); 4 months 76.2 (SD 10.9); and 12 months 71.5 (SD 12.77). Recruitment of control participants was problematic. Recruitment to treatment was feasible via ADHD support groups, charities, police support agencies and social services, not schools or NHS services. Attending appointments was problematic for some participants, but home visits did not improve uptake. The best venue was a familiar clinic. Some participants took medicines inappropriately, but generally taking homeopathic remedies was acceptable and well implemented. L (80 items) was problematic for some parents. MYMOP was preferred by parents but not acceptable to stakeholders. In this small consecutive sample the intervention was associated with improvements in criminality, anger and children with a concomitant diagnosis of Autism Spectrum Disorder ASD. Treatment by a homeopath was associated with sustained, increasing improvements and the intervention was acceptable to participants. More

Improving the sludge disintegration efficiency of sonication by combining with alkalization and thermal pre-treatment methods.

Science.gov (United States)

Şahinkaya, S; Sevimli, M F; Aygün, A

2012-01-01

One of the most serious problems encountered in biological wastewater treatment processes is the production of waste activated sludge (WAS). Sonication, which is an energy-intensive process, is the most powerful sludge pre-treatment method. Due to lack of information about the combined pre-treatment methods of sonication, the combined pre-treatment methods were investigated and it was aimed to improve the disintegration efficiency of sonication by combining sonication with alkalization and thermal pre-treatment methods in this study. The process performances were evaluated based on the quantities of increases in soluble chemical oxygen demand (COD), protein and carbohydrate. The releases of soluble COD, carbohydrate and protein by the combined methods were higher than those by sonication, alkalization and thermal pre-treatment alone. Degrees of sludge disintegration in various options of sonication were in the following descending order: sono-alkalization > sono-thermal pre-treatment > sonication. Therefore, it was determined that combining sonication with alkalization significantly improved the sludge disintegration and decreased the required energy to reach the same yield by sonication. In addition, effects on sludge settleability and dewaterability and kinetic mathematical modelling of pre-treatment performances of these methods were investigated. It was proven that the proposed model accurately predicted the efficiencies of ultrasonic pre-treatment methods.

Pegademase bovine (PEG-ADA for the treatment of infants and children with severe combined immunodeficiency (SCID

Directory of Open Access Journals (Sweden)

Claire Booth

2009-06-01

Full Text Available Claire Booth1,2, H Bobby Gaspar1,21Centre for Immunodeficiency, Molecular Immunology Unit, UCL Institute of Child Health, London, UK; 2Dept of Clinical Immunology, Great Ormond Street Hospital NHS Trust, London, UKAbstract: Adenosine deaminase deficiency (ADA is a rare, inherited disorder of purine metabolism characterized by immunodeficiency, failure to thrive and metabolic abnormalities. A lack of the enzyme ADA allows accumulation of toxic metabolites causing defects of both cell mediated and humoral immunity leading to ADA severe combined immune deficiency (SCID, a condition that can be fatal in early infancy if left untreated. Hematopoietic stem cell transplant is curative but is dependent on a good donor match. Other therapeutic options include enzyme replacement therapy (ERT with pegademase bovine (PEG-ADA and more recently gene therapy. PEG-ADA has been used in over 150 patients worldwide and has allowed stabilization of patients awaiting more definitive treatment with hematopoietic stem cell transplant. It affords both metabolic detoxification and protective immune function with patients remaining clinically well, but immune reconstitution is often suboptimal and may not be long lived. We discuss the pharmacokinetics, immune reconstitution, effects on systemic disease and side effects of treatment with PEG-ADA. We also review the long-term outcome of patients receiving ERT and discuss the role of PEG-ADA in the management of infants and children with ADA-SCID, alongside other therapeutic options.Keywords: adenosine deaminase deficiency, PEG-ADA, enzyme replacement therapy, severe combined immune deficiency (SCID

Locally advanced prostate cancer: a population-based study of treatment patterns.

Science.gov (United States)

Lowrance, William T; Elkin, Elena B; Yee, David S; Feifer, Andrew; Ehdaie, Behfar; Jacks, Lindsay M; Atoria, Coral L; Zelefsky, Michael J; Scher, Howard I; Scardino, Peter T; Eastham, James A

2012-05-01

Study Type--Therapy (practice patterns). Level of Evidence 2b. What's known on the subject? And what does the study add? The treatment of locally advanced prostate cancer varies widely even though there is level one evidence supporting the use of multimodality therapy as compared with monotherapy. This study defines treatment patterns of locally advanced prostate cancer within the United States and identifies predicators of who receives multimodality therapy rather than monotherapy. • To identify treatment patterns and predictors of receiving multimodality therapy in patients with locally advanced prostate cancer (LAPC). • The cohort comprised patients ≥66 years with clinical stage T3 or T4 non-metastatic prostate cancer diagnosed between 1998 and 2005 identified from the Surveillance, Epidemiology and End Results (SEER) cancer registry records linked with Medicare claims. • Treatments were classified as radical prostatectomy (RP), radiation therapy (RT) and androgen deprivation therapy (ADT) received within 6 and 24 months of diagnosis. • We assessed trends over time and used multivariable logistic regression to identify predictors of multimodality treatment. • Within the first 6 months of diagnosis, 1060 of 3095 patients (34%) were treated with a combination of RT and ADT, 1486 (48%) received monotherapy (RT alone, ADT alone or RP alone), and 461 (15%) received no active treatment. • The proportion of patients who received RP increased, exceeding 10% in 2005. • Use of combined RT and ADT and use of ADT alone fluctuated throughout the study period. • In all 6% of patients received RT alone in 2005. • Multimodality therapy was less common in patients who were older, African American, unmarried, who lived in the south, and who had co-morbidities or stage T4 disease. • Treatment of LAPC varies widely, and treatment patterns shifted during the study period. • The slightly increased use of multimodality therapy since 2003 is encouraging, but

Inhibition of glioblastoma tumorspheres by combined treatment with 2-deoxyglucose and metformin.

Science.gov (United States)

Kim, Eui Hyun; Lee, Ji-Hyun; Oh, Yoonjee; Koh, Ilkyoo; Shim, Jin-Kyoung; Park, Junseong; Choi, Junjeong; Yun, Mijin; Jeon, Jeong Yong; Huh, Yong Min; Chang, Jong Hee; Kim, Sun Ho; Kim, Kyung-Sup; Cheong, Jae-Ho; Kim, Pilnam; Kang, Seok-Gu

2017-02-01

Deprivation of tumor bioenergetics by inhibition of multiple energy pathways has been suggested as an effective therapeutic approach for various human tumors. However, this idea has not been evaluated in glioblastoma (GBM). We hypothesized that dual inhibition of glycolysis and oxidative phosphorylation could effectively suppress GBM tumorspheres (TS). Effects of 2-deoxyglucose (2DG) and metformin, alone and in combination, on GBM-TS were evaluated. Viability, cellular energy metabolism status, stemness, invasive properties, and GBM-TS transcriptomes were examined. In vivo efficacy was tested in a mouse orthotopic xenograft model. GBM-TS viability was decreased by the combination of 2DG and metformin. ATP assay and PET showed that cellular energy metabolism was also decreased by this combination. Sphere formation, expression of stemness-related proteins, and invasive capacity of GBM-TS were also significantly suppressed by combined treatment with 2DG and metformin. A transcriptome analysis showed that the expression levels of stemness- and epithelial mesenchymal transition-related genes were also significantly downregulated by combination of 2DG and metformin. Combination treatment also prolonged survival of tumor-bearing mice and decreased invasiveness of GBM-TS. The combination of 2DG and metformin effectively decreased the stemness and invasive properties of GBM-TS and showed a potential survival benefit in a mouse orthotopic xenograft model. Our findings suggest that targeting TS-forming cells by this dual inhibition of cellular bioenergetics warrants expedited clinical evaluation for the treatment of GBM. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Multi-Aperture Digital Coherent Combining for Free-Space Optical Communication Receivers

Science.gov (United States)

2016-04-21

emulated by a cascade of fiber beam splitters . Fig. 4(a) depicts the transmitter, which consisted of two cascaded Mach- Zehnder modulators (MZMs) that...Sons, Inc., Hoboken, New Jersey, 2006). 5. D. O. Caplan, "Laser communication transmitter and receiver design ," J. Opt. Fiber. Commun. 4(4-5), 225...and A. E. Willner, eds. (Elsevier, 2013). 7. S. B. Alexander, Optical Communication Receiver Design (SPIE, 1997). 8. D. M. Boroson, "A survey of

The effect of topical piperine combined with narrowband UVB on vitiligo treatment: A clinical trial study.

