scholarly journals Ozonated water lavage and physiological saline irrigation combined with vacuum-sealed drainage in the treatment of 18 cases of chronic osteomyelitis

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199953
Author(s):  
Tayierjiang Yasheng ◽  
Aini Mijiti ◽  
Maimaiaili Yushan ◽  
Zhenhui Liu ◽  
Yanshi Liu ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Negative Pressure ◽  
Chronic Osteomyelitis ◽  
Physiological Saline ◽  
Clinical Effects ◽  
Saline Irrigation ◽  
Closed Drainage ◽  
Length Of Hospitalization ◽  
Ozonated Water

Objective Ozone is a colorless gas used as a disinfectant and to treat diseases by limiting the effects of bacteria, viruses, fungi, yeast, and protozoa. In this study, we investigated the clinical efficacy of ozonated water lavage and physiological saline irrigation combined with vacuum-sealed drainage (VSD) in the treatment of chronic osteomyelitis. Methods Eighteen patients (14 men and 4 women) with chronic osteomyelitis in the limbs (tibia: 13 cases; femur: 4 cases; humerus: 1 case) admitted to our hospital between April 2012 and October 2018 were selected. The patients were aged 9 to 52 years, with a mean age of 31 years. All patients underwent ozonated water lavage and physiological saline irrigation combined with VSD negative pressure closed drainage during hospitalization. The patients were followed up for 18 to 84 months, with a mean of 31 months. Results Osteomyelitis recurred in only one case of nonunion. The length of hospitalization was 18 to 29 days, with a mean of 21 days. Conclusions A combination of ozonated water lavage, physiological saline irrigation, and VSD provided good clinical effects in the treatment of chronic osteomyelitis, and thus, is recommended for such treatment.

scholarly journals Randomized clinical trial comparing spinal anesthesia with local anesthesia with sedation for loop colostomy closure

2010 ◽  
Vol 47 (3) ◽  
pp. 270-274 ◽  
Author(s):  
Rone Antônio Alves de Abreu ◽  
Filinto Anibal Alagia Vaz ◽  
Ricardo Laurino ◽  
Manlio Basilio Speranzini ◽  
Luís Cesar Fernandes ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Spinal Anesthesia ◽  
Randomized Clinical Trial ◽  
Local Anesthesia ◽  
Physiological Saline ◽  
Loop Colostomy ◽  
Colostomy Closure ◽  
Physiological Saline Solution ◽  
Spinal Anesthesia Group ◽  
Length Of Hospitalization

CONTEXT: Recent studies have shown that local anesthesia for loop colostomy closure is as safe as spinal anesthesia for this procedure. OBJECTIVES: Randomized clinical trial to compare the results from these two techniques. METHODS: Fifty patients were randomized for loop colostomy closure using spinal anesthesia (n = 25) and using local anesthesia (n = 25). Preoperatively, the bowel was evaluated by means of colonoscopy, and bowel preparation was performed with 10% oral mannitol solution and physiological saline solution for lavage through the distal colostomy orifice. All patients were given prophylactic antibiotics (cefoxitin). Pain, analgesia, reestablishment of peristaltism or peristalsis, diet reintroduction, length of hospitalization and rehospitalization were analyzed postoperatively. RESULTS: Surgery duration and local complications were greater in the spinal anesthesia group. Conversion to general anesthesia occurred only with spinal anesthesia. There was no difference in intraoperative pain between the groups, but postoperative pain, reestablishment of peristaltism or peristalsis, diet reintroduction and length of hospitalization were lower with local anesthesia. CONCLUSIONS: Local anesthesia plus sedation offers a safer and more effective method than spinal anesthesia for loop colostomy closure.

