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Sample records for supplemental treatment literature

  1. Hanford Supplemental Treatment: Literature and Modeling Review of SRS HLW Salt Dissolution and Fractional Crystallization

    Energy Technology Data Exchange (ETDEWEB)

    Choi, A. S.; Flach, G. P.; Martino, C. J.; Zamecnik, J. R.; Harris, M. K.; Wilmarth, W. R.; Calloway, T. B.

    2005-03-23

    In order to accelerate waste treatment and disposal of Hanford tank waste by 2028, the Department of Energy (DOE) and CH2M Hill Hanford Group (CHG), Inc. are evaluating alternative technologies which will be used in conjunction with the Waste Treatment Plant (WTP) to safely pretreat and immobilize the tank waste. Several technologies (Bulk Vitrification and Steam Reforming) are currently being evaluated for immobilizing the pretreated waste. Since the WTP does not have sufficient capacity to pretreat all the waste going to supplemental treatment by the 2028 milestone, two technologies (Selective Dissolution and Fractional Crystallization) are being considered for pretreatment of salt waste. The scope of this task was to: (1) evaluate the recent Savannah River Site (SRS) Tank 41 dissolution campaign and other literature to provide a more complete understanding of selective dissolution, (2) provide an update on the progress of salt dissolution and modeling activities at SRS, (3) investigate SRS experience and outside literature sources on industrial equipment and experimental results of previous fractional crystallization processes, and (4) evaluate recent Hanford AP104 boildown experiments and modeling results and recommend enhancements to the Environmental Simulation Program (ESP) to improve its predictive capabilities. This report provides a summary of this work and suggested recommendations.

  2. Influence of radiation treatment on pharmaceuticals and adjuvants: A literature study. Pt. 9. Supplement

    International Nuclear Information System (INIS)

    Lindemann, L.; Schuettler, C.; Boegl, K.W.

    1993-01-01

    Sterilization of medical aid articles (e.g. catheters, one-way syringes) with ionizing radiation is a successful practice in many countries. During recent years, the results from numerous experiments of radiosterillization of pharmaceuticals and adjuvants have likewise been published. Experience has shown that radiation treatment, in many cases, is leading to transformations of the irradiated substances. In the present part IX of the bibliographic study on the influence of radiation treatment on pharmaceuticals and adjuvants the results of experiments on ca. 80 substances from 36 different sources have been evaluated. In all parts of the study results of about 560 experiments on 360 substances from 176 different sources are present. (orig.)

  3. Vitamin supplementation in the treatment of schizophrenia.

    Science.gov (United States)

    Brown, Hannah E; Roffman, Joshua L

    2014-07-01

    This article reviews the current literature addressing the treatment of schizophrenia with vitamin supplementation. It describes the important roles that vitamins play in normal metabolism, and reviews the evidence pertaining to vitamin deficiency and supplementation in patients with schizophrenia. There is mounting evidence suggesting that vitamin supplementation, in particular with folic acid, vitamin B12 and vitamin D, may be important in treatment within certain subgroups of patients. There is a need for larger randomized controlled trials, and further studies examining the incidence of schizophrenia in countries with poor prenatal care and malnutrition, as well as in countries that have adopted mandatory folic acid fortification of grain products, are recommended.

  4. Vitamin Supplementation in the Treatment of Schizophrenia

    Science.gov (United States)

    Brown, Hannah E.; Roffman, Joshua L.

    2014-01-01

    In this article we review the current literature addressing the treatment of schizophrenia with vitamin supplementation. We first describe the important roles that vitamins play in normal metabolism, then review the evidence pertaining to vitamin deficiency and supplementation in patients with schizophrenia. We then describe mounting evidence suggesting that vitamin supplementation, in particular with folic acid, vitamin B12 and vitamin D, may be important in treatment within certain subgroups of patients. We highlight the need for larger, randomized controlled trials, and recommend further studies examining the incidence of schizophrenia in countries with poor prenatal care and malnutrition, as well as in countries that have adopted mandatory folic acid fortification of grain products. PMID:24846474

  5. 40 CFR 141.809 - Supplemental treatment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Supplemental treatment. 141.809... treatment. (a) Any supplemental drinking water treatment units installed onboard existing or new aircraft... the manufacturer's plans and specifications and FAA requirements. (b) Water supplemental treatment and...

  6. Supplemental Reading for Ninth Graders: Classic or Young Adult Literature

    Science.gov (United States)

    Hill, Katherine Jane Roney

    2012-01-01

    The project addressed the debate over supplemental literature: young adult or classic selections to better support teaching ninth graders Tennessee's English I curriculum standards. Research supported both classical and contemporary literature for teaching ninth graders, making it difficult to determine which type of literature might produce the…

  7. Review of nutritional supplements for the treatment of bipolar depression.

    Science.gov (United States)

    Rakofsky, Jeffrey J; Dunlop, Boadie W

    2014-05-01

    Many patients view psychotropics with skepticism and fear and view nutritional supplements as more consistent with their values and beliefs. The purpose of this review was to critically evaluate the evidence base for nutritional supplements in the treatment of bipolar depression (BD). A literature search for all randomized, controlled clinical trials using nutritional supplements in the treatment of BD was conducted via PubMed and Ovid MEDLINE computerized database. The studies were organized into essential nutrients/minerals, nonessential nutrients, and combinations of nutritional products. Among essential nutrients/minerals, omega-3-fatty acids (O3FAs) have the strongest evidence of efficacy for bipolar depression, although some studies failed to find positive effects from O3FAs. Weak evidence supports efficacy of vitamin C whereas no data support the usefulness of folic acid and choline. Among nonessential nutrients, cytidine is the least supported treatment. Studies of N-acetylcysteine have not resolved its efficacy in treating acute depressive episodes relative to placebo. However, one study demonstrates its potential to improve depressive symptoms over time and the other, though nonsignificant, suggests it has a prophylactic effect. Studies of inositol have been mostly negative, except for 1 study. Those that were negative were underpowered but demonstrated numerically positive effects for inositol. There is no evidence that citicholine is efficacious for uncomplicated BD depression, though it may have value for comorbid substance abuse among BD patients. Finally, combination O3FA-cytidine lacks evidence of efficacy. The findings of this review do not support the routine use of nutritional supplements in the treatment or prophylaxis of BD depression. Studies with more rigorous designs are required before definitive conclusions can be made. Despite the inadequacy of the existing data, clinicians should remain open to the value of nutritional supplements: after

  8. Effect of vitamin D supplementation on chronic liver disease: systematic literature review

    Directory of Open Access Journals (Sweden)

    Hooman Mosannen Mozaffari

    2017-01-01

    Full Text Available Introduction: It is long known that vitamin D deficiency was common in patients with liver disease, but little is known on the therapeutic effects of vitamin D, especially in patients with chronic liver disease. In this study, we aimed to systematically review the literatures and study the evidences in which the effects of vitamin D supplementation had been investigated on the severity of chronic liver disease or liver cirrhosis.Methods: A systematic literature search was performed by using the following key terms “vitamin D supplementation” and “chronic liver disease” in the PubMed, Scopus and Google scholar to find relevant articles. After collecting the eligible documents, data were extracted and described based on the purpose of this review.Result: Of total 196 articles found, only 7 relevant documents with 518 studied patients were included. The results of this study showed that the levels of 25(OH D were considerably lower in patients with chronic liver disease. Findings showed that vitamin D supplementation can rise up the mean serum level of 25(OH D in patients with severe vitamin D deficiency, especially patients with liver cirrhosis.Conclusion:The results of this review showed that vitamin D deficiency is associated with the severity of liver disease and may have prognostic value in the assessment of liver disease. Also, it was shown that vitamin D supplementation may be helpful for the treatment of liver disease at least in certain groups of patients.

  9. Effects of nutritional supplementation for HIV patients starting antiretroviral treatment

    DEFF Research Database (Denmark)

    Olsen, Mette Frahm; Abdissa, Alemseged; Kæstel, Pernille

    2014-01-01

    Objectives: To determine the effects of lipid based nutritional supplements with either whey or soy protein in patients with HIV during the first three months of antiretroviral treatment (ART) and to explore effects of timing by comparing supplementation at the start of ART and after three months....../µL (−2 to 53 cells/µL) were CD4. Effects of the soy containing supplement on immune recovery were not significant. The effects of the two supplements, however, were not significantly different in direct comparison. Exploratory analysis showed that relatively more lean body mass was gained by patients...... with undetectable viral load at three months. Patients receiving delayed supplementation had higher weight gain but lower gains in functional outcomes. Conclusions: Lipid based nutritional supplements improved gain of weight, lean body mass, and grip strength in patients with HIV starting ART. Supplements...

  10. The effect of dietary supplements on clinical aspects of autism spectrum disorder: A systematic review of the literature.

    Science.gov (United States)

    Gogou, Maria; Kolios, George

    2017-09-01

    Autism spectrum disorder is associated with significant social and financial burden and no definite treatment for this entity has been identified, yet. In recent years there has been an increasing interest in the use of dietary interventions as a complementary therapeutic option for these patients. The aim of this systematic review is to provide high evidence level literature data about the effect of dietary supplements on clinical aspects of children with autism. A comprehensive literature search was conducted using Pubmed as the medical database source. Randomized controlled trials conducted in pediatric populations and including measures of clinical outcomes were considered. A total of 17 eligible prospective studies were selected. Types of dietary supplements evaluated in these studies included amino acids, fatty acids and vitamins/minerals. N-acetylcysteine was shown to exert a beneficial effect on symptoms of irritability. On the other hand, literature data about the efficacy of d-cycloserine and pyridoxine-magnesium supplements was controversial. No significant effect was identified for fatty acids, N,N-dimethylglycine and inositol. Literature data about ascorbic acid and methyl B12 was few, although some encouraging results were found. No serious adverse events were reported in the vast majority of the studies, while the prevalence of adverse reactions was similar between treatment and placebo groups. The use of dietary supplements in children with autism seems to be a safe practice with encouraging data about their clinical efficacy. More studies are needed to further investigate this issue. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  11. Dietary Supplements and Cancer Treatment: A Risky Mixture

    Science.gov (United States)

    Some patients with cancer turn to dietary supplements advertised as having anticancer effects or being supportive of general health. But these biologically active compounds may interact dangerously with chemotherapy, radiation, or other cancer treatments.

  12. Mozart ear: diagnosis, treatment, and literature review.

    Science.gov (United States)

    Yamashita, Ken; Yotsuyanagi, Takatoshi; Saito, Tamotsu; Isogai, Noritaka; Mori, Hiromasa; Itani, Yoshihito

    2011-11-01

    Mozart ear is a congenital auricular deformity, which is mainly characterized by a bulging appearance of the anterosuperior portion of the auricle, a convexly protruded cavum conchae, and a slit-like narrowing of the orifice of the external auditory meatus. It is said to be uncommon, and because no one has yet fully described neither the disease nor the treatment, the concept of Mozart ear has not been unified. This report describes a case of a 13-year-old girl presented with an unusual congenital deformity which showed the features of Mozart ear. It is an extremely rare deformity that only about 4 clinical cases have been reported in medical literature thereby a treatment method has not been fully discussed. For surgical correction of our cases, we excised deformed conchal cartilage, turned it over, regrafted, and maintained a cosmetically positive result. We also reviewed and described the origin, current concept, and treatment method of Mozart ear.

  13. Evidence for supplemental treatments in androgenetic alopecia.

    Science.gov (United States)

    Famenini, Shannon; Goh, Carolyn

    2014-07-01

    Currently, topical minoxidil and finasteride are the only treatments that have been FDA approved for the treatment of female pattern hair loss and androgenetic alopecia. Given the incomplete efficacy and sife effect profile of these medications, some patients utilize alternative treatments to help improve this condition. In this review, we illustrate the scientific evidence underlying the efficacy of these alternative approaches, including biotin, caffeine, melatonin, a marine extract, and zinc.

  14. Effect of protein supplementation and urea treatment on utilization of ...

    African Journals Online (AJOL)

    Authorised User

    Abstract. Six Red Maasai sheep were used to investigate the effects of urea treatment and cotton seed cake supplementation of maize stover on intake, digestibility and rumen fermentation parameters. The basal feeds were Rhodes grass (Chloris gayana) hay (H), untreated maize (Zea mays) stover (US) and treated maize.

  15. Maternal supplementation for prevention and treatment of vitamin D deficiency in exclusively breastfed infants.

    Science.gov (United States)

    Haggerty, Linda L

    2011-06-01

    Current research links newborn and infant vitamin D deficiency with various clinical outcomes, including rickets, failure to thrive, type 1 diabetes, and other immune-related diseases. Breastfed infants are often at a greater risk of developing deficiency due to their mothers' low vitamin D status. Human milk reflects the vitamin D status of the mother and often contains inadequate levels of 25-hydroxyvitamin D for infant nutrition. In 2008 the American Academy of Pediatrics (AAP) recommended 400 IU of vitamin D supplementation of all infants. However, research has indicated low levels of compliance of vitamin D supplementation of breastfed infants and a high incidence of vitamin D deficiency in the United States. Many breastfeeding advocates believe that the AAP's recommendations undermine breastfeeding, implying that human milk is inadequate for infant nutrition. Lactating mothers are also reluctant to add any supplements to their breastmilk. The literature review will examine the effectiveness and safety of maternal vitamin D supplementation for prevention and/or treatment of vitamin D deficiency in breastfed infants and lactating mothers. This method of prevention and intervention provides pediatric providers and certified lactation consultants with an alternative approach for education, counseling, promotion of breastfeeding, and treatment to improve maternal and infant health.

  16. Nutrient supplementation approaches in the treatment of ADHD.

    Science.gov (United States)

    Rucklidge, Julia J; Johnstone, Jeanette; Kaplan, Bonnie J

    2009-04-01

    Attention-deficit/hyperactivity disorder (ADHD) is a chronic, debilitating psychiatric illness that often co-occurs with other common psychiatric problems. Although empirical evidence supports pharmacological and behavioral treatments, side effects, concerns regarding safety and fears about long-term use all contribute to families searching for alternative methods of treating the symptoms of ADHD. This review presents the published evidence on supplementation, including single ingredients (e.g., minerals, vitamins, amino acids and essential fatty acids), botanicals and multi-ingredient formulas in the treatment of ADHD symptoms. In most cases, evidence is sparse, mixed and lacking information. Of those supplements where we found published studies, the evidence is best for zinc (two positive randomized, controlled trials); there is mixed evidence for carnitine, pycnogenol and essential fatty acids, and more research is needed before drawing conclusions about vitamins, magnesium, iron, SAM-e, tryptophan and Ginkgo biloba with ginseng. To date, there is no evidence to support the use of St John's wort, tyrosine or phenylalanine in the treatment of ADHD symptoms. Multi-ingredient approaches are an intriguing yet under-researched area; we discuss the benefits of this approach considering the heterogeneous nature of ADHD.

  17. Probiotics in allergy treatment: a literature review

    Directory of Open Access Journals (Sweden)

    Louise Crovesy

    2017-10-01

    Full Text Available Allergy is a exacerbate response of immune system to a triggering element. A probable cause of allergies is gut microbiota composition. It has strong relationship with development of human immune system and this is formed in intrauterine life and early childhood, crucial periods for formation adequate microbiota. In this sense modulation gut microbiota by probiotics could prevent or help in the treatment of allergic diseases such as allergic rhinitis, asthma, atopic dermatitis and food allergy. Studies published to date are controversial. It is difficult to determine whether the probiotic can be used in the treatment and prevention of allergic diseases.

  18. Treatment of nasopharyngeal tumors: literature review

    International Nuclear Information System (INIS)

    Noel, G.; Dessard-Diana, B.; Vignot, S.; Mazeron, J.J.; Noel, G.; Mazeron, J.J.

    2002-01-01

    The conventional radiotherapy and the associated treatments improved the prognostic of nasopharyngeal cancer. A better selection of the patients who must have a more aggressive treatment also probably contributed to this improvement. Even if a relation could be found between the locoregional relapse rate and the distant relapse rate, these two events remain often independent. It results from it that the improvement of local control rate necessarily does not result in a better control of the disease. The patients with a locally advanced tumor, with or not an invasion of the base of the skull and/or neurological symptoms, must have an aggressive locally treatment. This probably includes the increase in dose delivered to the tumor via a more conformational radiotherapy, a brachytherapy, radiotherapy in stereotaxic conditions or other techniques. Dose within the tumor must be at least 70 Gy and the prophylactic nodal dose, at least 50 Gy. CT scan and MRI are essential for delineating the volumes of interest. The protocols of hyperfractionated radiotherapy did not give convincing results. Association with chemotherapy allowed, on the other hand, an improvement of the prognostic locally advanced cancers. Neo-adjuvant or adjuvant chemotherapy was largely used to attempt to limit the risks of systemic dissemination, but an improvement of results was not clearly demonstrated. An improvement of the rates of survival and control of the disease, on the other hand, was observed in a certain number of studies with the chemoradiotherapy. In the event of locoregional relapse, an aggressive attitude can allow the control of the disease in the absence of systemic dissemination. Salvage treatments are, however, disappointing for when distant relapse occurs which suggests. (author)

  19. Stereotactic treatment. Definitions and literature overview

    International Nuclear Information System (INIS)

    Fontenla, D.P.

    2008-01-01

    The topics discussed include, among others, the following: Radiosurgery definitions; Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT); Available uncertainties in SRS; Gamma knife; Linac-based SRS; Components of a radiosurgery system; Stereotactic hardware (brain lab); m3 linac attachment; Radiosurgery - clinical procedure; Cancer management; Rationale for SRT; Role of radiosurgery in the management of intracranial tumors; Indications for stereotactic SRS/SRT; Physical components required for SRS/SRT; Stereotactic patient set-up; Stereotactic CT scan for SRS; Physical components required for SRT: Relocatable head frame (GTC); Patient immobilization; Treatment planning system; Basic requirements for SRS dosimetry (Linac based); Stereotactic set-up QA (Linac); Stereotactic frames and QA; Beam dose measurements; Dose evaluation tools; Phantoms. (P.A.)

  20. Zinc Supplementation in Treatment of Children With Urinary Tract Infection.

    Science.gov (United States)

    Yousefichaijan, Parsa; Naziri, Mahdyieh; Taherahmadi, Hassan; Kahbazi, Manijeh; Tabaei, Aram

    2016-07-01

    Urinary tract infection (UTI) is very common in children. Precocious diagnosis and appropriate treatment are important because of the permanent disease complications. Zinc increases the response to treatment in many infections. In this study, we explored the effect of zinc in treating UTI. Two hundred children with UTI were divided into 2 groups of 100 who were comparable in terms of age, sex, urine laboratory profiles, and clinical signs and symptoms. The control group received a standard treatment protocol for UTI and the intervention group received oral zinc sulfate syrup plus routine treatment of UTI. A faster recovery was observed in the patients receiving zinc, but abdominal pain was exacerbated by zinc and lasted longer. Three months after the treatment, there was no significant difference between the two groups in the time of fever stop and negative urine culture. In children with UTI, zinc supplementation has a positive effect in ameliorating severe dysuria and urinary frequency while the use of this medication is not recommended in the presence of abdominal pain.

  1. BJR supplements and radiotherapy treatment planning data - a review

    International Nuclear Information System (INIS)

    Agrawal, M.S.

    2000-01-01

    Scientific community has depended on the BJR Supplements on central axis depth dose data published from time to time. There have been five supplements since 1953 when Supplement No. 5 was first published on the subject. The frequent revisions, addition of new data and updating with the technological advancements are special features of these supplements. The most recent supplement is numbered 25 and has been brought out in 1996. A review of the data in respect of cobalt-60, MV X-rays and electron beams as described in the supplements is the subject matter of this write-up. (author)

  2. Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review.

    Science.gov (United States)

    Lopatiene, Kristina; Borisovaite, Marija; Lapenaite, Egle

    2016-01-01

    The aim of the systematic literature review is to update the evidence for the prevention of white spot lesions, using materials containing fluoride and/or casein phosphopeptide-amorphous calcium phosphate during and after treatment with fixed orthodontic appliances. Information search for controlled studies on humans published between January 2008 and February 2016 was performed in PubMed, ScienceDirect, Embase, The Cochrane Library. Inclusion criteria were: the English language, study on humans, patients undergoing orthodontic treatment with fixed appliances, randomized or quasi-randomized controlled clinical studies fluoride-containing product or casein derivates used throughout the appliance therapy or straightaway after debonding. 326 articles were reviewed (Embase 141, PubMed 129, ScienceDirect 41, Cochrane 15). Twelve clinical studies fulfilled all inclusion criteria. Use of fluoridated toothpaste had a remineralizing effect on white spot lesions (WSLs) (P < 0.05); fluoride varnish and casein supplements were effective in prevention and early treatment of WSLs (P < 0.05). Early detection of white spot lesions during orthodontic treatment would allow implementing preventive measures to control the demineralization process before lesions progress. The systemic review has showed that the usage of fluoride and casein supplements in ameliorating white spot lesions during and after fixed orthodontic treatment is significantly effective. However the use of casein phosphopeptide-amorphous calcium phosphate can be more beneficial than fluoride rinse in the reduction of demineralization spots.

  3. Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Kristina Lopatiene

    2016-06-01

    Full Text Available Objectives: The aim of the systematic literature review is to update the evidence for the prevention of white spot lesions, using materials containing fluoride and/or casein phosphopeptide-amorphous calcium phosphate during and after treatment with fixed orthodontic appliances. Material and Methods: Information search for controlled studies on humans published between January 2008 and February 2016 was performed in PubMed, ScienceDirect, Embase, The Cochrane Library. Inclusion criteria were: the English language, study on humans, patients undergoing orthodontic treatment with fixed appliances, randomized or quasi-randomized controlled clinical studies fluoride-containing product or casein derivates used throughout the appliance therapy or straightaway after debonding. Results: 326 articles were reviewed (Embase 141, PubMed 129, ScienceDirect 41, Cochrane 15. Twelve clinical studies fulfilled all inclusion criteria. Use of fluoridated toothpaste had a remineralizing effect on white spot lesions (WSLs (P < 0.05; fluoride varnish and casein supplements were effective in prevention and early treatment of WSLs (P < 0.05. Conclusions: Early detection of white spot lesions during orthodontic treatment would allow implementing preventive measures to control the demineralization process before lesions progress. The systemic review has showed that the usage of fluoride and casein supplements in ameliorating white spot lesions during and after fixed orthodontic treatment is significantly effective. However the use of casein phosphopeptide-amorphous calcium phosphate can be more beneficial than fluoride rinse in the reduction of demineralization spots.

  4. Cost-effectiveness of vitamin D and calcium supplementation in the treatment of elderly women and men with osteoporosis.

    Science.gov (United States)

    Hiligsmann, Mickaël; Ben Sedrine, Wafa; Bruyère, Olivier; Evers, Silvia M; Rabenda, Véronique; Reginster, Jean-Yves

    2015-02-01

    The supplementation with vitamin D and calcium has been recommended for elderly, specifically those with increased risk of fractures older than 65 years. This study aims to assess the cost-effectiveness of vitamin D and calcium supplementation in elderly women and men with osteoporosis and therefore to assess if this recommendation is justified in terms of cost-effectiveness. A validated model for economic evaluations in osteoporosis was used to estimate the cost per quality-adjusted life-year (QALY) gained of vitamin D/calcium supplementation compared with no treatment. The model was populated with cost and epidemiological data from a Belgian health-care perspective. Analyses were conducted in women and men with a diagnosis of osteoporosis (i.e. bone mineral density T-score ≤-2.5). A literature search was conducted to describe the efficacy of vitamin D and calcium in terms of fracture risk reduction. The cost per QALY gained of vitamin D/calcium supplementation was estimated at €40 578 and €23 477 in women and men aged 60 years, respectively. These values decreased to €7912 and €10 250 at the age of 70 years and vitamin D and calcium supplementation was cost-saving at the age of 80 years, meaning that treatment cost was less than the costs of treating osteoporotic fractures of the no-treatment group. This study suggests that vitamin D and calcium supplementation is cost-effective for women and men with osteoporosis aged over 60 years. From an economic perspective, vitamin D and calcium should therefore be administrated in these populations including those also taking other osteoporotic treatments. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  5. Herbal Supplement in a Buffer for Dry Eye Syndrome Treatment.

    Science.gov (United States)

    Chen, Hung-Chang; Chen, Zhi-Yu; Wang, Tsung-Jen; Drew, Victor J; Tseng, Ching-Li; Fang, Hsu-Wei; Lin, Feng-Huei

    2017-08-03

    Dry eye syndrome (DES) is one of the most common types of ocular diseases. There is a major need to treat DES in a simple yet efficient way. Artificial tears (AT) are the most commonly used agents for treating DES, but are not very effective. Herbal extractions of ferulic acid (FA), an anti-oxidant agent, and kaempferol (KM), an anti-inflammatory reagent, were added to buffer solution (BS) to replace ATs for DES treatment. The cytotoxicity and anti-inflammatory effects were examined in vitro by co-culture with human corneal epithelial cells (HCECs) to obtain the optimal concentration of KM and FA for treating HCECs. Physical properties of BS, such as pH value, osmolality, and refractive index were also examined. Then, rabbits with DES were used for therapeutic evaluation. Tear production, corneal damage, and ocular irritation in rabbits' eyes were examined. The non-toxic concentrations of KM and FA for HCEC cultivation over 3 days were 1 µM and 100 µM, respectively. Live/dead stain results also show non-toxicity of KM and FA for treating HCECs. Lipopolysaccharide-stimulated HCECs in inflammatory conditions treated with 100 µM FA and 1 µM KM (FA100/KM1) showed lower IL-1B , IL-6 , IL-8 , and TNFα expression when examined by real-time PCR. The BS with FA100/KM1 had neutral pH, and a similar osmolality and refractive index to human tears. Topical delivery of BS + FA100/KM1 showed no irritation to rabbit eyes. The corneal thickness in the BS + FA100/KM1 treated group was comparable to normal eyes. Results of DES rabbits treated with BS + FA100/KM1 showed less corneal epithelial damage and higher tear volume than the normal group. In conclusion, we showed that the combination of FA (100 µM) and KM (1 µM) towards treating inflamed HCECs had an anti-inflammatory effect, and it is effective in treating DES rabbits when BS is added in combination with these two herbal supplements and used as a topical eye drop.

  6. Herbal Supplement in a Buffer for Dry Eye Syndrome Treatment

    Directory of Open Access Journals (Sweden)

    Hung-Chang Chen

    2017-08-01

    Full Text Available Dry eye syndrome (DES is one of the most common types of ocular diseases. There is a major need to treat DES in a simple yet efficient way. Artificial tears (AT are the most commonly used agents for treating DES, but are not very effective. Herbal extractions of ferulic acid (FA, an anti-oxidant agent, and kaempferol (KM, an anti-inflammatory reagent, were added to buffer solution (BS to replace ATs for DES treatment. The cytotoxicity and anti-inflammatory effects were examined in vitro by co-culture with human corneal epithelial cells (HCECs to obtain the optimal concentration of KM and FA for treating HCECs. Physical properties of BS, such as pH value, osmolality, and refractive index were also examined. Then, rabbits with DES were used for therapeutic evaluation. Tear production, corneal damage, and ocular irritation in rabbits’ eyes were examined. The non-toxic concentrations of KM and FA for HCEC cultivation over 3 days were 1 µM and 100 µM, respectively. Live/dead stain results also show non-toxicity of KM and FA for treating HCECs. Lipopolysaccharide-stimulated HCECs in inflammatory conditions treated with 100 µM FA and 1 µM KM (FA100/KM1 showed lower IL-1B, IL-6, IL-8, and TNFα expression when examined by real-time PCR. The BS with FA100/KM1 had neutral pH, and a similar osmolality and refractive index to human tears. Topical delivery of BS + FA100/KM1 showed no irritation to rabbit eyes. The corneal thickness in the BS + FA100/KM1 treated group was comparable to normal eyes. Results of DES rabbits treated with BS + FA100/KM1 showed less corneal epithelial damage and higher tear volume than the normal group. In conclusion, we showed that the combination of FA (100 µM and KM (1 µM towards treating inflamed HCECs had an anti-inflammatory effect, and it is effective in treating DES rabbits when BS is added in combination with these two herbal supplements and used as a topical eye drop.

  7. Total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism

    OpenAIRE

    He, Xin-Hong; Li, Wen-Tao; Peng, Wei-Jun; Li, Guo-Dong; Wang, Sheng-Ping; Xu, Li-Chao

    2011-01-01

    AIM: To study the safety and feasibility of total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism with thrombocytopenia or leukocytopenia accompanying liver cirrhosis.

  8. Multi-organ damage induced by anabolic steroid supplements: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Samaha Ali A

    2008-10-01

    Full Text Available Abstract Introduction The use of anabolic supplements and other related drugs for body building and to enhance athletic performance is nowadays widespread and acutely pervasive all around the world. This alarming increase in the use of anabolic and amino acid supplements has been linked to a diverse array of pathologies. As previously reported, the abuse of androgenic steroids is not without severe physiological, psychiatric and physical costs. The case we report here describes multi-organ damage resulting from the abuse and uncontrolled use of anabolic steroid supplements, mainly testosterone. Case presentation A 24-year-old white man presented with abdominal pain concomitant with nausea and vomiting. Laboratory analysis revealed hypercalcemia, elevated liver enzymes and high levels of amylase, lipase and creatine protein kinase. Conclusion Amino acid as well as anabolic supplements may lead to abnormal functioning of many organs, which could be fatal in some instances. This mandates worldwide and concerted efforts to educate the public, especially the youth, about the dangers of these increasingly abused drugs.

  9. Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature

    NARCIS (Netherlands)

    Vural, Esmée M. S.; van Munster, Barbara C.; de Rooij, Sophia E.

    2014-01-01

    Melatonin is a hormone that regulates circadian rhythm, and its levels decline with age. As melatonin levels decrease, older adults are prone to develop disorders related to an altered circadian rhythm. The effective dose of melatonin supplementation in these disorders remains unclear. Our objective

  10. Lysine supplementation is not effective for the prevention or treatment of feline herpesvirus 1 infection in cats: a systematic review.

    Science.gov (United States)

    Bol, Sebastiaan; Bunnik, Evelien M

    2015-11-16

    Feline herpesvirus 1 is a highly contagious virus that affects many cats. Virus infection presents with flu-like signs and irritation of ocular and nasal regions. While cats can recover from active infections without medical treatment, examination by a veterinarian is recommended. Lysine supplementation appears to be a popular intervention (recommended by > 90 % of veterinarians in cat hospitals). We investigated the scientific merit of lysine supplementation by systematically reviewing all relevant literature. NCBI's PubMed database was used to search for published work on lysine and feline herpesvirus 1, as well as lysine and human herpesvirus 1. Seven studies on lysine and feline herpesvirus 1 (two in vitro studies and 5 studies with cats), and 10 publications on lysine and human herpesvirus 1 (three in vitro studies and 7 clinical trials) were included for qualitative analysis. There is evidence at multiple levels that lysine supplementation is not effective for the prevention or treatment of feline herpesvirus 1 infection in cats. Lysine does not have any antiviral properties, but is believed to act by lowering arginine levels. However, lysine does not antagonize arginine in cats, and evidence that low intracellular arginine concentrations would inhibit viral replication is lacking. Furthermore, lowering arginine levels is highly undesirable since cats cannot synthesize this amino acid themselves. Arginine deficiency will result in hyperammonemia, which may be fatal. In vitro studies with feline herpesvirus 1 showed that lysine has no effect on the replication kinetics of the virus. Finally, and most importantly, several clinical studies with cats have shown that lysine is not effective for the prevention or the treatment of feline herpesvirus 1 infection, and some even reported increased infection frequency and disease severity in cats receiving lysine supplementation. We recommend an immediate stop of lysine supplementation because of the complete lack of

  11. Tongue-tie, from embriology to treatment: a literature review

    Directory of Open Access Journals (Sweden)

    Maria Dezio

    2015-03-01

    Full Text Available The aim of this review is to create a complete analysis about tongue-tie (or short lingual frenum or ankyloglossia according to the most important works published in literature. The analysis allowed us to do a complete evaluation of this problem, from embriology to the therapeutic approach we could use today, focusing our attention on laser-assisted therapy. This review is based on the research on the PubMed Database (www.ncbi.nlm.nih.gov of studies about lingual frenum written in English between January 1980 and May 2014. The keywords inserted were “lingual frenum”, “frenectomy”, “laser therapy”. We have analyzed: case series, case reports, clinical studies, and also literature reviews in which embryology, physiology, diagnosis and treatment of ankyloglossia were described. We excluded laboratory studies, studies based on animal tests and studies about patients with particular syndromes in which we can also find tongue-tie. The selection criteria allowed us to select 42 articles. The treatment options for the releasing of the frenum are surgically represented by frenotomy (i.e. simple horizontal cut of this training and frenectomy (i.e. removal. In both cases, the intervention on the short lingual frenum is simple, short-lasting, and without particular complications. Furthermore, this kind of treatment can be carried out with different devices: with the typical cold blade scalpel or by the use of laser, a new method that shows more advantages over the prior art. Laser-assisted therapy permits to intervene on newborns (from 0 to 20 days, when there are breastfeeding problems without total anesthesia and suture. The Er:YAG, CO2 laser (according to literature data and Diode laser (according to our experience are advantageous, safe and effective in tongue-tie treatment.

  12. Using research literature to develop a perceptual retraining treatment protocol.

    Science.gov (United States)

    Neistadt, M E

    1994-01-01

    Treatment protocols derived from research literature can help therapists provide more rigorous treatment and more systematic assessment of client progress. This study applied research findings about the influence of task, subject, and feedback parameters on adult performance with block designs to an occupational therapy treatment protocol for parquetry block assembly--an activity occupational therapists use to remediate constructional deficits. Task parameter research suggests that parquetry tasks can be graded according to the features of the design cards, with cards having all block boundaries drawn in being easier than those with some block boundaries omitted. Subject parameter findings suggest that clients' lesions and initial constructional competence can influence their approaches to parquetry tasks. Feedback parameter research suggests that a combination of perceptual and planning cues is most effective for parquetry tasks. Methods to help clients transfer constructional skills from parquetry to functional tasks are also discussed.

  13. Oral Zinc Supplementation for the Treatment of Acute Diarrhea in Children: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Laura M. Lamberti

    2013-11-01

    Full Text Available Evidence supporting the impact of therapeutic zinc supplementation on the duration and severity of diarrhea among children under five is largely derived from studies conducted in South Asia. China experiences a substantial portion of the global burden of diarrhea, but the impact of zinc treatment among children under five has not been well documented by previously published systematic reviews on the topic. We therefore conducted a systematic literature review, which included an exhaustive search of the Chinese literature, in an effort to update previously published estimates of the effect of therapeutic zinc. We conducted systematic literature searches in various databases, including the China National Knowledge Infrastructure (CNKI, and abstracted relevant data from studies meeting our inclusion and exclusion criteria. We used STATA 12.0 to pool select outcomes and to generate estimates of percentage difference and relative risk comparing outcomes between zinc and control groups. We identified 89 Chinese and 15 non-Chinese studies for the review, including studies in 10 countries from all WHO geographic regions, and analyzed a total of 18,822 diarrhea cases (9469 zinc and 9353 control. None of the included Chinese studies had previously been included in published pooled effect estimates. Chinese and non-Chinese studies reported the effect of therapeutic zinc supplementation on decreased episode duration, stool output, stool frequency, hospitalization duration and proportion of episodes lasting beyond three and seven days. Pooling Chinese and non-Chinese studies yielded an overall 26% (95% CI: 20%−32% reduction in the estimated relative risk of diarrhea lasting beyond three days among zinc-treated children. Studies conducted in and outside China report reductions in morbidity as a result of oral therapeutic zinc supplementation for acute diarrhea among children under five years of age. The WHO recommendation for zinc treatment of diarrhea

  14. Treatment of holistic suffering in cancer: A systematic literature review.

    Science.gov (United States)

    Best, Megan; Aldridge, Lynley; Butow, Phyllis; Olver, Ian; Price, Melanie A; Webster, Fleur

    2015-12-01

    Holistic suffering is a debilitating problem for cancer patients. Although many treatments have been suggested for its alleviation, they have not been compared for effectiveness. This literature review seeks to identify what interventions are effective in treatment of holistic suffering of cancer patients. A systematic review was conducted to identify and evaluate studies of interventions for holistic suffering in adult cancer patients. Search terms were generated iteratively from the literature. MEDLINE, EMBASE, the Cochrane Library and PsycINFO databases were searched for the years 1992-2015. Included studies were peer-reviewed, English language reports of either a controlled trial or a randomised controlled trial focusing on therapies aimed at relieving suffering in adult cancer patients. Articles were excluded if focused predominantly on spiritual or existential issues or concerns not leading to suffering. Studies were graded for quality using the QualSyst quantitative checklist. Levels of evidence were ascertained by completing the National Health and Medical Research Council criteria. Results are reported according to AMSTAR guidelines. The studies represented seven intervention types. Meaning-centred, hope-centred and stress-reduction interventions were found to be effective. Results of both psycho-educational and spiritual interventions in improving spiritual well-being were mixed. Supportive-expressive interventions - with the exception of forgiveness therapy - were not efficacious. There was little or no evidence for the efficacy of creative and healing arts and other assessed interventions such as animal therapy and haptotherapy. This systematic review found that spiritual well-being, meaning, hope and benefit finding can be positively impacted by a variety of treatment modalities. © The Author(s) 2015.

  15. Relationship between temporomandibular disorders and orthodontic treatment: a literature review

    Directory of Open Access Journals (Sweden)

    Ronaldo Antônio Leite

    2013-02-01

    Full Text Available OBJECTIVE: The objective of this study was to review the most recent studies from the last 15 years, in search of clinical studies that report the relationship between TMD and orthodontic treatment and/or malocclusion. Our intention was to determine whether orthodontic treatment would increase the incidence of signs and symptoms of TMD, and whether orthodontic treatment would be recommended for treating or preventing signs and symptoms of TMD. METHODS: Literature reviews, editorials, letters to the editor, experimental studies in animals and short communications were excluded from this review. Were included only prospective, longitudinal, case-control or retrospective studies with a large sample and significant statistical analysis. Studies that dealt with craniofacial deformities and syndromes or orthognathic surgery treatment were also excluded, as well as those that reported only the association between malocclusion and TMD. RESULTS: There were 20 articles relating orthodontics to TMD according to the inclusion criteria. The studies that associated signs and symptoms of TMD to orthodontic treatment showed discrepant results. Some have found positive effects of orthodontic treatment on signs and symptoms of TMD, however, none showed a statistically significant difference. CONCLUSIONS: All studies cited in this literature review reported that orthodontic treatment did not provide risk to the development of signs and symptoms of TMD, regardless of the technique used for treatment, the extraction or non-extraction of premolars and the type of malocclusion previously presented by the patient. Some studies with long-term follow-up concluded that orthodontic treatment would not be preventive or a treatment option for TMD.OBJETIVO: revisar a literatura mais atual, dos últimos 15 anos, em busca de estudos clínicos que relatem a relação entre a disfunção temporomandibular (DTM e o tratamento ortodôntico e/ou a má oclusão. A intenção foi

  16. Safety profile of drugs used in the treatment of osteoporosis: a systematical review of the literature

    Directory of Open Access Journals (Sweden)

    M. Varenna

    2013-10-01

    Full Text Available The range of osteoporosis treatments is increasingly large and, like any disease, the pharmacological management of patients should involve a risk/benefit evaluation to attain the greatest reduction in risk of fracture with the lowest incidence of adverse events. The aim of this review is to critically appraise the literature about the safety issues of the main pharmacological treatments of osteoporosis. This document is the result of a consensus of experts based on a systematic review of regulatory documents, randomized controlled trials, metaanalyses, pharmacovigilance surveys and case series related to possible adverse drug reactions to osteoporosis treatment with calcium and vitamin D supplements, bisphosphonates, strontium ranelate, selective estrogen receptor modulators, denosumab, and teriparatide. As expected, randomized controlled trials showed only the most common adverse events due to the samples size and the short observation time. Case series and observational studies are able to provide data about uncommon side effects, but in some cases a sure cause-effect relationship needs still to be confirmed. Consistently with methodological limitations, the newer drugs have a tolerance profile that has not been fully explored yet. Osteoporosis treatments showed an overall good tolerance profile with rare serious adverse events that, however, must be well known by the clinician who prescribes these drugs. The concern about possible adverse events should be weighed against the reduction of morbidity and mortality associated with a significant fracture risk reduction.

  17. Treatment of Holocaust Denial Literature in Association of Research Libraries

    Science.gov (United States)

    Spidal, Debra F.

    2012-01-01

    Holocaust denial literature has been treated inconsistently in library collections. At one time Holocaust denial literature was classed and subject headings assigned with Holocaust literature. After specific Library of Congress classification numbers and subject headings for Holocaust denial and Holocaust denial literature became available in the…

  18. The treatment of contaminated sodium: a literature study

    Energy Technology Data Exchange (ETDEWEB)

    Van Alsenoy, V; Rahier, A.

    1996-07-01

    At the Belgian Nuclear Research Centre SCK-CEN, several experiments concerning safety aspects of Liquid Metal Fast Breeder reactors were carried out. During these experiments, an important amount of sodium containing waste was produced. In view of the treatment of this waste, a literature study was performed and third parties were contacted to find a solution. This document summarizes the results of this study. The sodium waste has been characterized by a theoretical study and by radiological measurements. The waste consists mainly of metallic sodium contaminated with corrosion activation products, fission products and even fuel particles. The sodium might also be contaminated with oxidation and reduction products like Na{sub 2}O and NaH. The most important contaminant is {sup 137}Cs. Several third parties, with experience in treating sodium, were contacted and they proposed a treatment of the sodium based on its reaction with water or alcohol. From a safety point of view, these reactions are not satisfactory because they are all exothermic and lead to flammable products or even make use of flammable reactants. Therefore, all the parties foresee extensive and expensive studies prior to the treatment. The urgent nature of the issues together with the important safety aspects were the incentives for the Research and Development group of the Radioactive Waste and Cleanup to look for alternatives. For this purpose, a research programme has been started with the aim to define, test, demonstrate and finally apply a safe process for the treatment of contaminated sodium by oxidation on a fluidized bed followed by vitrification. The collected information confirms that the oxidation of sodium vapour can be carried out safely, leading to the formation of sodium peroxide and oxide.

  19. The treatment of contaminated sodium: a literature study

    International Nuclear Information System (INIS)

    Van Alsenoy, V; Rahier, A.

    1996-07-01

    At the Belgian Nuclear Research Centre SCK-CEN, several experiments concerning safety aspects of Liquid Metal Fast Breeder reactors were carried out. During these experiments, an important amount of sodium containing waste was produced. In view of the treatment of this waste, a literature study was performed and third parties were contacted to find a solution. This document summarizes the results of this study. The sodium waste has been characterized by a theoretical study and by radiological measurements. The waste consists mainly of metallic sodium contaminated with corrosion activation products, fission products and even fuel particles. The sodium might also be contaminated with oxidation and reduction products like Na 2 O and NaH. The most important contaminant is 137 Cs. Several third parties, with experience in treating sodium, were contacted and they proposed a treatment of the sodium based on its reaction with water or alcohol. From a safety point of view, these reactions are not satisfactory because they are all exothermic and lead to flammable products or even make use of flammable reactants. Therefore, all the parties foresee extensive and expensive studies prior to the treatment. The urgent nature of the issues together with the important safety aspects were the incentives for the Research and Development group of the Radioactive Waste and Cleanup to look for alternatives. For this purpose, a research programme has been started with the aim to define, test, demonstrate and finally apply a safe process for the treatment of contaminated sodium by oxidation on a fluidized bed followed by vitrification. The collected information confirms that the oxidation of sodium vapour can be carried out safely, leading to the formation of sodium peroxide and oxide

  20. Is there a place for nutritional supplements in the treatment of idiopathic male infertility?

    Directory of Open Access Journals (Sweden)

    Davide Arcaniolo

    2014-09-01

    Full Text Available Objective: Infertility affects 15% of couples in fertile age. Male factor is a cause of infertility in almost half of cases, mainly due to oligoasthenoteratozoospermia (OAT. The purpose of this study is to review the effects of nutritional supplements as medical treatment for idiopathic male infertility. Material and methods: A Pub Med and Medline review of the published studies utilizing nutritional supplements for the treatment of male infertility has been performed. Results: Clinical trials on Vitamin E, Vitamin A, Vitamin C. Arginine, Carnitine, N-Acetyl-Carnitine, Glutathione, Coenzyme Q10, Selenium and Zinc were reviewed. Although there is a wide variability in selected population, dose regimen and final outcomes, nutritional supplements both alone and in combination seems to be able to improve semen parameters (sperm count, sperm motility and morphology and pregnancy rate in infertile men. Conclusions: There are rising evidences from published randomized trials and systematic review suggesting that nutritional supplementation may improve semen parameters and the likelihood of pregnancy in men affected by OAT. This improvement, however, is not consistent and there is a wide variation in the treatment regimens used. Well designed and adequately powered RCTs are needed to better clarify the role of nutritional supplements as treatment for male infertility.

  1. Literature Review: Herbal Medicine Treatment after Large-Scale Disasters.

    Science.gov (United States)

    Takayama, Shin; Kaneko, Soichiro; Numata, Takehiro; Kamiya, Tetsuharu; Arita, Ryutaro; Saito, Natsumi; Kikuchi, Akiko; Ohsawa, Minoru; Kohayagawa, Yoshitaka; Ishii, Tadashi

    2017-01-01

    Large-scale natural disasters, such as earthquakes, tsunamis, volcanic eruptions, and typhoons, occur worldwide. After the Great East Japan earthquake and tsunami, our medical support operation's experiences suggested that traditional medicine might be useful for treating the various symptoms of the survivors. However, little information is available regarding herbal medicine treatment in such situations. Considering that further disasters will occur, we performed a literature review and summarized the traditional medicine approaches for treatment after large-scale disasters. We searched PubMed and Cochrane Library for articles written in English, and Ichushi for those written in Japanese. Articles published before 31 March 2016 were included. Keywords "disaster" and "herbal medicine" were used in our search. Among studies involving herbal medicine after a disaster, we found two randomized controlled trials investigating post-traumatic stress disorder (PTSD), three retrospective investigations of trauma or common diseases, and seven case series or case reports of dizziness, pain, and psychosomatic symptoms. In conclusion, herbal medicine has been used to treat trauma, PTSD, and other symptoms after disasters. However, few articles have been published, likely due to the difficulty in designing high quality studies in such situations. Further study will be needed to clarify the usefulness of herbal medicine after disasters.

  2. Stenting in the treatment of acute ischemic stroke: literature review.

    Directory of Open Access Journals (Sweden)

    Edgar A Samaniego

    2011-12-01

    Full Text Available Recanalization of acute large artery occlusions is a strong predictor of good outcome. The development of thrombectomy devices resulted in a significant improvement in recanalization rates compared to thrombolytics alone. However, clinical trials and registries with these thrombectomy devices in acute ischemic stroke (AIS have shown recanalization rates in the range of 40-81%. The last decade has seen the development of nickel titanium self-expandable stents (SES. These stents, in contrast to balloon-mounted stents, allow better navigability and deployment in tortuous vessels and therefore are optimal for the cerebral circulation. SES were initially used for stent-assisted coil embolization of intracranial aneurysms and for treatment of intracranial stenosis. However, a few authors have recently reported feasibility of deployment of SES in AIS. The use of these devices yielded higher recanalization rates compared to traditional thrombectomy devices. Encouraged by these results, retrievable SES systems have been recently used in AIS. These devices offer the advantage of resheathing and retrieving of the stent even after full deployment. Some of these stents can also be detached in case permanent stent placement is needed. Retrievable SES are being used in Europe and currently tested in clinical trials in the United States. We review the recent literature in the use of stents for the treatment of AIS secondary to large vessel occlusion.

  3. Literature-Related Discovery: Potential Treatments and Preventives for SARS

    Science.gov (United States)

    2010-01-01

    We recently demonstrated that kefir modulates the immune response in mice, increasing the number of IgA+ cells in the intestinal and bronchial...retrieval and analysis of the core SARS literature and literatures related directly to the core SARS literature (e.g., immune system component literatures...According to recent reviews of the pandemic, none of the drugs worked. Those who recovered did so by natural means; their immune systems were

  4. Treatment of petroleum drill cuttings using bioaugmentation and biostimulation supplemented with phytoremediation.

    Science.gov (United States)

    Kogbara, Reginald B; Ogar, Innocent; Okparanma, Reuben N; Ayotamuno, Josiah M

    2016-07-28

    This study sought to compare the effectiveness of bioaugmentation and biostimulation, as well as the combination of both techniques, supplemented with phytoremediation, in the decontamination of petroleum drill cuttings. Drill cuttings with relatively low concentration of total petroleum hydrocarbons (TPH) and metals were mixed with soil in the ratio 5:1 and treated with three different combinations of the bioremediation options. Option A entailed bioaugmentation supplemented with phytoremediation. Option B had the combination of biostimulation and bioaugmentation supplemented with phytoremediation. While biostimulation supplemented with phytoremediation was deployed in option C. Option O containing the drill cuttings-soil mixture without treatment served as untreated control. Fertilizer application, tillage and watering were used for biostimulation treatment, while spent mushroom substrate (Pleurotus ostreatus) and elephant grass (Pennisetum purpureum) were employed for bioaugmentation and phytoremediation treatment, respectively. The drill cuttings-soil mixtures were monitored for TPH, organic carbon, total nitrogen, pH, metal concentrations, and fungal counts, over time. After 56 days of treatment, there was a decline in the initial TPH concentration of 4,114 mg kg(-1) by 5.5%, 68.3%, 75.6% and 48% in options O, A, B and C, respectively. Generally, higher TPH loss resulted from the phytoremediation treatment stage. The treated options also showed slight reductions in metal concentrations ranging from 0% to 16% of the initial low concentrations. The results highlight the effectiveness of bioaugmentation supplemented with phytoremediation. The combination of bioaugmentation and biostimulation supplemented with phytoremediation, however, may prove better in decontaminating petroleum drill cuttings to environmentally benign levels.

  5. The Treatment of Wife Abuse in Recent Social Science Literature.

    Science.gov (United States)

    Wardell, Laurie; And Others

    This paper reviews the social science literature dealing with gender relations in marriage and the issues of wife abuse. It is argued that the old anti-woman biases of the literature have not really diminished under the impact of feminism. The sexist assumptions and victim-blaming focus of the new battery literature are examined through…

  6. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review.

    Science.gov (United States)

    Tsai, H-H; Lin, H-W; Simon Pickard, A; Tsai, H-Y; Mahady, G B

    2012-11-01

    The use of herbs and dietary supplements (HDS) alone or concomitantly with medications can potentially increase the risk of adverse events experienced by the patients. This review aims to evaluate the documented HDS-drug interactions and contraindications. A structured literature review was conducted on PubMed, EMBASE, Cochrane Library, tertiary literature and Internet. While 85 primary literatures, six books and two web sites were reviewed for a total of 1,491 unique pairs of HDS-drug interactions, 213 HDS entities and 509 medications were involved. HDS products containing St. John's Wort, magnesium, calcium, iron, ginkgo had the greatest number of documented interactions with medications. Warfarin, insulin, aspirin, digoxin, and ticlopidine had the greatest number of reported interactions with HDS. Medications affecting the central nervous system or cardiovascular system had more documented interactions with HDS. Of the 882 HDS-drug interactions being described its mechanism and severity, 42.3% were due to altered pharmacokinetics and 240 were described as major interactions. Of the 152 identified HDS contraindications, the most frequent involved gastrointestinal (16.4%), neurological (14.5%), and renal/genitourinary diseases (12.5%). Flaxseed, echinacea, and yohimbe had the largest number of documented contraindications. Although HDS-drug interactions and contraindications primarily concerned a relatively small subset of commonly used medications and HDS entities, this review provides the summary to identify patients, HDS products, and medications that are more susceptible to HDS-drug interactions and contraindications. The findings would facilitate the health-care professionals to communicate these documented interactions and contraindications to their patients and/or caregivers thereby preventing serious adverse events and improving desired therapeutic outcomes. © 2012 Blackwell Publishing Ltd.

  7. Initial Selection of Supplemental Treatment Technologies for Hanford's Low-Activity Tank Waste

    International Nuclear Information System (INIS)

    Raymond, Richard E.; Powell, Roger W.; Hamilton, Dennis W.; Kitchen, William A.; Mauss, Billie M.; Brouns, Thomas M.

    2004-01-01

    In 2002, the U.S. Department of Energy (DOE) documented a plan for accelerating cleanup of the Hanford Site, located in southeastern Washington State, by at least 35 years (DOE 2002). A key element of the accelerated cleanup plan was a strategic initiative for acceleration of the tank waste program and completion of ''tank waste treatment by 2028 by increasing the capacity of the planned Waste Treatment Plant (ETP) and using supplemental technologies for waste treatment and immobilization''. The plan identified specific technologies to be evaluated for supplemental treatment of as much as 70% of the low-activity waste (LAW). The objective was to complete required testing and evaluation that would ''...bring an appropriate combination of the above technologies to deployment to supplement LAW treatment and immobilization in the WTP to achieve the completion of tank waste treatment by 2028''. In concert with this acceleration plan, DOE, the U.S. Environmental Protection Agency, and the Washington State Department of Ecology have proposed to accelerate from 2012 to 2005 the Hanford Federal Facility Compliance Agreement (Tri-Party Agreement) milestone (M-62-08) associated with a final decision on treatment of the balance of tank waste that is beyond the capacity of the currently designed WTP

  8. Dietary Chromium Supplementation for Targeted Treatment of Diabetes Patients with Comorbid Depression and Binge Eating

    Science.gov (United States)

    Brownley, Kimberly A.; Boettiger, Charlotte A.; Young, Laura; Cefalu, William T.

    2015-01-01

    Dietary chromium supplementation for the treatment of diabetes remains controversial. The prevailing view that chromium supplementation for glucose regulation is unjustified has been based upon prior studies showing mixed, modest-sized effects in patients with type 2 diabetes (T2DM). Based on chromium's potential to improve insulin, dopamine, and serotonin function, we hypothesize that chromium has a greater glucoregulatory effect in individuals who have concurrent disturbances in dopamine and serotonin function – that is, complex patients with comorbid diabetes, depression, and binge eating. We propose, as suggested by the collective data to date, the need to go beyond the “one size fits all” approach to chromium supplementation and put forth a series of experiments designed to link physiological and neurobehavioral processes in the chromium response phenotype. PMID:25838140

  9. Understanding brittle deformation at the Olkiluoto site. Literature Supplement 2010: an Update of Posiva Working Report 2006-25

    Energy Technology Data Exchange (ETDEWEB)

    Milnes, A. (GEA Consulting, Corcelles (CH))

    2011-07-15

    Posiva Working Report 2006-25 arose from the belief that geological modelling at Olkiluoto, Finland, where an underground repository for spent nuclear fuel is at present under construction, could be significantly improved by an increased understanding of the phenomena being modelled, in conjunction with the more sophisticated data acquisition and processing methods which are now being introduced. Since the geological model is the necessary basis for the rock engineering and hydrological models, which in turn provide the foundation for identifying suitable rock volumes underground and for demonstrating long-term safety, its scientific basis is of critical importance. As a contribution to improving this scientific basis, the literature on brittle deformation in the Earth's crust was reviewed up to and including year 2005. The result was a compilation of scientific articles, reports and books on some of the key topics of significance for an improved understanding of brittle deformation of hard, crystalline rocks, particularly heterogeneous migmatitic and metamorphic rocks like those that make up the Olkiluoto bedrock. The present report is a supplement to WR 2006-25, covering the 5-year period 2006-2010, with some key earlier references and an Annotated Bibliography. The present report is subdivided into five chapters, listing recent literature on (1) background subjects and basic principles, (2) the fabric of Olkiluoto-type intact rock (gneisses, migmatites, fault rocks), (3) formation and characteristics of brittle deformation features (fracture mechanics, brittle microtectonics), (4) fracture data acquisition and processing (statistical characterisation and modelling of fracture systems), and (5) the characterisation of brittle deformation zones (for deterministic and dynamic modelling), corresponding to the first five chapters of the earlier report

  10. Understanding brittle deformation at the Olkiluoto site. Literature Supplement 2010: an Update of Posiva Working Report 2006-25

    International Nuclear Information System (INIS)

    Milnes, A.

    2011-07-01

    Posiva Working Report 2006-25 arose from the belief that geological modelling at Olkiluoto, Finland, where an underground repository for spent nuclear fuel is at present under construction, could be significantly improved by an increased understanding of the phenomena being modelled, in conjunction with the more sophisticated data acquisition and processing methods which are now being introduced. Since the geological model is the necessary basis for the rock engineering and hydrological models, which in turn provide the foundation for identifying suitable rock volumes underground and for demonstrating long-term safety, its scientific basis is of critical importance. As a contribution to improving this scientific basis, the literature on brittle deformation in the Earth's crust was reviewed up to and including year 2005. The result was a compilation of scientific articles, reports and books on some of the key topics of significance for an improved understanding of brittle deformation of hard, crystalline rocks, particularly heterogeneous migmatitic and metamorphic rocks like those that make up the Olkiluoto bedrock. The present report is a supplement to WR 2006-25, covering the 5-year period 2006-2010, with some key earlier references and an Annotated Bibliography. The present report is subdivided into five chapters, listing recent literature on (1) background subjects and basic principles, (2) the fabric of Olkiluoto-type intact rock (gneisses, migmatites, fault rocks), (3) formation and characteristics of brittle deformation features (fracture mechanics, brittle microtectonics), (4) fracture data acquisition and processing (statistical characterisation and modelling of fracture systems), and (5) the characterisation of brittle deformation zones (for deterministic and dynamic modelling), corresponding to the first five chapters of the earlier report

  11. Effect of Antioxidant Mineral Elements Supplementation in the Treatment of Hypertension in Albino Rats

    Directory of Open Access Journals (Sweden)

    S. A. Muhammad

    2012-01-01

    Full Text Available Oxidative stress has been implicated in various pathologies, including hypertension, atherosclerosis, diabetes, and chronic renal disease. The current work was designed with the aim of investigating the potentials of antioxidants copper, manganese, and zinc in the treatment of hypertension in Wistar rats. The rats were fed 8% NaCl diet for 5 weeks and treatment with supplements in the presence of the challenging agent for additional 4 weeks. The supplementation significantly decreased the blood pressure as compared with hypertensive control. The result also indicated significant decreased in the levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol, malondialdehyde, insulin and increase in the high-density lipoprotein cholesterol, total antioxidant activities, and nitric oxide of the supplemented groups relative to the hypertensive control. The average percentage protection against atherogenesis indicated 47.13 ± 9.60% for all the supplemented groups. The mean arterial blood pressure showed significant positive correlation with glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, atherogenic index, insulin resistance and malondialdehyde while high density lipoprotein-cholesterol and total antioxidant activities showed negative correlation. The result therefore indicated strong relationship between oxidative stress and hypertension and underscores the role of antioxidant minerals in reducing oxidative stress, dyslipidemia, and insulin resistance associated with hypertension.

  12. On the Effectiveness of Supplemental Instruction: A Systematic Review of Supplemental Instruction and Peer-Assisted Study Sessions Literature between 2001 and 2010

    Science.gov (United States)

    Dawson, Phillip; van der Meer, Jacques; Skalicky, Jane; Cowley, Kym

    2014-01-01

    Supplemental instruction (SI)--variously known as peer-assisted learning, peer-assisted study sessions, and other names--is a type of academic support intervention popular in higher education. In SI sessions, a senior student facilitates peer learning between undergraduates studying a high-risk course. This article presents a systematic review of…

  13. PELVIC CONGESTION SYNDROME. METHODS OF DIAGNOSIS AND TREATMENT. LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Svetlana Vladimirovna Verezgova

    2014-10-01

    Full Text Available Pelvic pain syndrome is not rare clinical condition without specific symptoms and usually affects multiparous women. Numerous controversies in the management such patients are still present in current publications.Different diagnostic modalities were and are now used to delineate of anatomy and physiology of pelvic venous system. The well-known and recently developed approaches to treat patients with  pelvic congestion syndrome are discussed in present overview of the scientific literature.

  14. Vitamin C supplementation improve the sputum conversion culture rate in pulmonary tuberculosis treatment while rifampicin susceptible

    Science.gov (United States)

    Susanto, L.; Siregar, Y.; Kusumawati, L.

    2018-03-01

    The failure of first-line tuberculosis treatment greatly affects multiple drug-resistant tuberculosis. In vitro study of vitamin C induces the death of M. tuberculosis bacteria and accelerates healing of tuberculosis, so the multiple drug-resistant tuberculosis can be avoided. This research aimed to identify the effect of vitamin C as a supportive treatment on the sputum conversion rate. The randomizedand double group with a parallel design by matching pair method was used to collect samples. The first group was treated with standard tuberculosis treatment, and the other was given vitamin C supplementation. Vitamin C plasma level analyzation was performed before and after two months of treatment. Sputum conversion was evaluated every week for eight weeks. The comparison of vitamin C plasma level in pre and post-treatment group was significant (p=0.03) but not in the other group. There was no significant difference in vitamin C plasma level between two groups (p=0.21). The proportion of sputum conversion rate in both group in the first week was 0% vs. 9.6% (p=0.83) and the last week of study was 83.9% vs. 100% (p=0.02). In conclusion, vitamin C supplementation has effects in improving the healing process of tuberculosis patients as indicated by higher in sputum conversion rate.

  15. Pharmacological treatment of chronic constipation: a literature review

    Directory of Open Access Journals (Sweden)

    Roshanak Salari

    2016-07-01

    Full Text Available Chronic constipation is a very common disease that is particularly commonplace among members of the elderly population. It is one of the most widespread bowel disorders, and it causes significant pain and discomfort; as such, it usually requires medical attention. The major causes of constipation are slow colonic movements and/or functional gastrointestinal disorders. This review aimed to examine the pharmacological treatments that are currently available for chronic constipation. To develop insights into the causes and treatments of chronic constipation, relevant review articles that were published on the Pubmed, Cochrane database, and Embase websites, were examined. The outputs of these studies indicated that high daily intake of fibers and fluids in addition to regular exercise can be very helpful in avoiding and treating constipation. The pharmacological treatments that are administered to treat this disease typically increase the water content of the bowel lumen, and this leads to more regular bowel movements. Novel drugs have been introduced to treat constipation, and many of these are now subject to formal research studies. Since constipation can facilitate the development of other gastrointestinal diseases, it is important that we develop an understanding the therapeutic treatments that are available with the intention of identifying which of these may represent the most effective method for treating this disease. With that objective in mind, this review was undertaken to review the clinical effectiveness of the different pharmacological treatments that are employed to treat or prevent constipation.

  16. Herbs and natural supplements in the prevention and treatment of delayed-onset muscle soreness

    Directory of Open Access Journals (Sweden)

    Abbas Meamarbashi

    2017-01-01

    Full Text Available Objective:  Unaccustomed and intense eccentric exercise is a common cause of delayed-onset muscle soreness (DOMS. There are multiple remedies for the treatment of DOMS, but its clinical and laboratory pieces of evidence are scarce. Currently, the treatments proposed for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and other alternatives. To find a holistic treatment with effective pain relief and minimum side effects, complementary and alternative medicine, including herbal therapies, plays a main role.Methods: In this review, the existing published studies investigating the efficacy of herbal and natural supplementation therapies for the prevention or treatment of side effects, symptoms, and signs of DOMS are summarized.Results: Previous studies have documented the efficacy of herbal therapies to treat pain, inflammation, as well as laboratory and clinical side effects of DOMS.Conclusion: The use of herbs in DOMS seems safer and has lower side effects than pharmacotherapy. However, the potential for side effects and drug interactions should be considered.

  17. Prevention and treatment of erectile dysfunction using lifestyle changes and dietary supplements: what works and what is worthless, part II.

    Science.gov (United States)

    Moyad, Mark A; Barada, James H; Lue, Tom F; Mulhall, John P; Goldstein, Irwin; Fawzy, Ahmed

    2004-05-01

    It seems naïve to believe that some plants or herbs do not contain specific compounds that could benefit patients with ED. Many supplements have not been investigated in a laboratory or clinical research setting before commercial sale, however,which creates a complex situation. If efficacy is or is not demonstrated through adequate research, then the benefit or lack thereof cannot be mentioned on the label. Furthermore, clinicians and the public cannot be made aware of which compounds or supplements are effective because no general standards for sale exist under the current guidelines. Dietary supplements have received a tremendous amount of publicity. The large and growing market for ED treatment seems to have contributed partly to the promotion of numerous supplements and their apparent benefits. Whether these dietary supplements have merit is questionable. Some supplements may produce results opposite to those advertised. Other supplements may be enjoying the benefits of the placebo effect. Because a placebo response of 25% to 50% has been recorded in clinical trials with effective agents, it is understandable that some supplements enjoy financial success despite the limited research espousing their use. If one to two of four individuals or one of three individuals who try a dietary supplement gain some benefit for their ED, the market for these supplements will remain extraordinary. On a larger scale, of 100,000 men who try a supplement, approximately 25,000 to 50,000 will claim some success. The challenge for clinicians is to discuss the placebo response properly and the need for good research before any intervention, especially supplements, can be advocated for general use. Table 2 summarizes some popular ED supplements and general conclusions that can be drawn from clinical investigations. Some dietary supplements may have an active ingredient that benefits patients with certain types of ED. An exciting area of future dietary supplement research is the

  18. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Emily K Tarleton

    Full Text Available Current treatment options for depression are limited by efficacy, cost, availability, side effects, and acceptability to patients. Several studies have looked at the association between magnesium and depression, yet its role in symptom management is unclear. The objective of this trial was to test whether supplementation with over-the-counter magnesium chloride improves symptoms of depression. An open-label, blocked, randomized, cross-over trial was carried out in outpatient primary care clinics on 126 adults (mean age 52; 38% male diagnosed with and currently experiencing mild-to-moderate symptoms with Patient Health Questionnaire-9 (PHQ-9 scores of 5-19. The intervention was 6 weeks of active treatment (248 mg of elemental magnesium per day compared to 6 weeks of control (no treatment. Assessments of depression symptoms were completed at bi-weekly phone calls. The primary outcome was the net difference in the change in depression symptoms from baseline to the end of each treatment period. Secondary outcomes included changes in anxiety symptoms as well as adherence to the supplement regimen, appearance of adverse effects, and intention to use magnesium supplements in the future. Between June 2015 and May 2016, 112 participants provided analyzable data. Consumption of magnesium chloride for 6 weeks resulted in a clinically significant net improvement in PHQ-9 scores of -6.0 points (CI -7.9, -4.2; P<0.001 and net improvement in Generalized Anxiety Disorders-7 scores of -4.5 points (CI -6.6, -2.4; P<0.001. Average adherence was 83% by pill count. The supplements were well tolerated and 61% of participants reported they would use magnesium in the future. Similar effects were observed regardless of age, gender, baseline severity of depression, baseline magnesium level, or use of antidepressant treatments. Effects were observed within two weeks. Magnesium is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated

  19. LITERATURE REVIEW ON STEM CELL TREATMENT & ORAL SUBMUCOUS FIBROSIS (OSMF)

    OpenAIRE

    Prathipaty James; Kameswararao

    2015-01-01

    Stem cell therapy is a part of regenerative medicine that involves the use of undifferentiated cells in order to cure the disease. Stem cell - based therapies are being investigated for the treatment of many conditions, including neurodegenerative conditions such as Parkinson's disease, cardiovascular disease, liver disease, diabetes, autoimmune diseases and for nerve regeneration. (1) In orofacial region these therapies are being used for tooth and periodonta...

  20. Pharmacological treatment of chronic constipation: a literature review

    OpenAIRE

    Roshanak Salari; Mahdi Yousefi; Masoumeh Salari

    2016-01-01

    Chronic constipation is a very common disease that is particularly commonplace among members of the elderly population. It is one of the most widespread bowel disorders, and it causes significant pain and discomfort; as such, it usually requires medical attention. The major causes of constipation are slow colonic movements and/or functional gastrointestinal disorders. This review aimed to examine the pharmacological treatments that are currently available for chronic constipation. To develop ...

  1. Maternal Choline Supplementation: A Potential Prenatal Treatment for Down Syndrome and Alzheimer's Disease.

    Science.gov (United States)

    Strupp, Barbara J; Powers, Brian E; Velazquez, Ramon; Ash, Jessica A; Kelley, Christy M; Alldred, Melissa J; Strawderman, Myla; Caudill, Marie A; Mufson, Elliott J; Ginsberg, Stephen D

    2016-01-01

    Although Down syndrome (DS) can be diagnosed prenatally, currently there are no effective treatments to lessen the intellectual disability (ID) which is a hallmark of this disorder. Furthermore, starting as early as the third decade of life, DS individuals exhibit the neuropathological hallmarks of Alzheimer's disease (AD) with subsequent dementia, adding substantial emotional and financial burden to their families and society at large. A potential therapeutic strategy emerging from the study of trisomic mouse models of DS is to supplement the maternal diet with additional choline during pregnancy and lactation. Studies demonstrate that maternal choline supplementation (MCS) markedly improves spatial cognition and attentional function, as well as normalizes adult hippocampal neurogenesis and offers protection to basal forebrain cholinergic neurons (BFCNs) in the Ts65Dn mouse model of DS. These effects on neurogenesis and BFCNs correlate significantly with spatial cognition, suggesting functional relationships. In this review, we highlight some of these provocative findings, which suggest that supplementing the maternal diet with additional choline may serve as an effective and safe prenatal strategy for improving cognitive, affective, and neural functioning in DS. In light of growing evidence that all pregnancies would benefit from increased maternal choline intake, this type of recommendation could be given to all pregnant women, thereby providing a very early intervention for individuals with DS, and include babies born to mothers unaware that they are carrying a fetus with DS.

