scholarly journals Active Cerebrospinal Fluid Exchange System for Treatment of Pyogenic Ventriculitis

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Behnam Rezai Jahromi ◽  
Päivi Tanskanen ◽  
Anniina Koski-Pàlken ◽  
Christoph Schwartz ◽  
Päivi Koroknay-Pal ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Tissue ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Current Treatment ◽  
Exchange System ◽  
Fluid Exchange ◽  
Infection Treatment ◽  
Lumen Catheter ◽  
Healthcare Associated

ABSTRACT BACKGROUND Despite recent advances in antibiotic treatment, pyogenic ventricular brain infections are still associated with adverse clinical outcome in 80% of affected patients and mortality rates approaching 60%. The limitation of antibiotic penetration into the cerebrospinal fluid (CSF) challenges the treatment. Intrathecal treatment remains an option for adjunctive therapy to intravenous (iv) antibiotics when the iv therapy fails to sterilize the CFS. Current treatment options do not allow for changing the CSF composition without adversely affecting intracranial pressure (ICP) and power of hydrogen (pH). OBJECTIVE To investigate if CSF composition exchange has impact on ventriculitis patients. METHODS We report 2 cases with pyogenic ventriculitis treated with a new intracranial active fluid exchange system that consists of a dual-lumen catheter to facilitate irrigation and drainage coupled with an intelligent digital pump. RESULTS This new technique allowed us to change the composition of CSF to an antibiotic-consisted fluid. This resulted in the ability to directly modify the concentration of the targeted antibiotics in the CSF, while simultaneously removing bacterial mass without harming brain tissue and controlling ICP and pH. CONCLUSION Our reported experience shows that drainage of purulent fluid caused by healthcare-associated ventriculitis or meningitis is now possible without harming brain tissue and ICP while also changing the composition of CSF to an antibiotic-consisted fluid. Actively removing pus and altering CSF in this manner had an impact on infection treatment and antibiotic penetration. Further cases are needed to confirm that our treatment algorithm is correctly tailored to assist clinicians in reliably treating this catastrophic condition.

Sinecatechins and imiquimod as proactive sequential therapy of external genital and perianal warts in adults

2017 ◽  
Vol 28 (14) ◽  
pp. 1433-1443 ◽  
Author(s):  
Helmut Schöfer ◽  
Silvio Tatti ◽  
Charles W Lynde ◽  
Mihael Skerlev ◽  
Jana Hercogová ◽  
...  
Keyword(s):  
Viral Infections ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Healthcare Providers ◽  
Sequential Therapy ◽  
Diagnostic Procedures ◽  
Current Treatment ◽  
Clinical Appearance ◽  
Clinical Literature ◽  
International Experts

This review about the proactive sequential therapy (PST) of external genital and perianal warts (EGW) is based on the most current available clinical literature and on the broad clinical experience of a group of international experts, physicians who are well versed in the treatment of human papillomavirus-associated diseases. It provides a practical guide for the treatment of EGW, including epidemiology, etiology, clinical appearance, and diagnostic procedures for these viral infections. Furthermore, the treatment goals and current treatment options, elucidating provider- and patient-applied therapies, and the parameters driving treatment decisions are summarized. Specifically, the mode of action of the topical treatments sinecatechins and imiquimod, as well as the PST for EGW to achieve rapid and sustained clearance is discussed. The group of experts has developed a treatment algorithm giving healthcare providers a practical tool for the treatment of EGW which is very valuable in the presence of many different treatment options.

scholarly journals Research Biomarkers For The Diagnosis Of Alzheimer’s Disease

2019 ◽  
Vol 8 (6) ◽  
pp. 3633-3636
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Early Diagnosis ◽  
Treatment Options ◽  
Current Treatment ◽  
Neuronal Disease

Alzheimer’s disease (AD) is a neuronal disease that is characterized by the loss of neurons and cognitive impairment. There is no definitive cure and current treatment options are focused more on reducing the damage caused by the disease and providing care for the patients. Early diagnosis of the disease will help in minimizing the damage and give better treatment options. In this review we try to analyze a few important risk factors and identify some biomarkers in blood and cerebrospinal fluid (CSF) which could be used for the diagnosis of AD

scholarly journals Management of constant proptosis after traumatic orbital roof fracture caused by firearm projectile

2021 ◽  
Vol 9 (12) ◽  
Author(s):  
Craig Czyz ◽  
Tyler Greenlee ◽  
Reece Bergstrom
Keyword(s):  
Cerebrospinal Fluid ◽  
Compartment Syndrome ◽  
Brain Tissue ◽  
Treatment Options ◽  
Cerebrospinal Fluid Leak ◽  
Gunshot Wounds ◽  
High Energy ◽  
Ocular Tissues ◽  
Orbital Roof ◽  
Fluid Leak