Science.gov (United States)

Shafiee, Anoosh; Hoormand, Mahmood; Shahidi-Dadras, Mohammad; Abadi, Alireza

2018-05-21

Vitiligo is the most common acquired hypopigmentary disease in the community. Piperine as an herbal extract derived from black pepper has strong impact on the melanocyte proliferation and adverse side effects less than synthetic drugs such as corticosteroids. For the first time, this study was aimed to evaluate the effect of topical piperine combined with narrowband ultraviolet B (NB-UVB) on vitiligo treatment. In this double-blind clinical trial, 63 patients with facial vitiligo were randomly divided into 2 groups: treated with piperine (case) and placebo (control). Also, both groups received NB-UVB phototherapy every other day for 3 months. In the case group, 10 patients have burning sensation on their skin areas (p value = .002). Also, redness of the treated areas was observed in 6 patients (p value = .028). Both side effects were temporary. Regarding repigmentation at time intervals of 1, 2, and 3 months after treatment, its level in the case group was significantly higher than the control group (p value topical piperine has more influence on facial vitiligo than that of NB-UVB alone. It could be concluded that the simultaneous use of NB-UVB and topical piperine has a remarkable effect on treatment of vitiligo. Copyright © 2018 John Wiley & Sons, Ltd.

Effects of alcoholism typology on response to naltrexone in the COMBINE study.

Science.gov (United States)

Bogenschutz, Michael P; Scott Tonigan, J; Pettinati, Helen M

2009-01-01

This study investigated whether subgroups of alcohol-dependent patients responded differently to naltrexone versus placebo in the NIAAA COMBINE study. In particular, the A versus B and the Early Onset versus Late Onset typologies were examined. Relative to Type A alcoholics, Type B alcoholics are characterized by greater severity, earlier onset, stronger family history, more childhood risk factors (e.g., conduct disorder), and greater frequency of comorbid psychiatric and substance use disorders. COMBINE study participants were categorized as Type A or Type B using k-means cluster analysis and variables from 5 domains that have been shown to replicate the original Babor typology efficiently. Early Onset was defined as alcohol dependence beginning before age 25. For the planned analyses, the sample was reduced to the 618 participants receiving naltrexone alone or placebo, either with medical management (MM) alone or with MM plus the Combined Behavioral Intervention (CBI). The a priori primary outcome was percent heavy drinking days during treatment in the groups receiving MM without CBI. Among those receiving MM without CBI, Type A alcoholics had better drinking outcomes with naltrexone than placebo, whereas medication condition did not influence outcomes significantly in the Type Bs. Age of onset was not significantly related to outcome. For those receiving CBI, no significant effects were found for either typology. In this sample, the beneficial effects of opioid antagonism were limited to Type A alcoholics receiving treatment in a MM model. Future studies should investigate the relationship between clinically relevant genotypes, phenotypes such as typologies, and treatment response. More work is also needed to develop practical algorithms for phenotypic assignment.

Clinical impact of non-organ-specific autoantibodies on the response to combined antiviral treatment in patients with hepatitis C.

Science.gov (United States)

Muratori, Paolo; Muratori, Luigi; Guidi, Marcello; Granito, Alessandro; Susca, Micaela; Lenzi, Marco; Bianchi, Francesco B

2005-02-15

Hepatitis C virus (HCV)-related chronic hepatitis is frequently associated with non-organ-specific autoantibodies (NOSAs), but available data about the relationship between NOSA positivity and the effect of antiviral therapy in persons with hepatitis C are few and controversial. Our aim was to evaluate the impact of NOSA positivity on the outcome of combined antiviral therapy in HCV-positive patients. A total of 143 consecutive adult patients with hepatitis C were studied. Antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), and anti-liver/kidney microsomal antibody type 1 (LKM1) were detected by indirect immunofluorescence. All patients were treatment naive and received combined antiviral therapy (interferon [IFN]-ribavirin) after enrollment in the study. Patients were classified as nonresponders if HCV RNA was detectable after 6 months of therapy, as relapsers if abnormal transaminase levels and reactivation of HCV replication were observed after the end of treatment, and as long-term responders if transaminase levels were persistently normal and HCV RNA was undetectable 6 months after the end of treatment. Thirty-seven patients (25%) were NOSA positive (SMA was detected in 19 patients, ANA in 10, ANA and SMA in 4, LKM1 in 3, and SMA and LKM1 in 1). The prevalence of long-term response was similar between NOSA-positive patients and NOSA-negative patients (48.6% vs. 56.6%; P=not significant). Compared with HCV genotype 1 (HCV-1), HCV genotypes other than 1 were more often associated with long-term response among NOSA-positive patients (93.3% vs. 30%; P=.0017). The overall rate of long-term response, irrespective of NOSA status, was 54.5%. Detection of HCV-1 and elevated gamma-glutamyl transpeptidase serum levels were independent negative prognostic factors of treatment response (P=.007 and P=.026, respectively). Combined antiviral treatment (IFN-ribavirin) is safe and effective in NOSA-positive patients with hepatitis C, even if long-term response is

Using the 60Co source to assess the dose received by risky organs during a cancer brain treatment

International Nuclear Information System (INIS)

Faik Ouahab, Z.; Jehouani, A.; Ghassoun, J.; Senhou, N.; Mouhssine, D.; Groetz, J.E.

2010-01-01

Summary of an investigation of exposures associated with brain cancer treatment for a child in order to determine the level of doses received by the different organs at risk during the treatment. Measurements have been performed at the vicinity of a cobalto therapy apparatus. Then, cumulative doses in each organ have been compared to admitted doses with respect to the organ

Evaluation of a combined laser-radio frequency device (Polaris WR) for the nonablative treatment of facial wrinkles.

Science.gov (United States)

Kulick, Michael

2005-06-01

Nonablative wrinkle reduction or skin tightening is desired by individuals who, ideally, hope to have the skin improvement associated with chemical or laser ablative techniques but without the undesirable recovery process. Electro-optical synergy (ELOS) technology that combines radio frequency (RF) and diode laser energy (900 nm) was used to treat 15 patients in this IRB sanctioned study. Energy settings were based on the depth of wrinkles (the greater the depth and concentration of wrinkles, the higher the RF setting) and ranged from 50-100 J/cm2 RF and 15 J/cm2 for the optical, laser component. Patients received three full-face treatments, and results were evaluated by comparison of standardized photographs and patient questionnaire given prior to each treatment and one month after the third treatment. The primary investigator and three other "blinded" physicians evaluated these photographs using Fitzpatrick's wrinkle classification to assess the improvement, if any, between the initial and final visit. Eight patients completed the study. Explanation for the exclusion of the remaining six patients were: one decided to have surgery, two felt the treatment was too painful, and three moved out of the area. Following treatment, all patients had mild swelling (resolved skin hyperemia (resolved skin wrinkles (range 14%-32%). There were no adverse side effects. The major concern of the patients was the discomfort associated with the treatment. As part of an FDA investigation to assess efficacy, long-term follow-up was not a part of this study protocol.

