scholarly journals P86 Treatment modalities in peripheral facial nerve palsy in children and adolescents

2019 ◽  
Vol 104 (6) ◽  
pp. e53.1-e53
Author(s):  
J Samardzic ◽  
B Kukolj ◽  
M Jovanovic ◽  
O Djuric ◽  
J Jancic
Keyword(s):  
Recovery Rate ◽  
Combined Therapy ◽  
Recovery Period ◽  
Treatment Modalities ◽  
P Value ◽  
Physical Treatment ◽  
Therapeutic Modalities ◽  
Peripheral Facial Palsy ◽  
Younger Age ◽  
Peripheral Facial Nerve Palsy

BackgroundBell´s palsy is the most common type of peripheral facial palsy in pediatrics. Recent studies strongly support the combined therapy with corticosteroids (CS), antiviral drugs and vitamins B. Our study aims to assess the effectiveness of proposed therapeutic modalities, including the relation between the patients‘ recovery and their age, etiological factors and applied treatment.MethodsThe retrospective analysis involved 88 patients (52 females/36 males), between 18 months and 18 years old; the average age was 11.7 years. Data was obtained from the documentation of patients hospitalized at the Clinic of Neurology and Psychiatry for Children and Youth in Belgrade, from 2000 to 2017. House Brackmann´s scale was used for the assessment of disease course and outcome. Pearson´s χ2 test, Friedman´s test and general linear model were applied for statistical data processing.ResultsThe majority of patients were treated with combined CS/vitamins (42.0%) and CS/antiviral/vitamins (17.0%), whereas CS only received 22.7% of patients, all with an appropriate physical treatment. The group of idiopathic paralysis makes 62.5%, while the incidence of symptomatic paralysis is 37.5%; however, the recovery rate between these groups has not been shown (p=0.309). Patients received CS therapy were divided into 4 groups: CS only, CS+antiviral, CS+vitamins B, and CS+antiviral+vitamins B. The statistically significant recovery was registered in each group (p< 0.001); however, no difference was found between the groups in term of recovery rate (p=865). For the assessment of recovery period in relation to the age, the obtained p value was 0.054, a borderline level, suggesting a faster recovery of children at younger age.ConclusionThe acute one-sided mimic musculature weakness is mostly idiopathic. The effectiveness of the CS therapy was strongly supported, suggesting CS as a core treatment for the Bell´s palsy. It has been shown the faster recovery of children at younger age.Disclosure(s)Nothing to disclose

scholarly journals MiRNA10b-directed nanotherapy effectively targets brain metastases from breast cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Byunghee Yoo ◽  
Alana Ross ◽  
Pamela Pantazopoulos ◽  
Zdravka Medarova
Keyword(s):  
Breast Cancer ◽  
Rna Interference ◽  
Lymph Nodes ◽  
Therapeutic Effect ◽  
Metastatic Breast ◽  
Treatment Modalities ◽  
Transcriptional Level ◽  
Metastatic Progression ◽  
Therapeutic Modalities ◽  
Metastatic Colonization

AbstractRNA interference represents one of the most appealing therapeutic modalities for cancer because of its potency, versatility, and modularity. Because the mechanism is catalytic and affects the expression of disease-causing antigens at the post-transcriptional level, only small amounts of therapeutic need to be delivered to the target in order to exert a robust therapeutic effect. RNA interference is also advantageous over other treatment modalities, such as monoclonal antibodies or small molecules, because it has a much broader array of druggable targets. Finally, the complementarity of the genetic code gives us the opportunity to design RNAi therapeutics using computational, rational approaches. Previously, we developed and tested an RNAi-targeted therapeutic, termed MN-anti-miR10b, which was designed to inhibit the critical driver of metastasis and metastatic colonization, miRNA-10b. We showed in animal models of metastatic breast cancer that MN-anti-miR10b accumulated into tumors and metastases in the lymph nodes, lungs, and bone, following simple intravenous injection. We also found that treatment incorporating MN-anti-miR10b was effective at inhibiting the emergence of metastases and could regress already established metastases in the lymph nodes, lungs, and bone. In the present study, we extend the application of MN-anti-miR10b to a model of breast cancer metastatic to the brain. We demonstrate delivery to the metastatic lesions and obtain evidence of a therapeutic effect manifested as inhibition of metastatic progression. This investigation represents an additional step towards translating similar RNAi-targeted therapeutics for the systemic treatment of metastatic disease.

