Comparison of Different Treatment Modalities and Treatment Algorithm for Esophageal Achalasia

2019 ◽  
pp. 91-102
Author(s):  
Nicolás H. Dreifuss ◽  
Francisco Schlottmann ◽  
Marco Di Corpo ◽  
Marco G. Patti
Keyword(s):  
Treatment Algorithm ◽  
Esophageal Achalasia ◽  
Treatment Modalities

Systemic Monotherapy Treatments for Generalized Pustular Psoriasis: A Systematic Review

2018 ◽  
Vol 22 (6) ◽  
pp. 591-601 ◽  
Author(s):  
Linghong Linda Zhou ◽  
Jorge R. Georgakopoulos ◽  
Arvin Ighani ◽  
Jensen Yeung
Keyword(s):  
Treatment Options ◽  
Treatment Algorithm ◽  
Pustular Psoriasis ◽  
Treatment Modalities ◽  
High Morbidity ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Treatment Regimens ◽  
Generalized Pustular Psoriasis ◽  
Pubmed Search

Generalized pustular psoriasis (GPP) is a rare but serious and difficult to treat cutaneous disease, with high morbidity and mortality rates. Despite the numerous treatment regimens available, the overall quality of evidence-based research is limited with a lack of an algorithmic approach available. In this review, we aim to evaluate the current level of evidence regarding the efficacy and safety/tolerability of systemic monotherapies available in the treatment of GPP. A comprehensive MEDLINE, EMBASE, and PubMed search of clinical studies examining systemic monotherapy treatment options for GPP was conducted. In total, 31 studies met eligibility criteria. Described treatment modalities included retinoids, cyclosporine, biologics, and dapsone. Despite the lack of high-quality evidence or a well-accepted treatment algorithm for GPP, systemic retinoids, cyclosporine, biologics, and dapsone are all possible first-line agents, with retinoids being one of the best-supported treatment options and biologics as an emerging therapeutic field with great potential requiring additional data. However, the final choice of treatment should be considered within the unique context of each patient.

Combining Chemotherapy with Immunotherapy in Colorectal Cancer: A Review

2020 ◽  
Vol 07 ◽  
Author(s):  
John Thomas Palathingal ◽  
Basil Sunny ◽  
Vismaya Vijayan
Keyword(s):  
Colorectal Cancer ◽  
Time Window ◽  
Positive Impact ◽  
Combined Treatment ◽  
Treatment Algorithm ◽  
Treatment Modalities ◽  
Cancer Society ◽  
Treatment Techniques ◽  
Comprehensive Knowledge

Abstract:: American Cancer Society estimates that about 1 in 21 men and 1 in 23 women in US will develop colorectal cancer during their lifetime. Due to the advances in screening and treatment modalities, the mortality rate has reduced. Rising resistance to treatment have directed the focus towards different approaches as combination therapies involving different treatment techniques available. One such approach is chemo-immunotherapy that targets to modulate TIME and improve the response to immunotherapy. The chemo-immunotherapy has shown a positive impact in improving the outcome of CRC treatment. The ensemble of results discussed herein supports the role of biomarkers in determining the most effective treatment algorithm. A comprehensive knowledge about the off-target effects of the cytotoxic drugs helps in designing more efficacious combined treatment. The time-window for optimal combination must also be considered carefully.

ACLS Guidelines 2000: Focus on What’s “New” in the Pulseless Ventricular Tachycardia/Ventricular Fibrillation Algorithm

2002 ◽  
Vol 15 (4) ◽  
pp. 334-343
Author(s):  
Cynthia A. Sanoski
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Life Support ◽  
Treatment Algorithm ◽  
Treatment Modalities ◽  
Evidence Based ◽  
Probability Of Survival ◽  
Intravenous Amiodarone ◽  
Life Threatening

Despite the use of conventional treatment modalities, the probability of survival for patients experiencing cardiac arrest due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) remains quite poor. Therefore, the management of cardiac arrest remains a challenge. The most recent Advanced Cardiovascular Life Support (ACLS) guidelines have adopted an evidence-based approach toward the treatment of pulseless VT/VF. A number of evidence-based changes have been made in the treatment algorithms for these life-threatening arrhythmias, including the new recommendations for using vasopressin and intravenous amiodarone. This article will provide an overview of the evidence-based approach that was used in the development of the 2000 ACLS guidelines and will summarize the key trials that were used to support the inclusion of vasopressin and intravenous amiodarone in the pulseless VT/VF treatment algorithm. Additionally, dosing and administration issues for these agents will be discussed.