The Hip Suction Seal, Part I: The Role of Acetabular Labral Height on Hip Distractive Stability

2020 ◽  
Vol 48 (11) ◽  
pp. 2726-2732 ◽  
Author(s):  
Hunter W. Storaci ◽  
Hajime Utsunomiya ◽  
Bryson R. Kemler ◽  
Samuel I. Rosenberg ◽  
Grant J. Dornan ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Clinical Effects ◽  
Acetabular Labrum ◽  
Peak Negative Pressure ◽  
Hip Stability ◽  
New Strategy ◽  
Fresh Frozen ◽  
Articular Pathology ◽  
Distraction Force ◽  
Suction Seal

Background: The acetabular labrum has been found to provide a significant contribution to the distractive stability of the hip. However, the influence of labral height on hip suction seal biomechanics is not known. Hypothesis: The smaller height of acetabular labrum is associated with decreased distractive stability. Study Design: Descriptive laboratory study. Methods: A total of 23 fresh-frozen cadaveric hemipelvises were used in this study. Hips with acetabular dysplasia or femoroacetabular impingement–related bony morphologic features, intra-articular pathology, or no measurable suction seal were excluded. Before testing, each specimen’s hip capsule was removed, a pressure sensor was placed intra-articularly, and the hip was fixed in a heated saline bath. Labral size was measured by use of a digital caliper. Maximum distraction force, distance to suction seal rupture, and peak negative pressure were recorded while the hip underwent distraction at a rate of 0.5 mm/s. Correlations between factors were analyzed using the Spearman rho, and differences between groups were detected using Mann-Whitney U test. Results: Of 23 hips, 12 satisfied inclusion criteria. The maximum distraction force and peak negative pressure were significantly correlated ( R = −0.83; P = .001). Labral height was largely correlated with all suction seal parameters (maximum distraction force, R = 0.69, P = .013; distance to suction seal rupture, R = 0.55, P = .063; peak negative pressure, R = −0.62, P = .031). Labral height less than 6 mm was observed in 5 hips, with a mean height of 6.48 mm (SD, 2.65 mm; range, 2.62-11.90 mm; 95% CI, 4.80-8.17 mm). Compared with the 7 hips with larger labra (>6 mm), the hips with smaller labra had significantly shorter distance to suction seal rupture (median, 2.3 vs 7.2 mm; P = .010) and significantly decreased peak negative pressure (median, −59.3 vs −66.9 kPa; P = .048). Conclusion: Smaller height (<6 mm) of the acetabular labrum was significantly associated with decreased distance to suction seal rupture and decreased peak negative pressure. A new strategy to increase the size of the labrum, such as labral augmentation, could be justified for patients with smaller labra in order to optimize the hip suction seal. Clinical Relevance: The height of the acetabular labrum is correlated with hip suction seal biomechanics. Further studies are required to identify the clinical effects of labral height on hip stability.

scholarly journals Clinical Population Pharmacokinetics/Pharmacodynamics Protocol of Alkaloids from Leaf of Alstonia scholaris on Acute Bronchitis Patients

2019 ◽  
Author(s):  
Rui Li ◽  
Wan-Tong Zhang ◽  
Yun-Li Zhao ◽  
Ming-Yue Sun ◽  
Mao-Rong Fan ◽  
...  
Keyword(s):  
Population Pharmacokinetics ◽  
Clinical Efficacy ◽  
Acute Bronchitis ◽  
Interindividual Variation ◽  
Clinical Population ◽  
Mucosal Inflammation ◽  
Clinical Effects ◽  
Post Dose ◽  
Blood Samples ◽  
Alstonia Scholaris