  2. Effect of Supplemental Vitamin E for the Prevention and Treatment of Cardiovascular Disease

    Science.gov (United States)

    Shekelle, Paul G; Morton, Sally C; Jungvig, Lara K; Udani, Jay; Spar, Myles; Tu, Wenli; Suttorp, Marika J; Coulter, Ian; Newberry, Sydne J; Hardy, Mary

    2004-01-01

    OBJECTIVE To evaluate and synthesize the evidence on the effect of supplements of vitamin E on the prevention and treatment of cardiovascular disease. DESIGN Systematic review of placebo-controlled randomized controlled trials; meta-analysis where justified. MEASUREMENTS AND MAIN RESULTS Eighty-four eligible trials were identified. For the outcomes of all-cause mortality, cardiovascular mortality, fatal or nonfatal myocardial infarction, and blood lipids, neither supplements of vitamin E alone nor vitamin E given with other agents yielded a statistically significant beneficial or adverse pooled relative risk (for example, pooled relative risk of vitamin E alone = 0.96 [95% confidence interval (CI), 0.84 to 1.10]; 0.97 [95% CI, 0.80 to 1.90]; and 0.72 [95% CI, 0.51 to 1.02] for all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction, respectively. CONCLUSIONS There is good evidence that vitamin E supplementation does not beneficially or adversely affect cardiovascular outcomes. PMID:15061748

  3. Impact of probiotic supplements on microbiome diversity following antibiotic treatment of mice.

    Science.gov (United States)

    Grazul, Hannah; Kanda, L Leann; Gondek, David

    2016-01-01

    Shifts in microbial populations of the intestinal tract have been associated with a multitude of nutritional, autoimmune, and infectious diseases. The limited diversity following antibiotic treatments creates a window for opportunistic pathogens, diarrhea, and inflammation as the microbiome repopulates. Depending on the antibiotics used, microbial diversity can take weeks to months to recover. To alleviate this loss of diversity in the intestinal microbiota, supplementation with probiotics has become increasingly popular. However, our understanding of the purported health benefits of these probiotic bacteria and their ability to shape the microbiome is significantly lacking. This study examined the impact of probiotics concurrent with antibiotic treatment or during the recovery phase following antibiotic treatment of mice. We found that probiotics did not appear to colonize the intestine themselves or shift the overall diversity of the intestinal microbiota. However, the probiotic supplementation did significantly change the types of bacteria which were present. In particular, during the recovery phase the probiotic caused a suppression of Enterobacteriaceae outgrowth (Shigella and Escherichia) while promoting a blooming of Firmicutes, particularly from the Anaerotruncus genus. These results indicate that probiotics have a significant capacity to remodel the microbiome of an individual recovering from antibiotic therapy.

  4. Fournier's Gangrene Complicating Hematologic Malignancies: Literature Review and Treatment Suggestions

    Directory of Open Access Journals (Sweden)

    Giovanni D'Arena

    2013-11-01

    Full Text Available Fournier’s gangrene (FG is a rare but severe necrotizing fasciitis of the external genitalia that may complicate the clinical course of hematologic malignancies and sometimes may be the first sign of the disease. The clinical course of FG is very aggressive and the mortality is still high despite the improvement in its management. Early recognition of FG and prompt appropriate treatment with surgical debridement and administration of antibiotics are the cornerstone of the management of this very severe disease.

  5. Treatment of morphea or localized scleroderma: review of the literature.

    Science.gov (United States)

    Vilela, Fernanda Aguiar Santos; Carneiro, Sueli; Ramos-e-Silva, Marcia

    2010-10-01

    Scleroderma is a disease that affects the microvasculature and the connective tissue. These alterations produce fibrosis and blood vessel occlusion. Its cause is still unknown, although the exaggerated synthesis of collagens I and IV, detected in skin and vessels, may be related to genetic, immunologic and, less frequently, exogenous factors as inhalation of silica and polyvinyl chloride. There is a localized and a systemic form, which affects both adults and children. The treatment of the localized form, also called morphea, is still controversial, and, in this article, the authors will discuss the main agents that were found to improve the lesions and symptoms.

  6. Assessing Side Effects of Pharmacotherapy Treatment of Bipolar Disorder: A 20-Year Review of the Literature

    Science.gov (United States)

    Matson, Johnny L.; Gonzalez, Melissa L.; Smith, Kimberly R.; Terlonge, Cindy; Thorson, Ryan T.; Dixon, Dennis R.

    2006-01-01

    A substantial literature on the effective treatment of bipolar disorder has begun to appear, particularly in the last 20 years.The majority of treatments studied have employed medications, particularly mood stabilizers, a typical antipsychotics and antidepressants. Most treatments produce side effects and medications are no exception. A review of…

  7. Glycyrrhizic Acid in the Treatment of Liver Diseases: Literature Review

    Directory of Open Access Journals (Sweden)

    Jian-yuan Li

    2014-01-01

    Full Text Available Glycyrrhizic acid (GA is a triterpene glycoside found in the roots of licorice plants (Glycyrrhiza glabra. GA is the most important active ingredient in the licorice root, and possesses a wide range of pharmacological and biological activities. GA coupled with glycyrrhetinic acid and 18-beta-glycyrrhetic acid was developed in China or Japan as an anti-inflammatory, antiviral, and antiallergic drug for liver disease. This review summarizes the current biological activities of GA and its medical applications in liver diseases. The pharmacological actions of GA include inhibition of hepatic apoptosis and necrosis; anti-inflammatory and immune regulatory actions; antiviral effects; and antitumor effects. This paper will be a useful reference for physicians and biologists researching GA and will open the door to novel agents in drug discovery and development from Chinese herbs. With additional research, GA may be more widely used in the treatment of liver diseases or other conditions.

  8. Telemedicine and Pediatric Obesity Treatment: Review of the literature and lessons learned

    OpenAIRE

    Cohen, Gail M.; Irby, Megan B.; Boles, Katie; Jordan, Christine; Skelton, Joseph A.

    2012-01-01

    Pediatric obesity is more prevalent in rural areas, yet rural families may not have access to pediatric obesity treatment programs. Use of new technologies, particularly telemedicine, has proven effective in other behavioral fields, such as psychiatry. This paper reviews the literature on the use of telemedicine in pediatric obesity treatment, and describes one tertiary-care pediatric obesity telemedicine program. We performed a systematic review of the literature from 1990–2011 using the fol...

  9. Hepatotoxicity Associated with Use of the Weight Loss Supplement Garcinia cambogia: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Jiten P. Kothadia

    2018-01-01

    Full Text Available The use of herbal and dietary supplements for weight loss is becoming increasingly common as obesity is becoming major health problem in the United States. Despite the popularity of these natural supplements, there are no guidelines for their therapeutic doses and their safety is always a concern. Garcinia cambogia extract with its active ingredient “hydroxycitric acid” is a component of many weight loss regimens. It suppresses fatty acid biosynthesis and decreases appetite. However, its prolonged use in weight maintenance is unknown. Here we describe a case of acute hepatitis after the use of Garcinia cambogia for weight loss.

  10. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease.

    Science.gov (United States)

    Asbell, Penny A; Maguire, Maureen G; Pistilli, Maxwell; Ying, Gui-shuang; Szczotka-Flynn, Loretta B; Hardten, David R; Lin, Meng C; Shtein, Roni M

    2018-05-03

    change, 0.0 points; 95% CI, -0.2 to 0.1), corneal staining score (0.1 point; 95% CI, -0.2 to 0.4), tear break-up time (0.2 seconds; 95% CI, -0.1 to 0.5), and result on Schirmer's test (0.0 mm; 95% CI, -0.8 to 0.9). At 12 months, the rate of adherence to treatment in the active supplement group was 85.2%, according to the level of n-3 fatty acids in red cells. Rates of adverse events were similar in the two trial groups. Among patients with dry eye disease, those who were randomly assigned to receive supplements containing 3000 mg of n-3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo. (Funded by the National Eye Institute, National Institutes of Health; DREAM ClinicalTrials.gov number, NCT02128763 .).

  11. Low intensity behavioral treatment supplementing preschool services for young children with autism spectrum disorders and severe to mild intellectual disability

    NARCIS (Netherlands)

    Peters-Scheffer, N.C.; Didden, H.C.M.; Mulders, M.; Korzilius, H.P.L.M.

    2010-01-01

    This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5 h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers)

  12. Treatment of autoinflammatory diseases: results from the Eurofever Registry and a literature review

    NARCIS (Netherlands)

    Haar, N. Ter; Lachmann, H.; Ozen, S.; Woo, P.; Uziel, Y.; Modesto, C.; Kone-Paut, I.; Cantarini, L.; Insalaco, A.; Neven, B.; Hofer, M.; Rigante, D.; Al-Mayouf, S.; Touitou, I.; Gallizzi, R.; Papadopoulou-Alataki, E.; Martino, S.; Kuemmerle-Deschner, J.; Obici, L.; Iagaru, N.; Simon, A.; Nielsen, S.; Martini, A.; Ruperto, N.; Gattorno, M.; Frenkel, J.; et al.,

    2013-01-01

    OBJECTIVE: To evaluate the response to treatment of autoinflammatory diseases from an international registry and an up-to-date literature review. METHODS: The response to treatment was studied in a web-based registry in which clinical information on anonymised patients with autoinflammatory diseases

  13. [Endodontic treatment in one or several sessions? Review of the literature].

    Science.gov (United States)

    Darbinyan, M; Bogaerts, P; Van Nieuwenhuysen, J P

    2005-01-01

    This literature review compares the endodontic treatment in one or more appointments on the healing of periapical lesions and the occurrence of postoperative pain and flare-ups. It turns out that the root canal treatment completed in one session has many advantages and may he considered the prime option in the majority of clinical cases.

  14. Sexual, Psychological, and Relational Functioning in Women after Surgical Treatment for Vulvar Malignancy: A Literature Review

    NARCIS (Netherlands)

    Aerts, Leen; Enzlin, Paul; Vergote, Ignace; Verhaeghe, Johan; Poppe, Willy; Amant, Frederic

    2012-01-01

    Introduction. Vulvectomy is an intrusive treatment option for women with vulvar malignancy that theoretically may affect sexual function. Aim. This study aims to provide a comprehensive review of the literature on the impact of surgical treatment for vulvar malignancy on sexual functioning, overall

  15. Refeeding syndrome: treatment considerations based on collective analysis of literature case reports.

    Science.gov (United States)

    Boateng, Akwasi Afriyie; Sriram, Krishnan; Meguid, Michael M; Crook, Martin

    2010-02-01

    Refeeding syndrome (RFS) represents a group of clinical findings that occur in severely malnourished individuals undergoing nutritional support. Cardiac arrhythmias, multisystem organ dysfunction, and death are the most severe symptoms observed. As the cachectic body attempts to reverse its adaptation to the starved state in response to the nutritional load, symptoms result from fluid and electrolyte imbalances, with hypophosphatemia playing a central role. Because guidelines for feeding the malnourished patient at risk for refeeding syndrome is scarce, we have provided management recommendations based on the knowledge derived from a collection of reported English literature cases of the RFS. A MEDLINE search using keywords including "refeeding syndrome," "RFS," and "refeeding hypophosphatemia" was performed. References from initial cases were utilized for more literature on the subject. We have emphasized the continued importance of managing patients at risk for RFS, compared how management of the severely malnourished patients have evolved over time, and provided comprehensive clinical guidelines based on the sum of experience documented in the case reports for the purpose of supplementing the guidelines available. Based on our review, the most effective means of preventing or treating RFS were the following: recognizing the patients at risk; providing adequate electrolyte, vitamin, and micronutrient supplementation; careful fluid resuscitation; cautious and gradual energy restoration; and monitoring of critical laboratory indices. 2010 Elsevier Inc. All rights reserved.

  16. Influence of radiation treatment on pharmaceuticals. A study of the relevant literature

    International Nuclear Information System (INIS)

    Dahlhelm, H.; Boess, C.

    2002-01-01

    The present communication provides a quick overview of the behaviour of individual substances when treated with ionizing radiation while making reference to the respective original literature. The choosen form of an encyclopaedia enables the user to find information at a glance. It is based on parts I - XII of our review of literature on the influence of radiation treatment on pharmaceutical products and adjuvants/excipients we started in 1978. (orig.)

  17. Treatment Of Chronic Kidney Disease Patients With A Supplemented Low Protein Diet And A Supplemented Very Low Protein Diet

    Directory of Open Access Journals (Sweden)

    SV Subhramanyam

    2012-06-01

    Full Text Available The primary results of the Modification of Diet in Renal Disease were inconclusive and did confuse a lot of physicians about the dietary approach to CKD management. The study design was flawed and thus compromised the results and conclusions. Re-analysis of the MDRD study however clearly showed the benefits of dietary protein restriction and also more importantly an additional benefit by ketoanalogue supplementation in delaying progression of CKD. Despite the obvious benefits of protein restriction, concern has been raised recently especially patients on very low dietary protein (very-low-protein diets; VLPDs, which could lead to deterioration in the nutritional status of CKD patients. To address this particular issue of whether a sVLPD diet induces malnutrition the present study has been taken up 132 adult patients with Stage 3 to Stage 5 (Predialysis were initiated on a protein restricted ketoanalogue supplemented diet after informed consent and the necessary Institutional Ethics Committee approvals. Based on their affordability, 92 patients randomly were assigned to the sLPD group whereby they received 0.6 G/Kg BW of dietary proteins supplemented by ketoanalogues at a dosage of one tablet per 10 Kg body weight. 40 patients received 0.3 G/Kg BW supplemented by ketoanalogues at a dose of one tablet per 5 Kg body weight. Renolog® tablets manufactured by La Renon Healthcare Ltd, Ahmebabad, India were prescribed as the ketoanalogue supplements. Renal, Metabolic, Nutritional parameters and Anthropometric analysis were done in both groups at the start of the study and at the end of 6 months of follow up. The mean blood urea in the SLPD group showed a decrease from 81.17+_ 00 mg/dl to 74.45+_30.75 mg/dl (p0.05 at the end of six months indicating an improvement in renal function . The serum creatinine also showed a decrease from 3.52+_00 mg/dl to 3.30 +_1.63 mg/dl(p>0.05 in the SLPD group and a decrease from 3.74+_00 mg/dl to 3.55+_1.67

  18. Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition.

    Science.gov (United States)

    Iannotti, Lora L; Trehan, Indi; Manary, Mark J

    2013-09-12

    World Health Organization (WHO) guidelines recommend for children with severe acute malnutrition (SAM), high-dose vitamin A (VA) supplements be given on day 1 of admission, and on days 2 and 14 in the case of clinical signs of vitamin A deficiency (VAD). Daily low-dose VA follows, delivered in a premix added to F-75 and F-100. This study aimed to systematically review the evidence for safety and effectiveness of high-dose VA supplementation (VAS) in treatment of children with SAM. A comprehensive literature review was undertaken for all relevant randomized controlled trials (RCT) and observational studies from 1950 to 2012. Studies identified for full review were evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology using a set of pre-defined criteria: indirectness; inconsistency; imprecision; and study limitations. A quality rating of high, moderate, or low was then assigned to each study, and only those attaining moderate to high were considered in making recommendations. Of the 2072 abstracts screened, 38 met criteria for full review, and 20 were rated moderate to high quality. Only one study replicated the WHO VA protocol in children with SAM. Indirectness was a critical limitation, as studies were not exclusive to children with SAM. There was inconsistency across trials for definitions of malnutrition, morbidities, and ages studied; and imprecision arising from sub-group analyses and small sample sizes. Evidence showed improved outcomes associated with low-dose compared to high-dose VAS, except in cases presenting with signs of VAD, measles, and severe diarrhea or shigellosis. Adverse outcomes related to respiratory infection, diarrhea, and growth were associated with high-dose VAS in children who were predominantly adequately nourished. No adverse effects of the high dose were found in children with SAM in the trial that replicated the WHO VA guideline. This is the first systematic review of the safety and

  19. Pregnancy, Proteinuria, Plant-Based Supplemented Diets and Focal Segmental Glomerulosclerosis: A Report on Three Cases and Critical Appraisal of the Literature

    Directory of Open Access Journals (Sweden)

    Rossella Attini

    2017-07-01

    Full Text Available Chronic kidney disease (CKD is increasingly recognized in pregnant patients. Three characteristics are associated with a risk of preterm delivery or small for gestational age babies; kidney function reduction, hypertension, and proteinuria. In pregnancy, the anti-proteinuric agents (ACE–angiotensin converting enzyme-inhibitors or ARBS -angiotensin receptor blockers have to be discontinued for their potential teratogenicity, and there is no validated approach to control proteinuria. Furthermore, proteinuria usually increases as an effect of therapeutic changes and pregnancy-induced hyperfiltration. Based on a favourable effect of low-protein diets on proteinuria and advanced CKD, our group developed a moderately protein-restricted vegan-vegetarian diet tsupplemented with ketoacids and aminoacids for pregnant patients. This report describes the results obtained in three pregnant patients with normal renal function, nephrotic or sub-nephrotic proteinuria, and biopsy proven diagnosis of focal segmental glomerulosclerosis, a renal lesion in which hyperfiltration is considered of pivotal importance (case 1: GFR (glomerular filtration rate: 103 mL/min; proteinuria 2.1 g/day; albumin 3.2 g/dL; case 2: GFR 86 mL/min, proteinuria 3.03 g/day, albumin 3.4 g/dL; case 3: GFR 142 mL/min, proteinuria 6.3 g/day, albumin 3.23 g/dL. The moderately restricted diet allowed a stabilisation of proteinuria in two cases and a decrease in one. No significant changes in serum creatinine and serum albumin were observed. The three babies were born at term (38 weeks + 3 days, female, weight 3180 g-62th centile; 38 weeks + 2 days, female, weight 3300 g-75th centile; male, 38 weeks + 1 day; 2770 g-8th centile, thus reassuring us of the safety of the diet. In summary, based on these three cases studies and a review of the literature, we suggest that a moderately protein-restricted, supplemented, plant-based diet might contribute to controlling proteinuria in pregnant CKD

  20. Omega-3 fatty acid supplementation as an adjunctive therapy in the treatment of chronic kidney disease: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Jing Hu

    Full Text Available The aim of this study was to evaluate the benefits and risks of omega-3 fatty acid supplementation in patients with chronic kidney disease. A systematic search of articles in PubMed, Embase, the Cochrane Library, and reference lists was performed to find relevant literature. All eligible studies assessed proteinuria, the serum creatinine clearance rate, the estimated glomerular filtration rate, or the occurrence of end-stage renal disease. Standard mean differences with 95% confidence intervals for continuous data were used to estimate the effects of omega-3 fatty acid supplementation on renal function, as reflected by the serum creatinine clearance rate, proteinuria, the estimated glomerular filtration rate, and relative risk. Additionally, a random-effects model was used to estimate the effect of omega-3 fatty acid supplementation on the risk of end-stage renal disease. Nine randomized controlled trials evaluating 444 patients with chronic kidney disease were included in the study. The follow-up duration ranged from 2 to 76.8 months. Compared with no or low-dose omega-3 fatty acid supplementation, any or high-dose omega-3 fatty acid supplementation, respectively, was associated with a lower risk of proteinuria (SMD: -0.31; 95% CI: -0.53 to -0.10; p=0.004 but had little or no effect on the serum creatinine clearance rate (SMD: 0.22; 95% CI: -0.40 to 0.84; p=0.482 or the estimated glomerular filtration rate (SMD: 0.14; 95% CI: -0.13 to 0.42; p=0.296. However, this supplementation was associated with a reduced risk of end-stage renal disease (RR: 0.49; 95% CI: 0.24 to 0.99; p=0.047. In sum, omega-3 fatty acid supplementation is associated with a significantly reduced risk of end-stage renal disease and delays the progression of this disease.

  1. Evaluation Of Supplemental Pre-Treatment Development Requirements To Meet TRL 6: Rotary Microfiltration

    International Nuclear Information System (INIS)

    Huber, H.J.

    2011-01-01

    In spring 2011, the Technology Maturation Plan (TMP) for the Supplemental Treatment Project (RPP-PLAN-49827, Rev. 0), Technology Maturation Plan for the Treatment Project (T4S01) was developed. This plan contains all identified actions required to reach technical maturity for a field-deployable waste feed pretreatment system. The supplemental pretreatment system has a filtration and a Cs-removal component. Subsequent to issuance of the TMP, rotary microfiltration (RMF) has been identified as the prime filtration technology for this application. The prime Cs-removal technology is small column ion exchange (ScIX) using spherical resorcinol formaldehyde (sRF) as the exchange resin. During fiscal year 2011 (FY2011) some of the tasks identified in the TMP have been completed. As of September 2011, the conceptual design package has been submitted to DOE as part of the critical decision (CD-1) process. This document describes the remaining tasks identified in the TMP to reach technical maturity and evaluates the validity of the proposed tests to fill the gaps as previously identified in the TMP. The potential vulnerabilities are presented and the completed list of criteria for the DOE guide DOE G 413.3-4 different technology readiness levels are added in an attachment. This evaluation has been conducted from a technology development perspective - all programmatic and manufacturing aspects were excluded from this exercise. Compliance with the DOE G 413.3-4 programmatic and manufacturing requirements will be addressed directly by the Treatment Project during the course of engineering design. The results of this evaluation show that completion of the proposed development tasks in the TMP are sufficient to reach TRL 6 from a technological point of view. The tasks involve actual waste tests using the current baseline configuration (2nd generation disks, 40 psi differential pressure, 30 C feed temperature) and three different simulants - the PEP, an AP-Farm and an S

  2. The role of food supplements in the treatment of the infertile man.

    Science.gov (United States)

    Comhaire, Frank H; Mahmoud, Ahmed

    2003-01-01

    Recently, concerns have been raised about the presumptive increased risk of serious undesirable side effects in children born after IVF and intracytoplasmic sperm injection (ICSI). These treatments must, therefore, be reserved as the ultimate option after evidence-based and cause-directed treatment of the male patient with deficient semen has been exhausted. The present authors found that sperm quality and function improved with the intake of complementary food supplementation using a combination of zinc and folic acid, or the antioxidant astaxanthin (Astacarox), or an energy-providing combination containing (actyl)-carnitine (Proxeed). Also, double blind trials showed that the latter two substances increase spontaneous or intrauterine insemination- (IUI-) assisted conception rates. Extracts of Pinus maritima bark (Pycnogenol), which inhibits the cyclo-oxygenase enzyme, reducing prostaglandin production and inflammatory reaction, and extracts of the Peruvian plant Lepidium meyenii were shown to improve sperm morphology and concentration, respectively, in uncontrolled trials. Linseed (flaxseed) oil contains alfa-linolenic acid and lignans. The former corrects the deficient intake of omega-3 essential fatty acids, which is correlated with impaired sperm motility among subfertile men. Lignans are precursors of enterolacton, which inhibits aromatase and reduces the ratio of 16-OH over 2-OH oestrogen metabolites. The resulting reduction in oestrogen load may favourably influence Sertoli cell function.

  3. Supplemental Transcatheter Arterial Chemoembolization Through a Collateral Omental Artery: Treatment for Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Won, Jong Yun; Lee, Do Yun; Lee, Jong Tae; Park, Sung Il; Kim, Myeong-Jin; Yoo, Hyung Sik; Suh, Sang-Hyun; Park, Sang Joon

    2003-01-01

    Purpose: To evaluate the therapeutic efficacy and safety of supplemental transcatheter arterialchemoembolization (TACE) through the extrahepatic collateral omentalartery (OA) for the treatment of hepatocellular carcinoma (HCC). Methods: We studied 21 patients with extrahepatic collaterals of the OA, among 1,512 patients with HCC who had undergone angiography. HCCs supplied by collateral OAs were located at: segment IV in seven, segment V in five, segment III in three, segment VI in three and segment VIII in three patients (Couinaud classification of segments). On preoperative CT scans, every HCC was abutting the liver surface. Adjacent omental infiltration or engorgement was noted in 11 patients. Celiac and hepatic arteriograms showed hypertrophy of the feeding OA in all patients. TACE of the OA was performed in 19 patients with an emulsion of iodized oil and doxorubicin hydrochloride.Embolization with gelatin sponge particles was added in five patients. Results: Collaterals of the OA to the HCC were found on the first to seventeenth sessions of TACE. On follow-up CT scans, five patients showed complete uptake of iodized oil in the tumor. Partial uptake of iodized oil was noted in 13 patients and no uptake in one patient. There was no serious complication that related to the omental embolization, such as omental or bowel ischemia. The cumulative survival rates from the time of the TACE of the OA were 81% at 6 months and 68% at 12 months. Conclusion: TACE of the OA is safe and has a potential therapeutic effect in the treatment of HCC

  4. Treatments for Reversing Warfarin Anticoagulation in Patients with Acute Intracranial Hemorrhage: A Structured Literature Review

    Science.gov (United States)

    2011-07-08

    available soon. Treatments for reversing warfarin anticoagulation in patients with acute intracranial hemorrhage: a structured literature review...DATE 08 JUL 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Treatments For Reversing Warfarin ...distribution unlimited 13. SUPPLEMENTARY NOTES International Journal of Emergency Medicine 2011 14. ABSTRACT The acute management of patients on warfarin

  5. Psychosocial Treatments for Major Depression and Dysthymia in Older Adults: A Review of the Research Literature

    Science.gov (United States)

    Zalaquett, Carlos P.; Stens, Andrea N.

    2006-01-01

    Older adults represent a growing segment of the population with the highest suicide rate and an increasing need of counseling services for major depression and dysthymia. The present study examined the literature with the purpose of identifying research addressing psychosocial treatments of depression in later life. A summary of treatments…

  6. Fearing Fat: A Literature Review of Family Systems Understandings and Treatments of Anorexia and Bulimia.

    Science.gov (United States)

    Killian, Kyle D.

    1994-01-01

    Reviews literature examining family variables associated with anorexia nervosa and bulimia nervosa and family systems treatments for these eating disorders. Presents definitions of and diagnostic criteria for anorexia and bulimia, and discusses prevalence of these disorders. Reviews role played by psychopathological, sociological, and…

  7. Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic

    Directory of Open Access Journals (Sweden)

    Wendy E. Ward

    2013-04-01

    Full Text Available Dietary supplement use may modify the risk of periodontal disease but effects on wound healing after periodontal procedures are less clear. This study characterized dietary supplement use by male and female patients (n = 376 attending a periodontal clinic—information that is essential for evidence-based intervention studies that may improve patient outcomes after periodontal procedures. Calcium, vitamin D, multivitamin and vitamin C were most commonly used. A greater (p ≤ 0.05 number of males took no supplements compared to females, and more (p ≤ 0.05 females than males took ≥ four supplements. Females took more (p ≤ 0.05 calcium, vitamin D, fish oil, green tea, magnesium, omega 3,6,9 and B vitamin complex. Younger patients (31–50 years had the highest (p ≤ 0.05 frequency of no supplement use compared to older age groups. Patients over age 50 had a higher (p ≤ 0.05 frequency of using ≥ four supplements including calcium and vitamin D. Supplement use was lower (p ≤ 0.05 in smokers, particularly for calcium, fish oil, green tea and vitamin D. In conclusion, females, older individuals and non-smokers have higher supplement use. Future dietary intervention studies can focus on supplements with known biological activities—anti-inflammatory, antioxidant or osteogenic activity—that may enhance wound healing after reconstructive periodontal procedures.

  8. Nutritional supplement during the treatment with ionizing radiations in patients with head and neck tumors in advanced stages

    International Nuclear Information System (INIS)

    Chon Rivas, Ivonne; Roca Muchuli, Carlos; Vilau Prieto, Luis; Rubio Hernandez, Maria C.; Rodriguez Diaz, Ronald; Leon, Roberto; Rodriguez Abascal, Alicia; Mederos, Nuria

    2005-01-01

    Malnutrition in the patient with advanced cancer favors immunosuppression and implies a low Karnofsky index, poor tolerance and response to the onco specific curative or palliative treatments, high susceptibility to infections and, as a result, a decline of the quality of life. Patients with head and neck tumors in advanced stages (III-IV) are one of the groups of high risk for malnutrition due to the reduction of the intake of nutrients, anorexia, alterations of the deglutition mechanism, and mechanical obstruction of the upper digestive tract, among other causes.Numerous studies show the convenience of the nutritional supplement in these patients during the onco specific treatment. A prospective study that included 15 patients with head and neck neoplasia in advanced stages, and with clinical signs of malnutrition, was conducted in order to evaluate the necessary calorie-energy supplement. All of them were administered an oral nutritional supplement (Adn-22 %) during the radiation treatment to assess the possibility of improving their tolerance and response to the treatment. Of the 15 studied cases, 13 presented complications in connection with the treatment, but most them were mild, and they did not affect in a significant way the time of duration and the total dose of treatment. There was a favorable response in relation to the tumor

  9. Preferences for trauma treatment: A systematic review of the empirical literature.

    Science.gov (United States)

    Simiola, Vanessa; Neilson, Elizabeth C; Thompson, Richard; Cook, Joan M

    2015-11-01

    The prevalence of trauma histories and related psychological problems is high in general clinical settings, but little is known about trauma patient preferences for mental health treatment. The purpose of this article is to systematically review and synthesize the literature on treatment preferences in survivors of traumatic events. Studies were identified using comprehensive searches of PsycINFO, Medline, PubMed, Published International Literature on Traumatic Stress, and Cumulative Index to Nursing and Allied Health Literature databases. Included in the review were articles published between January 1980 and September 2014, in English that reported patient preference of treatment for trauma related disorders in either clinical or nonclinical (e.g., analog) samples. The total number of individual participants was 6,091. Of the identified studies, 35 were quantitative and 6 were qualitative. Methodological concerns included the use of analog samples, small sample sizes, and the assessment of a limited number of treatment options (e.g., asking about only 1 type of psychotherapy or medication). Overall, participants expressed a preference for psychotherapy over medication and for talking about their trauma. Understanding and addressing trauma patient preferences may assist in improving treatment initiation as well as facilitate engagement, retention and outcome. (c) 2015 APA, all rights reserved).

  10. CINDA 99, supplement 2 to CINDA 97 (1988-1999). The index to literature and computer files on microscopic neutron data

    International Nuclear Information System (INIS)

    1999-01-01

    CINDA, the Computer Index of Neutron Data, contains bibliographical references to measurements, calculations, reviews and evaluations of neutron cross-sections and other microscopic neutron data; it includes also index references to computer libraries of numerical neutron data available from four regional neutron data centres. The present issue, CINDA 99, is the second supplement to CINDA 97, the index to the literature on neutron data published after 1987. It supersedes the first supplement, CINDA 98. The complete CINDA file as of 1 June 1999 is contained in: the archival issue CINDA-A (5 volumes, 1990), CINDA 97 and the current issue CINDA 99. The compilation and publication of CINDA are the result of worldwide co-operation involving the following four data centres. Each centre is responsible for compiling the CINDA entries from the literature published in a defined geographical area given in brackets below: the USA National Nuclear Data Center at the Brookhaven National Laboratory, USA (United States of America and Canada); the Russian Nuclear Data Centre at the Fiziko-Energeticheskij Institut, Obninsk, Russian Federation (former USSR countries); the NEA Data Bank in Paris, France (European OECD member countries in Western Europe and Japan); and the IAEA Nuclear Data Section in Vienna, Austria (all other countries in Eastern Europe, Asia, Australia, Africa, Central and South America; also IAEA publications and translation journals). Besides the published CINDA books, up-to-date computer retrievals for specified CINDA information are currently available on request from the responsible CINDA centres, or via direct access to the on-line services as described in this publication

  11. Trends in Vitamin A, C, D, E, K Supplement Prescriptions From Military Treatment Facilities: 2007 to 2011.

    Science.gov (United States)

    Morioka, Travis Y; Bolin, Jeremy T; Attipoe, Selasi; Jones, Donnamaria R; Stephens, Mark B; Deuster, Patricia A

    2015-07-01

    Although prior studies have examined the prevalence of dietary supplement use among various populations, data on single vitamins prescribed by health care providers are limited. This study examined trends in single-vitamin supplement (A, C, D, E, K) prescriptions by providers from military treatment facilities from 2007 to 2011. We examined prescription data from the Department of Defense Pharmacy Data Transaction Service to determine trends in the aforementioned single-vitamin supplement prescriptions. Prescription rates per 1,000 active duty personnel were estimated using population data retrieved from the Defense Medical Epidemiology Database (i.e., [number of prescriptions/population size] × 1,000). Across the 5-year period, the number of vitamin D prescriptions per 1,000 active duty personnel increased 454%. In contrast, the number of vitamin A, vitamin E, and vitamin K prescriptions per 1,000 active duty personnel decreased by 32%, 53%, and 29% respectively. Vitamin C prescriptions remained relatively constant. Across all age groups, total single-vitamin supplement prescriptions increased by 180%. Together, prescriptions examined in this study increased steadily from 2007 to 2011, primarily because of the increase in vitamin D prescriptions. The exhibited trend reflects the current general-population pattern of dietary supplement use, with large increases in vitamin D and declines in vitamin E. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  12. Children and adolescents with severe mental illness need vitamin D supplementation regardless of disease or treatment.

    Science.gov (United States)

    Bonnot, Olivier; Inaoui, Rachida; Raffin-Viard, Marie; Bodeau, Nicolas; Coussieu, Christiane; Cohen, David

    2011-04-01

    To protect against osteoporosis, keeping the vitamin D blood level (25[OH]D; VDBL) above 30 ng/mL is recommended. It is established that regular intake of vitamin D, calcium intake, and physical exercise contribute to maximizing bone mineral mass during childhood and adolescence. Recent articles suggest that patients with schizophrenia treated with antipsychotics have low VDBL and may have a higher risk of hip fractures in their later years than the general population. To evaluate whether adolescent psychiatric inpatient VDBL is lower than the 30-ng/mL optimal threshold and to document low-VDBL risk factors. We determined the VDBL of all consecutive inpatients from three adolescents units in 2009 (N = 136). Univariate analyses explored the influence on VDBL of (1) well-documented risk factors (e.g., age, gender, ethnic origin, body mass index, or season) and (2) suspected risk factors (e.g., disease type or antipsychotic treatment). All but six patients had a VDBL vitamin D supplementation.

  13. Prevention and treatment of radiotherapy-induced oral mucositis: a literature review

    International Nuclear Information System (INIS)

    Albuquerque, Ieda Lessa de Souza; Camargo, Teresa Caldas

    2007-01-01

    The prevention and treatment of radiotherapy-induced oral mucositis have still not been fully defined. The current study thus involved a literature search aimed at identifying preventive and therapeutic measures in relation to oral mucositis in patients submitted to radiotherapy, analyzing the level of evidence in the selected studies, identifying which indications for prevention and treatment in the literature pertain to the field of nursing, and critically analyzing the results and their implications for nursing care. This was a systematic literature survey without a meta analysis, consulting the following databases: BIREME, Medline, CancerLit, Scirus, CAPES, Free medical journal, High wire press, SCIELO, and Medscape, from 2000 to 2005. According to observations, nursing care was capable of improving patient's quality of life, promoting education of patients, implementing and supervising oral care programs, and providing guidance on hygiene, prevention, and treatment of oral mucositis, including pain management. However, no Brazilian nursing publications were found on the subject. Research and publications focusing on nursing experience in the prevention and treatment of radiotherapy-related oral mucositis and the implications for patients and nurses are important to provide evidence-based nursing guidelines. (author)

  14. Effect of micronutrient supplementation on treatment outcomes in children with intrathoracic tuberculosis

    DEFF Research Database (Denmark)

    Lodha, Rakesh; Mukherjee, Aparna; Singh, Varinder

    2014-01-01

    BACKGROUND: Micronutrients play an important role in immune function. To our knowledge, there have been no comprehensive studies on the role of micronutrient supplementation in children with tuberculosis. OBJECTIVE: We assessed the effect of micronutrient supplementation in children treated...... with antituberculosis therapy (ATT). DESIGN: A randomized, double-blind, placebo-controlled trial that used a 2 × 2 factorial design was undertaken at 2 teaching hospitals in Delhi. Children with newly diagnosed intrathoracic tuberculosis were enrolled, and they received ATT together with daily supplementation for 6 mo...

  15. Treatment plan in amelogenesis imperfecta: A structured literature review on treatment protocols and dedicating the best possible options

    Directory of Open Access Journals (Sweden)

    Azari A.

    2008-12-01

    Full Text Available "nAmelogenesis imperfecta is an inherited disease that disturbs the formation of the enamel. It occurs as two main categories, hypomineralized and hypoplastic. Both deciduous and permanent teeth are affected, and the disorder may create unaesthetic appearance, dental sensitivity, and severe attrition. In this article through performing a structured literature review, numerous treatment modalities which so far advocated in rehabilitation of amelogenesis imperfecta in adults and children is discussed. The progressive changes on open bite, the problem of bonding during restorative phase of treatment , the rehabilitation difficulties of deciduous as well as permanent teeth is also discussed in detail and finally the interdisciplinary approach for treatment of this disability is demonstrated and some points for decision making in treatment protocols are suggested.

  16. Association between the clinical classification of hypothyroidism and reduced TSH in LT4 supplemental replacement treatment for pregnancy in China.

    Science.gov (United States)

    Zhang, Lyu; Zhang, Zhaoyun; Ye, Hongying; Zhu, Xiaoming; Li, Yiming

    2016-01-01

    The study was aimed to evaluate the effects of levothyroxine (LT4) supplemental replacement treatment for pregnancy and analyze the associations between the clinical classification of hypothyroidism and reduced thyroid-stimulating hormone (TSH) in LT4 therapy. Totally, 195 pregnant women with hypothyroidism receiving routine prenatal care were enrolled. They were categorized into three groups: overt hypothyroidism (OH), subclinical hypothyroidism (SCH) with negative thyroperoxidase antibody (TPOAb), and SCH with positive TPOAb. The association between the clinical classification and reduced TSH in LT4 supplemental replacement treatment was assessed. The results indicated that reduced TSH was significantly different among the groups according to the clinical classifications (p = 0.043). The result was also significantly different between patients with OH and patients with SCH and negative TPOAb (p = 0.036). Similar result was reported for the comparison between patients with OH and patients with SCH and positive TPOAb (p = 0.016). Multiple variable analyses showed that LT4 supplementation, gestational age and the variable of clinical classifications were associated with reduced TSH independently. Our data suggested that the therapeutic effect of substitutive treatment with LT4 was significantly associated with different clinical classifications of hypothyroidism in pregnancy and the treatment should begin as soon as possible after diagnosis.

  17. Catalytic Enzyme-Based Methods for Water Treatment and Water Distribution System Decontamination. 1. Literature Survey

    Science.gov (United States)

    2006-06-01

    best examples of this is glucose isomerase, which has been used in the commercial production of high fructose corn syrup (HFCS) since 1967.230 Most...EDGEWOOD CHEMICAL BIOLOGICAL CENTER U.S. ARMY RESEARCH, DEVELOPMENT AND ENGINEERING COMMAND ECBC-TR-489 CATALYTIC ENZYME-BASED METHODS FOR WATER ...TREATMENT AND WATER DISTRIBUTION SYSTEM DECONTAMINATION 1. LITERATURE SURVEY Joseph J. DeFrank RESEARCH AND TECHNOLOGY DIRECTORATE June 2006 Approved for

  18. Radioinduced optic nerve neuropathy after treatment for nasopharynx cancer. About two cases and literature review

    International Nuclear Information System (INIS)

    Mnejja, W.; Siala, W.; Daoud, J.; Fki, J.; Ghorbel, M.; Frikha, M.

    2007-01-01

    The radioinduced neuropathy of the optic nerve is a rare and delayed complication. Its incidence is difficult to evaluate in the literature. It depends on the whole irradiation dose, fractionation and irradiated volume. Currently, it does not exist any efficient treatment, only the prevention play an important part on avoiding the high doses, and the broad irradiation volumes. The innovating techniques using conformal radiotherapy with or without modulated intensity could contribute to reduce this toxicity incidence. (N.C.)

  19. Aortopexy for the treatment of tracheomalacia in children: review of the literature

    OpenAIRE

    Torre Michele; Carlucci Marcello; Speggiorin Simone; Elliott Martin J

    2012-01-01

    Abstract Severe tracheomalacia presents a significant challenge for Paediatricians, Intensivists, Respiratory Physicians, Otolaryngologists and Paediatric Surgeons. The treatment of tracheomacia remains controversial, but aortopexy is considered by most to be one of the best options. We conducted a review of the English literature relating to aortopexy. Among 125 papers, 40 have been included in this review. Among 758 patients (62% males) affected with tracheomalacia, 581 underwent aortopexy....

  20. Complementarity in dietary supplements and foods: are supplement users vegetable eaters?

    Science.gov (United States)

    Kang, Hyoung-Goo; Joo, Hailey Hayeon; Choi, Kyong Duk; Lee, Dongmin; Moon, Junghoon

    2017-01-01

    Background : The consumption of fruits, vegetables, and dietary supplements correlate. Most previous studies have aimed to identify the determinants of supplement uses or the distinct features of supplement users; this literature lacks a discussion on dietary supplement consumption as a predictor of fruit and vegetable consumption. Objective : This study examines how dietary supplement consumption correlates with fruit and vegetable consumption by combining scanner data and surveys of Korean household grocery shopping. Methods : Propensity score matching (PSM) is used to identify the relationship between dietary supplement consumption and fruit and vegetable consumption in a household. A logit regression using supplement consumption as the dependent variable is used. Then, the supplement takers (the treatment group) are matched with non-takers (the control group) based on the propensity scores estimated in the logit regression. The fruit and vegetable consumption levels of the groups are then compared. Results : We found that dietary supplement use is associated with higher fruit and vegetable consumption. This supports the health consciousness hypothesis based on attention bias, availability heuristics, the focusing effect, and the consumption episode effect. It rejects the health substitute hypothesis based on economic substitutes and mental accounting. Conclusions : Future research on the health benefits of dietary supplements should address the complementary consumption of fruits/vegetables and their health benefits to avoid misstating the health effects of supplements.

  1. Coconut-based biosorbents for water treatment--a review of the recent literature.

    Science.gov (United States)

    Bhatnagar, Amit; Vilar, Vítor J P; Botelho, Cidália M S; Boaventura, Rui A R

    2010-10-15

    Biosorption is an emerging technique for water treatment utilizing abundantly available biomaterials (especially agricultural wastes). Among several agricultural wastes studied as biosorbents for water treatment, coconut has been of great importance as various parts of this tree (e.g. coir, shell, etc.) have been extensively studied as biosorbents for the removal of diverse type of pollutants from water. Coconut-based agricultural wastes have gained wide attention as effective biosorbents due to low-cost and significant adsorption potential for the removal of various aquatic pollutants. In this review, an extensive list of coconut-based biosorbents from vast literature has been compiled and their adsorption capacities for various aquatic pollutants as available in the literature are presented. Available abundantly, high biosorption capacity, cost-effectiveness and renewability are the important factors making these materials as economical alternatives for water treatment and waste remediation. This paper presents a state of the art review of coconut-based biosorbents used for water pollution control, highlighting and discussing key advancement on the preparation of novel adsorbents utilizing coconut wastes, its major challenges together with the future prospective. It is evident from the literature survey that coconut-based biosorbents have shown good potential for the removal of various aquatic pollutants. However, still there is a need to find out the practical utility of such developed adsorbents on commercial scale, leading to the superior improvement of pollution control and environmental preservation. Copyright © 2010 Elsevier B.V. All rights reserved.

  2. Treatment of peri-implant diseases: a review of the literature and protocol proposal.

    Science.gov (United States)

    Armas, Joshé; Culshaw, Shauna; Savarrio, Lee

    2013-01-01

    Over 100,000 implants were placed in the UK in 2010. As the numbers of patients with implant-retained prostheses increases, operators are encountering an increasing number of biological implant complications, most commonly peri-implant mucositis and peri-implantitis. The effective management of these complications is crucial to maintain patients' oral health. In particular, in contrast to common periodontal infections, some peri-implant infections may benefit from surgical intervention as a first line approach. This article reviews the literature on the treatment options for peri-implant mucositis and peri-implantitis and proposes a protocol for their treatment.

  3. [Transference in the treatment of dissociative identity disorder: A review of literature and a case example].

    Science.gov (United States)

    Lambert, Ann Marie; Gagnon, Lise; Fontaine, Francine S

    2014-01-01

    A literature review about transference in the treatment of dissociative identity disorder (DID) is presented. Common transference reactions resulting from serious traumas are explored, considering that those kind of trauma are higly present in the pathways of DID patients. Post traumatic transference aspects specific to DID are also presented. In addition, common transference patterns and dissociative aspects of transference in the treatment of DID are explained. Transference is also discussed in relationship to the possible impact of disorganized attachment, which is a main component in the development of DID. The clinical implications of this proposition will be discussed and supported by a case example.

  4. Diagnostic criteria and treatment of discogenic pain: a systematic review of recent clinical literature.

    Science.gov (United States)

    Malik, Khalid M; Cohen, Steven P; Walega, David R; Benzon, Honorio T

    2013-11-01

    Pain innate to intervertebral disc, often referred to as discogenic pain, is suspected by some authors to be the major source of chronic low back and neck pain. Current management of suspected discogenic pain lacks standardized diagnosis, treatment, and terminology. In an attempt to determine whether patterns existed that may facilitate standardization of care, we sought to analyze the terminologies used and the various modes of diagnosis and treatment of suspected discogenic pain. A systematic review of the recent literature. A Medline search was performed using the terms degenerative disc disease, discogenic pain, internal disc disruption while using the limits of human studies, English language, and clinical trials, for the last 10 years. The search led to a total of 149 distinct citations, of which 53 articles, where the intervertebral disc itself was considered the principal source of patient's pain and was the main target of the treatment, were retained for further analysis. The results of this review confirm and help quantify the significant differences that existed in the terminology and all the areas of diagnosis and treatment of presumed discogenic pain. Our findings show that suspected discogenic pain, despite its extensive affirmation in the literature and enormous resources regularly devoted to it, currently lacks clear diagnostic criteria and uniform treatment or terminology. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. STATUS and DIRECTION OF THE BULK VITRIFICATION PROGRAM FOR THE SUPPLEMENTAL TREATMENT OF LOW ACTIVITY TANK WASTE AT HANFORD

    International Nuclear Information System (INIS)

    RAYMOND, R.E.

    2005-01-01

    The DOE Office of River Protection (ORP) is managing a program at the Hanford site that will retrieve and treat more than 200 million liters (53 million gal.) of radioactive waste stored in underground storage tanks. The waste was generated over the past 50 years as part of the nation's defense programs. The project baseline calls for the waste to be retrieved from the tanks and partitioned to separate the highly radioactive constituents from the large volumes of chemical waste. These highly radioactive components will be vitrified into glass logs in the Waste Treatment Plant (WTP), temporarily stored on the Hanford Site, and ultimately disposed of as high-level waste in the offsite national repository. The less radioactive chemical waste, referred to as low-activity waste (LAW), is also planned to be vitrified by the WTP, and then disposed of in approved onsite trenches. However, additional treatment capacity is required in order to complete the pretreatment and immobilization of the tank waste by 2028, which represents a Tri-Party Agreement milestone. To help ensure that the treatment milestones will be met, the Supplemental Treatment Program was undertaken. The program, managed by CH2M HILL Hanford Group, Inc., involves several sub-projects each intended to supplement part of the treatment of waste being designed into the WTP. This includes the testing, evaluation, design, and deployment of supplemental LAW treatment and immobilization technologies, retrieval and treatment of mixed TRU waste stored in the Hanford Tanks, and supplemental pre-treatment. Applying one or more supplemental treatment technologies to the LAW has several advantages, including providing additional processing capacity, reducing the planned loading on the WTP, and reducing the need for double-shell tank space for interim storage of LAW. In fiscal year 2003, three potential supplemental treatment technologies were evaluated including grout, steam reforming and bulk vitrification using AMEC

  6. Retinoic acid for treatment of systemic sclerosis and morphea: A literature review.

    Science.gov (United States)

    Thomas, Renee M; Worswick, Scott; Aleshin, Maria

    2017-03-01

    Systemic sclerosis and morphea are connective tissue diseases characterized by tightening, thickening, and hardening of the skin, leading to significant morbidity. Unfortunately, current treatment options have limited efficacy for many patients. Cutaneous manifestations of these diseases arise from excess collagen deposition and fibrosis in the skin, through pathogenic mechanisms which have yet to be extensively detailed at the causal immune and cellular levels. Research elucidating the mechanism of action of retinoic acid on collagen production in the skin and case series highlighting the success of retinoic acid on the skin manifestations of systemic sclerosis and on morphea demonstrate its promise as a treatment. Herein they will briefly review the treatment options for both systemic sclerosis and morphea, and will discuss the potential of retinoic acid as a therapy and the supporting evidence from the literature, highlighting the previously published basic science and clinical studies investigating the role of retinoic acid in the treatment of sclerotic skin diseases. © 2016 Wiley Periodicals, Inc.

  7. Supplemented Triage and Rapid Treatment (START) improves performance measures in the emergency department.

    Science.gov (United States)

    White, Benjamin A; Brown, David F M; Sinclair, Julia; Chang, Yuchiao; Carignan, Sarah; McIntyre, Joyce; Biddinger, Paul D

    2012-03-01

    Emergency Department (ED) crowding is well recognized, and multiple studies have demonstrated its negative effect on patient care. This study aimed to assess the effect of an intervention, Supplemented Triage and Rapid Treatment (START), on standard ED performance measures. The START program complemented standard ED triage with a team of clinicians who initiated the diagnostic work-up and selectively accelerated disposition in a subset of patients. This retrospective before-after study compared performance measures over two 3-month periods (September-November 2007 and 2008) in an urban, academic tertiary care ED. Data from an electronic patient tracking system were queried over 12,936 patients pre-intervention, and 14,220 patients post-intervention. Primary outcomes included: 1) overall length of stay (LOS), 2) LOS for discharged and admitted patients, and 3) the percentage of patients who left without complete assessment (LWCA). In the post-intervention period, patient volume increased 9% and boarder hours decreased by 1.3%. Median overall ED LOS decreased by 29 min (8%, 361 min pre-intervention, 332 min post-intervention; p < 0.001). Median LOS for discharged patients decreased by 23 min (7%, 318 min pre-intervention, 295 min post-intervention; p < 0.001), and by 31 min (7%, 431 min pre-intervention, 400 min post-intervention) for admitted patients. LWCA was decreased by 1.7% (4.1% pre-intervention, 2.4% post-intervention; p < 0.001). In this study, a comprehensive screening and clinical care program was associated with a significant decrease in overall ED LOS, LOS for discharged and admitted patients, and rate of LWCA, despite an increase in ED patient volume. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. A natural pharma standard supplement formulation to control treatment-related toxicity and oxidative stress in genitourinary cancer: a preliminary study.

    Science.gov (United States)

    Ledda, A; Belcaro, G; Dugall, M; Luzzi, R; Hosoi, M; Feragalli, B; Cotellese, R; Cosentino, V; Cosentino, M; Eggenhoffner, R; Pellizzato, M; Fratter, A; Giacomelli, L

    2017-09-01

    Oncological treatments are associated with toxicities that may decrease compliance to treatment in most genitourinary cancer patients. Supplementation with pharmaceutical-standardized supplement may be a supplementary method to control the side effects after chemo- and radiotherapy and the increased oxidative stress associated to treatments. This registry study evaluated a natural combination of supplements containing curcumin, cordyceps, and astaxanthin (Oncotris™) used as supplementary management in genitourinary cancer patients who had undergone oncological therapy. Patients with genitourinary cancers (prostate or bladder malignancies) who had undergone and completed cancer treatments (radiotherapy, chemotherapy or intravesical immunotherapy with increased oxidative stress and residual symptoms) were recruited in this registry, supplement study. Registry subjects (n = 61) freely decided to follow either a standard management (SM) (control group = 35) or SM plus oral daily supplementation (supplement group = 26). Evaluation of severity of treatment-related residual side effects, blood count test, prostate-specific antigen (PSA) test and plasma free radicals (oxidative stress) were performed at inclusion and at the end of the observational period (6 weeks). Two patients dropped out during the registry. Therefore, the analysis included 59 participants: 26 individuals in the supplementation group and 33 in the control group. In the supplement group, the intensity of signs and symptoms (treatment-related) and residual side effects significantly decreased at 6 weeks: minimal changes were observed in controls. Supplementation with Oncotris™ was associated with a significant improvement in blood cell count and with a decreased level of plasmatic PSA and oxidative stress. Naturally-derived supplements, specifically Oncotris™ (patent pending), could support the body to overcome the treatment-related toxicities - and the relative oxidative stress in cancer patients.

  9. Diet in the treatment of ADHD in children-A systematic review of the literature

    DEFF Research Database (Denmark)

    Heilskov Rytter, Maren Johanne; Andersen, Louise Beltoft Borup; Houmann, Tine

    2015-01-01

    Background: Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric conditions in childhood. Dietary changes have been suggested as a way of reducing ADHD symptoms. Aims: To provide an overview of the evidence available on dietary interventions in children with ADHD......, a systematic review was carried out of all dietary intervention studies in children with ADHD. Methods: Relevant databases were searched in October 2011, with an update search in March 2013. The studies included describe diet interventions in children with ADHD or equivalent diagnoses measuring possible......). Conclusion: Elimination diets and fish oil supplementation seem to be the most promising dietary interventions for a reduction in ADHD symptoms in children. However, the studies on both treatments have shortcomings, and more thorough investigations will be necessary to decide whether they are recommendable...

  10. Cognitive-behavioral treatments for tinnitus: a review of the literature.

    Science.gov (United States)

    Cima, Rilana F F; Andersson, Gerhard; Schmidt, Caroline J; Henry, James A

    2014-01-01

    Tinnitus can be defined as the perception of an auditory sensation, perceivable without the presence of an external sound. The aim of this article is to systematically review the peer-reviewed literature on treatment approaches for tinnitus based on cognitive-behavioral therapy (CBT) and to provide a historical overview of developments within these approaches. Experimental studies, (randomized) trials, follow-up assessments, and reviews assessing educational, counseling, psychological, and CBT treatment approaches were identified as a result of an electronic database metasearch. A total of 31 (of the initial 75 studies) were included in the review. Results confirm that CBT treatment for tinnitus management is the most evidence-based treatment option so far. Though studied protocols are diverse and are usually a combination of different treatment elements, and tinnitus diagnostics and outcome assessments vary over investigations, a common ground of therapeutic elements was established, and evidence was found to be robust enough to guide clinical practice. Treatment strategy might best be CBT-based, moving toward a more multidisciplinary approach. There is room for the involvement of different disciplines, using a stepped-care approach. This may provide brief and effective treatment for a larger group of tinnitus patients, and additional treatment steps can be provided for those suffering on a more severe level. American Academy of Audiology.

  11. Treatment of Scoliosis-Evidence and Management (Review of the Literature

    Directory of Open Access Journals (Sweden)

    Weiss

    2016-04-01

    Full Text Available Context Scoliosis is a three-dimensional deformity of the spine and trunk which includes lateral deviation, rotation, and a disturbance of the sagittal profile. Treatment is indicated for scoliosis because it may lead to negative consequences with regard to the quality of life and other health issues for some patients. The purpose of this review was to gather current, up-to-date information, and to search the recent articles on scoliosis for evidence of the different modes of treatment. Evidence Acquisition A PubMed search for review articles, prospective controlled trials (PCT, and randomized controlled trials (RCT was performed. The search terms were: 1 scoliosis, treatment (12,045 items found; 2 scoliosis, physiotherapy (776 items found; 3 scoliosis, brace treatment (1,447 items found; and 4 scoliosis, surgery (10,485 items found. Results When looking at the current literature, high quality evidence (level I was found to support physical rehabilitation and brace treatments, while no evidence was found to support spinal fusion surgery. The numerous long-term complications that patients may face post-operation, and the lack of evidence for spinal fusion surgery indicate that there is no clear medical indication for this kind of treatment. Conclusions There is a high level of evidence for the conservative treatment of scoliosis, but there are varying levels of success in the different approaches. The better the correction of the curve, the better the end result and outcome for the patient. This is supported by the current evidence reviewed in this paper. Physiotherapy and bracing should be used and, specifically, those approaches using high corrective methods. Spinal fusion surgery is not supported by the current evidence. According to the literature, the long-term complications of surgery for scoliosis far outweigh the consequences of untreated scoliosis.

  12. [Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

    Science.gov (United States)

    Mehrmann, Lena; Ollenschläger, Günter

    2014-01-01

    Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

  13. Omalizumab for the Treatment of Chronic Idiopathic Urticaria: Systematic Review of the Literature.

    Science.gov (United States)

    Tonacci, Alessandro; Billeci, Lucia; Pioggia, Giovanni; Navarra, Michele; Gangemi, Sebastiano

    2017-04-01

    Omalizumab is recombinant humanized monoclonal antibody to immunoglobulin E. Guidelines for the treatment of chronic idiopathic urticaria (also known as chronic spontaneous urticaria) recommend the use of omalizumab as third-line therapy in addition to high doses of histamine receptor type 1 (H 1 ) antihistamines when they are unsuccessful as first- and second-line therapy. We performed a systematic review of the literature to identify studies that evaluated the efficacy of omalizumab for the treatment of chronic idiopathic urticaria, in both controlled and real-world settings, to assess its potential role as a preferred therapy. The PubMed, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences Literature), and Google Scholar databases were searched between January 1, 2000, and November 21, 2016. The search was limited to articles published in peer-reviewed journals in the English language, and 29 studies were included in this review. Omalizumab 300 mg administered every 4 weeks appears to be the most effective and safe dosage, with a rapid response time, for the treatment of chronic idiopathic urticaria, with few minor adverse effects, and appears to be safe in the offspring of pregnant patients who received the drug. However, as published studies of omalizumab are sparse, future studies are warranted. When findings are confirmed in larger studies, due to its efficacy, safety, and increased benefit/cost ratio, omalizumab could become the preferred method of treatment for chronic idiopathic urticaria in patients unresponsive to H 1 antihistamines. © 2017 Pharmacotherapy Publications, Inc.

  14. The Evidence for Dietary Interventions and Nutritional Supplements as Treatment Options in Multiple Sclerosis: a Review.

    Science.gov (United States)

    Mische, Leah J; Mowry, Ellen M

    2018-03-17

    This review aims to critically evaluate published studies examining diets and nutritional supplements (excepting vitamin D) for the impact on prevention and prognosis of multiple sclerosis (MS). There is a negative relationship between the Mediterranean diet and vascular disease, and vascular co-morbidities are associated with a worse MS prognosis. Low-fat, fish-based diets, sodium-restricted diets, calorie restriction, the paleo diet, and gluten-free diets have been examined, mostly in observational studies; results are inconclusive. With regard to nutritional supplements, pilot data show a possible benefit of biotin with respect to disability worsening in people with progressive MS (PMS). The best designed randomized controlled trials (RCTs) for PUFA supplementation have not shown significant impact, but several weaker RCTs have. Many other nutritional supplements have been tested, including several anti-oxidants. While some early studies show positive results, no result has been definitive. Unfortunately, there is no strong evidence for a direct benefit of any given dietary intervention on MS risk or prognosis. However, due to its relationship with vascular co-morbidities, the Mediterranean diet has the strongest rationale for employment in PwMS. Higher-quality clinical trials are needed to ascertain the possible benefits of nutritional supplements.

  15. Pharmacotherapy as prophylactic treatment of post-traumatic stress disorder: a review of the literature.

    Science.gov (United States)

    Roque, Autumn Pearl

    2015-01-01

    Post-traumatic stress disorder has a lifetime prevalence of almost 9% in the United States. The diagnosis is associated with increased rates of comorbid substance abuse and increased rates of depression. Providers are taught how to diagnose and treat PTSD, but little discussion is devoted to how to prevent the disorder. Behavioral research in animal studies has provided some evidence for the use of medications in decreasing the fear response and the reconsolidation of memories. A heightened fear response and the re-experience of traumatic memory are key components for diagnosis. The purpose of this literature review is to examine the evidence for pharmacotherapy as prophylactic treatment in acute stress/trauma in order to prevent the development of post-traumatic stress disorder. The body of the review includes discussions on medications, medications as adjunct to script-driven imagery, and special considerations for military, first responders, and women. This article concludes with implications for practice and recommendations for future research. The key words used for the literature search were "prophylactic treatment of PTSD," "pharmacotherapy and trauma," "pharmacological prevention of PTSD," "beta blockers and the prevention of PTSD," "acute stress and prevention of PTSD," "propranolol and PTSD," "secondary prevention of PTSD," and "medications used to prevent PTSD." Findings were categorized by medications and medications as adjunct to script-driven imagery. The literature suggests that hydrocortisone, propranolol, and morphine may decrease symptoms and diagnosis of post-traumatic stress disorder.

  16. [Court-ordered treatment: Analysing a complex practise through a literature review].

    Science.gov (United States)

    Orsat, M; Auffret, E; Brunetière, C; Decamps-Mini, D; Canet, J; Olié, J-P; Richard-Devantoy, S

    2015-10-01

    In France, there are two main types of court-ordered treatment (COT) as far as mental health is concerned: obligations of treatment and injunctions of treatment. Obligations of treatment date back from 1958 whereas the law implementing injunctions of treatment is fairly recent as it was passed in 1998. Obligations and injunctions of treatment are two different types of COT that differ in terms of proceedings (obligations of treatment require no preliminary forensic psychiatric assessment; as for injunctions of treatment, they require the appointment of a coordinating medical doctor) and that are applied for different offences. However, both are psychiatric commitment procedures connecting the judicial, medical and social fields and their overall numbers have been on the rise. These common psychiatric practices have seldom been assessed and no review of the literature on the subject has ever been published. Better knowledge of such forensic practices is essential to their improvement and even to adjust the legal framework of these measures that are enjoying a boom. The purpose of this literature review is to define the prevalence of COT as well as the sociodemographic, criminal and psychiatric characteristics of those concerned by such measures. A review of the French medical literature on COT was carried out using Science Direct up to December 2013. The results of seven studies were included and analysed. This was completed with a review of the articles listed in social sciences and law databases (Cairn and Dalloz). It has become increasingly frequent to rely on psychiatric teams to implement COT while at the same time public mental health services have to face a surge in activity with restricted financial means. Obligations of treatment are far more common (about 20,000 court orders a year) than injunctions of treatment (about 4000 measures are currently being enforced). However the latter have showed an increase of 506% over the 2000 decade. Both measures

  17. Family based treatment for children with functional somatic symptoms: A systematic literature review

    DEFF Research Database (Denmark)

    Hulgaard, Ditte Roth; Dehlholm-Lambertsen, Birgitte; Rask, Charlotte

    2015-01-01

    Background: Young patients with Functional Somatic Symptoms (FSS) are common and may present in all clinical settings. Clinical presentation varies from self–limiting to severe and disabling symptoms with impairment in several domains of daily life. In daily clinical practice there is no consensus...... on which treatment to offer children and adolescents with FSS. Research in adults shows that different FSS respond to the same kind of treatment, with the effect of cognitive behavioural therapy being well established. In the understanding of mental health issues in children, it is well established...... is broadly defined and encompasses a wide range of interventions. Aims: As part of a PhD study on family based treatment for children with FSS a systematic review of the literature will be performed in which the type and characteristics of existing family based psychological interventions for children...

  18. Clinical, biological, histological features and treatment of oral mucositis induced by radiation therapy: a literature review

    International Nuclear Information System (INIS)

    Bonan, Paulo Rogerio Ferreti; Lopes, Marcio Ajudarte; Almeida, Oslei Paes de; Alves, Fabio de Abreu

    2005-01-01

    The oral mucositis is a main side effect of radiotherapy on head and neck, initiating two weeks after the beginning of the treatment. It is characterized by sensation of local burning to intense pain, leading in several cases, to the interruption of the treatment. The purpose of this work is to review the main published studies that discuss the clinical, biological and histopathological features of oral mucositis induced by radiation therapy and to describe the main approaches recommended to prevent or to treat it. Although the clinical features of mucositis are intensively described in the literature, few studies address the histopathological alterations in oral mucositis and only recently, its biological processes have been investigated. The biological mechanisms involved in the radiation tissue damage have been only recently discussed and there is no consensus among treatment modalities. Yet, the progressive knowledge in the histopathology and biological characteristics of oral mucositis probably will lead to more effective in prevention and control strategies. (author)

  19. Herbs, Supplements and Alternative Medicines

    Science.gov (United States)

    ... A A Listen En Español Herbs, Supplements and Alternative Medicines It is best to get vitamins and minerals ... this section Medication Other Treatments Herbs, Supplements, and Alternative Medicines Types of Dietary Supplements Side Effects and Drug ...

  20. Treatment of recurrent aphthous stomatitis by laser therapy: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Pavlić Verica

    2015-01-01

    Full Text Available Background/Aim. Recurrent aphthous stomatitis (RAS is defined as multifactor immunologic inflammatory lesions in the oral cavity, characterized by painful, recurrent single/multiple, shallow, round or ovoid ulcerations of mucosal tissues. To date, a considerable number of RAS treatment protocols have been suggested, but since the etiology of RAS is idiopathic, these treatment options have symptomatic rather than curative or preventive effect. Recently, it has been suggested that laser therapy could be successfully used as an efficient treatment approach in therapy of RAS. Therefore, the aim of this review was to estimate the effects of laser therapy in treatment of RAS analyzing results of clinical studies published in peer reviewed journals. Methods. The studies published until 31 December 2013 were obtained from the Medline/PubMed, Science Direct and Cochrane Library of the Cochrane Collaboration (CENTRAL online databases, using following search terms and key words: “laser” AND “recurrent aphthous stomatitis”, “laser” AND “aphthous”, and “laser” AND “aphthae”. In total 4 original research articles met the all required inclusion/exclusion criteria, and were used for this review. The main outcome measures assessed were: a reduction of pain associated with RAS and a reduction in episode duration (faster RAS healing. Results. The assessed literature demonstrates the benefits of laser therapy mainly due to immediate analgesia and ability to speed up a RAS healing process. Conclusion. Even though the assessed literature suggests beneficial outcomes of laser therapy in treatment of RAS, these results should be interpreted with caution. The issues related to the study designs and different sets of laser irradiation parameters of a limited number of available studies with the same treatment outcomes prevent us from making definite conclusions.

  1. Exercise and Omega-3 Polyunsaturated Fatty Acid Supplementation for the Treatment of Hepatic Steatosis in Hyperphagic OLETF Rats

    Directory of Open Access Journals (Sweden)

    Sarah J. Borengasser

    2012-01-01

    Full Text Available Background and Aims. This study examined if exercise and omega-3 fatty acid (n3PUFA supplementation is an effective treatment for hepatic steatosis in obese, hyperphagic Otsuka Long-Evans Tokushima Fatty (OLETF rats. Methods. Male OLETF rats were divided into 4 groups (n=8/group: (1 remained sedentary (SED, (2 access to running wheels; (EX (3 a diet supplemented with 3% of energy from fish oil (n3PUFA-SED; and (4 n3PUFA supplementation plus EX (n3PUFA+EX. The 8 week treatments began at 13 weeks, when hepatic steatosis is present in OLETF-SED rats. Results. EX alone lowered hepatic triglyceride (TAG while, in contrast, n3PUFAs failed to lower hepatic TAG and blunted the ability of EX to decrease hepatic TAG levels in n3PUFAs+EX. Insulin sensitivity was improved in EX animals, to a lesser extent in n3PUFA+EX rats, and did not differ between n3PUFA-SED and SED rats. Only the EX group displayed higher complete hepatic fatty acid oxidation (FAO to CO2 and carnitine palmitoyl transferase-1 activity. EX also lowered hepatic fatty acid synthase protein while both EX and n3PUFA+EX decreased stearoyl CoA desaturase-1 protein. Conclusions. Exercise lowers hepatic steatosis through increased complete hepatic FAO, insulin sensitivity, and reduced expression of de novo fatty acid synthesis proteins while n3PUFAs had no effect.

  2. Status and progress of treatment methods for root caries in the last decade: a literature review.

    Science.gov (United States)

    Cai, J; Palamara, Jea; Manton, D J; Burrow, M F

    2018-03-01

    The aim of this literature review is to explore the treatment methods for root caries in laboratory and clinical research in the last decade. A systematic search of publications in PubMed and Web of Science databases was performed. The timespan was limited to the last 10 years and English language. Further retrieval was conducted using the search terms of specific therapies or treatments. Eighty-two articles were included in this systematic review and full texts were retrieved. Types of studies included laboratory studies and clinical trials. Therapeutic approaches for root caries without risk of pulp exposure can be categorized into non-invasive and restorative treatment. Non-invasive treatments which targeted different causative factors of root caries have been developed in the last decade. Accordingly, several artificial caries model systems have been proposed for the study of root caries in the laboratory. Carious tissue excavation techniques and restorative materials and procedures have been modified to improve the prognosis of invasive treatment. It is of importance to determine the most appropriate therapy for root caries and further clinical trials are needed to draw firm conclusions concerning the efficacy and consistency of the various treatment methods proposed. © 2017 Australian Dental Association.

  3. Orthodontic treatment in periodontitis‐susceptible subjects: a systematic literature review

    Science.gov (United States)

    Lindsten, Rune; Slotte, Christer; Bjerklin, Krister

    2016-01-01

    Abstract The aim is to evaluate the literature for clinical scientific data on possible effects of orthodontic treatment on periodontal status in periodontitis‐susceptible subjects. A systematic literature review was performed on studies in English using PubMed, MEDLINE, and Cochrane Library central databases (1965‐2014). By manually searching reference lists of selected studies, we identified additional articles; then we searched these publications: Journal of Periodontology, Periodontology 2000, Journal of Clinical Periodontology, American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, International Journal of Periodontics & Restorative Dentistry, and European Journal of Orthodontics. Search terms included randomized clinical trials, controlled clinical trials, prospective and retrospective clinical studies, case series >5 patients, periodontitis, orthodontics, alveolar bone loss, tooth migration, tooth movement, orthodontic extrusion, and orthodontic intrusion. Only studies on orthodontic treatment in periodontally compromised dentitions were included. One randomized controlled clinical trial, one controlled clinical trial, and 12 clinical studies were included. No evidence currently exists from controlled studies and randomized controlled clinical trials, which shows that orthodontic treatment improves or aggravates the status of periodontally compromised dentitions. PMID:29744163

  4. [Surgical treatment of secondary hyperparathyroidism: a systematic review of the literature].