Efficacy of modest dose irradiation in combination with long-term endocrinal treatment for high-risk prostate cancer. A preliminary report

International Nuclear Information System (INIS)

Sasaki, Tomonari; Nakamura, Katsumasa; Shioyama, Yoshiyuki

2004-01-01

Although radiotherapy in combination with endocrinal manipulation has been identified as an effective treatment for patients with high-risk prostate cancer, the optimal dose for locoregional control of prostate cancer in combination with hormonal therapy has not yet been determined. The efficacy of modest doses of irradiation (60-62 Gy) combined with long-term endocrinal treatment for patients with high-risk prostate cancer (defined as a pretreatment prostate-specific antigen (PSA) level greater than 20 ng/ml or a Gleason's score of 8-10 or T3-T4 disease) was analyzed in 60 Japanese patients. The patients included in this study had received radical radiotherapy with long-term endocrinal manipulation in the period between 1993 and 2000. The median age of the patients was 70 years (range, 56-83). Neoadjuvant hormonal therapy with a median duration of 3.9 months was performed prior to radiotherapy, and hormonal therapy was continued until recurrence. A median dose of 61.4 Gy (range, 44-71.4) was delivered to the prostate. Pelvic node irradiation was performed in 49 patients (81.6%). After a median follow-up period of 28.5 months, the overall survival, cause-specific survival and biochemical relapse-free survival at 3 years were 94.4%, 96% and 89.8%, respectively. Local failure was observed in one patient, distant metastases were observed in three patients and a late toxic effect greater than Grade 2 was not observed in any patients. This study, though preliminary due to a short-term follow-up period, reveals the possibility that modest doses of irradiation combined with long-term endocrinal treatment could be an effective means of achieving excellent local control of high-risk prostate cancer. (author)

Reduced hepatotoxicity by total glucosides of paeony in combination treatment with leflunomide and methotrexate for patients with active rheumatoid arthritis.

Science.gov (United States)

Chen, Zhu; Li, Xiang-Pei; Li, Zhi-Jun; Xu, Liang; Li, Xiao-Mei

2013-03-01

Combination use of methotrexate (MTX) and leflunomide (LEF) has been proved effective in the treatment of active rheumatoid arthritis (RA). However, previous trials have documented that both are associated with increased incidence of liver toxicity. As active compounds extracted from the roots of the traditional Chinese herb Paeonia lactiflora Pall, total glucosides of paeony (TGP) have been shown to have anti-inflammatory, hepatoprotective and immuno-regulatory activities, without evident toxicity or side effects. In this 24-week, open label, randomized multicenter clinical trial, we investigated the efficacy of TGP and the protective effect on hepatotoxicity in the combination treatment with LEF and MTX for patients with active RA. A total of 204 patients with active RA (DAS28>3.2) recruited from 3 regional referral centers were enrolled and received MTX and LEF combination therapy (MTX 10 mg/week plus LEF 20 mg/day) with or without TGP for up to 24 weeks by randomization. Hepatotoxicity was defined as an increase of at least 1.5-fold the upper limits of normal (ULN) of alanine aminotransferase (ALT) or aspartate aminotransferase (AST). Significantly less frequent hepatotoxicity was observed in patients with TGP than those without (9.5% vs 34.8%, p 1.5 to ≤2 times and >2 to ≤3 times the ULN were lower in TGP group than the control (1.9% vs 10.1%, 2.9% vs 12.4%, p TGP group achieved a European League Against Rheumatism (EULAR) good response or moderate response at 12 weeks, although there is no statistical significance. Similar results were observed at 24 weeks. Our preliminary study demonstrates the hepatoprotective and additive role of TGP in combination with MTX and LEF in the treatment of active RA. Copyright © 2013 Elsevier B.V. All rights reserved.

Tramadol/paracetamol fixed-dose combination in the treatment of moderate to severe pain

Science.gov (United States)

Pergolizzi, Joseph V; van de Laar, Mart; Langford, Richard; Mellinghoff, Hans-Ulrich; Merchante, Ignacio Morón; Nalamachu, Srinivas; O’Brien, Joanne; Perrot, Serge; Raffa, Robert B

2012-01-01

Pain is the most common reason patients seek medical attention and pain relief has been put forward as an ethical obligation of clinicians and a fundamental human right. However, pain management is challenging because the pathophysiology of pain is complex and not completely understood. Widely used analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen) have been associated with adverse events. Adverse event rates are of concern, especially in long-term treatment or at high doses. Paracetamol and NSAIDs are available by prescription, over the counter, and in combination preparations. Patients may be unaware of the risk associated with high dosages or long-term use of paracetamol and NSAIDs. Clinicians should encourage patients to disclose all medications they take in a “do ask, do tell” approach that includes patient education about the risks and benefits of common pain relievers. The ideal pain reliever would have few risks and enhanced analgesic efficacy. Fixed-dose combination analgesics with two or more agents may offer additive or synergistic benefits to treat the multiple mechanisms of pain. Therefore, pain may be effectively treated while toxicity is reduced due to lower doses. One recent fixed-dose combination analgesic product combines tramadol, a centrally acting weak opioid analgesic, with low-dose paracetamol. Evidence-based guidelines recognize the potential value of combination analgesics in specific situations. The current guideline-based paradigm for pain treatment recommends NSAIDs for ongoing use with analgesics such as opioids to manage flares. However, the treatment model should evolve how to use low-dose combination products to manage pain with occasional use of NSAIDs for flares to avoid long-term and high-dose treatment with these analgesics. A next step in pain management guidelines should be targeted therapy when possible, or low-dose combination therapy or both, to achieve maximal efficacy with

A unique combination of infrared and microwave radiation accelerates wound healing.

Science.gov (United States)

Schramm, J Mark; Warner, Dave; Hardesty, Robert A; Oberg, Kerby C

2003-01-01

Light or electromagnetic radiation has been reported to enhance wound healing. The use of selected spectra, including infrared and microwave, has been described; however, no studies to date have examined the potential benefit of combining these spectra. In this study, a device that emits electromagnetic radiation across both the infrared and microwave ranges was used. To test the effects of this unique electromagnetic radiation spectrum on wound healing, two clinically relevant wound-healing models (i.e., tensile strength of simple incisions and survival of McFarlane flaps) were selected. After the creation of a simple full-thickness incision (n = 35 rats) or a caudally based McFarlane flap (n = 33 rats), animals were randomly assigned to one of three treatment groups: untreated control, infrared, or combined electromagnetic radiation. Treatment was administered for 30 minutes, twice daily for 18 days in animals with simple incisions, and 15 days in animals with McFarlane flaps. The wound area or flap was harvested and analyzed, blinded to the treatment regimens. A p value of less than 0.05 obtained by analysis of variance was considered to be statistically significant. Animals receiving combined electromagnetic radiation demonstrated increased tensile strength (2.62 N/mm2) compared with animals receiving infrared radiation (2.36 N/mm2) or untreated controls (1.73 N/mm2, p radiation had increased flap survival (78.0 percent) compared with animals receiving infrared radiation (69.7 percent) and untreated controls (63.1 percent, p radiation provided a distinct advantage in wound healing that might augment current treatment regimens.

[Evaluating an effectiveness of surgical treatment of gastroesophageal reflux disease combined with hiatal hernia].

