Treatment failure in trichomoniasis and persistance of the parasite after Lactobacillus immunotherapy; two case reports

1990 ◽  
Vol 34 (1-2) ◽  
pp. 171-178 ◽  
Author(s):  
R.M.F. van der Weiden ◽  
W.I. van der Meijden ◽  
D.H. Bogchelman ◽  
A.M. Polderman
Keyword(s):  
Treatment Failure ◽  
Case Reports

Challenges in Treating Chlamydia trachomatis, Including Rectal Infections: Is It Time to Go Back to Doxycycline?

2021 ◽  
pp. 106002802110299
Author(s):  
S. Lena Kang-Birken
Keyword(s):  
Chlamydia Trachomatis ◽  
Treatment Failure ◽  
English Language ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Controlled Trial ◽  
Absolute Difference ◽  
Cochrane Library ◽  
Increased Risk ◽  
Meta Analyses

Objective: To evaluate recent publications on efficacy of single-dose azithromycin and 7-day doxycycline when treating Chlamydia trachomatis. Data Sources: A literature search of MEDLINE, EMBASE, PubMed, and Cochrane library was conducted (1990 to June 13, 2021) using the terms: Chlamydia trachomatis, genital chlamydia, rectal chlamydia, extragenital chlamydia, azithromycin, doxycycline, and treatment guidelines. ClinicalTrials.gov was searched to identify ongoing trials. Study Selection and Data Extraction: English language studies, including controlled studies, retrospective analyses, systematic reviews, meta-analyses, and case reports, reporting microbiological or clinical outcomes in adolescents and adults were considered. Data Synthesis: Systemic reviews and meta-analyses of randomized trials reported azithromycin efficacy of 96% to 97% in genital chlamydia. However, reports of treatment failure have emerged, especially among symptomatic males, with an increased risk of microbiological failure after azithromycin than doxycycline (relative risk = 2.45; 95% CI = 1.36-4.41). Retrospective analyses and prospective observational cohort studies reported lower efficacy range following azithromycin than doxycycline (74%-87% vs 92%-100%, respectively) in rectal chlamydia. First randomized controlled trial comparing azithromycin and doxycycline reported significantly higher microbiological cure following doxycycline, with absolute difference of 26% (95% CI = 16%-36%; P < 0.001). The proposed 2021 Centers for Disease Control and Prevention treatment guidelines designate doxycycline as the preferred agent for treatment at any site. Relevance to Patient Care and Clinical Practice: A growing body of evidence for treatment failure following azithromycin, especially in rectal chlamydia supports updating current practice. Conclusions: Doxycycline continues to achieve high efficacy in genital and rectal chlamydia. Clinicians should consider efficacy with convenience of dosing regimen, medication compliance, and sexual behavior risks when treating chlamydia infections.

scholarly journals Resistance Mutations A30K and Y93N Associated with Treatment Failure with Sofosbuvir and Daclatasvir for Hepatitis C Virus Infection Non-Responder Patients: Case Reports

Viruses ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 1004
Author(s):  
Vanessa D. Costa ◽  
Patricia Pellegrini ◽  
Vivian Rotman ◽  
Ana Maria Pittella ◽  
Estevão P. Nunes ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Failure ◽  
Case Reports ◽  
Rescue Therapy ◽  
Combined Therapy ◽  
Virologic Response ◽  
Resistance Mutations ◽  
Viral Determinants ◽  
Direct Acting

In Brazil, hepatitis C treatment has been evolving significantly with the licensing of direct-acting antivirals (DAAs). However, viral determinants (amino acid substitutions in hepatitis C virus (HCV) genome and infective genotype) associated with host factors (hepatic condition and prior HCV therapy) might limit the achievement of sustained virologic response (SVR). Here, we described two case reports in which the occurrence of HCV NS5A mutations A30K (subtype 3a) and Y93N (subtype 1a) might have influenced daclatasvir (DCV)/sofosbuvir (SOF) combined therapy non-response. Despite high response rates for DAA combined therapies in Brazil, these case reports stated the importance of an investigation about how to manage a DAA treatment failure since a combination of factors, especially the occurrence of resistance substitutions, could impact a rescue therapy with new available antivirals in clinical routine.