    Science.gov (United States)

    Magnabosco, Felipe Ferraz; Tavares, Marcos Roberto; Montenegro, Fábio Luiz de Menezes

    2014-07-01

    Secondary hyperparathyroidism (HPT) has a high prevalence in renal patients. Secondary HPT results from disturbances in mineral homeostasis, particularly calcium, which stimulates the parathyroid glands, increasing the secretion of parathyroid hormone (PTH). Prolonged stimulation can lead to autonomy in parathyroid function. Initial treatment is clinical, but parathyroidectomy (PTx) may be required. PTx can be subtotal or total followed or not followed by parathyroid tissue autograft. We compared the indications and results of these strategies as shown in the literature through a systematic literature review on surgical treatment of secondary HPT presented in MedLine and LILACS from January 2008 to March 2014. The search terms were: hyperparathyroidism; secondary hyperparathyroidism; parathyroidectomy and parathyroid glands, restricted to research only in humans, articles available in electronic media, published in Portuguese, Spanish, English or French. We selected 49 articles. Subtotal and total PTx followed by parathyroid tissue autograft were the most used techniques, without consensus on the most effective surgical procedure, although there was a preference for the latter. The choice depends on surgeon's experience. There was consensus on the need to identify all parathyroid glands and cryopreservation of parathyroid tissue whenever possible to graft if hypoparathyroidism arise. Imaging studies may be useful, especially in recurrences. Alternative treatments of secondary HPT, both interventional and conservative, require further study.

  5. Successful treatment of refractory TAFRO syndrome with elevated vascular endothelial growth factor using thyroxine supplements.

    Science.gov (United States)

    Oka, Satoko; Ono, Kazuo; Nohgawa, Masaharu

    2018-04-01

    Although the clinical significance of hypothyroidism in TAFRO syndrome is unknown, vascular endothelial growth factor (VEGF) levels decreased with improvements in the condition of our refractory TAFRO cases after thyroxine supplement therapy. Our results indicate that elevated VEGF levels are a potential factor in the pathogenesis and anasarca of TAFRO syndrome with hypothyroidism.

  6. Oral Lichen Planus: Clinical Features, Etiology, Treatment and Management; A Review of Literature

    Directory of Open Access Journals (Sweden)

    Marzieh Boorghani

    2010-03-01

    Full Text Available Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many unestablished etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.

  7. Neural Correlates of Psychotherapeutic Treatment of Post-traumatic Stress Disorder: A Systematic Literature Review.

    Science.gov (United States)

    Malejko, Kathrin; Abler, Birgit; Plener, Paul L; Straub, Joana

    2017-01-01

    Post-traumatic stress disorder (PTSD) is a common psychiatric disease with changes in neural circuitries. Neurobiological models conceptualize the symptoms of PTSD as correlates of a dysfunctional stress reaction to traumatic events. Functional imaging studies showed an increased amygdala and a decreased prefrontal cortex response in PTSD patients. As psychotherapeutic approaches represent the gold standard for PTSD treatment, it is important to examine its underlying neurobiological correlates. Studies published until August 2016 were selected through systematic literature research in the databases PubMed, PsychInfo, and Cochrane Library's Central Register of Controlled Trials or were identified manually by searching reference lists of selected articles. Search terms were "neural correlates" OR "fMRI" OR "SPECT," AND "therapy" AND "PTSD." A total of 19 articles were included in the present review whereof 15 studies compared pre-to-post-therapy signal changes, six studies related pre-treatment activity to pre-to-post-symptom improvement, and four studies compared neural correlates of responders versus non-responders. The disposed therapy forms were cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing, cognitive therapy, exposure therapy, mindfulness-based intervention, brief eclectic psychotherapy, and unspecified therapy. Successful psychotherapy of PTSD was repeatedly shown to be accompanied by decreased activity in the amygdala and the insula as well as increased activity in the dorsal anterior cingulate cortex (dACC) and hippocampus. Elevated dACC activity prior to treatment was related to subsequent treatment success and a positive predictor for treatment response. Elevated amygdala and insula pre-treatment activities were related to treatment failure. Decreased activity in limbic brain regions and increased activity in frontal brain areas in PTSD patients after successful psychotherapeutic treatment might reflect regained top

  8. Dental treatment under general anesthesia for special-needs patients: analysis of the literature.

    Science.gov (United States)

    Mallineni, Sreekanth K; Yiu, Cynthia K Y

    2016-11-01

    The aim of the present review was to identify the studies published on dental treatment under general anesthesia for special-needs patients. A comprehensive search of the reported literature from January 1966 to May 2012 was conducted using PubMed, Medline, and Embase. Keywords used in the search were "dental treatment under general anesthesia", "special-needs patients", "medically-compromised patients", and "children", in various combinations. Studies published only on dental treatment under general anesthesia and in English were included. Only 10 studies were available for final analysis. Age range from 1 to 50 years, and restorative procedures, were most prevalent. Only two studies discussed repeated general anesthesia, with rates of 7.2% and 10.2%. Over time, the provision of general anesthesia for special-needs patients has changed from dental clinics to general hospitals. The demand for dental treatment for special-needs patients under general anesthesia continues to increase. Currently, there are no certain accepted protocols for the provision of dental treatment under general anesthesia. © 2015 Wiley Publishing Asia Pty Ltd.

  9. Self care programs and multiple sclerosis: physical therapeutics treatment - literature review.

    Science.gov (United States)

    Demaille-Wlodyka, S; Donze, C; Givron, P; Gallien, P

    2011-03-01

    To clarify the therapeutic education program impact with multiple sclerosis patients, literature review. Highlight contents and efficacy. A non-systematic review on Medline, PubMed and Cochrane library databases from 1966 to 2010 using the following keywords: "multiple sclerosis", "self-care", "self-management" and specific symptoms keywords. Clinical trials and randomized clinical trials, as well as literature reviews published in English, French and German will be analyzed. Counseling is a part of the non-pharmacological management of chronic illnesses such as multiple sclerosis. Symptoms' diversity and the different clinical forms limit standardized programs of self-care management, applicable to patients. In the literature review, counseling programs have often low metrology. A behavior change with patients and medical staff could exist. To empower the patient, to reduce symptoms' impact and to improve treatment access are the aims of educational therapy. Therapeutic education program for multiple sclerosis patients could progress with their standardization and assessment, for each sign. To promote the educational therapy of multiple sclerosis patients, a specific training for medical staff, as specific financing are necessary. 2011 Elsevier Masson SAS. All rights reserved.

  10. Methamphetamine: An Update on Epidemiology, Pharmacology, Clinical Phenomenology, and Treatment Literature

    Science.gov (United States)

    Courtney, Kelly E.; Ray, Lara A.

    2014-01-01

    Background Despite initial reports of a decline in use in the early 2000s, methamphetamine remains a significant public health concern with known neurotoxic and neurocognitive effects to the user. The goal of this review is to update the literature on methamphetamine use and addiction since its assent to peak popularity in 1990s. Methods Specifically, we first review recent epidemiological reports with a focus on methamphetamine accessibility, changes in use and disorder prevalence rates over time, and accurate estimates of the associated burden of care to the individual and society. Second, we review methamphetamine pharmacology literature with emphasis on the structural and functional neurotoxic effects associated with repeated use of the drug. Third, we briefly outline the findings on methamphetamine-related neurocognitive deficits as assessed via behavioral and neuroimaging paradigms. Lastly, we review the clinical presentation of methamphetamine addiction and the evidence supporting the available psychosocial and pharmacological treatments within the context of an addiction biology framework. Conclusion Taken together, this review provides a broad-based update of the available literature covering methamphetamine research over the past two decades and concludes with recommendations for future research. PMID:25176528

  11. N-Acetyl Cysteine and Vitamin D Supplementation in Treatment Resistant Obsessive- compulsive Disorder Patients: a General Review.

    Science.gov (United States)

    di Michele, Flavia; Siracusano, Alberto; Talamo, Alessandra; Niolu, Cinzia

    2018-04-17

    Obsessive-compulsive disorder (OCD) is a disabling mental illness for which pharmacological and psychosocial interventions are all too often inadequate. This demonstrates the need for more targeted therapeutics. Recent preclinical and clinical studies have implicated dysfunction of glutamatergic neurotransmission in the pathophysiology of OCD. Moreover there are studies suggesting that neuroimmune abnormalities may play an important role in the pathogenesis of OCD. N-acetyl cysteine (NAC) is a safe and readily available agent that would modify the synaptic release of glutamate in subcortical brain regions via modulation of the cysteine-glutamate antiporter. The modulation of inflammatory pathways may also play a role in the benefits seen following NAC treatment. Therefore NAC can be considered a neuroprotective agent. This paper explores the role of NAC in the treatment of OCD conditions refractory to first-line pharmacological interventions, reviewing the clinical studies published in the last decade. The possible benefit mechanisms of NAC for this disorder will be discussed, as well as the role of vitamin D supplementation, given its specific property of stimulating the formation of glutathione in the brain. Nutraceutical supplementation in treatment resistance OCD may be important not only for improving obsessive-compulsive symptomatology, but also from a psychological perspective, given its better acceptance by the patients compared to pharmacological treatment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  12. The indications and timing for operative management of spinal epidural abscess: literature review and treatment algorithm.

    Science.gov (United States)

    Tuchman, Alexander; Pham, Martin; Hsieh, Patrick C

    2014-08-01

    Delayed or inappropriate treatment of spinal epidural abscess (SEA) can lead to serious morbidity or death. It is a rare event with significant variation in its causes, anatomical locations, and rate of progression. Traditionally the treatment of choice has involved emergency surgical evacuation and a prolonged course of antibiotics tailored to the offending pathogen. Recent publications have advocated antibiotic treatment without surgical decompression in select patient populations. Clearly defining those patients who can be safely treated in this manner remains in evolution. The authors review the current literature concerning the treatment and outcome of SEA to make recommendations concerning what population can be safely triaged to nonoperative management and the optimal timing of surgery. A PubMed database search was performed using a combination of search terms and Medical Subject Headings, to identify clinical studies reporting on the treatment and outcome of SEA. The literature review revealed 28 original case series containing at least 30 patients and reporting on treatment and outcome. All cohorts were deemed Class III evidence, and in all but two the data were obtained retrospectively. Based on the conclusions of these studies along with selected smaller studies and review articles, the authors present an evidence-based algorithm for selecting patients who may be safe candidates for nonoperative management. Patients who are unable to undergo an operation, have a complete spinal cord injury more than 48 hours with low clinical or radiographic concern for an ascending lesion, or who are neurologically stable and lack risk factors for failure of medical management may be initially treated with antibiotics alone and close clinical monitoring. If initial medical management is to be undertaken the patient should be made aware that delayed neurological deterioration may not fully resolve even after prompt surgical treatment. Patients deemed good surgical

  13. Contributions of Nursing in adherence to treatment of hypertension: a systematic review of Brazilian literature

    Directory of Open Access Journals (Sweden)

    Ernandes Gonçalves Dias

    2016-07-01

    Full Text Available Background and Objectives: Hypertension is a prevalent chronic disease in health services in Brazil and the nursing is co-responsible in the development of strategies to improve adherence of hypertensive treatment. This study aimed to verify the contributions of the nursing team, active in Basic Health Units to facilitate adherence to treatment of hypertension. Contents: We conducted a systematic review of the Brazilian literature of descriptive and qualitative kind, carried with 17 original scientific articles and research published in national journals in Portuguese between the years 2010 and 2015, indexed in the Virtual Library Database in health / BIREME, Medline, Lilacs and SciELO. Conclusion: The Nursing is present and active in assisting the hypertensive patients of the Health Units and shows evolution incorporating the use of technology as a way of innovation and management of care.

  14. Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment.

    Science.gov (United States)

    Lahaie, Marie-André; Boyer, Stéphanie C; Amsel, Rhonda; Khalifé, Samir; Binik, Yitzchak M

    2010-09-01

    Vaginismus is currently defined as an involuntary vaginal muscle spasm interfering with sexual intercourse that is relatively easy to diagnose and treat. As a result, there has been a lack of research interest with very few well-controlled diagnostic, etiological or treatment outcome studies. Interestingly, the few empirical studies that have been conducted on vaginismus do not support the view that it is easily diagnosed or treated and have shed little light on potential etiology. A review of the literature on the classification/diagnosis, etiology and treatment of vaginismus will be presented with a focus on the latest empirical findings. This article suggests that vaginismus cannot be easily differentiated from dyspareunia and should be treated from a multidisciplinary point of view.

  15. [Modern treatments for degenerative disc diseases of the lumbosacral spine. A literature review].

    Science.gov (United States)

    Konovalov, N A; Nazarenko, A G; Asyutin, D S; Zelenkov, P V; Onoprienko, R A; Korolishin, V A; Cherkiev, I U; Martynova, M A; Zakirov, B A; Timonin, S Yu; Kosyr'kova, A V; Pimenova, L F; Pogosyan, A L; Batyrov, A A

    Many researchers consider degenerative diseases of the spine as a pandemic of the XXIst century. Herniated intervertebral discs of the lumbosacral spine occur in 61% of patients with degenerative spine diseases. Of these, 15% of patients have herniated discs at the LII-LIII level, 10% of patients at the LIII-LIV level, and 40% of patients at the LIV-LV and LV-SI levels. A high cost of conservative treatment of degenerative spine disease symptoms and its low efficacy in reducing the intensity and duration of pain necessitate the development of new methods of surgical treatment. In this paper, we analyze the literature data on minimally invasive spine surgery and demonstrate the main advantages of percutaneous endoscopic surgical techniques.

  16. IDM as a "Minor" Literature: The Treatment of Cultural and Musical Norms by "Intelligent Dance Music"

    Directory of Open Access Journals (Sweden)

    Ramzy Alwakeel

    2009-09-01

    Full Text Available This piece opens with a consideration of the etymology and application of the term “IDM”, before examining the treatment of normative standards by the work associated therewith. Three areas in particular will be focused upon: identity, tradition, and morphology. The discussion will be illuminated by three case studies, the first of which will consider Warp Records’ relationship to narrative; the two remaining will explore the work of Autechre and Aphex Twin with some reference to the areas outlined above. The writing of Deleuze and Guattari will inform the ideas presented, with particular focus being made upon the notions of “minority”, “deterritorialisation”, and “continuous variation”. Based upon the interaction of the wider IDM “text” with existing “constants”, and its treatment of itself, the present work will conclude with the suggestion that IDM be read as a “minor” literature.

  17. Evaluation of adherence to the treatment of type 1 diabetes mellitus: Literature review

    Directory of Open Access Journals (Sweden)

    Luziane Fatima Kirchner

    2014-08-01

    Full Text Available This work aimed to identify methods, objectives and type of studies that assessed adherence to the treatment of type 1 Diabetes Mellitus, published from 2000 to 2013. We analyzed 111 articles, collected in the survey by the Web of Science database. The results indicated that 95 studies are descriptive, with prevalence of adolescents (74 studies and children (34 studies. It was also found that those studies that have prevailed: Used an informer (67 studies, the carrier of the disease who reported more data (72 studies, evaluated one (35 studies or five (25 studies treatment medical, by means of an instrument (68 studies, being standardized instruments the most used procedures in this assessment (40 studies. Data leaded to the conclusion that the methods used to assess adherence, in the studies analyzed, do not comply with the suggestions made in Literature to make the results in adherence more reliable. Discussions about this subject need to be further developed.

  18. Secukinumab in the Treatment of Psoriasis and Psoriatic Arthritis: A Review of the Literature.

    Science.gov (United States)

    Abrouk, M; Gandy, J; Nakamura, M; Lee, K; Brodsky, M; Singh, R; Zhu, H; Farahnik, B; Bhutani, T; Koo, J

    2017-07-01

    While there are several commercially available treatment options for psoriasis and psoriatic arthritis, there remains a large number of individuals who are refractory to current modalities. In the recent past, there has been increasing evidence that interleukin (IL)-17 plays a vital role in the pathophysiology of psoriasis. Preclinical, phase II, and phase III studies of secukinumab (Cosentyx®) targeting IL-17 and its receptor have thus far proved to be promising. We reviewed the results of phase II and phase III clinical trials for secukinumab in the treatment of psoriasis and psoriatic arthritis. Only published studies were considered in the present review. We also performed an English language literature search from January 2003 to September 2015 using PubMed with any of the following key words: (secukinumab OR AIN457) AND (psoriasis OR psoriatic arthritis). In our review of the literature, seven phase III and five phase II clinical trials, as well as open-label extension studies with unpublished findings were found. Results from phase III clinical trials indicated secukinumab to be efficacious and safe for the treatment of psoriasis and psoriatic arthritis according to Psoriasis Area and Severity Index (PASI) and American College of Rheumatology (ACR) scores. The safety profile of this agent was similar across all studies, with the most frequently reported adverse events of nasopharyngitis, upper respiratory infections, headache, and injection site reaction. Secukinumab demonstrates rapid and robust clinical improvement accompanied by a favorable short- term safety profile. The results of the phase III trials continue to reinforce the theory that the IL-17 pathway is an essential target in psoriasis and psoriatic arthritis treatment. Additional extension studies of lower level evidence are needed to further understand the safety profile of the drug.

  19. Selenium supplementation of Portuguese wheat cultivars through foliar treatment in actual field conditions

    International Nuclear Information System (INIS)

    Catarina Galinha; Pacheco, A.M.G.; Maria do Carmo Freitas; Jose Coutinho; Benvindo Macas; Ana Sofia Almeida

    2013-01-01

    Selenium (Se) is a trace element essential to the well-being and health quality of humankind. Plant-derived foodstuffs, namely cereals, are the major dietary sources of Se in most countries throughout the world, even if Se contents are strongly dependent upon the corresponding levels in cereal-growing soils. Therefore, wheat is one of the staple crops that appears as an obvious candidate for Se biofortification, considering its gross-tonnage production and nutritional relevance worldwide. The present paper focuses on the ability of bread and durum wheat-Triticum aestivum L. and Triticum durum Desf., respectively-to accumulate Se after supplementation via a foliar-addition procedure. Two of the most representative wheat cultivars in Portugal - Jordao (bread) and Marialva (durum) - have been selected for supplementation trials, following the same agronomic practices and field schedules as the regular (non-supplemented) crops of those varieties (sowing: November 2010; harvesting: July 2011). Foliar additions were performed at the booting and grain-filling stages, using sodium selenate and sodium selenite solutions at three different Se concentrations-equivalent to field supplementation rates of 4, 20 and 100 g of Se per ha-with and without potassium iodide. Selenium contents in wheat grains obtained under foliar application are compared to data from regular wheat samples (field blanks) grown at the same soil/season, yet devoid of any Se supplementation. Total Se in all field samples was determined by cyclic neutron activation analysis (CNAA), via the short-lived nuclide 77m Se (half-life time: 17.5 s), in the Portuguese Research Reactor (RPI; CTN-IST, Sacavem). Quality control of the analytical procedure was asserted through concurrent analyses of NIST-SRM R 1567a (Wheat Flour). Results show that foliar additions can increase Se contents in mature grains up to 15 and 40 times for Marialva and Jordao, respectively, when compared to non-supplemented crops. Jordao and

  20. Radiation Treatment for Primary Adenocarcinoma of Bartholin Gland- A Case Report and Review of Literature

    International Nuclear Information System (INIS)

    Oh, Won Yong; Whang, In Soon

    1989-01-01

    A patient with primary adenocarcinoma of Bartholin gland is reported and the literatures relevant to this disease reviewed. Not only this disease is very rare but also primary carcinomas of Bartholin gland are misdiagnosed as cysts or abscesses in half of the cases, leading to considerable delay in diagnosis. And so, It was wasted long time before definitive therapy. However, because of a different clinical behavior, cancer of the Bartholin gland should be distinguished from other vulvar carcinomas. Histologically, squamous cell carcinoma and adenocarcinoma are the most common. Virtually all histologic types of Bartholin gland carcinoma metastasize to lymph node, bone, lung and liver in distant sites. The authors data and a review of the literature support the concept that radical vulvectomy with or without bilateral inguina1-femoral lymphadenectomy is required. On the other hand, except primary radiation treatment for small or medium sized cancers, the results obtained by radiation therapy in carcinoma of the vulva including Bartholin gland are generally discouraging. A role for postoperative adjuvant radiation therapy suggests because of high incidence of positive inguinal-femoral lymph nodes. In the near time, natural history and biological behavior of Bartholin gland cancer must be disclosed in detail. And also optimal treatment modality and prognostic factors shall be determine

  1. mHealth for HIV Treatment & Prevention: A Systematic Review of the Literature

    Science.gov (United States)

    Catalani, Caricia; Philbrick, William; Fraser, Hamish; Mechael, , Patricia; Israelski, Dennis M.

    2013-01-01

    This systematic review assesses the published literature to describe the landscape of mobile health technology (mHealth) for HIV/AIDS and the evidence supporting the use of these tools to address the HIV prevention, care, and treatment cascade. The speed of innovation, broad range of initiatives and tools, and heterogeneity in reporting have made it difficult to uncover and synthesize knowledge on how mHealth tools might be effective in addressing the HIV pandemic. To do address this gap, a team of reviewers collected literature on the use of mobile technology for HIV/AIDS among health, engineering, and social science literature databases and analyzed a final set of 62 articles. Articles were systematically coded, assessed for scientific rigor, and sorted for HIV programmatic relevance. The review revealed evidence that mHealth tools support HIV programmatic priorities, including: linkage to care, retention in care, and adherence to antiretroviral treatment. In terms of technical features, mHealth tools facilitate alerts and reminders, data collection, direct voice communication, educational messaging, information on demand, and more. Studies were mostly descriptive with a growing number of quasi-experimental and experimental designs. There was a lack of evidence around the use of mHealth tools to address the needs of key populations, including pregnant mothers, sex workers, users of injection drugs, and men who have sex with men. The science and practice of mHealth for HIV are evolving rapidly, but still in their early stages. Small-scale efforts, pilot projects, and preliminary descriptive studies are advancing and there is a promising trend toward implementing mHealth innovation that is feasible and acceptable within low-resource settings, positive program outcomes, operational improvements, and rigorous study design PMID:24133558

  2. Disorders of orgasm in women: a literature review of etiology and current treatments.

    Science.gov (United States)

    Ishak, Waguih William; Bokarius, Anna; Jeffrey, Jessica K; Davis, Michael C; Bakhta, Yekaterina

    2010-10-01

    Disorders of orgasm in women, defined as the persistent or recurrent delay in or absence of orgasm, affect up to a quarter of the female population. To review existing research findings on the etiology and treatments of disorders of orgasm in women to provide a useful reference tool for clinicians who evaluate and treat patients with these conditions. PubMed and PsycINFO search for articles published between 1980 and 2009 using the keywords "orgasm*,"anorgasmia," and "female*,"woman," or "women," in addition to "female orgasmic disorder" and "disorders of orgasm in women." Findings on the etiological factors and effects of a variety of treatment interventions on improving disorders of orgasm in women. Results.  Literature on prevalence and causes of disorders of orgasm in women is abundant, yet more reports of successful treatments are needed. Nevertheless, many promising approaches have been suggested, and data support several potential treatments such as bupropion, sildenafil, estrogen, and testosterone among others. Although more research is needed to better understand and manage disorders of orgasm in women, significant progress is being made. © 2010 International Society for Sexual Medicine.

  3. Evidence-based treatment for gynoid lipodystrophy: A review of the recent literature.

    Science.gov (United States)

    Pérez Atamoros, Francisco M; Alcalá Pérez, Daniel; Asz Sigall, Daniel; Ávila Romay, Alfonsina A; Barba Gastelum, José A; de la Peña Salcedo, José A; Escalante Salgado, Pablo E; Gallardo Palacios, Guillermo J; Guerrero-Gonzalez, Guillermo A; Morales De la Cerda, Rodrigo; Ponce Olivera, Rosa María; Rossano Soriano, Fabiola; Solís Tinoco, Eduardo; Welsh Hernández, Esperanza C

    2018-04-30

    Gynoid lipodystrophy (GLD) is a structural, inflammatory, and biochemical disorder of the subcutaneous tissue causing alterations in the topography of the skin. Commonly known as "cellulite," GLD affects up to 90% of women, practically in all stages of the life cycle, beginning in puberty. It is a clinical condition that considerably affects the patients' quality of life. It is a frequent reason for consultation, although the patients resort to empirical, improvised, nonevidence-based treatments which discourage and can be a source of frustration not only because of the lack of results but also due to the complications derived from those treatments. In this article, a panel of experts from different specialties involved in the management of this clinical skin disorder presents the results of a systematic literature search and of the consensus discussion of the evidence obtained from different treatments currently available. The analysis was divided into topical, systemic, noninvasive, and minimally invasive treatments. © 2018 The Authors. Journal of Cosmetic Dermatology Published by Wiley Periodicals, Inc.

  4. Topiramate in the treatment of substance related disorders: a critical review of the literature

    Science.gov (United States)

    Shinn, Ann K.; Greenfield, Shelly F.

    2013-01-01

    Objective To critically review the literature on topiramate in the treatment of substance related disorders. Data Sources A PubMed search of human studies published in English through January 2009. Study Selection 26 articles were identified and reviewed; these studies examined topiramate in disorders related to alcohol, nicotine, cocaine, methamphetamine, opioids, ecstasy, and benzodiazepines. Data Extraction Study design, sample size, topiramate dose and duration, and study outcomes were reviewed. Data Synthesis There is compelling evidence for the efficacy of topiramate in the treatment of alcohol dependence. Two trials show trends for topiramate’s superiority over oral naltrexone in alcohol dependence, while one trial suggests topiramate is inferior to disulfiram. Despite suggestive animal models, evidence for topiramate in treating alcohol withdrawal in humans is slim. Studies of topiramate in nicotine dependence show mixed results. Human laboratory studies that used acute topiramate dosing show that topiramate actually enhances the pleasurable effects of both nicotine and methamphetamine. Evidence for topiramate in the treatment of cocaine dependence is promising, but limited by small sample size. The data on opioids, benzodiazepines, and ecstasy are sparse. Conclusion Topiramate is efficacious for the treatment of alcohol dependence, but side effects may limit widespread use. While topiramate’s unique pharmacodynamic profile offers a promising theoretical rationale for use across multiple substance related disorders, heterogeneity both across and within these disorders limits topiramate’s broad applicability in treating substance related disorders. Recommendations for future research include exploration of genetic variants for more targeted pharmacotherapies. PMID:20361908

  5. The Effects of Source Water Quality on Drinking Water Treatment Costs: A Review and Synthesis of Empirical Literature - Ecological Economics

    Science.gov (United States)

    Watershed protection, and associated in situ water quality improvements, has received considerable attention as a means of mitigating health risks and avoiding expenditures at drinking water treatment plants (DWTPs). This study reviews the extant cost function literature linking ...

  6. The Effects of Source Water Quality on Drinking Water Treatment Costs: A Review and Synthesis of Empirical Literature - slides

    Science.gov (United States)

    Watershed protection, and associated in situ water quality improvements, has received considerable attention as a means of mitigating health risks and avoiding expenditures at drinking water treatment plants (DWTPs). In this presentation, we review the literature linking raw wate...

  7. Treatment of an adrenomyeloneuropathy patient with Lorenzo's oil and supplementation with docosahexaenoic acid-A case report

    Directory of Open Access Journals (Sweden)

    Bergh Jacobus J

    2011-08-01

    Full Text Available Abstract This is a case report of adrenomyeloneuropathy (AMN, the adult variant of adrenoleukodystryphy (ALD. The diagnoses in the patient, aged 34, was confirmed via increased serum very long chain fatty acid concentration (VLCFA. Treatment started with the cholesterol lowering drug, atorvastatin, followed by add-on therapy with Lorenzo's oil (LO and finally supplementation with docosahexaenoic acid (DHA. The magnetic resonance imaging (MRI scan of the AMN patient before DHA treatment, already showed abnormal white matter in the brain. Although the MRI showed no neurological improvement after 6 months of DHA treatment, no selective progression of demyelination was detected in the AMN patient. Contrary to what was expected, LO failed to sustain or normalize the VLCFA levels or improve clinical symptoms. It was however, shown that DHA supplementation in addition to LO, increased DHA levels in both plasma and red blood cells (RBC. Additionally, the study showed evidence that the elongase activity in the elongation of eicosapentaenoic acid (EPA to docosapentaenoic acid (DPA might have been significantly compromised, due to the increased DHA levels.

  8. A Novel Treatment Decision Tree and Literature Review of Retrograde Peri-Implantitis.

    Science.gov (United States)

    Sarmast, Nima D; Wang, Howard H; Soldatos, Nikolaos K; Angelov, Nikola; Dorn, Samuel; Yukna, Raymond; Iacono, Vincent J

    2016-12-01

    Although retrograde peri-implantitis (RPI) is not a common sequela of dental implant surgery, its prevalence has been reported in the literature to be 0.26%. Incidence of RPI is reported to increase to 7.8% when teeth adjacent to the implant site have a previous history of root canal therapy, and it is correlated with distance between implant and adjacent tooth and/or with time from endodontic treatment of adjacent tooth to implant placement. Minimum 2 mm space between implant and adjacent tooth is needed to decrease incidence of apical RPI, with minimum 4 weeks between completion of endodontic treatment and actual implant placement. The purpose of this study is to compile all available treatment modalities and to provide a decision tree as a general guide for clinicians to aid in diagnosis and treatment of RPI. Literature search was performed for articles published in English on the topic of RPI. Articles selected were case reports with study populations ranging from 1 to 32 patients. Any case report or clinical trial that attempted to treat or rescue an implant diagnosed with RPI was included. Predominant diagnostic presentation of a lesion was presence of sinus tract at buccal or facial abscess of apical portion of implant, and subsequent periapical radiographs taken demonstrated a radiolucent lesion. On the basis of case reports analyzed, RPI was diagnosed between 1 week and 4 years after implant placement. Twelve of 20 studies reported that RPI lesions were diagnosed within 6 months after implant placement. A step-by-step decision tree is provided to allow clinicians to triage and properly manage cases of RPI on the basis of recommendations and successful treatments provided in analyzed case reports. It is divided between symptomatic and asymptomatic implants and adjacent teeth with vital and necrotic pulps. Most common etiology of apical RPI is endodontic infection from neighboring teeth, which was diagnosed within 6 months after implant placement. Most

  9. Endovascular Treatment of Active Splenic Bleeding After Colonoscopy: A Systematic Review of the Literature

    International Nuclear Information System (INIS)

    Corcillo, Antonella; Aellen, Steve; Zingg, Tobias; Bize, Pierre; Demartines, Nicolas; Denys, Alban

    2013-01-01

    Purpose: Colonoscopy is reported to be a safe procedure that is routinely performed for the diagnosis and treatment of colorectal diseases. Splenic rupture is considered to be a rare complication with high mortality and morbidity that requires immediate diagnosis and management. Nonoperative management (NOM), surgical treatment (ST), and, more recently, proximal splenic artery embolization (PSAE) have been proposed as treatment options. The goal of this study was to assess whether PSAE is safe even in high-grade ruptures. Methods: We report two rare cases of post colonoscopy splenic rupture. A systematic review of the literature from 2002 to 2010 (first reported case of PSAE) was performed and the three types of treatment compared. Results: All patients reviewed (77 of 77) presented with intraperitoneal hemorrhage due to isolated splenic trauma. Splenic rupture was high-grade in most patients when grading was possible. Six of 77 patients (7.8 %) were treated with PSAE, including the 2 cases reported herein. Fifty-seven patients (74 %) underwent ST. NOM was attempted first in 25 patients with a high failure rate (11 of 25 [44 %]) and requiring a salvage procedure, such as PSAE or ST. Previous surgery (31 of 59 patients), adhesions (10 of 13), diagnostic colonoscopies (49 of 71), previous biopsies or polypectomies (31 of 57) and female sex (56 of 77) were identified as risk factors. In contrast, splenomegaly (0 of 77 patients), medications that increase the risk of bleeding (13 of 30) and difficult colonoscopies (16 of 51) were not identified as risk factors. PSAE was safe and effective even in elderly patients with comorbidities and those taking medications that increase the risk of bleeding, and the length of the hospital stay was similar to that after ST. Conclusion: We propose a treatment algorithm based on clinical and radiological criteria. Because of the high failure rate after NOM, PSAE should be the treatment of choice to manage grade I through IV splenic

  10. Endovascular Treatment of Active Splenic Bleeding After Colonoscopy: A Systematic Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Corcillo, Antonella, E-mail: antonella.corcillo@chuv.ch [Centre Hospitalier Universitaire Vaudois (CHUV), Departement de Medecine Interne (Switzerland); Aellen, Steve, E-mail: steve.aellen@hopitalvs.ch; Zingg, Tobias [Centre Hospitalier Universitaire Vaudois (CHUV), Service de Chirurgie Viscerale (Switzerland); Bize, Pierre [Centre Hospitalier Universitaire Vaudois (CHUV), Departement de Radiologie Interventionnelle (Switzerland); Demartines, Nicolas [Centre Hospitalier Universitaire Vaudois (CHUV), Service de Chirurgie Viscerale (Switzerland); Denys, Alban [Centre Hospitalier Universitaire Vaudois (CHUV), Departement de Radiologie Interventionnelle (Switzerland)

    2013-10-15

    Purpose: Colonoscopy is reported to be a safe procedure that is routinely performed for the diagnosis and treatment of colorectal diseases. Splenic rupture is considered to be a rare complication with high mortality and morbidity that requires immediate diagnosis and management. Nonoperative management (NOM), surgical treatment (ST), and, more recently, proximal splenic artery embolization (PSAE) have been proposed as treatment options. The goal of this study was to assess whether PSAE is safe even in high-grade ruptures. Methods: We report two rare cases of post colonoscopy splenic rupture. A systematic review of the literature from 2002 to 2010 (first reported case of PSAE) was performed and the three types of treatment compared. Results: All patients reviewed (77 of 77) presented with intraperitoneal hemorrhage due to isolated splenic trauma. Splenic rupture was high-grade in most patients when grading was possible. Six of 77 patients (7.8 %) were treated with PSAE, including the 2 cases reported herein. Fifty-seven patients (74 %) underwent ST. NOM was attempted first in 25 patients with a high failure rate (11 of 25 [44 %]) and requiring a salvage procedure, such as PSAE or ST. Previous surgery (31 of 59 patients), adhesions (10 of 13), diagnostic colonoscopies (49 of 71), previous biopsies or polypectomies (31 of 57) and female sex (56 of 77) were identified as risk factors. In contrast, splenomegaly (0 of 77 patients), medications that increase the risk of bleeding (13 of 30) and difficult colonoscopies (16 of 51) were not identified as risk factors. PSAE was safe and effective even in elderly patients with comorbidities and those taking medications that increase the risk of bleeding, and the length of the hospital stay was similar to that after ST. Conclusion: We propose a treatment algorithm based on clinical and radiological criteria. Because of the high failure rate after NOM, PSAE should be the treatment of choice to manage grade I through IV splenic

  11. Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review.

    Science.gov (United States)

    Warkentin, Theodore E; Pai, Menaka; Linkins, Lori-Ann

    2017-08-31

    Direct oral anticoagulants (DOACs) are attractive options for treatment of heparin-induced thrombocytopenia (HIT). We report our continuing experience in Hamilton, ON, Canada, since January 1, 2015 (when we completed our prospective study of rivaroxaban for HIT), using rivaroxaban for serologically confirmed HIT (4Ts score ≥4 points; positive platelet factor 4 [PF4]/heparin immunoassay, positive serotonin-release assay). We also performed a literature review of HIT treatment using DOACs (rivaroxaban, apixaban, dabigatran, edoxaban). We focused on patients who received DOAC therapy for acute HIT as either primary therapy (group A) or secondary therapy (group B; initial treatment using a non-DOAC/non-heparin anticoagulant with transition to a DOAC during HIT-associated thrombocytopenia). Our primary end point was occurrence of objectively documented thrombosis during DOAC therapy for acute HIT. We found that recovery without new, progressive, or recurrent thrombosis occurred in all 10 Hamilton patients with acute HIT treated with rivaroxaban. Data from the literature review plus these new data identified a thrombosis rate of 1 of 46 patients (2.2%; 95% CI, 0.4%-11.3%) in patients treated with rivaroxaban during acute HIT (group A, n = 25; group B, n = 21); major hemorrhage was seen in 0 of 46 patients. Similar outcomes in smaller numbers of patients were observed with apixaban (n = 12) and dabigatran (n = 11). DOACs offer simplified management of selected patients, as illustrated by a case of persisting (autoimmune) HIT (>2-month platelet recovery with inversely parallel waning of serum-induced heparin-independent serotonin release) with successful outpatient rivaroxaban management of HIT-associated thrombosis. Evidence supporting efficacy and safety of DOACs for acute HIT is increasing, with the most experience reported for rivaroxaban. © 2017 by The American Society of Hematology.

  12. Appendix F: Supplemental Risk Management Program Guidance for Wastewater Treatment Plants

    Science.gov (United States)

    Detail for wastewater treatment plants (WWTPs), including publicly owned treatment works (POTWs) and other industrial treatment systems, on complying with part 68 with respect to chlorine, ammonia (anhydrous and aqueous), sulfur dioxide, and digester gas.

  13. Patients' experiences of dental implant treatment: A literature review of key qualitative studies.

    Science.gov (United States)

    Kashbour, W A; Rousseau, N S; Ellis, J S; Thomason, J M

    2015-07-01

    To identify and summarise the findings of previous qualitative studies relating to patients' experience of dental implant treatment (DIT) at various stages of their implant treatment, by means of textual narrative synthesis. Original articles reporting patients' experience with dental implant were included. A two-stage search of the literature, electronic and hand search identified relevant qualitative studies up to July 2014. An extensive electronic search was conducted of databases including PubMed, Embase, Scopus, Web of Knowledge, Cochrane Database and Google Scholar. Included primary studies (n=10) used qualitative research methods and qualitative analysis to investigate patients' experiences with dental implants treatment. While the growing interest in implant treatment for the replacement of missing dentition is evident, it is essential to investigate patients' perceptions of different aspects of implant treatment. This textual narrative synthesis conducted to review qualitative studies which provided insight into patients' experience of two types of implant prostheses namely ISOD (implant-supported overdenture) and FISP (fixed implant supported prostheses). Primary reviewed studies tended to include samples of older patients with more extensive tooth loss, and to focus on experiences prior to and post-treatment rather than on the treatment period itself. Findings across reviewed studies (n=10) suggested that patients with FISP thought of implant treatment as a process of 'normalisation'(1) and believed that such implant restorations could be similar to natural teeth, whereas patients with ISOD focused more on the functional and social advantages of their implant treatment. The growing interest in qualitative research is evident in several branches of clinical dentistry and dental implantology is not an exception. Qualitative studies concerning the patients account of their experience of dental implants is however limited. The aim of this review is to

  14. Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm.

    Science.gov (United States)

    Baumbach, Sebastian F; Lobo, Christopher M; Badyine, Ilias; Mutschler, Wolf; Kanz, Karl-Georg

    2014-03-01

    Olecranon bursitis and prepatellar bursitis are common entities, with a minimum annual incidence of 10/100,000, predominantly affecting male patients (80 %) aged 40-60 years. Approximately 1/3 of cases are septic (SB) and 2/3 of cases are non-septic (NSB), with substantial variations in treatment regimens internationally. The aim of the study was the development of a literature review-based treatment algorithm for prepatellar and olecranon bursitis. Following a systematic review of Pubmed, the Cochrane Library, textbooks of emergency medicine and surgery, and a manual reference search, 52 relevant papers were identified. The initial differentiation between SB and NSB was based on clinical presentation, bursal aspirate, and blood sampling analysis. Physical findings suggesting SB were fever >37.8 °C, prebursal temperature difference greater 2.2 °C, and skin lesions. Relevant findings for bursal aspirate were purulent aspirate, fluid-to-serum glucose ratio 3,000 cells/μl, polymorphonuclear cells >50 %, positive Gram staining, and positive culture. General treatment measures for SB and NSB consist of bursal aspiration, NSAIDs, and PRICE. For patients with confirmed NSB and high athletic or occupational demands, intrabursal steroid injection may be performed. In the case of SB, antibiotic therapy should be initiated. Surgical treatment, i.e., incision, drainage, or bursectomy, should be restricted to severe, refractory, or chronic/recurrent cases. The available evidence did not support the central European concept of immediate bursectomy in cases of SB. A conservative treatment regimen should be pursued, following bursal aspirate-based differentiation between SB and NSB.

  15. Psychotropic treatments in Prader-Willi syndrome: a critical review of published literature.

    Science.gov (United States)

    Bonnot, O; Cohen, D; Thuilleaux, D; Consoli, A; Cabal, S; Tauber, M

    2016-01-01

    Prader-Willi syndrome (PWS) is a rare genetic syndrome. The phenotype includes moderate to intellectual disability, dysmorphia, obesity, and behavioral disturbances (e.g., hetero and self-injurious behaviors, hyperphagia, psychosis). Psychotropic medications are widely prescribed in PWS for symptomatic control. We conducted a systematic review of published literature to examine psychotropic medications used in PWS. MEDLINE was searched to identify articles published between January 1967 and December 2014 using key words related to pharmacological treatments and PWS. Articles with original data were included based on a standardized four-step selection process. The identification of studies led to 241 records. All selected articles were evaluated for case descriptions (PWS and behavioral signs) and treatment (type, titration, efficiency, and side effects). Overall, 102 patients were included in these studies. Treatment involved risperidone (three reports, n = 11 patients), fluoxetine (five/n = 6), naltrexone (two/n = 2), topiramate (two/n = 16), fluvoxamine (one/n = 1), mazindol (one/n = 2), N-acetyl cysteine (one/n = 35), rimonabant (one/n = 15), and fenfluramine (one/n = 15). We identified promising treatment effects with topiramate for self-injury and impulsive/aggressive behaviors, risperidone for psychotic symptoms associated with uniparental disomy (UPD), and N-acetyl cysteine for skin picking. The pharmacological approach of behavioral impairment in PWS has been poorly investigated to date. Further randomized controlled studies are warranted. Behavioral disturbances in Prader-Willi syndrome including aggressive reactions, skin picking, and hyperphagia might be very difficult to manage. Antipsychotic drugs are widely prescribed, but weight gain and increased appetite are their major side effects. Topiramate might be efficient for self-injury and impulsive/aggressive behaviors, N-acetyl cysteine is apromising treatment for

  16. Relationship between treatment adherence and quality of life: integrative literature review

    Directory of Open Access Journals (Sweden)

    Samilly Márjore Dantas Liberato

    2014-03-01

    Full Text Available The objective of the present study is to investigate the relationships between treatment adherence and quality of life that have been published in scientific literature. This is an integrative review performed on the Virtual Health Library database, SCOPUS, ISI Web of Knowledge and CINAHL, including articles published in the period between 2007 and 2012. Considering the inclusion and exclusion criterion, 14 articles were selected. Most articles studied adults (61.5% with evidence level VI (69.2%. The number of participants involved in the studies ranged between 25 and 1,860. All studies were on chronic diseases. Of all articles, 69.2% of the studies found a significant relationship between treatment adhesion and quality of life. The studies pointed at a relationship between treatment adherence and quality of life, but it was not possible to determine the causality of the phenomenon. Including the studies that found no statistical significance, the referred relationships proved positive. Descriptors: Patient Compliance; Quality of Life; Comprehensive Health Care.

  17. Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class.

    Science.gov (United States)

    Jansen, T T G; Timmers, H J L M; Marres, H A M; Kaanders, J H A M; Kunst, H P M

    2018-04-01

    Key for successful jugulotympanic paraganglioma management is a personalised approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control and complication rates for the different treatment modalities stratified by the broadly accepted Fisch classification. A systematic literature review according to the PRISMA statement was performed. A detailed overview of individual treatment outcomes per Fisch class is provided. Local control, cranial nerve damage, complications, function recovery. Eighteen studies were selected, resembling 83 patients treated with radiotherapy and 299 with surgery. Excellent local control was found post-surgery for class A and B tumours, and risk of cranial nerve damage was class C1-4 tumours, local control was 80%-95% post-surgery (84% post-radiotherapy), and cranial nerve damage was found in 71%-76% (none post-radiotherapy; P class. For class C1-4De/Di tumours, local control was 38%-86% (98% post-radiotherapy; P class. For class A and B tumours, surgery is a suitable treatment option. For class C and D tumours, radiotherapy results in lower complication rates and similar or better local control rates when compared to the surgical group. © 2017 John Wiley & Sons Ltd.

  18. [Pharmacological Treatment of Apathy in Parkinson's Disease: a Systematic Review of the Literature].

    Science.gov (United States)

    Holguín Lew, Jorge Carlos; Caamaño Jaraba, Jessica; Gómez Alzate, Alejandra; Hidalgo López, Catalina; Marino Mondragón, Daniel Felipe; Restrepo Moreno, Sebastián; Rico Abella, Liz Evelin

    2017-10-01

    Apathy, defined as a deficit for initiating and maintaining action, is a symptom affecting patients with diverse psychiatric and neuropsychiatric diseases, including dementia, sequelae of traumatic brain injury, schizophrenia, depression, and Parkinson's disease (PD). Apathy negatively affects function and quality of life of PD patients, and it is an important cause of caregiver's distress. The pharmacological treatment of apathy in PD is the focus of this systematic review. A comprehensive search and systematic selection was performed in different databases of original research papers on the treatment of apathy in PD. The results were then consolidated, and a critical analysis was made of the research papers. The results are then discussed according to the methodological standards for systematic reviews of the literature. A total of 11 studies were included. Although some studies showed efficacy, all of them had important methodological limitations that hampered the interpretation of results. The results of the examined studies cannot be considered as evidence for guiding clinical decisions. So far, no evidence-based recommendations can be offered for the treatment of apathy in PD. More studies with better methodological quality are needed. It is a potentially fruitful area for research and one badly needed by both PD patients and their caregivers. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  19. Luminally Acting Agents for Constipation Treatment: A Review Based on Literatures and Patents

    Directory of Open Access Journals (Sweden)

    Hong Yang

    2017-06-01

    Full Text Available Constipation is one of the most frequently reported gastrointestinal (GI disorders that negatively impacts quality of life and is associated with a significant economic burden to the patients and society. Traditional treatments including lifestyle modification and laxatives are often ineffective in the more severe forms of constipation and over the long term. New medications targeting at intestinal chloride channels and colonic serotonin receptors have been demonstrated effective in recent years. Emerging agents focusing on improving intestinal secretion and/or colonic motility have been shown effective in animal models and even in clinical trials. Recognization of the role of cystic fibrosis transmembrane regulator (CFTR and calcium-activated chloride channels (CaCCs in intestine fluid secretion and motility modulation makes CFTR and CaCCs promising molecule targets for anti-constipation therapy. Although there are multiple choices for constipation treatment, there is still a recognized need for new medications in anti-constipation therapy. The present review covers the discovery of luminally acting agents for constipation treatment described in both patents (2011–present and scientific literatures.

  20. Retention in methadone maintenance treatment in mainland China, 2004-2012: a literature review.

    Science.gov (United States)

    Zhou, Kaina; Zhuang, Guihua

    2014-01-01

    Methadone maintenance treatment (MMT) was implemented in mainland China since 2004. Numerous individual studies have investigated MMT retention but the overview still remains unclear. The aim of the study was to review MMT retention rates and predicting factors in mainland China during 2004-2012. Chinese and English databases of literature were searched for studies reporting on retention rates and predicting factors in non-transfer MMT patients of fixed-site clinics in mainland China (2004-2012). Qualitative methods were used to synthesize the results. Nineteen studies were eligible for review, with sample size ranging from 29 to 3758. Retention rates varied between 30.0% at 6 months in Shanghai and 70.3% at 12 months in Xi'an. Predicting factors were non-treatment including sociodemographics (n=14), support system and social function (n=9), economic status (n=2) and psychological status (n=1), and treatment-related including drug use (n=15), methadone use (n=12), MMT clinics (n=9), MMT participation (n=7), awareness on MMT (n=5) and HIV serostatus (n=3). Methadone dose (n=12) and age (n=7) were the first two important specific factors. In mainland China, MMT retention rates are heterogeneous and relatively lower, and predicting factors mainly focus on objective aspects. Future work should further explore subjective predicting factors regarding MMT retention. © 2013.

  1. Omalizumab in the treatment of chronic spontaneous urticaria – literature review and own experience

    Directory of Open Access Journals (Sweden)

    Joanna Dawicka

    2016-02-01

    Full Text Available Chronic urticaria is a condition characterized by the appearance of wheals and/or angioedema that last for at least 6 weeks. According to the recent recommendations, if H1-antihistamines used in four times licensed doses remain ineffective, add-on treatment with omalizumab, cyclosporine A or montelukast should be applied. This paper offers a literature review of the studies on using omalizumab in chronic spontaneous urticaria (CSU treatment. Moreover, it presents our own experience with the use of omalizumab in the treatment of two patients with CSU. Both patients were treated with H1-antihistamines in four times licensed doses recommended by European guidelines, oral corticosteroids, montelukast, and methotrexate – all without satisfactory results. During the time of the omalizumab therapy both patients achieved a significant improvement measured by the decrease in the Average Urticaria Activity Score for 7 days (UAS7 – the first patient from 34 to 11.8 points, the second one from 41 to 5.76.

  2. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment.

    Science.gov (United States)

    Tanalp, J; Güngör, T

    2014-03-01

    Extrusion of intracanal debris as well as irrigants is a common occurrence during root canal treatment, and no instrument or technique has thoroughly solved this problem. Because flare-ups may arise with any irritation directed towards periapical tissues, a shaping or irrigation technique should minimize the risk of apical extrusion, even though it may not be prevented. There has been a rapid evolution of root canal instruments and irrigation systems through the last decade, and many have been assessed for their debris extrusion potential. The purpose of this review was to identify publications regarding the evaluation of debris, bacteria and irrigant extrusion during root canal treatment. A PubMed, Ovid and MEDLINE search was conducted using the keywords "apical extrusion", "debris extrusion" and "endodontic treatment". The literature search extended over a period of more than 30 years up to 2012. Content of the review was limited to apical extrusion of debris and irrigants, extrusion of liquid by irrigation methods and bacterial extrusion. Issues relevant to apical extrusion were obtained by further search in the reference sections of the retrieved articles. The review provides an update on the current status of apical extrusion. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  3. Bone metastases only pure seminoma, evolution and treatment. Literature review and report of a clinical case

    International Nuclear Information System (INIS)

    Vázquez, A.; Cuello, M.; Terzieff, V.; Viola, A.

    2004-01-01

    The only bone metastases in pure seminoma is a biological entity extremely rare. We report a case studied since 2000, treatment and outcome. Case report: 35. Orquiectomizado in September 2000 AP: pure seminoma in the presence of a neoplastic nodule in the spermatic cord.Adjuvant lumboaorticas, left iliac and inguinal chains Rt., 3060 cGy in 3.2 sem. until December 2000 Normal tumor markers throughout the period. In Oct. 2001 TAC control morfoestructural altered posterior the sixth left costal arch. AP: puncture under TAC. Malignant germ cell tumor compatible with pure seminoma. C.O. single lesion. MDT is performed based on PEB for 4 cycles and additional RT obtaining a complete response with reduction bone lesion, asymptomatic until November 2002, again at the level falls costal, VIP x 3 New relapse dorsal paravertebral June 2003, Gemcitabine and Rt paclitaxel, dose intensification transplant. Keeps score high. Poor prognosis. Discussion: In the literature we found no reports of bone lesions only secondary to a pure seminoma. They are described in the context of a frame overall spread in advanced patients and in more than three or four including accompanying synchronous nodal, liver and lung damage. Subsequent developments mark the disease resistance to treatments performed. The three lines are Qt prior to transplantation have shown that best results for the treatment of disease. We discuss the time introduction thereof to obtain a durable complete response. If the marker not normalized but not displayed clinical or paraclinical disease prognosis is bad in the short term

  4. Successful treatment with tacrolimus in TAFRO syndrome: two case reports and literature review.

    Science.gov (United States)

    Shirai, Taiichiro; Onishi, Akira; Waki, Daisuke; Saegusa, Jun; Morinobu, Akio

    2018-06-01

    TAFRO syndrome is a systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly. In contrast to that in multicentric Castleman disease, interleukin-6 targeting strategies seem ineffective in some TAFRO syndrome cases; however, the optimal treatment remains unclear. Here, we report 2 cases of TAFRO syndrome, where 1 with cardiomyopathy, successfully treated with tacrolimus. This is the first case report of successful treatment with tacrolimus in TAFRO syndrome. Both patients (cases 1 and 2) developed fever, anasarca, thrombocytopenia, renal dysfunction, and mild hepatosplenomegaly. In both patients, lymph node pathology revealed mixed type Castleman disease-like features, and bone marrow showed reticulin myelofibrosis. TAFRO syndrome was diagnosed based on the patients' laboratory, clinical, and pathologic findings. In case 2, we observed a rare complication of cardiomyopathy with no evidence of takotsubo cardiomyopathy or viral myocarditis. In case 1, tocilizumab combined with glucocorticoids was ineffective and caused septic shock; additionally, cyclosporine A was discontinued because of hepatotoxicity. However, tacrolimus was effective in resolving TAFRO syndrome without any adverse events. In case 2, tacrolimus completely reversed TAFRO syndrome and was also effective in cardiomyopathy. This report suggests that tacrolimus is potentially effective and safe as an initial treatment and a glucocorticoid-sparing agent. Our literature review shows that calcineurin inhibitors, including tacrolimus, may be effective in TAFRO syndrome. Since previous studies indicate a role of Th1 inflammation in TAFRO syndrome pathogenesis, tacrolimus may, therefore, be effective in treating TAFRO syndrome.

  5. Factors associated with dropout from treatment for eating disorders: a comprehensive literature review

    Directory of Open Access Journals (Sweden)

    Tomba Elena

    2009-10-01

    Full Text Available Abstract Background Dropout (DO is common in the treatment of eating disorders (EDs, but the reasons for this phenomenon remain unclear. This study is an extensive review of the literature regarding DO predictors in EDs. Methods All papers in PubMed, PsycINFO and Cochrane Library (1980-2009 were considered. Methodological issues and detailed results were analysed for each paper. After selection according to inclusion criteria, 26 studies were reviewed. Results The dropout rates ranged from 20.2% to 51% (inpatient and from 29% to 73% (outpatient. Predictors of dropout were inconsistent due to methodological flaws and limited sample sizes. There is no evidence that baseline ED clinical severity, psychiatric comorbidity or treatment issues affect dropout. The most consistent predictor is the binge-purging subtype of anorexia nervosa. Good evidence exists that two psychological traits (high maturity fear and impulsivity and two personality dimensions (low self-directedness, low cooperativeness are related to dropout. Conclusion Implications for clinical practice and areas for further research are discussed. Particularly, these results highlight the need for a shared definition of dropout in the treatment of eating disorders for both inpatient and outpatient settings. Moreover, the assessment of personality dimensions (impulse control, self-efficacy, maturity fear and others as liability factors for dropout seems an important issue for creating specific strategies to reduce the dropout phenomenon in eating disorders.

  6. Treatment patterns of youth with bipolar disorder: results from the National Comorbidity Survey-Adolescent Supplement (NCS-A).

    Science.gov (United States)

    Khazanov, Gabriela Kattan; Cui, Lihong; Merikangas, Kathleen Ries; Angst, Jules

    2015-02-01

    Despite growing evidence that bipolar disorder often emerges in adolescence, there are limited data regarding treatment patterns of youth with bipolar disorder in community samples. Our objective was to present the prevalence and clinical correlates of treatment utilization for a nationally representative sample of US adolescents with bipolar disorder. Analyses are based on data from the National Comorbidity Survey-Adolescent Supplement, a face-to-face survey of 10,123 adolescents (ages 13-18) identified in household and school settings. We found that of adolescents meeting DSM-IV criteria for bipolar I or II disorder (N = 250), 49 % were treated for depression or mania, 13 % were treated for conditions other than depression or mania, and 38 % did not report receiving treatment. Treatment for depression or mania was associated with increased rates of suicide attempts, as well as greater role disability and more comorbid alcohol use relative to those who had not received treatment. Treated adolescents had triple the rate of ADHD and double the rates of behavior disorders than those without treatment. Our findings demonstrate that a substantial proportion of youth with bipolar disorder do not receive treatment, and of those who do, many receive treatment for comorbid conditions rather than for their mood-related symptoms. Treatment was more common among youth with severe manifestations and consequences of bipolar disorder and those with behavior problems. These trends highlight the need to identify barriers to treatment for adolescents with bipolar disorder and demonstrate that those in treatment are not representative of youth with bipolar disorder in the general population.

  7. [Conservative treatment of nonspecific, chronic low back pain : Evidence of the efficacy - a systematic literature review].

    Science.gov (United States)

    Bredow, J; Bloess, K; Oppermann, J; Boese, C K; Löhrer, L; Eysel, P

    2016-07-01

    Non-specific chronic low back pain (NSCLBP): Which conservative therapy shows an evident effectiveness - A review of the current literature. Our results are based on literature reviews of current randomised control studies, reviews and meta-analysis drawn from the Cochrane Library and Medline-Database between the years 2004 until 2015. German and English Studies were included. We focused on different conservative Treatments of NSCLBP, which are listed at, the NVL-Guidelines. Based on the given evidence we evaluated their effectiveness. As part of the review we identified 4657 Publications, 85 were included in this study. Therapeutic options such as bed rest, TENS, Massage, Spine Supports, Back Schools and Antidepressants showed no evident effectiveness. Injections, NSAR analgesic therapy, Thermotherapy and Opioid analgesic therapy indicated a short-time effectiveness. A long term success (> 6 weeks) however, can not be shown. Only the Movement therapy can, in the summation of the included studies, postulate an evident (Evidence Level I) long-term effect treating NSCLBP. Only a few therapy options indicate a significant evident effectiveness for treating NSCLBP conservatively. At short notice methods such as injection therapy, thermo-therapy and analgesic therapies with NSAR and/or opioids help coping the acute phase. In the long term only movement therapy seems to provide an evident effectiveness. In the case of therapy-refractory NSCLBP a multimodal therapy should be considered.

  8. Thermoradiation treatment of sewage sludge using reactor waste to obtain acceptable fertilizer or animal supplement feed

    International Nuclear Information System (INIS)

    Sivinski, H.D.

    1976-01-01

    This document is a report of the Beneficial Uses Program. This program consists of a number of activities at Sandia Laboratories to develop the necessary technology for cost-beneficial use of a maximum amount of radioactive waste. Major activity is currently concentrated in the Waste Resources Utilization Program which has as its objective the use of cesium-134/137 as a gamma radiation source, coupled with modest heating, to treat sewage sludge to rid it of pathogenic organisms so that it may safely be used as a fertilizer or a feed supplement for ruminant animals. (author)

  9. Vitamin D supplementation for treatment of seasonal affective symptoms in healthcare professionals

    DEFF Research Database (Denmark)

    Frandsen, Tenna Bloch; Pareek, Manan; Hansen, Jens Peter

    2014-01-01

    BACKGROUND: Low serum 25-hydroxyvitamin D levels (25(OH)D) have been associated with a higher likelihood of seasonal affective disorder (SAD) and poor mental well-being, yet firm evidence for either remains lacking. Thus, vitamin D supplementation may alleviate symptoms associated with SAD. METHODS...... for the Hamilton Depression Rating Scale, Seasonal Affective Disorders (SIGH-SAD). The secondary outcome was World Health Organization-Five Well-Being Index (WHO-5) of the healthcare professionals during the winter period and the exploratory outcome measures were weight, waist circumference, blood pressure...

  10. The use of magnetic fields in treatment of patients with rheumatoid arthritis. Review of the literature

    Directory of Open Access Journals (Sweden)

    Jolanta Zwolińska

    2016-10-01

    Full Text Available Magnetic fields are commonly used in therapies designed for subjects with rheumatic diseases, yet the effects of magnetotherapy are not entirely clear in these disorders. This study is designed to examine the literature investigating applications of magnetotherapy in the treatment of rheumatoid arthritis (RA. The review focused on publications related to administering magnetotherapy in patients with RA. The databases Science Direct, SpringerLink, Medline, PubMed, and Polska Bibliografia Lekarska were searched for reports published since 2005. Despite the numerous reports showing an impact of magnetic field in subjects with RA, the effectiveness of magnetotherapy has not been explicitly confirmed. Given the above, further research appears to be necessary to clarify the impact of magnetic fields on biological systems, and the relationship between magnetic field intensity and the obtained results as well as their durability. The majority of clinical trials have failed to identify any undesirable outcomes or side effects of this physical therapeutic factor.

  11. Treatment of refractory chest angina with spinal electrical stimulator: literature review

    International Nuclear Information System (INIS)

    Gomezese, Omar F; Paola, Aranda; Echeverria, Luis E; Saibi, Jose F; Calderon, Jaime; Barrera, Juan G

    2008-01-01

    There is a group of patients with chronic refractory chest angina, who are not ideal candidates for surgical or percutaneous revascularization and who although having a good medical handling continues to experience severe episodes of angina. The spinal electrical stimulator is a neuromodulators used as an alternative to treat these patients. The objective is to realize a review of scientific literature regarding the spinal electric stimulation in the treatment of chest angina, its mechanism of action, benefits and its cost effectiveness. Materials and methods: using the Cochrane methodology, a search of articles published from January 1980 to January 2007 in Medline using the terms spinal cord stimulation, was realized. The papers considered most pertinent were selected. Conclusions: the anti-ischemic effect of the electrical spinal stimulator reduces the episodes of chest angina, improves the quality of life and the tolerance to exercise, diminishes the hospital stay and delays the appearance of ischemic signs

  12. The use of magnetic fields in treatment of patients with rheumatoid arthritis. Review of the literature.

    Science.gov (United States)

    Zwolińska, Jolanta; Gąsior, Monika; Śnieżek, Elżbieta; Kwolek, Andrzej

    Magnetic fields are commonly used in therapies designed for subjects with rheumatic diseases, yet the effects of magnetotherapy are not entirely clear in these disorders. This study is designed to examine the literature investigating applications of magnetotherapy in the treatment of rheumatoid arthritis (RA). The review focused on publications related to administering magnetotherapy in patients with RA. The databases Science Direct, SpringerLink, Medline, PubMed, and Polska Bibliografia Lekarska were searched for reports published since 2005. Despite the numerous reports showing an impact of magnetic field in subjects with RA, the effectiveness of magnetotherapy has not been explicitly confirmed. Given the above, further research appears to be necessary to clarify the impact of magnetic fields on biological systems, and the relationship between magnetic field intensity and the obtained results as well as their durability. The majority of clinical trials have failed to identify any undesirable outcomes or side effects of this physical therapeutic factor.

  13. Meta-Analysis of the Related Nutritional Supplements Dimethyl Sulfoxide and Methylsulfonylmethane in the Treatment of Osteoarthritis of the Knee

    Directory of Open Access Journals (Sweden)

    Sarah Brien

    2011-01-01

    Full Text Available Dimethyl sulphoxide and methylsulfonylmethane are two related nutritional supplements used for symptomatic relief of osteoarthritis (OA. We conducted a meta-analysis to evaluate their efficacy in reducing pain associated with OA. Randomized or quasi-randomized controlled trials (RCTs, identified by systematic electronic searches, citation tracking and searches of clinical trial registries, assessing these supplements in osteoarthritis of any joint were considered for inclusion. Meta-analysis, based on difference in mean pain related outcomes between treatment and comparator groups, was carried out based on a random effect model. Seven potential trials were identified of which three RCTs, two DMSO and one MSM (total N=326 patients were eligible for inclusion. All three trials were considered high methodological quality. A significant degree of heterogeneity (χ2=6.28, P=.043 was revealed. Two studies demonstrated statistically significant (but not clinically relevant reduction in pain compared with controls; with one showing no group difference. The meta-analysis confirmed a non significant reduction of pain on visual analogue scale of 6.34 mm (SE = 3.49, 95% CI, −0.49, 13.17. The overall effect size of 1.82 was neither statistically nor clinically significant. Current evidence suggests DMSO and MSM are not clinically effective in the reduction of pain in the treatment of OA. No definitive conclusions can currently be drawn from the data due to the mixed findings and the use of inadequate dosing periods.

  14. Effects of anthelmintic treatment and feed supplementation on grazing Tuli weaner steers naturally infected with gastrointestinal nematodes

    Directory of Open Access Journals (Sweden)

    A. Magaya

    2000-07-01

    Full Text Available A study was carried out to determine the epidemiology of gastrointestinal nematodes in indigenous Tuli cattle and the effect of dietary protein supplementation and anthelmintic treatment on productivity in young growing cattle. Forty steers with an average age of 18 months were divided into 4 groups; 1 fenbendazole (slow release bolus and cottonseed meal (FCSM group, 2 fenbendazole (FBZ group, 3 cottonseed meal (CSM group and 4 control (no cottonseed meal and no fenbendazole (control group. Performance parameters measured included wormeggs per gram of faeces (EPG, packed cell volume (PCV, albumin and live-weight gain. Results showed that faecal worm egg counts were lower and PCV was higher in the FCSM and FBZ groups than in the CSM and control groups (P < 0.01. Weight gains were higher in the CSMand FCSM groups than in the FBZ and control groups (P < 0.05. The cost benefits of anthelmintic treatment and dietary supplementation were apparent in this study. The improved growth performance of the FCSM, FBZ and CSM groups reflected a financial gain over the controls on termination of the study. The dominant genera of gastrointestinal nematodes on faecal culture, pasture larval counts and necropsy were Cooperia and Haemonchus. The incidences of Trichostrongylus, Oesophagostomum and Bunostomum were low.

  15. The use of monoamine pharmacological agents in the treatment of sexual dysfunction: evidence in the literature.

    Science.gov (United States)

    Moll, Jennifer L; Brown, Candace S

    2011-04-01

    The monoamine neurotransmitters serotonin, dopamine, and norepinephrine play an important role in many medical and psychological conditions, including sexual responsiveness and behavior. Pharmacological agents that modulate monoamines may help alleviate sexual dysfunction. To provide an overview of pharmacological agents that modulate monoamines and their use in the treatment of sexual dysfunction. EMBASE and PubMed search for articles published between 1950 and 2010 using key words "sexual dysfunction,"monoamines,"monoaminergic receptors," and "generic names for pharmacological agents." To assess the literature evaluating the efficacy of monoamine pharmacologic agents used in the treatment of sexual dysfunction. The literature primarily cites the use of monoaminergic agents to treat sexual side effects from serotonergic reuptake inhibitors (SSRIs), with bupropion, buspirone and ropinirole providing the most convincing evidence. Controlled trials have shown that bupropion improves overall sexual dysfunction, but not frequency of sexual activity in depressed and nondepressed patients. Nefazodone and apomorphine have been used to treat sexual dysfunction, but their use is limited by significant side effect and safety profiles. New research on pharmacologic agents with subtype selectivity at dopaminergic and serotonergic receptors and those that possess dual mechanisms of action are being investigated. There has been tremendous progress over the past 50 years in understanding the role of monoamines in sexual function and the effect of pharmacologic agents which stimulate or antagonize monoaminergic receptors on sexual dysfunction. Nevertheless, large, double-blind, placebo-controlled studies evaluating the efficacy of currently available agents in populations without comorbid disorders are limited, preventing adequate interpretation of data. Continued research on sexual function and specific receptor subtypes will result in the development of more selective

  16. [Advances in the research of zinc deficiency and zinc supplementation treatment in patients with severe burns].

    Science.gov (United States)

    Wang, X X; Zhang, M J; Li, X B

    2018-01-20

    Zinc is one of the essential trace elements in human body, which plays an important role in regulating acute inflammatory response, glucose metabolism, anti-oxidation, immune and gastrointestinal function of patients with severe burns. Patients with severe burns may suffer from zinc deficiency because of insufficient amount of zinc intake from the diet and a large amount of zinc lose through wounds and urine. Zinc deficiency may affect their wound healing process and prognosis. This article reviews the characteristics of zinc metabolism in patients with severe burns through dynamic monitoring the plasma and urinary concentration of zinc. An adequate dosage of zinc supplemented to patients with severe burns by an appropriate method can increase the level of zinc in plasma and skin tissue and improve wound healing, as well as reduce the infection rates and mortality. At the same time, it is important to observe the symptoms and signs of nausea, dizziness, leukopenia and arrhythmia in patients with severe burns after supplementing excessive zinc.

  17. Supplements to Textbook Materials.

    Science.gov (United States)

    Holmes, Ken

    1994-01-01

    Describes the many kinds of materials that English teachers can draw upon to enrich and expand students' experiences with literature. Outlines ancillary materials used to supplement the study of William Shakespeare's "Julius Caesar." (HB)

  18. Sports Supplements

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Sports Supplements KidsHealth / For Teens / Sports Supplements What's in ... really work? And are they safe? What Are Sports Supplements? Sports supplements (also called ergogenic aids ) are ...

  19. Diagnosis and treatment of pancreatic pseudocysts and cystic tumors based on own material and quoted literature

    Directory of Open Access Journals (Sweden)

    Grzegorz Ćwik

    2013-09-01

    Full Text Available Pseudocysts constitute the most basic cystic lesions of the pancreas. Symptomatic cysts may be treated by means of both minimally invasive methods and surgery. Currently, it is believed that approximately 5% of cystic lesions in the pancreas may in fact, be neoplastic cystic tumors. Their presence is manifested by generally irregular multilocular structures, solid nodules inside the cyst or in the pancreatic duct, frequently vascularized, as well as fragmentary thickening of the cystic wall or septation. Aim: The aim of this paper was to present current management, both diagnostic and therapeutic, in patients with pancreatic pseudocysts and cystic tumors. The article has been written based on the material collected and prepared in the author’s Department as well as on the basis of current reports found in the quoted literature. Material and methods, results: In 2000–2012, the Second Department of General, Gastrointestinal and Oncological Surgery of the Alimentary Tract treated 179 patients with cystic lesions in the region of the pancreas. This group comprised 12 cases of cystic tumors and 167 pseudocysts. Twenty-three patients (13.8% were monitored only and 144 received procedural treatment. Out of the latter group, 75 patients underwent drainage procedures and 48 were qualified to endoscopic cystogastrostomy or cystoduodenostomy. The endoscopic procedure was unsuccessful in 11 cases (23%. In a group of patients with a pancreatic cystic tumor (12 patients, 6 of them (50% underwent therapeutic resection of the tumor with adequate fragment of the gland. Conclusions: Endoscopic drainage is an effective and safe method of minimally invasive treatment of pancreatic cysts. The patients who do not qualify to endoscopic procedures require surgical treatment. The differentiation of a neoplasm from a typical cyst is of fundamental significance for the selection of the treatment method.