scholarly journals Finding an easy way to harmonize: a review of advances in clinical research and combination strategies of EZH2 inhibitors

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Chen Li ◽  
Yan Wang ◽  
Yueqing Gong ◽  
Tengrui Zhang ◽  
Jiaqi Huang ◽  
...  
Keyword(s):  
Treatment Modalities ◽  
Preclinical Studies ◽  
Combination Therapies ◽  
Tumor Treatment ◽  
Antitumor Effects ◽  
Therapeutic Modalities ◽  
Combination Strategies ◽  
Anti Cancer ◽  
Underlying Mechanisms ◽  
The Individual

AbstractEnhancer of zeste homolog 2 inhibitors (EZH2i) have garnered increased attention owing to their anticancer activity by targeting EZH2, a well-known cancer-promoting factor. However, some lymphomas are resistant to EZH2i, and EZH2i treatment alone is ineffective in case of EZH2-overexpressing solid tumors. The anti-cancer efficacy of EZH2i may be improved through safe and effective combinations of these drugs with other treatment modalities. Preclinical evidence indicates that combining EZH2i with other therapies, such as immunotherapy, chemotherapy, targeted therapy, and endocrine therapy, has complementary or synergistic antitumor effects. Therefore, elucidating the underlying mechanisms of the individual constituents of the combination therapies is fundamental for their clinical application. In this review, we have summarized notable clinical trials and preclinical studies using EZH2i, their progress, and combinations of EZH2i with different therapeutic modalities, aiming to provide new insights for tumor treatment.

scholarly journals Belantamab Mafodotin to Treat Multiple Myeloma: A Comprehensive Review of Disease, Drug Efficacy and Side Effects

2021 ◽  
Vol 28 (1) ◽  
pp. 640-660
Author(s):  
Grace Lassiter ◽  
Cole Bergeron ◽  
Ryan Guedry ◽  
Julia Cucarola ◽  
Adam M. Kaye ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Hematologic Malignancy ◽  
Drug Efficacy ◽  
Treatment Modalities ◽  
Blurred Vision ◽  
Refractory Multiple Myeloma ◽  
Therapeutic Modalities ◽  
Clonal Proliferation ◽  
Refractory State

Multiple myeloma (MM) is a hematologic malignancy characterized by excessive clonal proliferation of plasma cells. The treatment of multiple myeloma presents a variety of unique challenges due to the complex molecular pathophysiology and incurable status of the disease at this time. Given that MM is the second most common blood cancer with a characteristic and unavoidable relapse/refractory state during the course of the disease, the development of new therapeutic modalities is crucial. Belantamab mafodotin (belamaf, GSK2857916) is a first-in-class therapeutic, indicated for patients who have previously attempted four other treatments, including an anti-CD38 monoclonal antibody, a proteosome inhibitor, and an immunomodulatory agent. In November 2017, the FDA designated belamaf as a breakthrough therapy for heavily pretreated patients with relapsed/refractory multiple myeloma. In August 2020, the FDA granted accelerated approval as a monotherapy for relapsed or treatment-refractory multiple myeloma. The drug was also approved in the EU for this indication in late August 2020. Of note, belamaf is associated with the following adverse events: decreased platelets, corneal disease, decreased or blurred vision, anemia, infusion-related reactions, pyrexia, and fetal risk, among others. Further studies are necessary to evaluate efficacy in comparison to other standard treatment modalities and as future drugs in this class are developed.