Randomized phase II trial of intravenous ascorbic acid (AA) as an adjunct to pazopanib for metastatic and unresectable clear cell renal cell carcinoma (ccRCC): A study of Academic and Community Cancer Research United (ACCRU) GU1703.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. TPS679-TPS679
Author(s):  
Niraj Konchady Shenoy ◽  
Fang-Shu Ou ◽  
John C. Cheville ◽  
Tushar Bhagat ◽  
Benjamin Adam Gartrell ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Case Reports ◽  
Alternative Therapy ◽  
Dehydroascorbic Acid ◽  
Epigenetic Mechanism ◽  
H2o2 Production ◽  
Type I ◽  
Cell Renal Cell Carcinoma ◽  
High Iron Content ◽  
Anti Cancer

TPS679 Background: AA has re-emerged as a promising anti-cancer agent based on recent knowledge of pharmacokinetics, discovery of unexpected mechanisms of action, and early phase trials with IV AA.(Shenoy et al, Cancer Cell 34: 2018, in press) We hypothesized that ccRCC would be particularly susceptible to anti-cancer effects of IV AA due to: a. TET dependent demethylation of the hypermethylated genome of ccRCC causing re-expression of tumor suppressors (Shenoy et al, AACR 2018 Targeting DNA methylation conf. A11; Hu et al, Clin Cancer Res 20:4349-60, 2014) b. H2O2 production causing intra-tumoral oxidative damage, hypothesized to be enhanced by high iron content in RCC microenvironment c. Intracellular accumulation of dehydroascorbic acid secondary to high HIF activity in ccRCC. Animal data and case reports support the hypothesis. Methods: Trial design: Patients (pts) with newly diagnosed metastatic/ unresectable ccRCC are randomized 1:1 to arm A (pazopanib 800 mg/d plus IV AA 1g/kg 3 times/week) or arm B (pazopanib 800 mg/d). Protocol treatment is for 10 cycles (unless PD, unacceptable AE, alternative therapy, or pt refusal), each cycle being 28 days. Primary endpoint is Treatment Failure-Free rate at 40 weeks (TFF40). Treatment Failure is defined as: Radiographic disease progression, off-protocol treatment due to AE, alternative therapy initiation (except metastasectomy post clinical benefit), or death. Secondary endpoints include OS, PFS, ORR and AE. Statistical methods: 82 eligible pts (41 in each in arm) will provide 81% power to detect a 19% increase of TFF40 from 45% in arm B to 64% in arm A assuming a one-sided type I error rate of 0.19 (EAST 6.4). Correlatives: Epigenetic mechanism: 5mC, 5hmC and H3K27me3 IHC, MeDIP/ hMeDIP seq, RNA seq. H2O2 mechanism: tumor microenvironment iron, tumor catalase IHC. Dehydroascorbic acid mechanism: HIF-1 alpha, HIF-2 alpha, GLUT-1 IHC. Key exclusion criteria: G6PD deficiency, renal disease (Cockcroft Gault CrCl < 55 ml/min). ClinicalTrials.gov Identifier: NCT03334409 Status: Open for accrual in 9/10 planned sites. Funding Source: Foundation. Clinical trial information: NCT03334409.

scholarly journals Endodontic Management of Three Rooted Mandibular First Molar: Report of Three Cases

2014 ◽  
Vol 2 (2) ◽  
pp. 40-45
Author(s):  
N Acharya ◽  
PS Samant ◽  
V Gautam ◽  
O Singh ◽  
A Shrestha
Keyword(s):  
Treatment Failure ◽  
Root Canal ◽  
Clinical Case ◽  
Case Reports ◽  
Root Canal Treatment ◽  
Successful Outcome ◽  
Medical Sciences ◽  
Root Canal Anatomy ◽  
Mandibular First Molar

In everyday endodontic practice, clinicians face various atypical configurations, such as presence of extra root and/or atypical canal configuration. One of the major reason of the treatment failure is the missed extra root and/or canals. Mandibular first molars typically have two roots (one mesial and one distal), but sometimes present with a supernumerary root either distolingually (radix entomolaris), or mesiobuccally (radix paramolaris). Hence, the thorough knowledge of root canal anatomy and morphology along with its variation is crucial for the successful outcome of the root canal treatment. The aim of this paper is to present and describe the three clinical case reports of three rooted mandibular first molars and its endodontic management. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11173 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 40-45

scholarly journals Artroplastia Reversa em um Caso de Reabordagem de Cisto Ósseo em Úmero Proximal