  20. Topiramate in the treatment of substance-related disorders: a critical review of the literature.

    Science.gov (United States)

    Shinn, Ann K; Greenfield, Shelly F

    2010-05-01

    To critically review the literature on topiramate in the treatment of substance-related disorders. A PubMed search of human studies published in English through January 2009 was conducted using the following search terms: topiramate and substance abuse, topiramate and substance dependence, topiramate and withdrawal, topiramate and alcohol, topiramate and nicotine, topiramate and cocaine, topiramate and opiates, and topiramate and benzodiazepines. 26 articles were identified and reviewed; these studies examined topiramate in disorders related to alcohol, nicotine, cocaine, methamphetamine, opioids, Ecstasy, and benzodiazepines. Study design, sample size, topiramate dose and duration, and study outcomes were reviewed. There is compelling evidence for the efficacy of topiramate in the treatment of alcohol dependence. Two trials show trends for topiramate's superiority over oral naltrexone in alcohol dependence, while 1 trial suggests topiramate is inferior to disulfiram. Despite suggestive animal models, evidence for topiramate in treating alcohol withdrawal in humans is slim. Studies of topiramate in nicotine dependence show mixed results. Human laboratory studies that used acute topiramate dosing show that topiramate actually enhances the pleasurable effects of both nicotine and methamphetamine. Evidence for topiramate in the treatment of cocaine dependence is promising, but limited by small sample size. The data on opioids, benzodiazepines, and Ecstasy are sparse. Topiramate is efficacious for the treatment of alcohol dependence, but side effects may limit widespread use. While topiramate's unique pharmacodynamic profile offers a promising theoretical rationale for use across multiple substance-related disorders, heterogeneity both across and within these disorders limits topiramate's broad applicability in treating substance-related disorders. Recommendations for future research include exploration of genetic variants for more targeted pharmacotherapies.

  1. Outcomes following the main treatment options in patients with a leaking esophagus: a systematic literature review.

    Science.gov (United States)

    Persson, S; Rouvelas, I; Irino, T; Lundell, L

    2017-12-01

    Leakage from the esophagus and gastroesophageal junction can be lethal due to uncontrolled contamination of the mediastinum. The most predominant risk factors for the subsequent clinical outcome are the patients' delay as well as the delay of diagnosis. Two major therapeutic concepts have been advocated: either prompt closure of the leakage by insertion of a self-expandable metal stent (SEMS) or more traditionally, surgical exploration. The objective of this review is to carefully scrutinize the recent literature and assess the outcomes of these two therapeutic alternatives in the management of iatrogenic perforation-spontaneous esophageal rupture as separated from those with anastomotic leak. A systematic web-based search using PubMed and the Cochrane Library was performed, reviewing literature published between January 2005 and December 2015. Eligible studies included all studies that presented data on the outcome of SEMS or surgical exploration in case of esophageal leak (including >3 patients). Only patients older than 15 years of age by the time of admission were included. Articles in other languages but English were excluded. Treatment failure was defined as a need for change in therapeutic strategy due to uncontrolled sepsis and mediastinitis, which usually meant rescue esophagectomy with end esophagostomy, death occurring as a consequence of the leakage or development of an esophagorespiratory fistula and/or other serious life threatening complications. Accordingly, the corresponding success rate is composed of cases where none of the failures above occurred. Regarding SEMS treatment, 201 articles were found, of which 48 were deemed relevant and of these, 17 articles were further analyzed. As for surgical management, 785 articles were retrieved, of which 82 were considered relevant, and 17 were included in the final analysis. It was not possible to specifically extract detailed clinical outcomes in sufficient numbers, when we tried to separately analyze the

  2. Effect of forage supplementation and alkali treatment of cocoa pod on the utilization of cocoa pod based diets by ruminants

    International Nuclear Information System (INIS)

    Smith, O.B.

    1987-01-01

    Two treatment methods - forage supplementation and chemical treatment - both potentially capable of improving cocoa pod utilization by ruminants were evaluated. Forage supplementation, using Gliricidia sepium of cattle fed a 50% cocoa pod diet yielded no positive results. Consumption of Gliricidia was poor and equalled only 0.2 kg/head/d. Feed intake (4.6 versus 4.8 kg dry matter (DM)/d), growth rate (0.37 versus 0.40 kg/d) and feed/gain (12.7 versus 12.0) for control and test cattle were similar (P>0.05). Chemical treatment using cocoa pod ash solutions (PAS) - a caustic material - was more successful. Rumen digestibility (as determined by the nylon bag technique) of cocoa pods treated with PAS, equivalent in alkalinity to 2 (P 2 ), 4 (P 4 ), 6 (P 6 ) and 8% (P 8 ) NaOH, was linearly improved (P 0.05). Dry matter, ADF and NDF degradabilities increased (P 6 and 55, 46 and 42%, respectively, for P 8 treated samples. Dry matter digestibilities of cocoa pod based diets also increased (P 8 treated) in sheep and to 60% in goats. Nevertheless, treatment with P 8 solutions reduced (P 0.75 in sheep and from 48 to 42 g DM/kg W 0.75 in goats. Feed intake, however, was normal for diets containing P 6 treated cocoa pods (67 and 61 g DM/kg W 0.75 ) for sheep and goats, respectively. Cocoa pod ash for treating cocoa pods should therefore not be stronger than the P 6 level which corresponds in alkalinity to 6% NaOH. (author)

  3. Surgical Outcomes of Plaque Excision and Grafting and Supplemental Tunica Albuginea Plication for Treatment of Peyronie's Disease With Severe Compound Curvature.

    Science.gov (United States)

    Chow, Alexander K; Sidelsky, Steven A; Levine, Laurence A

    2018-05-22

    There are limited data in the literature that describe the management of Peyronie's disease (PD) with severe compound curvature, which often requires additional straightening procedures after plaque excision and grafting (PEG) to achieve functional penile straightening (compound curvature treated with PEG and supplemental tunica albuginea plication (TAP). We performed a retrospective chart review of patients with PD and acute angulation who underwent PEG (group 1) and patients with compound curvature who underwent PEG with TAP (group 2) between 2007 and 2016. Primary post-operative outcomes of interest include change in penile curvature, change in measured stretched penile length, and subjective report on penile sensation and sexually induced penile rigidity. 240 Men with PD were included in the study, of which 79 (33%) patients in group 1 underwent PEG and 161 (67%) in group 2 underwent PEG and TAP. There was no difference in associated PD co-morbidities including age, hypertension, hyperlipidemia, hypogonadism, diabetes, or tobacco use. After artificial induction of erection with intracorporal trimix injection, the average primary curvature was 73 (range, 20-120) degrees for group 1 compared to 79 (range, 35-140) degrees for group 2 (P = .01). Group 2 had an average secondary curvature of 36 (20-80 degrees). After completion of PEG, men in group 2 had an average residual curvature of 30 (range, 20-50) degrees which required 1-6 TAPs to achieve functional straightness (compound curvature to date. Limitations of this study include the retrospective nature of the analysis as well as the lack of a validated objective measurement of erectile function after penile straightening. Our study found no baseline difference in underlying co-morbidities in men with severe compound curvature compared with men with acute severe angulated curvature. Men with severe compound curvature represent a severe and under-recognized population of men with PD who can be surgically

  4. Treatment of lymphatic malformations with OK-432 (Picibanil): review of the literature.

    Science.gov (United States)

    Poldervaart, Michelle T; Breugem, Corstiaan C; Speleman, Lucienne; Pasmans, Suzanne

    2009-07-01

    Lymphatic malformations (LM) are benign structural defects that can cause serious complications because of their size and location. Traditionally, surgical removal was the first treatment modality, but this could be associated with many complications and risks. Since Ogita introduced OK-432 (picibanil) in 1987 as a treatment method, this sclerosant has become popular. This paper is a review of the trials published so far on this topic. A literature search of English trials with 5 or more patients in it with LM who had never been treated before was done. The paper had to use the microcystic-macrocystic classification and have a mean follow-up of more than a year to be included in this review. Results were classified as "excellent" when the lesions show a regression of more than 90%, "good" when regression is more than 50%, and "poor" when shrinkage is less than 50% (this also includes no response at all). Twenty-seven percent of microcystic LMs show an excellent result; 33%, a good result; and 40%, a poor result. Of the macrocystic LMs, 88% have excellent results. Recurrence rates vary from 5% to 8%. The adverse effects are mostly mild. Most trials have a short follow-up; therefore, there are uncertainties when it comes to cure and regression. Mostly, the adverse effects of OK-432 are trivial and disappear after a week, but the need for a temporary tracheostomy has been described. Screening for allergic reactions to penicilline is needed, with the risk of anaphylactic shock in mind. It is difficult to compare the different techniques used by the authors, and none of the trials included in this study are randomized controlled trials; most are retrospective and were so-called level 4 studies. This review demonstrates that OK-432 is an effective way to treat LM. Because of a possible risk of airway obstruction, treatment should always take place in specialized treatment facilities. Macrocystic lesions show a better response to OK-432 treatment than microcystic lesions

  5. Retail sector distribution chains for malaria treatment in the developing world: a review of the literature

    Directory of Open Access Journals (Sweden)

    Hanson Kara G

    2010-02-01

    Full Text Available Abstract Background In many low-income countries, the retail sector plays an important role in the treatment of malaria and is increasingly being considered as a channel for improving medicine availability. Retailers are the last link in a distribution chain and their supply sources are likely to have an important influence on the availability, quality and price of malaria treatment. This article presents the findings of a systematic literature review on the retail sector distribution chain for malaria treatment in low and middle-income countries. Methods Publication databases were searched using key terms relevant to the distribution chain serving all types of anti-malarial retailers. Organizations involved in malaria treatment and distribution chain related activities were contacted to identify unpublished studies. Results A total of 32 references distributed across 12 developing countries were identified. The distribution chain had a pyramid shape with numerous suppliers at the bottom and fewer at the top. The chain supplying rural and less-formal outlets was made of more levels than that serving urban and more formal outlets. Wholesale markets tended to be relatively concentrated, especially at the top of the chain where few importers accounted for most of the anti-malarial volumes sold. Wholesale price mark-ups varied across chain levels, ranging from 27% to 99% at the top of the chain, 8% at intermediate level (one study only and 2% to 67% at the level supplying retailers directly. Retail mark-ups tended to be higher, and varied across outlet types, ranging from 3% to 566% in pharmacies, 29% to 669% in drug shops and 100% to 233% in general shops. Information on pricing determinants was very limited. Conclusions Evidence on the distribution chain for retail sector malaria treatment was mainly descriptive and lacked representative data on a national scale. These are important limitations in the advent of the Affordable Medicine Facility for

  6. Retail sector distribution chains for malaria treatment in the developing world: a review of the literature.

    Science.gov (United States)

    Patouillard, Edith; Hanson, Kara G; Goodman, Catherine A

    2010-02-11

    In many low-income countries, the retail sector plays an important role in the treatment of malaria and is increasingly being considered as a channel for improving medicine availability. Retailers are the last link in a distribution chain and their supply sources are likely to have an important influence on the availability, quality and price of malaria treatment. This article presents the findings of a systematic literature review on the retail sector distribution chain for malaria treatment in low and middle-income countries. Publication databases were searched using key terms relevant to the distribution chain serving all types of anti-malarial retailers. Organizations involved in malaria treatment and distribution chain related activities were contacted to identify unpublished studies. A total of 32 references distributed across 12 developing countries were identified. The distribution chain had a pyramid shape with numerous suppliers at the bottom and fewer at the top. The chain supplying rural and less-formal outlets was made of more levels than that serving urban and more formal outlets. Wholesale markets tended to be relatively concentrated, especially at the top of the chain where few importers accounted for most of the anti-malarial volumes sold. Wholesale price mark-ups varied across chain levels, ranging from 27% to 99% at the top of the chain, 8% at intermediate level (one study only) and 2% to 67% at the level supplying retailers directly. Retail mark-ups tended to be higher, and varied across outlet types, ranging from 3% to 566% in pharmacies, 29% to 669% in drug shops and 100% to 233% in general shops. Information on pricing determinants was very limited. Evidence on the distribution chain for retail sector malaria treatment was mainly descriptive and lacked representative data on a national scale. These are important limitations in the advent of the Affordable Medicine Facility for Malaria, which aims to increase consumer access to artemisinin

  7. Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment

    Science.gov (United States)

    2013-01-01

    Restoration of weight and nutritional status are key elements in the treatment of anorexia nervosa (AN). This review aims to describe issues related to the caloric requirements needed to gain and maintain weight for short and long-term recovery for AN inpatients and outpatients. We reviewed the literature in PubMed pertaining to nutritional restoration in AN between 1960–2012. Based on this search, several themes emerged: 1. AN eating behavior; 2. Weight restoration in AN; 3. Role of exercise and metabolism in resistance to weight gain; 3. Medical consequences of weight restoration; 4. Rate of weight gain; 5. Weight maintenance; and 6. Nutrient intake. A fair amount is known about overall caloric requirements for weight restoration and maintenance for AN. For example, starting at 30–40 kilocalories per kilogram per day (kcal/kg/day) with increases up to 70–100 kcal/kg/day can achieve a weight gain of 1–1.5 kg/week for inpatients. However, little is known about the effects of nutritional deficits on weight gain, or how to meet nutrient requirements for restoration of nutritional status. This review seeks to draw attention to the need for the development of a foundation of basic nutritional knowledge about AN so that future treatment can be evidenced-based. PMID:24200367

  8. The application of diode laser in the treatment of oral soft tissues lesions. A literature review.

    Science.gov (United States)

    Ortega-Concepción, Daniel; Cano-Durán, Jorge A; Peña-Cardelles, Juan-Francisco; Paredes-Rodríguez, Víctor-Manuel; González-Serrano, José; López-Quiles, Juan

    2017-07-01

    Since its appearance in the dental area, the laser has become a treatment of choice in the removal of lesions in the oral soft tissues, due to the numerous advantages they offer, being one of the most used currently the diode laser. The aim of this review was to determine the efficacy and predictability of diode laser as a treatment of soft tissue injuries compared to other surgical methods. A literature review of articles published in PubMed/MEDLINE, Scopus and the Cochrane Library databases between 2007 and 2017 was performed. "Diode laser", "soft tissue", "oral cavity" and "oral surgery" were employed for the search strategy. Only articles published English or Spanish were selected. The diode laser is a minimally invasive technology that offers great advantages, superior to those of the conventional scalpel, such as reduction of bleeding, inflammation and the lower probability of scars. Its effectiveness is comparable to that of other types of lasers, in addition to being an option of lower cost and greater ease of use. Its application in the soft tissues has been evaluated, being a safe and effective method for the excision of lesions like fibromas, epulis fissuratum and the accomplishment of frenectomies. The diode laser can be used with very good results for the removal of lesions in soft tissues, being used in small exophytic lesions due to their easy application, adequate coagulation, no need to suture and the slightest inflammation and pain. Key words: Diode laser, soft tissues, oral cavity, oral surgery.

  9. Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review.

    Science.gov (United States)

    Bartel, Ricardo; Gonzalez-Compta, Xavier; Cisa, Enric; Cruellas, Francesc; Torres, Alberto; Rovira, Aleix; Manos, Manel

    2017-10-20

    Olfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/-adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature. A retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution. 9 patients were included. Mean follow-up of 52.5 months (range 10-107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%. Neoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  10. Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

    Directory of Open Access Journals (Sweden)

    Crippa José AS

    2012-01-01

    Full Text Available Abstract Background Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition. Objective To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis. Methods A search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review. Results The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol. Conclusion Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.

  11. The Motivational Enhancement Therapy and Cognitive Behavioral Therapy Supplement: 7 Sessions of Cognitive Behavioral Therapy for Adolescent Cannabis Users, Cannabis Youth Treatment (CYT) Series, Volume 2.

    Science.gov (United States)

    Webb, Charles; Scudder, Meleney; Kaminer, Yifrah; Kaden, Ron

    This manual, a supplement to "Motivational Enhancement Therapy and Cognitive Behavioral Therapy for Adolescent Cannabis Users: 5 Sessions, Cannabis Youth Treatment (CYT) Series, Volume 1", presents a seven-session cognitive behavioral treatment (CBT7) approach designed especially for adolescent cannabis users. It addresses the implementation and…

  12. The Role of Environmental Design in Cancer Prevention, Diagnosis, Treatment, and Survivorship: A Systematic Literature Review.

    Science.gov (United States)

    Gharaveis, Arsalan; Kazem-Zadeh, Mahshad

    2018-01-01

    The purpose of this literature review is to provide a better understanding of the impact that environmental design can have on the process of cancer prevention, diagnosis, treatment, and survivorship. Cancer is considered a chronic disease in the United States, and more than 1.6 million new cases are diagnosed annually. New strategies of cancer care propose patient-centered services to achieve the best outcome, and researchers have found that environmental design can be an important part of improving this care. Searches were conducted in the PubMed and Google Scholar databases as well as in specific healthcare design journals such as Health Environments Research & Design, Environmental Psychology, and Environment and Behavior. The criteria for articles included in the review were (a) English-language articles related to facility design, which addressed (b) the topics of built environment in relation to cancer diagnosis, treatment, and survivorship, and were (c) published in peer-reviewed journals between 2000 and 2017. Finally, 10 articles were selected, and the contents were analyzed. The selected articles demonstrate that environmental design is one of the critical factors for success throughout the whole continuum of cancer care from diagnosis to end-of-treatment. Some of the specific conclusions from the review are that "neighborhood-oriented" design strategies can be beneficial (by providing accessibility to all facilities along the patient's path), that access to nature for patients, staff, and visitors alike is associated with better outcomes, and that provisions for natural lighting and noise reduction are associated with cancer patients' well-being.

  13. The standardization of acupuncture treatment for radiation-induced xerostomia: A literature review.

    Science.gov (United States)

    Li, Ling-Xin; Tian, Guang; He, Jing

    2016-07-01

    To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia. A literature search was carried out up to November 10, 2012 in the databases PubMed/MEDLINE, EMBASE and China National Knowledge Infrastruction with the terms: radiation-induced xerostomia, acupuncture, acupuncture treatment, and acupuncture therapy. Five ancient Chinese classic acupuncture works were also reviewed with the keywords "dry mouth, thirst, dry tongue, dry eyes and dry lips" to search the effective acupuncture points for dry mouth-associated symptoms in ancient China. Twenty-two full-text articles relevant to acupuncture treatment for radiation-induced xerostomia were included and a total of 48 acupuncture points were searched in the 5 ancient Chinese classic acupuncture works, in which the most commonly used points were Chengjiang (CV24), Shuigou (GV 26), Duiduan (GV 27), Jinjin (EX-HN 12), and Yuye (EX-HN 13) on head and neck, Sanjian (LI 3), Shangyang (LI 1), Shaoshang (LU 11), Shaoze (SI 1), Xialian (LI 8) on hand, Fuliu (KI 7), Dazhong (KI 4), Zuqiaoyin (GB 44), Taichong (LR 3), Zhaohai (KI 6) on foot, Burong (ST 19), Zhangmen (LR 13), Tiantu (CV 22), Qimen (LR 14) on abdomen, Feishu (BL 13), Danshu (BL 19), Xiaochaogshu (BL 27), Ganshu (BL 18) on back, Shenmen (TF 4), Shen (CO10, Kidney), Yidan (CO11, Pancreas) and Pi (CO13, Spleen) on ear. There were considerable heterogeneities in the current acupuncture treatment protocols for radiation-induced xerostomia. Based on the results of the review and the personal perspectives, the authors provide a recommendation for manual acupuncture protocols in treating radiationinduced xerostomia patients with head and neck cancer.

  14. Homeopathy in the treatment of fibromyalgia--a comprehensive literature-review and meta-analysis.

    Science.gov (United States)

    Boehm, Katja; Raak, Christa; Cramer, Holger; Lauche, Romy; Ostermann, Thomas

    2014-08-01

    Coping with the complex nature of fibromyalgia symptoms (FMS) still remains a challenge for patients. Taking into account the possible adverse events of pharmacological treatments patients often seek additional treatments for the management of fibromyalgia and turn towards complementary and alternative medicine (CAM). In this review, we aimed to investigate the current state of literature of homeopathy in the treatment of FMS. We searched Medline, the Cochrane Register of Controlled Trials, Embase, AMED, PsycInfo and CAMbase for the terms "fibromyalgia AND homeopath$" through February 2013. In addition we searched Google Scholar, the library of the Carstens Foundation and that of the Deutsche Homöopathische Union (DHU). Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated and meta-analyzed using the generic inverse variance method. We found 10 case-reports, 3 observational studies, 1 non-randomized and 4 randomized controlled trials (RCTs) on homeopathy for fibromyalgia. Both case reports and observational studies are naturally predominated by the use of qualitative and not validated outcome measures. Meta-analyses of CCTs revealed effects of homeopathy on tender point count (SMD=-0.42; 95%CI -0.78, -0.05; P=0.03), pain intensity (SMD=-0.54; 95%CI -0.97, -0.10; P=0.02), and fatigue (SMD=-0.47; 95%CI -0.90, -0.05; P=0.03) compared to placebo. The results of the studies as well as the case reports define a sufficient basis for discussing the possible benefits of homeopathy for patients suffering from fibromyalgia syndrome although any conclusions based on the results of this review have to be regarded as preliminary. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. A Systematic Literature Review of Economic Evaluations of Antibiotic Treatments for Clostridium difficile Infection.

    Science.gov (United States)

    Burton, Hannah E; Mitchell, Stephen A; Watt, Maureen

    2017-11-01

    Clostridium difficile infection (CDI) is associated with high management costs, particularly in recurrent cases. Fidaxomicin treatment results in lower recurrence rates than vancomycin and metronidazole, but has higher acquisition costs in Europe and the USA. This systematic literature review summarises economic evaluations (EEs) of fidaxomicin, vancomycin and metronidazole for treatment of CDI. Electronic databases (MEDLINE ® , Embase, Cochrane Library) and conference proceedings (ISPOR, ECCMID, ICAAC and IDWeek) were searched for publications reporting EEs of fidaxomicin, vancomycin and/or metronidazole in the treatment of CDI. Reference bibliographies of identified manuscripts were also reviewed. Cost-effectiveness was evaluated according to the overall population of patients with CDI, as well as in subgroups with severe CDI or recurrent CDI, or those at higher risk of recurrence or mortality. Overall, 27 relevant EEs, conducted from the perspective of 12 different countries, were identified. Fidaxomicin was cost-effective versus vancomycin and/or metronidazole in 14 of 24 EEs (58.3%), vancomycin was cost-effective versus fidaxomicin and/or metronidazole in five of 27 EEs (18.5%) and metronidazole was cost-effective versus fidaxomicin and/or vancomycin in two of 13 EEs (15.4%). Fidaxomicin was cost-effective versus vancomycin in most of the EEs evaluating specific patient subgroups. Key cost-effectiveness drivers were cure rate, recurrence rate, time horizon, drug costs and length and cost of hospitalisation. In most EEs, fidaxomicin was demonstrated to be cost-effective versus metronidazole and vancomycin in patients with CDI. These results have relevance to clinical practice, given the high budgetary impact of managing CDI and increasing restrictions on healthcare budgets. This analysis was initiated and funded by Astellas Pharma Inc.

  16. Down-titration of biologics for the treatment of rheumatoid arthritis: a systematic literature review.

    Science.gov (United States)

    Lau, Chak Sing; Gibofsky, Allan; Damjanov, Nemanja; Lula, Sadiq; Marshall, Lisa; Jones, Heather; Emery, Paul

    2017-11-01

    Biologic therapies have improved the management of rheumatoid arthritis (RA) and the treat-to-target approach has resulted in many patients achieving remission. In the current treatment landscape, clinicians have begun considering dose reduction/tapering for their patients. Rheumatology guidelines in Asia, Europe, and the United States include down-titration of biologics but admit that the level of evidence is moderate. We conducted a systematic literature review to assess the published studies that evaluate down-titration of biologics in RA. The published literature was searched for studies that down-titrated the following biologics: abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, and tocilizumab. Eligible studies included randomized controlled trials (RCTs), non-RCTs, observational, and pharmacoeconomic studies. The outcomes of interest were (1) efficacy and health-related quality of life, (2) disease flares, and (3) impact on cost. Eleven full-text publications were identified; only three were RCTs. Study results suggest that dosing down may be an option in many patients who have achieved remission or low disease activity. However, some patients are likely to experience a disease flare. Across the studies, the definition of disease flare and the down-titration criteria were inconsistent, making it difficult to conclude which patients may be appropriate and when to attempt down-titration. Studies have evaluated the practice of dosing down biologic therapy in patients with RA; however, a relatively small number of RCTs have been published. Although down-titration may be an option for some patients in LDA or remission, additional RCTs are needed to provide guidance on this practice.

  17. Adherence to zinc supplementation guidelines for the treatment of diarrhea among children under–five in Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    Laura M Lamberti

    2015-12-01

    Full Text Available There is limited evidence on adherence to the recommended dose and duration of zinc supplementation for diarrheal episodes in children under five years of age. In selected districts of Uttar Pradesh, India, we sought to assess adherence to the nationally advised zinc treatment regimen (ie, 10 mg/day for ages 2–6 months and 20 mg/day for ages 7–59 months for 14 days among caregivers of zinc–prescribed children. We identified and conducted follow–up visits to children advised zinc for the treatment of diarrhea. At the initial visit, we collected data on the treatment instructions received from providers. Caregivers were asked to record treatments administered on a pictorial tracking form and were asked to retain all packaging for collection at follow–up. We quantified the average dose and duration of zinc therapy and built logistic regression models to assess the factors associated with caregiver adherence to national guidelines. Caregivers administered zinc for an average of 10.7 days (standard deviation (SD = 3.9 days; median = 13 days, and 47.8% continued treatment for the complete 14 days. Among children receiving zinc syrups and tablets respectively, the age appropriate dose was received by 30.8% and 67.3%. Adherence to age appropriate dose and continuation of zinc for 14 days were highly associated with having received appropriate provider instructions. Our results indicate moderate–to–good adherence to national zinc treatment guidelines for diarrhea among caregivers in rural India. Our findings also highlight the importance of provider guidance in ensuring adherence to zinc dose and duration. Programs aiming to scale–up zinc treatment for childhood diarrhea should train providers to successfully communicate dosing instructions to caregivers, while also addressing the tendency of caregivers to terminate treatment once a child appears to have recovered from an acute diarrheal episode.

  18. Critical evaluation of paliperidone in the treatment of schizophrenia in Chinese patients: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Zhang LL

    2016-01-01

    Full Text Available LiLi Zhang,1 JiTao Li,2–4 YanJie Zhao,5 Yun’Ai Su,2–4 Tianmei Si2–4 1Medical Affairs, Xian Janssen Pharmaceutical Co, Ltd, 2National Clinical Research Center for Mental Disorders, 3Peking University Sixth Hospital, Institute of Mental Health, 4The Key Laboratory of Mental Health, Ministry of Health, Peking University, 5National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China Background: Paliperidone (9-hydroxyrisperidone, the major active metabolite of risperidone, has been introduced as a novel atypical antipsychotic agent in many countries. It is available both as an oral extended-release (ER formulation and as a long-acting injection (paliperidone palmitate, PP, which have been approved for treating schizophrenia in the People’s Republic of China since 2009 and 2012, respectively. This systematic review summarizes the efficacy, effectiveness, and safety of paliperidone in the treatment of schizophrenia in the Chinese population. Methods: A systematic literature search was conducted on the databases covering international and Chinese core journals, published from January 1, 2008, to May 22, 2015. Results: A total of 122 publications were retrieved, of which 63 studies were identified for inclusion; most studies were related to paliperidone ER (n=53, nine were related to PP, and one study was related to both agents. Paliperidone ER demonstrated at least comparable efficacy with active comparators, including risperidone, olanzapine, ziprasidone, or aripiprazole, and was found to be superior with respect to the onset of action and improvement in the Personal and Social Performance Scale score. Paliperidone ER appeared to be associated with a lower risk of metabolic syndromes; the most common treatment-emergent adverse events were extrapyramidal symptoms, akathisia, insomnia, and somnolence. Results from interventional and observational studies showed that PP

  19. Improvement of Rice Straw for Ruminant Feed Through Unconventional Alkali Treatment and Supplementation of Various Protein Sources

    Directory of Open Access Journals (Sweden)

    SNO Suwandyastuti

    2010-05-01

    Full Text Available Various chemical treatments were conducted to increase the utilization of rice straw as feed for ruminant animals. Various sources of protein, minerals and energy should be added to improve the nutritive value of feeds. Two experiments were conducted in this study. The objective of the first experiments was to study the effect of chemical treatment on the ruminal fermentation products in cattle. Unconventional alkali treatment made from filtrate of a 10% rice hulls ash solution enriched with urea and minerals (treatment 1 increased volatile fatty acid (VFA production, ammonia nitrogen (NH3-N and rumen microbial protein synthesis (MPS. The maximum values of NH3-N production and rumen microbial protein synthesis were reached at 4 hours after incubation, while VFA was reached at 6 hours. The second experiment was conducted to study the increase of nutritive value of rice straw previously treated in experiment 1 through supplementation with various protein sources. Protein sources from the residues of vegetative oil production such as coconut, peanut and soybean showed higher responses compared to soy-sauce making residue and tofu making residue. The protein effluent production was highest (2.19 g/d at a VFA/NH3-N ration of 37.74 (r = 0.912. It can be recommended that protein sources from agro-industrial wastes can be used to increase the nutritive value and utilization of rice straw as ruminant feed. (Animal Production 12(2: 82-85 (2010Key Words: rice straw, rumen, fermentation

  20. Effects of supplemental vibrational force on space closure, treatment duration, and occlusal outcome: A multicenter randomized clinical trial.

    Science.gov (United States)

    DiBiase, Andrew T; Woodhouse, Neil R; Papageorgiou, Spyridon N; Johnson, Nicola; Slipper, Carmel; Grant, James; Alsaleh, Maryam; Khaja, Yousef; Cobourne, Martyn T

    2018-04-01

    A multicenter parallel 3-arm randomized clinical trial was carried out in 3 university hospitals in the United Kingdom to investigate the effect of supplemental vibratory force on space closure and treatment outcome with fixed appliances. Eighty-one subjects less than 20 years of age with mandibular incisor irregularity undergoing extraction-based fixed appliance treatment were randomly allocated to supplementary (20 minutes/day) use of an intraoral vibrational device (AcceleDent; OrthoAccel Technologies, Houston, Tex) (n = 29), an identical nonfunctional (sham) device (n = 25), or fixed-appliance only (n = 27). Space closure in the mandibular arch was measured from dental study casts taken at the start of space closure, at the next appointment, and at completion of space closure. Final records were taken at completion of treatment. Data were analyzed blindly on a per-protocol basis with descriptive statistics, 1-way analysis of variance, and linear regression modeling with 95% confidence intervals. Sixty-one subjects remained in the trial at start of space closure, with all 3 groups comparable for baseline characteristics. The overall median rate of initial mandibular arch space closure (primary outcome) was 0.89 mm per month with no difference for either the AcceleDent group (difference, -0.09 mm/month; 95% CI, -0.39 to 0.22 mm/month; P = 0.57) or the sham group (difference, -0.02 mm/month; 95% CI, -0.32 to 0.29 mm/month; P = 0.91) compared with the fixed only group. Similarly, no significant differences were identified between groups for secondary outcomes, including overall treatment duration (median, 18.6 months; P >0.05), number of visits (median, 12; P >0.05), and percentage of improvement in the Peer Assessment Rating (median, 90.0%; P >0.05). Supplemental vibratory force during orthodontic treatment with fixed appliances does not affect space closure, treatment duration, total number of visits, or final occlusal outcome. NCT02314975

  1. [Dietary supplements from ground fish meat with DNA for treatment and prophylaxis].

    Science.gov (United States)

    Boiarkina, L G; Kas'ianenko, Iu I; Epshteĭn, L M; Iakush, E V

    1998-01-01

    It has been developed a receipt of a new treatment-and-prophylactic products based on fish farce with treatment-and-prophylactic additive--DNA. It is recommended to be produced. As biological active additive keeps its initial pharmacological characteristics under technological processing this product is recommended for rendering general effect and increasing of physical and mental activity of organism.

  2. Handbook supplement to the Alberta private sewage treatment and disposal regulations

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    This manual was prepared to assist in the selection and installation of private sewage treatment and disposal systems which are best suited to location, water and soil conditions in a safe and efficient manner. The manual covers piping, frost protection, pumps, septic tanks and sewage holding tanks, soil tests and water softeners, disposal fields, treatment mounds, open discharge, and lagoons.

  3. A Systematic Scoping Literature Review of Publications Supporting Treatment Guidelines for Pediatric Atopic Dermatitis in Contrast to Clinical Practice Patterns.

    Science.gov (United States)

    Siegfried, Elaine C; Jaworski, Jennifer C; Mina-Osorio, Paola

    2018-06-01

    Treatment guidelines endorse a variety of strategies for atopic dermatitis (AD) which may vary from published data and clinical practice patterns. The objective of this review was to quantify the volume of available medical literature supporting pediatric AD treatments and compare these patterns to those recommended by published guidelines and/or clinical practice patterns. Searches of Embase (2005-2016) and abstracts from selected meetings (2014-2016) related to AD treatment in patients younger than 17 years of age yielded references that were assessed by study design, primary treatment, age groups, and AD severity. Published literature partially supports clinical guidelines, with emollients and topical medications being the most investigated. There were disproportionately more publications for topical calcineurin inhibitors (TCI) compared with topical corticosteroids (TCS); however, the search interval may have biased the results toward treatments approved near the beginning of the time frame. In contrast, publications documenting clinical practice patterns reflect greater use of emollients and TCS (over TCI), as well as systemic corticosteroids. Data is relatively limited for long-term and combination treatment, treatment of severe AD, and patients younger than 2 years of age, and completely lacking for systemic corticosteroids. This scoping review demonstrates that available medical literature largely supports published guidelines for topical therapy; however, clinical practice patterns are less aligned. There is a lack of data for older, more frequently used generic treatments, including oral antihistamines, oral antibiotics, and systemic corticosteroids. Overall, literature is lacking for long-term treatment, treatment for patients younger than 2 years of age, and for systemic treatment for severe disease. Regeneron Pharmaceuticals Inc.

  4. Digit-sucking: a review of the literature, clinical observations and treatment recommendations.

    Science.gov (United States)

    Van Norman, R A

    1997-01-01

    Prolonged digit-sucking habits can have a negative impact on dental, speech, physical and emotional development. Children can be helped to eliminate their sucking habits quickly, without coercion, and in a positive way. Admittedly, most of my data is based purely on clinical observation. However, clinical observation is the basis for classical scientific investigation. I welcome this investigation; it is long overdue. Much of the literature available to parents appears to take a rather cavalier attitude with regard to the dental consequences of sucking habits. Parents are frequently left with the impression that no harm is done to the teeth. This perspective is based on the assumption that most children stop the sucking behavior before permanent teeth erupt into the mouth. Therefore, any dental malocclusion in the primary teeth will often be transitional or will spontaneously self-correct. However, as demonstrated by Kelly, et al (1973), millions of children do not discontinue their sucking habits before permanent teeth erupt. In addition, stress levels in today's world are probably significantly greater than when this study was done. Because stress is a powerful stimulus for the sucking activity, it is highly probable that if a similar study were done today, it would produce a substantially greater number of individuals with prolonged sucking habits. The active pursuit of insurance benefits for the Certified Orofacial Myologist providing therapy for the elimination of these habits will be germane to prevention. Research is needed to accomplish this goal including: investigation of the incidence of prolonged digit-sucking habits; the impact of these habits on the entire stomatognathic system, speech development and emotional health; efficacy of treatment (including psychological response) both through the utilization of habit appliances and motivational therapy. The Certified Orofacial Myologist provides many valuable therapeutic programs to enhance dental and

  5. A case of neurosarcoidosis secondary to treatment of etanercept and review of the literature.

    Science.gov (United States)

    Berrios, Idanis; Jun-O'Connell, Adalia; Ghiran, Sorina; Ionete, Carolina

    2015-07-06

    There are only three cases in the literature that describe development of neurosarcoidosis in a patient who is on tumour necrosis factor α inhibitors. We describe a case of a 33-year-old woman with a history of juvenile rheumatoid arthritis and refractory uveitis (with previous treatment trials of adalimumab, infliximab, mycophenolate, methotrexate) who had been stable for 2 years on etanercept. She was diagnosed with biopsy-proven systemic sarcoidosis with meningeal and parenchymal neurosarcoidosis. She was switched to infliximab and methotrexate, with clinical and imaging improvements. This is a case that demonstrates the difficulty of choosing tumour necrosis factor α (TNF-α) inhibitors when treating patients with multiple clinical autoimmune entities. It is also a case where a change in the mechanism of TNF-α inhibition pathway can still be used to treat refractory sarcoidoisis and rheumatoid arthritis. It is still unclear what the exact difference between the TNF-α blockers and their neurological complications is, and who the patients at risk of developing neurological complications are. 2015 BMJ Publishing Group Ltd.

  6. Literature Review On Impact Of Glycolate On The 2H Evaporator And The Effluent Treatment Facility

    International Nuclear Information System (INIS)

    Adu-Wusu, K.

    2012-01-01

    Glycolic acid (GA) is being studied as an alternate reductant in the Defense Waste Processing Facility (DWPF) feed preparation process. It will either be a total or partial replacement for the formic acid that is currently used. A literature review has been conducted on the impact of glycolate on two post-DWPF downstream systems - the 2H Evaporator system and the Effluent Treatment Facility (ETF). The DWPF recycle stream serves as a portion of the feed to the 2H Evaporator. Glycolate enters the evaporator system from the glycolate in the recycle stream. The overhead (i.e., condensed phase) from the 2H Evaporator serves as a portion of the feed to the ETF. The literature search revealed that virtually no impact is anticipated for the 2H Evaporator. Glycolate may help reduce scale formation in the evaporator due to its high complexing ability. The drawback of the solubilizing ability is the potential impact on the criticality analysis of the 2H Evaporator system. It is recommended that at least a theoretical evaluation to confirm the finding that no self-propagating violent reactions with nitrate/nitrites will occur should be performed. Similarly, identification of sources of ignition relevant to glycolate and/or update of the composite flammability analysis to reflect the effects from the glycolate additions for the 2H Evaporator system are in order. An evaluation of the 2H Evaporator criticality analysis is also needed. A determination of the amount or fraction of the glycolate in the evaporator overhead is critical to more accurately assess its impact on the ETF. Hence, use of predictive models like OLI Environmental Simulation Package Software (OLI/ESP) and/or testing are recommended for the determination of the glycolate concentration in the overhead. The impact on the ETF depends on the concentration of glycolate in the ETF feed. The impact is classified as minor for feed glycolate concentrations (le) 33 mg/L or 0.44 mM. The ETF unit operations that will have

  7. LITERATURE REVIEW ON IMPACT OF GLYCOLATE ON THE 2H EVAPORATOR AND THE EFFLUENT TREATMENT FACILITY

    Energy Technology Data Exchange (ETDEWEB)

    Adu-Wusu, K.

    2012-05-10

    Glycolic acid (GA) is being studied as an alternate reductant in the Defense Waste Processing Facility (DWPF) feed preparation process. It will either be a total or partial replacement for the formic acid that is currently used. A literature review has been conducted on the impact of glycolate on two post-DWPF downstream systems - the 2H Evaporator system and the Effluent Treatment Facility (ETF). The DWPF recycle stream serves as a portion of the feed to the 2H Evaporator. Glycolate enters the evaporator system from the glycolate in the recycle stream. The overhead (i.e., condensed phase) from the 2H Evaporator serves as a portion of the feed to the ETF. The literature search revealed that virtually no impact is anticipated for the 2H Evaporator. Glycolate may help reduce scale formation in the evaporator due to its high complexing ability. The drawback of the solubilizing ability is the potential impact on the criticality analysis of the 2H Evaporator system. It is recommended that at least a theoretical evaluation to confirm the finding that no self-propagating violent reactions with nitrate/nitrites will occur should be performed. Similarly, identification of sources of ignition relevant to glycolate and/or update of the composite flammability analysis to reflect the effects from the glycolate additions for the 2H Evaporator system are in order. An evaluation of the 2H Evaporator criticality analysis is also needed. A determination of the amount or fraction of the glycolate in the evaporator overhead is critical to more accurately assess its impact on the ETF. Hence, use of predictive models like OLI Environmental Simulation Package Software (OLI/ESP) and/or testing are recommended for the determination of the glycolate concentration in the overhead. The impact on the ETF depends on the concentration of glycolate in the ETF feed. The impact is classified as minor for feed glycolate concentrations {le} 33 mg/L or 0.44 mM. The ETF unit operations that will have

  8. Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues: a literature review

    International Nuclear Information System (INIS)

    Pasquier, David; Hoelscher, Tobias; Schmutz, Jorg; Dische, Stanley; Mathieu, Daniel; Baumann, Michael; Lartigau, Eric

    2004-01-01

    Late complications are one of the major factors limiting radiotherapy treatment, and their treatment is not codified. Hyperbaric oxygen (HBO) has been used in combination with radiotherapy for over half a century, either to maximise its effectiveness or in an attempt to treat late complications. In this latter case, retrospective trials and case reports are prevailing in literature. This prompted European Society for Therapeutic Radiotherapy and Oncology and European Committee for Hyperbaric Medicine to organise a consensus conference in October 2001, dealing with the HBO indications on radiotherapy for the treatment and prevention of late complications. This updated literature review is part of the documents the jury based its opinion on. A systematic search was done on literature from 1960 to 2004, by only taking into account the articles that appeared in peer review journals. Hyperbaric oxygen treatment involving complications to the head and neck, pelvis and nervous system, and the prevention of complications after surgery in irradiated tissues have been studied. Despite the small number of controlled trials, it may be indicated for the treatment of mandibular osteoradionecrosis in combination with surgery, haemorrhagic cystitis resistant to conventional treatments and the prevention of osteoradionecrosis after dental extraction, whose level of evidence seems to be the most significant though randomised trials are still necessary. The other treatment methods are also outlined for each location

  9. Methods of removing uranium from drinking water. 1. A literature survey. 2. Present municipal water treatment and potential removal methods

    International Nuclear Information System (INIS)

    Drury, J.S.; Michelson, D.; Ensminger, J.T.; Lee, S.Y.; White, S.K.

    1982-12-01

    Literature was searched for methods of removing uranium from drinking water. U.S. manufacturers and users of water-treatment equipment and products were also contacted regarding methods of removing uranium from potable water. Based on the results of these surveys, it was recommended that untreated, partially treated, and finished water samples from municipal water-treatment facilities be analyzed to determine the extent of removal of uranium by presently used procedures, and that additional laboratory studies be performed to determine what changes are needed to maximize the effectiveness of treatments that are already in use in existing water-treatment plants

  10. The effect of vitamin C and E supplementation in the treatment of ...

    African Journals Online (AJOL)

    Malaria infects a number of people in Sub-Saharan Africa and is gradually becoming endemic in this region. This study was undertaken to assess the effect of malaria on antioxidant status and also to ascertain whether antioxidant vitamins could be useful in the treatment of malaria. The study group comprised of 40 patients ...

  11. Efficacy of resveratrol to supplement oral nifedipine treatment in pregnancy-induced preeclampsia

    Directory of Open Access Journals (Sweden)

    Jian Ding

    2017-10-01

    Full Text Available Objective: Preeclampsia (PE is a complication affecting pregnant women worldwide, which usually manifests as severe maternal hypertension. Resveratrol (RESV, a naturally existing polyphenol, is known to exhibit beneficial effects in cardiovascular disease including hypertension. We evaluated the outcome of treatment combining oral nifedipine (NIFE and RESV against PE. Design and methods: Using a randomized group assignment, 400 PE patients were enrolled and received oral treatments of either NIFE + RESV or NIFE + placebo. Primary endpoints were defined as time to control blood pressure and time before a new hypertensive crisis. Secondary endpoints were defined as the number of doses needed to control blood pressure, maternal and neonatal adverse effects. Results: Compared with the NIFE + placebo group, the time needed to control blood pressure was significantly reduced in NIFE + RESV group, while time before a new hypertensive crisis was greatly delayed in NIFE + RESV group. The number of treatment doses needed to control blood pressure was also categorically lower in NIFE + RESV group. No differences in maternal or neonatal adverse effects were observed between the two treatment groups. Conclusion: Our data support the potential of RESV as a safe and effective adjuvant of oral NIFE to attenuate hypertensive symptoms among PE patients.

  12. LITERATURE SURVEY FOR GROUNDWATER TREATMENT OPTIONS FOR NITRATE IODINE-129 AND URANIUM 200-ZP-1 OPERABLE UNIT HANFORD SITE

    Energy Technology Data Exchange (ETDEWEB)

    BYRNES ME

    2008-06-05

    This literature review presents treatment options for nitrate, iodine-129, and uranium, which are present in groundwater at the 200-ZP-I Groundwater Operable Unit (OU) within the 200 West Area of the Hanford Site. The objective of this review is to determine available methods to treat or sequester these contaminants in place (i.e., in situ) or to pump-and-treat the groundwater aboveground (i.e., ex situ). This review has been conducted with emphasis on commercially available or field-tested technologies, but theoretical studies have, in some cases, been considered when no published field data exist. The initial scope of this literature review included only nitrate and iodine-I 29, but it was later expanded to include uranium. The focus of the literature review was weighted toward researching methods for treatment of nitrate and iodine-129 over uranium because of the relatively greater impact of those compounds identified at the 200-ZP-I OU.

  13. LITERATURE SURVEY FOR GROUNDWATER TREATMENT OPTIONS FOR NITRATE, IODINE-129 AND URANIUM 200-ZP-1 OPERABLE UNIT, HANFORD SITE

    International Nuclear Information System (INIS)

    BYRNES ME

    2008-01-01

    This literature review presents treatment options for nitrate, iodine-129, and uranium, which are present in groundwater at the 200-ZP-I Groundwater Operable Unit (OU) within the 200 West Area of the Hanford Site. The objective of this review is to determine available methods to treat or sequester these contaminants in place (i.e., in situ) or to pump-and-treat the groundwater aboveground (i.e., ex situ). This review has been conducted with emphasis on commercially available or field-tested technologies, but theoretical studies have, in some cases, been considered when no published field data exist. The initial scope of this literature review included only nitrate and iodine-I 29, but it was later expanded to include uranium. The focus of the literature review was weighted toward researching methods for treatment of nitrate and iodine-129 over uranium because of the relatively greater impact of those compounds identified at the 200-ZP-I OU

  14. Intractable occipital lobe epilepsy: clinical characteristics, surgical treatment, and a systematic review of the literature.

    Science.gov (United States)

    Yang, Peng-Fan; Jia, Yan-Zeng; Lin, Qiao; Mei, Zhen; Chen, Zi-Qian; Zheng, Zhi-Yong; Zhang, Hui-Jian; Pei, Jia-Sheng; Tian, Jun; Zhong, Zhong-Hui

    2015-01-01

    We reported our experience in the surgical treatment of a relatively large cohort of patients with occipital lobe epilepsy (OLE). We also carried out a systematic review of the literature on OLE. Thirty-five consecutive patients who underwent occipital resection for epilepsy were included. Diagnoses were made following presurgical evaluations, including magnetic resonance imaging (MRI), fluorodeoxyglucose-positron emission tomography (FDG-PET), scalp video-electroencephalogram (EEG) monitoring, and intracranial EEG monitoring. At last follow-up, seizure outcome was classified using the Engel classification scheme. Twenty-five of 35 patients experienced/had experienced ≥1 type of aura before the seizure. Invasive recordings were used to define the epileptogenic area in 30 of 35 patients (85.7 %). All patients underwent occipital lesionectomies or topectomies. Histopathology revealed: cortical dysplasias, gliosis, dysembryoplastic neuroepithelial tumor, ganglioglioma, and tuberous sclerosis. After a mean follow-up of 44 months, 25 patients (71.4 %) were seizure free (Engel class I), 3 (8.6 %) rarely had seizures (Engel class II), 5 (14.3 %) improved more than 75 % (Engel class III), and 2 (5.7 %) had no significant improvement (Engel class IV). Preoperatively, 12 of 33 patients (36.4 %) had visual field deficits. Postoperatively, 25 patients (75.8 %) had new or aggravated visual field deficits. The management of OLE has been aided greatly by the availability of high-resolution diagnosis. Postoperative visual field deficits occur in a significant proportion of patients. Comprehensive intracranial EEG coverage of all occipital surfaces helps to define the epileptogenic area and preserve visual function, especially in cases of focal cortical dysplasia undetectable by MRI.

  15. Endoluminal brachytherapy in the treatment of oesophageal cancer: technique description, case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Luisa Castilla

    2015-07-01

    Full Text Available Endoesophageal brachytherapy is a useful technique for the palliative treatment of dysphagia in advanced oesophageal cancer. This technique offers good results on dysphagia control and quality of life. We report the case of a patient treated with this technique presenting complete response to the dysphagia. We describe endoesophageal brachyterapy technique and we comment on the literature.

  16. Review of the Literature Regarding the Efficacy of Neurofeedback in the Treatment of Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Lingenfelter, Jennifer E.

    This document presents a review of the most recent literature regarding the efficacy of electroencephalographic biofeedback, more commonly known as neurofeedback, in the treatment of attention deficit hyperactivity disorder (ADHD). The studies reviewed indicated that neurofeedback can be a successful component of treating attentional deficits and…

  17. Sludge Treatment Project Engineered Container Retrieval And Transfer System Preliminary Design Hazard Analysis Supplement 1

    International Nuclear Information System (INIS)

    Franz, G.R.; Meichle, R.H.

    2011-01-01

    This 'What/If' Hazards Analysis addresses hazards affecting the Sludge Treatment Project Engineered Container Retrieval and Transfer System (ECRTS) NPH and external events at the preliminary design stage. In addition, the hazards of the operation sequence steps for the mechanical handling operations in preparation of Sludge Transport and Storage Container (STSC), disconnect STSC and prepare STSC and Sludge Transport System (STS) for shipping are addressed.

  18. Energy supplementation in Santa Inês sheep subjected to estrus induction treatment

    Directory of Open Access Journals (Sweden)

    Sabrina Silva Venturi

    2016-02-01

    Full Text Available The aim of this study was to evaluate the effect of a 20% increase in dietary energy during short-term estrus induction treatment on the reproductive parameters of Santa Inês ewes. Females (n=43 were allocated into two experimental groups according to the amount of energy inclusion in the diet: maintenance diet or maintenance diet plus 20% energy. Ultrasound examinations were performed in order to detect ovulation. To assess sexual behavior, ewes were teased and further mated. Blood samples were collected for the determination of glucose and insulin concentrations. There was no difference (P>0.05 between groups in the following categories: ovulation rate (80.00% vs. 60.00%, largest follicle diameter (6.00 ± 0.20 vs. 5.90 ± 0.60, interval from device removal to ovulation (52.80 ± 14.87 vs. 59.01 ± 8.34 hours, animals in estrus (75.00% vs. 65.21%, interval from device removal to estrus (30.00 ± 15.49 vs. 30.00 ± 13.35 hours and conception rate (50.00% vs. 21.73%. There were differences (P<0.05 in the concentrations of insulin and glucose. It can be concluded that the 20% increase in energy in the diet during short-term estrus induction treatment did not affect the reproductive parameters studied.

  19. Engaging Foster Parents in Treatment: A Randomized Trial of Supplementing Trauma-focused Cognitive Behavioral Therapy with Evidence-based Engagement Strategies

    OpenAIRE

    Dorsey, Shannon; Pullmann, Michael D.; Berliner, Lucy; Koschmann, Elizabeth; McKay, Mary; Deblinger, Esther

    2014-01-01

    The goal of this study was to examine the impact of supplementing Trauma-focused Cognitive Behavioral Therapy (TF-CBT; Cohen, Mannarino, & Deblinger, 2006) with evidence-based engagement strategies on foster parent and foster youth engagement in treatment, given challenges engaging foster parents in treatment. A randomized controlled trial of TF-CBT standard delivery compared to TF-CBT plus evidence-based engagement strategies was conducted with 47 children and adolescents in foster care and ...

  20. Optimising the physicochemical treatment of textile effluents by supplementing it with biological processes; Optimizacion de la depuracion fisocoquimica en efluentes textiles, completandola con procesos biologicos

    Energy Technology Data Exchange (ETDEWEB)

    Crespi Rosell, M. [Instituto de Investigacion Textil y Cooperacion Industrial de Tarrasa (Spain)

    1999-07-01

    This article sets out how to increase the elimination of organic material in physicochemical coagulation/flocculation processes. It describes the optimisation of a coagulation/flocculation waste water treatment plant in a flock dyeing factory through increasing the biological activity in the homogenization pond by supplementing it with a percolating filter. Other modifications made subsequently to physicochemical waste water treatment plants for the same purpose are also described. (Author) 9 refs.

  1. Further analysis of multicentre cystathionine beta synthase deficiency thrombosis data and metabolic pathways suggests potentially better treatment via improved cysteine supplementation, diet, antioxidant supplementation, follow-up and testing for thrombophilic mutations

    Directory of Open Access Journals (Sweden)

    David Vance

    2017-01-01

    Full Text Available Background Homozygous or compound heterozygous Cystathionine-beta-synthase deficiency (CBS-- may result in thrombosis. Treatment has included various combinations of: low-methionine diets, cystine (cystine dimer-enriched amino acid supplementation, vitamin B6, folic acid, vitamin B12 and betaine. Treatment compliance and outcomes even in the most-developed countries are mostly sub-optimal and variable, and the differing theoretical metabolic ramifications due to differing treatments have not been well addressed. The aim of this work was to further analyse the thrombosis events data of Yap et al (2001/2003, and to compare these with the rate of thrombosis in the general population, and to examine the theoretical significance of the metabolic pathways affected by CBS-- and its treatments, and so find any potential improvements in treatments, considering also less-developed areas. Methods Yap et al’s (2001/2003 data of the thrombosis outcomes of five major (CBS---treating centers: in Dublin, Sydney, Nijmegen, Manchester and London; were statistically compared with outcomes predicted by Mudd et al’s (1985 untreated natural history outcomes, and then Dublin versus the others; these rates were then compared with those of general populations; and treatments were examined regarding their theoretical metabolic ramifications. Results There were less thrombosis outcomes (P<.05 in the treated and followed CBS-- patient groups of each of the five centers, even when considered singly, than that expected in the absence of treatment by reference to the natural history data of Mudd et al (1985, but the reduction was less than half that claimed by Yap et al, and the remaining level of thrombosis is roughly 10 times that of the general population. The thromboses outcome (nil of the Dublin group is better than that of the other four groups, but only at P ~ 0.16 with the other four groups combined, or P = 0.14 to 0.23 singly. Treatment regimens differ, including

  2. Phytoestrogens in menopausal supplements induce ER-dependent cell proliferation and overcome breast cancer treatment in an in vitro breast cancer model

    International Nuclear Information System (INIS)

    Duursen, Majorie B.M. van; Smeets, Evelien E.J.W.; Rijk, Jeroen C.W.; Nijmeijer, Sandra M.; Berg, Martin van den

    2013-01-01

    Breast cancer treatment by the aromatase inhibitor Letrozole (LET) or Selective Estrogen Receptor Modulator Tamoxifen (TAM) can result in the onset of menopausal symptoms. Women often try to relieve these symptoms by taking menopausal supplements containing high levels of phytoestrogens. However, little is known about the potential interaction between these supplements and breast cancer treatment, especially aromatase inhibitors. In this study, interaction of phytoestrogens with the estrogen receptor alpha and TAM action was determined in an ER-reporter gene assay (BG1Luc4E2 cells) and human breast epithelial tumor cells (MCF-7). Potential interactions with aromatase activity and LET were determined in human adrenocorticocarcinoma H295R cells. We also used the previously described H295R/MCF-7 co-culture model to study interactions with steroidogenesis and tumor cell proliferation. In this model, genistein (GEN), 8-prenylnaringenin (8PN) and four commercially available menopausal supplements all induced ER-dependent tumor cell proliferation, which could not be prevented by physiologically relevant LET and 4OH-TAM concentrations. Differences in relative effect potencies between the H295R/MCF-7 co-culture model and ER-activation in BG1Luc4E2 cells, were due to the effects of the phytoestrogens on steroidogenesis. All tested supplements and GEN induced aromatase activity, while 8PN was a strong aromatase inhibitor. Steroidogenic profiles upon GEN and 8PN exposure indicated a strong inhibitory effect on steroidogenesis in H295R cells and H295R/MCF-7 co-cultures. Based on our in vitro data we suggest that menopausal supplement intake during breast cancer treatment should better be avoided, at least until more certainty regarding the safety of supplemental use in breast cancer patients can be provided. - Highlights: • Supplements containing phytoestrogens are commonly used by women with breast cancer. • Phytoestrogens alter steroidogenesis in a co-culture breast

  3. Phytoestrogens in menopausal supplements induce ER-dependent cell proliferation and overcome breast cancer treatment in an in vitro breast cancer model

    Energy Technology Data Exchange (ETDEWEB)

    Duursen, Majorie B.M. van, E-mail: M.vanDuursen@uu.nl [Endocrine Toxicology, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 104, PO Box 80177, 3508 TD, Utrecht (Netherlands); Smeets, Evelien E.J.W. [Endocrine Toxicology, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 104, PO Box 80177, 3508 TD, Utrecht (Netherlands); Rijk, Jeroen C.W. [RIKILT - Institute for Food Safety, Wageningen UR, P.O. Box 230, 6700 AE, Wageningen (Netherlands); Nijmeijer, Sandra M.; Berg, Martin van den [Endocrine Toxicology, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 104, PO Box 80177, 3508 TD, Utrecht (Netherlands)

    2013-06-01

    Breast cancer treatment by the aromatase inhibitor Letrozole (LET) or Selective Estrogen Receptor Modulator Tamoxifen (TAM) can result in the onset of menopausal symptoms. Women often try to relieve these symptoms by taking menopausal supplements containing high levels of phytoestrogens. However, little is known about the potential interaction between these supplements and breast cancer treatment, especially aromatase inhibitors. In this study, interaction of phytoestrogens with the estrogen receptor alpha and TAM action was determined in an ER-reporter gene assay (BG1Luc4E2 cells) and human breast epithelial tumor cells (MCF-7). Potential interactions with aromatase activity and LET were determined in human adrenocorticocarcinoma H295R cells. We also used the previously described H295R/MCF-7 co-culture model to study interactions with steroidogenesis and tumor cell proliferation. In this model, genistein (GEN), 8-prenylnaringenin (8PN) and four commercially available menopausal supplements all induced ER-dependent tumor cell proliferation, which could not be prevented by physiologically relevant LET and 4OH-TAM concentrations. Differences in relative effect potencies between the H295R/MCF-7 co-culture model and ER-activation in BG1Luc4E2 cells, were due to the effects of the phytoestrogens on steroidogenesis. All tested supplements and GEN induced aromatase activity, while 8PN was a strong aromatase inhibitor. Steroidogenic profiles upon GEN and 8PN exposure indicated a strong inhibitory effect on steroidogenesis in H295R cells and H295R/MCF-7 co-cultures. Based on our in vitro data we suggest that menopausal supplement intake during breast cancer treatment should better be avoided, at least until more certainty regarding the safety of supplemental use in breast cancer patients can be provided. - Highlights: • Supplements containing phytoestrogens are commonly used by women with breast cancer. • Phytoestrogens alter steroidogenesis in a co-culture breast

  4. Treatment of acne scarring using a dual-spot-size ablative fractionated carbon dioxide laser: review of the literature.

    Science.gov (United States)

    Tierney, Emily P

    2011-07-01

    Fractional photothermolysis has been reported in the literature to improve pigmentary and textural changes associated with acne scarring. To review the literature for the treatment of acne scarring using nonablative fractional laser (NAFL) and ablative fractional laser (AFL) resurfacing. Review of the Medline literature evaluating NAFL and AFL for acne scarring. NAFL and AFL are safe and effective treatments for acne scarring. It is likely that the controlled, limited dermal heating of fractional resurfacing initiates a cascade of events in which normalization of the collagenesis-collagenolysis cycle occurs. We present the results of a patient treated using a novel dual-spot-size AFL device. Three months after the final treatment, the patient reported 75% improvement in acne scarring and 63% overall improvement in photoaging. Fractionated resurfacing for the treatment of acne scarring is associated with lesser risks of side effects of prolonged erythema and risks of delayed-onset dyspigmentation and scarring which complicate traditional ablative laser resurfacing approaches. We present herein preliminary data suggesting that a dual-spot-size AFL device presents novel advantages of improving texture and pigmentation in acne scarring and photoaging. © 2011 by the American Society for Dermatologic Surgery, Inc.

  5. Clinical Usefulness of Oral Supplementation with Alpha-Lipoic Acid, Curcumin Phytosome, and B-Group Vitamins in Patients with Carpal Tunnel Syndrome Undergoing Surgical Treatment

    Directory of Open Access Journals (Sweden)

    Giorgio Pajardi

    2014-01-01

    Full Text Available We investigated the clinical usefulness of oral supplementation with a combination product containing alpha-lipoic acid, curcumin phytosome, and B-group vitamins in 180 patients with carpal tunnel syndrome (CTS, scheduled to undergo surgical decompression of the median nerve. Patients in Group A (n=60 served as controls and did not receive any treatment either before or after surgery. Patients in Group B (n=60 received oral supplementation twice a day for 3 months both before and after surgery (totaling 6 months of supplementation. Patients in Group C (n=60 received oral supplementation twice a day for 3 months before surgery only. Patients in Group B showed significantly lower nocturnal symptoms scores compared with Group A subjects at both 40 days and 3 months after surgery (both P values <0.05. Moreover, patients in Group B had a significantly lower number of positive Phalen’s tests at 3 months compared with the other study groups (P<0.05. We conclude that oral supplementation with alpha-lipoic acid, curcumin phytosome, and B-group vitamins twice a day both before and after surgery is safe and effective in CTS patients scheduled to undergo surgical decompression of the median nerve.

  6. Treatment Considerations for the Cardiometabolic Signs of Polycystic Ovary Syndrome: A Review of the Literature Since the 2013 Endocrine Society Clinical Practice Guidelines.

    Science.gov (United States)

    Fields, Errol L; Trent, Maria E

    2016-05-01

    Polycystic ovary syndrome is characterized by an excess in androgen levels, ovarian dysfunction, and polycystic ovarian morphology but is also associated with metabolic dysfunction and risk factors for cardiovascular disease. To our knowledge, there are few therapeutic recommendations for these cardiometabolic risk factors and little evidence of their long-term clinical relevance to cardiovascular health. To determine metabolic and/or cardiovascular outcomes in polycystic ovary syndrome treatment literature since the publication of the most recent Endocrine Society clinical practice guidelines in 2013. We searched PubMed using a string of variations of polycystic ovary syndrome, therapy/treatment, and adolescence, and we included English-language original research articles published while the 2013 clinical practice guidelines were disseminated (ie, articles published from January 1, 2011, to June 1, 2015). Articles that appeared relevant based on a review of titles and abstracts were read in full to determine relevancy. References from relevant articles were reviewed for additional studies. Four topic areas emerged: (1) lifestyle modification, (2) metformin vs placebo or estrogen-progestin oral contraceptives, (3) insulin-sensitizing agents, and (4) estrogen-progestin formulations. Most studies assessed the role of metformin as a monotherapy or dual therapy supplement and found significant benefit when including metformin in polycystic ovary syndrome treatment regimens. Studies showed improvements in cardiometabolic risk factors and, in several, androgen excess and cutaneous and menstrual symptoms. Studies were limited by sample size (range, 22-171), few adolescent participants, and short-term outcomes. Findings show potential for metformin and estrogen-progestin dual therapy but warrant longitudinal studies examining outcomes from adolescence through middle age to determine the effect on long-term cardiovascular health.

  7. Literature search on the use of resins for treatment of radioactive wastes

    International Nuclear Information System (INIS)

    AlMahamid, I.; Smith, B.M.

    1997-10-01

    Over 100 commercial providers with mixed-waste treatability capabilities exist in the US. The maturity level of these technologies varies from a bench scale to a pilot or a commercial scale. The techniques include deactivation, chemical oxidation, recovery of metals, stabilization, vitrification, incineration, biodegradation, and chemical extraction. This report focuses on the use of resins to remove actinides and heavy metals from aqueous waste streams. Only the literature that described resins with high removing efficiency are presented here. The majority of the literature reviewed are proceedings and national or international reports ordered through the Berkeley Lab Library. Some of the reports that the authors requested have not yet arrived. Only a few papers were found in the open literature (journals or magazines). Although this report does not include all existing references, it provides an accurate assessment of efficient resins to be considered for waste minimization procedures. 70 refs

  8. A Proposed Molecular Mechanism of High-Dose Vitamin D3 Supplementation in Prevention and Treatment of Preeclampsia.

    Science.gov (United States)

    Zabul, Piotr; Wozniak, Michal; Slominski, Andrzej T; Preis, Krzysztof; Gorska, Magdalena; Korozan, Marek; Wieruszewski, Jan; Zmijewski, Michal A; Zabul, Ewa; Tuckey, Robert; Kuban-Jankowska, Alicja; Mickiewicz, Wieslawa; Knap, Narcyz

    2015-06-09

    A randomized prospective clinical study performed on a group of 74 pregnant women (43 presenting with severe preeclampsia) proved that urinary levels of 15-F(2t)-isoprostane were significantly higher in preeclamptic patients relative to the control (3.05 vs. 2.00 ng/mg creatinine). Surprisingly enough, plasma levels of 25-hydroxyvitamin D3 in both study groups were below the clinical reference range with no significant difference between the groups. In vitro study performed on isolated placental mitochondria and placental cell line showed that suicidal self-oxidation of cytochrome P450scc may lead to structural disintegration of heme, potentially contributing to enhancement of oxidative stress phenomena in the course of preeclampsia. As placental cytochrome P450scc pleiotropic activity is implicated in the metabolism of free radical mediated arachidonic acid derivatives as well as multiple Vitamin D3 hydroxylations and progesterone synthesis, we propose that Vitamin D3 might act as a competitive inhibitor of placental cytochrome P450scc preventing the production of lipid peroxides or excess progesterone synthesis, both of which may contribute to the etiopathogenesis of preeclampsia. The proposed molecular mechanism is in accord with the preliminary clinical observations on the surprisingly high efficacy of high-dose Vitamin D3 supplementation in prevention and treatment of preeclampsia.

  9. A Proposed Molecular Mechanism of High-Dose Vitamin D3 Supplementation in Prevention and Treatment of Preeclampsia

    Directory of Open Access Journals (Sweden)

    Piotr Zabul

    2015-06-01

    Full Text Available A randomized prospective clinical study performed on a group of 74 pregnant women (43 presenting with severe preeclampsia proved that urinary levels of 15-F2t-isoprostane were significantly higher in preeclamptic patients relative to the control (3.05 vs. 2.00 ng/mg creatinine. Surprisingly enough, plasma levels of 25-hydroxyvitamin D3 in both study groups were below the clinical reference range with no significant difference between the groups. In vitro study performed on isolated placental mitochondria and placental cell line showed that suicidal self-oxidation of cytochrome P450scc may lead to structural disintegration of heme, potentially contributing to enhancement of oxidative stress phenomena in the course of preeclampsia. As placental cytochrome P450scc pleiotropic activity is implicated in the metabolism of free radical mediated arachidonic acid derivatives as well as multiple Vitamin D3 hydroxylations and progesterone synthesis, we propose that Vitamin D3 might act as a competitive inhibitor of placental cytochrome P450scc preventing the production of lipid peroxides or excess progesterone synthesis, both of which may contribute to the etiopathogenesis of preeclampsia. The proposed molecular mechanism is in accord with the preliminary clinical observations on the surprisingly high efficacy of high-dose Vitamin D3 supplementation in prevention and treatment of preeclampsia.

  10. Hepatitis C and Dietary Supplements: What the Science Says

    Science.gov (United States)

    ... Integrative Health NCCIH Clinical Digest for health professionals Hepatitis C and Dietary Supplements: What the Science Says ... Thinkstock Clinical Guidelines, Scientific Literature, Info for Patients: Hepatitis C and Dietary Supplements Dietary Supplements Milk Thistle ...

  11. Coenzyme Q10 Supplementation and Oocyte Aneuploidy in Women Undergoing IVF-ICSI Treatment

    Directory of Open Access Journals (Sweden)

    Yaakov Bentov

    2014-01-01

    Full Text Available Background The age-related reduction in live-birth rate is attributed to a high rate of aneuploidy and follicle depletion. We showed in an animal model that treatment with Coenzyme Q10 (CoQ10 markedly improved reproductive outcome. The aim of this study was to compare the post-meiotic oocyte aneuploidy rate in in vitro fertilization (IVF and intra cytoplasmic sperm injection (ICSI patients treated with CoQ10 or placebo. Methods We conducted a double blind placebo controlled randomized trial that included IVF-ICSI patients 35-43 years of age. The patients were treated with either 600 mg of CoQ10 or an equivalent number of placebo caps. We compared the post-meiotic aneuploidy rate using polar body biopsy (PBBX and comparative genomic hybridization (CGH. According to the power calculation, 27 patients were needed for each arm. Results Owing to safety concerns regarding the effects of polar body biopsy on embryo quality and implantation, the study was terminated before reaching the target number of participants. A total of 39 patients were evaluated and randomized (17 CoQ10, 22 placebo, 27 were given the study medication (12 CoQ10, 15 placebo, and 24 completed an IVF-ICSI cycle including PBBX and embryo transfer (10 CoQ10, 14 placebo. Average age, base line follicle stimulating hormone (FSH, peak estradiol and progesterone serum level, as well as the total number of human menopausal gonadotropin (hMG units–-did not differ between the groups. The rate of aneuploidy was 46.5% in the CoQ10 group compared to 62.8% in the control. Clinical pregnancy rate was 33% for the CoQ10 group and 26.7% for the control group. Conclusion No significant differences in outcome were detected between the CoQ10 and placebo groups. However, the final study was underpowered to detect a difference in the rate of aneuploidy.