Therapeutic Management of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Treatment Algorithm

2020 ◽  
pp. 119-134
Author(s):  
Rafat Zreiq ◽  
Najoua Haouas ◽  
Asma M. Khemakhem ◽  
Rawan M. Obeidat ◽  
Reem M. Ali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Algorithm ◽  
Treatment Modalities ◽  
Cure Rate ◽  
Randomized Controlled ◽  
Therapeutic Algorithm ◽  
Significant Comparison ◽  
Being There ◽  
Third Line ◽  
Passive Antibody Transfer

Coronavirus disease 2019 (COVID-19) is emerging contagious pneumonia due to the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It initially appeared in Wuhan China in December 2019 then rapidly spread worldwide and became a pandemic. For the time being, there is no specific therapeutic treatment for this disease. Herein, the "state-of-the-art" of treatment modalities was systematically reviewed and ultimately a practical therapeutic algorithm for the COVID-19 management was proposed. The systematic review was performed by using published articles retrieved from Science Direct, MEDLINE, and Scopus databases concerning this topic. Among 1060 articles collected from the different databases, 19 publications were studied in-depth and incorporated in this review. The most three frequently used medications for the treatment of COVID-19 was: the available anti-viral drugs (n= 9), the antimalarial hydroxychloroquine or chloroquine (n = 8), and the passive antibody transfer therapy (n = 2). Among all treatment modalities, antimalarial hydroxychloroquine ranked the highest cure rate. Therefore, this drug is considered as the first‐line of COVID-19 treatment. The second‐line treatment includes the lopinavir/ritonavir drugs combined with interferon β-1b and ribavirin. Finally, the third‐line treatments include the remdesivir drug and passive antibody transfer therapy. However, our review emphasis the urgent need for adequately designed randomized controlled trials, enabling a more significant comparison between the most used treatment modalities.

Histoplasmosis of the Upper Extremities: Clinical Case, Treatment Algorithm, and Systematic Review

Hand ◽  
2020 ◽  
pp. 155894472091121
Author(s):  
Maria T. Huayllani ◽  
David J. Restrepo ◽  
Daniel Boczar ◽  
Andrea Sisti ◽  
Brian D. Rinker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Treatment Algorithm ◽  
Clinical Signs ◽  
Upper Extremities ◽  
Treatment Modalities ◽  
Treatment Recommendation ◽  
Persistent Symptoms ◽  
Tunnel Syndrome

Background: Histoplasmosis of the upper extremities is extremely rare, and there is no consensus in its management. The aim of this study was to present a case report and literature review of histoplasmosis in the upper extremities to provide the best treatment recommendation and to increase awareness of this disease. Methods: A systematic review of the literature was performed in PubMed, MEDLINE, and EMBASE databases with the search terms “(Tenosynovitis AND histoplasmosis)” OR “(Upper limbs AND histoplasmosis)” OR “(Upper extremities AND histoplasmosis)” OR “((finger OR arm OR hand OR forearm OR wrist) AND histoplasmosis).” Manuscripts were included in the study if they described diagnosis of histoplasmosis in the bone, joint, synovia, or tendons of the upper extremities. Results: In all, 14 manuscripts and 15 cases of histoplasmosis of the upper extremities from 1992 to 2015 met the inclusion criteria. Eight (53.3%) patients were diagnosed with tenosynovitis, 5 (33.3%) with osteomyelitis, 1 (6.7%) with carpal tunnel syndrome, and 1 (6.7%) with joint wrist abscess. Immunosuppression, travel history, previous diagnosis with histoplasmosis, and persistent symptoms may suggest infectious causes. Surgery and medical treatment together are recommended to optimize outcomes compared with single treatment alone. Conclusions: Histoplasmosis of the upper extremities may have various clinical presentations, including tenosynovitis, osteomyelitis, carpal tunnel syndrome, and joint wrist abscess. The type of surgical approach may depend on the etiology of disease. Increased awareness and knowledge of the clinical signs, symptoms, and effective treatment modalities will help decrease possible complications, such as tendon rupture and functional impairment of the upper extremities.