Abstract Background Acute tracheobronchitis is the acute tracheobronchial mucosal inflammation caused by biological, physical, chemical stimulation, and accompanied by symptoms of cough and expectoration. The capsule of alkaloids from leaf of Alstonia scholaris (CALAS), an effective part riches in alkaloids, has the antiviral, antibacterial, anti-inflammatory, expectorant, anti-tussive, anti-asthmatic, immunoregulation effects. However, whether the clinical indexes could be improved by the same ingredients and pathways after oral administration, and the changes in the relationship between ingredients and pharmacodynamics indexes, still need further clinical verification.Methods/design This is a prospectively planned, blinded, placebo-controlled, parallel-grouped clinical trial with aggregated population pharmacokinetics/pharmacodynamics (PPK/PD) data. 55 subjects will be randomly allocated into four arms, specifically, 10 of the 55 subjects were selected randomly for the placebo arm who will be orally administered with placebo (Tid), and 45 subjects were randomly assigned to CALAS treatment group (20 mg, 40 mg, 80 mg Tid, 15 subjects per group). The medication, cough and phlegm, body temperature of every subject should be recorded daily during treatment. Each subject will be collected 3-4 blood samples at the following points for PPK/PPD parameters analysis. Blood samples will be acquired pre-dose (0 h) and post-dose at 15 min, 40 min, 1 h, 1.5 h, 2 h, 3 h, 4 h, 6 h, 8 h, 12 h, 24 h, 30 h, 48 h after last dosing. All subjects will receive a laboratory examination and efficacy evaluation on day 8.Discussion A new integrating strategy to explore relationship among drug ingredients, action pathway and clinical efficacy will be established through this study. We aim to explore the mechanism of CALAS in treatment of acute bronchitis on the premise of definite active ingredients and reliable clinical efficacy. It is difficult to be accepted by patients since classical pharmacokinetics (PK) research adopts intensive sampling method, meanwhile, it cannot quantify the variability of PK parameters (Intra-individual variation, interindividual variation and weekly variation). Moreover, extrapolation and prediction of dosage regimen between different species and populations cannot be realized. Therefore, PPK/PPD method, usually taking advantage of sparse data (3-5 time points sampling per patient), which be selected to find out the measurable factors of pathology and physiology that lead to the change of dose-concentration, and guide reasonable dose adjustment to achieve the optimal clinical effects.

scholarly journals The Efficacy of Tripterygium Glycosides Combined with LMWH in Treatment of HSPN in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yan Jin ◽  
Yanzheng Wang ◽  
Sai Wang ◽  
Qiongqiong Zhao ◽  
Donghua Zhang ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Clinical Symptoms ◽  
Effective Rate ◽  
Control Group ◽  
Clinical Effects ◽  
Observation Group ◽  
Significant Difference ◽  
Before And After ◽  
Qilu Hospital ◽  
Tripterygium Glycosides

Objective. This study aimed to explore the clinical efficacy and relevant mechanism of Tripterygium glycosides combined with low molecular weight heparin calcium (LMWH) in the treatment of Henoch–Schönlein purpura nephritis (HSPN) in children. Methods. 64 cases of children patients with HSPN treated at Qilu Hospital (Qingdao) from January 2015 to May 2020 were selected and randomly divided into the control group and the observation group and 32 cases in each group. Conventional medical treatment was applied in the two groups, besides which the control group was given LMWH while the observation group was given Tripterygium glycosides based on the control group. The clinical efficacy and the indexes of clinical symptoms of the two groups were compared. Immune globulin level, fibrinogen content (FIB), prothrombin time (PT), platelet level (PLT), and activated partial thromboplastin time (APTT) level of the two groups were compared before and after the treatment. Results. The total effective rate in the observation group was significantly higher than that of the control group, and the recurrence rate in the observation group was lower than that in the control group. After treatment, urine red blood cell count and 24 h urine protein were obviously better than those of the control group. There was no statistically significant difference in PT between the two groups of children before and after treatment. The levels of PLT and FIB in the two groups of patients after treatment were significantly lower than before treatment, and the PLT levels in the observation group were lower than those in the control group. Conclusion. The combination of Tripterygium glycosides and LMWH had good clinical effects in the treatment of children with HSPN, and it could improve the clinical symptoms, the mechanism of which might be related to the increase of PT, a decrease of PLT, and the improvement of coagulation function.