Orbital injuries causing severe proptosis are most often caused by high-energy, blunt force trauma, but can also be associated with penetrating traumas, such as firearm projectiles. Head trauma resulting in orbital roof fracture and significant communication between the anterior cranial fossa and posterior orbit are rare events, with herniation of brain tissue and cerebrospinal fluid into the orbit even more uncommon and found in only a small percentage of cases. When present, the herniating tissue and/or fluid can cause significant proptosis and potentially orbital compartment syndrome that increases the risk of damage to the optic nerve and its surrounding structures. Often this condition is managed surgically in an urgent manner to preserve visual acuity and the ocular tissues. In cases of constant proptosis in the setting of orbitocranial injuries, practitioners should balance the risks and benefits of intervention ensuring the best possible clinical outcomes. It is imperative to remember that the proptosis is a clinical finding that is itself not pathognomonic for any particular disease entity. The following case describes a 20-year old male that presented with multiple gunshot wounds, one of which caused a penetrating injury to the orbit and subsequent brain tissue herniation and cerebrospinal fluid leak with associated constant proptosis and orbital compartment syndrome. This case report examines the treatment options in severe cases of traumatic, constant proptosis, with or without orbital compartment syndrome, and the methods used to preserve vision, anatomy, and prevent severe complications.

scholarly journals Interprofessional Management of Allergic Conjunctivitis

2018 ◽  
Vol 80 (3) ◽  
pp. 11-27 ◽  
Author(s):  
C. Lisa Prokopich ◽  
Michael Lee-Poyb ◽  
Harold Kimc
Keyword(s):  
Daily Living ◽  
Allergic Conjunctivitis ◽  
Treatment Options ◽  
Management Strategies ◽  
Treatment Algorithm ◽  
Current Treatment ◽  
Inflammatory Drugs ◽  
Patient Presentation ◽  
Symptoms And Signs

Ocular allergies affect a large and increasing number of people in North America. Canada’s statistics are likely to mirror those of the U.S., where up to 40% of the population is affected by ocular allergies. The symptoms and signs of ocular allergies can greatly affect productivity and have a dramatic effect on overall quality of life (QoL). Over the years, many effective treatments have been developed for the management of ocular allergies. For allergic conjunctivitis, topical ophthalmic agents include antihistamines, mast-cell stabilizers, dual-activity agents, steroids, nonsteroidal anti-inflammatory drugs, and other immune-modulating drugs. Oral antihistamines are commonly chosen by patients for all forms of allergy, including allergic conjunctivitis. This review provides a summary of the forms of ocular allergy, with a particular focus on the symptoms and signs, diagnosis, current treatment options, and impact on QoL. More importantly, through multidisciplinary collaboration, a simplified treatment algorithm is proposed for Canadian clinical practice. This algorithm provides practitioners the best possible management strategies based on an individual patient presentation, thereby maximizing treatment efficacy and minimizing the effects on tasks of daily living and QoL.

Integrating Biologic Agents into Management of Moderate-to-Severe Psoriasis: A Consensus of the Canadian Psoriasis Expert Panel

2004 ◽  
Vol 8 (5) ◽  
pp. 321-337 ◽  
Author(s):  
Lyn Guenther ◽  
Richard G Langley ◽  
Neil H. Shear ◽  
Robert Bissonnette ◽  
Vincent Ho ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Expert Panel ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Current Treatment ◽  
Biologic Agents ◽  
Severe Psoriasis ◽  
Appropriate Treatment ◽  
Current Therapies

Background: Approximately 2% of people worldwide have psoriasis, with as many as 1 million people with psoriasis in Canada alone.1,2 The severity of psoriasis ranges from mild to severe. It can lead to substantial morbidity and psychological stress and have a profound negative impact on patient quality of life.3,4 Although available therapies reduce therapies reduce the extent and severity of the disease and improve quality of life,3 reports have indicated a patient preference for more aggressive therapy and a dissatisfaction with the effectiveness of current treatment options.5 Objective: A Canadian Expert Panel, comprising Canadian dermatologists, convened in Toronto on 27 February 2004 to reach a consensus on unmet needs of patients treated with current therapies and how to include the pending biologic agents in and improve the current treatment algorithm for moderate-to-severe psoriasis. Current treatment recommendations suggest a stepwise strategy starting with topical agents followed by phototherapy and then systemic agents.3,6,7 The Panel evaluated the appropriate positioning of the biologic agents, once approved by Health Canada, for the treatment of moderate-to-severe psoriasis. Methods: The Panel reviewed available evidence and quality of these data on current therapies and from randomized, controlled clinical trials.8–14 Subsequently, consensus was achieved by small-group workshops followed by plenary discussion. Results: The Panel determined that biologic agents are an important addition to therapies currently available for moderate-to-severe psoriasis and proposed an alternative treatment algorithm to the current step wise paradigm. Conclusion: The Panel recommended a new treatment algorithm for moderate-to-severe psoriasis whereby all appropriate treatment options, including biologic agents, are considered together and patients' specific characteristics and needs are taken into account when selecting the most appropriate treatment option.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