Posterior Tibial Artery Pseudoaneurysm with Arteriovenous Fistula: Impact of Duplex Ultrasound on Diagnosis and Treatment

2017 ◽  
Vol 41 (1) ◽  
pp. 31-35
Author(s):  
Keith Himes ◽  
Amanda Bornais ◽  
Emelia Bittenbinder ◽  
Judith Cook
Keyword(s):  
Treatment Algorithm ◽  
Duplex Ultrasound ◽  
Posterior Tibial Artery ◽  
Diagnosis And Treatment ◽  
Treatment Modalities ◽  
Artery Pseudoaneurysm ◽  
Post Traumatic ◽  
Orthopedic Injuries ◽  
Venous Fistula

Post traumatic peripheral vascular injuries resulting in pseudoaneurysm (PSA) or arterial venous fistula (AVF) are rarely reported and may occur independently, or less commonly, concomitantly, following lower extremity fractures, penetrating or blunt trauma, and sports-related or orthopedic injuries. 1 Concomitant traumatic PSA and AVF requires accurate imaging and evaluation of hemodynamics for accurate diagnosis and treatment. Modalities for PSA repair include ultrasound-guided occlusion (thrombin injection), endovascular repair (coils, stents), and open surgical procedures (repair, ligation). A coexisting AVF can potentially impact the efficacy and safety of these options. This case demonstrates the important role of duplex ultrasound in the diagnosis and treatment algorithm of traumatic PSA.

scholarly journals Beyond Chemotherapy, PD-1, and HER-2: Novel Targets for Gastric and Esophageal Cancer

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4322
Author(s):  
Ali Zubair Siddiqui ◽  
Khaldoun Almhanna
Keyword(s):  
Esophageal Cancer ◽  
Growth Factor ◽  
Patient Population ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Growth Factor Receptor ◽  
Incidence Rates ◽  
Treatment Modalities ◽  
Her 2 ◽  
Endothelial Growth Factor

Together, gastric cancer and esophageal cancer (EC) possess two of the highest incidence rates amongst all cancers. They exhibit poor prognoses in which the 5-year survival rate is dismal. In addition to cytotoxic chemotherapy, treatment efforts have been geared toward targeting human epidermal growth factor receptor 2 (HER-2), vascular endothelial growth factor (VEGF), and programmed death ligand-1 (PD-1). Although ample success has been recorded with these agents, gastric and esophageal cancer remain lethal, and further research into potential treatment alternatives is needed. In this article, we will review some of the targets at the forefront of investigation such as claudin, Dickkopf-related protein 1 (DKK-1), fibroblast growth factor receptor (FGFR), and matrix metalloproteinases (MMPs). These innovative target pathways are in the midst of clinical trials to be implemented in the treatment algorithm for this patient population. Ultimately, exploiting the oncogenic tendencies of these potential biomarkers creates an opportunity for precise treatment and improved prognosis for these cancers. Lastly, research aimed toward reversing PD-1 antibodies resistance by combining it with other novel agents or other treatment modalities is underway in order to expand existing treatment options for this patient population.

scholarly journals Diagnosis and treatment in primary bladder small cell carcinoma: Literature review