  12. Treatment of Hyperthyroidism in Down Syndrome: Case Report and Review of Literature.

    Science.gov (United States)

    Ali, Fawzi E.; Al-Busairi, Waleed A.; Al-Mulla, Fatema A.

    1999-01-01

    A case of an institutionalized adult male with Down syndrome and hyperthyroidism is reported. After treatment with radioactive iodine, he was found to be markedly hypothyroid when he was reviewed 11 weeks later. Three treatment options for hyperthyroidism in Down syndrome are reviewed: surgery, medical treatments, and radiotherapy. (Author/CR)

  13. Habit Reversal Treatment of Tic Disorders: A Methodological Critique of the Literature

    Science.gov (United States)

    Carr, James E.; Chong, Ivy M.

    2005-01-01

    One of the most commonly reported and successful behavioral interventions for tic disorders is habit reversal (HR). Several narrative literature reviews have adequately summarized the outcomes of these studies. The purpose of this article was to review studies that used HR to treat tics in terms of their methodological characteristics and rigor.…

  14. Treatment of symptomatic vertebral hemangioma by radiotherapy - case report and review of the literature

    International Nuclear Information System (INIS)

    Castro, Douglas Guedes de; Lima, Renato Pierre; Maia, Maria Aparecida Conte; Pellizzon, Antonio Cassio Assis; Fogaroli, Ricardo Cesar; Ferrigno, Robson

    2002-01-01

    We report the clinical and imaging findings of a patient with a symptomatic vertebral hemangioma treated with radiotherapy alone. There was partial relief of the pain 3 months after radiotherapy. We recommend a total dose of 40 Gy at 2 Gy per fraction. A review of literature is also presented. (author)

  15. Transarterial embolization treatment for aberrant systemic arterial supply to the normal lung: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Ra; Jo, Jeong Hyun; Park, Byeong Ho [Dept. of Radiology, Dong A University Hospital, Dong A University College of Medicine, Busan (Korea, Republic of)

    2017-06-15

    A 24-year-old man presented with dyspnea on exertion and intermittent blood-tinged sputum. He was diagnosed with aberrant systemic arterial supply to the normal lung (ASANL) based on the results of imaging studies. The patient was successfully treated with transarterial embolization using coils and a vascular plug and his symptoms disappeared during the follow-up. Herein, we reported the imaging findings of ASANL, differential diagnoses, and its treatment options. In addition, we reviewed the relevant literature.

  16. Radiotherapy in fascial fibromatosis: a case series, literature review and considerations for treatment of early-stage disease

    International Nuclear Information System (INIS)

    Grenfell, Solveig; Borg, Martin

    2014-01-01

    Palmar and plantar fascial fibromatoses are benign hyperproliferative disorders of the deep fascia of the palm and sole. This study seeks to examine the role of radiotherapy in the management of fascial fibromatosis. Six consecutive cases of early-stage fascial fibromatosis treated with radiotherapy at the Adelaide Radiotherapy Centre between July 2008 and May 2011 were analysed. The results of the case series were compared with a systematic review of the literature. All six cases regressed or showed a reduction of symptoms following radiotherapy. Treatment was well tolerated with minor toxicities. Median follow-up for the case series was 38.5 months. The systematic review identified seven studies describing the use of radiotherapy as primary treatment for fascial fibromatosis between 1946 and 2013. The literature indicates that radiotherapy can prevent disease progression and improve symptoms for early-stage disease, with low likelihood of significant toxicities. Early results from our case series are consistent with the literature, showing that radiotherapy can provide an effective management option for patients with early-stage fascial fibromatosis, and justify consideration of radiotherapy as a primary treatment for early-stage disease.

  17. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality

    Directory of Open Access Journals (Sweden)

    Berman Stuart

    2011-04-01

    Full Text Available Abstract Background Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity. Objectives This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4MU benzathine penicillin (or equivalent on syphilis-related stillbirths and neonatal mortality. Methods We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken. Results Moderate quality evidence (3 studies supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 – 98% with detection and treatment of women with active syphilis in pregnancy with at least 2.4MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 – 90% (8 studies, a 64% reduction in preterm delivery (95% c.i. 53 – 73% (7 studies and an 80% reduction in neonatal deaths (95% c.i. 68 – 87% (5 studies. Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong. Conclusion Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required.

  18. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality

    Science.gov (United States)

    2011-01-01

    Background Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity. Objectives This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4MU benzathine penicillin (or equivalent) on syphilis-related stillbirths and neonatal mortality. Methods We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken. Results Moderate quality evidence (3 studies) supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 – 98%) with detection and treatment of women with active syphilis in pregnancy with at least 2.4MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 – 90%) (8 studies), a 64% reduction in preterm delivery (95% c.i. 53 – 73%) (7 studies) and an 80% reduction in neonatal deaths (95% c.i. 68 – 87%) (5 studies). Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong. Conclusion Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required. PMID:21501460

  19. Mycotic Aneurysm after Bacillus Calmette-Guérin Treatment: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Nathaniel D. Coddington

    2017-01-01

    Full Text Available Background. Intravesicular Bacillus Calmette-Guérin (BCG is an effective adjunctive therapy for superficial bladder cancer that has been shown to delay recurrence and progression of disease. Serious side effects are relatively rare but are difficult to diagnosis and commonly overlooked. Case Presentation. We report the case of a patient who was found to have mycotic aortic aneurysms secondary to treatment with BCG after a prolonged course with multiple intervening hospitalizations. Conclusion. Through this report, we discuss our present understanding of BCG infection following treatment and review the literature regarding this particular rare manifestation.

  20. Influence of biological aerosol from wastewater treatment plants on workers and the local residents health – literature review

    Directory of Open Access Journals (Sweden)

    Aleksandra Michalak

    2012-12-01

    Full Text Available Bioaerosol forms microbes, their toxins and fragments of microorganisms suspended as small droplets or solid particles. The group particularly exposed are workers of sewage treatment plants and local residents. Literature reports stress the role of the fecal bacteria from the Enterobacteriaceae family and yeasts, which create a real risk of air pollution near the waste water treatment plants Emission of pathogenic microbes prevails in the neighbourhood of of sedimentation tanks, sludge drying beds. Research shows that the extent of bioaerosol influence reaches the distance of 3 km away from any waster water treatment plant.. The most frequent symptoms reported by workers from waste water treatment plants and local residents are respiratory disorders. There are also gastrointestinal and skin problems and general disorders, that can be explained by exposure to endotoxins in bioaerosol.

  1. Aortopexy for the treatment of tracheomalacia in children: review of the literature

    Science.gov (United States)

    2012-01-01

    Abstract Severe tracheomalacia presents a significant challenge for Paediatricians, Intensivists, Respiratory Physicians, Otolaryngologists and Paediatric Surgeons. The treatment of tracheomacia remains controversial, but aortopexy is considered by most to be one of the best options. We conducted a review of the English literature relating to aortopexy. Among 125 papers, 40 have been included in this review. Among 758 patients (62% males) affected with tracheomalacia, 581 underwent aortopexy. Associated co-morbidities were reported in 659 patients. The most frequent association was with oesophageal atresia (44%), vascular ring or large vessel anomalies (18%) and innominate artery compression (16%); in 9% tracheomalacia was idiopathic. The symptoms reported were various, but the most important indication for aortopexy was an acute life-threatening event (ALTE), observed in 43% of patients. The main preoperative investigation was bronchoscopy. Surgical approach was through a left anterior thoracotomy in 72% of patients, while median approach was chosen in 14% and in 1.3% a thoracoscopic aortopexy was performed. At follow-up (median 47 months) more than 80% of the patients improved significantly, but 8% showed no improvement, 4% had a worsening of their symptoms and 6% died. Complications were observed in 15% of patients, in 1% a redo aortopexy was deemed necessary. In our review, we found a lack of general consensus about symptom description and evaluation, indications for surgery, though ALTE and bronchoscopy were considered by all an absolute indication to aortopexy and the gold standard for the diagnosis of tracheomalacia, respectively. Differences were reported also in surgical approaches and technical details, so that the same term “aortopexy” was used to describe different types of procedures. Whatever approach or technique was used, the efficacy of aortopexy was reported as high in the majority of cases (more than 80%). A subgroup of patients particularly

  2. Treatment of Malignant Gliomas in Elderly Patients: A Concise Overview of the Literature

    Directory of Open Access Journals (Sweden)

    Patrizia Farina

    2014-01-01

    Full Text Available Gliomas are the most frequent primary brain tumors and the incidence data has increased in the elderly population. Unfortunately, prospective studies on this population are few and so the right treatment is unknown. In the elderly patients no standard treatment has been established and therefore the optimal treatment should be individualized. We performed a review analyzing the prognostic and predictive factors, the clinical studies, and the correct management of this population.

  3. The Treatment of Tacrolimus (FK506 for Psoriasis: One Case Report and Literature Analysis

    Directory of Open Access Journals (Sweden)

    Cao Wei-gang

    2013-12-01

    Full Text Available Psoriasis is a chronic recurrent inflammatory dermatosis, which is characterized by epidermal proliferation and erythema scales. Its etiology and pathogenesis are still unknown and treatment is difficult. The concentration of tacrolimus for the treatment of psoriasis has not been reported at home and abroad. In this report, we detected the tacrolimus plasma concentration and hope to provide a certain reference value for the clinical treatment of psoriasis.

  4. Physical exercise as a supplement to outpatient treatment of alcohol use disorders – design and preliminary results of a randomized controlled trial

    DEFF Research Database (Denmark)

    Sari, Sengül; Bilberg, Randi Marie; Roessler, Kirsten Kaya

    Background and aim Alcohol use disorder is a widespread problem in Denmark and has severe impacts on health and quality of life of each individual. The clinical treatment of alcohol use disorder involves evidence-based knowledge on medical treatment, physical training, and psychological management...... the study and inform about the first preliminary results. Perspectives If this study detects a positive relationship between exercise as a supplement to alcohol treatment and patients’ alcohol intake, quality of life, fitness, well-being, anxiety, depression and interpersonal problems...

  5. Palliative radiotherapy for painful bone metastases, single versus multiple fraction treatment: a literature review

    International Nuclear Information System (INIS)

    McKee, L.

    2005-01-01

    Palliative radiotherapy provides pain relief for patients with painful bone metastases. The practice among radiation oncologists as to whether a large single fraction is most effective, or whether multiple smaller fractions are preferable in providing the quickest, most durable pain relief is inconsistent. A literature review was completed to see if there is consensus about whether there is better pain response and control following single versus multiple fraction radiotherapy. The Pub Med search engine was used to find all reported studies comparing single and multiple fraction radiotherapy for painful bone metastases. Each article was reviewed according to specific criteria. A generalized conclusion was ascertained from each study and then compared. Among the studies reviewed, the consensus concluded that single fraction radiotherapy was the better choice for palliation of painful bone metastases. According to the literature reviewed, single fraction radiotherapy provides adequate pain relief with reasonable duration of pain response. (author)

  6. An overview of the literature on sexual harassment: Perpetrator, theory, and treatment issues

    OpenAIRE

    Pina, Afroditi; Gannon, Theresa A.; Saunders, Benjamin

    2009-01-01

    Sexual harassment has been recognized as a serious problem in the literature over the past 30 years. In this\\ud paper, we review the existing research surrounding the phenomenon of sexual harassment, paying particular\\ud attention to factors of relevance for understanding perpetrators of sexual harassment. We also provide an\\ud overview of the perplexing nature of sexual harassment and the various concerns that have surrounded the\\ud topic leading to its recognition. The different theoretical...

  7. The use of cultured epithelial autograft in the treatment of major burn injuries: a critical review of the literature.

    Science.gov (United States)

    Wood, F M; Kolybaba, M L; Allen, P

    2006-06-01

    The need to achieve rapid wound closure in patients with massive burns and limited skin donor sites led to the investigation of in vitro cellular expansion of keratinocytes. The use of cultured epithelial autografts (CEA) was first reported in the treatment of major burns in 1981. Since that time, support for the use of CEA has varied, ranging from 'a useful agent' to having 'no demonstrable effect on the outcome of extensively burned patients'. This critical review of the literature examines issues associated with the use of CEA and the introduction of the technology into clinical practice. The factors potentially limiting the use of cultured CEA are the time necessary to culture CEA sheets, the reliability of 'take', vulnerability of grafts on the newly healed surface, long-term durability and the cost implications of such treatment. The available literature was located and critically evaluated using the Australian National Health and Medical Research Council Guidelines. In the identified literature, the level of evidence to support the use of CEA in major burn injures is limited and often restricted to case studies and case series with no Level 1 evidence currently available. The main question arising 'Does CEA have a role in the treatment of major burns?' has proven difficult to answer due to the wide variation in both the quality of study design and the findings. At best, the literature review has highlighted areas of concern that have hindered the successful use of CEA. Our review critically evaluates the use of CEA and explores the advances in techniques towards attempting to improve reliable clinical implementation of CEA. The need for higher level research into the use of CEA is emphasised by this review.

  8. Update of endovenous treatment modalities for insufficient saphenous veins-A review of literature

    NARCIS (Netherlands)

    van Eekeren, Ramon R. J. P.; Boersma, Doeke; de Vries, Jean-Paul P. M.; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    Lower-limb venous insufficiency resulting from saphenous vein incompetence is a common disorder, increasing with age. For decades, surgical stripping of the great saphenous vein has been the gold standard in varicose vein treatment. The desire to optimize outcomes of treatment and reduce surgical

  9. Premorbid and illness-related social difficulties in eating disorders: an overview of the literature and treatment developments.

    Science.gov (United States)

    Cardi, Valentina; Tchanturia, Kate; Treasure, Janet

    2018-01-17

    Social difficulties in eating disorders can manifest as predisposing traits and premorbid difficulties, and/or as consequences of the illness. Objective The aim of this paper is to briefly review the evidence for social problems in people with eating disorders and to consider the literature on treatments that target these features. Method A narrative review of the literature was conducted. Results People with eating disorders often manifest traits, such as shyness, increased tendency to submissiveness and social comparison, and problems with peer relationships before illness onset. Further social difficulties occur as the illness develops, including impaired social cognition and increased threat sensitivity. All relationships with family, peers and therapists are compromised by these effects. Thus, social difficulties are both risk and maintaining factors of eating disorders and are suitable targets for interventions. Several forms of generic treatments (e.g. interpersonal psychotherapy, cognitive analytic therapy, focal psychodynamic therapy) have an interpersonal focus and show some efficacy. Guided self-management based on the cognitive interpersonal model of the illness and directed to both individuals and support persons have been found to improve outcomes for all parties. Adjunctive treatments that focus on specific social difficulties, such as Cognitive Remediation and Emotion Skills Training and Cognitive Bias Modification have been shown to have promise. Conclusion More work is needed to establish whether these approaches can improve on the rather disappointing outcomes that are attained by currently used treatments for eating disorders. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Thyroidectomy for Painful Thyroiditis Resistant to Steroid Treatment: Three New Cases with Review of the Literature

    Science.gov (United States)

    Mazza, Enrico; Quaglino, Francesco; Suriani, Adolfo; Palestini, Nicola; Gottero, Cristina; Leli, Renzo; Taraglio, Stefano

    2015-01-01

    Thyroidal pain is usually due to subacute thyroiditis (SAT). In more severe forms prednisone doses up to 40 mg daily for 2-3 weeks are recommended. Recurrences occur rarely and restoration of steroid treatment cures the disease. Rarely, patients with Hashimoto's thyroiditis (HT) have thyroidal pain (painful HT, PHT). Differently from SAT, occasional PHT patients showed no benefit from medical treatment so that thyroidectomy was necessary. We report three patients who did not show clinical response to prolonged high dose prednisone treatment: a 50-year-old man, a 35-year-old woman, and a 33-year-old woman. Thyroidectomy was necessary, respectively, after nine-month treatment with 50 mg daily, two-month treatment with 75 mg daily, and one-month treatment with 50 mg daily. The two women were typical cases of PHT. Conversely, in the first patient, thyroid histology showed features of granulomatous thyroiditis, typical of SAT, without fibrosis or lymphocytic infiltration, typical of HT/PHT, coupled to undetectable serum anti-thyroid antibodies. Our data (1) suggest that not only PHT but also SAT may show resistance to steroid treatment and (2) confirm a previous observation in a single PHT patient that increasing prednisone doses above conventional maximal dosages may not be useful in these patients. PMID:26137327

  11. Thyroidectomy for Painful Thyroiditis Resistant to Steroid Treatment: Three New Cases with Review of the Literature

    Directory of Open Access Journals (Sweden)

    Enrico Mazza

    2015-01-01

    Full Text Available Thyroidal pain is usually due to subacute thyroiditis (SAT. In more severe forms prednisone doses up to 40 mg daily for 2-3 weeks are recommended. Recurrences occur rarely and restoration of steroid treatment cures the disease. Rarely, patients with Hashimoto’s thyroiditis (HT have thyroidal pain (painful HT, PHT. Differently from SAT, occasional PHT patients showed no benefit from medical treatment so that thyroidectomy was necessary. We report three patients who did not show clinical response to prolonged high dose prednisone treatment: a 50-year-old man, a 35-year-old woman, and a 33-year-old woman. Thyroidectomy was necessary, respectively, after nine-month treatment with 50 mg daily, two-month treatment with 75 mg daily, and one-month treatment with 50 mg daily. The two women were typical cases of PHT. Conversely, in the first patient, thyroid histology showed features of granulomatous thyroiditis, typical of SAT, without fibrosis or lymphocytic infiltration, typical of HT/PHT, coupled to undetectable serum anti-thyroid antibodies. Our data (1 suggest that not only PHT but also SAT may show resistance to steroid treatment and (2 confirm a previous observation in a single PHT patient that increasing prednisone doses above conventional maximal dosages may not be useful in these patients.

  12. Literature-based recommendations for treatment planning and execution in high-dose radiotherapy for lung cancer

    International Nuclear Information System (INIS)

    Senan, Suresh; De Ruysscher, Dirk; Giraud, Philippe; Mirimanoff, Rene; Budach, Volker

    2004-01-01

    Background and purpose: To review the literature on techniques used in high-dose radiotherapy of lung cancer in order to develop recommendations for clinical practice and for use in research protocols. Patients and methods: A literature search was performed for articles and abstracts that were considered both clinically relevant and practical to use. The relevant information was arbitrarily categorized under the following headings: patient positioning, CT scanning, incorporating tumour mobility, definition of target volumes, radiotherapy planning, treatment delivery, and scoring of response and toxicity. Results: Recommendations were made for each of the above steps from the published literature. Although most of the recommended techniques have yet to be evaluated in multicenter clinical trials, their use in high-dose radiotherapy to the thorax appears to be rational on the basis of current evidence. Conclusions: Recommendations for the clinical implementation of high-dose conformal radiotherapy for lung tumours were identified in the literature. Procedures that are still considered to be investigational were also highlighted

  13. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<.001). This association was still significant while controlling for other contributing factors. In the absence of a controlled trial, we recommend the utmost vigilance and consideration of surgical management in treating such patients. PMID:23102495

  14. Calcium supplements

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007477.htm Calcium supplements To use the sharing features on this page, please enable JavaScript. WHO SHOULD TAKE CALCIUM SUPPLEMENTS? Calcium is an important mineral for the ...

  15. Primary EBV-positive Hodgkin's lymphoma of the CNS under azathioprine treatment. Case report and review of the literature

    International Nuclear Information System (INIS)

    Henkenberens, Christoph; Christiansen, Hans; Franzke, Anke; Raab, Peter; Oschlies, Ilske; Klapper, Wolfram

    2014-01-01

    Retrospective and prospective cohort studies suggest that central nervous system involvement occurs in approximately 0.5 % of patients with advanced Hodgkin's lymphoma. The isolated primary intracranial manifestation of Hodgkin's lymphoma is an extremely rare finding, with few cases reported in the literature. Little is known about the optimal treatment and prognosis of these tumors. Here, we present a case report with a review of the literature. A 47-year-old Caucasian man with persistent frontal headache and unspecific vertigo for half a month was diagnosed with nodular space-occupying lesions in the cerebellum. His medical history included multiple sclerosis, which was treated for 20 years with the immunosuppressive drug azathioprine. Further staging revealed no additional lesions suspected of being malignant. The patient underwent total tumor resection. Immunohistopathological examination showed Epstein-Barr virus-associated classic Hodgkin's lymphoma. Diagnostic bone marrow punction excluded lymphoma involvement of the bone marrow. The patient had no B symptoms. Consequently, the patient was classified as having stage I E A disease according to the Modified Ann Arbor Classification of Hodgkin Lymphoma and received systemic chemotherapy followed by radiation therapy for the former cerebellar tumor region. He was in complete clinical remission at the last follow-up 9 months after the initial diagnosis. This case report and literature review suggest that multimodal treatment leads to a remarkable clinical outcome in Hodgkin's lymphoma with intracranial involvement. (orig.) [de

  16. Emerging (val)ganciclovir resistance during treatment of congenital CMV infection: a case report and review of the literature.

    Science.gov (United States)

    Morillo-Gutierrez, Beatriz; Waugh, Sheila; Pickering, Ailsa; Flood, Terence; Emonts, Marieke

    2017-08-22

    Congenital cytomegalovirus (cCMV) infection is an important illness that is a common cause of hearing loss in newborn infants and a major cause of disability in children. For that reason, treatment of symptomatic patients with either ganciclovir or its pro-drug valganciclovir is recommended. Treatment duration of 6 months has been shown to be more beneficial than shorter courses; however, there is uncertainty regarding emergence of resistance strains, secondary effects and long term sequelae. Here we present a female infant with symptomatic cCMV who was treated from day 5 of life with oral valganciclovir. In spite of close monitoring of her drug levels and increments of her treatment dose according to weight gain, she developed ganciclovir resistance after 4 months of treatment, with increasing viraemia and petechiae. Adherence to treatment was assessed and felt to be good. Clinically, although she had marked developmental delay, she was making steady progress. In view of the development of resistance treatment was stopped at 5 months of age. No secondary effects of ganciclovir were noted during the whole course. There were few cases in the literature reporting resistance to ganciclovir for cCMV before the new recommendations for a 6 months treatment course for this infection were published. As demonstrated in our patient, surveillance with periodic viral loads and drug monitoring are vital to identify emerging resistance and optimise antiviral dosing according to weight gain.

  17. Tail gas treatment of SEWGS technology. Literature review on CO2 and H2S separation

    Energy Technology Data Exchange (ETDEWEB)

    Fabbri, E.N.; Van Dijk, H.A.J. [ECN Biomass and Energy Efficiency, Petten (Netherlands)

    2011-12-15

    This literature review is the result of an investigation of the most important way to remove sulphur for the last decades. We will discuss Claus and Claus tail gas process options to solve the problem. Next to solutions which come from membranes, direct oxidation catalysis, from acid gas removal technology, sorbent technology, and liquid oxidation. Each field will be described and explained to understand in which way it could be suitable to separate CO2 and H2S and reach our goals with regard to CO2 transport and storage conditions. Finally, the target of this work will be to propose some interesting and promising solutions in view of future experiments.

  18. Treatment of symptomatic splenomegaly with low doses of radiotherapy: Retrospective analysis and review of the literature

    Directory of Open Access Journals (Sweden)

    Carolina de la Pinta

    2017-09-01

    Conclusion: Low doses of radiation therapy for treatment of symptomatic splenomegaly were effective, with a low rate of side effects. Splenic pain and abdominal discomfort completely improved and cytopenias rised to secure levels.

  19. Treatment of Lymphatic Malformations With OK-432 (Picibanil) : Review of the Literature

    NARCIS (Netherlands)

    Poldervaart, Michelle T.; Breugem, Corstiaan C.; Speleman, Lucienne; Pasmans, Suzanne

    Introduction: Lymphatic malformations (LM) are benign structural defects that call cause serious complications because of their size and location. Traditionally surgical removal was the first treatment modality, but this Could be associated with many complications and risks. Since Ogita introduced

  20. Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class

    NARCIS (Netherlands)

    Jansen, T.T.G.; Timmers, H.J.L.M.; Marres, H.A.M.; Kaanders, J.H.A.M.; Kunst, H.P.M.

    2018-01-01

    OBJECTIVE: Key for successful jugulotympanic paraganglioma management is a personalised approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control and complication rates for the different treatment modalities

  1. SPORT SUPPLEMENTATION

    OpenAIRE

    Alexandаr Marinkov

    2016-01-01

    Sport supplementation is essential for athletes performance and achievements. The well balanced and structured supplementation is a challenge for sport medicine because must be done a balance between potential benefits and potential risks (anti-doping rule violations and others). In this review are structured the most used categories sport supplementations. Nutritional supplements used in sport could be divided in some main categories like: amino acids, vitamins, proteins and antioxidants. Fo...

  2. Atypical leg ulcers after sclerotherapy for treatment of varicose veins: Case reports and literature review

    OpenAIRE

    Mwipatayi, Bibombe P.; Western, Catherine E.; Wong, Jackie; Angel, Donna

    2016-01-01

    Introduction: Skin necrosis is a rare complication of foam sclerotherapy, a common form of treatment for varicose veins. Presentation of case: Both patients presented to the outpatient clinic within 2–14 days after foam sclerotherapy with Aethoxysklerol® 1%, with severe soft tissue and skin necrosis. Further aggressive treatment of the ulcer was required to resolve the necrosis, resulting in marked residual scar and well granulated leg ulcer respectively. Discussion: Foam sclerotherapy ...

  3. Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement: A randomized controlled trial.

    Science.gov (United States)

    Macpherson, Helen; Ellis, Kathryn A; Sali, Avni; Pipingas, Andrew

    2012-03-01

    There is potential for multivitamin supplementation to improve cognition in the elderly. This randomized, double-blind, placebo-controlled trial was conducted to investigate the effects of 16 weeks multivitamin supplementation (Swisse Women's 50+ Ultivite ®) on cognition in elderly women. Participants in this study were 56 community dwelling, elderly women, with subjective complaints of memory loss. Cognition was assessed using a computerized battery of memory and attention tasks designed to be sensitive to age-related declines to fluid intelligence, and a measure of verbal recall. Biochemical measures of selected nutrients, homocysteine, markers of inflammation, oxidative stress, and blood safety parameters were also collected. All cognitive and haematological parameters were assessed at baseline and 16 weeks post-treatment. The multivitamin improved speed of response on a measure of spatial working memory, however benefits to other cognitive processes were not observed. Multivitamin supplementation decreased levels of homocysteine and increased levels of vitamin B(6) and B(12), with a trend for vitamin E to increase. There were no hepatotoxic effects of the multivitamin formula indicating this supplement was safe for everyday usage in the elderly. Sixteen weeks ssupplementation with a combined multivitamin, mineral and herbal formula may benefit working memory in elderly women at risk of cognitive decline.

  4. Rape treatment outcome research: empirical findings and state of the literature.

    Science.gov (United States)

    Vickerman, Katrina A; Margolin, Gayla

    2009-07-01

    This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery.

  5. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature

    Directory of Open Access Journals (Sweden)

    Paulo Kertzman

    2015-02-01

    Full Text Available Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed.

  6. Rape Treatment Outcome Research: Empirical Findings and State of the Literature

    Science.gov (United States)

    Vickerman, Katrina A.; Margolin, Gayla

    2009-01-01

    This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery. PMID:19442425

  7. Streptomycin-lidocaine injections for the treatment of postherpetic neuralgia: Report of three cases with literature review.

    Science.gov (United States)

    Waghray, Shefali; Asif, Shaik Mohammed; Duddu, Mahesh Kumar; Arakeri, Gururaj

    2013-09-01

    The sudden, stabbing, paroxysmal pain of neuralgia is the fiercest agony that a patient may experience in his life. Many varied medical treatments and surgical procedures have been suggested in the literature for neuralgic pain. Most of the patients fail to respond to medical treatments or succumb to complications of total anesthesia owing to surgical procedures. Herein, we tried a new treatment modality in patients suffering from postherpetic neuralgia with appreciable success in all the three cases that are presented in this paper. Streptomycin sulfate dissolved in 2% lidocaine solution was deposited at the peripheral branches on the involved nerves targeting the trigger zones, given weekly once for a maximum of 6 week period and continued once in 2 weeks if symptoms persisted. All patients were followed-up for 1 year and there was a marked improvement on follow-up.

  8. A comparative study of the bone metabolic response to dried plum supplementation and PTH treatment in adult, osteopenic ovariectomized rat.

    Science.gov (United States)

    Smith, Brenda J; Bu, So Young; Wang, Yan; Rendina, Elizabeth; Lim, Yin F; Marlow, Denver; Clarke, Stephen L; Cullen, Diane M; Lucas, Edralin A

    2014-01-01

    Dried plum has been reported to have potent effects on bone in osteopenic animal models, but the mechanisms through which bone metabolism is altered in vivo remain unclear. To address this issue, a study comparing the metabolic response of dried plum to the anabolic agent, parathyroid hormone (PTH), was undertaken. Six month-old female Sprague Dawley rats (n=84) were sham-operated (SHAM) or ovariectomized (OVX) and maintained on a control diet for 6wks until osteopenia was confirmed. Treatments were initiated consisting of a control diet (AIN-93M) supplemented with dried plum (0, 5, 15 or 25%; w/w) or a positive control group receiving PTH. At the end of 6wks of treatment, whole body and femoral bone mineral density (BMD) were restored by the two higher doses of dried plum to the level of the SHAM group. Trabecular bone volume and cortical thickness were also improved with these two doses of dried plum. Dried plum suppressed the OVX-induced increase in bone turnover as indicated by systemic biomarkers of bone metabolism, N-terminal procollagen type 1 (P1NP) and deoxypyridinoline (DPD). Dynamic bone histomorphometric analysis of the tibial metaphysis revealed that dried plum restored the OVX-induced increase in cancellous bone formation rate (BFR) and mineralizing surface (MS/BS) to the SHAM group, but some doses of dried plum increased endocortical mineral apposition rate (MAR). As expected, PTH significantly increased endocortical MAR and BFR, periosteal BFR, and trabecular MAR and BFR beyond that of the OVX and maintained the accelerated rate of bone resorption associated with OVX. Dried plum up-regulated bone morphogenetic protein 4 (Bmp4) and insulin-like growth factor 1 (Igf1) while down-regulating nuclear factor T cell activator 1 (Nfatc1). These findings demonstrate that in the adult osteopenic OVX animal, the effects of dried plum differ from that of PTH in that dried plum primarily suppressed bone turnover with the exception of the indices of bone

  9. Tic Symptoms Induced by Atomoxetine in Treatment of ADHD: A Case Report and Literature Review.

    Science.gov (United States)

    Yang, Rongwang; Li, Rong; Gao, Weijia; Zhao, Zhengyan

    Patients with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for tic disorders. Atomoxetine (ATX) has been accepted as an alternative medication for patients with ADHD and a comorbid tic disorder. It is rarely reported that tic symptoms are induced by ATX. This present report described a boy with ADHD who developed tic symptoms during ATX initiation. We used an ABAB trial to confirm the tics were related to ATX administration. In addition, we reviewed the published literature of patients whose tic symptoms were confirmed or suspected of relating to ATX usage. This present case with an ABAB design showed on-off control of tics with or without ATX, which allowed us to make a strong conclusion that the tics were related to ATX administration. Literature review also indicated that ATX might induce tic symptoms in children with ADHD, especially in those being boys and having a history of tics. The time from starting ATX to tics symptoms appearing was approximately 19 days. The most common tic symptoms were eye blinking, vocal tics, or throat clearing, and neck movements. These tics symptoms in most cases could be resolved after discontinuing ATX without further pharmacotherapy. Pediatricians and child psychiatrists should be well aware of this potential adverse effect in children with ADHD receiving ATX.

  10. Micropapillary bladder cancer: current treatment patterns and review of the literature.

    Science.gov (United States)

    Willis, Daniel L; Flaig, Thomas W; Hansel, Donna E; Milowsky, Matthew I; Grubb, Robert L; Al-Ahmadie, Hikmat A; Plimack, Elizabeth R; Koppie, Theresa M; McConkey, David J; Dinney, Colin P; Hoffman, Vanessa A; Droller, Michael J; Messing, Edward; Kamat, Ashish M

    2014-08-01

    No guidelines exist for the management of micropapillary bladder cancer (MPBC) and most reports of this variant of urothelial carcinoma are case series comprising small numbers of patients. We sought to determine current practice patterns for MPBC using a survey sent to the Society of Urologic Oncology (SUO) and to present those results in the setting of a comprehensive review of the existing literature. A survey developed by the Translational Science Working Group of the Bladder Cancer Advocacy Network-sponsored Think Tank meeting was distributed to members of the SUO. The results from 118 respondents were analyzed and presented with a literature review. Most survey respondents were urologists, with 80% considering bladder cancer their primary area of interest. Although 78% of the respondents reported a dedicated genitourinary pathologist at their institution, there were discrepant opinions on how a pathologic diagnosis of MPBC is determined as well as variability on the proportion of MPBC that is clinically significant. Among them, 78% treat MPBC differently than conventional urothelial carcinoma, with 81% reporting that they would treat cT1 MPBC with upfront radical cystectomy. However, the respondents had split opinions regarding the sensitivity of MPBC to cisplatin-based chemotherapy, which affected utilization of neoadjuvant chemotherapy in muscle-invasive disease. The management of MPBC is diverse among members of the SUO. Although most favors early cystectomy for cT1 MPBC, there is no consensus on the use of neoadjuvant chemotherapy for muscle-invasive MPBC. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Proximal myopathy in lacto-vegetarian Asian patients responding to Vitamin D and calcium supplement therapy - two case reports and review of the literature

    LENUS (Irish Health Repository)

    Thabit, Hood

    2011-05-13

    Abstract Introduction Severe proximal myopathy can occasionally be the first presenting complaint of patients with osteomalacia. This may lead to investigations and misdiagnosis of a neuromuscular disease, rather than a metabolic bone disease. Case presentations We present here two cases of severe proximal myopathy in patients who were both of South Asian origin and lacto-vegetarians: a 31-year-old Indian man and a 34-year-old Indian woman. In both cases, their clinical symptoms fully resolved following vitamin D and calcium replacement therapy. These patients were at risk of osteomalacia due to their dietary intake and ethnicity. The role of dietary intake and sunlight exposure in the development of osteomalacia in certain ethnic groups living in Western Europe is reviewed here. Conclusion These two cases emphasize the importance of recognizing osteomalacia in at-risk individuals, as the condition is reversible and easily treated with vitamin D and calcium supplementation. It may also help avoid prolonged and unnecessary investigations of these patients.

  12. Proximal myopathy in lacto-vegetarian Asian patients responding to Vitamin D and calcium supplement therapy - two case reports and review of the literature

    Directory of Open Access Journals (Sweden)

    Sreenan Seamus

    2011-05-01

    Full Text Available Abstract Introduction Severe proximal myopathy can occasionally be the first presenting complaint of patients with osteomalacia. This may lead to investigations and misdiagnosis of a neuromuscular disease, rather than a metabolic bone disease. Case presentations We present here two cases of severe proximal myopathy in patients who were both of South Asian origin and lacto-vegetarians: a 31-year-old Indian man and a 34-year-old Indian woman. In both cases, their clinical symptoms fully resolved following vitamin D and calcium replacement therapy. These patients were at risk of osteomalacia due to their dietary intake and ethnicity. The role of dietary intake and sunlight exposure in the development of osteomalacia in certain ethnic groups living in Western Europe is reviewed here. Conclusion These two cases emphasize the importance of recognizing osteomalacia in at-risk individuals, as the condition is reversible and easily treated with vitamin D and calcium supplementation. It may also help avoid prolonged and unnecessary investigations of these patients.

  13. Proximal myopathy in lacto-vegetarian Asian patients responding to Vitamin D and calcium supplement therapy - two case reports and review of the literature.

    LENUS (Irish Health Repository)

    Thabit, Hood

    2012-02-01

    INTRODUCTION: Severe proximal myopathy can occasionally be the first presenting complaint of patients with osteomalacia. This may lead to investigations and misdiagnosis of a neuromuscular disease, rather than a metabolic bone disease. CASE PRESENTATIONS: We present here two cases of severe proximal myopathy in patients who were both of South Asian origin and lacto-vegetarians: a 31-year-old Indian man and a 34-year-old Indian woman. In both cases, their clinical symptoms fully resolved following vitamin D and calcium replacement therapy. These patients were at risk of osteomalacia due to their dietary intake and ethnicity. The role of dietary intake and sunlight exposure in the development of osteomalacia in certain ethnic groups living in Western Europe is reviewed here. CONCLUSION: These two cases emphasize the importance of recognizing osteomalacia in at-risk individuals, as the condition is reversible and easily treated with vitamin D and calcium supplementation. It may also help avoid prolonged and unnecessary investigations of these patients.

  14. Treatment of cervical lymph node metastasis from an unknown primary tumor, with a review of the literature

    International Nuclear Information System (INIS)

    Planken, H.J.M. van der; Tiwari, R.M.; Karim, A.B.M.F.

    1997-01-01

    Background: The results of treatment at the Free University Hospital of 44 patients with cervical lymph node metastasis of an unknown primary tumor were reviewed in order to establish an optimal treatment policy and to look for prognostic parameters. These results were compared with results of other treatment policies known from the literature. Patients and Method: Thirty-three out of the 44 patients received a treatment with curative intent; 22 cases received a unilateral neck dissection and postoperative radiotherapy, 7 were irradiated after an excisional biopsy and 4 received radical radiotherapy alone. Results: For the whole group 5- and 10-year overall survival was 50% and 44%, respectively, and for the group treated with curative intent 68% and 56%, respectively. Disease-free survival at 5 and 10 years after treatment for the whole group was 48% and 32%, respectively, and for the group treated with curative intent 63% and 37%, respectively. Conclusions: Multivariate analysis showed only treatment with intent and histology as significant independent prognostic factors for the whole group. For the patients treated with curative intent no significant influences of variables were found. (orig.) [de

  15. The successful treatment of vocal cord dysfunction with low-dose amitriptyline – including literature review

    Directory of Open Access Journals (Sweden)

    VA Varney

    2009-11-01

    Full Text Available VA Varney1, H Parnell1, J Evans1, NT Cooke1, J Lloyd2, J Bolton31Department of Respiratory Medicine, 2Department of Speech and Language Therapy, 3Department of Liaison Psychiatry, St Helier Hospital, Carshalton, Surrey, UKAbstract: Vocal cord dysfunction is an asthma mimic. Diagnosis of this condition requires a high index of suspicion if unnecessary treatments are to be avoided. We describe the findings from our case series of 62 patients (age range 18 to 90 years in whom the diagnosis was confirmed. Our findings show low-dose amitriptyline to be very effective in 90% of cases, with rapid benefit for those patients whose symptoms had been present for less than 12 months. This treatment, in conjunction with psycho-therapeutic and behavioral therapies may reduce unnecessary hospital admissions. Future studies may show whether this treatment regimen may reduce demands on the speech and language therapists.Keywords: vocal cord dysfunction, asthma, amitriptyline, wheeze, anxiety

  16. Diagnosis and treatment of malignant pleural effusion: a systematic literature review and new approaches.

    Science.gov (United States)

    Lombardi, Giuseppe; Zustovich, Fable; Nicoletto, Maria Ornella; Donach, Martin; Artioli, Grazia; Pastorelli, Davide

    2010-08-01

    Malignant pleural effusion is a frequent complication in many types of tumors, and its presence indicates short expected survival. This review updates the current knowledge about diagnosis and management of malignant pleural effusion. In recent years, progress has been made in diagnosis through the use of new pathologic and radiologic approaches, such as the introduction of positron emission tomography-computed tomography, immunohistochemical marker combinations, and genetic studies to identify malignant cells. Treatment is always palliative. New promising drugs have been tested, but, awaiting randomized studies, talc pleurodesis is still the treatment of choice, although doubts remain about its safety. A long-term indwelling pleural catheter could be a valid alternative to talc pleurodesis in selected patients with trapped lung syndrome (a lung that fails to reexpand after drainage of pleural effusion) and short life expectancy. However, the correct treatment depends on several factors such as performance status, expected survival, presence of lung reexpansion following pleural drainage and comorbidities.

  17. The role of family meals in the treatment of eating disorders: a scoping review of the literature and implications.

    Science.gov (United States)

    Cook-Darzens, Solange

    2016-09-01

    Family meal research is a fast growing field that has significant implications for the prevention and treatment of eating disorders (ED). Using a scoping review procedure, this article overviewed major historical and clinical trends that have guided the use of family meals or lunch sessions in adolescent ED family therapy over the past 40 years, and synthesized essential findings from current therapeutic family meal research. The relevant body of literature is reported within the framework of three models of family therapy (Maudsley model, family-based treatment, multi-family therapy), with a focus on their specific use of family lunch sessions and related empirical evidence. Although promising, current evidence remains contradictory, tentative and colored by therapists' convictions, resistance and fears. Future research priorities are discussed, including the need for a more direct examination of the impact of the family meal practice on therapeutic change, as well as a better understanding of its active ingredients and of the characteristics of patients/families that may benefit most from it. This review of the literature may help clinicians and family therapists (1) adhere more reliably and confidently to ED-focused treatment protocols that include a strong family meal component, and (2) make more informed decisions regarding the inclusion or exclusion of family meals in their practice. When feasibility or acceptability issues preclude their use, alternatives to family meals are also discussed, including family meal role-plays and drawings, coaching of home-based family meals and manual/DVD-based guidance.

  18. The Use of Sodium Bicarbonate in the Treatment of Acidosis in Sepsis: A Literature Update on a Long Term Debate

    Directory of Open Access Journals (Sweden)

    Dimitrios Velissaris

    2015-01-01

    Full Text Available Introduction. Sepsis and its consequences such as metabolic acidosis are resulting in increased mortality. Although correction of metabolic acidosis with sodium bicarbonate seems a reasonable approach, there is ongoing debate regarding the role of bicarbonates as a therapeutic option. Methods. We conducted a PubMed literature search in order to identify published literature related to the effects of sodium bicarbonate treatment on metabolic acidosis due to sepsis. The search included all articles published in English in the last 35 years. Results. There is ongoing debate regarding the use of bicarbonates for the treatment of acidosis in sepsis, but there is a trend towards not using bicarbonate in sepsis patients with arterial blood gas pH>7.15. Conclusions. Routine use of bicarbonate for treatment of severe acidemia and lactic acidosis due to sepsis is subject of controversy, and current opinion does not favor routine use of bicarbonates. However, available evidence is inconclusive, and more studies are required to determine the potential benefit, if any, of bicarbonate therapy in the sepsis patient with acidosis.

  19. Topiramate for the treatment of kleptomania: a case series and review of the literature.

    Science.gov (United States)

    Dannon, Pinhas N

    2003-01-01

    Kleptomania--the inability to resist the impulse to steal objects, not for personal use or monetary gain--is currently classified in psychiatric nomenclature as an impulse control disorder. There is no standard pharmacologic therapy for this disorder. If kleptomania was considered a form of obsessive-compulsive disorder, treatments used for this spectrum, including serotonin reuptake inhibitors (SSRI), other antidepressants, opioid receptor antagonist medications, and mood stabilizers, could be logically tested. Topiramate is currently used for the treatment of patients with affective and compulsive eating disorders. This report documents three kleptomanic patients who responded well to topiramate given either alone or in combination with SSRIs.

  20. Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

    International Nuclear Information System (INIS)

    Santos-Filho, Sebastiao David; Fonseca, Adenilson de Souza da; Bernardo-Filho, Mario; Missailids, Sotiris

    2008-01-01

    Prostate (PR) cancer (CA) is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC) is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT). Hormone Therapy (HT) or chemotherapy (CH) is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU) or erectile dysfunction (ED), can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) in the period 1950 to 2008 using the words: CA, CA and PR or penis or testis, CA and PR and RT, CA and PR and surgery (SU), CA and PR and CH and, CA and PR and HT and CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V) PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer. Moreover, this finding is

  1. [Treatment with sunitinib and hypothyroidism--a case report and overview of literature].

    Science.gov (United States)

    Kreze, A; Stáhalová, V; Zadrazilová, A; Koskuba, J; Kosák, M

    2009-01-01

    In the article the authors present the case of a patient with clear cell renal carcinoma, where after nephrectomy local metastases appeared. The treatment of choice was sunitinib. After 20 cycles of therapy heavy hypothyroidism was verified which required substitution by thyroxine. Elevated levels of TSH appeared in up to 70% and hypothyrodism in up to 40% of thus treated patients. Also described is the mechanism of action of sunitinib. There seems to exist a correlation between the "adverse effects" of the drug and a better result of the therapy of cancer, however, prospective studies are absent. Most experts agree that the thyroid function during treatment with sunitinib needs to be monitored.

  2. Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

    Energy Technology Data Exchange (ETDEWEB)

    Santos-Filho, Sebastiao David; Fonseca, Adenilson de Souza da; Bernardo-Filho, Mario [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Dept. de Biofisica e Biometria]. E-mail: santos-filho@uer.br; Missailids, Sotiris [The Open University, Milton Keynes (United Kingdom). Dept. of Chemistry and Analytical Sciences

    2008-12-15

    Prostate (PR) cancer (CA) is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC) is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT). Hormone Therapy (HT) or chemotherapy (CH) is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU) or erectile dysfunction (ED), can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) in the period 1950 to 2008 using the words: CA, CA and PR or penis or testis, CA and PR and RT, CA and PR and surgery (SU), CA and PR and CH and, CA and PR and HT and CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V) PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer. Moreover, this finding is

  3. Chondrosarcoma of the temporal bone. Diagnosis and treatment of 13 cases and review of the literature

    International Nuclear Information System (INIS)

    Coltrera, M.D.; Googe, P.B.; Harrist, T.J.; Hyams, V.J.; Schiller, A.L.; Goodman, M.L.

    1986-01-01

    Chondrosarcoma of the temporal bone is a rare lesion. Clinically it has been confused with multiple sclerosis, glomus jugulare tumors, meningioma, and chordomas. The cranial nerve palsies frequently observed with the tumors are related to the anatomic locations of the tumors. Thirteen patients with this entity are presented and the eleven other cases in the literature are reviewed. Histologically the tumors are low grade and exhibit myxoid features. The myxoid features must be differentiated from chordoma and chondroid chordoma. The tumor locations preclude surgical excision and conventional radiation therapy can cause unacceptable neurologic sequelae. Proton beam therapy has been effective in short-term results and appears capable of avoiding serious neurologic side effects

  4. A systematic review on the role of vitamins, minerals, proteins, and other supplements for the treatment of cachexia in cancer: a European Palliative Care Research Centre cachexia project.

    Science.gov (United States)

    Mochamat; Cuhls, Henning; Marinova, Milka; Kaasa, Stein; Stieber, Christiane; Conrad, Rupert; Radbruch, Lukas; Mücke, Martin

    2017-02-01

    We provide a systematic review to support the European Palliative Care Research Collaboration development of clinical guidelines for cancer patients suffering from cachexia. CENTRAL, MEDLINE, PsycINFO, ClinicalTrials.gov, and a selection of cancer journals have been searched up until 15 April 2016. The systematic literature research yielded 4214 publications with 21 of these included in the final evaluation. Regarding minerals, our search identified only one study examining the use of magnesium with no effect on weight loss. As far as vitamins are concerned, vitamin E in combination with omega-3 fatty acids displayed an effect on survival in a single study, vitamin D showed improvement of muscle weakness in prostate cancer patients, and vitamin C supplementation led to an improvement of various quality of life aspects in a sample with a variety of cancer diagnoses. For proteins, a combination therapy of β-hydroxy-β-methylbutyrate (HMB), arginine, and glutamine showed an increase in lean body mass after 4 weeks in a study of advanced solid tumour patients, whereas the same combination did not show a benefit on lean body mass in a large sample of advanced lung and other cancer patients after 8 weeks. L-carnitine led to an increase of body mass index and an increase in overall survival in advanced pancreatic cancer patients. Adverse effects of food supplementation were rare and showed mild intensity. There is not enough solid evidence for the use of minerals, vitamins, proteins, or other supplements in cancer. No serious adverse effects have been reported with dietary supplementation. © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.

  5. Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV-uninfected but not HIV-infected patients in Mwanza, Tanzania

    DEFF Research Database (Denmark)

    PrayGod, George; Range, Nyagosya; Faurholt-Jepsen, Daniel

    2011-01-01

    Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi-micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patients with smear-positive (PTB+) or -negative (PTB......-) pulmonary TB were randomly allocated to receive a daily biscuit with or without multi-micronutrients for 60 d during the intensive phase of TB treatment. Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi...

  6. Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Katrina V Deardorff

    2018-02-01

    Full Text Available Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns.We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%, distributor incentives (n = 2, +25.3%, distribution along kinship networks (n = 1, +24.5%, intensified information, education, and communication activities (n = 8, +21.6%, fixed-point delivery (n = 1, +21.4%, door-to-door delivery (n = 1, +14.0%, integrated service distribution (n = 9, +12.7%, conversion from school- to community-based delivery (n = 3, +11.9%, and management by a non-governmental organization (n = 1, +5.8%.Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

  7. Literature Review: Update on Amphetamine Neurotoxicity and Its Relevance to the Treatment of ADHD

    Science.gov (United States)

    Advokat, Claire

    2007-01-01

    Objective: A review of amphetamine treatment for attention-deficit/hyperactivity disorder (ADHD) was conducted, to obtain information on the long-term neurological consequences of this therapy. Method: Several databases were accessed for research articles on the effects of amphetamine in the brain of laboratory animals and ADHD diagnosed…

  8. Percutaneous treatment of insufficiency fractures. Principles, technique and review of literature

    International Nuclear Information System (INIS)

    Beall, Douglas P.; Datir, Abhijit; D'Souza, Sharon L.; D'Souza, Logan S.; Gunda, Divya; Morelli, John; Johnson, Michael Brandon; Nabavizadeh, Nima

    2010-01-01

    Insufficiency fractures of the pelvis, sacrum, spine, and long bones are painful, debilitating, and are common consequences of osteoporosis. Conventional treatment for these fractures varies from conservative therapy to surgery with plate and screw fixation. The former fails to address the underlying problem of fracture and frequently does not alleviate symptoms, while the latter is invasive and not always possible in older populations with low bone density and numerous co-morbidities. Osseous augmentation with polymethylmethacrylate (PMMA) has been used for over two decades to treat fractures related to osteoporosis, but has not been commonly used to treat fractures outside of the vertebral bodies. Osseous augmentation with PMMA is an image-guided procedure and various techniques have been utilized to treat fracture in different locations. We describe various techniques for image-guided osseous augmentation and treatment of insufficiency fractures with bothPMMA and allograft bone for fractures of the pelvis including sacrum, acetabulum, pubic symphysis, pubic rami ilium; appendicular skeleton including distal radius, proximal femur, and vertebral body. We also describe the potential risks and complications associated with percutaneous treatment of insufficiency fractures and techniques to avoid the pitfalls of the various procedures. We will present the process for patient follow-up and data regarding the pre- and postprocedure pain response in patients undergoing treatment for pelvic insufficiency fractures. (orig.)

  9. Adjunctive Application of Antimicrobial Photodynamic Therapy in Nonsurgical Periodontal Treatment: A Review of Literature

    Directory of Open Access Journals (Sweden)

    Takeshi Kikuchi

    2015-10-01

    Full Text Available Periodontal disease is caused by dental plaque biofilms, and the removal of these biofilms from the root surface of teeth plays a central part in its treatment. The conventional treatment for periodontal disease fails to remove periodontal infection in a subset of cases, such as those with complicated root morphology. Adjunctive antimicrobial photodynamic therapy (aPDT has been proposed as an additional treatment for this infectious disease. Many periodontal pathogenic bacteria are susceptible to low-power lasers in the presence of dyes, such as methylene blue, toluidine blue O, malachite green, and indocyanine green. aPDT uses these light-activated photosensitizer that is incorporated selectively by bacteria and absorbs a low-power laser/light with an appropriate wavelength to induce singlet oxygen and free radicals, which are toxic to bacteria. While this technique has been evaluated by many clinical studies, some systematic reviews and meta-analyses have reported controversial results about the benefits of aPDT for periodontal treatment. In the light of these previous reports, the aim of this review is to provide comprehensive information about aPDT and help extend knowledge of advanced laser therapy.

  10. A Review of Educational Outcomes in the Children's Mental Health Treatment Literature

    Science.gov (United States)

    Becker, Kimberly D.; Brandt, Nicole Evangelista; Stephan, Sharon H.; Chorpita, Bruce F.

    2014-01-01

    We examined the measurement of educational outcomes related to children's mental health treatments. A total of 85 papers describing 88 randomized controlled trials that included at least one educational outcome and one mental health outcome were included in these analyses. Forty-five different measures were identified as the primary educational…

  11. Do therapists address gender and power in infidelity? A feminist analysis of the treatment literature.

    Science.gov (United States)

    Williams, Kirstee; Knudson-Martin, Carmen

    2013-07-01

    Sociocontextual factors such as gender and power play an important role in the etiology of affairs and in recovery from them, yet it is unclear how current treatment models address these issues. Drawing on feminist epistemology, this study utilized a grounded theory analysis of 29 scholarly articles and books on infidelity treatment published between 2000 and 2010 to identify the circumstances under which gender and power issues were or were not part of treatment. We found five conditions that limit attention to gender and power: (a) speaking (or assuming) as though partners are equal, (b) reframing infidelity as a relationship problem, (c) limiting discussion of societal context to background, (d) not considering how societal gender and power patterns impact relationship dynamics, and (e) limiting discussion of ethics on how to position around infidelity. Analysis explored how each occurred across three phases of couple therapy. The findings provide a useful foundation for a sociocontextual framework for infidelity treatment. © 2012 American Association for Marriage and Family Therapy.

  12. Child Abuse and Multiple Personality Disorders: Review of the Literature and Suggestions for Treatment.

    Science.gov (United States)

    Coons, Philip M.

    1986-01-01

    Multiple personality disorder is associated with a high incidence of physical and sexual abuse during childhood. While difficult to diagnose, multiple personality is easier to treat if diagnosed early in childhood or adolescence. Treatment for multiple personality focuses on establishing trust and communicating with and integrating the…

  13. The Causes, Diagnosis, and Treatment of Academic Underachievement--Research of the Recent Literature.

    Science.gov (United States)

    Lowenstein, L. F.

    The first of three papers on underachievement in children focuses on causes, identification and treatment. Research is reviewed concerning 11 factors (including low self esteem, socioeconomic influences, and teachers' expectations) in underachievement. Identification and diagnosis through observation and self observation are examined. Seven…

  14. Atypical leg ulcers after sclerotherapy for treatment of varicose veins: Case reports and literature review

    Directory of Open Access Journals (Sweden)

    Bibombe P. Mwipatayi

    2016-01-01

    Conclusion: We would like to emphasise that whilst skin and soft tissue necrosis is a rare complication of foam sclerotherapy, it is a complication that is highly disfiguring and requires aggressive treatment. As such, it should be adequately discussed with the patient prior to obtaining informed consent.

  15. Effect of beta-alanine supplementation on the onset of blood lactate accumulation (OBLA during treadmill running: Pre/post 2 treatment experimental design

    Directory of Open Access Journals (Sweden)

    Misic Mark

    2010-05-01

    Full Text Available Abstract Background β-Alanine (βA has been shown to improve performance during cycling. This study was the first to examine the effects of βA supplementation on the onset of blood lactate accumulation (OBLA during incremental treadmill running. Methods Seventeen recreationally-active men (mean ± SE 24.9 ± 4.7 yrs, 180.6 ± 8.9 cm, 79.25 ± 9.0 kg participated in this randomized, double-blind, placebo-controlled pre/post test 2-treatment experimental design. Subjects participated in two incremental treadmill tests before and after 28 days of supplementation with either βA (6.0 g·d-1(βA, n = 8 or an equivalent dose of Maltodextrin as the Placebo (PL, n = 9. Heart rate, percent heart rate maximum (%HRmax, %VO2max@OBLA (4.0 mmol.L-1 blood lactate concentration and VO2max (L.min-1 were determined for each treadmill test. Friedman test was used to determine within group differences; and Mann-Whitney was used to determine between group differences for pre and post values (p Results The βA group experienced a significant rightward shift in HR@OBLA beats.min-1 (p 2max@OBLA increased (p 2max (L.min-1 decreased (p Conclusions βA supplementation for 28 days enhanced sub-maximal endurance performance by delaying OBLA. However, βA supplemented individuals had a reduced aerobic capacity as evidenced by the decrease in VO2max values post supplementation.

  16. Systematic literature review on patterns of pharmacological treatment and adherence among patients with bipolar disorder type I in the USA

    Directory of Open Access Journals (Sweden)

    Greene M

    2018-06-01

    Full Text Available Mallik Greene,1 Luciano Paladini,2 Teresa Lemmer,2 Alexandra Piedade,2 Maelys Touya,3 Otavio Clark2 1Health Economics & Outcomes Research, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA; 2Evidências – Kantar Health, Campinas, Brazil; 3Lundbeck Pharmaceuticals Services, LLC, Deerfield, IL, USA Background: Bipolar disorder type I (BD-I is a chronic condition characterized by mania episodes followed by syndromic recovery periods, usually permeated by depressive symptomatology and recurring acute manic episodes. It requires long-term pharmacological treatment; thus, it is critical to understand the patterns of drug therapy use and medication compliance to better plan health care policies and needs. This systematic literature review aims to study these data among patients with BD-I in the USA, focusing on medications to treat mania. Methods: Articles published in the last 10 years to October 2016 were searched on MEDLINE and Embase. Studies on patterns of drug therapy, concordance of prescription with clinical practice guidelines, and adherence and persistence with pharmacological treatments for BD-I in the USA under observational conditions, with focus on treatments for mania, were selected. Results: Treatment prevalence for BD-I is low in the USA, with the most current study showing a 46% 12-month rate. There is a lack of studies addressing the use of long-acting injectable (LAI antipsychotics. Second-generation antipsychotics (SGAs have been used by nearly all patients receiving oral antipsychotics since the 2000s. However, 30%–60% of individuals with BD do not receive appropriate treatment, and adherence to oral therapies is poor, with medication possession ratios ≥80% seen in only approximately 60% of patients. For persistence rates, results suggest that treatment duration is short for a condition with recommendation for at least 6 months of maintenance therapy. Literature indicates that LAI SGAs may be

  17. Role of nondrug methods in a package of measures for the prevention and treatment of osteoporosis: A review of literature

    Directory of Open Access Journals (Sweden)

    N. G. Badalov

    2016-01-01

    Full Text Available The review represents the results of investigations into the role of nondrug methods in the treatment and prevention of osteoporosis (OA. The data available in the literature suggest that a number of non-drug technologies, first of all exercise therapy, aquatic therapy, reflexotherapy, electrical stimulation, and electromagnetic therapy, have proven efficiency and a certain potential for reducing the risk of osteoporosis and its complications and for improving bone metabolism. Expanding the range of these methods and increasing their validity for clinical introduction are very promising.

  18. Postoperative Issues of Sacral Nerve Stimulation for Fecal Incontinence and Constipation: A Systematic Literature Review and Treatment Guideline

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Matzel, Klaus; Lundby, Lilli

    2011-01-01

    BACKGROUND: There is a lack of knowledge on the incidence and management of suboptimal therapeutic effect and the complications associated with sacral nerve stimulation for fecal incontinence and constipation. OBJECTIVE: This study aimed to review current literature on postoperative issues...... and to propose a treatment algorithm. DATA SOURCE: PubMed, MEDLINE, and EMBASE were searched using the keywords “sacral nerve stimulation,” “sacral neuromodulation,” “fecal incontinence,” and “constipation” for English-language articles published from January 1980 to August 2010. A further search was conducted...

  19. Paraneoplastic pemphigus associated with inflammatory myofibroblastic tumour of the mediastinum: A favourable response to treatment and review of the literature.

    Science.gov (United States)

    Ghandi, Narges; Ghanadan, Alireza; Azizian, Mohammad-Reza; Hejazi, Pardis; Aghazadeh, Nessa; Tavousi, Parvin; Daneshpazhooh, Maryam

    2015-05-01

    Paraneoplastic pemphigus (PNP) is an autoimmune blistering disorder that occurs in association with an underlying neoplasm. Inflammatory myofibroblastic tumour (IMT) is a rare low-grade sarcoma of fibroblasts and myofibroblasts associated with inflammatory cells, most commonly occurring in the lung. In this study, a case of PNP associated with IMT of the mediastinum is reported. The patient had a favourable outcome following surgical resection and treatment with a systemic steroid, azathioprine, and i.v. immunoglobulin. The occurrence of PNP with sarcomas, specifically IMT, is noteworthy although it is not well studied in the existing literature. © 2014 The Australasian College of Dermatologists.

  20. Use of acupuncture therapy as a supplement to conventional medical treatments for acute ischaemic stroke patients in an academic medical centre in Korea.

    Science.gov (United States)

    Chang, Hyejung; Kwon, Young Dae; Yoon, Sung Sang

    2011-10-01

    Acupuncture has served as a major complementary and alternative therapy that supplements conventional medicine and is the subject of growing public interest. This study was conducted to estimate the usage rate of acupuncture as a supplemental treatment in acute ischaemic stroke patients and to identify factors associated with the choice to use this therapy. Using the registry of stroke patients admitted to an academic medical centre in Korea, the use of acupuncture therapy was recorded and analysed, along with the patients' socio-demographic characteristics, hospital access variables, risk factors for ischaemic stroke and clinical characteristics. The data were analysed using descriptive statistics, chi-square tests and multiple logistic regression analyses. Of 2167 patients, 18% received acupuncture therapy. The choice of acupuncture therapy was significantly associated with stroke severity as well as gender, age, geographical residence and previous history of stroke. After controlling for other significant factors, there was an approximately 3.4-fold greater usage in patients with moderately severe strokes (95% confidence interval (CI)=2.5-4.6) and 4.1-fold greater usage in patients with severe strokes (95% CI=2.7-6.4). The findings provide a better understanding of patients' utilization of acupuncture therapy as a supplement to conventional medical treatments and of factors associated with the utilization of acupuncture in patients with acute ischemic stroke. Strategic implications of acupuncture therapy are suggested for both health-care providers and policy makers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Engaging foster parents in treatment: a randomized trial of supplementing trauma-focused cognitive behavioral therapy with evidence-based engagement strategies.

    Science.gov (United States)

    Dorsey, Shannon; Pullmann, Michael D; Berliner, Lucy; Koschmann, Elizabeth; McKay, Mary; Deblinger, Esther

    2014-09-01

    The goal of this study was to examine the impact of supplementing Trauma-focused Cognitive Behavioral Therapy (TF-CBT; Cohen et al., 2006) with evidence-based engagement strategies on foster parent and foster youth engagement in treatment, given challenges engaging foster parents in treatment. A randomized controlled trial of TF-CBT standard delivery compared to TF-CBT plus evidence-based engagement strategies was conducted with 47 children and adolescents in foster care and one of their foster parents. Attendance, engagement, and clinical outcomes were assessed 1 month into treatment, end of treatment, and 3 months post-treatment. Youth and foster parents who received TF-CBT plus evidence-based engagement strategies were more likely to be retained in treatment through four sessions and were less likely to drop out of treatment prematurely. The engagement strategies did not appear to have an effect on the number of canceled or no-show sessions or on treatment satisfaction. Clinical outcomes did not differ by study condition, but exploratory analyses suggest that youth had significant improvements with treatment. Strategies that specifically target engagement may hold promise for increasing access to evidence-based treatments and for increasing likelihood of treatment completion. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Scleroderma skin ulcers definition, classification and treatment strategies our experience and review of the literature.

    Science.gov (United States)

    Giuggioli, Dilia; Manfredi, Andreina; Lumetti, Federica; Colaci, Michele; Ferri, Clodoveo

    2018-02-01

    Skin ulcers (SU) are one of the most frequent manifestations of systemic sclerosis (SSc). SSc-SU are very painful, often persistent and recurrent; they may lead to marked impairment of patient's activities and quality of life. Despite their severe impact on the whole SSc patient's management, the proposed definition, classification criteria, and therapeutic strategies of SSc-SU are still controversial. The present study aimed to elaborate a comprehensive proposal of definition, classification, and therapeutic strategy of SSc-SU on the basis of our long-term single center experience along with a careful revision of the world literature on the same topic. A series of 282 SSc patients (254 females and 28 males; 84% with limited and 16% diffuse cutaneous SSc; mean age of 51.5±13.9SD at SSc onset; mean follow-up 5.8±4.6SDyears) enrolled during the last decade at our Rheumatology Unit were retrospectively evaluated with specific attention to SSc-SU. The SSc-SU were classified in 5 subtypes according to prominent pathogenetic mechanism(s) and localization, namely 1. digital ulcers (DU) of the hands or feet, 2. SU on bony prominence, 3. SU on calcinosis, 4. SU of lower limbs, and 5. DU presenting with gangrene. This latter is a very harmful evolution of both DU of the hands and feet needing a differential diagnosis with critical limb ischemia. During the follow up period, one or more episodes of SSc-SU were recorded in over half patients (156/282, 55%); skin lesions were often recurrent and difficult-to-heal because of local complications, mainly infections (67.3%), in some cases associated to osteomyelitis (19.2%), gangrene (16%), and/or amputation (11.5%). SSc-SU were significantly associated with lower patients' mean age at the disease onset (p=0.024), male gender (p=0.03), diffuse cutaneous subset (p=0.015), calcinosis (p=0.002), telangiectasia (p=0.008), melanodermia (pTIME (necrotic Tissue, Infection/Inflammation, Moisture balance, and Epithelization). The updated

  3. Radioprotectors effect on the efficiency of combined treatment of radiation injuries (review of the literature)

    International Nuclear Information System (INIS)

    Farshatov, M.N.

    1986-01-01

    Therapeutic efficiency of radioprotector action (cystamine, in particular) under isolated and combined (in combination with burns, mechanical injuries of skull, brain, limbs internal organs etc.) radiation affection is discussed on the basis of experiment data, obtained by different authors. The conclusion is drawn, that under combined radiation affections with leading radial component, radioprotectors provide for approximately the same protection effect as under isolated radioactive irradiation by a corresponding dose. In combination with radial and nonradial injury means they can sufficiently reduce lethality and create better conditions for favourable course of burn deseases and mechanical injuries. It is pointed out, that preliminary protection gains decisive value in cases, when under combined radiation affection the radial component prevails. In this case radiosensitive tissue protection becomes necessary condition for the victim's life preservation, complication frequency reduction and improvement of treatment results. Advisability of inclusion of medical protection means into the step-by-step treatment system, wile foreseeing both isolated and combined radiation affections, is shown

  4. Radiotherapy and chemotherapy in cancer treatment during pregnancy: a literature review

    International Nuclear Information System (INIS)

    Schuenemann Junior, Eduardo; Urban, Cicero de Andrade; Lima, Rubens Silveira de; Rabinovich, Iris; Spautz, Cleverton C.

    2007-01-01

    The coexistence of pregnancy and cancer is a challenging situation for the physician. Chemotherapy and radiotherapy are often necessary, depending on the type and stage of cancer at diagnosis. When applying such treatment, several key points concerning the health of the fetus must be carefully monitored. Meanwhile, if the appropriate treatment is delayed until postpartum, the mother's life may be at risk. Historically, the mother's health was placed above that of the fetus. This concept has changed, and harmonization of maternal and fetal health is now considered ideal. Numerous reports have shown the safe use of chemotherapy especially during the second and third trimesters of pregnancy. In 2004 our department treated seven cases of simultaneous cancer and pregnancy, leading us to review the use of chemotherapy and radiotherapy during pregnancy and the repercussions on neonatal outcome. (author)

  5. Thyroid cancer post radioactive iodine treatment for hyperthyroidism - case series and review of the literature.

    Science.gov (United States)

    Al Eyadeh, Abdallah A; Al-Sarihin, Khaldon; Etewi, Suzan; Al-Omari, Ahmed; Al-Asa'd, Rania Atallah; Haddad, Fares Halim

    2017-01-01

    To assess the rate of thyroid cancer and mortality rate in a cohort of patients who received RAI¹³¹ treatment for hyperthyroidism and to report the index cases' characteristics and management MATERIAL AND METHODS: A cohort of 264 patients who received RAI¹³¹ treatment for different causes of thyrotoxicosis were followed up over a period of 18 years (1996-2014) by physical exam, radiological evaluation and serial thyroid function tests. During the follow up period, three cases of thyroid cancer were identified. The prevalence of thyroid cancer was 1.136% of cases who received RAI¹³¹. The relative risk was 378.79 (95% CI: 76.8 effect relationship between RAI and thyroid cancer could be established, these cases highlights the importance of life-long surveillance of patients who receive RAI¹³¹.

  6. Orthomolecular medicine: the therapeutic use of dietary supplements for anti-aging

    OpenAIRE

    Janson, Michael

    2006-01-01

    Dietary supplements at high doses as part of medical therapy have been controversial, but the evidence suggests that they play a significant role in prevention and treatment of diseases as well as protection from accelerated aging that results from oxygen free-radical damage, inflammation, and glycation. This literature review examines several supplements that have documented roles in medical therapy, including vitamins C and E, coenzyme Q10, alpha-lipoic acid, chromium, L-carnitine, and quer...