Initiation of Clozapine Therapy in a Patient With Preexisting Leukopenia: A Discussion of the Rationale of Current Treatment Options

2001 ◽  
Vol 13 (4) ◽  
pp. 233-237 ◽  
Author(s):  
Roger Boshes ◽  
Theo Manschreck ◽  
Jean Desrosiers ◽  
Steven Candela ◽  
Meredith Hanrahan-Boshes
Keyword(s):  
Treatment Options ◽  
Current Treatment ◽  
Clozapine Therapy

Nano Drug Delivery in Treatment of Oral Cancer, A Review of the Literature

2019 ◽  
Vol 20 (10) ◽  
pp. 1008-1017 ◽  
Author(s):  
Vandita Kakkar ◽  
Manoj Kumar Verma ◽  
Komal Saini ◽  
Indu Pal Kaur
Keyword(s):  
Drug Delivery ◽  
Oral Cancer ◽  
Treatment Options ◽  
Oral Submucous Fibrosis ◽  
Survival Rates ◽  
Cancer Therapeutics ◽  
Developed Countries ◽  
Current Treatment ◽  
Poor Overall Survival ◽  
Hereditary Disorders

Oral Cancer (OC) is a serious and growing problem which constitutes a huge burden on people in more and less economically developed countries alike. The scenario is clearly depicted from the increase in the expected number of new cases in the US diagnosed with OC from 49,670 people in 2016, to 49,750 cases in 2017. The situation is even more alarming in India, with 75,000 to 80,000 new cases being reported every year, thus making it the OC capital of the world. Leukoplakia, erythroplakia, oral lichen planus, oral submucous fibrosis, discoid lupus erythmatosus, hereditary disorders such as dyskeratosis congenital and epidermolisys bullosa are highlighted by WHO expert working group as the predisposing factors increasing the risk of OC. Consumption of tobacco and alcohol, genetic factors, and human papilloma virus are assigned as the factors contributing to the aetiology of OC. On the other hand, pathogenesis of OC involves not only apoptosis but also pain, inflammation and oxidative stress. Inspite of current treatment options (surgery, radiotherapy, and chemotherapy), OC is often associated with recurrence and formation of secondary primary tumours resulting in poor overall survival rates (∼50%). The intervention of nano technology-based drug delivery systems as therapeutics for cancers is often viewed as a cutting edge for technologists. Though ample literature on the usefulness of nano-coutured cancer therapeutics, rarely any product is in pipeline. Yet, despite all the hype about nanotechnology, there are few ongoing trials. This review discusses the current and future trends of nano-based drug delivery for the treatment of OC.

scholarly journals Role of Dendritic Cell in Diabetic Nephropathy

2021 ◽  
Vol 22 (14) ◽  
pp. 7554
Author(s):  
Hyunwoo Kim ◽  
Miyeon Kim ◽  
Hwa-Young Lee ◽  
Ho-Young Park ◽  
Hyunjhung Jhun ◽  
...  
Keyword(s):  
T Cells ◽  
Diabetic Nephropathy ◽  
Microvascular Complications ◽  
Treatment Options ◽  
Renal Tissue ◽  
Current Treatment ◽  
Diabetic Patients ◽  
Activated T Cells ◽  
Stage Renal Disease ◽  
Incident Cases

Diabetic nephropathy (DN) is one of the most significant microvascular complications in diabetic patients. DN is the leading cause of end-stage renal disease, accounting for approximately 50% of incident cases. The current treatment options, such as optimal control of hyperglycemia and elevated blood pressure, are insufficient to prevent its progression. DN has been considered as a nonimmune, metabolic, or hemodynamic glomerular disease initiated by hyperglycemia. However, recent studies suggest that DN is an inflammatory disease, and immune cells related with innate and adaptive immunity, such as macrophage and T cells, might be involved in its development and progression. Although it has been revealed that kidney dendritic cells (DCs) accumulation in the renal tissue of human and animal models of DN require activated T cells in the kidney disease, little is known about the function of DCs in DN. In this review, we describe kidney DCs and their subsets, and the role in the pathogenesis of DN. We also suggest how to improve the kidney outcomes by modulating kidney DCs optimally in the patients with DN.

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