ROLE OF COMPUTED TOMOGRAPHY SCAN IN POST-COVID SINO-NASAL MUCORMYCOSIS WITH CLINICO-EPIDEMIOLOGICAL CORELATION

2021 ◽  
pp. 49-52
Author(s):  
Srijit Saha ◽  
Aarti Anand ◽  
Debraj Saha
Keyword(s):  
Broad Spectrum ◽  
Health Care Professionals ◽  
Epidemiological Data ◽  
Treatment Modalities ◽  
Intracranial Extension ◽  
P Value ◽  
Comorbid Condition ◽  
Invasive Ventilation ◽  
Broad Spectrum Antibiotics

Ÿ OBJECTIVE: Ÿ To evaluate the spectrum of radiological ndings in post-COVID sinonasal mucormycosis cases Ÿ To evaluate the demography, comorbidities and treatment modalities used in these patients which may be attributable to development of sinonasal mucormycosis after recovery from COVID-19 disease. Ÿ MATERIALS AND METHODS: In this retrospective study, 80 out of 793 patients who came for follow-up after recovering from COVID pneumonia, had symptoms related to paranasal sinus and orbit. CECT PNS and orbit was performed in them and 69 patients had positive CT ndings. Clinico-epidemiological data was recorded. The correlation between CT ndings and clinical history was performed by Chi2 test. P value <0.05 was considered as statistically signicant. Ÿ RESULTS: Majority - 48 (69.5%) belonged to age group between 40-60 years. Diabetes mellitus was the most common comorbid condition seen in 58 (84%) patients. The treatment history during COVID-19 disease revealed administration of intravenous or oral steroids in 54 (78.2%) patients, Injection Remdesivir in 48 (69.5%), broad-spectrum antibiotics in 36 (52.2%). 15 (21.7%) were given non-invasive ventilation and 7 (10.1%) needed invasive ventilation. Ethmoidal sinus- 68 cases (98.5%) and maxillary sinus- 65 cases (94.2%) were most frequently affected sinus. Intraorbital extension of the soft tissue was seen in 37 (53.6%) and intracranial extension was seen in 11 (15.9%) cases. On follow-up, fungal hyphae were detected in 39 (56.5%) cases via KOH mount or biopsy. Ÿ CONCLUSION: The widespread use of steroids/monoclonal antibodies/broad-spectrum antibiotics/oxygen therapy for treating COVID-19 may lead to the development/exacerbation of pre-existing fungal diseases. Health care professionals should act promptly when there is a suspicion of mucormycosis

Effect of Ultrasound and Calf Stretching in relieving Gastrocnemius Tightness in subjects with Plantar Fascitis

2021 ◽  
pp. 3025-3028
Author(s):  
Sowmya M V ◽  
Nandhini S ◽  
Manigandan V
Keyword(s):  
Functional Ability ◽  
Combined Therapy ◽  
Statistical Significance ◽  
Mean Value ◽  
P Value ◽  
Functional Activities ◽  
Post Test ◽  
Foot Function ◽  
The Difference ◽  
Gastrocnemius Tightness

Objective: To evaluate the efficacy of ultrasound and calf stretching in subjects with gastrocnemius tightness in plantar fascitis to reduce pain and improve functional ability. Method: 30 patients with plantar fascitis selected from Saveetha college of physiotherapy and rehabilitation center (SPARC) based on inclusion and exclusion criteria. The patients were treated with ultrasound therapy and calf stretching. The pre and post test values of pain and functional ability was be calculated using Silfverskiold test and Foot Function Index as an outcome measure. Results: The mean value and standard errors were calculated for different variables and the difference in mean value was tested for statistical significance using paired t test. P value of <0.0001 was considered as statistically significant. Conclusion: From the statistical analysis and graphical interpretation the final derived results concluded that combined therapy of ultrasound and calf stretching is found to be effective in relieving gastrocnemius tightness in patient suffering with plantar fascitis and it can be used to improve the functional activities.

scholarly journals Knowledge, Attitude, and Practices Regarding Maxillofacial Defects and their Prosthetic Rehabilitation among Dental Undergraduate Students in Belagavi District- A Cross-sectional Study