  7. Cost of Tuberculosis Diagnosis and Treatment in Patients with HIV: A Systematic Literature Review.

    Science.gov (United States)

    de Siqueira-Filha, Noemia Teixeira; Legood, Rosa; Cavalcanti, Aracele; Santos, Andreia Costa

    2018-04-01

    To summarize the costs of tuberculosis (TB) diagnosis and treatment in human immunodeficiency virus (HIV)-infected patients and to assess the methodological quality of these studies. We included cost, cost-effectiveness, and cost-utility studies that reported primary costing data, conducted worldwide and published between 1990 and August 2016. We retrieved articles in PubMed, Embase, EconLit, CINAHL plus, and LILACS databases. The quality assessment was performed using two guidelines-the Consolidated Health Economic Evaluation Reporting Standards and the Tool to Estimate Patient's Costs. TB diagnosis was reported as cost per positive result or per suspect case. TB treatment was reported as cost of TB drugs, TB/HIV hospitalization, and treatment. We analyzed the data per level of TB/HIV endemicity and perspective of analysis. We included 34 articles, with 24 addressing TB/HIV treatment and 10 addressing TB diagnosis. Most of the studies were carried out in high TB/HIV burden countries (82%). The cost of TB diagnosis per suspect case varied from $0.5 for sputum smear microscopy to $175 for intensified case finding. The cost of TB/HIV hospitalization was higher in low/medium TB/HIV burden countries than in high TB/HIV burden countries ($75,406 vs. $2,474). TB/HIV co-infection presented higher costs than TB from the provider perspective ($814 vs. $604 vs. $454). Items such as "choice of discount rate," "patient interview procedures," and "methods used for valuing indirect costs" did not achieve a good score in the quality assessment. Our findings point to the need of generation of more standardized methods for cost data collection to generate more robust estimates and thus, support decision-making process. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Stomathologycal conditions in cancer patients during and after cancer treatment: narrative literature review.

    OpenAIRE

    Rebolledo-Cobos, Martha Leonor; Toloza-Gutiérrez, Olga Patricia; Alonso-Brujes, Iran David

    2017-01-01

    Introduction: The consequences of antineoplastic treatments bring about oralimplications and worsening of other lesions established prior to the oncological diagnosis, regardless of the organ affected by the tumor. Complications such as oral mucositis, oral candidiasis, trismus, xerostomia, caries, among other lesions, occur frequently and may be transient in the course of the application of cancer therapies, such as chemotherapy and radiotherapy; others prevail after completion of these ther...

  9. Clinical presentation, diagnosis and treatment of vulvovaginitis in girls: a current approach and review of the literature.

    Science.gov (United States)

    Beyitler, İlke; Kavukcu, Salih

    2017-04-01

    Vulvovaginitis is the most common cause of gynecological complaints in children and young girls. Some of the factors which cause vulvovaginitis include hypoestrogenism, the anatomical proximity of rectum and delicate vulvar skin and vaginal mucosa. We made a literature search with Pubmed, Medline and Cochrane database from January 2002 to May 2015 in English language using the key words vulvovaginitis, children, clinical, diagnosis and treatment. Vulvovaginitis in girls is usually caused by non-specific factors and hygiene measures, bioyoghurt and avoidance of chemical irritants are generally useful. Weight control if necessary and prevention of voiding dysfunction are effective. Vaginal flora is important in girls and results should be interpreted with clinical features to decide whether an isolated microorganism is part of the normal microflora or is the cause of symptomatic vulvovaginitis. Specific treatment is generally considered in case of a detected pathogen microorganism. Isolation of a sexually transmitted organism requires further investigation. Persistent disease may not always indicate a foreign body but it must be taken into account. Girls and parents are encouraged psychologically in all steps of evaluation, diagnosis and treatment. Probiotics, nanotechnology and petroleum jelly are other important treatment options used in vulvovaginitis. In this review, we present current approach to the presentation and management of vulvovaginitis in childhood. This disorder requires a comprehensive evaluation in all steps of diagnosis, differential diagnosis and treatment.

  10. The role of radiotherapy in the treatment of ovarian cancer: Review of the literature

    International Nuclear Information System (INIS)

    Bianchi G, Benjamin; Silva P, Gonzalo; Carvajal C, Claudia; Santini B, Alejandro

    2011-01-01

    Several studies have reviewed the potential coadjuvant of Radiotherapy (RT) and chemotherapy in the treatment of ovary cancer. However the effectiveness of total abdomen RT (RTAT) versus new QT drugs have not been adequately compared. Both surgery and QT prior to RT increase total and freedom from the disease since tumors become radiosensitive, thus favoring destruction. Diverse techniques such as IMRT (Intensity modulated radiation therapy) are being used with excellent results. Despite these advances, many of the patients develop intraabdominal recurrence leaving them out of the therapeutic scope/range for QT. RT may then be used as a palliative in big unique cases watching possible complications. RTAT may eventually be restarted in the treatment of ovary cancer depending on the findings during surgery. Finally, RT/QT concomitants have shown their effect in sensitivity and synergy and it is expected that new drugs with different interactions such as taxan and target molecules are added. Treatment of ovarian cancer remains essentially surgical and with chemotherapy, but both radio and chemotherapy has demonstrated their adjuvant effect. Despite being an unexplored alternative is necessary to study prospectively the promising results of new techniques of radiation therapy in these patients

  11. The role of radiotherapy in cancer treatment ovary: Review of the literature

    International Nuclear Information System (INIS)

    Bianchi G, Benjamin; Silva P, Gonzalo; Carvajal C, Claudia; Santini B, Alejandro

    2011-01-01

    Several studies have reviewed the potential coadjuvant of Radiotherapy (RT) and chemotherapy in the treatment of ovary cancer. However the effectiveness of total abdomen RT (RTAT) versus new QT drugs have not been adequately compared. Both surgery and QT prior to RT increase total and freedom from the disease since tumors become radiosensitive, thus favoring destruction. Diverse techniques such as IMRT (Intensity modulated radiation therapy) are being used with excellent results. Despite these advances, many of the patients develop intraabdominal recurrence leaving them out of the therapeutic scope/range for QT. RT may then be used as a palliative in big unique cases watching possible complications. RTAT may eventually be restarted in the treatment of ovary cancer depending on the findings during surgery. Finally, RT/QT concomitants have shown their effect in sensitivity and synergy and it is expected that new drugs with different interactions such as taxan and target molecules are added. Treatment of ovarian cancer remains essentially surgical and with chemotherapy, but both radio and chemotherapy has demonstrated their adjuvant effect. Despite being an unexplored alternative is necessary to study prospectively the promising results of new techniques of radiation therapy in these patients

  12. Ginkgo biloba in the treatment of tinnitus: An updated literature review.

    Science.gov (United States)

    Mahmoudian-Sani, Mohammad Reza; Hashemzadeh-Chaleshtori, Morteza; Asadi-Samani, Majid; Yang, Qian

    2017-06-01

    Tinnitus is one of the common diseases of the ear that is associated with numerous physical and mental disorders. One of the known mechanisms in the tinnitus area with unknown reason is oxidative events. Based on the prevalence and economic costs and physical- psychological side effects caused by tinnitus and the importance of finding a suitable solution for its prevention and treatment, the need for further studies becomes more obvious in this context. This review article aimed to review studies on the effectiveness of Ginkgo biloba as a medicinal plant on patients with tinnitus. Google Scholar, Directory of Open Access Journals (DOAJ), PubMed, LISTA (EBSCO) and Web of Science have been searched. There are many studies on the therapeutic effect of Ginkgo biloba on patients with tinnitus. Most findings are in contrast with each other so that some of studies reported that Ginkgo biloba is effective in the treatment of tinnitus and other studies referred to it as ineffective herbal medicine. Generally, according to the previous studies and the present study, it can mention that the Ginkgo biloba may somewhat improve tinnitus. Since tinnitus is multifactorial, it is recommended to evaluate patients individually based on the cause of tinnitus, treatment formulas, and different doses of Ginkgo biloba at the more extensive level in future studies.

  13. Successful Treatment of Canine Sporotrichosis with Terbinafine: Case Reports and Literature Review.

    Science.gov (United States)

    Viana, Paula Gonçalves; Figueiredo, Anna Barreto Fernandes; Gremião, Isabella Dib Ferreira; de Miranda, Luisa Helena Monteiro; da Silva Antonio, Isabela Maria; Boechat, Jéssica Sepulveda; de Sá Machado, Ana Caroline; de Oliveira, Manoel Marques Evangelista; Pereira, Sandro Antonio

    2018-04-01

    Sporotrichosis occurs worldwide, and the metropolitan region of Rio de Janeiro, Brazil, is a main endemic area, with a large number of human and animal cases in the last 19 years. This mycosis is more frequently described in cats rather than in dogs. There are a limited number of oral antifungal agents for the treatment of sporotrichosis in animals. In this context, the effectiveness of terbinafine in the treatment of sporotrichosis in humans, as well as the promising results of in vitro susceptibility tests, inspired us to use this drug in the therapy of this mycosis in dogs. We reported for the first time the use of terbinafine in the treatment of two dogs with sporotrichosis caused by Sporothrix brasiliensis. Moreover, we provided an overview of therapeutic features of canine sporotrichosis cases reported since the 1960s. One of the dogs presented the fixed cutaneous form of the disease, while the other patient presented hyperemia of the nasal mucosa and respiratory signs only. Terbinafine showed high antifungal activity in vitro against the canine Sporothrix isolates. The dogs were successfully treated with terbinafine, with remission of all clinical signs initially presented. The current reports indicate that this drug can emerge as a therapeutic option for canine sporotrichosis.

  14. BIOLOGICAL AND SYNTHETIC MATERIALS IN RECONSTRUCTIVE SURGERY FOR BREAST CANCER TREATMENT (LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    A. D. Zikiryakhodzhaev

    2018-01-01

    Full Text Available During the last years has been a worldwide trend towards rejuvenating breast cancer, and the evolution of reconstructive breast surgery is proceeding at a rapid pace. The surgical method is the primary method in the combined and complex treatment of breast cancer, and radical mastectomy is still the main option for surgical treatment in most Russian clinics. Most women who need a mastectomy prefer a one-stage breast reconstruction, because the woman is quickly rehabilitated psychologically and physically after this operation. Nevertheless, the use of silicone endoprostheses did not solve the problems of breast reconstruction in combined treatment in oncology. The issue remains unresolved of various complications, related not only to infections, but also to the development of capsular contracture after radiotherapy. Many patients with a one-stage breast reconstruction using a silicone endoprostheses lack the volume of their own tissues for reliable shelter of the endoprosthesis. In such cases, synthetic reticulated implants, biological implants or autologous flaps are used to cover and strengthen the lower slope of the reconstructed breast.

  15. Generalized Aggressive Periodontitis and Its Treatment Options: Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    T. Roshna

    2012-01-01

    Full Text Available Generalized aggressive periodontitis results in rapid destruction of the periodontium and can lead to early tooth loss in the affected individuals if not diagnosed early and treated appropriately. The diagnostic features of the disease are characteristic, but the clinical presentation and patterns of destructions may vary between patients. Successful management of the disease is challenging especially if diagnosed at advanced stages of the disease, but not impossible with the current therapeutic choices for the disease. A vast array of treatment modalities is available which can be employed in the treatment of generalized aggressive periodontitis with varying success rates, but a definite guideline for the management is yet to be formulated. However, with the exponential rate of developments in periodontal research, regenerative therapy, tissue engineering, and genetic technologies, the future seems promising in regard to options at managing the disease. This paper attempts to describe the clinical and radiographic diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of generalized aggressive periodontitis patients with case reports and a brief review.

  16. Essure a novel option for the treatment of hydrosalpinx: a case series and literature review.

    Science.gov (United States)

    Lorente González, Juan; Ríos Castillo, José Enrique; Pomares Toro, Elvira; Romero Nieto, María Inmaculada; Castelo-Branco, Camil; Arjona Berral, José Eduardo

    2016-01-01

    The aim of this study is to evaluate the use of hysteroscopic Essure device placement for the treatment of hydrosalpinx (HS)-related infertility in patients with laparoscopic contraindications and compared their pregnancy outcomes following IVF-ICSI treatment with those patients having had laparoscopic tubal occlusion (LTO). From 2008 to 2014 a total of 50 patients were diagnosed with unilateral or bilateral hydrosalpinges: 29 patients had laparoscopic contraindications and were treated hysteroscopically and 21 patients were treated with laparoscopical salpingectomy. Of the 29 patients who underwent treatment with Essure(®), 21 began a cycle of in vitro fertilization (IVF), and 13 finished in embryo transfer that resulted in seven clinical pregnancies. Furthermore, in the group of women treated with salpingectomy, 17 started an IVF cycle that resulted in 12 clinical pregnancies. The clinical pregnancy rate per patient with an IVF cycle started was 33.3% and 70.6%, the live-birth rate per patient was 14.3% and 52.9%, the miscarriage rate was 57.1% and 18.2%, and the implantation rate was 16.3% and 34.1% for hysteroscopy and laparoscopy, respectively. Essure(®) placement is an alternative method for occlusion of hydrosalpinges before IVF. Monitoring the live-birth rate confirms that this option may be considered when laparoscopy is impossible or contraindicated.

  17. Could early rheumatoid arthritis resolve after periodontitis treatment only?: case report and review of the literature.

    Science.gov (United States)

    Salemi, Simonetta; Biondo, Michela I; Fiorentino, Chiara; Argento, Giuseppe; Paolantonio, Michele; Di Murro, Carlo; Malagnino, Vito A; Canzoni, Marco; Diamanti, Andrea Picchianti; D'Amelio, Raffaele

    2014-12-01

    Rheumatoid arthritis (RA) is an immune-mediated polyarthritis; currently no pathogenic agent has been identified as a disease trigger. A patient with RA, presumably caused by periodontal infection, whose remission has been observed after periodontitis treatment in absence of specific RA therapy, is reported here for the first time, to our knowledge. A 61-year-old male patient presented migrant arthritis associated with antibodies against citrullinated protein antigens positivity. The clinical features allowed to make RA diagnosis according to the 2010 European League against Rheumatism/American College of Rheumatology RA classification criteria. X-ray of the second upper molar showed chronic apical periodontitis. After its treatment, arthritis remission has been observed in the absence of specific RA therapy. It has been suggested that periodontitis may have a trigger role in RA pathogenesis. This could be explained by the enzymatic action of Porphyromonas gingivalis, probably leading to break tolerance to collagen. The identification and subsequent treatment of periodontitis should therefore be considered pivotal in RA prophylaxis and management.

  18. A bibliometric study of scientific literature in Scopus on botanicals for treatment of androgenetic alopecia.

    Science.gov (United States)

    Rondanelli, Mariangela; Perna, Simone; Peroni, Gabriella; Guido, Davide

    2016-06-01

    In androgenetic alopecia, a number of botanicals are available that can effectively slow or reduce hair loss and inflammation or stimulate partial hair regrowth. The aim of this study was to provide a descriptive overview of the impact and production of literature on botanicals used for androgenetic alopecia and to perform a citation analysis of the related research articles. We searched for "alopecia" OR "androgenetic alopecia" OR "hair loss" AND "Camelia sinensis" OR (and other 15 botanicals) in ARTICLE (Title/Abstract/Keyword) in Scopus database. A total of 29 references, that is, research articles, were retrieved by SCOPUS search, and 93.1% had been published since 2000. The majority (48.3%) describe applications of hair grow stimulants, followed by inhibitors of 5-alpha-reductase applications (27.6%), and studies concerning inhibitors of inflammation (24.1%). The citation analysis revealed a growing interest for this topic and the papers on hair grow stimulants are most cited. Citation trend of inhibition of 5-alpha-reductase articles is growing in the last years. This study has highlighted three important aspects: (1) growing interest for this topic; (2) evidences mainly in hair grow stimulants and recently in the inhibition of 5-alpha-reductase, as demonstrated by article and citation counts across years; (3) in addition, all major studies have been focused on green tea epigallocatechin-3-gallate, Serenoa repens, Citrullus colocynthis and Cuscuta reflexa. © 2015 Wiley Periodicals, Inc.

  19. Mesothelioma: treatment and survival of a patient population and review of the literature.

    Science.gov (United States)

    Stathopoulos, John; Antoniou, Dimosthenis; Stathopoulos, George P; Rigatos, Sotiris K; Dimitroulis, John; Koutandos, John; Michalopoulou, Pinelopi; Athanasiades, Athanasios; Veslemes, Marinos

    2005-01-01

    Our purpose was to evaluate the survival of patients with pleural and intraperitoneal malignant mesothelioma and, particularly, to estimate the efficacy of chemotherapy as well as radiotherapy and surgery. A review of the literature with respect to these parameters is included. Thirty-five patients with malignant mesothelioma (28 with pleural and 7 with intraperitoneal) were enrolled. Twenty-eight patients underwent chemotherapy, 7/35 radiation and 9/35 surgery (2 with pleural and 7 with abdominal disease). Combination chemotherapy included cisplatin-gemcitabine, cisplatin (or carboplatin) with premetrexed and doxorubicin-cyclophosphamide. In 2/28 patients with pleural mesothelioma the tumor was excised and in 7 with intraperitoneal disease, surgical therapy was palliative and there was survival prolongation. Radiotherapy was only palliative. Chemotherapy produced a very low response: 2/28 (7.14%) patients achieved a partial response. The median survival was 17 months, 4-year survival, 24.4% and 5-year survival, 12.12%. No serious toxicity was observed. Malignant mesothelioma of the pleura and intraperitoneum is a slow-growing disease which is indicated by the long survival, despite the failure of chemotherapy, radiation therapy and surgery.

  20. Literature review of the causes, treatment, and prevention of dermatitis linearis.

    Science.gov (United States)

    Beaulieu, Brooke A; Irish, Seth R

    2016-04-01

    Dermatitis linearis is a skin condition that affects both local populations and travelers alike. Dermatitis linearis is caused by some beetles within the subtribe Paederina and manifests as painful lesions, blisters and intense itching. Though outbreaks are widespread, the condition as a whole still remains relatively unknown. An extensive search of the existing Paederus literature was conducting in order to elucidate relevant information regarding the occurrence of outbreaks, seasonality, exposure and symptom onset, and management of dermatitis linearis. Special consideration was given to behavioral and environmental factors. Epidemics of dermatitis linearis are most commonly observed during the rainy season or after particularly hot and humid weather patterns. Symptom onset is typically delayed 6-48 h after exposure. The most common symptoms are stinging, burning and itching, with later development of erythematous plaques and blisters. Though symptoms of dermatitis linearis resolve spontaneously, wet compresses, antihistamines and topical steroid ointments and lotions are recommended to alleviate symptoms. Dermatitis linearis in travelers and local populations can be prevented through minimizing or modifying sources of artificial light, using pesticide-treated nets near beds and lights, general housekeeping and vegetation maintenance, and by raising awareness regarding the conditions caused by Paederus. Published by Oxford University Press International Society of Travel Medicine 2015. This work is written by US Government employees and is in the public domain in the US.

  1. TAFRO Syndrome Associated with EBV and Successful Triple Therapy Treatment: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Malorie Simons

    2016-01-01

    Full Text Available TAFRO syndrome is a rare constellation of symptoms: thrombocytopenia, anasarca, reticulin fibrosis of the bone marrow, renal dysfunction, and organomegaly. Its pathogenesis involves an excessive and inappropriate cytokine storm, most notably from IL-6, causing multiorgan failure; however, its etiology is undetermined. Starting in 2012, TAFRO syndrome was first identified in Japan as an atypical variant of Castleman’s disease. Previous reports include various different treatment protocols with inconsistent survival outcomes. Here we report the first known American, EBV positive but HIV and HHV-8 negative, male with TAFRO syndrome. He was successfully treated with an unusual three-drug regimen including tocilizumab, etoposide, and rituximab. We review the literature of TAFRO syndrome, discuss its possible viral etiology, and propose an original treatment regimen.

  2. [Surgical treatment of choledocholithiasis in a patient with situs inversus totalis: a case report and literature review].

    Science.gov (United States)

    Morales-Rodríguez, Jerson Francisco; Corina Cotillo, Estefania; Moreno-Loaiza, Oscar

    2017-07-26

    Situs inversus totalis (SIT) is a rare condition, in which there is transposition of the thoraco-abdominal organs. This situation leads to diagnostic and therapeutic difficulties in patients with acute surgical abdomen. The objective of this report is to present the case of a patient who presented with colonic pain in the epigastrium and left hypochondrium, in which the diagnosis of SIT, cholelithiasis and choledocholithiasis was reached after the respective imaging studies. Once the diagnosis was made, treatment was performed through retrograde endoscopic cholangiopancreatography (ERCP) and subsequent surgical exploration of bile ducts. Both procedures were failed due to technical difficulties generated by the patient's condition. In conclusion, in spite of the report of successful cases in the literature of ERCP and surgical treatment of the biliary tract in SIT, there may be situations that do not allow a successful approach, so meticulous surgical planning and the use of support methods are necessary In the management of these patients.

  3. Multi-organ sarcoidosis treatment with fumaric acid esters: a case report and review of the literature.

    Science.gov (United States)

    Zouboulis, Christos C; Lippert, Undine; Karagiannidis, Ioannis

    2014-01-01

    Sarcoidosis is a rare, systemic disease that is characterized by the formation of granulomas in various organs, including the skin. As the etiology remains unknown, the treatment of sarcoidosis is challenging. We present a 47-year-old female patient with progressive, multi-organ sarcoidosis who had a complete clinical improvement of the skin lesions, a moderate reduction in pulmonary opacities on chest X-ray, a marked subjective improvement in general status and pulmonary efficiency and a marked reduction in serum angiotensin-converting enzyme and soluble interleukin-2 receptor after 6 months of therapy with fumaric acid esters. The present case and similar reports in the literature highlight the probable efficacy of fumaric acid esters in the treatment of sarcoidosis and other non-infectious, granulomatous diseases. © 2014 S. Karger AG, Basel.

  4. Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition

    Science.gov (United States)

    World Health Organization (WHO) guidelines recommend for children with severe acute malnutrition (SAM), high-dose vitamin A (VA) supplements be given on day 1 of admission, and on days 2 and 14 in the case of clinical signs of vitamin A deficiency (VAD). Daily low-dose VA follows, delivered in a pre...

  5. Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc supplementation together with antimony treatment

    Directory of Open Access Journals (Sweden)

    Miguel Guzman-Rivero

    2014-11-01

    Full Text Available Background: The role of micronutrient status for the incidence and clinical course of cutaneous leishmaniasis is not much studied. Still zinc supplementation in leishmaniasis has shown some effect on the clinical recovery, but the evidence in humans is limited. Objective: To compare biochemical nutritional status in cutaneous leishmaniasis patients with that in controls and to study the effects of zinc supplementation for 60 days. Design: Twenty-nine patients with cutaneous leishmaniasis were treated with antimony for 20 days. Fourteen of them got 45 mg zinc daily and 15 of them got placebo. Biomarkers of nutritional and inflammatory status and changes in size and characteristics of skin lesions were measured. Results: The level of transferrin receptor was higher in patients than in controls but otherwise no differences in nutritional status were found between patients and controls. No significant effects of zinc supplementation on the clinical recovery were observed as assessed by lesion area reduction and characteristics or on biochemical parameters. Conclusions: It is concluded that nutritional status was essentially unaffected in cutaneous leishmaniasis and that oral zinc supplementation administered together with intramuscular injection of antimony had no additional clinical benefit.

  6. Wheat straw as ruminant feed : effect of supplementation and ammonia treatment on voluntary intake and nutrient availability

    NARCIS (Netherlands)

    Oosting, S.J.

    1993-01-01

    This thesis describes the results of experiments with goats, sheep and cattle fed untreated or ammonia-treated wheat straw. Aim of the experiments was to identify factors limiting voluntary intake and digestion of these low-quality feeds. Supplementation of urea to untreated wheat straw

  7. Surgical Regenerative Treatments for Peri-Implantitis: Meta-analysis of Recent Findings in a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Povilas Daugela

    2016-09-01

    Full Text Available Objectives: The purpose of the present study was to systematically review the literature on the surgical regenerative treatment of the peri-implantitis and to determine an effective therapeutic predictable option for their clinical management. Material and Methods: The study searched MEDLINE and EMBASE databases from 2006 to 2016. Clinical human studies that had reported changes in probing depth (PD and/or bleeding on probing (BOP and/or radiologic marginal bone level (RBL changes after peri-implantitis surgical treatment at 12-month follow-up or longer were included accordingly to PRISMA guidelines. Results: The initial search obtained 883 citations. After screening and determination of eligibility, 18 articles were included in the review. The meta-analysis of selected studies revealed that the weighted mean RBL fill was 1.97 mm (95% confidence interval [CI] = 1.58 to 2.35 mm, PD reduction was 2.78 mm (95% CI = 2.31 to 3.25 mm, and BOP reduced by 52.5% (95% CI = 41.6 to 63.1%. Defect fill in studies using and not using barrier membranes for graft coverage was 1.86 mm (95% CI = 1.36 to 2.36 mm and 2.12 mm (95% CI = 1.46 to 2.78 mm correspondingly. High heterogeneity among the studies regarding defects morphology, surgical protocols, and selection of biomaterials were found. Conclusions: All included studies underlined an improvement of clinical conditions after the surgical regenerative treatment of peri-implantitis, however, there is a lack of scientific evidence in the literature regarding the superiority of the regenerative versus non-regenerative surgical treatment. The presence of a barrier membrane or submergence in the regenerative procedure does not seem to be fundamental in order to obtain clinical success of the surgery.

  8. Treatment of Primary Fetal Hydrothorax with OK-432 (Picibanil): Outcome in 14 Fetuses and a Review of the Literature.

    Science.gov (United States)

    O'Brien, Brooke; Kesby, Greg; Ogle, Robert; Rieger, Ingrid; Hyett, Jon A

    2015-01-01

    Primary fetal hydrothorax (PFHT) is an uncommon condition with an estimated prevalence of 1 in 10,000/15,000 pregnancies. Therapeutic interventions include thoracocentesis, thoraco-amniotic shunting (TAS), and pleurodesis using OK-432. A review of the literature was performed to identify all cases of PFHT treated with TAS and OK-432. All cases of PFHT referred to the Fetal Maternal Unit at Royal Prince Alfred Hospital between 2002 and 2012 were retrospectively reviewed. In the cohort of fetuses treated with OK-432, the main perinatal outcomes evaluated were termination of pregnancy, live birth, neonatal death, and fetal death in utero. Secondary outcomes included gestational age (GA) at diagnosis, GA at treatment, GA at resolution, birth weight, and GA at birth. The development of the children was screened using the Ages and Stages Questionnaires, Version 3 (ASQ-3, 2009). Primary hydrothorax was diagnosed in 31 fetuses, of which 14 had treatment with OK-432. One pregnancy terminated after treatment with OK-432. Survival was 85% (11/13): 100% in fetuses treated with OK-432 without hydrops, and 78% in those treated with hydrops. This compares well to the cases of TAS in the literature with an average survival of 63%: 85% in fetuses without hydrops and 55% with hydrops. The mean GA at birth was 36(+4) weeks and mean birth weight 3,007 g. Eight of the 9 children screened with ASQ-3 scored well within the normal range. OK-432 appears to be a valid treatment option in fetuses with PFHT, particularly in those diagnosed at early GAs. © 2014 S. Karger AG, Basel.

  9. Breast cancer arising within fibroadenoma: collective analysis of case reports in the literature and hints on treatment policy.

    Science.gov (United States)

    Wu, Yu-Ting; Chen, Shou-Tung; Chen, Chih-Jung; Kuo, Yao-Lung; Tseng, Ling-Ming; Chen, Dar-Ren; Kuo, Shou-Jen; Lai, Hung-Wen

    2014-11-10

    Breast cancer arising within a fibroadenoma (BcaFad) is rare; the rate varies from 0.002% to 0.125% in fibroadenoma specimens. Owing to its rarity, the clinicopathologic feature and treatment principle of BcaFad is still not clear. Therefore, the aim of this study was to perform a collective analysis of case reports in the literature to identify the characteristics and optimal treatment for BcaFad. We analyzed an aggregated sample of 30 patients with BcaFad from case reports in the literature (n=24 cases) and our present study (n=6 cases). We collected and analyzed the clinicopathologic features and prognoses of patients with BcaFad, as well as treatments they received. The patients' mean age at diagnosis was 46.9 years. Twenty BcaFad patients (66.7%) received breast-conserving surgery (BCS), and nine other patients (30.0%) were treated with mastectomy. The rate of lymph node metastasis in BcaFad patients was 23.8%. The breakdown of the histological types of BcaFad was invasive ductal carcinoma (53.3%), followed by ductal carcinoma in situ (23.3%), lobular carcinoma in situ (16.7%) and invasive lobular carcinoma (13.3%). More than half of patients with positive hormone receptor status received hormone therapy. Most BcaFad patients with lymph node metastases received chemotherapy, and 20.0% of BcaFad patients treated with BCS received further radiotherapy. Only one patient had recurrence after surgery, and another had lung metastasis when diagnosed with BcaFad. Most BcaFad patients could be managed by BCS. Adjuvant radiotherapy could be performed, but was not mandatory. Chemotherapy should be considered as a treatment option in the presence of lymph node metastasis.

  10. Marijuana and other cannabinoids as a treatment for posttraumatic stress disorder: A literature review.

    Science.gov (United States)

    Steenkamp, Maria M; Blessing, Esther M; Galatzer-Levy, Isaac R; Hollahan, Laura C; Anderson, William T

    2017-03-01

    Posttraumatic stress disorder (PTSD) is common in the general population, yet there are limitations to the effectiveness, tolerability, and acceptability of available first-line interventions. We review the extant knowledge on the effects of marijuana and other cannabinoids on PTSD. Potential therapeutic effects of these agents may largely derive from actions on the endocannabinoid system and we review major animal and human findings in this area. Preclinical and clinical studies generally support the biological plausibility for cannabinoids' potential therapeutic effects, but underscore heterogeneity in outcomes depending on dose, chemotype, and individual variation. Treatment outcome studies of whole plant marijuana and related cannabinoids on PTSD are limited and not methodologically rigorous, precluding conclusions about their potential therapeutic effects. Reported benefits for nightmares and sleep (particularly with synthetic cannabinoid nabilone) substantiate larger controlled trials to determine effectiveness and tolerability. Of concern, marijuana use has been linked to adverse psychiatric outcomes, including conditions commonly comorbid with PTSD such as depression, anxiety, psychosis, and substance misuse. Available evidence is stronger for marijuana's harmful effects on the development of psychosis and substance misuse than for the development of depression and anxiety. Marijuana use is also associated with worse treatment outcomes in naturalistic studies, and with maladaptive coping styles that may maintain PTSD symptoms. Known risks of marijuana thus currently outweigh unknown benefits for PTSD. Although controlled research on marijuana and other cannabinoids' effects on PTSD remains limited, rapid shifts in the legal landscape may now enable such studies, potentially opening new avenues in PTSD treatment research. © 2017 Wiley Periodicals, Inc.

  11. How patients take malaria treatment: a systematic review of the literature on adherence to antimalarial drugs.

    Directory of Open Access Journals (Sweden)

    Katia Bruxvoort

    Full Text Available BACKGROUND: High levels of patient adherence to antimalarial treatment are important in ensuring drug effectiveness. To achieve this goal, it is important to understand levels of patient adherence, and the range of study designs and methodological challenges involved in measuring adherence and interpreting results. Since antimalarial adherence was reviewed in 2004, there has been a major expansion in the use of artemisinin-based combination therapies (ACTs in the public sector, as well as initiatives to make them more widely accessible through community health workers and private retailers. These changes and the large number of recent adherence studies raise the need for an updated review on this topic. OBJECTIVE: We conducted a systematic review of studies reporting quantitative results on patient adherence to antimalarials obtained for treatment. RESULTS: The 55 studies identified reported extensive variation in patient adherence to antimalarials, with many studies reporting very high adherence (90-100% and others finding adherence of less than 50%. We identified five overarching approaches to assessing adherence based on the definition of adherence and the methods used to measure it. Overall, there was no clear pattern in adherence results by approach. However, adherence tended to be higher among studies where informed consent was collected at the time of obtaining the drug, where patient consultations were directly observed by research staff, and where a diagnostic test was obtained. CONCLUSION: Variations in reported adherence may reflect factors related to patient characteristics and the nature of their consultation with the provider, as well as methodological variations such as interaction between the research team and patients before and during the treatment. Future studies can benefit from an awareness of the impact of study procedures on adherence outcomes, and the identification of improved measurement methods less dependent on self-report.

  12. How patients take malaria treatment: a systematic review of the literature on adherence to antimalarial drugs.

    Science.gov (United States)

    Bruxvoort, Katia; Goodman, Catherine; Kachur, S Patrick; Schellenberg, David

    2014-01-01

    High levels of patient adherence to antimalarial treatment are important in ensuring drug effectiveness. To achieve this goal, it is important to understand levels of patient adherence, and the range of study designs and methodological challenges involved in measuring adherence and interpreting results. Since antimalarial adherence was reviewed in 2004, there has been a major expansion in the use of artemisinin-based combination therapies (ACTs) in the public sector, as well as initiatives to make them more widely accessible through community health workers and private retailers. These changes and the large number of recent adherence studies raise the need for an updated review on this topic. We conducted a systematic review of studies reporting quantitative results on patient adherence to antimalarials obtained for treatment. The 55 studies identified reported extensive variation in patient adherence to antimalarials, with many studies reporting very high adherence (90-100%) and others finding adherence of less than 50%. We identified five overarching approaches to assessing adherence based on the definition of adherence and the methods used to measure it. Overall, there was no clear pattern in adherence results by approach. However, adherence tended to be higher among studies where informed consent was collected at the time of obtaining the drug, where patient consultations were directly observed by research staff, and where a diagnostic test was obtained. Variations in reported adherence may reflect factors related to patient characteristics and the nature of their consultation with the provider, as well as methodological variations such as interaction between the research team and patients before and during the treatment. Future studies can benefit from an awareness of the impact of study procedures on adherence outcomes, and the identification of improved measurement methods less dependent on self-report.

  13. S-1 for treatment of advanced hepatocellular carcinoma: a systematic review of the literature

    OpenAIRE

    Huang, Wu-kui; You, Li-na; Yang, Shu-fa; Liu, Deng-yao; Liu, Mo; Fan, Xi-wen

    2017-01-01

    Hepatocellular carcinoma (HCC) is the most common liver neoplasm worldwide. Based on its potent inhibition of dihydropyrimidine dehydrogenase (DPD), S-1 is expected to be more active than other fluoropyrimidines against HCC with DPD activity. This systematic review was aimed to assess the efficacy and safety of S-1 for treatment of advanced HCC. PubMed, the Cochrane Library, EMBA- SE, and ClinicalTrials.gov were searched using the terms “Hepatocellular Carcinoma” or “HCC” or “Hepatoma...

  14. Pasireotide in the treatment of neuroendocrine tumors: a review of the literature.

    Science.gov (United States)

    Vitale, Giovanni; Dicitore, Alessandra; Sciammarella, Concetta; Di Molfetta, Sergio; Rubino, Manila; Faggiano, Antongiulio; Colao, Annamaria

    2018-06-01

    Somatostatin analogs have an important role in the medical therapy of neuroendocrine tumors (NETs). Octreotide and lanreotide, both somatostatin analogs binding with high affinity for the somatostatin receptor (SSTR)2, can control symptoms in functional NETs. In addition, these compounds, because of their antiproliferative effects, can stabilize growth of well-differentiated NETs. Pasireotide is a novel multireceptor-targeted somatostatin analog with high affinity for SSTR1, 2, 3, and 5. This review provides an overview of the state of the art of pasireotide in the treatment of NETs, with the aim of addressing clinical relevance and future perspectives for this molecule in the management of NETs. © 2018 Society for Endocrinology.

  15. Severe/Extreme Hypertriglyceridemia and LDL Apheretic Treatment: Review of the Literature, Original Findings

    Directory of Open Access Journals (Sweden)

    Olga Diakoumakou

    2014-01-01

    Full Text Available Hypertriglyceridemia (HTG is a feature of numerous metabolic disorders including dyslipidemias, metabolic syndrome, and diabetes mellitus type 2 and can increase the risk of premature coronary artery disease. HTG may also be due to genetic factors (called primary HTG and particularly the severe/extreme HTG (SEHTG, which is a usually rare genetic disorder. Even rarer are secondary cases of SEHTG caused by autoimmune disease. This review considers the causes of SEHTG, and their management including treatment with low density lipoprotein apheresis and analyzes the original findings.

  16. Cost-Effectiveness of Fecal Microbiota Transplantation in the Treatment of Recurrent Clostridium Difficile Infection: A Literature Review.

    Science.gov (United States)

    Arbel, Leor T; Hsu, Edmund; McNally, Keegan

    2017-08-23

    Clostridium difficile ( C. difficile ) is a common cause of antibiotic--associated diarrhea (AAD), being responsible for 15--25% of all AAD cases. The purpose of this literature review is to determine the cost-effectiveness of fecal microbiota transplantation (FMT) and how it compares in this regard to the standard treatments of choice for recurrent C. difficile infection (CDI). The review of the literature along with the evaluation of three comparative cost effective analyses yielded findings consistent with the view that FMT is the most cost-effective option in treating recurrent CDI. There are some (but considerably less) data indicating that FMT may be a cost effective strategy in treating initial CDI, as well. The superior cost-effectiveness of FMT as compared to the preferred standards of treatment for recurrent CDI suggest FMT use should become more integrated in routine clinical practice. Increased utilization of FMTs would allow for better control of this increasingly problematic disease as well as lower costs associated with its management.

  17. Laser and Light Treatments for Hair Reduction in Fitzpatrick Skin Types IV-VI: A Comprehensive Review of the Literature.

    Science.gov (United States)

    Fayne, Rachel A; Perper, Marina; Eber, Ariel E; Aldahan, Adam S; Nouri, Keyvan

    2018-04-01

    Unwanted facial and body hair presents as a common finding in many patients, such as females with hirsutism. With advances in laser and light technology, a clinically significant reduction in hair can be achieved in patients with light skin. However, in patients with darker skin, Fitzpatrick skin types (FST) IV-VI, the higher melanin content of the skin interferes with the proposed mechanism of laser-induced selective photothermolysis, which is to target the melanin in the hair follicle to cause permanent destruction of hair bulge stem cells. Many prospective and retrospective studies have been conducted with laser and light hair-removal devices, but most exclude patients with darkly pigmented skin, considering them a high-risk group for unwanted side effects, including pigmentation changes, blisters, and crust formation. We reviewed the published literature to obtain studies that focused on hair reduction for darker skin types. The existing literature for this patient population identifies longer wavelengths as a key element of the treatment protocol and indicates neodymium-doped yttrium aluminum garnet (Nd:YAG), diode, alexandrite, and ruby lasers as well as certain intense pulsed light sources for safe hair reduction with minimal side effects in patients with FST IV-VI, so long as energy settings and wavelengths are appropriate. Based on the findings in this review, safe and effective hair reduction for patients with FST IV-VI is achievable under proper treatment protocols and energy settings.

  18. Cost-Effectiveness of Fecal Microbiota Transplantation in the Treatment of Recurrent Clostridium Difficile Infection: A Literature Review

    Science.gov (United States)

    Arbel, Leor T; McNally, Keegan

    2017-01-01

    Clostridium difficile (C. difficile) is a common cause of antibiotic-­associated diarrhea (AAD), being responsible for 15­-25% of all AAD cases. The purpose of this literature review is to determine the cost-effectiveness of fecal microbiota transplantation (FMT) and how it compares in this regard to the standard treatments of choice for recurrent C. difficile infection (CDI). The review of the literature along with the evaluation of three comparative cost effective analyses yielded findings consistent with the view that FMT is the most cost-effective option in treating recurrent CDI. There are some (but considerably less) data indicating that FMT may be a cost effective strategy in treating initial CDI, as well. The superior cost-effectiveness of FMT as compared to the preferred standards of treatment for recurrent CDI suggest FMT use should become more integrated in routine clinical practice. Increased utilization of FMTs would allow for better control of this increasingly problematic disease as well as lower costs associated with its management. PMID:29067223

  19. True precocious puberty following treatment of a Leydig cell tumour: two case reports and literature review

    Directory of Open Access Journals (Sweden)

    Alberto eVerrotti

    2015-11-01

    Full Text Available Leydig cell testicular tumours are a rare cause of precocious pseudopuberty in boys. Surgery is the main therapy and shows good overall prognosis. The physical signs of precocious puberty are expected to disappear shortly after surgical removal of the mass. We report two children, 7.5 and 7.7 year-old boys, who underwent testis-sparing surgery for a Leydig cell testicular tumour causing precocious pseudopuberty. During follow-up, after an immediate clinical and laboratory regression, both boys presented signs of precocious puberty and ultimately developed central precocious puberty. They were successfully treated with gonadotropin releasing hormone analogues. Only 6 other cases have been described regarding the development of central precocious puberty after successful treatment of a Leydig cell tumour causing precocious pseudo puberty. Gonadotropin-dependent precocious puberty should be considered in children treated for a Leydig cell tumour presenting persistent or recurrent physical signs of puberty activation. In such cases, therapy with gonadotropin releasing hormone analogues appears to be the most effective medical treatment.

  20. [Non-pharmacological treatment of neurobehavioural disorders following severe traumatic brain injury. A commented literature review].

    Science.gov (United States)

    Fayol, P

    2003-03-01

    Neurobehavioural disorders are a major public health problem and a daily challenge for neurological rehabilitation. This review presents the state of art in the field of traumatic brain injury regarding non-pharmacological treatments of neurobehavioral disorders. Medline data base and main reference books going back for 15 years were searched. Prevention is based on information and counselling for a better coherence in the care and a better understanding of behaviour problems. Prevention of complications is based on adaptation of units and management (one-on-one care for example). Non-pharmacological treatment can be classified according to 3 approaches: (1) Behavioural approaches: with well-established procedures for each patient; (2) Holistic approaches: addressing both lesional and psychopathological as well as environmental features; (3) Psychotherapeutic approaches: either integrated to holistic programs, or adapted from classical psychotherapy, or systemic therapy. Practices trend to a convergence through a comprehensive approach: behaviour analysis and management of its neuropsychological, psychopathological and environmental components. Everybody will be able to pick out elements adaptable for his own practice.

  1. Pharmacological Treatment of ADHD in Addicted Patients: What Does the Literature Tell Us?

    Science.gov (United States)

    Carpentier, Pieter-Jan; Levin, Frances R.

    2017-01-01

    Learning objectives After participating in this activity, learners should be better able to: Evaluate pharmacologic treatment of attention deficit/hyperactivity disorder (ADHD) in patients with substance use disorder (SUD)Assess the causes of the diminished efficacy of ADHD medication in patients with comorbid SUD Objective Substance use disorder (SUD) and attention-deficit/hyperactivity disorder (ADHD) frequently co-occur, and the presence of ADHD complicates the treatment of the addiction. Pharmacotherapy is a potent intervention in childhood and adult ADHD, but findings have been mixed in adolescent and adult ADHD patients with SUDs. This review focuses on several contributing factors and possible explanations, with implications both for future research and for clinical practice. Method This systematic review examined all randomized, placebo-controlled trials of pharmacotherapy for ADHD in adult and adolescent SUD patients. Results The number of studies is limited, and several studies are hampered by qualitative flaws. The results, in general, are inconclusive for most medications studied, but more recent trials using psychostimulants in robust dosing have demonstrated significantly positive results. Conclusion In reviewing these trials, possible explanations relating to the particular characteristics and problems of this complex patient group are discussed. Several factors, including ADHD symptom severity, psychiatric comorbidity, persistent drug use, choice of medication, and concomitant psychosocial intervention, influence study results. Taking these factors into account may improve the likelihood of detecting significant effects in future research, as the recent positive trials have indicated, and may help in the appropriate selection of pharmacotherapy in clinical practice. PMID:28272130

  2. Optimal Conventional and Semi-Natural Treatments for the Upper Yakima Spring Chinook Salmon Supplementation Project, Treatment Definitions and Descriptions, and Biological Specifications for Facility Design, Final Report 1999

    International Nuclear Information System (INIS)

    Hager, Robert C.; Costello, Ronald J.

    1999-01-01

    This report describes the Yakima Fisheries Project facilities (Cle Elum Hatchery and acclimation satellites) which provide the mechanism to conduct state-of-the-art research for addressing questions about spring chinook supplementation strategies. The definition, descriptions, and specifications for the Yakima spring chinook supplementation program permit evaluation of alternative fish culture techniques that should yield improved methods and procedures to produce wild-like fish with higher survival that can be used to rebuild depleted spring chinook stocks of the Columbia River Basin. The definition and description of three experimental treatments, Optimal Conventional (OCT), Semi-Natural (SNT), Limited Semi-Natural (LSNT), and the biological specifications for facilities have been completed for the upper Yakima spring chinook salmon stock of the Yakima Fisheries Project. The task was performed by the Biological Specifications Work Group (BSWG) represented by Yakama Indian Nation, Washington Department of Fish and Wildlife, National Marine Fisheries Service, and Bonneville Power Administration. The control and experimental variables of the experimental treatments (OCT, SNT, and LSNT) are described in sufficient detail to assure that the fish culture facilities will be designed and operated as a production scale laboratory to produce and test supplemented upper Yakima spring chinook salmon. Product specifications of the treatment groups are proposed to serve as the generic templates for developing greater specificity for measurements of product attributes. These product specifications will be used to monitor and evaluate treatment effects, with respect to the biological response variables (post release survival, long-term fitness, reproductive success and ecological interactions)

  3. Optimal Conventional and Semi-Natural Treatments for the Upper Yakima Spring Chinook Salmon Supplementation Project; Treatment Definitions and Descriptions and Biological Specifications for Facility Design, 1995-1999 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Hager, Robert C. (Hatchery Operations Consulting); Costello, Ronald J. (Mobrand Biometrics, Inc., Vashon Island, WA)

    1999-10-01

    This report describes the Yakima Fisheries Project facilities (Cle Elum Hatchery and acclimation satellites) which provide the mechanism to conduct state-of-the-art research for addressing questions about spring chinook supplementation strategies. The definition, descriptions, and specifications for the Yakima spring chinook supplementation program permit evaluation of alternative fish culture techniques that should yield improved methods and procedures to produce wild-like fish with higher survival that can be used to rebuild depleted spring chinook stocks of the Columbia River Basin. The definition and description of three experimental treatments, Optimal Conventional (OCT), Semi-Natural (SNT), Limited Semi-Natural (LSNT), and the biological specifications for facilities have been completed for the upper Yakima spring chinook salmon stock of the Yakima Fisheries Project. The task was performed by the Biological Specifications Work Group (BSWG) represented by Yakama Indian Nation, Washington Department of Fish and Wildlife, National Marine Fisheries Service, and Bonneville Power Administration. The control and experimental variables of the experimental treatments (OCT, SNT, and LSNT) are described in sufficient detail to assure that the fish culture facilities will be designed and operated as a production scale laboratory to produce and test supplemented upper Yakima spring chinook salmon. Product specifications of the treatment groups are proposed to serve as the generic templates for developing greater specificity for measurements of product attributes. These product specifications will be used to monitor and evaluate treatment effects, with respect to the biological response variables (post release survival, long-term fitness, reproductive success and ecological interactions).

  4. EFFECTIVENESS OF VENETOСLAX IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA (LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    V. V. Strugov

    2017-01-01

    Full Text Available Currently we are facing a revolution in therapy of chronic lymphocytic leukemia, related to the development of novel target drugs, which have markedly improved treatment results in all groups of patients. While inhibitors of Bruton’s tyrosine kinase (ibrutinib, acalabrutinib etc. and phosphatidylinositol-3 kinase isoforms (idelalisib, umbralisib etc. are currently in the spotlight, much less attention is paid to antiapoptotic protein inhibitors such as venetoclax. In this review we summarize the results of venetoclax clinical studies in CLL as monotherapy and in combinations. The drug is distinguished by a high rate of complete responses and minimal residual disease eradication in high risk CLL patients, as well as a favorable toxicity profile. This makes it an ideal component of non-genotoxic regimens, aimed at the cure of the disease.

  5. Nivolumab in the treatment of malignant melanoma: review of the literature

    Directory of Open Access Journals (Sweden)

    Mashima E

    2015-08-01

    Full Text Available Emi Mashima, Akiha Inoue, Yumiko Sakuragi, Takashi Yamaguchi, Natsuko Sasaki, Yoko Hara, Daisuke Omoto, Shun Ohmori, Sanehito Haruyama, Yu Sawada, Manabu Yoshioka, Daisuke Nishio, Motonobu Nakamura Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan Abstract: Nivolumab was developed as a monoclonal antibody against programmed death receptor-1, an immune checkpoint inhibitor which negatively regulates T-cell proliferation and activation. Intravenous administration of nivolumab was approved for the treatment of unresectable malignant melanoma in 2014 in Japan. When advanced melanoma patients were treated with nivolumab, median overall survival became longer. Overall survival rate was significantly better in nivolumab-treated melanoma patients than dacarbazine-treated melanoma patients. Nivolumab had an acceptable long-term tolerability profile, with 22% of patients experiencing grade 3 or 4 adverse events related to the drug. Therefore, nivolumab can become an alternative therapy for advanced malignant melanoma. Keywords: monoclonal antibody, PD-1, PD-L1

  6. Effective treatment of different phenotypes of chronic urticaria with omalizumab: Case reports and review of literature.

    Science.gov (United States)

    Kasperska-Zajac, A; Jarząb, J; Żerdzińska, A; Bąk, K; Grzanka, A

    2016-06-01

    Despite the excellent efficacy and safety profile of omalizumab in chronic spontaneous urticaria (CSU), there are scarce data concerning its role in the treatment of refractory cases with different phenotypes of urticaria. We describe our experience with the therapy of nine patients with CSU co-existing with delayed pressure urticaria (DPU) or angioedema or both and refractory to treatment with high-dose antihistamines. The first patient, with severe CSU and recurrent angioedema, did not respond well to cyclosporine A or corticosteroids and suffered from numerous side effects of long-term corticosteroid therapy. The second patient presented with severe symptoms of DPU, which first of all prevented any daily activities of the professional routines. Both patients showed a complete remission of urticaria after the first injection of omalizumab. The third patient with CSU and severe DPU had been ineffectively treated for more than 20 years with various medications. Following the administration of omalizumab, the symptoms of CSU subsided but those of DPU intensified, and the drug was withdrawn after two cycles. In another four patients with refractory CSU and angioedema, the symptoms subsided after the first administration of omalizumab, and the patients have been in remission for about 5 weeks. In the remaining two patients, the symptoms did not resolve despite four 300 mg doses of omalizumab. It is important to establish a therapeutic regimen with omalizumab (150-300 mg; every 4-8 weeks) tailored to individual patient's needs and dependent on the type of urticaria; this may minimize unnecessary the medication exposure, adverse drug effects, and healthcare costs. © The Author(s) 2015.

  7. Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

    Science.gov (United States)

    Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

    2018-04-11

    The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  8. Integrative Therapeutic Approaches for the Management and Control of Nausea in Children Undergoing Cancer Treatment: A Systematic Review of Literature.

    Science.gov (United States)

    Momani, Tha'er G; Berry, Donna L

    Chemotherapy-induced nausea and vomiting (CINV) continues to be a common symptom experienced by children undergoing cancer treatment despite the use of contemporary antiemetics. Integrative therapeutic approaches in addition to standard pharmacologic antiemetic regimes offer potential to control CINV. The purpose of this review was to identify current evidence on integrative therapeutic approaches for the control of CINV in children with cancer. Online search engines (PubMed, CINAHL, PsychINFO) were queried using MESH terms. Titles, abstracts, and then full-text articles were reviewed for relevance to the review. The search resulted in 53 studies. Twenty-one studies met our review criteria. Integrative therapies identified included acupuncture/acupressure, aromatherapy, herbal supplements, hypnosis, and other cognitive behavioral interventions. Our review identified little information on the effectiveness and safety of most integrative therapeutic approaches for the control and management of CINV in children with cancer. However, evidence from adult cancer studies and some pediatric studies identify promising interventions for further testing.

  9. Supplemental Colleges

    Data.gov (United States)

    Department of Homeland Security — The Supplemental Colleges layer attempts to capture additional Post Secondary Education campuses of colleges and universities associated with a single campus listed...

  10. Reviewing the literature on access to prompt and effective malaria treatment in Kenya: implications for meeting the Abuja targets

    Directory of Open Access Journals (Sweden)

    Tetteh Gladys

    2009-10-01

    Full Text Available Abstract Background Effective case management is central to reducing malaria mortality and morbidity worldwide, but only a minority of those affected by malaria, have access to prompt effective treatment. In Kenya, the Division of Malaria Control is committed to ensuring that 80 percent of childhood fevers are treated with effective anti-malarial medicines within 24 hours of fever onset, but this target is largely unmet. This review aimed to document evidence on access to effective malaria treatment in Kenya, identify factors that influence access, and make recommendations on how to improve prompt access to effective malaria treatment. Since treatment-seeking patterns for malaria are similar in many settings in sub-Saharan Africa, the findings presented in this review have important lessons for other malaria endemic countries. Methods Internet searches were conducted in PUBMED (MEDLINE and HINARI databases using specific search terms and strategies. Grey literature was obtained by soliciting reports from individual researchers working in the treatment-seeking field, from websites of major organizations involved in malaria control and from international reports. Results The review indicated that malaria treatment-seeking occurs mostly in the informal sector; that most fevers are treated, but treatment is often ineffective. Irrational drug use was identified as a problem in most studies, but determinants of this behaviour were not documented. Availability of non-recommended medicines over-the-counter and the presence of substandard anti-malarials in the market are well documented. Demand side determinants of access include perception of illness causes, severity and timing of treatment, perceptions of treatment efficacy, simplicity of regimens and ability to pay. Supply side determinants include distance to health facilities, availability of medicines, prescribing and dispensing practices and quality of medicines. Policy level factors are around

  11. Humoral responses of broiler chickens challenged with NDV following supplemental treatment with extracts of Aloe vera, Alma millsoni, Ganoderma lucidum and Archachatina marginata.

    Science.gov (United States)

    Ojiezeh, Tony I; Eghafona, Nosahkare'Odeh

    2015-01-01

    The significance of nutritional supplements for immunity has been documented. Locally sourced extracts used in alternative medicine were studied to determine their potential effects on antibody production and humoral responses in viral challenged birds. Three hundred and eighty birds were distributed into 19 groups of 20 birds each. Following acclimatization for 16 days, they were fed with standard broilers feed and water ad libitum. Group A was supplemented with Aloe vera (AV) extract, group B was given Alma millsoni (AM) extract, group C was given Archachatina marginata (AMS) extract and group D was given Ganoderma lucidum (GL) extract, and group E was the control group. Extract concentrations of 50 mg, 100 mg and 150 mg were given to three subsets of each treatment group for 30 days. Birds were then challenged with intramuscular administration of 0.2 ml of 50% Embryo Lethal Dose of saline suspension of the challenge strain of Newcastle Disease Virus (NDV) on the 30(th) day, and were examined for clinical signs and symptoms. Serum from venous blood was used for antibody and immunological assay. Aloe vera at 50 µg and A. millsoni extracts supplementations yielded a significant antibody titre (p vera enhanced the ability to mount humoral responses against viral infection in broiler chickens.

  12. Literature Review of Saccharomyces boulardii in the Treatment of Refractory Recurrent Clostridium difficile Infection

    Directory of Open Access Journals (Sweden)

    Rachel Warila

    2017-09-01

    Full Text Available Objective: To evaluate the efficacy of S. boulardii for the treatment of recurrent C. difficile infections.Methods: Eligible articles included S. boulardii in patients with recurrent C. difficile infection. The primary endpoint examined was clinical resolution of infection with no further recurrences during follow-up.Results: Six studies met inclusion criteria. A case report showed resolution of recurrences in one patient, and an experimental trial showed a trend towards decreased recurrences in patients receiving S. boulardii (85% no further recurrences. Two randomized controlled trials found a significant decrease in recurrences for S. boulardii versus placebo (34.6% vs 64.7%, P=0.04; 16.7% vs 50%, P=0.05. One meta-analysis determined significant efficacy for S. boulardii in reducing relapses (RR 0.59, 95% CI 0.35-0.98, while another concluded there was insufficient evidence to recommend probiotics for C. difficile infection.Conclusions: S. boulardii may be considered for patients with recurrent C. difficile infection, refractory to antibiotic regimens alone.

  13. Successful treatment of paraganglioma with sorafenib: a case report and brief review of the literature

    Directory of Open Access Journals (Sweden)

    Lin Y

    2013-11-01

    Full Text Available Yun Lin,1,* Qun Li,1,* Wei Huang,1 Xinyan Jia,1 Hong Jiang,1 Yong Gao,1 Qi Li1,21Department of Oncology, Shanghai East Hospital, 2Department of Oncology, Shanghai First People's Hospital, Shanghai, People's Republic of China*These authors contributed equally to this work, and are joint first authorsIntroduction: To date, no effective systemic therapies have been made available for paraganglioma. However, multiple mutations in susceptibility genes have been identified that are potential targets for sorafenib, an oral multitargeted tyrosine-kinase inhibitor.Case presentation: We report the case of a 69-year-old Chinese man with mediastinal paraganglioma that had metastasized to the bone. The paraganglioma responded to sorafenib, a novel multi-tyrosine kinase inhibitor that targets angiogenesis, the Raf-kinase pathway, the platelet-derived growth factor Ret, and c-Kit. The patient was diagnosed as having paraganglioma after biopsy of the mediastinal mass. We first treated the patient with radiotherapy. Then he tolerated an etoposide-and-cisplatin chemotherapy regimen. Subsequently, he received 6 months of maintenance treatment with sorafenib (400 mg twice daily. A dramatic reduction in tumor volume was observed. At present, the patient has achieved a partial response, and his clinical status remains unchanged.Conclusion: We suggest that sorafenib should be further investigated in the management of patients with paraganglioma.Keywords: sorafenib, paraganglioma, molecular-targeted drug

  14. Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Belinchón I

    2016-11-01

    Full Text Available I Belinchón,1 R Rivera,2 C Blanch,3 M Comellas,4 L Lizán4,5 1Department of Dermatology, Hospital General Universitario de Alicante, Alicante, 2Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, 3Novartis Farmacéutica S.A., Barcelona, 4Outcomes’10, Castellón, Spain; 5Medical Department, University Jaime I, Castellón, Spain Background and objective: Adherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU.Methods: Electronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts’ opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded.Results: A total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4, preferences (n=5 and satisfaction with treatment (n=7. Results related to health-related quality of life articles (n=30 have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is

  15. The effect of vitamin C and/or E supplementations on type 2 diabetic adult males under metformin treatment: A single-blinded randomized controlled clinical trial.

    Science.gov (United States)

    El-Aal, Ali Abd; El-Ghffar, Eman A Abd; Ghali, Asmaa Abu; Zughbur, Mohammed R; Sirdah, Mahmoud M

    2018-03-16

    Recently, there has been an increasing interest in the influence of antioxidant vitamins on the efficacy of oral hypoglycemic therapy in type 2 diabetic patients (T2DM). This single-blinded randomized controlled clinical trial aimed to investigate the effect of vitamin C and/or E supplementation on the efficacy of oral hypoglycemic therapy in T2DM Palestinian male patients from the Gaza Strip. Forty T2DM male patients aged 40-60 years on metformin treatment were randomly divided into four groups, each group received an additional one of the following daily oral supplements for 90 days: placebo; vitamin C; vitamin E and vitamin C plus vitamin E. After overnight fasting, venous blood specimens were collected from all individuals into K3-EDTA tubes and serum tubes for measuring the biochemical and hematological parameters of the study at baseline and after 90 days of vitamins supplementation. The results revealed that vitamin C and/or E improve fasting blood sugar (FBS), HbA1c, lipid profile, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), reduced glutathione (GSH); and Quantitative Insulin Sensitivity Check Index (QISCI) compared with diabetic patients group that received placebo. This study provided additional evidence on the beneficial effects of supplementing antioxidant vitamins in T2DM which could improve the clinical condition and attenuate or prevent diabetic pathogenesis and complications that, secondly to poor glycemic control, could attribute to the imbalance between the decline in the endogenous antioxidants and increasing production of the reactive oxygen species leading to the oxidant-mediated damage present in the diabetic context. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  16. Atheroprotective effects of pure tocotrienol supplementation in the treatment of rabbits with experimentally induced early and established atherosclerosis

    Directory of Open Access Journals (Sweden)

    Thuhairah Abdul Rahman

    2016-10-01

    6.7 vs. 60.5±7.6; 11.3±2.2 vs. 27.7±4.8%; 23.0±1.7 vs. 46.5±3.4%; and 17.6±1.9 vs. 45.9±1.7%, respectively, p<0.05. Conclusion: These findings suggest the possible atheroprotective role T3 plays as an adjunct supplementation to standard treatment in the prevention of CAD.

  17. [Combined treatment of BPS with tamsulosin and finasteride : Literature review and prescription data].

    Science.gov (United States)

    Höfner, K; Ulrich, S; Berges, R

    2017-05-01

    Combined therapy of benign prostatic syndrome (BPS) with α 1 -blockers and 5α-reductase (5AR)-inhibitors is recommended according to two leading studies on doxazosin/finasteride and tamsulosin/dutasteride for all 10 in Germany possible combinations (five α 1 -blockers and two 5AR inhibitors). Because tamsulosin and finasteride predominate in the treatment of BPS in Germany, the role of the combination tamsulosin/finasteride and its scientific basis from clinical studies has been investigated. A pharmacoepidemiological extrapolation from receipts of pharmacy data centres showed a strong increase of the combination tamsulosin/finasteride since 2003. As a free combination, tamsulosin/finasteride beside the fixed combination tamsulosin/dutasteride accounts to about 50% of all α 1 -blocker/5AR-inhibitor combinations today. Clinical studies on tamsulosin/finasteride have been published including controlled studies of the combination and both monotherapies. The results of improvement of lower urinary tract symptoms (LUTS), maximum urinary flow rate (Q max ), prostate volume (PV) and prostate-specific antigen (PSA) as well as adverse events and drug safety are in agreement with the leading studies. However, results due to chance cannot be excluded because of deficiencies in study design. A reliable comparison of the risk of progression between tamsulosin/finasteride and both monotherapies is lacking completely. Because of the great coherence and continuous evaluation of available data of all combinations, and with the established strong class effect of monotherapies, a continuation of the therapeutic practice with the combination tamsulosin/finasteride is possible.

  18. Brace treatment for patients with Scheuermann's disease - a review of the literature and first experiences with a new brace design

    Directory of Open Access Journals (Sweden)

    Turnbull Deborah

    2009-09-01

    Full Text Available Abstract Background In contemporary literature few have written in detail on the in-brace correction effects of braces used for the treatment of hyperkyphosis. Bradford et al. found their attempts effective, treating Scheuermann's kyphosis with Milwaukee braces, but their report did not specifically focus on in-brace corrections. White and Panjabi's research attempted to correct a curvature of > 50° with the help of distraction forces, but consequently led to a reduction in patient comfort in the application of the Milwaukee brace. In Germany they avoid this by utitlising braces to treat hyperkyphosis that use transverse correction forces instead of distraction forces. Further efforts to reduce brace material have resulted in a special bracing design called kyphologic™ brace. The aim of this review is to present appropriate research to collect and evaluate possible in-brace corrections which have been achieved with brace treatment for hyperkyphosis. This paper introduces new methods of bracing and compares the results of these with other successful bracing concepts. Materials and methods 56 adolescents with the diagnosis of thoracic Scheuermann's hyperkyphosis or a thoracic idiopathic hyperkyphosis (22 girls and 34 boys with an average age of 14 years (12-17 yrs. were treated with the kyphologic™ brace between May 2007 and December 2008. The average Stagnara angle was 55,6° (43-80. In-brace correction was recorded and compared to the initial angle using the t-test. Results The average Stagnara angle in the brace was 39°. The average in-brace correction was 16.5° (1-40°. The verage percentage of in-brace correction compared to the initial value was 36%. The differences were significant in the t-test (t = 5.31, p Discussion If we assume that outcome of brace treatment positively correlates with in-brace correction, the treatment should be initiated before the curvature angle exceeds 50 - 55° in a growing adolescent. In scoliosis bracing

  19. Comparison of Four Search Engines and their efficacy With Emphasis on Literature Research in Addiction (Prevention and Treatment).

    Science.gov (United States)

    Samadzadeh, Gholam Reza; Rigi, Tahereh; Ganjali, Ali Reza

    2013-01-01

    Surveying valuable and most recent information from internet, has become vital for researchers and scholars, because every day, thousands and perhaps millions of scientific works are brought out as digital resources which represented by internet and researchers can't ignore this great resource to find related documents for their literature search, which may not be found in any library. With regard to variety of documents presented on the internet, search engines are one of the most effective search tools for finding information. The aim of this study is to evaluate the three criteria, recall, preciseness and importance of the four search engines which are PubMed, Science Direct, Google Scholar and federated search of Iranian National Medical Digital Library in addiction (prevention and treatment) to select the most effective search engine for offering the best literature research. This research was a cross-sectional study by which four popular search engines in medical sciences were evaluated. To select keywords, medical subject heading (Mesh) was used. We entered given keywords in the search engines and after searching, 10 first entries were evaluated. Direct observation was used as a mean for data collection and they were analyzed by descriptive statistics (number, percent number and mean) and inferential statistics, One way analysis of variance (ANOVA) and post hoc Tukey in Spss. 15 statistical software. P Value search engines had different operations with regard to the evaluated criteria. Since P Value was 0.004 search engines. PubMed, Science Direct and Google Scholar were the best in recall, preciseness and importance respectively. As literature research is one of the most important stages of research, it's better for researchers, especially Substance-Related Disorders scholars to use different search engines with the best recall, preciseness and importance in that subject field to reach desirable results while searching and they don't depend on just one

  20. Hyperbaric oxygen therapy in the treatment of osteonecrosis of the femoral head: a review of the current literature.

    Science.gov (United States)

    Uzun, Gunalp; Mutluoglu, Mesut; Ersen, Omer; Yildiz, Senol

    2016-01-01

    To review the current literature on the use of hyperbaric oxygen (HBO₂) therapy in the treatment of osteonecrosis of the femoral head (ONFH). We searched PubMed, Directory of Open Access Journals (DOAJ), EMBASE, Web of Science, Academic Search Complete, CINAHL and MEDLINE through April 2015. We hand-searched relevant textbooks, conference proceedings and the reference lists of review articles and clinical studies Randomized controlled trials (RCT) and observational studies (cohort study, case-control study, case series) that reported the outcome of patients who received HBO₂therapy for ONFH were included. Only English-language articles were included. Study quality was not used as an exclusion criterion. Two authors independently assessed trials for inclusion, extracted data and presented to other authors. Disagreements were resolved by consensus. We identified eight clinical studies; two randomized controlled trials (RCTs); one historically controlled study; and five case series. The majority of the studies were small-scale, heterogeneous and methodologically weak. In four of the studies HBO₂therapy was combined with other treatment modalities, making it impossible to draw firm conclusions on the specific effects of HBO₂therapy. Hip survivorship in studies wherein HBO₂therapy was used alone was 95.5% in Steinberg Stage I lesions, 89% in Steinberg Stage II lesions and 100% in Ficat Stage II lesions. There is a room for HBO₂therapy in the management ONFH. Further RCTs, however, are required to better elucidate the role of HBO₂therapy in the treatment of ONFH.

  1. A case study and literature review of surgical treatment for brachial plexus pain caused by Pancoast syndrome

    Directory of Open Access Journals (Sweden)

    Xian Hang

    2016-10-01

    Full Text Available This study reports the diagnosis and treatment of brachial plexus-associated intractable pain caused by Pancoast syndrome, along with the associated literature review, based on a patient we attended to in April 2011. A full examination was performed after his admission, and neurolysis was conducted on the right brachial plexus of lower trunk. Follow-ups and treatment evaluations were carried out 1, 2, 3, and 6 months after the initial neurolysis procedure, which was followed by a radiation therapy two months later. The patient’s pain symptoms were relieved and he partially regained sense awareness and movement of his right hand. We found that early clinical manifestations of Pancoast syndrome are atypical and are sometimes difficult to detect. It is very similar to brachial plexus injury-related pain, and the patient must be referred to an orthopaedics or hand surgery specialist for treatment. Therefore, improving medical practitioners’ general understanding of this disease is essential in order to avoid potential misdiagnoses.

  2. The use of sildenafil in the treatment of persistent pulmonary hypertension of the newborn: a review of the literature.

    Science.gov (United States)

    Iacovidou, Nicoletta; Syggelou, Aggeliki; Fanos, Vassilios; Xanthos, Theodoros

    2012-01-01

    Persistent pulmonary hypertension of the newborn (PPHN) is a serious and potentially fatal condition, characterized by hypoxemia due to increased pulmonary vascular resistance (PVR) with resultant shunting of pulmonary blood to the systemic circulation. Inhaled nitric oxide (iNO) has been considered a revolutionary treatment of PPHN. Data show that the use of iNO has reduced the need of ECMO in neonates with severe PPHN, while in moderate PPHN, iNO administration has been associated with a significant decrease in ventilatory support and prevented progression to severe PPHN. Not all neonates respond to iNO therapy though, and phosphodiesterase (PDE) inhibitors with their potent vasodilator properties have evolved as an alternative therapy or as an adjunct to the treatment of PPHN with iNO. There are ten families of PDE isoenzymes. PDE 5 is particularly prevalent in vascular smooth muscle (VSM) and PDE 5 inhibitors, such as sildenafil, have been used in clinical practice. This review provides a comprehensive account of existing data in the literature, from animal and clinical studies, on the use of sildenafil for the treatment of PPHN. Sildenafil may also have a role as a single mode of therapy, since in resource-limited settings the cost of iNO is a serious concern.

  3. Intravenous lacosamide for treatment of absence status epilepticus in genetic generalized epilepsy: A case report and review of literature.