Science.gov (United States)

Mozharovskiy, V V; Tsyganov, A A; Mozharovskiy, K V; Tarasov, A A

To assess an effectiveness of surgical treatment of gastroesophageal reflux disease (GERD) combined with hiatal hernia (HH). The trial included 96 patients with GERD and HH who were divided into 2 groups. The principal difference between groups was the use of surgery in the main group and therapeutic treatment in the comparison group. The effectiveness of surgical treatment is superior to therapeutic treatment of GERD by more than 2.5 times. HH combined with GERD is an indication for surgical treatment. Fundoplication cuff should not lead to angular and rotational esophageal deformation. Nissen procedure in Donahue modification (Short Floppy Nissen) simulates optimally the geometry of esophago-gastric junction and His angle.

Interventional recanalization combined with chinese traditional medicine in the treatment of fallopian tube obstruction

International Nuclear Information System (INIS)

Sun Lizhe; Liu Hui; He Zhao; Wei Feng; Ma Xuanpeng

2004-01-01

Objective: To observe the curative effect of interventional recanalization combined with chinese traditional medicine in treatment of fallopian tube obstruction. Methods: There were 200 cases in treatment group and 120 cases in control group. In the treatment group patients were given chinese herbal medicine after the intervention. In sixth month a follow up imaging was performed assessing the patency. The follow up also included the pregnancy rate 1 year later. Results: The patency rate was 83% in treatment group, and 81.5% in control group (P>0.05). Re-conjunction rate was 7.6% in the study group and 22% in control group (P<0.01). The pregnancy rate was 67% in study group and 42% in control group (P<0.01). Conclusion: With interventional recanalization combined with chinese traditional medicine, good curative effect obtained in treatment of fallopian tube obstructive infertility. Combined with Chinese traditional medicine, the post-procedure re-conjunction rate is decreased, especially in the case of short fallopian tube obstruction

Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose.

Science.gov (United States)

Salem, Ahmed; Mohamad, Issa; Dayyat, Abdulmajeed; Kanaa'n, Haitham; Sarhan, Nasim; Roujob, Ibrahim; Salem, Abdel-Fattah; Afifi, Shatha; Jaradat, Imad; Mubiden, Rasmi; Almousa, Abdelateif

2015-01-01

Radiation pneumonitis is a well-documented side effect of radiation therapy for breast cancer. The purpose of this study was to compare combined photon-electron, photon-only, and electron-only plans in the radiation treatment of the supraclavicular lymph nodes. In total, 13 patients requiring chest wall and supraclavicular nodal irradiation were planned retrospectively using combined photon-electron, photon-only, and electron-only supraclavicular beams. A dose of 50Gy over 25 fractions was prescribed. Chest wall irradiation parameters were fixed for all plans. The goal of this planning effort was to cover 95% of the supraclavicular clinical target volume (CTV) with 95% of the prescribed dose and to minimize the volume receiving ≥ 105% of the dose. Comparative end points were supraclavicular CTV coverage (volume covered by the 95% isodose line), hotspot volume, maximum radiation dose, contralateral breast dose, mean total lung dose, total lung volume percentage receiving at least 20 Gy (V(20 Gy)), heart volume percentage receiving at least 25 Gy (V(25 Gy)). Electron and photon energies ranged from 8 to 18 MeV and 4 to 6 MV, respectively. The ratio of photon-to-electron fractions in combined beams ranged from 5:20 to 15:10. Supraclavicular nodal coverage was highest in photon-only (mean = 96.2 ± 3.5%) followed closely by combined photon-electron (mean = 94.2 ± 2.5%) and lowest in electron-only plans (mean = 81.7 ± 14.8%, p dose was higher in the electron-only (mean = 69.7 ± 56.1 cm(3)) as opposed to combined photon-electron (mean = 50.8 ± 40.9 cm(3)) and photon-only beams (mean = 32.2 ± 28.1 cm(3), p = 0.114). Heart V(25 Gy) was not statistically different among the plans (p = 0.999). Total lung V(20 Gy) was lowest in electron-only (mean = 10.9 ± 2.3%) followed by combined photon-electron (mean = 13.8 ± 2.3%) and highest in photon-only plans (mean = 16.2 ± 3%, p electron-only beams, in terms of decreasing lung dose, is set back by the dosimetric hotspots

Initiation and persistence to statin treatment in patients with diabetes receiving glucose-lowering medications 1997- 2006

DEFF Research Database (Denmark)

Dominguez, H; Schramm, T K; Norgaard, M L

2009-01-01

AIMS: Since 2001 guidelines recommend statin treatment in most patients with diabetes. We investigated secular changes in initiation and persistence to statin treatment during a 10-year period in a nationwide cohort of patients initiating glucose-lowering medication (GLM). METHODS: All Danish...... citizens 30 years and older who claimed prescriptions of GLM between 1997 and 2006 were identified from nationwide registers of drug dispensing from pharmacies and hospitalizations, and followed until 2006. Statin treatment was registered if a prescription was claimed during the period. By logistic...... regression we analyzed factors related to initiation and persistence to statin treatment. RESULTS: In total 128,106 patients were included. In 1997 only 7% of the patients receiving GLM claimed statins within the first year after GLM initiation. Despite increasing statin prescriptions the following years...

Assessment of satisfaction with pharmaceutical services in patients receiving antiretroviral therapy in outpatient HIV treatment setting.

Science.gov (United States)

Agu, Kenneth Anene; Oqua, Dorothy; Agada, Peter; Ohiaeri, Samuel I; Adesina, Afusat; Abdulkareem, Mohammed Habeeb; King, Rosalyn C; Wutoh, Anthony K

2014-06-01

The patient's perception and satisfaction are increasingly considered as a useful factor in the assessment of competency of health care providers and quality of care. However, these patient focused assessments are largely ignored when assessing health care outcomes. The study assessed the perception and satisfaction of patients receiving antiretroviral therapy (ART) with pharmaceutical services received in outpatient HIV treatment settings. Seventeen HIV treatment centres in Nigeria. This cross-sectional survey included 2,700 patients randomly selected from 26,319 HIV patients on ART, who received pharmaceutical services in the study setting. A study-specific Likert-type instrument was administered to the participants at point of exit from the pharmacy. Midpoint of the 5-point scale was computed and scores above it were regarded as positive while below as negative. Chi-square was used for inferential statistics. All reported p values were 2-sided at 95 % confidence interval (CI). Patient satisfaction with pharmaceutical services. Of 2,700 patients sampled, data from 1,617 (59.9 %) were valid for analysis; 62.3 % were aged 26-40 years and 65.4 % were females. The participants had received pharmaceutical services for a mean duration of 25.2 (95 % CI 24.3-26.1) months. Perception of participants regarding the appearance of pharmacy was positive while that regarding the pharmacists' efforts to solve patients' medication related problems was negative. The participants' rating of satisfaction with the waiting time to access pharmaceutical services was negative; the satisfaction decreases with increasing waiting time. However, the satisfaction with the overall quality of pharmaceutical services received was rated as positive; 90.0 % reported that they got the kind of pharmaceutical services they wanted; 98.2 % would come back to the pharmacy if they were to seek help again and would recommend services to others. The level of satisfaction was found to be associated with

Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection.

Science.gov (United States)

Garcez, Aguinaldo S; Ribeiro, Martha S; Tegos, George P; Núñez, Silvia C; Jorge, Antonio O C; Hamblin, Michael R

2007-01-01

To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-micro fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (Ptreatment. Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy. (c) 2006 Wiley-Liss, Inc.

Effects of music in combination with vibration in acupuncture points on the treatment of fibromyalgia.