2020 ◽  
Author(s):  
S Shreya ◽  
Ramesh P Nayakar
Keyword(s):  
Undergraduate Students ◽  
Clinical Training ◽  
Early Stage ◽  
Dental Health ◽  
Basic Knowledge ◽  
Treatment Modalities ◽  
P Value ◽  
Prosthetic Rehabilitation ◽  
Cross Sectional Survey ◽  
Cross Sectional

Introduction: Maxillofacial defects are facial disfigurements resulting from congenital abnormalities, surgical resection of tumours, trauma, or a combination of these. The resulting deformity often leads to a difficult path of recovery with lifelong consequences, causing both physical disability and mental distress. Prosthetic rehabilitation is not only a solution to cover the physical deficit, but also a way to improve function as well as the quality of life for such patients. However, the knowledge amongst undergraduate dental health professionals about the same has been at sparse. Aim: To evaluate the knowledge, attitude, and practices regarding maxillofacial defects and their prosthetic rehabilitation amongst dental undergraduate students. Materials and Methods: A cross-sectional survey was conducted between January 2020 and June 2020, amidst the third year, fourth year undergraduate students, and interns of Belagavi city, Karnataka, India. The data was collected using a 16-item custom designed proforma, comprising of questions evaluating student’s basic knowledge about the diagnosis, treatment procedures, and treatment planning of maxillofacial defects and their prosthetic rehabilitation. Statistical analysis was done using Chi-square test in each group, using SPSS version 22 p-value <0.05 to be considered significant. Results: A total of 286 participants answered the questionnaire, of which 117 (40.9%) were interns, 116 (40.6%) were third year students, and 53 (18.5%) were fourth year students. 279 (97.6%) participants had an understanding regarding maxillofacial defects. Of those who had witnessed cases, only 18.2% had observed more than three cases (p-value <0.001). Out of respondents with treatment understanding, 184 (64.3%) answered that it required a multidisciplinary approach (p-value <0.001). 197 (68.9%) of the respondents felt that silicone was the most commonly used material (p<0.003). 165 (57.7%) answered that waxes were the most commonly used impression material (p-value <0.001). Out of the respondents awared about treatment modalities, 120 (42%) respondents majority answered that CAD-CAM would contribute the most to maxillofacial rehabilitation. Conclusion: Comprehensive understanding and clinical application of prosthodontic rehabilitation of maxillofacial defects among undergraduate students was found to be lacking. This awareness should be initiated at an early stage of the clinical training for undergraduate training programme, as it will help to understand the basic aspects involved in the prosthodontic rehabilitation of maxillofacial defects.

scholarly journals EFFICACY OF LATERAL WEDGING IN FOOTWEAR IN MEDIAL COMPARTMENT OSTEOARTHRITIS KNEE

2019 ◽  
pp. 1-3
Author(s):  
Suman Badhal ◽  
U. Singh ◽  
S. L Yadav ◽  
Gita Handa
Keyword(s):  
Intervention Group ◽  
Cost Effective ◽  
Mean Difference ◽  
Medial Compartment ◽  
Treatment Modalities ◽  
Rank Test ◽  
P Value ◽  
Knee Oa ◽  
The Mean ◽  
Group B

INTRODUCTION: In Knee osteoarthritis (OA) Shoe modifications, such as lateral-wedge insoles or shock absorbing shoes with insoles, have been recommended for conservative therapy of mild knee OA but with little objective data on Indian patients. OBJECTIVE : this prospective study was done to study the effect of lateral heel sole wedging (insole) in the patients of OA of knee (medial compartment) and its relation to function,pain and stiffness parameters status on VAS and WOMAC scale and to see the requirement of the number of Aceclofenac tablets. METHODS: 60 patients fulfilling the inclusion criteria were enrolled and divided into intervention group A (30) and nonintervention Group B (30) with random allocation.Paired t-test,Wilcoxon sign rank test and Man Whitney U test were applied at significant p-value of <0.05%. RESULTS: the reduction of mean difference in pain on VAS and WOMAC scale, improvement in Mean difference in function parameters the mean reduction of pain in standing/ walking,bending and ascending/descending at WOMAC scale was significantly higher in intervention group. Also the mean reduction in the need for aceclofenac was significantly lower in intervention group evident from fourth week onward to fifth and sixth week.Conclusion:The lateral wedging in shoes in medial joint osteoarthritis is beneficial and it can be cost-effective conservative treatment modalities in early osteoarthritis patients, particularly in developing countries as it can reduces the requirement of NSAIDS and improve functional level of patients by reducing pain in various activities.