    Science.gov (United States)

    Reif, P S; Männer, A; Willems, L M; Kay, L; Zöllner, J P; Klein, K M; Rosenow, F; Strzelczyk, A

    2018-04-06

    Nearly 10 years after its introduction into the market, the significance of lacosamide in genetic generalized epilepsies is still unclear. Its new mode of action may qualify lacosamide as a therapeutic agent in this entity, but only a limited number of cases have been published so far. To describe the efficacy of lacosamide as treatment in a patient with the absence status epilepticus. We report on a 28-year-old woman with genetic generalized epilepsy who suffered recurrent absence status epilepticus during video-EEG-monitoring. After treatment failure of first- and second-line medication, lacosamide was administered. The outcome in this patient was evaluated, and a systematic literature review was performed for the use of lacosamide in the absence status epilepticus. After application of 400 mg lacosamide intravenously, the absence status epilepticus terminated within 30 minutes. No further seizures or epileptiform discharges reoccurred until the end of video-EEG-Monitoring 3 days later. The role of lacosamide as a therapeutic option in patients with the absence status epilepticus is unclear. Only two cases have been reported so far with conflicting results. Further randomized controlled studies are required to validate the relevance of lacosamide as treatment for status epilepticus in genetic generalized and the absence epilepsy. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Implant-assisted removable partial dentures as an alternative treatment for partial edentulism: a review of the literature.

    Science.gov (United States)

    Chatzivasileiou, Konstantinos; Kotsiomiti, Eleni; Emmanouil, Ioannis

    2015-01-01

    This study reviewed the current literature concerning implant-assisted removable partial dentures (RPDs) in order to present the existing knowledge about performance issues. An electronic search was conducted on the PubMed database for published English-language articles that contained information about implant-assisted RPDs. A review of these articles indicated that the combination of dental implants with RPDs constitutes a cost-efficient prosthetic protocol that can offer solutions to problematic aspects of treatment with removable partial dentures. Well-designed studies are still needed to provide robust evidence on critical issues, such as design guidelines, long-term survival of implants associated with RPDs, and their effect on patients' quality of life.

  5. Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review.

    Science.gov (United States)

    Severo, Antônio Lourenço; Lemos, Marcelo Barreto; Lech, Osvandré Luiz Canfield; Barreto Filho, Danilo; Strack, Daniel Paulo; Candido, Larissa Knapp

    2017-01-01

    Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria. In most cases VBGs were used, especially those based on the 1,2 intercompartmental supraretinacular artery, due to greater reproducibility in performing the surgical technique.

  6. The impact of iron overload and its treatment on quality of life: results from a literature review

    Directory of Open Access Journals (Sweden)

    Jones Paula

    2006-09-01

    Full Text Available Abstract Background To assess the literature for the impact of iron overload and infusion Iron Chelation Therapy (ICT on patients' quality of life (QoL, and the availability of QoL instruments for patients undergoing infusion ICT. Also, to obtain patients' experiences of having iron overload and receiving infusion ICT, and experts' clinical opinions about the impact of treatment on patients' lives. Methods A search of studies published between 1966 and 2004 was conducted using Medline and the Health Economic Evaluation Database (HEED. Qualitative results from patient and expert interviews were analysed. Hand searching of relevant conference abstracts completed the search. Results Few studies measuring the impact of ICT with deferoxamine (DFO on patients QoL were located (n = 15. QoL domains affected included: depression; fatigue; dyspnoea; physical functioning; psychological distress; decrease in QoL during hospitalization. One theme in all articles was that oral ICT should improve QoL. No iron overload or ICT-specific QoL instruments were located in the articles. Interviews revealed that the impact of ICT on patients with thalassemia, sickle cell disease, and myelodysplastic syndromes is high. Conclusion A limited number of studies assessed the impact of ICT or iron overload on QoL. All literature suggested a need for easily administered, efficacious and well tolerated oral iron overload treatments, given the impact of current ICT on adherence. Poor adherence to ICT was documented to negatively impact survival. Further research is warranted to continue the qualitative and quantitative study of QoL using validated instruments in patients receiving ICT to further understanding the issues and improve patients QoL.

  7. The impact of iron overload and its treatment on quality of life: results from a literature review.

    Science.gov (United States)

    Abetz, Linda; Baladi, Jean-Francois; Jones, Paula; Rofail, Diana

    2006-09-28

    To assess the literature for the impact of iron overload and infusion Iron Chelation Therapy (ICT) on patients' quality of life (QoL), and the availability of QoL instruments for patients undergoing infusion ICT. Also, to obtain patients' experiences of having iron overload and receiving infusion ICT, and experts' clinical opinions about the impact of treatment on patients' lives. A search of studies published between 1966 and 2004 was conducted using Medline and the Health Economic Evaluation Database (HEED). Qualitative results from patient and expert interviews were analysed. Hand searching of relevant conference abstracts completed the search. Few studies measuring the impact of ICT with deferoxamine (DFO) on patients QoL were located (n = 15). QoL domains affected included: depression; fatigue; dyspnoea; physical functioning; psychological distress; decrease in QoL during hospitalization. One theme in all articles was that oral ICT should improve QoL. No iron overload or ICT-specific QoL instruments were located in the articles. Interviews revealed that the impact of ICT on patients with thalassemia, sickle cell disease, and myelodysplastic syndromes is high. A limited number of studies assessed the impact of ICT or iron overload on QoL. All literature suggested a need for easily administered, efficacious and well tolerated oral iron overload treatments, given the impact of current ICT on adherence. Poor adherence to ICT was documented to negatively impact survival. Further research is warranted to continue the qualitative and quantitative study of QoL using validated instruments in patients receiving ICT to further understanding the issues and improve patients QoL.

  8. Effect of the use of probiotics in the treatment of children with atopic dermatitis; a literature review.

    Science.gov (United States)

    da Costa Baptista, Ingrid Pillar; Accioly, Elizabeth; de Carvalho Padilha, Patricia

    2013-01-01

    Atopic dermatitis (AD) is a disease that mainly affects the pediatric population involving chronic and repetitive inflammatory skin manifestations. Its evolution is known as atopic march, which is characterized by the occurrence of respiratory and food allergies. To carry out a classical review of the state-of-theart scientific literature regarding the effect of probiotics on the treatment of children with AD. Searches were conducted in Medline and Lilacs through the portals PubMed (http://www.ncbi.nlm. nih.gov/pubmed/) and SciELO (http://www.scielo.br). There was a selection of the available publications in the period from 2001 to 2011, using the keywords atopic dermatitis and probiotics (in English and in Portuguese). After applying the inclusion and exclusion criterias, we selected 12 case-control studies which were conducted in four European countries and Australia. The methodological quality of the studies was assessed according to the STROBE recommendations. Assessment of agreement among researches in classifying the quality of the articles showed excellent agreement (k = 1.00, 95%) with a total of 9 papers at B level. The majority of the studies (75%) indicated a beneficial biological effect of probiotics on AD, including protection against infections, enhancement of the immune response, inflammation reduction and changes in gut the flora. The remaining studies showed no beneficial effects according to the outcomes of interest. The majority of the studies in the scientific literature in this review showed improvements in some inflammatory parameters and in intestinal microbiota and not exactly, changes in clinical parameters. However, the biological effects observed in most of them suggest the possibility of benefits of the use of probiotics as an adjuvant in the treatment of AD. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  9. Dietary supplements for football.

    Science.gov (United States)

    Hespel, P; Maughan, R J; Greenhaff, P L

    2006-07-01

    Physical training and competition in football markedly increase the need for macro- and micronutrient intake. This requirement can generally be met by dietary management without the need for dietary supplements. In fact, the efficacy of most supplements available on the market is unproven. In addition, players must be cautious of inadequate product labelling and supplement impurities that may cause a positive drug test. Nonetheless, a number of dietary supplements may beneficially affect football performance. A high endurance capacity is a prerequisite for optimal match performance, particularly if extra time is played. In this context, the potential of low-dose caffeine ingestion (2 - 5 mg . kg body mass(-1)) to enhance endurance performance is well established. However, in the case of football, care must be taken not to overdose because visual information processing might be impaired. Scoring and preventing goals as a rule requires production of high power output. Dietary creatine supplementation (loading dose: 15 - 20 g . day(-1), 4 - 5 days; maintenance dose: 2 - 5 g g . day(-1)) has been found to increase muscle power output, especially during intermittent sprint exercises. Furthermore, creatine intake can augment muscle adaptations to resistance training. Team success and performance also depend on player availability, and thus injury prevention and health maintenance. Glucosamine or chondroitin may be useful in the treatment of joint pain and osteoarthritis, but there is no evidence to support the view that the administration of these supplements will be preventative. Ephedra-containing weight-loss cocktails should certainly be avoided due to reported adverse health effects and positive doping outcomes. Finally, the efficacy of antioxidant or vitamin C intake in excess of the normal recommended dietary dose is equivocal. Responses to dietary supplements can vary substantially between individuals, and therefore the ingestion of any supplement must be assessed

  10. Effectiveness of cognitive behavioral therapy in the treatment of fibromyalgia syndrome: a meta-analytic literature review Effectiveness of cognitive behavioral therapy in the treatment of fibromyalgia syndrome: a meta-analytic literature review

    Directory of Open Access Journals (Sweden)

    A. Minelli

    2012-07-01

    Full Text Available Fibromyalgia (FM is a chronic disorder caused by a dysfunction of central nervous system sensitization. This syndrome is characterized by widespread pain and diffuse tenderness, but often also presents fatigue, sleep disturbances, and a whole range of symptoms such as morning stiffness, decreased physical function and dyscognition. FM is usually treated with pharmacological and non-pharmacological treatments. The non-pharmacological interventions include cognitive behavioral therapy (CBT, physiotherapy, acupuncture and patient education programs. In order to evaluate the efficacy of CBT and compare it with other non-pharmacological treatments, we performed a review of the meta-analytic literature. We evaluated the methodological quality of publications found by following the recommendations of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data showed that CBT does not provide better results than other non-pharmacological treatments on outcomes of pain, fatigue, sleep disturbance and quality of life, at either a short or long-term evaluation. On the contrary, CBT seems to be more effective on symptoms of depression for a short period, whereas it considerably improves the pain self-management and reduces the number of visits to the doctor. The data currently available indicate that cost-effectiveness studies could help us to understand whether the reduction in the number of visits to the doctor could balance the cost of CBT to the health public system.Fibromyalgia (FM is a chronic disorder caused by a dysfunction of central nervous system sensitization. This syndrome is characterized by widespread pain and diffuse tenderness, but often also presents fatigue, sleep disturbances, and a whole range of symptoms such as morning stiffness, decreased physical function and dyscognition. FM is usually treated with pharmacological and non-pharmacological treatments. The nonpharmacological interventions include

  11. Virtual and augmented reality in the treatment of phantom limb pain: A literature review.

    Science.gov (United States)

    Dunn, Justin; Yeo, Elizabeth; Moghaddampour, Parisah; Chau, Brian; Humbert, Sarah

    2017-01-01

    Phantom limb pain (PLP), the perception of discomfort in a limb no longer present, commonly occurs following amputation. A variety of interventions have been employed for PLP, including mirror therapy. Virtual Reality (VR) and augmented reality (AR) mirror therapy treatments have also been utilized and have the potential to provide an even greater immersive experience for the amputee. However, there is not currently a consensus on the efficacy of VR and AR therapy. The aim of this review is to evaluate and summarize the current research on the effect of immersive VR and AR in the treatment of PLP. A comprehensive literature search was conducted utilizing PubMed and Google Scholar in order to collect all available studies concerning the use of VR and/or AR in the treatment of PLP using the search terms "virtual reality," "augmented reality," and "phantom limb pain." Eight studies in total were evaluated, with six of those reporting quantitative data and the other two reporting qualitative findings. All studies located were of low-level evidence. Each noted improved pain with VR and AR treatment for phantom limb pain, through quantitative or qualitative reporting. Additionally, adverse effects were limited only to simulator sickness occurring in one trial for one patient. Despite the positive findings, all of the studies were confined purely to case studies and case report series. No studies of higher evidence have been conducted, thus considerably limiting the strength of the findings. As such, the current use of VR and AR for PLP management, while attractive due to the increasing levels of immersion, customizable environments, and decreasing cost, is yet to be fully proven and continues to need further research with higher quality studies to fully explore its benefits.

  12. Barriers to innovation in human rabies prophylaxis and treatment: A causal analysis of insights from key opinion leaders and literature.

    Science.gov (United States)

    van de Burgwal, L H M; Neevel, A M G; Pittens, C A C M; Osterhaus, A D M E; Rupprecht, C E; Claassen, E

    2017-12-01

    Rabies is an essentially 100% fatal, zoonotic disease, caused by Lyssaviruses. Currently, the disease is vaccine-preventable with pre- and post-exposure prophylaxis (PrEP and PEP). Still, rabies virus is estimated to cause up to 60,000 human deaths annually, of which the vast majority occurs in rural Asia and Africa, due to the inaccessibility of prophylaxis and non-existence of treatment. Despite these unmet clinical needs, rabies control mainly focuses on the sylvatic reservoir and drug innovation receives relatively little attention compared to other neglected tropical diseases (NTDs). As such, the lag of innovation in human rabies prophylaxis and treatment cannot be explained by limited return on investment alone. Strategies countering rabies-specific innovation barriers are important for the acceleration of innovation in human rabies prophylaxis and treatment. Barriers throughout society, science, business development and market domains were identified through literature review and 23 semi-structured interviews with key opinion leaders worldwide. A subsequent root cause analysis revealed causal relations between innovation barriers and a limited set of root causes. Finally, prioritization by experts indicated their relative importance. Root causes, which are fundamental to barriers, were aggregated into four types: market and commercial, stakeholder collaboration, public health and awareness, and disease trajectory. These were found in all domains of the innovation process and thus are relevant for all stakeholders. This study identifies barriers that were not previously described in this specific context, for example the competition for funding between medical and veterinary approaches. The results stress the existence of barriers beyond the limited return on investment and thereby explain why innovation in human rabies medication is lagging behind NTDs with a lower burden of disease. A re-orientation on the full spectrum of barriers that hinder innovation in

  13. L-carnitine supplementation for the management of fatigue in patients with hypothyroidism on levothyroxine treatment: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    An, Jee Hyun; Kim, Yoon Jung; Kim, Kyeong Jin; Kim, Sun Hwa; Kim, Nam Hoon; Kim, Hee Young; Kim, Nan Hee; Choi, Kyung Mook; Baik, Sei Hyun; Choi, Dong Seop; Kim, Sin Gon

    2016-10-29

    Hypothyroid patients experience fatigue-related symptoms despite adequate thyroid hormone replacement. Thyroid hormone plays an essential role in carnitine-dependent fatty acid import and oxidation. We investigated the effects of L-carnitine supplementation on fatigue in patients with hypothyroidism. In total, 60 patients (age 50.0 ± 9.2 years, 3 males, 57 females) who still experienced fatigue (fatigue severity scale [FSS] score ≥ 36) were given L-carnitine (n = 30, 990 mg L-carnitine twice daily) or placebo (n = 30) for 12 weeks. After 12 weeks, although neither the FSS score nor the physical fatigue score (PFS) changed significantly, the mental fatigue score (MFS) was significantly decreased by treatment with L-carnitine compared with placebo (from 4.5 ± 1.9 to 3.9 ± 1.5 vs. from 4.2 ± 1.8 to 4.6 ± 1.6, respectively; P treatment with L-carnitine compared with placebo. Additionally, the MFS was significantly improved in patients taking thyroid hormone after thyroid cancer surgery. These results suggest that L-carnitine supplementation may be useful in alleviating fatigue symptoms in hypothyroid patients, especially in those younger than 50 years and those who have hypothyroidism after thyroidectomy for thyroid cancer (ClinicalTrials.gov: NCT01769157).

  14. Atypical antipsychotics in the treatment of pathological aggression in children and adolescents: literature review and clinical recommendations

    Directory of Open Access Journals (Sweden)

    Eduardo Henrique Teixeira

    2013-01-01

    Full Text Available Objective: To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents. Method: The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior. Results: Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA. All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects. Conclusions: There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use.

  15. A 4-year treatment with clodronate plus calcium and vitamin D supplements does not improve bone mass in primary biliary cirrhosis.

    Science.gov (United States)

    Floreani, A; Carderi, I; Ferrara, F; Rizzotto, E R; Luisetto, G; Camozzi, V; Baldo, V

    2007-06-01

    International guidelines for managing osteoporosis in cirrhosis or severe cholestasis indicate a m. disodium clodronate 100mg every 10 days for 4 years. Ninety-six patients completed the study: 30 had a normal bone mineral density (group 1), 37 had osteopenia (group 2), 29 had osteoporosis (group 3). No significant differences in biochemical parameters of bone metabolism were observed between the three groups. A total of 288 bone mineral density measurements were taken. Linear regression analysis failed to reveal significant changes in t-score over the follow-up in all groups. A 4-year treatment with clodronate+calcium/vitamin D3 supplements does not significantly improve osteoporosis or osteopenia in primary biliary cirrhosis women in menopause, but prevents the natural bone loss in these patients. Extensive international trials are warranted to optimize the prevention and treatment of bone loss in primary biliary cirrhosis.

  16. Combined ω3 and ω6 supplementation in children with attention-deficit hyperactivity disorder (ADHD) refractory to methylphenidate treatment: a double-blind, placebo-controlled study.

    Science.gov (United States)

    Perera, Hemamali; Jeewandara, Kamal Chandima; Seneviratne, Sudarshi; Guruge, Chandima

    2012-06-01

    Children (6-12 years) with attention-deficit hyperactivity disorder (ADHD) being treated with methylphenidate and standard behavior therapy for more than 6 months, whose parents reported no improvement in behavior and academic learning, were randomly assigned to receive supplementation with a combined ω3 and ω6 preparation or a placebo. Outcome was measured at 3 and 6 months after treatment using a self-assessment checklist completed by the parents. Statistically significant improvement was found in the treatment group compared with the placebo group (P parents and teachers. Distractibility failed to show improvement. Effect sizes ranged from 0.3 to 1.1 at 3 months and 0.2 to 1.4 at 6 months for individual symptom variables.

  17. Volumetric Brain Morphometry Changes in patients with Obstructive Sleep Apnea Syndrome : effects of CPAP treatment and literature review.

    Directory of Open Access Journals (Sweden)

    Nelly T Huynh

    2014-04-01

    Full Text Available Introduction: Obstructive sleep apnea syndrome (OSAS is a frequent breathing disorder occurring during sleep that is characterized by recurrent hypoxic episodes and sleep fragmentation. It remains unclear whether OSAS leads to structural brain changes, and if so, in which brain regions. Brain region-specific gray and white matter volume (GMV and WMV changes can be measured with voxel-based morphometry (VBM. The aims of this study were to use VBM to analyze GMV and WMV in untreated OSAS patients compared to healthy controls (HC; examine the impact of OSAS-related variables (nocturnal hypoxemia duration and sleep fragmentation index on GMV and WMV; and assess the effects of therapeutic versus sham continuous positive airway pressure (CPAP. We discuss our results in light of previous findings and provide a comprehensive literature review. Methods: Twenty-seven treatment-naïve male patients with moderate to severe OSAS and seven healthy age- and education-matched control subjects (HC were recruited. After a baseline fMRI scan, patients randomly received either active (therapeutic, n=14 or sham (subtherapeutic, n=13 nasal CPAP treatment for 2 months. Results: Significant negative correlations were observed between nocturnal hypoxemia duration and GMV in bilateral lateral temporal regions. No differences in GMV or WMV were found between OSAS patients and HC, and no differences between CPAP versus sham CPAP treatment effects in OSAS patients. Conclusion: It appears that considering VBM GMV changes there is little difference between OSAS patients and HC. The largest VBM study to date indicates structural changes in the lateral aspect of the temporal lobe, which also showed a significant negative correlation with nocturnal hypoxemia duration in our study. This finding suggests an association between the effect of nocturnal hypoxemia and decreased GMV in OSAS patients.

  18. Pathogenesis-based treatments in primary Sjogren's syndrome using artificial intelligence and advanced machine learning techniques: a systematic literature review.

    Science.gov (United States)

    Foulquier, Nathan; Redou, Pascal; Le Gal, Christophe; Rouvière, Bénédicte; Pers, Jacques-Olivier; Saraux, Alain

    2018-05-17

    Big data analysis has become a common way to extract information from complex and large datasets among most scientific domains. This approach is now used to study large cohorts of patients in medicine. This work is a review of publications that have used artificial intelligence and advanced machine learning techniques to study physio pathogenesis-based treatments in pSS. A systematic literature review retrieved all articles reporting on the use of advanced statistical analysis applied to the study of systemic autoimmune diseases (SADs) over the last decade. An automatic bibliography screening method has been developed to perform this task. The program called BIBOT was designed to fetch and analyze articles from the pubmed database using a list of keywords and Natural Language Processing approaches. The evolution of trends in statistical approaches, sizes of cohorts and number of publications over this period were also computed in the process. In all, 44077 abstracts were screened and 1017 publications were analyzed. The mean number of selected articles was 101.0 (S.D. 19.16) by year, but increased significantly over the time (from 74 articles in 2008 to 138 in 2017). Among them only 12 focused on pSS but none of them emphasized on the aspect of pathogenesis-based treatments. To conclude, medicine progressively enters the era of big data analysis and artificial intelligence, but these approaches are not yet used to describe pSS-specific pathogenesis-based treatment. Nevertheless, large multicentre studies are investigating this aspect with advanced algorithmic tools on large cohorts of SADs patients.

  19. [USE, EFFECTS, AND KNOWLEDGE OF THE NUTRITIONAL SUPPLEMENTS FOR THE SPORT IN UNIVERSITY STUDENTS].

    Science.gov (United States)

    Colls Garrido, Christian; Gómez-Urquiza, José Luis; Cañadas-De la Fuente, Guillermo Arturo; Fernández-Castillo, Rafael

    2015-08-01

    consumption and marketing of supplements that help improve athletic performance has increased in semi-professional sport. Moreover, in the market are increasingly a wide variety of such products pressure and high performance requirements push many young athletes to have recourse to the use of supplements to improve your fitness. However, this type of treatment should be advised and guided by an expert since improper use of such supplements favors the appearance of adverse effects and can be harmful to the health of the individual. to know the use of supplements to improve athletic performance by college athletes methods: was a systematic review in the Pubmed database, care, BIREME CUIDEN, BIREME (IBECS y Scielo) and CINHAL limited to articles published in the last ten years. 25 articles were analyzed. The main themes were found in the literature reviewed have been three: the "levels of supplements to increase athletic performance in college students", "effect of sports supplements" and "knowledge, behaviors and motivations for sports supplements". taking into account that the around 55% of University athletes using supplements but show a lack significant knowledge is necessary to provide a health education on such supplements. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Nutritional supplements

    DEFF Research Database (Denmark)

    Petersen, Gry Bjerg; Andersen, Jens Rikardt

    2015-01-01

    Background: Several studies have indicated that cancer patients have significantly altered taste sensitivity without specifying the preferences. One of the related problems is low compliance to nutritional therapy with oral nutritional supplements (ONS) in patients suffering severe weight loss...

  1. Supplemental information

    Data.gov (United States)

    U.S. Environmental Protection Agency — Supplemental information showing results of inter-comparison between C-PORT, AERMOD and R-LINE dispersion algorithms. This dataset is associated with the following...

  2. Characteristics, treatment, and health care expenditures of Medicare supplemental-insured patients with painful diabetic peripheral neuropathy, post-herpetic neuralgia, or fibromyalgia.

    Science.gov (United States)

    Johnston, Stephen S; Udall, Margarita; Alvir, Jose; McMorrow, Donna; Fowler, Robert; Mullins, Daniel

    2014-04-01

    To describe the characteristics, treatment, and health care expenditures of Medicare Supplemental-insured patients with painful diabetic peripheral neuropathy (pDPN), post-herpetic neuralgia (PHN), or fibromyalgia. Retrospective cohort study. United States clinical practice, as reflected within a database comprising administrative claims from 2.3 million older adults participating in Medicare supplemental insurance programs. Selected patients were aged ≥65 years, continuously enrolled in medical and prescription benefits throughout years 2008 and 2009, and had ≥1 medical claim with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for DPN, PHN, or fibromyalgia, followed within 60 days by a medication or pain intervention procedure used in treating pDPN, PHN, or fibromyalgia during 2008-2009. Utilization of, and expenditures on, pain-related and all-cause pharmacotherapy and medical interventions in 2009. The study included 25,716 patients with pDPN (mean age 75.2 years, 51.2% female), 4,712 patients with PHN (mean age 77.7 years, 63.9% female), and 25,246 patients with fibromyalgia (mean age 74.4 years, 73.0% female). Patients typically had numerous comorbidities, and many were treated with polypharmacy. Mean annual expenditures on total pain-related health care and total all-cause health care, respectively, (in 2010 USD) were: $1,632, $24,740 for pDPN; $1,403, $16,579 for PHN; and $1,635, $18,320 for fibromyalgia. In age-stratified analyses, pain-related health care expenditures decreased as age increased. The numerous comorbidities, polypharmacy, and magnitude of expenditures in this sample of Medicare supplemental-insured patients with pDPN, PHN, or fibromyalgia underscore the complexity and importance of appropriate management of these chronic pain patients. Wiley Periodicals, Inc.

  3. Thermoradiation treatment of sewage sludge to eliminate pathogens for safe use as fertilizer and animal feed supplement

    International Nuclear Information System (INIS)

    Sivinski, H.D.; Whitfield, W.J.

    1975-01-01

    This paper describes a research program titled ''Waste Resources Utilization'' using a new technique called thermoradiation to destroy pathogenic organisms in sewage sludge. The thermoradiated sewage sludge will be used to study the feasibility of use for safe land application as fertilizer and soil conditioner and use as a feed supplement for ruminant animals. Experiments to date have shown good results for sludge disinfection of resistant bacteria, viruses, and parasites. Thermoradiation experiments are being carried out at a temperature of 65 0 C combined with 160 krad gamma dose for a total of 2000 pounds of dried treated sludge. The sludge will be shipped to New Mexico State University for the feeding studies and land application studies. (auth)

  4. Is vitamin C supplementation beneficial?

    DEFF Research Database (Denmark)

    Lykkesfeldt, Jens; Poulsen, Henrik Enghusen

    2010-01-01

    of the benefit:harm ratio of antioxidant supplements. We have examined the literature on vitamin C intervention with the intention of drawing a conclusion on its possible beneficial or deleterious effect on health and the result is discouraging. One of several important issues is that vitamin C uptake is tightly...... controlled, resulting in a wide-ranging bioavailability depending on the current vitamin C status. Lack of proper selection criteria dominates the currently available literature. Thus, while supplementation with vitamin C is likely to be without effect for the majority of the Western population due...... to saturation through their normal diet, there could be a large subpopulation with a potential health problem that remains uninvestigated. The present review discusses the relevance of the available literature on vitamin C supplementation and proposes guidelines for future randomised intervention trials....

  5. Are religion and spirituality barriers or facilitators to treatment for HIV: a systematic review of the literature.

    Science.gov (United States)

    Medved Kendrick, Haley

    2017-01-01

    Much attention has been given to the relationship between religion/spirituality (R/S) and HIV in recent years, but comparatively little has been explored in regard to R/S and HIV testing, retention in care, and adherence to medication. Religious views concerning HIV risk behavior pose challenges to communication and education about sexual health in religious communities and may serve as barriers to HIV treatment and care. Conversely, religious coping and spiritual well-being, as well as social support could serve as facilitators to HIV treatment and care. This study aims to fill a gap in the literature by addressing the following questions: (1) what dimensions of R/S have been found to be factors associated with HIV outcomes?; (2) which R/S factors function as barriers or facilitators to care among people living with HIV (PLWH)?; and (3) which R/S factors, if any, vary across socio-demographic groups? Thirty-three empirical articles were identified for systematic review. Of the 33 empirical studies included, 24 studies found that at least one measure of R/S was associated with better adherence and clinical health outcomes. Twelve studies found at least one measure of R/S to be associated with poorer adherence and clinical health outcomes. Seven of the studies found at least one R/S measure to have no significant association with outcomes. Though all of the studies included in this review focused on R/S experiences of PLWH, there was very little consistency in regard to measurement of R/S. Studies in this review included a wide range of R/S measures, including beliefs, religious/spiritual practices, R/S coping, organizational religion, and many more. Of the 33 studies reviewed, only 9 focused on unique populations such as women, people with histories of substance abuse, immigrants, etc. Findings from this review highlight opportunities for more studies in various populations using standardized R/S measures.

  6. [Bladder injury during sling operation in the treatment of SUI--review of literature and case report].

    Science.gov (United States)

    Gałczyński, Krzysztof; Futyma, Konrad; Bar, Krzysztof; Rechberger, Tomasz

    2012-10-01

    Sling operations have been performed for over 15 years. In recent years these operations have become the gold standard in the treatment of stress urinary incontinence (SUI) due to their efficacy safety and low invasiveness. Approximately 4% of women will undergo a surgery for SUI in the course of their life. As with any surgical intervention, there may be some technical problems, as well as intra- and postoperative complications, the most common of which is bladder injury Other complications encountered during mid-urethral slings procedures include bleeding (retropubic or vaginal hematomas), urethral perforation, urinary tract infections, postoperative vaginal or urethral erosions, bowel perforation, chronic pelvic pain, wound infection, nerve injury transient and persistent voiding dysfunction such as de novo urgency incomplete bladder emptying or urinary retention. Below we present a case of a patient with diagnosed vesicovaginal fistula after sling operation (TVT-tension-free vaginal tape). Upon admission the patient reported dysuria, persistent urinary leakage and abnormal, abundant vaginal discharge. Case report and review of literature concerning surgical treatment of stress urinary incontinence and its complications. Analysis of medical documentation of the patient treated at the Second Department of Gynecology Medical University of Lublin. Review of abstracts or papers in the Medline database related to surgical treatment of urinary incontinence and its complications. Bladder perforation is one of the most common complications of the retropubic approach for MUS placement. The presence of mesh within the bladder may arise from direct bladder perforation or from subsequent erosion of the sling. Such lesions do not cause any serious health consequences for patients on condition they are detected intraoperatively and appropriately repaired, but when unrecognized, they results in the development of considerable symptoms and negatively influence the quality of

  7. Urea cycle disorders: a case report of a successful treatment with liver transplant and a literature review.

    Science.gov (United States)

    Foschi, Francesco Giuseppe; Morelli, Maria Cristina; Savini, Sara; Dall'Aglio, Anna Chiara; Lanzi, Arianna; Cescon, Matteo; Ercolani, Giorgio; Cucchetti, Alessandro; Pinna, Antonio Daniele; Stefanini, Giuseppe Francesco

    2015-04-07

    The urea cycle is the final pathway for nitrogen metabolism. Urea cycle disorders (UCDs) include a variety of genetic defects, which lead to inefficient urea synthesis. Elevated blood ammonium level is usually dominant in the clinical pattern and the primary manifestations affect the central nervous system. Herein, we report the case of a 17-year-old girl who was diagnosed with UCD at the age of 3. Despite a controlled diet, she was hospitalized several times for acute attacks with recurrent life risk. She came to our attention for a hyperammonemic episode. We proposed an orthotopic liver transplant (OLT) as a treatment; the patient and her family were in complete agreement. On February 28, 2007, she successfully received a transplant. Following the surgery, she has remained well, and she is currently leading a normal life. Usually for UCDs diet plays the primary therapeutic role, while OLT is often considered as a last resort. Our case report and the recent literature data on the quality of life and prognosis of traditionally treated patients vs OLT patients, support OLT as a primary intervention to prevent life-threatening acute episodes and chronic mental impairment.

  8. Acetylcholinesterase Inhibitors (AChEI's for the treatment of visual hallucinations in schizophrenia: A review of the literature

    Directory of Open Access Journals (Sweden)

    Patel Sachin S

    2010-09-01

    Full Text Available Abstract Background Visual hallucinations occur in various neurological diseases, but are most prominent in Lewy body dementia, Parkinson's disease and schizophrenia. The lifetime prevalence of visual hallucinations in patients with schizophrenia is much more common than conventionally thought and ranges from 24% to 72%. Cortical acetylcholine (ACh depletion has been associated with visual hallucinations; the level of depletion being related directly to the severity of the symptoms. Current understanding of neurobiological visual processing and research in diseases with reduced cholinergic function, suggests that AChEI's may prove beneficial in treating visual hallucinations. This offers the potential for targeted drug therapy of clinically symptomatic visual hallucinations in patients with schizophrenia using acetylcholinesterase inhibition. Methods A systematic review was carried out investigating the evidence for the effects of AChEI's in treating visual hallucinations in Schizophrenia. Results No evidence was found relating to the specific role of AChEI's in treating visual hallucinations in this patient group. Discussion Given the use of AChEI's in targeted, symptom specific treatment in other neuropsychiatric disorders, it is surprising to find no related literature in schizophrenia patients. The use of AChEI's in schizophrenia has investigated effects on cognition primarily with non cognitive effects measured more broadly. Conclusions We would suggest that more focused research into the effects of AChEI's on positive symptoms of schizophrenia, specifically visual hallucinations, is needed.

  9. Flow-diverting Stent in the Treatment of Cervical Carotid Dissection and Pseudoaneurysm: Review of Literature and Case Report.

    Science.gov (United States)

    Baptista-Sincos, Anna Paula Weinhardt; Simplício, Aline Bigatão; Sincos, Igor Rafael; Leaderman, Alex; Neto, Fernando Saliture; Moraes, Adjaldes; Aun, Ricardo

    2018-01-01

    The endovascular technique has been recommended over the past few years to extracranial carotid dissection and pseudoaneurysm with promising results, especially after medical therapy failure. Flow-diverting stents are an alternative for complex cases. These stents have proven to be effective treatment devices for intracranial aneurysms. The reference list of Pham's systematic review, published in 2011, and Seward's literature review, published in 2015, was considered, as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE and Literatura Latino-Americana e do Caribe em Ciências da Saúde. For carotid dissection and pseudoaneurysm, our review yielded 3 published articles including 12 patients. The technical success rate of flow-diverting stent was 100% with no procedural complication described. Mean clinical follow-up was 27.2 months (range 5-48), and in 5 months' angiographic follow-up, all lesions had healed. No new neurological events were reported during the clinical follow-up. Flow diverter stent use on intracranial and peripheral vascular surgery demonstrates satisfactory initial results, but it is still under investigation. There are very few cases treated till now and the initial results with flow-diverting stents to cervical carotid dissection are promising. In well-selected cases, where simple embolization or conventional stent is not appropriate, this technic may be considered. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Inszenierung eines Supplements / Staging a Supplement

    Directory of Open Access Journals (Sweden)

    Thomas-M. Seibert

    2006-06-01

    Full Text Available Richter Adam, Anwalt Liebling und William, der Detektiv. Die Rechtspraxis setzt etwas voraus, das sie nicht nur begründet oder ergänzt, sondern grundsätzlich in Frage stellt. So macht der Zwang, in einem Verfahren zu entscheiden und zu begründen, zugleich deutlich, dass jede Form der Entscheidung unangemessen, unbegründet und in ganz anderer Weise neu herzustellen ist. Das ist das juridische Supplement im Geiste von Jacques Derrida. Supplementiert wird die Wahrheit des Rechts in anderen Medien: in Drama, Film und Literatur etwa. Dort wird in Szene gesetzt, was in der real erlebbaren Rechtswelt nicht wirklich erlebt werden kann, was aber doch – wie kein Amtsträger bestreiten würde – zum Verfahrensergebnis gehört. Judge Adam, Advocate “Liebling” and William, the Detective. Legal practice is based on something that is not only an integral part of it and complements it, but also puts it into question generally. The compulsion to argue and reach decisions in a legal trial clarifies simultaneously that all forms of decision are inapproprate, unreasonable, and can be recreated in an entirely new manner [to suit the needs of the trial]. This is the legalistic supplement in the spirit of Jacques Derrida. The legal truth is supplemented by other forms of media such as drama, film and literature, which are able to stage scenes that cannot be experienced in a real life legal world, but – as no legal official would deny – are an integral part of the trial and verdict procedure.

  11. Nutritional supplements in eating disorders.

    Science.gov (United States)

    Díaz-Marsá, Marina; Alberdi-Páramo, Iñigo; Niell-Galmés, Lluis

    2017-09-01

    Eating disorders (EDs) are a series of differentiated nosological entities sharing the common link of a continuous alteration in food intake or in food intake-related behavior. Within this classification, the following disorders are noteworthy: anorexia nerviosa (AN) and bulimia nerviosa (BN). Anorexia nervosa is a chronic disorder characterized mainly by negative or decreased food intake accompanied by a distortion of body image and intense accompanying fear of weight gain. The estimated vital prevalence of this disorder in adolescence is approximately 0.5%-1%.1 The primary feature of BN is the presence of binge eating accompanied by compensatory behavior (in the form of intense exercise and the use of laxatives and diuretics, etc.). The prevalence of BN is estimated to be between 2% and 4% in young women, and it generally starts at somewhat later stages than AN. It is believed that biological, psychological, and environmental factors, as well as genetic vulnerability, influence the pathogenesis of EDs. A variety of therapies exist, both biological and psychological, whose effectiveness is supported by the scientific literature. Nonetheless, we find these therapies only partially effective and new targets as well as new treatments should be sought. Although the etiopathogenesis of EDs is unclear, some of the neurobiological dysfunction found suggests that diet and nutrient supplementation could be relevant in their treatment. We review in this article new treatments focusing on nutritional deficits.

  12. The Analysis of Treatment Modes of Juxta-articular Fractures of Proximal Part of a Femur and their Effect (Literature Review

    Directory of Open Access Journals (Sweden)

    O.A. Kauts

    2010-03-01

    Full Text Available The article concerns the current status of the topical problem in traumatology - treatment of juxta-articular fractures of proximal part of a femur and their effect. Analytical review of domestic and foreign literature has allowed to determine the basic problems in treatment of the particular group of patients and to define long-term trends of osteosynthesis of juxta-articular fractures of proximal part of a femur at the present stage

  13. Treatment of Creatine Transporter (SLC6A8) Deficiency With Oral S-Adenosyl Methionine as Adjunct to L-arginine, Glycine, and Creatine Supplements.

    Science.gov (United States)

    Jaggumantri, Sravan; Dunbar, Mary; Edgar, Vanessa; Mignone, Cristina; Newlove, Theresa; Elango, Rajavel; Collet, Jean Paul; Sargent, Michael; Stockler-Ipsiroglu, Sylvia; van Karnebeek, Clara D M

    2015-10-01

    Creatine transporter (SLC6A8) deficiency is an X-linked inborn error of metabolism characterized by cerebral creatine deficiency, behavioral problems, seizures, hypotonia, and intellectual developmental disability. A third of patients are amenable to treatment with high-dose oral creatine, glycine, and L-arginine supplementation. Given the limited treatment response, we initiated an open-label observational study to evaluate the effect of adjunct S-adenosyl methionine to further enhance intracerebral creatine synthesis. Significant and reproducible issues with sleep and behavior were noted in both male patients on a dose of 50/mg/kg. One of the two patients stopped S-adenosyl methionine and did not come for any follow-up. A safe and tolerable dose (17 mg/kg/day) was identified in the other patient. On magnetic resonance spectroscopy, this 8-year-old male did not show an increase in intracerebral creatine. However, significant improvement in speech/language skills, muscle mass were observed as well as in personal outcomes as defined by the family in activities related to communication and decision making. Further research is needed to assess the potential of S-adenosyl methionine as an adjunctive therapy for creatine transporter deficiency patients and to define the optimal dose. Our study also illustrates the importance of pathophysiology-based treatment, individualized outcome assessment, and patient/family participation in rare diseases research. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Study Protocol for a Randomized Double Blind, Treatment Control Trial Comparing the Efficacy of a Micronutrient Formula to a Single Vitamin Supplement in the Treatment of Premenstrual Syndrome.

    Science.gov (United States)

    Retallick-Brown, Hannah; Rucklidge, Julia; Blampied, Neville

    2016-12-07

    Background: The recent addition of Premenstrual Dysphoric Disorder (PMDD) to the Diagnostic and Statistical Manual (5th ed.) has highlighted the seriousness of this disorder. Many alternatives to psychoactive medication in the form of vitamins, minerals, and plant extracts have been trialled by women seeking a natural treatment approach. We plan to explore whether a well validated micronutrient formula, EMPowerplus Advanced, can outperform a recognized single nutrient treatment, vitamin B6, for the treatment of Premenstrual Syndrome (PMS). Methods: This will be a randomized treatment control study. Eighty women will be recruited and assigned to one of two treatment groups; EMPowerplus Advanced or vitamin B6. Baseline daily data will be collected for an initial two cycles, followed by three months of active treatment. A natural follow up will take place three cycles post treatment. Results: The primary outcome measure will be PMS change scores as based on results from the Daily Record of Severity of Problems (DRSP). The number of treatment responders for each of the two groups will yield a comparison score between the two treatments, with participants deemed as a responder if they show a total PMS score improvement of 50% from their baseline scores on the DRSP. Conclusion: If a micronutrient formula proves more effective for treating PMS, not only does it give women suffering from the condition a viable treatment option, but it may also suggest one cause of PMS; that is insufficient minerals and vitamins.

  15. Bronchiole alveolar carcinoma: biological profile, clinicopathologic presentation, evaluation and treatment. Literature review and national series of 26 cases

    International Nuclear Information System (INIS)

    Vázquez, A.; Terzieff, V.

    2004-01-01

    B. Objective: To study the biological profile, clinic pathologic presentation of BAC, characterized by a peculiar evolutionary behavior, study and treatment. P Methodology: Literature review national and international communication based on 26 cases clinical studied and treated in our midst. Results: The BAC behaves as a well-differentiated adenocarcinoma of origin peripheral, typically linked to the Airborne spread to bilateral intrapulmonary cell its three forms: a clear cells and mucous secreting alveolar type II. Present day not considered characteristic of BAC nodal dissemination or hematologic level in the absence of type IV collagenase secretion by tumor cells. It is of no destroying, in one or more cell layers, the bronchiole alveolar septa. Its origin is discussed single or multicenter, while some authors establish etiological factors from benign diseases that can evolve into this neoplasm. It may or may not be linked smoking, presenting clinically in three forms: uni nodular, multi nodular and sclerosing, is studied by CT, FBC generally negative cytological aspiration, puncture or biopsy. It is treated by curative treatment with surgery alone, Rt, Qt and this study the use of tyrosine kinase inhibitors with apparent antitumor activity in BAC Conclusions Some authors present it as a different adenocarcinoma to other CBPNPC, especially in its advanced form multi nodular. Biological tests set for it that his understanding is confirmed. In its evolution can indiferenciarse to infiltrantres forms characteristic of other adenocarcinomas, particularly in the form sclerosing. this fact biological can explain the emergence of mixed tumors with extensive BAC component together another adenocarcinoma. We believe that there is insufficient evidence at present to say that this is a different from the rest of the CBPNCP adenocarcinoma, although studies biological-genetic of this point to gather evidence for this difference. characteristically FBC is usually negative

  16. Side effects of creatine supplementation in athletes.

    OpenAIRE

    Francaux, Marc; Poortmans, Jacques R

    2006-01-01

    Context: Allegations about side effects of creatine supplementation by athletes have been published in the popular media and scientific publications. Purpose: To examine the experimental evidence relating to the physiological effects of creatine supplementation. Results: One of the purported effects of oral creatine supplementation is increased muscle mass. A review of the literature reveals a 1.0% to 2.3% increase in body mass, which is attributed to fat-free mass and, more specifically, to ...

  17. Compliance to the recommended use of folic acid supplements for women in Sweden is higher among those under treatment for infertility than among fertile controls and is also related to socioeconomic status and lifestyle.

    Science.gov (United States)

    Murto, Tiina; Yngve, Agneta; Skoog Svanberg, Agneta; Altmäe, Signe; Salumets, Andres; Wånggren, Kjell; Stavreus-Evers, Anneli

    2017-01-01

    Background : Folate has been discussed in relation to fertility among women, but studies on women under treatment for infertility are lacking. Objective : The objective of this study was to investigate folic acid supplement use and folate status among women under treatment for infertility (hereafter infertile) and fertile women also in regard to socioeconomic and lifestyle factors. Design : Lifestyle and dietary habits, and use of dietary supplements were assessed using a questionnaire. Blood samples were obtained for analysis of folate status. 24-hour recall interviews were also performed. Results : Highly educated, employed and infertile women were most prone to using folic acid supplements. The infertile women had a significantly better folate status than the fertile women. Folate status did not correlate with socioeconomic or lifestyle factors. The infertile women were physically more active, smoked less and were employed. Our questionnaire data had only fair agreement with the data from 24-hour recalls, but the folate status data was clearly correlated to our questionnaire results. Conclusions : Infertile women were most prone to using folic acid supplements and had better folate status than the controls. High educational and employment status were found to be key factors for high compliance to the recommended use folic acid supplements.

  18. [Treatment of Gaucher disease with allogeneic hematopoietic stem cell transplantation: report of three cases and review of literatures].

    Science.gov (United States)

    Tang, Xiangfeng; Luan, Zuo; Wu, Nanhai; Zhang, Bo; Jing, Yuanfang; Du, Hong; Lu, Wei; Xu, Shixia

    2015-11-01

    To explore the efficacy of unrelated umbilical cord blood transplantation (UCBT) in the treatment of Gaucher disease. The clinical characteristics of three children with Gaucher disease underwent UCBT in our hospital between April 2013 and September 2014 were retrospectively analyzed. Literature on allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of Gaucher disease was searched at Wanfang and Pubmed databases between 1983 and 2015 and was reviewed and summaried. Three children with Gaucher disease, all were female, received UCBT. These patients' age at receiving transplantation was 3.8 years, 7.1 years and 2.6 years, respectively. The second case received the second transplantation. The first and third case received splenectomy before UCBT. The pretreatment regimen was busulfan (Bu)/fludarabine (Flu)/cyclophosphamide (CTX)/antithymocyte globulin (ATG), and for the patient received the second transplantation melphalan was added to the myeloablative conditioning regimen of Bu/Flu/CTX/ATG. Cyclosporine and mycophenolate mofetil (MMF) wee used for prophylaxis of acute graft versus host disease (aGVHD). The dose of cord blood stem cell nucleated cell counts was 9.7 × 10⁷ /kg,11.9 × 10⁷ /kg and 7.6 × 10⁷/kg respectively. The dose of cord blood stem cell CD34⁺ cell counts was 5.4 × 10⁵/kg , 3.5 × 10⁵/kg and 3.2 × 10⁵/kg respectively. The day of granulocytes exceeding 0.5 × 10⁹/L was day 11, 12 and 19 after transplantation, respectively. The day of platelets exceeding 20 × 10⁹/L was day 14, 33 and 74 after transplantation, respectively. At one month after transplantation the rate of chimerism was over 95% and all patients got donor complete chimerism. The level of β-glucocerebrosidase recovered to normal at one month after transplantation. During transplantation, all patients developed cytomegalovirus (CMV) and Epstein-Barr virus (EBV) viremia. In case 1 immune thrombocytopenia occurred at five month after

  19. Transgender women, hormonal therapy and HIV treatment: a comprehensive review of the literature and recommendations for best practices.

    Science.gov (United States)

    Radix, Asa; Sevelius, Jae; Deutsch, Madeline B

    2016-01-01

    Studies have shown that transgender women (TGW) are disproportionately affected by HIV, with an estimated HIV prevalence of 19.1% among TGW worldwide. After receiving a diagnosis, HIV-positive TGW have challenges accessing effective HIV treatment, as demonstrated by lower rates of virologic suppression and higher HIV-related mortality. These adverse HIV outcomes have been attributed to the multiple sociocultural and structural barriers that negatively affect their engagement within the HIV care continuum. Guidelines for feminizing hormonal therapy among TGW recommend combinations of oestrogens and androgen blockers. Pharmacokinetic studies have shown that certain antiretroviral therapy (ART) agents, such as protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and cobicistat, interact with ethinyl estradiol, the key oestrogen component of oral contraceptives (OCPs). The goal of this article is to provide an overview of hormonal regimens used by TGW, to summarize the known drug-drug interactions (DDIs) between feminizing hormonal regimens and ART, and to provide clinical care recommendations. The authors identified English language articles examining DDIs between oestrogen therapy, androgen blockers and ART published between 1995 and 2015 using PubMed, Cumulative Index to Nursing and Allied Health Literature and EBSCOhost. Published articles predominantly addressed interactions between ethinyl estradiol and NNRTIs and PIs. No studies examined interactions between ART and the types and doses of oestrogens found in feminizing regimens. DDIs that may have the potential to result in loss of virologic suppression included ethinyl estradiol and amprenavir, unboosted fosamprenavir and stavudine. No clinically significant DDIs were noted with other anti-retroviral agents or androgen blockers. There are insufficient data to address DDIs between ART and feminizing hormone regimens used by TGW. There is an urgent need for further research in this

  20. Comparison of efficacy of oral and intramuscular iron supplementation for treatment of iron deficiency anemia in children

    International Nuclear Information System (INIS)

    Hussain, S.; Ahmad, T.M.; Sbir, M.U.; Tarar, S.H.

    2015-01-01

    deficiency anemia in children. Study Design: Randomized controlled trial. Place and Duration of Study: Paediatric department of Combined Military Hospital Kharian, Pakistan, from October 2011 to March 2013. Patients and Methods: In total 200 anemic children from 6 months to 5 years of age were included. Cut off value for Hb was < 8 gm/dl. Patients were divided into two groups, each of 100, randomly. Group A received oral sodium feredetate (iron edetate) and group B received intramuscular iron sorbitol. Rise in Hb > 10 gm/dl was kept as the desired value. Maximum duration of treatment planned was 12 weeks for group A and 2 weeks for group B. Laboratory parameters such as Hb%, mean corpuscular volume (MCV), retic count and serum ferritin level were used to detect the responses in both groups at one week, two weeks, four weeks and twelve weeks of treatment. Results: Among 200 patients, male and female distribution was 45% and 55% respectively. Desired rise in Hb in group B was achieved much earlier i.e. at two weeks as compared to group A. Progressive rise in laboratory parameters was observed but this rise was more evident in group B as compared to group A. After one week treatment in group A, rise in retic count, Hb, ferritin and MCV was 0.759 ± 0.318, 0.814 ± 0.387, 0.47 ± 0.154 and 4.28 ± 2.468 respectively. But rise in these values in group B was 2.235±0.632, 2.335 ± 0.135, 6.31 ± 1.123 and 12.11 ± 0.414 respectively. Same persistent different trend was observed at 2 and 4 weeks. After 12 weeks treatment in group A, rise in retic count, Hb, ferritin and MCV was 1.044 ± 0.222, 5.204 ± 0.134, 17.39 ± 2.551 and 16.61 ± 1.214 respectively but rise in these laboratory indices in group B was 0.551 ± 0.261, 6.097 ± 0.21, 42.49 ± 2.768 and 20.68 ± 2.233 respectively. The comparison of hematological indices after 12 weeks in A and B groups show significant differences. All these parameters improved in both groups but improvement in group B was drastically

  1. Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review.

    Science.gov (United States)

    Hansotte, Elinor; Payne, Shirley I; Babich, Suzanne M

    2017-01-01

    Left undiagnosed and/or untreated, the short-and long-term sequelae of postpartum depression may negatively impact both mother and child. In Western countries, access to mental health care is influenced by socioeconomic factors. The objective of this systematic literature review is to compile factors that hinder and improve access to postpartum depression treatment in low-income women after a positive screen for postpartum depression. The key question of focus is: what are the characteristics associated with access to mental health treatment for low-income women with a positive postpartum depression screen in Western countries? A PRISMA-based systematic literature review was conducted of studies published in English before February 2016 that looked at treatment for postpartum depression in low-income women who had been identified with the condition. PubMed and EBSCO databases were searched using MESH and key terms and found 100 articles that met the selection criteria. After review by two independent researchers, 18 studies with 17 unique populations were included in the literature review. Two independent abstractors searched the included articles for themes surrounding impediments and advantages for low-income women identified with postpartum depression in obtaining mental health treatment. Characteristics of successful mental health treatment included studies that employed the use of a home visitor and those that separated outcomes for women with previous mental health treatment. Themes that emerged as treatment obstacles included cultural barriers, physical barriers, systemic health care barriers, and social barriers. This review will help to better inform screening and treatment priorities for those in the medical field who may encounter women experiencing postpartum depression and are not aware of the various barriers to care specific to low-income women. This review will also help policymakers identify specific obstacles that are not addressed in postpartum

  2. Small-quantity lipid-based nutrient supplements, together with malaria and diarrhoea treatment, improve growth and prevent MAM in young Burkinabe children

    International Nuclear Information System (INIS)

    Hess, Sonja Y; Abbeddou, Souheila; Somé, Jerome W; Vosti, Stephen A; Brown, Kenneth H; Yakes Jimenez, Elizabeth; Ouédraogo, Zinéwindé P; Guissou, Rosemonde M; Ouédraogo, Jean-Bosco

    2014-01-01

    Background: Supplementing young children’s diets with small-quantity lipid-based nutrient supplements (LNS) may prevent growth restriction, but the optimal amount of zinc to include in these products is uncertain. Objectives: To assess zinc-related functional responses among young Burkinabe children who received LNS without or with varied amounts of zinc, and to compare these outcomes among children who do or do not receive LNS and selected health services. Methods: In a partially masked, placebo-controlled, randomized trial, 34 communities were assigned to immediate (II) or non-intervention (NI) cohorts. 2469 eligible II children were randomly assigned to 1 of 4 groups to receive LNS containing 0, 5 or 10 mg zinc (and placebo tablet) or LNS without zinc and 5 mg zinc tablet from 9 to 18 months of age. The daily ration of LNS was 20 g which provided 118 kcal along with 20 other micronutrients in addition to zinc. Weekly morbidity surveillance was conducted at children’s homes; malaria treatment was provided for confirmed malaria, and ORS for reported diarrhea. Children in NI (n = 797) received neither supplements nor illness treatment. At 9 and 18 months, length, weight, mid-upper arm circumference (MUAC) and hemoglobin (Hb) concentration were measured in all children. Results: Reported adherence was 97 ± 5% for LNS and tablets. Mean baseline Hb was 89 ± 15 g/L, and 91% were anemic (Hb <110 g/L). At 18 months, change in Hb was greater in II cohort than NI (+8 vs -1 g/L, p<0.0001), but 79% of II were still anemic (vs. 91% in NI). During the 9 month follow-up in the II cohort, the incidence of diarrhea and malaria was 1.15 ± 1.18 and 0.55 ± 0.54 episodes per 100 child-days, respectively and did not differ by intervention group. At baseline, mean length-for-age z-score (LAZ), weight-for-length z-score (WLZ) and MUAC were -1.21 ± 1.10, -0.99 ± 1.05 and 133 ± 12 mm, respectively, in all groups combined. Mean length, weight and MUAC were significantly greater

  3. [Efficacy and tolerance of PDE-5 in the treatment of erectile dysfunction in schizophrenic patients: A literature review].

    Science.gov (United States)

    Bacconi, L; Gressier, F

    2017-02-01

    Sexual dysfunction is an important public health problem in men and is associated with reduced quality of life. It is more common in patients with schizophrenia. It is well-established that antipsychotic drugs cause sexual dysfunction with consequences on the quality of life of patients, adherence to treatment, and public health costs. Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) are indicated for the management of erectile dysfunction. However, there is little information on such treatment in schizophrenic patients. This literature review aimed to summarize the current data on the efficacy and tolerability of PDE-5 inhibitors in the erectile dysfunction in schizophrenic patients. PubMed, PsycInfo and Cochrane databases were searched for studies published until August 2014. Only 6 studies met the inclusion criteria. Three were randomized, double-blind, cross-over, placebo-controlled trials and three were open studies. Various scales were used to measure erectile and orgasmic function, desire, satisfaction during intercourse, overall satisfaction, quality of life and intensity of schizophrenic symptoms. In the 3 randomized studies (one with sildenafil 25-50 mg, one with lodenafil carbonate 80 mg/j and the last one with tadalafil 10 mg), the rate of participants who completed the trial was high (around 95 %). All three included patients with schizophrenia or schizophrenia spectrum disorders. Patients reported significant improvement on sexual dysfunction. However, no statistical difference was reported between lodenafil and placebo, on different scales, suggesting a very important placebo effect in patients with schizophrenia. All three found a good tolerance of PDE-5 inhibitors. Side effects were rare and were mainly nasal congestion, headaches, nausea and dizziness. There were no major side effects or drug interactions. Considering the 3 open studies, 2 involved sildenafil and one tadalafil. All concluded in improved erectile and orgasmic

  4. Prevention and treatment of radiotherapy-induced oral mucositis: a literature review; Prevencao e tratamento da mucosite oral induzida por radioterapia: revisao de literatura

    Energy Technology Data Exchange (ETDEWEB)

    Albuquerque, Ieda Lessa de Souza [Instituto Nacional de Cancer (INCa), Rio de Janeiro, RJ (Brazil). Hospital do Cancer I. Servico de Enfermagem]. E-mail: iedalessa@yahoo.com.br; Camargo, Teresa Caldas [Instituto Nacional de Cancer (INCa), Rio de Janeiro, RJ (Brazil). Hospital do Cancer III. Servico de Enfermagem]. E-mail: tcamargo@inca.gov.br

    2007-04-15

    The prevention and treatment of radiotherapy-induced oral mucositis have still not been fully defined. The current study thus involved a literature search aimed at identifying preventive and therapeutic measures in relation to oral mucositis in patients submitted to radiotherapy, analyzing the level of evidence in the selected studies, identifying which indications for prevention and treatment in the literature pertain to the field of nursing, and critically analyzing the results and their implications for nursing care. This was a systematic literature survey without a meta analysis, consulting the following databases: BIREME, Medline, CancerLit, Scirus, CAPES, Free medical journal, High wire press, SCIELO, and Medscape, from 2000 to 2005. According to observations, nursing care was capable of improving patient's quality of life, promoting education of patients, implementing and supervising oral care programs, and providing guidance on hygiene, prevention, and treatment of oral mucositis, including pain management. However, no Brazilian nursing publications were found on the subject. Research and publications focusing on nursing experience in the prevention and treatment of radiotherapy-related oral mucositis and the implications for patients and nurses are important to provide evidence-based nursing guidelines. (author)

  5. Literature survey

    International Nuclear Information System (INIS)

    Drury, J.S.; Michelson, D.; Ensminger, J.T.

    1982-01-01

    Literature was searched for methods of removing uranium from drinking water. No relevant papers were found, but approximately 1000 publications were identified in a less specific search for methods of removing uranium from water. Most of the latter publications dealt with the recovery of uranium from ores, industrial and analytical chemistry solutions, or seawater. The conditions under which these studies were performed were usually quite different from those normally occurring in municipal water treatment practice, but some potentially interesting systems of recovery were identified. A few papers addressed the problem of removing uranium from natural fresh waters and established the effectiveness of using adsorbents or coprecipitants, such as aluminum hydroxide, ferric hydroxide, activated carbon, and ion exchangers, under certain conditions. Also, many US manufacturers and users of water treatment equipment and products were contacted regarding recommended methods of removing uranium from potable water. Based on the results of these surveys, it is recommended that untreated, partially treated, and finished water samples from municipal water treatment facilities be analyzed to determine their extent of removal of uranium by presently used procedures. In addition, laboratory studies are suggested to determine what changes, if any, are needed to maximize the effectiveness of treatments that are already in use in existing water treatment plants

  6. Efficacy of Transcranial Magnetic Stimulation (TMS) in the Treatment of Schizophrenia: A Review of the Literature to Date.

    Science.gov (United States)

    Cole, Jonathan C; Green Bernacki, Carolyn; Helmer, Amanda; Pinninti, Narsimha; O'reardon, John P

    2015-01-01

    We reviewed the literature on transcranial magnetic stimulation and its uses and efficacy in schizophrenia. Multiple sources were examined on transcranial magnetic stimulation efficacy in relieving positive and negative symptoms of schizophrenia. Literature review was conducted via Ovid Medline and PubMed databases. We found multiple published studies and metaanalyses that give evidence that repetitive transcranial magnetic stimulation can have benefit in relieving positive and negative symptoms of schizophrenia, particularly auditory hallucinations. These findings should encourage the psychiatric community to expand research into other applications for which transcranial magnetic stimulation may be used to treat patients with psychiatric disability.

  7. Behavioral Treatment of Drooling: A Methodological Critique of the Literature With Clinical Guidelines and Suggestions for Future Research

    NARCIS (Netherlands)

    Burg, J.J.W. van der; Didden, H.C.M.; Jongerius, P.H.; Rotteveel, J.J.

    2007-01-01

    Many children with mental retardation and developmental disabilities suffer from the consequences of chronic drooling. Behavioral treatment for drooling should be considered before other, more intrusive treatments such as medication and surgery are implemented. However, empirical studies on

  8. Behavioral treatment of drooling: a methodological critique of the literature with clinical guidelines and suggestions for future research.

    NARCIS (Netherlands)

    Burg, J.J.W. van der; Didden, R.; Jongerius, P.H.; Rotteveel, J.J.

    2007-01-01

    Many children with mental retardation and developmental disabilities suffer from the consequences of chronic drooling. Behavioral treatment for drooling should be considered before other, more intrusive treatments such as medication and surgery are implemented. However, empirical studies on

  9. Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature

    International Nuclear Information System (INIS)

    Flood, Karen; Nicholson, Anthony A.

    2013-01-01

    Purpose. To describe the presentation, treatment, and outcomes for 14 patients with aneurysms of the inferior pancreaticoduodenal arteries associated with occlusive lesions of the celiac axis, and to review the literature for similar cases. Methods, Over a period of 12 years, 14 patients (10 women and 4 men) ranging in age from 26 to 50 (mean 46) years were demonstrated to have aneurysms of the inferior pancreaticoduodenal artery origin associated with stenosis or occlusion of the celiac axis. All patients were treated by a combination of surgery and interventional radiology. Results. Outcome data collected between 3 months and 4 years (mean 2 years) demonstrated that all aneurysms remained excluded, and all 14 patients were well. The 49 case reports in the literature confirm the findings of this cohort. Conclusion. In inferior pancreaticoduodenal artery aneurysm resulting from celiac occlusive disease, endovascular treatment is best achieved by stenting the celiac axis and/or embolizing the aneurysm when necessary.

  10. Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Flood, Karen, E-mail: karenrogers@doctors.org.uk; Nicholson, Anthony A. [Leeds Teaching Hospitals, Department of Radiology (United Kingdom)

    2013-06-15

    Purpose. To describe the presentation, treatment, and outcomes for 14 patients with aneurysms of the inferior pancreaticoduodenal arteries associated with occlusive lesions of the celiac axis, and to review the literature for similar cases. Methods, Over a period of 12 years, 14 patients (10 women and 4 men) ranging in age from 26 to 50 (mean 46) years were demonstrated to have aneurysms of the inferior pancreaticoduodenal artery origin associated with stenosis or occlusion of the celiac axis. All patients were treated by a combination of surgery and interventional radiology. Results. Outcome data collected between 3 months and 4 years (mean 2 years) demonstrated that all aneurysms remained excluded, and all 14 patients were well. The 49 case reports in the literature confirm the findings of this cohort. Conclusion. In inferior pancreaticoduodenal artery aneurysm resulting from celiac occlusive disease, endovascular treatment is best achieved by stenting the celiac axis and/or embolizing the aneurysm when necessary.

  11. A Comparison of the Effectiveness of Surgical and Nonsurgical Treatment of Legg-Calve-Perthes Disease: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Karimi

    2012-01-01

    Full Text Available Legg-Calve-Perthes disease (LCPD is a degenerative condition of the hip joint characterised by idiopathic avascular necrosis of the femoral head. Loss of bone mass causes a degree of collapse of the joint and may result in deformity of the ball of the femur and the surface of the hip socket. A reduction in hip joint range of motion, alternation in growth of femoral head, and associated pain are most important problems associated with this disease. Various treatment methods are currently in use and aim to increase containment of the femoral head within the acetabulum, redistribute loading patterns applied to the femoral head, and to decrease the final deformities associated with this condition. These treatments depend on a variety of underlying factors and the aim of this paper was to determine appropriate pathways for treatment and the evidence of treatment method success. A review of the relevant literature was carried out in a variety of data bases including PubMed and ISI Web of Knowledge, and Gale between 1950 and 2011. Research results were categorised depending on the identified treatment method. The success of each treatment pathway was assessed and reasons for the pathway selected were grouped by the age of disease onset, follow-up period, and the final outcome. Evidence relating to the effectiveness of the treatment method used was conflicting. Different methods of screening and follow-up periods were employed in each study which used subjects of varying ages. Minimal evidence of sufficient quality exists in the literature to determine the most appropriate treatment of Legg-Calve-Perthes disease. Research provides some evidence to suggest that nontreatment may be as effective as orthotic or surgical intervention. More research is required to determine the effectiveness of orthotic and surgical treatment.

  12. DESIGN OF THE DEMOSNTRATION BULK VITRIFICATION SYSTEM FOR THE SUPPLEMENTAL TREATMENT OF LOW ACTIVITY TANK WASTE AT HANFORD

    International Nuclear Information System (INIS)

    VAN BEEK JE

    2008-01-01

    In June 2004, the Demonstration Bulk Vitrification System (DBVS) was initiated with the intent to design, construct, and operate a full-scale bulk vitrification pilot-plant to treat low-activity tank waste from Hanford Tank 241-S-109. The DBVS facility uses In-Container Vitrification(trademark) (ICV(trademark)) at the core of the treatment process. The basic process steps combine liquid low-activity waste (LAW) and glassformers; dry the mixture; and then vitrify the mixture in a batch feed-while-melt process in a refractory lined steel container. Off-gases are processed through a state-of-the-art air pollution control system including sintered-metal filtration, thermal oxidation, acid gas scrubbing, and high-efficiency particulate air (HEPA) and high-efficiency gas adsorber (HEGA) filtration. Testing has focused on development and validation of the waste dryer, ICV, and sintered-metal filters (SMFs) equipment, operations enhancements, and glass formulation. With a parallel testing and design process, testing has allowed improvements to the DBVS equipment configuration and operating methodology, since its original inception. Design improvements include optimization of refractory panels in the ICV, simplifying glassformer addition equipment, increasing the number of waste feed chutes to the ICV, and adding capability for remote clean-out of piping, In addition, the U.S. Department of Energy (DOE) has provided an independent review of the entire DBVS process. While the review did not find any fatal flaws, some technical issues were identified that required a re-evaluation of the DBVS design and subsequent changes to the design. A 100 percent design package for the pilot plant will be completed and submitted to DOE for review in early 2008 that incorporates process improvements substantiated through testing and reviews. This paper provides a description of the bulk vitrification process and a discussion of major equipment design changes that have occurred based on full

  13. Pharmaceutical Treatment of Periodontal diseases. Groups of Drugs, Mechanism of Their Action, Indications and Contraindications for Use. Part VІ. Antibiotics. Literature review.

    OpenAIRE

    Kashivska, R. S.; Melnychuk, H. M.; Melnychuk, A. S.; Kyrylyuk, A. M.

    2014-01-01

    Literature of 1998-2013 has been reviewed; classifications of antibiotics have been described along with their advantages and disadvantages.    Different types of antibiotics used in treatment of generalized periodontitis have been described. It has been established that in some cases of dystrophic-inflammatory diseases antibiotic therapy may be used. Antibiotics with bone tissue tropism or the ones with bacteriostatic or bacteriocydic effect to the periodontal pathogens are used in such case...

  14. Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study.

    Science.gov (United States)

    Malaguarnera, Mariano; Risino, Corrado; Cammalleri, Lisa; Malaguarnera, Lucia; Astuto, Marinella; Vecchio, Ignazio; Rampello, Liborio

    2009-07-01

    Our earlier study has demonstrated that the administration of L-acetylcarnitine (LAC) improves neurological symptoms and serum parameters in hepatic coma. The aim of this work has been to evaluate the efficacy of the LAC and branched chain amino acids (BCAA) versus BCAA, administered in intravenous infusion, in patients with cirrhotic hepatic coma. Forty-eight highly selected patients were enrolled in the study and, after randomization, received blindly LAC+BCAA (n=24) versus BCAA (n=24). The two groups were similar in age, sex, pathogenesis of cirrhosis, and severity of liver disease. The comparison between values before and after LAC planned treatment showed statistical significant differences in neurological findings, evaluated by the Glasgow Scale, ammonia serum levels, blood urea nitrogen, and EEG. After 60 min of the study period, the LAC+BCAA treated patients compared with BCCA treated showed a significant decrease of ammonia serum levels: 41.20 versus 10.40 mumol PBCAA treated patients compared with BCCA treated patients showed a significant increase of Glasgow's score: 3.60 versus 1.50 score PBCAA supplemented with LAC might improve neurological symptoms and serum ammonium levels in selected cirrhotic patients with hepatic coma.

  15. Radiation-induced malignant melanoma following radiation treatment for squamous cell carcinoma of the oral cavity - a case report and review of literature -

    International Nuclear Information System (INIS)

    Shin, Young Ju; Yang, Koang Mo; Suh, Hyun Suk

    1998-01-01

    Malignant melanoma of the oral cavity is rare, accounting for 1 to 8% of all malignant melanomas. The overall prognosis remains poor despite the available treatments such as radical surgery, adjuvant radiotherapy, chemotherapy and immunotherapy due to failure in early detection and tendency in early metastasis. The etiology of mucosal malignant melanoma remains unkown. However, there are few cases of malignant melanoma of the oral cavity reported in the literature, which might be related to preexisting melanosis and radiation treatment. A case with malignant melanoma developed on the same site after 6 years following irradiation for squamous cell carcinoma of the oral cavity is reported in this article

  16. Epistaxis revealing the rupture of a carotid aneurysm of the cavernous sinus extending into the sphenoid: treatment using an uncovered stent and coils. Review of literature.

    Science.gov (United States)

    Lehmann, Pierre; Saliou, Guillaume; Page, Cyril; Balut, Antonia; Le Gars, Daniel; Vallée, Jean Noel

    2009-05-01

    True carotid aneurysms with sphenoid extension and revealed by epistaxis are rare. A review of the literature shows the mortality risk of this pathology and the different therapeutic options. A 41-year-old female presented with a cavernous carotid aneurysm with sphenoid extension revealed by massive epistaxis. We propose a combined treatment of the affected vessel using coils and an uncovered stent. The first stage to stop the hemorrhages and occlude the aneurysm using the coil and the second stage several days later after anticoagulation using the stent to prevent revascularization. This treatment has been shown to be effective in producing immediate hemostasis and stable long-term occlusion.