scholarly journals Ketoprofen as an Add-on Treatment to Sertraline for Drug-Naïve Major Depressed Patients: Normalization of Plasma Levels of Indoleamine-2,3-Dioxygenase in Association with Pro-Inflammatory and Immune Regulatory Cytokines

2018 ◽  
Author(s):  
Hussein Al-Hakeim ◽  
Ahmed Jasim Twayej ◽  
Arafat Hussein Al-Dujaili ◽  
Michael Maes
Keyword(s):  
Clinical Efficacy ◽  
Transforming Growth Factor ◽  
Inflammatory Responses ◽  
Serum Levels ◽  
Future Research ◽  
Control Group ◽  
Clinical Effects ◽  
Indoleamine 2,3 Dioxygenase ◽  
Anti Inflammatory ◽  
Normal Controls

Major Depression Disorder (MDD) is accompanied by an immune response characterized by increased levels of pro-inflammatory and immune-regulatory cytokines and cytokine-induced stimulation of indoleamine-2,3-dioxygenase (IDO). There is also some evidence that anti-inflammatory drugs may have a clinical efficacy in MDD.The aim of this study is to examine the clinical effects of an eight-week combinatorial treatment of ketoprofen (a nonsteroidal anti-inflammatory drug) combined or not with sertraline, on serum levels of IDO, interferon (IFN)-&gamma;, interleukin (IL)-4 and transforming growth factor (TGF)-&beta;1 in association with changes in the Beck-Depression Inventory-II (BDI-II). The study included 140 MDD patients and 40 normal controls. The pre-treatment serum levels of IDO, IFN-&gamma;, TGF-&beta;1 and IL-4 were significantly higher in MDD patients compared with the control group. Treatment with sertraline with or without ketoprofen significantly reduced the increased baseline production of all 4 biomarkers to levels which were similar as those of normal controls. Ketoprofen add-on had a significantly greater effect on IDO and BDI-II as compared with placebo. The reductions in IDO, IL-4 and TGF-&beta;1 during treatment were significantly associated with those in the BDI-II.In conclusion, the clinical efficacy of both sertraline + ketoprofen may be ascribed at least in part to attenuated IDO levels and immune-inflammatory responses in MDD. Moreover, add-on treatment with ketoprofen may augment the efficacy of sertraline by attenuating IDO. However, these treatments may also significantly reduce the more beneficial properties of T helper-2 and T regulatory (Treg) immune subsets. Future research should develop immune treatments that target the immune-inflammatory response in MDD, while enhancing the compensatory immune-regulatory system (CIRS).

scholarly journals Ultrastructural analysis of uninstrumented root canal areas following various irrigation regimens

2016 ◽  
Vol 63 (2) ◽  
pp. 57-65 ◽  
Author(s):  
Radomir Barac ◽  
Jelena Popović ◽  
Slavoljub Živković ◽  
Aleksandar Mitić ◽  
Marija Nikolić
Keyword(s):  
Root Canal ◽  
Control Sample ◽  
Physiological Saline ◽  
Endodontic Treatment ◽  
Smear Layer ◽  
Favorable Effect ◽  
Canal Wall ◽  
Saline Irrigation ◽  
Dentinal Tubules ◽  
Left Behind