Science.gov (United States)

Weber, Augusto; Werneck, Lineu; Paiva, Eduardo; Gans, Paulo

2015-02-01

Fibromyalgia (FM) is a disease that causes widespread pain and increased sensitivity to pain because of a dysfunction in the central nervous system. This study investigated the effect of music combined with vibration on acupuncture points for the treatment of FM. A total of 120 patients with FM were allocated randomly to four groups (30 patients each). One group listened to a sequence of Bach's compositions. The second group was subjected to vibratory stimuli on a combination of acupuncture points on the skin. The third group (complete) underwent both procedures in a simultaneous and synchronized manner, with inclusion of binaural beats. The fourth group (control) received no stimulation. The participants underwent the experimental procedure during five sessions performed on alternate days. They were assessed by the Fibromyalgia Impact Questionnaire (FIQ) and the Health Assessment Questionnaire (HAQ) before the first session and after the last session (20 days). All groups showed a significant improvement in FIQ and HAQ scores at the evaluation after the intervention. The complete group exhibited the best result on both the FIQ and HAQ (p<0.001), and the improvement in HAQ score was significant (p<0.004). The results suggest that the placebo effect in FM may be substantial. However, comparison between groups revealed that the complete group had the greatest reduction in both FIQ and HAQ, with a significant improvement in HAQ, suggesting that the combined use of music and vibration exerts a greater effect on FM symptoms.

Evaluation of photodynamic treatment efficiency on glioblastoma cells received from malignant lesions: initial studies

Science.gov (United States)

Borisova, Ekaterina; Kyurkchiev, Dobroslav; Tumangelova-Yuzeir, Kalina; Angelov, Ivan; Genova-Hristova, Tsanislava; Semyachkina-Glushkovskaya, Oxana; Minkin, Krassimir

2018-04-01

Photodynamic therapy is well-established and extensively used method in treatment of different cancer types. This research reveals its potential in the treatment of cultivated human glioblastoma cells with adherent morphology. As the blood-brain barrier (BBB) permeability of the drugs is a significant problem that could not be solved easily for large biomolecules, we search for an appropriate low-molecular weight photosensitizer that could be applied for photodynamic treatment of glioblastoma cells. We used delta-aminolevulinic acid (5-ALA), which could pass BBB and plays the role of precursor of a protoporphyrin IX (PpIX) - photosensitizer, that is accumulated selectively in the tumour cells and could be a proper tool in PDT of glioblastoma. However, differences from patient to patient and between the cell activities could also lead to different effectiveness of the PDT treatment of the tumour areas. Therefore in our study we investigated not only the effect of using different fluence rates and light doses, but aims to establish more efficient values for further clinical applications for each sub-type of the GBM lesions. For the needs of PDT application an illumination device was developed in Laboratory of Biophotonics, BAS based on light-emitting diode (LED) matrix light sources for therapeutic application emitting at 635 nm. The device is optimized for PDT in combination with aminolevulinic acid/protoporphyrin IX applied as a photosensitizer drug. By the means of FACSCalibur flow cytometer (Becton Dickinson, USA) and Cell Quest Software was made evaluation of PDT effect on used human glioblastoma cells. Treatment of glioblastoma tumours continues to be a very serious issue and there is growing need in development of new concepts, methods and cancer-fighting strategies. PDT may contribute in accomplishing better results in cancer treatment and can be applied as well in combination with other techniques.

Combination Immunotherapy for the Treatment of High-Risk HER2-Positive Breast Cancer

Science.gov (United States)

2017-10-01

AWARD NUMBER: W81XWH-14-1-0109 TITLE: Combination Immunotherapy for the Treatment of High-Risk HER2-Positive Breast Cancer PRINCIPAL INVESTIGATOR...Elizabeth A. Mittendorf, MD, PhD CONTRACTING ORGANIZATION: University of Texas MD Anderson Cancer Center Houston, TX 77030 REPORT DATE: October...CONTRACT NUMBER Combination Immunotherapy for the Treatment of High-Risk HER2-Positive Breast Cancer 5b. GRANT NUMBER W81XWH-14-1-0109 5c. PROGRAM

Brief report: Adherence to fluid recommendations in children receiving treatment for retentive encopresis.

Science.gov (United States)

Kuhl, Elizabeth S; Felt, Barbara T; Patton, Susana R

2009-01-01

Limited data are available regarding whether children being treated for retentive encopresis are adherent to recommendations to increase their daily fluid intake. The purpose of this study was to examine fluid adherence in children who received treatment for retentive encopresis. A retrospective chart review was performed using diet diary data for 26 children (ages 3-12) who completed a group behavioral intervention for retentive encopresis. Mean daily intake of clear fluid increased significantly during treatment and children relied primarily on water and juice to make this dietary change. However, adherence rates to clear fluid goals were <50%. Children's increased clear fluid intake did not equate to high fluid adherence. Children's high juice consumption is concerning as it could place them at risk for other negative health consequences. Future research should examine whether enhanced fluid education and use of behavior change strategies yield higher fluid adherence.

125I implantation combined with chemotherapy for treatment of local recurrent stage Ⅲ non-small cell lung cancer

International Nuclear Information System (INIS)

Luo Honglei; Yu Xiaojuan; Li Jin; Chen Xiaofei; He Jingdong

2013-01-01

Objective: To investigate the associated effect of 125 I implantation plus chemotherapy in local recurrent stage Ⅲ NSCLC patients. Methods: From January 2006 to January 2009, 34 patients documented with local recurrent stage Ⅲ NSCLC were divided into two groups by random number table. The treatment group was treated with 125 I permanent implantation combined with DP regimen (docetaxel 60 mg/m 2 + cisplatinum 75 mg/m 2 ), while the control group received only DP chemotherapy. According to the TPS, the treatment group received CT-guided percutaneous implantation of 125 I seeds with a particle activity of 2.22 ×10 7 -2.59 × 10 7 Bq. The prescribed dose was in the range of 90-110 Gy and the postoperatively matched peripheral dose (mPD) and D 90 were verified by TPS. The control group received a DP chemotherapy regime for 4 cycles after the procedure. This study was approved by the ethics committee,and all patients signed informed consents. The follow up time was up to disease progression. Kaplan-Meier survival analysis was used to describe the local lesion control (LLC) time and progression free survival (PFS). Log-rank test was used in the comparison of the survival rates between the two groups. Fisher's exact test was used to analyze the differences of CR rate and recent efficiency between two groups. Results: In the treatment group, postoperative mPD was 93.9-130.4 (M 116.7) Gy, and D 90 was 103.6-148.2 (M 130.6) Gy. The LLC time was 4.7 to 24.0 months with a median of 11.6 (95% CI: 8.7-14.6) months. In two cases, there was no recurrence during the follow-up time of 24 months.PFS was 4.7 to 24.0 months with a median of 10.5 (95% CI: 7.4-13.6) months. The recent effective rate of the treatment group was 64.7% (11/17).CR, PR, SD and PD were 41.2% (7/17), 23.5% (4/17), 23.5% (4/17) and 11.8% (2/17), respectively. In the control group, the LLC time was 4.5 to 11.4 months with a median of 7.5 (95 % CI: 6.7-8.3) months, and the median of PFS was 6.5 (4

Triamcinolone Acetonide and 5-Fluorouracil Intralesional Combination Injection in Keloid Treatment

Directory of Open Access Journals (Sweden)

Jono Hadi Agusni

2017-03-01

Full Text Available Objective: To evaluate the effectiveness of steroid and 5-fluorouracil (5-FU injection combination for keloid management. Methods: A 22-year-old female patient was presented with recurrent skin lesions. The skin lesions first appeared 10 years prior to consultation, had been surgically excised, and were given triamcinolone acetonide injection. However, no improvement was observed. A decision was made to use and evaluate treatment using an intralesional 4 mg (0.1 ml of 40 mg/ml triamcinolone acetonide and 45 mg (0.9 ml of 50 mg/ml 5-FU injection combination for 5 weeks. Results: Clinical improvements were observed in the third week as the lesions softened and pruritic sensation dinimished. At the end of the fifth week, improvements in the form of keloid lesion flattening and size reduction were observed. Conclusions: Intralesional injection using a combination of triamcinolone acetonide and 5-fluorouracil is effective for keloid lesion treatment.