  17. Orthomolecular medicine: the therapeutic use of dietary supplements for anti-aging.

    Science.gov (United States)

    Janson, Michael

    2006-01-01

    Dietary supplements at high doses as part of medical therapy have been controversial, but the evidence suggests that they play a significant role in prevention and treatment of diseases as well as protection from accelerated aging that results from oxygen free-radical damage, inflammation, and glycation. This literature review examines several supplements that have documented roles in medical therapy, including vitamins C and E, coenzyme Q10, alpha-lipoic acid, chromium, L-carnitine, and quercetin. The evidence shows benefits in diabetes, cardiovascular disease, hypertension, congestive heart failure, age-related deterioration of brain function and vision, and immune function, as well as other age-related health problems.

  18. Weight Loss Nutritional Supplements

    Science.gov (United States)

    Eckerson, Joan M.

    Obesity has reached what may be considered epidemic proportions in the United States, not only for adults but for children. Because of the medical implications and health care costs associated with obesity, as well as the negative social and psychological impacts, many individuals turn to nonprescription nutritional weight loss supplements hoping for a quick fix, and the weight loss industry has responded by offering a variety of products that generates billions of dollars each year in sales. Most nutritional weight loss supplements are purported to work by increasing energy expenditure, modulating carbohydrate or fat metabolism, increasing satiety, inducing diuresis, or blocking fat absorption. To review the literally hundreds of nutritional weight loss supplements available on the market today is well beyond the scope of this chapter. Therefore, several of the most commonly used supplements were selected for critical review, and practical recommendations are provided based on the findings of well controlled, randomized clinical trials that examined their efficacy. In most cases, the nutritional supplements reviewed either elicited no meaningful effect or resulted in changes in body weight and composition that are similar to what occurs through a restricted diet and exercise program. Although there is some evidence to suggest that herbal forms of ephedrine, such as ma huang, combined with caffeine or caffeine and aspirin (i.e., ECA stack) is effective for inducing moderate weight loss in overweight adults, because of the recent ban on ephedra manufacturers must now use ephedra-free ingredients, such as bitter orange, which do not appear to be as effective. The dietary fiber, glucomannan, also appears to hold some promise as a possible treatment for weight loss, but other related forms of dietary fiber, including guar gum and psyllium, are ineffective.

  19. Main properties of nanocrystalline hydroxyapatite as a bone graft material in treatment of periodontal defects. A review of literature

    International Nuclear Information System (INIS)

    Bayani, Mojtaba; Torabi, Sepehr; Shahnaz, Aysan; Pourali, Mohammad

    2017-01-01

    This study aims to provide a literature review on nanocrystalline hydroxyapatite (n-HA). n-HA constitutes the principle inorganic part of hard tissues. Therefore, preparation of commercial synthetic analogues, the so-called ‘biomimetic’, has gained a lot of attention since it can precisely mimic the physicochemical features of biological apatite compounds. Due to its improved osseointegrative properties, n-HA may represent a promising class of bone graft materials. n-HA binds to the bone and by stimulation of osteoblast activity and enhancing local growth factors it improves bone healing. Periodontitis is an inflammatory condition in response to microbial plaque that leads to periodontal tissue destruction and osseous defects in alveolar bone. A review of the extant literature reveals that n-HA has certain advantages in periodontal tissue regeneration including minimal patient morbidity, better biocompatibility, and lack of toxicity

  20. Multimodality Treatment in Ewing's Sarcoma Family Tumors of the Maxilla and Maxillary Sinus: Review of the Literature

    Science.gov (United States)

    Mamot, Christoph; Krasniqi, Fatime; Metternich, Frank

    2016-01-01

    The Ewing sarcoma family of tumors (ESFT) encompasses a group of highly aggressive, morphologically similar, malignant neoplasms sharing a common spontaneous genetic translocation that affect mostly children and young adults. These predominantly characteristic, small round-cell tumors include Ewing's sarcoma of the bone and soft tissue, as well as primitive neuroectodermal tumors (PNETs) involving the bone, soft tissue, and thoracopulmonary region (Askin's tumor). Extraosseous ESFTs are extremely rare, especially in the head and neck region, where literature to date consists of sporadic case reports and very small series. We hereby present a review of the literature published on ESFTs reported in the maxilla and maxillary sinus region from 1968 to 2016. PMID:27413360

  1. Can surgery improve neurological function in penetrating spinal injury? A review of the military and civilian literature and treatment recommendations for military neurosurgeons.

    Science.gov (United States)

    Klimo, Paul; Ragel, Brian T; Rosner, Michael; Gluf, Wayne; McCafferty, Randall

    2010-05-01

    Penetrating spinal injury (PSI), although an infrequent injury in the civilian population, is not an infrequent injury in military conflicts. Throughout military history, the role of surgery in the treatment of PSI has been controversial. The US is currently involved in 2 military campaigns, the hallmark of both being the widespread use of various explosive devices. The authors reviewed the evidence for or against the use of decompressive laminectomy to treat PSI to provide a triservice (US Army, Navy, and Air Force) consensus and treatment recommendations for military neurosurgeons and spine surgeons. A US National Library of Medicine PubMed database search that identified all literature dealing with acute management of PSI from military conflicts and civilian urban trauma centers in the post-Vietnam War period was undertaken. Nineteen retrospective case series (11 military and 8 civilian) met the study criteria. Eleven military articles covered a 20-year time span that included 782 patients who suffered either gunshot or blast-related projectile wounds. Four papers included sufficient data that analyzed the effectiveness of surgery compared with nonoperative management, 6 papers concluded that surgery was of no benefit, 2 papers indicated that surgery did have a role, and 3 papers made no comment. Eight civilian articles covered a 9-year time span that included 653 patients with spinal gunshot wounds. Two articles lacked any comparative data because of treatment bias. Two papers concluded that decompressive laminectomy had a beneficial role, 1 paper favored the removal of intracanal bullets between T-12 and L-4, and 5 papers indicated that surgery was of no benefit. Based on the authors' military and civilian PubMed literature search, most of the evidence suggests that decompressive laminectomy does not improve neurological function in patients with PSI. However, there are serious methodological shortcomings in both literature groups. For this and other reasons

  2. Behavioral Treatment of Drooling: A Methodological Critique of the Literature with Clinical Guidelines and Suggestions for Future Research

    Science.gov (United States)

    Van der Burg, Jan J. W.; Didden, Robert; Jongerius, Peter H.; Rotteveel, Jan J.

    2007-01-01

    Many children with mental retardation and developmental disabilities suffer from the consequences of chronic drooling. Behavioral treatment for drooling should be considered before other, more intrusive treatments such as medication and surgery are implemented. However, empirical studies on behavioral procedures are scarce. This article reviews 19…

  3. Tyrosine supplementation for phenylketonuria.

    Science.gov (United States)

    Webster, Diana; Wildgoose, Joanne

    2013-06-05

    Phenylketonuria is an inherited disease for which the main treatment is the dietary restriction of the amino acid phenylalanine. The diet has to be initiated in the neonatal period to prevent or reduce mental handicap. However, the diet is very restrictive and unpalatable and can be difficult to follow. A deficiency of the amino acid tyrosine has been suggested as a cause of some of the neuropsychological problems exhibited in phenylketonuria. Therefore, this review aims to assess the efficacy of tyrosine supplementation for phenylketonuria. To assess the effects of tyrosine supplementation alongside or instead of a phenylalanine-restricted diet for people with phenylketonuria, who commenced on diet at diagnosis and either continued on the diet or relaxed the diet later in life. To assess the evidence that tyrosine supplementation alongside, or instead of a phenylalanine-restricted diet improves intelligence, neuropsychological performance, growth and nutritional status, mortality rate and quality of life. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register which is comprised of references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. Additional studies were identified from handsearches of the Journal of Inherited Metabolic Disease (from inception in 1978 to 1998). The manufacturers of prescribable dietary products used in the treatment of phenylketonuria were also contacted for further references.Date of the most recent search of the Group's Inborn Errors of Metabolism Trials Register: 28 June 2012. All randomised or quasi-randomised trials investigating the use of tyrosine supplementation versus placebo in people with phenylketonuria in addition to, or instead of, a phenylalanine-restricted diet. People treated for maternal phenylketonuria were excluded. Two authors independently assessed the trial eligibility, methodological quality

  4. The effects of ionizing radiation on food, compared to the effects of conventional food treatment: A literature study. Pt. 1

    International Nuclear Information System (INIS)

    Leister, W.; Boegl, K.W.

    1987-08-01

    The extent and quality of changes due to irradiation is described and compared with conventional methods. Effects of radiation treatment on vegetable products as well as pork, beef, any type of fish and poultry product are compared with conventional thermic, micro-wave or smoke treatments, drying processes, ethylene oxide gas treatment, as well as effects from storage, temperature and sealed packaging. In this context the influences of the different treatment methods on various food components and on sensory, physical-chemical or biochemical characteristics were compared. The following tendencies were observed: conventional treatment methods produce partly more pronounced changes than irradiation with standard doses. Heat treatment, for instance, results in a greater weight loss, in altered sugar content, and in higher content of carbonyl and aldehyde releasing compounds. Gas treatment will cut the volatile oil content in half, while it remains nearly constant after irradiation. However, in some cases, an irradiation with standard doses may cause changes which should not be disregarded. In onions, for instance, irradiation is causing a stronger decomposition during storage than only cold storage. (orig./MG) [de

  5. A Prospective Study of Hepatitis During Antituberculous Treatment in Taiwanese Patients and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Hsin-Yun Sun

    2009-02-01

    Conclusion: Elevation of liver function tests was not uncommon during antituberculous treatment, especially in the first 2 months. Patients with abnormal liver function tests at baseline or liver cirrhosis should be closely monitored.

  6. Efficacy and safety of combinations of first-line topical treatments in chronic plaque psoriasis: a systematic literature review

    NARCIS (Netherlands)

    Hendriks, A.G.M.; Keijsers, R.R.M.C.; Jong, E.M.G.J. de; Seyger, M.M.B.; Kerkhof, P.C.M. van de

    2013-01-01

    Background Most psoriasis patients suffering from mild to moderate disease are treated with first-line topical treatments, including corticosteroids, vitamin D analogues, topical retinoids and calcineurin inhibitors. Although evidence-based guidelines on combinations are lacking, the majority of

  7. Comprehensive surgical. Orthodontic treatment of class III malocclusion in cleft patient involving minimally invasive surgery Case report and literature review.

    Science.gov (United States)

    Stojkovic, Goran; Stojkovic, Miodrag; Stojkovic, Jasna; Nikolic, Dejan; Stajcic, Zoran

    2016-12-19

    Surgical and orthodontic treatment of a teenage cleft patient. Authors describe the case of a 13 year old female cleft patient presented with class III malocclusion RESULT: The patient underwent comprehensive surgical secondary bone grafting and orthodontic treatment. Stable skeletal and occlusal class I relationship was achived and maintained in the post treatment observation period till the age of 16. Although several authors suggests primary gingivoperiosteoplasty, other advocates that such early intervention can cause later restrictions in maxillary growth. For alveolar reconstruction, maxillary growth and dental age were the main considerations in determining the timing of surgical intervention. This case showed that borderline cases of complex dentoalveolar and skeletal anomaly in cleft patients could be successfully treated with comprehensive secondary bone grafting and orthodontic treatment thus avoiding the need for orthognatic surgery. Alveolar bone grafting, Cleft, Malocclusion.

  8. Skin needling as a treatment for acne scarring: An up-to-date review of the literature

    Directory of Open Access Journals (Sweden)

    Adam G. Harris, MBChB

    2015-06-01

    Conclusion: There is moderate evidence to suggest that skin needling is beneficial and safe for the treatment of acne scarring. However, double-blinded, randomized controlled trials are required to make more definitive conclusions.

  9. Surgical treatment for unexplained severe pain of the thyroid gland: report of three cases and concise review of the literature

    NARCIS (Netherlands)

    van Schaik, Jan; Dekkers, Olaf M.; van der Kleij-Corssmit, Eleonora P. M.; Romijn, Johannes A.; Morreau, Hans; van de Velde, Cornelis J. H.

    2011-01-01

    Painful thyroid has a limited differential diagnosis. In rare cases, no clear cause can be found after careful clinical, biochemical, and radiological analysis. This may lead to extensive patient morbidity and frustration when symptomatic treatment proves insufficient. Hemithyroidectomy or total

  10. Eating difficulties and parental feeding strategies during and after childhood cancer treatment: The experiences of parents. : A systematic literature review.

    OpenAIRE

    Philippe, Kaat

    2017-01-01

    Childhood cancer is a life-threatening disease with a profound impact on the family. Treatment side-effects and accompanied dietary difficulties are for example severe stressors, as appropriate nutrition is important for the treatment success and quality of life. In addition, (unhealthy) dietary patterns established in childhood tend to maintain in survivors. Parents are key players in feeding and establishing these pat-terns, though, systematic research on how parents experience these dietar...

  11. Comparison of surgical, radiation and cytostatic treatment of gastric carcinomas in world literature from 1973 to 1978

    International Nuclear Information System (INIS)

    Delcker, A.

    1982-01-01

    Among the three possible therapeutic methods, surgical treatment gives the best results from a three-year survival time onwards. The five-year survival rate is between 8 and 18.6 pc. With radiation therapy the survival rate is already at 8.3 pc after three years. In cases of cytostatic treatment of locally restricted tumors, the rate of survival three years after the inception of the therapy is zero. The one-year survival rate with additional cytostatic treatment is 73.9 pc, without it there are 46.7 pc survivals. Surgery plus radiation therapy accounts for a one-year survival rate of 55.5 pc. This is more than with surgery alone (33 pc respectively 46.7 pc), but less than the one-year survival rate for surgical and cytostatic treatment (73.9 pc). Where radiation plus chemical therapy is applied, the percentage of survivals after two years is 28.5, respectively 40 for local tumors. None of the patients with metastases had survived two years after the treatment was started. (Comparison with surgery alone: five-year survival rate 9.4 pc of patients with affected lymph nodes). The best results are obtained by surgical combined with cytostatic treatment, possibly also by surgery in combination with radiation therapy. (orig./MG) [de

  12. Nearly 30 Years of Treatment for Recurrent Granulosa Cell Tumor of the Ovary: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Deanna Teoh

    2010-01-01

    Full Text Available A 30-year-old woman was diagnosed with a stage IA granulosa cell tumor (GCT of the ovary in 1979. Following removal of the adnexal mass and complete surgical staging, she remained disease-free for 12 years. In 1991 she underwent a resection of a retroperitoneal mass, confirmed to be a recurrent GCT. Despite adjuvant radiation treatment at the time of recurrence, the patient presented five years later with abdominal pain, and was found to have a second recurrence. Over the next 10 years the patient had multiple recurrences and progressive disease despite surgical resection, cytotoxic, hormonal and targeted chemotherapy treatments. In conclusion, there is no standard management for recurrent GCT of the ovary. We review this patient’s treatment in the context of the current literature.

  13. Effectiveness of preventive and treatment interventions for primary headaches in the workplace: A systematic review of the literature.

    Science.gov (United States)

    Lardon, Arnaud; Girard, Marie-Pier; Zaïm, Chérine; Lemeunier, Nadège; Descarreaux, Martin; Marchand, Andrée-Anne

    2017-01-01

    Aim The purpose of this systematic literature review is to assess the benefits of workplace-based occupational therapies and interventions, including acute and preventive medication, on headache intensity and frequency, related disability as well as work-related outcomes. Methods A search of the literature was conducted in PubMed, MEDLINE, Cochrane library, CINAHL and Embase using terms related to headache, workplace and occupational health. The Cochrane Collaboration's risk of bias assessment tool was used on individual studies to assess internal validity and the Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Results Fifteen articles were included in the systematic review. None of them were classified as low risk of bias according to the Cochrane Collaboration's tool for assessing risk of bias. This systematic review found preliminary low-quality evidence suggesting that exercise and acupuncture can reduce workers' headache pain intensity, frequency and related disability. Conclusion Although this systematic review provided preliminary low evidence in favour of work-based intervention, studies with more rigorous designs and methodologies are needed to provide further evidence of the effectiveness of workplace-based headache management strategies.

  14. Co-delivery of a laminin-111 supplemented hyaluronic acid based hydrogel with minced muscle graft in the treatment of volumetric muscle loss injury.

    Directory of Open Access Journals (Sweden)

    Stephen M Goldman

    Full Text Available Minced muscle autografting mediates de novo myofiber regeneration and promotes partial recovery of neuromuscular strength after volumetric muscle loss injury (VML. A major limitation of this approach is the availability of sufficient donor tissue for the treatment of relatively large VMLs without inducing donor site morbidity. This study evaluated a laminin-111 supplemented hyaluronic acid based hydrogel (HA+LMN as a putative myoconductive scaffolding to be co-delivered with minced muscle grafts. In a rat tibialis anterior muscle VML model, delivery of a reduced dose of minced muscle graft (50% of VML defect within HA+LMN resulted in a 42% improvement of peak tetanic torque production over unrepaired VML affected limbs. However, the improvement in strength was not improved compared to a 50% minced graft-only control group. Moreover, histological analysis revealed that the improvement in in vivo functional capacity mediated by minced grafts in HA+LMN was not accompanied by a particularly robust graft mediated regenerative response as determined through donor cell tracking of the GFP+ grafting material. Characterization of the spatial distribution and density of macrophage and satellite cell populations indicated that the combination therapy damps the heightened macrophage response while re-establishing satellite content 14 days after VML to a level consistent with an endogenously healing ischemia-reperfusion induced muscle injury. Moreover, regional analysis revealed that the combination therapy increased satellite cell density mostly in the remaining musculature, as opposed to the defect area. Based on the results, the following salient conclusions were drawn: 1 functional recovery mediated by the combination therapy is likely due to a superposition of de novo muscle fiber regeneration and augmented repair of muscle fibers within the remaining musculature, and 2 The capacity for VML therapies to augment regeneration and repair within the

  15. Treatment of Leptomeningeal Carcinomatosis in a Patient with Metastatic Pancreatic Cancer: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    William Rainey Johnson

    2018-05-01

    Full Text Available Pancreatic cancer is the fourth leading cause of cancer-related death with a median survival of 3–11 months when metastatic. We present a patient with metastatic pancreatic cancer and an exceptional response to initial systemic chemotherapy with FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin. Despite evidence of disease control on body imaging, he developed symptomatic leptomeningeal disease and brain metastases 29 months into treatment. He received aggressive treatment with capecitabine and irinotecan, intrathecal topotecan, and eventually bevacizumab. He did well for 36 weeks on this regimen until developing sepsis. This patient significantly outlived his expected survival and, moreover, did so with very good quality of life. This case demonstrates the natural history of pancreatic cancer progressing to involve the central nervous system when systemic disease is otherwise responsive to chemotherapy. It is the first case to demonstrate the potential effectiveness of intrathecal topotecan in combination with systemic chemotherapy for the treatment of leptomeningeal metastases of pancreatic cancer.

  16. Platelet-rich plasma-an 'Elixir' for treatment of alopecia: personal experience on 117 patients with review of literature.

    Science.gov (United States)

    Garg, Suruchi; Manchanda, Shweta

    2017-01-01

    Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery and dermatology. PRP is a simple, cost-effective and feasible treatment option with high patient satisfaction for hair loss and can be regarded as a valuable adjuvant treatment modality for androgenic alopecia and other types of non-scarring alopecias. Authors have proposed a hair model termed "Golden anchorage with 'molecular locking' of ectodermal and mesenchymal components for survival and integrity of hair follicle (HF)" in this article. Golden anchorage comprises of bulge stem cells, ectodermal basement membrane and bulge portion of APM. PRP with its autologous supply of millions of growth factors works on 'Golden anchorage' along with keratinocytes (PDGF), dermal papilla (IGF and fibroblast growth factor), vasculature (VEGF and PDGF) and neural cells (Nerve Growth Factor) in a multipronged manner serving as an 'elixir' for hair growth and improving overall environment.

  17. Collapsing focal segmental glomerulosclerosis following long-term treatment with oral ibandronate: case report and review of literature

    International Nuclear Information System (INIS)

    Jia, Ning; Cormack, Fionnuala C.; Xie, Bin; Shiue, Zita; Najafian, Behzad; Gralow, Julie R.

    2015-01-01

    Renal toxicity has been reported with bisphosphonates such as pamidronate and zolidronate but not with ibandronate, in the treatment of breast cancer patients with bone metastasis. One of the patterns of bisphosphonate-induced nephrotoxicity is focal segmental glomerulosclerosis (FSGS) or its morphological variant, collapsing focal segmental glomerulosclerosis (CFSGS). We describe a breast cancer patient who developed heavy proteinuria (protein/creatinine ratio 9.1) and nephrotic syndrome following treatment with oral ibandronate for 29 months. CFSGS was proven by biopsy. There was no improvement 1 month after ibandronate was discontinued. Prednisone and tacrolimus were started and she experienced a decreased in proteinuria. In patient who develops ibandronate-associated CFSGS, proteinuria appears to be at least partially reversible with the treatment of prednisone and/or tacrolimus if the syndrome is recognized early and ibandronate is stopped

  18. Eculizumab for the Treatment of Severe Antibody-Mediated Rejection: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Duy Tran

    2016-01-01

    Full Text Available In renal transplantation, treatment options for antibody-mediated rejection are limited. Here, we report a case of severe AMR treated with eculizumab. A 50-year-old woman known for end stage kidney disease secondary to IgA nephropathy received a kidney transplant from a 50-year-old deceased donor. At 5 months after transplantation, she presented with acute graft dysfunction and biopsy showed a severe antibody-mediated rejection associated with thrombotic microangiopathy. Despite an aggressive conventional immunosuppressive regimen, signs of rejection persisted and the patient was treated with 3 doses of eculizumab. Following the therapy, markers of TMA improved and graft function stabilized. However, ongoing signs of rejection remained in the repeated biopsy. In kidney transplantation, eculizumab is an expensive treatment and its role in the treatment of antibody-mediated rejection remains to be determined.

  19. Annual Statistical Supplement, 2002

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2002 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  20. Annual Statistical Supplement, 2010

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2010 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  1. Annual Statistical Supplement, 2007

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2007 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  2. Annual Statistical Supplement, 2001

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2001 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  3. Annual Statistical Supplement, 2016

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2016 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  4. Annual Statistical Supplement, 2011

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2011 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  5. Annual Statistical Supplement, 2005

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2005 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  6. Annual Statistical Supplement, 2015

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2015 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  7. Annual Statistical Supplement, 2003

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2003 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  8. Annual Statistical Supplement, 2017

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2017 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  9. Annual Statistical Supplement, 2008

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2008 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  10. Annual Statistical Supplement, 2014

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2014 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  11. Annual Statistical Supplement, 2004

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2004 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  12. Annual Statistical Supplement, 2000

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2000 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  13. Annual Statistical Supplement, 2009

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2009 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  14. Annual Statistical Supplement, 2006

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2006 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  15. The optimal treatment for stage 2-3 Goutallier rotator cuff tears: A systematic review of the literature.

    Science.gov (United States)

    Hollman, Freek; Wolterbeek, Nienke; Flikweert, Petra E; Yang, Kiem G Auw

    2018-06-01

    Fatty infiltration is an important prognostic factor for cuff healing after rotator cuff repair. Treatment options for stage 2-3 Goutallier rotator cuff tears vary widely and there is lack of decent comparative studies. The objective of this study was 1) to give an overview of the treatment options of stage 2-3 Goutallier rotator cuff tears and their clinical outcome and 2) to give a recommendation of the optimal treatment within this specific subgroup. We searched the databases of Medline, Embase, Cochrane library, NHS Centre for Reviews and Dissemination, PEDro from inception to December 12th, 2016. Two authors, F.H. and N.W., selected the studies after consensus. Data was extracted by one author (F.H.) and checked for completeness by a second author (N.W.). Our primary outcome was physical function, measured by shoulder-specific patient reported outcomes. Secondary outcomes were cuff integrity after rotator cuff repair, shoulder pain, general health, quality of life, activity level and adverse events. For the first research question 28 prospective as well as retrospective studies were included. For the clinical outcome of these treatments three randomized controlled trials were included. Despite the high reported retear rate, rotator cuff repair has comparable results (clinical improvement) as partial repair and isolated bicepstenotomy or tenodesis. These findings suggest that the additional effect of rotator cuff repair compared to the less extensive treatment options like isolated bicepstenotomy or tenodesis should be studied, as these might form a good alternative treatment based on this systematic review. Level IV; systematic review.

  16. Costs, quality of life and treatment compliance associated with antibiotic therapies in patients with cystic fibrosis: a review of the literature.

    Science.gov (United States)

    Weiner, Jennifer R; Toy, Edmond L; Sacco, Patricia; Duh, Mei Sheng

    2008-04-01

    Cystic fibrosis is the most common incurable hereditary disease in the US. Persistent respiratory infection is the leading cause of morbidity and mortality in cystic fibrosis patients. This study aimed to review the literature on economic and quality of life outcomes and treatment compliance associated with antibiotic therapies for cystic fibrosis patients. A systematic literature review was conducted using keyword searches of the MEDLINE database and selected conference abstracts. The review covered studies published between January 1990 and May 2007. Evidence suggests that inhaled tobramycin, a key chronic suppressive therapy, can reduce other healthcare costs. The main determinants of the cost of care include disease severity and respiratory infection. Costs vary widely by country. There is evidence that inhaled tobramycin and oral azithromycin improve quality of life and that treatment setting and patient convenience may also impact on quality of life. Antibiotic treatment compliance varied significantly and depended on the method of measurement, with more subjective measures tending to be higher. This review concludes by offering directions for future research.

  17. CLOMIPHENE CITRATE IN THE TREATMENT OF IDIOPATHIC OR FUNCTIONAL HYPOGONADOTROPIC HYPOGONADISM IN MEN: A CASE SERIES AND REVIEW OF THE LITERATURE.

    Science.gov (United States)

    Liel, Yair

    2017-03-01

    Late-onset hypogonadotropic hypogonadism (LOH) is a complex, heterogeneous entity. Whenever treatment is indicated, the endocrine literature has recommend testosterone replacement. We present our experience with clomiphene citrate treatment in patients with LOH and a review of the literature. This retrospective case series included 18 male patients with hypogonadotropic hypogonadism, roughly according to the European Male Aging Study criteria for LOH, attended at an academic hospital outpatient clinic. Data were retrieved from the patients' electronic medical records. The patients' mean age (±SD) was 44.3 ± 6.3 years (range 21-67 years) referred for evaluation of low testosterone together with decreased libido, erectile dysfunction, fatigue or tiredness, anxiety, and osteoporosis. Clomiphene was initially prescribed at doses between 25 mg 3 times a week and 50 mg/day. At 6 to 8 weeks following initiation of treatment, mean basal total-testosterone increased from 7.6 ± 2.6 to 19.3 ± 5.2 nmol/L (Phypogonadism.

  18. Manual lymphatic drainage with comprehensive anti-diabetic therapy (MLD / CDT as a method of treatment of lymphoedema - literature review

    Directory of Open Access Journals (Sweden)

    Ola Płoszaj

    2017-08-01

    Full Text Available Lymphedema is an accumulation of lymph, i.e stagnation of water and proteins in extracellular space and lymphatic vessel due to impairment of its transportation as an effect of congenital disorders or lymph vessel lesion. The priority in therapeutic approach to lymphedema should be establishing the cause of edema, setting medical diagnosis and treatment method as early as possible. Complex Decongestive Therapy is recommended by International Society of Lymphology and considered as a standard in lympedema treatment irrespective of their stage of development and the cause.

  19. IMPORTANCE OF CYCLOPHOSPHANUM IN THE TREATMENT OF INTERSTITIAL LUNG LESION IN PATIENTS WITH SCLERODERMA SYSTEMATICA (A REVIEW OF LITERATURE

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    Olga Aleksandrova Koneva

    2010-01-01

    Full Text Available Interstitial lung diseases (ILD are a common manifestation of scleroderma systematica (SSD that along with pulmonary arterial hypertension remains the leading cause of death in this nosological entity. As of now, cyclophosphanum remains the only immunosuppressant recommended by the European League against Rheumatism for the treatment of ILD in SSD. The paper analyzes the papers providing evidence for the efficacy of cyclophosphanum in ILD in patients with SSD. It also considers the regimens and duration of treatment with cyclophosphanum, ways of evaluating its efficacy and effects on extrapulmonary manifestations of SSD. It is concluded that cyclophosphanum has a positive, predominantly stabilizing, effect on the course of ILD in SSD.

  20. Introduction - NCS Dietary Assessment Literature Review

    Science.gov (United States)

    To assist in the planning of the National Children's Study, investigators at the NIH Office of Dietary Supplements, NCI and Johns Hopkins University contracted with Westat to conduct a comprehensive review of the scientific literature.

  1. Treatment of thoracolumbar burst fractures with variable screw placement or Isola instrumentation and arthrodesis: case series and literature review.

    Science.gov (United States)

    Alvine, Gregory F; Swain, James M; Asher, Marc A; Burton, Douglas C

    2004-08-01

    The controversy of burst fracture surgical management is addressed in this retrospective case study and literature review. The series consisted of 40 consecutive patients, index included, with 41 fractures treated with stiff, limited segment transpedicular bone-anchored instrumentation and arthrodesis from 1987 through 1994. No major acute complications such as death, paralysis, or infection occurred. For the 30 fractures with pre- and postoperative computed tomography studies, spinal canal compromise was 61% and 32%, respectively. Neurologic function improved in 7 of 14 patients (50%) and did not worsen in any. The principal problem encountered was screw breakage, which occurred in 16 of the 41 (39%) instrumented fractures. As we have previously reported, transpedicular anterior bone graft augmentation significantly decreased variable screw placement (VSP) implant breakage. However, it did not prevent Isola implant breakage in two-motion segment constructs. Compared with VSP, Isola provided better sagittal plane realignment and constructs that have been found to be significantly stiffer. Unplanned reoperation was necessary in 9 of the 40 patients (23%). At 1- and 2-year follow-up, 95% and 79% of patients were available for study, and a satisfactory outcome was achieved in 84% and 79%, respectively. These satisfaction and reoperation rates are consistent with the literature of the time. Based on these observations and the loads to which implant constructs are exposed following posterior realignment and stabilization of burst fractures, we recommend that three- or four-motion segment constructs, rather than two motion, be used. To save valuable motion segments, planned construct shortening can be used. An alternative is sequential or staged anterior corpectomy and structural grafting.

  2. Lipid based nutrient supplements (LNS) for treatment of children (6 months to 59 months) with moderate acute malnutrition (MAM): A systematic review

    Science.gov (United States)

    Pena-Rosas, Juan Pablo; Boy-Mena, Evelyn; Sachdev, Harshpal S.

    2017-01-01

    Background Moderate acute malnutrition is a major public health problem affecting children from low- and middle-income countries. Lipid nutrient supplements have been proposed as a nutritional intervention for its treatment. Objectives To evaluate the effectiveness and safety of LNS for the treatment of MAM in infants and children 6 to 59 months of age. Study design Systematic review of randomized-controlled trials and controlled before-after studies. Results Data from nine trials showed that use of LNS, in comparison to specially formulated foods, improved the recovery rate (RR 1.08; 95% CI 1.02–1.14, 8 RCTs, 8934 participants, low quality evidence); decreased the chances of no recovery (RR 0.70; 95% CI 0.58–0.85, 7 RCTs, 8364 participants, low quality evidence) and the risk of deterioration into severe acute malnutrition (RR 0.87; 95% CI 0.73–1.03, 6 RCTs, 6788 participants, low quality evidence). There was little impact on mortality (RR 0.94, 95% CI 0.54–1.52, 8 RCTs, 8364 participants, very-low- quality evidence) or default rate (RR 1.32; 95% CI 0.73–2.4, 7 studies, 7570 participants, low quality evidence). There was improvement in weight gain, weight-for-height z-scores, height-for-age z-scores and mid-upper arm circumference. Subset analyses suggested higher recovery rates with greater amount of calories provided and with ready-to-use therapeutic foods, in comparison to ready-to-use supplementary foods. One study comparing LNS with nutritional counselling (very low quality evidence) showed higher chance of recovery, lower risk of deteriorating into severe acute malnutrition and lower default rate, with no impact on mortality, and no recovery. Conclusions Evidence restricted to the African regions suggests that LNS may be slightly more effective than specially formulated fortified foods or nutritional counselling in recovery from MAM, lowering the risk of deterioration into SAM, and improving weight gain with little impact on mortality or default

  3. Supplemental treatment of rheumatoid arthritis with natural milk antibodies against enteromicrobes and their toxins: results of an open-labelled pilot study

    Directory of Open Access Journals (Sweden)

    Matsuno Takeo

    2011-01-01

    Full Text Available Abstract Background Environmental factors, particularly commensal bacteria in the gastrointestinal tract, may be involved in the pathogenesis of rheumatoid arthritis (RA. The aim of this study was to evaluate whether natural milk antibodies against a wide spectrum of pathogenic enteromicobes and their toxins modify the disease activity in RA. Methods Twenty patients with RA, whose disease activity was uncontrolled by authentic medications due to drug resistance, complications and/or risk factors were treated for 3 months with an oral administration of a whey protein concentrate (WPC containing high levels of natural milk antibodies. Eighteen background-matched RA patients, not supplemented with milk antibody adjunct, were used as controls. Results Statistically significant reduction of arthritis symptoms and improvement of intestinal disorders were observed only in the test group: effective in 8 (44%, possibly effective in 2 (12% and not effective in 8 (44% of 18 patients treated (2 patients withdrew based on an ad hoc "evaluation point", the sum of variables that are improved more than 20% among the 8 core variables used for the American College of Rheumatology (ACR response criteria. This disease modifying effect of the WPC disappeared upon cessation of treatment, but was reappeared upon reintroduction of it. Importantly, 7 of 8 non-responders carry DR15 haplotype (DRB1-1501 and 1502, whereas only 1 of 7 responders was DR15 positive (risk ratio: 6.1. Furthermore, the pre-clinical serum anti-LPS and anti-type II collagen antibody levels in the responders were higher or tended to be higher than those in the non-responders, suggesting that there are 2 sub-types of RA based on an interaction between gastrointestinal pathogens and MHC class II haplotypes. Conclusions The natural milk antibody preparation containing high levels antibodies against pathogenic enteromicrobes and their toxins seems to be effective in a certain RA subset, and deserves

  4. Hyperbaric oxygen therapy as treatment for bilateral arm compartment syndrome after CrossFit: case report and literature review.

    Science.gov (United States)

    Mendes, Adriano Fernando; Neto, José da Mota; Heringer, Erica Maciel; de Simoni, Leandro Furtado; Pires, Diego Demolinari; Labronici, Pedro José

    2018-01-01

    CrossFit is a physical fitness program characterized by high-intensity workouts that can be associated with serious injury. Acute compartment syndrome in the upper limbs is a rare occurrence. It may occur after intense physical exercise, and its usual treatment is surgical. Hyperbaric oxygen therapy is a treatment described as adjunctive in cases of compartmental syndrome. We describe the case of a CrossFit practitioner who, after intense training, developed progressive symptoms of rhabdomyolysis and acute bilateral arm compartment syndrome, who was successfully treated with hyperbaric oxygen therapy and required no fasciotomy as surgical treatment. Acute compartment syndrome in the arms after intense physical exercise is a rare occurrence that should be suspected by practitioners of physical activity experiencing intense, disproportionate and progressive pain. In the case presented, hyperbaric oxygen therapy was successfully used in the treatment of the disorder, with satisfactory progress, and without the need for a surgical fasciotomy as therapy. Copyright© Undersea and Hyperbaric Medical Society.

  5. Treatment Integrity of Literacy Interventions for Students with Emotional and/or Behavioral Disorders: A Review of Literature

    Science.gov (United States)

    Griffith, Annette K.; Hurley, Kristin Duppong; Hagaman, Jessica L.

    2009-01-01

    This review examines the treatment integrity data of literacy interventions for students with emotional and/or behavioral disorders (EBD). Forty-four studies published between 1977 and 2005 were examined. Findings indicate that studies focusing on literacy interventions for students with EBD included clear operational definitions and data on…

  6. Negative-pressure in treatment of persistent post-traumatic subcutaneous emphysema with respiratory failure: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Jakov Mihanović

    2018-02-01

    Full Text Available Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published. We report on patient injured in a motor vehicle accident who had serial rib fractures and bilateral pneumothorax managed initially in another hospital. Due to respiratory deterioration, haemodynamic instability and renal failure patient was transferred to our Intensive Care Unit. Massive and persistent subcutaneous emphysema despite adequate thoracic drainage with respiratory deterioration and potentially injurious mechanical ventilation with high airway pressures was the indication for active surgical treatment. Negative-pressure wound therapy dressing was applied on typical blowhole incisions which resulted in swift emphysema regression and respiratory improvement. Negative pressure wound therapy for decompression of severe subcutaneous emphysema represents simple, effective and relatively unknown technique that deserves wider attention.

  7. What is the evidence for viscosupplementation in the treatment of patients with hip osteoarthritis? Systematic review of the literature

    NARCIS (Netherlands)

    van den Bekerom, Michel P. J.; Lamme, Bas; Sermon, An; Mulier, Michiel

    2008-01-01

    Osteoarthritis (OA) is a disease of the synovial joints and is the most common cause of chronic pain in the elderly. One of the treatment modalities for OA of the hip is viscosupplementation (VS). Today there are several different formulations of viscosupplements produced by different manufactures

  8. Physiotherapeutic methods in the treatment of heel spurs and inflammation of plantar fasciitis - a review of the literature

    Directory of Open Access Journals (Sweden)

    Mariola Monika Uczciwek

    2017-06-01

    Full Text Available For aim of this paper and analysis of the treatment methods in question articles from Pumbed basis were used. Pumbed basis, which works under the auspices of US National Library of  Medicine and National Institute of  Health, helped to analyze the treatment methods for chronic condition of heel spur and plantar fascia. The analytical process was based on  bibliographical descript. Results of 1204 numbers were summarized because of specialist criterion.  Heel spurs are bony growths growing out of the plantar fascia and other soft tissues lining nearby which conduct to the plantar fascia ignition. The occurrence of these is connected with burdensome feeling of pain that can be felt when making first steps after getting up in the morning. It is a serious condition that applies to more and more people. Being overweight, training sports straining feet are the reasons contributing to this condition. Yet, it is not a general rule for the risk group. Treating methods in this sphere give many opportunities for physical therapist and doctors. The best sustainable method is physical therapy supported by medical aids. However, not every case gives intended results. If the sustainable methods are not enough, the surgical treatment should be introduced. There is no doubt that any method of treatment is individually reclaimed by every patient.

  9. Minimally invasive endoscopic treatment of necrotizing pancreatitis: A case report with images and review of the literature

    Directory of Open Access Journals (Sweden)

    Cassia Lemos Moura

    Full Text Available Summary Necrotizing pancreatitis with fluid collections can occur as a complication of acute pancreatitis. The management of these patients depends on the severity and involves multiple medical treatment modalities, as clinical intensive care and surgical intervention. In this article, we show a severe case of walled-off pancreatic necrosis that was conducted by endoscopic drainage with great clinical outcome.

  10. Emergency surgical treatment of complicated acute pancreatitis after kidney transplantation with acute rejection: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Dušan Klos

    2016-06-01

    Conclusions: With regard to the patient's comorbidities, early surgical therapy was indicated – drainage and closed lavage and immunosuppressive medication as a suspected tobe ethiological factor was discontinued. This course of treatment led to a complete recovery with preservation of good function of the cadaverous kidney.

  11. Transcranial and spinal cord magnetic stimulation in treatment of spasticity: a literature review and meta-analysis.

    Science.gov (United States)

    Korzhova, Julia; Sinitsyn, Dmitry; Chervyakov, Alexander; Poydasheva, Alexandra; Zakharova, Maria; Suponeva, Natalia; Chernikova, Lyudmila; Piradov, Michael

    2018-02-01

    Spasticity is associated with various diseases of the nervous system. Current treatments such as drug therapy, botulinum toxin injections, kinesitherapy, and physiotherapy are not sufficiently effective in a large number of patients. Transcranial magnetic stimulation (TMS) can be considered as an alternative method of treatment. The purpose of this article was to conduct a systematic review and meta-analysis of all available publications assessing the efficacy of repetitive TMS in treatment of spasticity. Search for articles was conducted in databases PubMed, Willey, and Google. Keywords included "TMS", "spasticity", "TMS and spasticity", "non-invasive brain stimulation", and "non-invasive spinal cord stimulation". The difference in scores according to the Modified Ashworth Scale (MAS) for one joint before and after treatment was taken as the effect size. We found 26 articles that examined the TMS efficacy in treatment of spasticity. Meta-analysis included 6 trials comprising 149 patients who underwent real stimulation or simulation. No statistically significant difference in the effect of real and simulated stimulation was found in stroke patients. In patients with spinal cord injury and spasticity, the mean effect size value and the 95% confidence interval were -0.80 and (-1.12, -0.49), respectively, in a group of real stimulation; in the case of simulated stimulation, these parameters were 0.15 and (-0.30, -0.00), respectively. Statistically significant differences between groups of real stimulation and simulation were demonstrated for using high-frequency repetitive TMS or iTBS mode for the M1 area of the spastic leg (P=0.0002). According to the meta-analysis, the statistically significant effect of TMS in the form of reduced spasticity was demonstrated only for the developed due to lesions at the brain stem and spinal cord level. To clarify the amount of the antispasmodic effect of repetitive TMS at other lesion levels, in particular in patients with

  12. The potential role of vagus-nerve stimulation in the treatment of HIV-associated depression: a review of literature

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    Nicholson WC

    2017-06-01

    Full Text Available William C Nicholson, Mirjam-Colette Kempf, Linda Moneyham, David E Vance School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA Abstract: Depression is the most common comorbidity and neuropsychiatric complication in HIV. Estimates suggest that the prevalence rate for depression among HIV-infected individuals is three times that of the general population. The association between HIV and clinical depression is complex; however, chronic activation of inflammatory mechanisms, which disrupt central nervous system (CNS function, may contribute to this association. Disruptions in CNS function can result in cognitive disorders, social withdrawal, fatigue, apathy, psychomotor impairment, and sleep disturbances, which are common manifestations in depression and HIV alike. Interestingly, the parasympathetic system-associated vagus nerve (VN has primary homeostatic properties that restore CNS function following a stress or inflammatory response. Unfortunately, about 30% of adults with HIV are resistant to standard psychotherapeutic and psychopharmacological treatments for depression, thus suggesting the need for alternative treatment approaches. VN stimulation (VNS and its benefits as a treatment for depression have been well documented, but remain unexplored in the HIV population. Historically, VNS has been delivered using a surgically implanted device; however, transcutanous VNS (tVNS with nonsurgical auricular technology is now available. Although it currently lacks Food and Drug Administration approval in the US, evidence suggests several advantages of tVNS, including a reduced side-effect profile when compared to standard treatments and comparable results to implantable VNS in treating depression. Therefore, tVNS could offer an alternative for managing depression in HIV via regulating CNS function; moreover, tVNS may be useful for treatment of other symptoms common in HIV. From this, implications for nursing research and practice

  13. Ibrutinib Treatment of Mantle Cell Lymphoma Relapsing at Central Nervous System: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Donato Mannina

    2017-01-01

    Full Text Available Mantle cell lymphoma (MCL accounts for about 5% of all lymphomas. Its clinical and histological features are heterogeneous. After a frequently good initial response, the disease generally and repeatedly relapses and finally the outcome is poor. Particularly severe is the prognosis of the rare occurrence of CNSi (Central Nervous System involvement. Ibrutinib, an oral inhibitor of Bruton tyrosine kinase (BTK, has shown strong activity in relapsing patients with Chronic Lymphocytic Leukemia (CLL and MCL. Few reports are available about treatment with ibrutinib of patients presenting CNSi by lymphoproliferative diseases (LPD. In all of them, ibrutinib, at the dosage between 420 and 560 mg/day, showed an impressive effectiveness. Here we describe a case of MCL with CNS relapse showing an excellent response to ibrutinib administered at the unusual dose of 280 mg/day because of concomitant treatment of cardiological disease.

  14. Clinical Applications of S53P4 Bioactive Glass in Bone Healing and Osteomyelitic Treatment: A Literature Review

    Directory of Open Access Journals (Sweden)

    N. A. P. van Gestel

    2015-01-01

    Full Text Available Nowadays, S53P4 bioactive glass is indicated as a bone graft substitute in various clinical applications. This review provides an overview of the current published clinical results on indications such as craniofacial procedures, grafting of benign bone tumour defects, instrumental spondylodesis, and the treatment of osteomyelitis. Given the reported results that are based on examinations, such as clinical examinations by the surgeons, radiographs, CT, and MRI images, S53P4 bioactive glass may be beneficial in the various reported applications. Especially in craniofacial reconstructions like mastoid obliteration and orbital floor reconstructions, in grafting bone tumour defects, and in the treatment of osteomyelitis very promising results are obtained. Randomized clinical trials need to be performed in order to determine whether bioactive glass would be able to replace the current golden standard of autologous bone usage or with the use of antibiotic containing PMMA beads (in the case of osteomyelitis.

  15. Lamotrigine in the treatment of psychotic depression associated with hereditary coproporphyria -- case report and a brief review of the literature.

    Science.gov (United States)

    Takács, Rozália; Makkos, Zoltán; Kassai-Farkas, Ákos; Pusztai, Ágnes; Ungvári, Gábor S; Gazdag, Gábor

    2014-03-01

    We report a successful treatment with lamotrigine of a patient with hereditary coproporphyria presenting with affective and psychotic symptoms. M.F., a 38-year-old, single woman was admitted to an acute psychiatric ward because of suddenly emerging psychosis. Ms F's hereditary coproporphyria was diagnosed 9 years before the current admission. While on treatment with olanzapine (20mg/day) the psychotic symptoms have gradually disappeared. In view of her significant mood fluctuations predominantly with depressed phases, lamotrigine was started and titrated up to 125 mg/day. Ms F's mood gradually became euthymic, suicidal ideations and anxiety disappeared. At 5-month follow-up, while still on lamotrigine, her porphyria was asymptomatic. To the best of our knowledge, this is the first report about the safe administration of lamotrigine in hereditary coproporphyria. Lamotrigine did not trigger an acute porphyric attack as confirmed by clinical and laboratory findings.

  16. Arterial hypertension in Turner syndrome: a review of the literature and a practical approach for diagnosis and treatment.

    Science.gov (United States)

    De Groote, Katya; Demulier, Laurent; De Backer, Julie; De Wolf, Daniel; De Schepper, Jean; Tʼsjoen, Guy; De Backer, Tine

    2015-07-01

    Turner syndrome is a rare chromosomal disorder with complete or partial absence of one X chromosome that only occurs in women. Clinical presentation is variable, but congenital and acquired cardiovascular diseases are frequently associated diseases that add significantly to the increased morbidity and mortality in Turner syndrome patients. Arterial hypertension is reported in 13-58% of adult Turner syndrome patients and confers an increased risk for stroke and aortic dissection. Hypertension can be present from childhood on and is reported in one-quarter of the paediatric Turner syndrome patients. This article reviews the prevalence and cause of arterial hypertension in Turner syndrome and describes the relationship between blood pressure, aortic dilation and increased cardiovascular risk. We compare current treatment strategies and also propose an integrated practical approach for the diagnosis and treatment of hypertension in Turner syndrome applicable in daily practice.

  17. Antiangiogenic Therapy in the Treatment of Recurrent Medulloblastoma in the Adult: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Giuseppe Privitera

    2009-01-01

    Full Text Available Medulloblastoma is a rare tumor in central nervous system, with an even rarer occurrence in adulthood. The management of a recurrent disease is a medical challenge; chemotherapy has been used as the treatment of choice, while reirradiation has been employed in selected cases. We report the case of a 51-year-old man with recurrent medulloblastoma. He was treated with local reirradiation, chemotherapy, and antiangiogenic drug, with the latter giving the longer progression-free interval. The aim of this report is to show that recurrent medulloblastoma in adults can be approached with a multimodality treatment and that antiangiogenic therapy should have a role in the management of this disease.

  18. Diabetic ketoacidosis associated with atypical antipsychotic drug, clozapine treatment: Report of a case and review of literature

    OpenAIRE

    Pillai L; Husainy SMK; Ramchandani K

    2006-01-01

    Atypical antipsychotic drugs are associated with metabolic disturbances like weight gain, type 2 diabetes hyperglycaemia and dyslipedemia, which can result in serious health risk in patients. Diabetic ketoacidosis resulting in serious metabolic acidosis, occurring in a schizophrenic patient on treatment with clozapine is being reported to draw attention this association. Frequent monitoring of the blood sugar and lipids is advised before and during therapy with atypical antipsychotic drugs.

  19. Magnetic resonance imaging patterns of treatment-related toxicity in the pediatric brain: an update and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Rossi Espagnet, Maria Camilla; Longo, Daniela [Bambino Gesu Children' s Hospital, IRCCS, Neuroradiology Unit, Department of Imaging, Rome (Italy); Pasquini, Luca [Bambino Gesu Children' s Hospital, IRCCS, Neuroradiology Unit, Department of Imaging, Rome (Italy); Sant' Andrea Hospital, Sapienza University, NESMOS Department, Rome (Italy); Napolitano, Antonio [Bambino Gesu Children' s Hospital, IRCCS, Enterprise Risk Management, Medical Physics Department, Rome (Italy); Cacchione, Antonella; Mastronuzzi, Angela; Caruso, Roberta [Bambino Gesu Children' s Hospital, IRCCS, Department of Hematology/Oncology and Stem Cell Transplantation, Rome (Italy); Toma, Paolo [Bambino Gesu Children' s Hospital, IRCCS, Department of Imaging, Rome (Italy)

    2017-05-15

    Treatment-related neurotoxicity is a potentially life-threatening clinical condition that can represent a diagnostic challenge. Differentiating diagnoses between therapy-associated brain injury and recurrent disease can be difficult, and the immediate recognition of neurotoxicity is crucial to providing correct therapeutic management, ensuring damage reversibility. For these purposes, the knowledge of clinical timing and specific treatment protocols is extremely important for interpreting MRI patterns. Neuroradiologic findings are heterogeneous and sometimes overlapping, representing the compounding effect of the different treatments. Moreover, MRI patterns can be acute, subacute or delayed and involve different brain regions, depending on (1) the mechanism of action of the specific medication and (2) which brain regions are selectively vulnerable to specific toxic effects. This review illustrates the most common radiologic appearance of radiotherapy, chemotherapy and medication-associated brain injury in children, with special focus on the application of advanced MRI techniques (diffusion, perfusion and proton spectroscopy) in the diagnosis of the underlying processes leading to brain toxicity. (orig.)

  20. Treatment patterns of children with spine and spinal cord tumors: national outcomes and review of the literature.

    Science.gov (United States)

    Shweikeh, Faris; Quinsey, Carolyn; Murayi, Roger; Randle, Ryan; Nuño, Miriam; Krieger, Mark D; Patrick Johnson, J

    2017-08-01

    Tumors of the spine in children are rare, and further clinical description is necessary. This study investigated epidemiology, interventions, and outcomes of pediatric patients with spine and spinal cord tumors. The National Inpatient Sample and Kids' Inpatient Database were used for the study. Outcomes were studied, and bivariate significant trends were analyzed in a multivariate setting. Analysis of 2870 patients between 2000 and 2009 found a median age of diagnosis of 11 years (Tables 1 and 2). Most were white (65.2%) and had private insurance (62.3%), and 46.8% of procedures were emergent operations. Treatment occurred at teaching (93.6%) and non-children's hospitals (81.1%). Overall mortality rate was 1.7%, non-routine discharges occurred at a rate 19.9%, complications at 21.1%, and average total charges were $66,087. A majority of patients (87.5%) had no intervention, and of those patients receiving treatment, 78.2% underwent surgery and 23.1% had radiotherapy. Treatment with surgery alone increased significantly over time (p spine and spinal cord tumors in children. Notably, a higher mortality rate is evident over time in addition to an increase in the proportion of patients undergoing surgery. The high percentage of emergent operations suggests a weak recognition of spine tumors in children and should prompt a call for increased awareness of this cancer. In spite of these findings, lack of tumor type identification was a limitation to this study.

  1. Long-term use of adalimumab in the treatment of moderate to severe plaque psoriasis: a review of the literature

    Directory of Open Access Journals (Sweden)

    Angela Y Moore

    2010-04-01

    Full Text Available Angela Y Moore, Blakely S RichardsonArlington Center for Dermatology, Arlington, Texas, USAAbstract: Psoriasis is a chronic T-cell-mediated inflammatory disease that primarily affects the skin and joints. Patients with moderate to severe psoriasis constitute about 30% of the psoriasis population. Treatment of this group is challenging due to the long-term side effects, toxicities and inconvenience of conventional treatments such as phototherapy, methotrexate and cyclosporine. However, recent advances in our understanding of the pathogenesis of psoriasis have led to the popular use of biologics, which offer a safer, more convenient and effective targeted therapy. Adalimumab was originally approved for treating rheumatoid arthritis. Currently, adalimumab is also approved for treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy or when other systemic therapies are medically less appropriate. Since the onset of the use of biologics, there have been concerns over safety and efficacy when used as long-term therapy. This paper reviews all publications, posters and abstracts reporting original data on the efficacy and/or safety of adalimumab in patients treated for chronic plaque psoriasis for more than 1 year.Keywords: psoriasis, adalimumab, biologics

  2. Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review.

    Science.gov (United States)

    Lawrenz, Joshua M; Mesko, Nathan W; Higuera, Carlos A; Molloy, Robert M; Simpfendorfer, Claus; Babic, Maja

    2017-01-01

    Prosthetic joint infection is an unfortunate though well-recognized complication of total joint arthroplasty. An iliacus and/or iliopsoas muscle abscess is a rarely documented presentation of hip prosthetic joint infection. It is thought an unrecognized retroperitoneal nidus of infection can be a source of continual seeding of the prosthetic hip joint, prolonging attempts to eradicate infection despite aggressive debridement and explant attempts. The current study presents five cases demonstrating this clinical scenario, and discusses various treatment challenges. In each case we report the patient's clinical history, pertinent imaging, management and outcome. Diagnosis of the iliacus muscle abscess was made using computed tomography imaging. In brief, the mean number of total drainage procedures (open and percutaneous) per patient was 4.2, and outcomes consisted of one patient with a hip girdlestone, two patients with delayed revisions, and two patients with retained prosthesis. All patients ended with functional pain and on oral antibiotic suppression with an average follow up of 18 months. This article highlights an iliacus muscle abscess as an unrecognized source of infection to a prosthetic hip. It demonstrates resilience to standard treatment protocols for prosthetic hip infection, and is associated with poor patient outcomes. Aggressive surgical debridement appears to remain critical to treatment success, and early retroperitoneal debridement of the abscess should be considered.

  3. Cardiovascular Effects of Calcium Supplements

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    Ian R. Reid

    2013-07-01

    Full Text Available Calcium supplements reduce bone turnover and slow the rate of bone loss. However, few studies have demonstrated reduced fracture incidence with calcium supplements, and meta-analyses show only a 10% decrease in fractures, which is of borderline statistical and clinical significance. Trials in normal older women and in patients with renal impairment suggest that calcium supplements increase the risk of cardiovascular disease. To further assess their safety, we recently conducted a meta-analysis of trials of calcium supplements, and found a 27%–31% increase in risk of myocardial infarction, and a 12%–20% increase in risk of stroke. These findings are robust because they are based on pre-specified analyses of randomized, placebo-controlled trials and are consistent across the trials. Co-administration of vitamin D with calcium does not lessen these adverse effects. The increased cardiovascular risk with calcium supplements is consistent with epidemiological data relating higher circulating calcium concentrations to cardiovascular disease in normal populations. There are several possible pathophysiological mechanisms for these effects, including effects on vascular calcification, vascular cells, blood coagulation and calcium-sensing receptors. Thus, the non-skeletal risks of calcium supplements appear to outweigh any skeletal benefits, and are they appear to be unnecessary for the efficacy of other osteoporosis treatments.

  4. Acupuncture Therapy for the Treatment of Myelosuppression after Chemotherapy: A Literature Review over the Past 10 Years.

    Science.gov (United States)

    Fu, Hongwei; Chen, Bo; Hong, Shouhai; Guo, Yi

    2015-06-01

    The aim of this study is to review current studies on the effect of acupuncture therapy on bone marrow suppression after chemotherapy. The authors of the present paper have searched related literature over the past 10 years at home and abroad, analyzing the features and the effects of acupuncture therapy (including acupuncture, moxibustion, point injection, point application, etc.) for treating myelosuppression after tumor chemotherapy. We also discuss the year of publication, document type, acupuncture therapy, acupoint selection, and adverse effects with figures. We analyzed 159 articles related to acupuncture therapy from 2004 to 2013, and the analysis revealed that point injection was the most frequently used therapy for clinical applications, and that Zusanli (ST36) was the most frequently used acupoint. The results showed that some problems regarding the design method, acupoint selection, and acupuncture intervention measure existed in those research studies. We hope to provide readers with an overall and objective understanding of acupuncture and moxibustion therapy for treating myelosuppression after tumor chemotherapy. Copyright © 2015. Published by Elsevier B.V.

  5. Chondrosarcoma of the hyoid bone - Report of a case and a literature review of the suitable treatment strategy.

    Science.gov (United States)

    Maki, Daisuke; Mori, Taisuke; Teshima, Masanori; Kobayashi, Kenya; Matsumoto, Fumihiko; Sakai, Akihiro; Okami, Kenji; Yoshimoto, Seiichi

    2017-10-01

    Chondrosarcoma is a rare malignant tumor occurring in the trunk and long bones. We present an extremely rare case of chondrosarcoma of the hyoid bone with clinical and pathological correlation and a literature review. We searched all cases of the hyoid chondrosarcoma in PubMed (MEDLINE) between 1990 and 2015. Eighteen cases were analyzed, including the present case. Most of them were low grade type. In 12 cases where intraoperative findings were recorded, no adhesion to the surrounding tissue was observed. Chondrosarcoma of the hyoid bone is usually low grade type, and there may be no invasion to the adjacent structures even if invasion is suspected by imaging findings. In order to preserve swallowing and laryngeal function, total hyoidectomy without laryngectomy should be indicated according to the intraoperative findings. Needle biopsy is an effective diagnostic technique, but open biopsy should be avoided to prevent the dissemination. To the best of our knowledge, this is the first presentation of hyoid bone chondrosarcoma with the investigation of intraoperative findings and pre-operative diagnostic modality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Composição química e eficácia da multimistura como suplemento dietético: revisão da literatura Chemical composition and efficacy of the multimixture as a dietary supplement: a literature review

    Directory of Open Access Journals (Sweden)

    Haroldo Silva Ferreira

    2010-10-01

    absorption of iron. Its use increases the fiber content of the diet, which can reduce the absorption of nutrients, which is not interesting in the case of malnourished children. Its high amount of phytate seems to be no problem because the prior treatment to which the bran is submitted reduces the chelating power of this compound. The possibility of poisoning by cyanide come from the cassava leaf is not discarded. Regarding the ability to promote the nutritional state, 12 out of 15 studies concluded its ineffectiveness. Considering risks and benefits and the available evidence in the literature, is not justified the use of MM as a strategy for prevention and control of malnutrition.

  7. Gonadal toxicity of Hodgkin lymphoma treatment in adolescents and young males: issue relevance and ways of solve (literature review

    Directory of Open Access Journals (Sweden)

    A. A. Vinokurov

    2011-01-01

    Full Text Available Hodgkin`s Lymphoma (HL is one of the most curable cancer disease. A half of all patients are young males under 35 years old. Gonadal toxicity is one of the most frequent late effects of HL therapy and associated with significant decrease in patient’s quality of life. In present article frequency and risk factors of gonadal toxicity in males with HL were summarized. It was shown that chemotherapy with alkylating agents and radiotherapy may lead to gonadal toxicity in significant number of patients. Current possibilities of semen cryopreservation before start of the treatment are discussed.

  8. Gonadal toxicity of Hodgkin lymphoma treatment in adolescents and young males: issue relevance and ways of solve (literature review

    Directory of Open Access Journals (Sweden)

    A. A. Vinokurov

    2014-07-01

    Full Text Available Hodgkin`s Lymphoma (HL is one of the most curable cancer disease. A half of all patients are young males under 35 years old. Gonadal toxicity is one of the most frequent late effects of HL therapy and associated with significant decrease in patient’s quality of life. In present article frequency and risk factors of gonadal toxicity in males with HL were summarized. It was shown that chemotherapy with alkylating agents and radiotherapy may lead to gonadal toxicity in significant number of patients. Current possibilities of semen cryopreservation before start of the treatment are discussed.

  9. Surgical treatment of neglected hip fracture in children with cerebral palsy: case report and review of the literature.

    Science.gov (United States)

    Toro, Giuseppe; Moretti, Antimo; Toro, Gabriella; Tirelli, Assunta; Calabrò, Giampiero; Toro, Antonio; Iolascon, Giovanni

    2017-01-01

    A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients.

  10. Giant renal artery pseudoaneurysm caused by rupture of renal angiomyolipoma following pregnancy: Endovascular treatment and review of the literature

    Directory of Open Access Journals (Sweden)

    Ilkay S Idilman

    2014-01-01

    Full Text Available Renal angiomyolipoma is a hamartomatous, benign tumor composed of blood vessels, fatty tissue and smooth muscle cells, and is often detected incidentally. It can also be associated with the tuberous-sclerosis complex (TSC. Pregnancy and use of oral contraceptives are known to be associated with an increased risk of tumoral rupture and bleeding. Herein, we report a unique case of renal angiomyolipoma associated with TSC who presented with hypovolemic shock as a result of spontaneous rupture of a giant renal pseudoaneurysm, immediately after pregnancy. Emergency endovascular treatment was successful with sparing of most of the affected kidney as demonstrated by follow-up computed tomography imaging.

  11. Benfotiamine and Alpha-Lipoic Acid in the Treatment of Diabetic Cardiovascular Autonomic Neuropathy (Review of Literature and Own Researches

    Directory of Open Access Journals (Sweden)

    V.O. Sergiyenko

    2014-04-01

    Full Text Available The analysis of current views on the mechanisms of fat-soluble form of vitamin B1 (benfotiamine and α-lipoic acid action, in particular features of their impact on carbohydrate and lipid metabolism, endothelial function, hemodynamics, vessel stiffness in cardiovascular diseases, cardiovascular autonomic neuropathy in type 2 diabetes mellitus, was perfomed. The results of experimental, randomized and own studies confirmed the value of the combined administration of benfotiamine and α-lipoic acid for the prevention and treatment of cardiovascular diseases, in particular cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus.

  12. Cryosurgical treatment of warts: dimethyl ether and propane versus liquid nitrogen - case report and review of the literature.

    Science.gov (United States)

    Nguyen, Nicholas V; Burkhart, Craig G

    2011-10-01

    For years, dermatologists have relied on cryotherapy with liquid nitrogen as a safe and effective treatment for warts. More recently, several over-the-counter (OTC) wart-freezing therapies have become available. Manufacturers have substituted liquid nitrogen with dimethyl ether and propane (DMEP), and marketed these new preparations to be safe and effective alternatives to in-office cryotherapy with liquid nitrogen. However, data from in vitro studies and comparative studies in humans refute manufacturers' claims that these products reproduce in-office cryotherapy.

  13. Erlotinib usage after prior treatment with gefitinib in advanced non-small cell lung cancer: A clinical perspective and review of published literature.

    Science.gov (United States)

    Singh, Navneet; Jindal, Aditya; Behera, Digambar

    2014-12-10

    Erlotinib and gefitinib are among the most widely researched, used and available molecularly targeted therapies for treatment of advanced non-small cell lung cancer (NSCLC). They are both tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR). In the past decade, there have been reports on clinical benefit from use of erlotinib after gefitinib failure in NSCLC patients. A review of published literature on this focussed topic is provided herein. Pooled analysis of published literature shows that majority of patients were female (60.6%), non-smokers (64.5%), had adenocarcinoma histology (88.3%) and were of East Asian ethnicity (92.3%). Presence of sensitizing EGFR mutation was detected in 48.4% of subjects. Disease control rates with prior gefitinib therapy and with subsequent erlotinib treatment were 79.4% and 45.4% respectively. Based upon our review, the most important predictive factor for clinical benefit from erlotinib identified was previous response to gefitinib. The exact explanations for the potential benefit from erlotinib use in this patient population is still not known and further studies are required to determine the role of molecular mechanisms especially those related to resistance to initial EGFR TKI therapy.

  14. Major destructive asymptomatic lumbar Charcot lesion treated with three column resection and short segment reconstruction. Case report, treatment strategy and review of literature.

    Science.gov (United States)

    Valancius, Kestutis; Garg, Gaurav; Duicu, Madalina; Hansen, Ebbe Stender; Bunger, Cody

    2017-01-01

    Charcot's spine is a long-term complication of spinal cord injury. The lesion is often localized at the caudal end of long fusion constructs and distal to the level of paraplegia. However, cases are rare and the literature relevant to the management of Charcot's arthropathy is limited. This paper reviews the clinical features, diagnosis, and surgical management of post-traumatic spinal neuroarthropathy in the current literature. We present a rare case of adjacent level Charcot's lesion of the lumbar spine in a paraplegic patient, primarily treated for traumatic spinal cord lesion 39 years before current surgery. We have performed end-to-end apposition of bone after 3 column resection of the lesion, 3D correction of the deformity, and posterior instrumentation using a four-rod construct. Although the natural course of the disease remains unclear, surgery is always favorable and remains the primary treatment modality. Posterior long-segment spinal fusion with a four-rod construct is the mainstay of treatment to prevent further morbidity. Our technique eliminated the need for more extensive anterior surgery while preserving distal motion. © The Authors, published by EDP Sciences, 2017.

  15. Major destructive asymptomatic lumbar Charcot lesion treated with three column resection and short segment reconstruction. Case report, treatment strategy and review of literature

    Directory of Open Access Journals (Sweden)

    Valancius Kestutis

    2017-01-01

    Full Text Available Charcot's spine is a long-term complication of spinal cord injury. The lesion is often localized at the caudal end of long fusion constructs and distal to the level of paraplegia. However, cases are rare and the literature relevant to the management of Charcot's arthropathy is limited. This paper reviews the clinical features, diagnosis, and surgical management of post-traumatic spinal neuroarthropathy in the current literature. We present a rare case of adjacent level Charcot's lesion of the lumbar spine in a paraplegic patient, primarily treated for traumatic spinal cord lesion 39 years before current surgery. We have performed end-to-end apposition of bone after 3 column resection of the lesion, 3D correction of the deformity, and posterior instrumentation using a four-rod construct. Although the natural course of the disease remains unclear, surgery is always favorable and remains the primary treatment modality. Posterior long-segment spinal fusion with a four-rod construct is the mainstay of treatment to prevent further morbidity. Our technique eliminated the need for more extensive anterior surgery while preserving distal motion

  16. What is the impact of innovation on output in healthcare with a special focus on treatment innovations in radiotherapy? A literature review.

    Science.gov (United States)

    Jacobs, Maria; Boersma, Liesbeth; Dekker, Andre; Swart, Rachelle; Lambin, Philippe; de Ruysscher, Dirk; Verhaegen, Frank; Stultiens, Joost; Ramaekers, Bram; van Merode, Frits

    2017-11-01

    To analyse how often innovations in healthcare are evaluated regarding output, especially in radiotherapy. Output was defined as either survival, toxicity, safety, service, efficiency or cost-effectiveness. A systematic literature review was conducted, using three search strategies: (1) innovations in general healthcare; (2) radiotherapy-specific innovations, i.e. organizational innovations and general implementation of innovations; (3) innovations per tumour group/radiotherapy technique. Scientific levels were classified according to the system used in European Society for Medical Oncology guidelines. Finally, we calculated the percentage of implemented innovations in Dutch radiotherapy centres for which we found evidence regarding output in the literature review. Only 94/1072 unique articles matched the inclusion criteria. Significant results on patient outcome, service or safety were reported in 65% of papers, which rose to 76% if confined to radiotherapy reviews. A significant technological improvement was identified in 26%, cost-effectiveness in 10% and costs/efficiency in 36% of the papers. The scientific level of organizational innovations was lower than that of clinical papers. Dutch radiotherapy treatment innovations were adequately evaluated on outcome data before implementation in clinical routine in a minimum of 64-92% of cases. Only few studies report on output when considering innovations in general, but radiotherapy reviews give a reasonably good insight into innovation output effects, with a higher level of evidence. In Dutch radiotherapy centres only small improvements are possible regarding evaluation of treatment innovations before implementation. Advances in knowledge: This study is the first of its kind measuring how innovations are evaluated in scientific literature, before implementation in clinical practice.

  17. The added value of mifepristone to non-surgical treatment regimens for uterine evacuation in case of early pregnancy failure: a systematic review of the literature.

    Science.gov (United States)

    van den Berg, Joyce; Gordon, Bernardus B M; Snijders, Marcus P M L; Vandenbussche, Frank P H A; Coppus, Sjors F P J

    2015-12-01

    Early pregnancy failure (EPF) is a common complication of pregnancy. Surgical intervention carries a risk of complications and, therefore, medical treatment appears to be a safe alternative. Unfortunately, the current medical treatment with misoprostol alone has complete evacuation rates between 53% and 87%. Some reports suggest that sequential treatment with mifepristone and misoprostol leads to higher success rates than misoprostol alone. To evaluate the added value of mifepristone to current non-surgical treatment regimens in women with EPF we performed a systematic literature search. Electronic databases were searched: PubMed, Cochrane Library, Current Controlled Trials, and ClinicalTrials.gov. Clinical studies, both randomised and non-randomised trials, reporting on the added value of mifepristone to current non-surgical treatment regimens in women with EPF were included. Data of sixteen studies were extracted using a data extraction sheet (based on the Cochrane Consumers and Communication Review Group's data extraction template). The methodological quality was assessed using the Cochrane Collaboration Risk of Bias tool. In five randomised and eleven non-randomised trials, success rates of sequential treatment with mifepristone and misoprostol in case of EPF varied between 52% and 95%. Large heterogeneity existed in treatment regimens and comparators between studies. The existing evidence is insufficient to draw firm conclusions about the added va