Abstract 3314: The Role of Bridging with Intravenous Thrombolysis in Endovascular Therapy of Acute Ischemic Stroke.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Omar Kass-Hout ◽  
Tareq Kass-Hout ◽  
Maxim Mokin ◽  
David Orion ◽  
Shadi Jahshan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Endovascular Therapy ◽  
Combined Therapy ◽  
Large Vessel ◽  
P Value ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Nihss Score

Background: Large vessel occlusions with a high clot burden are less likely to improve with the FDA-approved IV strategy. Endovascular therapy within the first 3 h of stroke symptom onset provides an effective alternative treatment in patients with large vessel occlusion. It is not clear if combination of IV thrombolysis and endovascular approach is superior to endovascular treatment alone. Methods: We retrospectively reviewed all cases of acute ischemic stroke with large vessel occlusion treated within the first 3 h stroke onset during the 2005-2010 period. First group received endovascular therapy within the first 3 h of stroke onset. Second group consisted of patients who received IV thrombolysis within the first 3 h followed by endovascular therapy. We compared the following outcomes: revascularization rates, NIHSS score at discharge, mRS at discharge and 3months, symptomatic hemorrhage rates and mortality. Results: Among 104 patients identified, 42 received combined therapy, and 62 received endovascular therapy only. The two groups had similar demographic (age and sex distribution) and vascular risk factors distribution, as well as NIHSS score on admission (14.8±4.7 and 16.0±5.3; p=0.23). We found no difference in TIMI recanalization rates (Thrombolysis in Myocardial Infarction scale score of 2 or 3) following combined or endovascular therapy alone (83.3% and 79.0%; p=0.59). A preferred outcome, defined as a mRS of 2 or less at 90 days also did not differ between the combined therapy group and the endovascular only group (37.5% and 34.5%; p=0.76). There was no difference in mortality rate (22.5% and 31.0%; p=0.36) and the rate of symptomatic intracranial hemorrhage (9.5% and 8.1%; p=0.73). There was a significant difference in mean time from symptom onset to endovascular treatment between the combined group (227±88 min) and endovascular only group (125±40 min; p<0.0001).Patients with good TIMI recanalization rate of 2 or 3 showed a trend of having a better mRS at 90 days in both bridging (16.67% vs. 41.18%, p-value: 0.3813) and endovascular groups (25% vs. 34.78%, p-value: 0.7326).When analyzing the correlation of mRS at 90 days with the site of occlusion, patients in the bridging group showed a trend of a better outcome when the site of occlusion was ICA (33.3% vs 30%) and MCA (66.67% vs. 27.59%) and worse outcome when the site of occlusion was in the posterior circulation (26.32% vs. 50%), however, these results were not statistically significant (p-values: 0.1735& 0.5366). Conclusion: Combining IV thrombolysis and endovascular therapy achieves similar rates of clinical outcomes, revascularization rates, complications and mortality rates, when compared with endovascular treatment alone. The combined therapy, however, significantly delays initiation of endovascular treatment. A randomized prospective trial comparing both treatment strategies in acute ischemic stroke is warranted

Abstract WMP85: Recovery Rate vs. Recovery Capacity: A Mathematical Model and its Implications for Rehabilitation