Clinical utility of phentermine/topiramate (Qsymia™ combination for the treatment of obesity

Directory of Open Access Journals (Sweden)

Shin JH

2013-04-01

Full Text Available Jin Hee Shin,1 Kishore M Gadde2 1Department of Community and Family Medicine, Duke University Medical Center, 2Obesity Clinical Trials Program, Duke University Medical Center, Durham, NC, USA Abstract: Qsymia™ (Vivus Inc, Mountain View, CA, USA, a combination of phentermine and delayed-release topiramate, has been available in the US since September 2012 for the treatment of obesity. Phentermine is an anorexigenic agent, which is approved for the short-term treatment of obesity, while topiramate is approved for nonweight loss indications – seizure disorders and migraine prophylaxis. The amount of weight loss achieved with combination therapy is of a greater magnitude than what could be achieved with either agent alone. Adverse events that occur with the combination therapy are in line with the known side effect profiles of the constituent drugs; teratogenicity, a slight increase in heart rate, psychiatric and cognitive adverse effects, and metabolic acidosis are concerns. Keywords: Qsymia, combination drug, antiobesity drugs, phentermine, topiramate, obesity, weight loss

Evaluation of effluents from bench-scale treatment combinations for landfill leachate in Ibadan, Nigeria.

Science.gov (United States)

Aluko, Olufemi Oludare; Sridhar, Mkc

2014-01-01

The removal of pollutants in landfill leachate was investigated using constructed wetlands, a trickling filter, alum flocculation and coagulation, and a sequencing batch reactor in various combinations. Thirteen combined operations were investigated involving three out of the four unit treatment methods in series. The study was conducted because unit operations, though achieved reductions in pollutants concentrations had effluent values above the national regulatory guideline values. The suspended solids of effluents were permissible in most treatment processes, while reductions in 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD) and ammonia (NH3) of leachates ranged from 80% to 97%; 86% to 97% and 92% to 98% respectively. However, there were significant increases in nitrate (85%) and dissolved oxygen of treatment (218%). In addition, the characteristics of the recommended treatment sequence, involving constructed wetlands, alum and trickling filter produced effluents with reductions in colour (97%), alkalinity (97%), BOD (97%), COD (97%) and NH3 (98%), and in metals, except nickel (29% reduction from the influent values). The recommended treatment combination is suitable for effective leachate management at the landfill. The cost of constructing and operating the recommended treatment combination at the facility, for 5 years, would be NGN6,009,750.00 ($38,036.39). The performance should be monitored on site prior to full adoption if effluent characteristics remain consistently low over dry and wet seasons.

Pregnancy and delivery while receiving vagus nerve stimulation for the treatment of major depression: a case report

Directory of Open Access Journals (Sweden)

Stegman Diane

2005-09-01

Full Text Available Abstract Background Depression during pregnancy can have significant health consequences for the mother and her infant. Antidepressant medications, which pass through the placenta, may increase the risk of low birth weight and preterm delivery. The use of selective serotonin reuptake inhibitors (SSRIs during pregnancy may induce serotonergic symptoms in the infant after delivery. Antidepressant medications in breast milk may also be passed to an infant. Vagus nerve stimulation (VNS therapy is an effective non-pharmacologic treatment for treatment-resistant depression (TRD, but little information exists regarding the use of VNS therapy during pregnancy. Case presentation The patient began receiving VNS therapy for TRD in March 1999. The therapy was effective, producing substantial reductions in depressive symptoms and improvement of function. In 2002, the patient reported that she was pregnant. She continued receiving VNS therapy throughout her pregnancy, labor, and delivery, which enabled the sustained remission of her depression. The pregnancy was uneventful; a healthy daughter was delivered at full term. Conclusion In this case, VNS therapy provided effective treatment for TRD during pregnancy and delivery. VNS was safe for the patient and her child.

Thymoptin in combined treatment of endometrical cancer patients

International Nuclear Information System (INIS)

Vusik, I.M.; Lozinskaya, I.N.; Kozyreva, T.V.; Kalmykova, I.Ya.; Skobel'tsina, E.S.; Yakimova, T.P.

1992-01-01

Examination of endometrial cancer patients revealed inhibition of function of the T-system of immunity with simultaneously increased levels of hydrocortisone. CEA and STH during combined treatment including operation and subsequent radiation therapy. The use of thymoptin during radiation therapy reduced the number of radiation reactions, prolonged a recurrence-free period, returned to normal the levels of STH, TSH, hydrocortisone, and CEA. The state of the T-system of immunity remained at the basal level

12 CFR 360.6 - Treatment by the Federal Deposit Insurance Corporation as conservator or receiver of financial...

Science.gov (United States)

2010-01-01

... accepted accounting principles, other than the “legal isolation” condition as it applies to institutions... the conditions for sale accounting treatment set forth by generally accepted accounting principles in... Corporation as conservator or receiver of financial assets transferred in connection with a securitization or...

Comparison of microbiological, histological, and immunomodulatory parameters in response to treatment with either combination therapy with prednisone and metronidazole or probiotic VSL#3 strains in dogs with idiopathic inflammatory bowel disease.

Science.gov (United States)

Rossi, Giacomo; Pengo, Graziano; Caldin, Marco; Palumbo Piccionello, Angela; Steiner, Jörg M; Cohen, Noah D; Jergens, Albert E; Suchodolski, Jan S

2014-01-01

Idiopathic inflammatory bowel disease (IBD) is a common chronic enteropathy in dogs. There are no published studies regarding the use of probiotics in the treatment of canine IBD. The objectives were to compare responses to treatment with either combination therapy (prednisone and metronidazole) or probiotic strains (VSL#3) in dogs with IBD. Twenty pet dogs with a diagnosis of IBD, ten healthy pet dogs, and archived control intestinal tissues from three euthanized dogs were used in this open label study. Dogs with IBD were randomized to receive either probiotic (D-VSL#3, n = 10) or combination drug therapy (D-CT, n = 10). Dogs were monitored for 60 days (during treatment) and re-evaluated 30 days after completing treatment. The CIBDAI (Pdogs in the D-VSL#3 group compared to the D-CT group. Changes in apical junction complex molecules occludin and claudin-2 differed depending on treatment. Faecalibacterium and Turicibacter were significantly decreased in dogs with IBD at T0, with a significant increase in Faecalibacterium abundance observed in the animals treated with VSL#3 strains. A protective effect of VSL#3 strains was observed in dogs with IBD, with a significant decrease in clinical and histological scores and a decrease in CD3+ T-cell infiltration. Protection was associated with an enhancement of regulatory T-cell markers (FoxP3+ and TGF-β+), specifically observed in the probiotic-treated group and not in animals receiving combination therapy. A normalization of dysbiosis after long-term therapy was observed in the probiotic group. Larger scale studies are warranted to evaluate the clinical efficacy of VSL#3 in canine IBD.

[Control of blood pressure in hypertensive patients on combination therapy].