Abstract Introduction During endodontic treatment smaller or larger areas of root canal wall remain non-instrumented. This can affect prognosis of endodontic treatment as some bacteria may be left behind. The purpose of this study was to evaluate the morphology of non-instrumented areas of the root canal wall using scanning-electron-microscopy (SEM) after completed instrumentation and various irrigation regiments. Materials and Methods Eighteen single-rooted extracted teeth were divided into the six groups. One tooth in each group represented a control sample. In all samples only one half of the canal was instrumented using ISO 40 hand files. Control samples were subjected to an irrigation protocols without instrumentation. Irrigants used were physiological saline, 3% sodium hypochlorite and 15% of ethylene-diamine-tetra-acetate. Irrigation protocol included using each of these irrigants alone, or a combination of NaOCl and EDTA, as well as their combination with final irrigation using NaOCl or chlorhexidine. Then after, roots were sectioned longitudinally and prepared for SEM. Results Saline irrigation left pulpal debris on uninstrumented areas of the canal wall. Irrigation with 3% NaOCl left behind canal wall with different forms of calcospherites. However, after EDTA irrigation dentin appeared as an undulating surface with open tubules without a smear layer. The combination of NaOCl and EDTA showed remnants of calcospherites and open slightly widened dentinal tubules. Final irrigation with NaOCl on the uninstrumented areas showed enlarged dentinal tubules along with dentinal erosion, while after final irrigation with CHX clean dentin and open dentinal tubules without smear layer were noted. Conclusion From the morphological point of view, the most favorable effect of irrigation on both uninstrumented and uninstrumented canal walls was achieved after irrigation with NaOCl and EDTA or NaOCl, EDTA and chlorhexidine as the final irrigant.

scholarly journals The comparison of the efficacy of Alveogyl, 0.8% Hyaluronic acid, and 0.2% Chlorhexidine Digluconate in alveolar osteitis

2021 ◽  
Vol 11 (1) ◽  
pp. 6-11
Author(s):  
Ömür Dereci ◽  
Görkem Tekin ◽  
Yasin Çağlar Koşar
Keyword(s):  
Hyaluronic Acid ◽  
Clinical Signs ◽  
Physiological Saline ◽  
Signs And Symptoms ◽  
Control Group ◽  
Chlorhexidine Digluconate ◽  
Saline Irrigation ◽  
Significant Difference ◽  
Alveolar Osteitis ◽  
Clinical Signs And Symptoms

Aim:  The aim of this study was to compare the efficacy of Alveogyl, 0.8% hyaluronic acid (HA), and 0.2% chlorhexidine digluconate (CHX) gel in reducing pain and improving clinical signs and symptoms of alveolar osteitis. Methodology: The clinical data of patients treated for alveolar osteitis between 01/01/2015 and 01/01/2019 were retrieved for this study. All patients were initially treated by curettage and physiological saline irrigation. Patients were then divided into 4 groups. Group 1 was considered the control group; no other biomaterials were administered after curettage and physiological saline irrigation. All other groups were administered an additional treatment in the socket after curettage and physiological saline irrigation (Group 1 – Alveogyl; Group 2 - 0.8% HA; Group 3 - 0.2% CHX). Patents were evaluated before surgery as well as days 3 and 7 after surgery. The postoperative evaluations included: Visual analog scale(VAS) pain scores, the presence of clinical signs and symptoms of exposed alveolar bone, disorganized blood clot, inflammation around the socket, and bad odor and taste. Results: Sixty-seven patients were included in the study. There was no statistically significant difference between groups in all control evaluations (p>0.05). There was significantly reduced inflammation around the extraction socket on postoperative day 7 in the CHX group compared to that in the control group (p<0.05). No other significant changes in clinical signs and symptoms were observed among groups. Conclusion: There was no significant difference between curettage with physiological saline irrigation alone and the addition of Alveogyl, 0.8% HA, or 0.2% CHX in the reduction of pain in alveolar osteitis. Nonetheless, CHX may reduce inflammation around the extraction sockets.   How to cite this article: Dereci Ö, Görkem T, Koşar YÇ. The comparison of the efficacy of Alveogyl, 0.8% Hyaluronic acid, and 0.2% Chlorhexidine Digluconate in alveolar osteitis. Int Dent Res 2021;11(1):6-11. https://doi.org/10.5577/intdentres.2021.vol11.no1.2   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

scholarly journals Immunological and clinical effects of low-dose interleukin-2 across 11 autoimmune diseases in a single, open clinical trial