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Adam B Schweber ◽  
Lauren E Dunn ◽  
Andrea R Lendaris ◽  
Brandon M Minzer ◽  
Ronald M Lazar ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Recovery Rate ◽  
Goodness Of Fit ◽  
Recovery Period ◽  
Stroke Onset ◽  
Motor Deficit ◽  
Model Parameters ◽  
Stroke Severity ◽  
Recovery Capacity ◽  
Rate Dynamic

INTRODUCTION: Recovery of most hemiparetic patients at 90 days can be well predicted as a fixed proportion (70%) of initial motor deficit. However, recent work has shown considerable variability in the rate of recovery among proportional recoverers, prompting consideration of whether rate of recovery and recovery capacity are independent and whether a single rate dynamic governs proportional recovery. HYPOTHESIS: Among proportional recoverers, recovery rate variability can be accounted for by a single mathematical model in which: 1) recovery rate is independent of recovery capacity and 2) recovery has a sigmoid trajectory parameterized only by initial stroke severity. METHODS: We studied 23 patients with first-ever unilateral hemiparetic stroke previously identified as proportional recoverers. Fugl-Meyer Upper Extremity Motor Exam (FM-UE) had been measured at <72h, 1 week, and 90 days. A non-linear model predicting patients’ FM-UE score at any time after stroke onset was posited and model parameters were estimated by regressing one-week FM-UE scores against initial scores. Statistical significance and goodness of fit were evaluated. RESULTS: The model accounted for 86% of variability in motor recovery achieved by patients at 1 week after stroke onset (pseudo-R 2 =0.863, F 23,21= 418.0, p <.0001) and predicted that more severely impaired patients will have a slower maximum recovery rate and a recovery period that is longer in duration and more delayed in onset. CONCLUSION: The model provides evidence that proportional recovery is governed by a single rate dynamic and that recovery rate is independent of recovery capacity. It provides a tool for predicting motor impairment at any time following stroke onset and suggests a framework for characterizing the biology of recovery and the role of therapeutic interventions as either capacity-enhancing or rate-enhancing.

scholarly journals Spectrum of Changes in Gastric Mucosa with Helicobacter Pylori Infection

2015 ◽  
Vol 12 (1) ◽  
pp. 29-31 ◽  
Author(s):  
PG Ghimire ◽  
P Ghimire ◽  
RG Goel ◽  
DV Bahl
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Histopathological Examination ◽  
Endoscopic Biopsy ◽  
Correlated Data ◽  
Histopathological Study ◽  
P Value ◽  
Female Ratio ◽  
Younger Age ◽  
H Pylori

Aim: To evaluate the spectrum of mucosal changes in endoscopy guided gastric biopsies and analyze the association of Helicobacter pylori with demographic factors.Materials and Methods: It was a cross sectional analytical study conducted in the Department of Pathology during the period from December 2011 to April 2012. A total of 52 endoscopic biopsy specimens, each fulfilling the inclusive criteria were selected and processed using standard histopathological technique and stained with Haematoxylin-Eosin stain and modified Giemsa stain for Helicobacter pylori. Histopathological, ultrasonographic and endoscopic findings were correlated. Data were analyzed using SPSS 17.Results: Out of 52 cases enrolled in our study, 29 (55.8%) were males and 23 (44.2%) were females with a male: female ratio of 1.2:1. H. pylori infection was present in 16 (30.8 %) of biopsies and was significantly greater in the younger age group between 21 to 40 years (p value <0.024). Histopathological examination showed atrophy of the gastric mucosa in 18 (34.6%) cases, dysplasia in one and intestinal metaplasia in three cases. Statistically significant relation (p value < 0.006) was seen between H. pylori and mucosal atrophy. No significant association was seen between gender and presence of H. pylori in the gastric mucosa (p value < 0.16).Conclusions: Histopathological study of endoscopic biopsy showed spectrum of changes in symptomatic cases. H pylori was seen significantly in younger age with atrophy of gastric mucosa as a significant finding.Journal of Nepalgunj Medical College Vol.12(1) 2014: 29-31

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