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de la Sierra, Alejandro; Oliveras, Anna; Armario, Pedro; Lucas, Silvia

2015-02-20

The impact of antihypertensive treatment on blood pressure (BP) control is fairly unknown. The aim of the study was to evaluate the degree of BP control and its relationship with treatment-related factors in hypertensive patients treated with 2 or 3 agents and attended in referral units. We studied 1,337 hypertensive subjects (41% women) with a mean age (SD) of 63 (12) years, who were receiving 2 or 3 antihypertensive drugs. The degree of BP control was estimated in a single visit by the proportion of patients with BP below 140/90mmHg. BP was controlled in 767 patients (57%). Lack of BP control was related to older age (12% risk for each 10-year increase) and the presence of microalbuminuria (64% risk increase). In those treated with 2 agents, BP control was 61%, without differences between those treated with fixed-drug or free combinations. BP control in those treated with 3 agents was 55%, higher in those receiving 3 agents in a fixed-drug combination (68%) compared with those on 3 agents administered separately (52%; P=.025). Drug classes used in combinations did not influence the degree of BP control. The degree of BP control in patients treated with 2 or 3 agents is 57%. Microalbuminuria is related to a lack of BP control. In those receiving 3 agents, the use of fixed-drug combinations is associated with better BP control. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Radiosensitization of tumors and normal tissues by combined treatment with misonidazole and heat

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Hofer, K.G.; MacKinnon, A.R.; Schubert, A.L.; Lehr, J.E.; Grimmett, E.V.

1981-01-01

Combination treatment of mice with misonidazole (0.5 mg/g body wt.) and hyperthermia (41.5/sup o/C for 45 mins.) produced dramatic radiosensitization in hypoxic BP-8 murine sarcoma cells. The dose modifying factor (DMF: 4.3) was such that hypoxic BP-8 cells subjected to combination therapy became more radiosensitive than untreated, fully oxygenated cell populations. In contrast, radiosensitization by combination treatment was comparatively minor or completely absent in normal body tissues such as skin (DMF: 1.57), intestine (DMF: 1.0), and bone marrow (DMF: 1.0). These results suggest that simultaneous administration of misonidazole and hyperthermia may prove an effective adjuvant to conventional clinical radiation therapy

The Evaluation of Minimal Erythema Dose For Narrowband UVB in Patients Receiving Isotretinoin Treatment

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Tuba Çetiner

2012-09-01

Full Text Available Background and Design: Although photosensitivity is considered as one of the side effects of retinoids, there is no consensus on this issue. In this study, we aimed to evaluate the minimal erythema dose (MED for narrowband ultraviolet B in patients receiving isotretinoin treatmentMaterial and Method: Phototesting was done by narrowband ultraviolet B irradiation on fifty patients for whom isotretinoin treatment was planned. MED values were calculated before treatment (MED1 and during treatment after reaching half of the target dose (kgx120 mg (MED2, and it was evaluated whether there was statistically significant difference between the two MED values. In addition, the patients were assessed according to their skin phototypes in this respect. Results: When the mean values of MED1 and MED2 were compared in all patients who were treated with 0.5-0.7 mg/kg/day isotretinoin, the mean of MED2 values was found to be lower than the mean of MED1 values. Clinically, sunburn erythema was seen in only 3 (6% patients during the treatment. When the patients were evaluated according to their skin phototypes, significant difference between the means of MED 1 and MED 2 values was not determined. Conclusion: Although isotretinoin treatment does not cause clinically sunburn erythema, it was associated with decrease in MED values.

Clinical application of femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract

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Qing-Song Gao

2018-02-01

Full Text Available AIM:To evaluate the effect of femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract. METHODS: Totally 86 cases(106 eyesof patients with double cataract in our hospital from January 2016 to January 2017 were selected, including 49 cases(59 eyeswere set as the observation group(treated with femtosecond laser assisted phacoemulsification combined with triple-focus intraocular lens implantation, and 37 cases(47 eyeswere set as the control group(received traditional phacoemulsification combined with triple-focus intraocular lens implantation. Corneal endothelial cell density, cumulative dissipated energy(CDE, distant and near visual accommodation before and after operation were compared between the two groups, postoperative complications were observed. RESULTS: The preoperative corneal endothelial cell density of two groups had no significant difference(P>0.05. The corneal endothelial cell density of two groups significantly decreased at postoperative 1wk, with statistic significance within groups(PPPPPP>0.05. The incidence of glare and halo in the observation group was 10.2% and 8.5% in the control group, and are in the patients whose age was above 60 years old, there was no significant difference between the two groups(P>0.05. CONCLUSION: Femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract can not only improve curative effect, but also provide high safety, while the adverse events including glare, halo and other adverse visual circumstances should be considered after triple-focus intraocular lens implantation.

Biological and genetic effects of combined treatments of sodium azide, gamma rays and EMS in barley

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Cheng, X.Y.; Gao, M.W.

1988-01-01

Dry seeds of diploid barley were subjected to mutagenic treatments of sodium azide, gamma rays and EMS alone or in combination. Damage (reduction in seedling height, plant height and fertility), the frequency of chimeras in the M1 generation, and the frequency of chlorophyll-deficient mutations as well as morphological mutations in the M2 generation induced by combined treatments were greater than those by either of the single treatments. Synergistic increase in the frequency of chimeras, chlorphyll-deficient mutations and morphological mutations were observed in both sodium azide post-irradiation treatments and pre-EMS treatments; interaction among the mutagens in the treatment combinations on M1 damage was generally subtractive. An 8- to 16-hr soaking period of irradiated seeds in distilled water prior to sodium azide treatment significantly increased chlorophyll mutation frequency, as compared to that from the non-soaking treatment. Damage and frequency of chimeras, chlorophyll mutations and morphological mutations were consistently reduced by the soaking treatment in sodium azide plus EMS treatments. (author)

Assessment of serum lipid metabolism index and cytokine levels in patients with type 2 diabetes mellitus complicated by coronary heart disease after telmisartan combined with lipid-lowering drug treatment

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Xin Wang

2017-07-01

Full Text Available Objective: To study the effect of telmisartan combined with lipid-lowering drug therapy on serum lipid metabolism index and cytokine levels in patients with type 2 diabetes mellitus complicated by coronary heart disease. Methods: A total of 106 patients with type 2 diabetes mellitus complicated by coronary heart disease who were treated in our hospital between September 2013 and October 2016 were collected and then divided into the control group (n=55 who received conventional treatment + lipid-lowering drug treatment and the observation group (n=51 who received conventional treatment + lipid-lowering drug + telmisartan treatment after the therapies were reviewed. Before and after treatment, serum levels of lipid metabolism indexes, inflammatory mediators and oxidative stress indexes were compared between two groups of patients. Results: Before treatment, the differences in serum levels of lipid metabolism indexes, inflammatory mediators and oxidative stress indexes were not statistically significant between two groups of patients. After treatment, serum TG and LDL-C levels in observation group were lower than those in control group while HDL-C level was higher than that in control group; serum inflammatory mediators IL-6, IL-8, HMGB1 and TNF-α levels were lower than those in control group; serum oxidative stress indexes MDA and ROS levels were lower than those in control group while GSH-Px level was higher than that in control group. Conclusion: Telmisartan combined with lipid-lowering drug therapy can effectively optimize the lipid metabolism and reduce the systemic inflammatory response and oxidative stress response in patients with type 2 diabetes mellitus complicated by coronary heart disease.

Efficacy of photodynamic therapy combined with minocycline for treatment of moderate to severe facial acne vulgaris and influence on quality of life.