2020 ◽  
Vol 4 (1) ◽  
pp. 52-56
Author(s):  
Lucas Fraga ◽  
Rogério Barros ◽  
Roberto Maia ◽  
Marcus Santos ◽  
Rodrigo Martins
Keyword(s):  
Treatment Failure ◽  
Efficient Solution ◽  
Pathological Fracture ◽  
Proximal Humerus ◽  
Case Reports ◽  
Bone Cyst ◽  
Shoulder Prosthesis ◽  
Bone Cysts ◽  
Simple Bone Cyst ◽  
Reverse Shoulder Prosthesis

Os cistos ósseos simples são, em regra, assintomáticos e encontrados incidentalmente, embora possam causar dor, edema, rigidez da articulação adjacente ou estarem associados a um quadro de fratura patológica. A curetagem é o modo mais comum de tratamento. O defeito ósseo após curetagem deve ser preenchido com enxertos ósseos ou substitutos, como hidroxiapatita, fosfato tricálcico e cimento. Entretanto, a falha no tratamento pode ser devastadora para o ombro, em decorrência da perda biomecânica da área. Assim, a reconstrução do úmero proximal, após a ressecção do cisto, é um grande desafio para o cirurgião ortopédico. Este caso relata a colocação de uma prótese reversa de ombro (PRO), realizada após a falha do tratamento de um cisto ósseo simples, como uma solução eficiente para a reparação do problema.   Simple bone cyst are commonly asymptomatic and incidentally found, although they can cause pain, edema, stiffness of the adjacent joint or be associated with a pathological fracture. Curettage is the most common way of treating simple bone cysts. The bone defect after curettage must be filled with bone grafts or substitutes such as hydroxyapatite, tricalcium phosphate and cement. However, treatment failure can be devastating for the shoulder, due to the biomechanical loss of the area. Thus, the reconstruction of the proximal humerus after resection of the cyst is a major challenge for the orthopedic surgeon. This case reports the placement of a reverse shoulder prosthesis (PRO), performed after the failure of the treatment of a simple bone cyst, as an efficient solution to the problems related to the failure of treatment for the simple bone cyst.

scholarly journals Systematic Review: A Comparison between Vancomycin and Daptomycin for Sepsis Infection Antibiotic Therapy

2021 ◽  
Vol 9 (F) ◽  
pp. 683-689
Author(s):  
Ratih Puspita Febrinasari ◽  
Benedictus Benedictus ◽  
Akhmad Azmiardi
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Case Reports ◽  
Controlled Trial ◽  
Journal Articles ◽  
Vancomycin Therapy ◽  
First Line Therapy ◽  
Mrsa Infection ◽  
Mrsa Strains ◽  
Dangerous Condition

BACKGROUND: Sepsis is a dangerous condition that threatens life because of immune system dysregulation caused by an infection resulting in organ failure. One of the most common resistant strain bacteria that can cause sepsis is Methicillin-resistant Staphylococcus aureus (MRSA). Vancomycin is the first-line therapy for treating sepsis infection caused by MRSA, but recently there have been some MRSA strains that are resistant to vancomycin therapy. AIM: This study aimed to review comparison between vancomycin and daptomycin for sepsis infection antibiotics therapy. MATERIALS AND METHODS: This research was a systematic review using three databases such as PubMed, ProQuest, and ScienceDirect. The journal articles included in this study were about randomized controlled trial (RCT) studies published from 2011 to 2020. RESULTS: This research included seven RCT studies, but none of them discuss the usage of daptomycin for sepsis treatment caused by MRSA. They discuss more the effect of dose, method of administration, and side effects of vancomycin therapy in relation to the outcome of the patient. CONCLUSIONS: Because of the lack of RCT articles that conducted experiments of daptomycin usage for sepsis treatment caused by MRSA infection, this research could not compare the effectiveness between vancomycin and daptomycin. However, from some case reports included in this research, there was evidence that the usage of daptomycin base after vancomycin treatment failure will cause another treatment failure.

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