2018 ◽  
Vol 78 (2) ◽  
pp. 209-217 ◽  
Author(s):  
Michelle Rosenzwajg ◽  
Roberta Lorenzon ◽  
Patrice Cacoub ◽  
Hang Phuong Pham ◽  
Fabien Pitoiset ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Autoimmune Diseases ◽  
Clinical Efficacy ◽  
T Cell Activation ◽  
Lupus Erythematosus ◽  
Cell Activation ◽  
Low Dose ◽  
Therapeutic Potential ◽  
Interleukin 2 ◽  
Clinical Effects

ObjectiveRegulatory T cells (Tregs) prevent autoimmunity and control inflammation. Consequently, any autoimmune or inflammatory disease reveals a Treg insufficiency. As low-dose interleukin-2 (ld-IL2) expands and activates Tregs, it has a broad therapeutic potential.AimWe aimed to assess this potential and select diseases for further clinical development by cross-investigating the effects of ld-IL2 in a single clinical trial treating patients with 1 of 11 autoimmune diseases.MethodsWe performed a prospective, open-label, phase I–IIa study in 46 patients with a mild to moderate form of either rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, psoriasis, Behcet’s disease, granulomatosis with polyangiitis, Takayasu’s disease, Crohn’s disease, ulcerative colitis, autoimmune hepatitis and sclerosing cholangitis. They all received ld-IL2 (1 million IU/day) for 5 days, followed by fortnightly injections for 6 months. Patients were evaluated by deep immunomonitoring and clinical evaluation.Resultsld-IL2 was well tolerated whatever the disease and the concomitant treatments. Thorough supervised and unsupervised immunomonitoring demonstrated specific Treg expansion and activation in all patients, without effector T cell activation. Indication of potential clinical efficacy was observed.ConclusionThe dose of IL-2 and treatment scheme used selectively activate and expand Tregs and are safe across different diseases and concomitant treatments. This and preliminary indications of clinical efficacy should licence the launch of phase II efficacy trial of ld-IL2 in various autoimmune and inflammatory diseases.Trial registration numberNCT01988506.

scholarly journals Therapeutic Effect Analysis of Sodium Aescinate Tablets on Knee Osteoarthritis Combined with Synovitis

2021 ◽  
Vol 5 (6) ◽  
pp. 1-6
Author(s):  
Xueqin Zeng ◽  
Baohui Wang ◽  
Liang Li ◽  
Tao Lei ◽  
Huajian Liu ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Therapeutic Effect ◽  
Knee Pain ◽  
Clinical Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Clinical Effects ◽  
Joint Function ◽  
Routine Treatment ◽  
The Difference

Objective: To observe therapeutic effect of sodium aescinate Tablets on knee osteoarthritis complicated with synovitis. Methods: 86 patients with knee osteoarthritis combined with synovitis treated in the Honghui Hospital Affiliated to Xi’an Jiaotong University from January 2018 to December 2019 were randomly divided into control group and intervention group, with 43 cases in each group. The control group was given routine treatment, and the intervention group was given sodium aescinate Tablets orally on the basis of routine treatment, twice a day, 2 tablets each time. The curative effect was evaluated after 2 weeks of treatment. The knee pain and joint function of the two groups were evaluated by Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the clinical effects of the two groups were compared. Results: Before treatment, there was no significant difference in general information, VAS and WOMAC scores between the two groups (P > 0.05). After treatment, the VAS and WOMAC scores of the two groups were both lower than those before treatment, and the difference was statistically significant (P < 0.05). The vas and WOMAC scores of the intervention group were lower than those of the control group (VAS, 1.87 ± 0.79 vs 3.38 ± 0.81. In this study, sodium aescinate tablets were applied to the treatment of KOA combined with synovitis. The results showed that the intervention group was better than the control group in alleviating knee pain, improving joint function and improving clinical efficacy, and the difference was statistically significant. The total effective rate of the intervention group was higher than that of the control group (100% vs 86.05%), and the difference was statistically significant (P < 0.05). Conclusion: Sodium aescinate tablet in the treatment of knee osteoarthritis combined with synovitis can effectively alleviate knee pain, improve joint function and improve clinical efficacy.

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