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Xu, Xinghua; Zheng, Yi; Zhao, Zigang; Zhang, Xin; Liu, Pengxiang; Li, Chengxin

2017-12-01

Acne vulgaris is a prevalent skin disorder impairing both physical and psychosocial health. This study was designed to investigate the effectiveness of photodynamic therapy (PDT) combined with minocycline in moderate to severe facial acne and influence on quality of life (QOL). Ninety-five patients with moderate to severe facial acne (Investigator Global Assessment [IGA] score 3-4) were randomly treated with PDT and minocycline (n = 48) or minocycline alone (n = 47). All patients took minocycline hydrochloride 100 mg/d for 4 weeks, whereas patients in the minocycline plus PDT group also received 4 times PDT treatment 1 week apart. IGA score, lesion counts, Dermatology Life Quality Index (DLQI), and safety evaluation were performed before treatment and at 2, 4, 6, and 8 weeks after enrolment. There were no statistically significant differences in characteristics between 2 treatment groups at baseline. Minocycline plus PDT treatment led to a greater mean percentage reduction from baseline in lesion counts versus minocycline alone at 8 weeks for both inflammatory (-74.4% vs -53.3%; P minocycline plus PDT achieved IGA score minocycline plus PDT got significant lower DLQI at 8 weeks (4.4 vs 6.3; P minocycline alone, the combination of PDT with minocycline significantly improved clinical efficacy and QOL in moderate to severe facial acne patients. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Effect of single and combined treatment with gamma rays and some chemical mutagens in rice

International Nuclear Information System (INIS)

Lyong Van Hin; Mekhandzhiev, A.; Murzova, P.; Chilikov, I.

1991-01-01

Dry rice seeds of 3 cvs and 2 lines have been irradiated (Co 60 , 10 krad) and treated with 0.0012% sodium azide (NaN 3 ) and 0.2% ethylmethanesulfonate (EMS) in definite combinations. It is found that chlorophyll mutations are less frequent after single gamma irradiation. Sodium azide produces a higher percentage of mutations than EMS. Highest mutation frequency has been observed following combined treatment with gamma rays and chemical mutagens. The combined treatment has resulted in a considerably higher mutation effect than the theoretically expected one in the lines Nora and Mega, and in cv. Krasnodarski 424. Highest mutation spectrum has been found in cv. Krasnodarski 424 and in Nora line following combined treatment. 1 tab., 5 figs., 20 refs

FLUORESCENCE DIAGNOSIS AND PHOTODYNAMIC THERAPY IN COMBINED TREATMENT OF CHOLANGIOCARCINOMA

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A. A. Shiryaev

2016-01-01

Full Text Available The results of the pilot study of combined treatment for non-resectable cholangiocarcinoma complicated with obstructive jaundice are represented this paper. Method included percutaneous transhepatic biliary drainage, endoscopic fluorescence diagnosis, photodynamic therapy of tumor stricture, and stenting of bile ducts. Fourteen patients who underwent the treatment in the surgery department clinic of I.M. Sechenov First Moscow State Medical University were enrolled in the study. Fluorescence diagnosis and photodynamic therapy were carried out using photosensitizers photosens (0.5 mg/kg, fotolon (1 mg/kg, and radachlorin (1 mg/kg. The average light dose for one session was 115±5 J/cm2. Fluorescence diagnosis using endoscopic video-fluorescence system for endoscopy and minimally invasive surgery allowed to obtain videoassisted fluorescence image of the tumor and to measure level of photosensitizer fluorescence in tumor in all patients. Malignant tumor was confirmed by morphological study in 12 patients, biopsy of material for morphological study failed in 2 patients with Klatskin tumor. The preliminary results of combined minimally invasive treatment were assessed as promising. The survival time in 4 patients after treatment accounted for 21, 17, 13 and 11 months, respectively. For now 5 patients are under follow-up. Follow-up periods are 13 and 19 months in 2 of them and from 4 to 6 months in 3 of them. Five patients with multiple distant metastases before the treatment died in 3±1 months after therapy. The average lifetime in the treatment group is 9.5 months up to date, however the duration is expected to belonger because 5 of 14 patients are alive.

Clinical research on cancer treatment with combined radiotherapy and chemotherapy

International Nuclear Information System (INIS)

Fuwa, Nobukazu; Ito, Yoshiyuki; Kato, Eriko; Koyama, Kazuyuki; Morita, Kozo

1993-01-01

There are two purposes of using combined chemotherapy and radiotherapy in the treatment of cancers. One is to suppress distant metastasis, especially micrometastasis; the other is to improve localized control. As a trial of the utility of the former, systemic chemotherapy with CDDP and 5 FU was given successively with radiotherapy to treat nasopharyngeal cancer. The survival rate was significantly improved compared with historical control cases. The main reason for this effectiveness was the improvement of localized control. The suppression of distant metastasis is the subject of future research. As a trial of the utility of the latter, a super-selective intraarterial chemotherapy with CBDCA combined with radiotherapy was used to head and neck localized progressive cancers. The control of localized cancer was remarkably effective. This treatment is considered to be especially suitable for locally advanced tongue cancer and cancer of the root of the tongue. (author)

A benfotiamine-vitamin B combination in treatment of diabetic polyneuropathy.

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Stracke, H; Lindemann, A; Federlin, K

1996-01-01

In a double-blind, randomized, controlled study, the effectiveness of treatment with a combination of Benfotiamine (an Allithiamine, a lipid-soluble derivative of vitamin B1 with high bioavailability) plus vitamin B6/B12 on objective parameters of neuropathy was studied over a period of 12 weeks on 24 diabetic patients with diabetic polyneuropathy. The results showed a significant improvement (p = 0.006) of nerve conduction velocity in the peroneal nerve and a statistical trend toward improvement of the vibration perception threshold. Long-term observation of 9 patients with verum over a period of 9 months support the results. Therapy-specific adverse effects were not seen. The results of this double-blind investigation, of the long-term observation and of the reports in the literature support the contention that the neurotropic benfotiamine-vitamin B combination represents a starting point in the treatment of diabetic polyneuropathy.

Occurrence, fate and interrelation of selected antibiotics in sewage treatment plants and their receiving surface water.

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Wu, Ming-Hong; Que, Chen-Jing; Xu, Gang; Sun, Yan-Feng; Ma, Jing; Xu, Hui; Sun, Rui; Tang, Liang

2016-10-01

The occurrence and fate of 12 commonly used antibiotics, two fluoroquinolones (FQs), three sulfonamides (SAs), three macrolides (MLs), two β-lactams and two tetracyclines (TCs), were studied in four sewage treatment plants (STPs) and their receiving water, the Huangpu River, Shanghai. The levels of selected antibiotics in the STPs ranged from ngL(-1) to μgL(-1), while ofloxacin (OFL) was predominant (reach up to 2936.94ngL(-1)). The highest and lowest proportions were of FQs (STP 1, STP 2 and STP 3) and TCs (in four STPs) respectively in both influents and effluents. And the second-highest proportion was of FQs in STP 4 (only 2% lower than the highest). What could be inferred was that the usage of TCs were extremely low while the usage of FQs were larger than other antibiotics in our study area. The elimination of antibiotics through these STPs was incomplete and a wide range of removal efficiencies (-442.8% to 100%) during the treatment was observed. Based on the mass loadings as well as the per-capita mass loadings of target antibiotics in four STPs, OFL was considered the primary contaminant herein. In the Huangpu River, 3 antibiotics were not detected in any water samples, while the detection frequencies of 4 antibiotics were 100%. The highest concentration detected in the river was 53.91ngL(-1) of sulfapyridine (SD). The Spearman correlation analysis of antibiotics in STPs and the nearby water samples suggests that the antibiotics discharged from some STPs might influence the receiving water to some extent. Moreover, most of the hazard quotient (HQ) values in STP effluents were one order magnitude higher than those in their receiving water. However, there is no imminent significant ecotoxicological risk caused by any single compound in the effluents and receiving waters. Copyright © 2016 Elsevier Inc. All rights reserved.