2016 ◽  
Vol 88 (1) ◽  
pp. 52 ◽  
Author(s):  
Orcun Celik ◽  
Gokhan Ekin ◽  
Tumay Ipekci ◽  
Salih Budak ◽  
Yusuf Ozlem Ilbey
Keyword(s):  
Bladder Cancer ◽  
Bladder Carcinoma ◽  
Treatment Algorithm ◽  
Small Cell ◽  
Treatment Modalities ◽  
Urothelial Bladder Cancer ◽  
Fatal Disease ◽  
Urothelial Bladder ◽  
Primary Bladder ◽  
Worse Prognosis

Small cell bladder carcinoma is a rare and frequently fatal disease. It can be distinguished from classical urothelial carcinoma microscopically and immunohistochemically. Small cell bladder carcinoma has histologically similar properties with other small cell carcinomas in other organs. It has a worse prognosis when compared to urothelial bladder cancer. Multimodal treatments are recommended although there is no widely accepted consensus regarding to the treatment algorithm because of its rarity. In this review, clinical properties and diagnosis of small cell bladder carcinoma, its histopathological and immunohistochemical properties and treatment modalities are examined.

scholarly journals Endovascular treatment of bilateral intracranial vertebral artery aneurysms: an algorithm based on a 10-year neurointerventional experience

2020 ◽  
Vol 5 (3) ◽  
pp. 291-301
Author(s):  
Yisen Zhang ◽  
Zhongbin Tian ◽  
Wei Zhu ◽  
Jian Liu ◽  
Yang Wang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Treatment Algorithm ◽  
High Volume ◽  
Single Stage ◽  
Treatment Modalities ◽  
Complete Obliteration ◽  
Aneurysm Growth

BackgroundThe management of bilateral intracranial vertebral artery dissecting aneurysms (IVADAs) is controversial, and requires the development of endovascular treatment modalities and principles. We aim to investigate the endovascular treatment strategy and outcomes of bilateral IVADAs.MethodsWe identified all bilateral IVADAs at a high-volume neurointerventional centre over a 10-year period (from January 2009 to December 2018). Radiographic and clinical data were recorded, and a treatment algorithm was derived.ResultsTwenty-seven patients with bilateral IVADAs (54 IVADAs in total, 51 unruptured, 3 ruptured) were diagnosed. Four patients (14.8%) received single-stage endovascular treatment, 12 patients (44.4%) with staged endovascular treatment and 11 patients (40.8%) with unilateral endovascular treatment of bilateral IVADAs. Thirty-six IVADAs (85.7%) have complete obliteration at the follow-up angiography. Two of three ruptured IVADAs with stent-assisted coiling recanalised, and had further recoiling. Three patients (11.1%) have intraprocedural or postprocedural complications (two in single-stage and one in staged). Twenty-five patients (92.6%) had a favourable clinical outcome, and two patients (7.4%, all in single-stage) showed an unfavourable clinical outcome at follow-up. For the patients with unilateral reconstructive endovascular treatment, the contralateral untreated IVADAs were stable and had no growth or ruptured during follow-up period. None of all IVADAs had rebleeding during the clinical follow-up.ConclusionsEndovascular treatment can be performed in bilateral IVADAs with high technical success, high complete obliteration rates and acceptable morbidity/mortality. Contralateral IVADAs had low rates of aneurysm growth and haemorrhage when treated in a staged/delayed fashion.

scholarly journals Facial Nerve Trauma: Evaluation and Considerations in Management

2015 ◽  
Vol 8 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Eli Gordin ◽  
Thomas S. Lee ◽  
Yadranko Ducic ◽  
Demetri Arnaoutakis
Keyword(s):  
Facial Nerve ◽  
Primary Repair ◽  
Botulinum Toxin Injection ◽  
Treatment Algorithm ◽  
Nerve Transfer ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Motor End Plates ◽  
Facial Nerve Anatomy ◽  
New Treatment

The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit. Adjunctive tools such as botulinum toxin injection and biofeedback can be helpful. Several new treatment modalities lie on the horizon which hold potential to alter the current treatment algorithm.

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