scholarly journals Neuro-Muscular Dentistry: the “diamond” concept of electro-stimulation potential for stomato-gnathic and oro-dental conditions

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Catalina P. Sandoval-Munoz ◽  
Ziyad S. Haidar
Keyword(s):  
Dental Health ◽  
Neuromuscular Electrical Stimulation ◽  
Therapeutic Modality ◽  
Language Therapy ◽  
Drug Induced ◽  
Dysphagic Patient ◽  
Treatment Regimens ◽  
Joint Disorder ◽  
Diamond Concept ◽  
Allied Health Profession

AbstractOro-Pharyngeal Dysphagia - or simply dysphagia - is the difficulty (persistent) in swallowing/passing food and/or liquid from the mouth to the pharynx into the esophagus and finally the stomach; a deglutition disorder (a symptom, by definition, often due to neuro-degenerative/−muscular, drug-induced or localized structural pathologies such as head and neck tumors, lesions and associated surgical and/or radiation injuries) linked to severe consequences on Quality of Life (QoL), including malnutrition, dehydration, and even sudden death. Likewise, Temporo-Mandibular Jaw and Joint disorder(s) – or simply TMD – is a multifactorial etiological condition, regularly encountered in the dental office. Whether due to malocclusion, bruxism, stress and/or trauma, TMD destabilizes the whole cranio-mandibular system structurally and functionally, via affecting mastication, teeth, supporting structures, comfort and aesthetics, and thus, QoL, again. While several treatment regimens do exist for such conditions, some of which have been standardized for use over the years, most continue to lack proper evidence-based literature support. Hence, (1) caution is to be exercised; and (2) the need for alternative therapeutic strategies is amplified, subsequently, the door for innovation is wide open. Indeed, neuromuscular electrical stimulation or “NMES”, is perhaps a fine example. Herein, we present the interested oro-dental health care provider with an up-dated revision of this therapeutic modality, its potential benefits, risks and concerns, to best handle the dysphagic patient: an intra-disciplinary approach or strategy bridging contemporary dentistry with speech and language therapy; a rather obscure and un-discovered yet critical allied health profession. A pre-clinical and clinical prospectus on employing inventive NMES-based regimens and devices to manage TMD is also highlighted.

CBIO-19. GENOME SHREDDING ENABLES CRISPR-MEDIATED GLIOBLASTOMA ONCOLYSIS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi31-vi31
Author(s):  
Christof Fellmann ◽  
I-Li Tan ◽  
Alexendar Perez ◽  
Rachel Lew ◽  
Karen Zhu ◽  
...  
Keyword(s):  
Residual Tumor ◽  
Therapy Resistance ◽  
Primary Brain Tumor ◽  
Therapeutic Modality ◽  
Dna Double Strand Breaks ◽  
Innovative Treatment ◽  
Treatment Regimens ◽  
Epigenetic Profile ◽  
Treatment Paradigm ◽  
Species Specific

Abstract Glioblastoma (GBM) is the most common and lethal primary brain tumor in adults 1. Despite multimodal treatment regimens including surgical resection, radio- and chemotherapy, the growth of residual tumor often results in therapy resistance and ultimately death. GBMs are highly diffuse and exhibit extensive intratumoral heterogeneity 2,3, confounding diagnostic efforts and presenting opportunities for therapy evasion. Therefore, innovative treatment paradigms that can efficiently eliminate GBM cells irrespective of their mutational and epigenetic profile are urgently needed. CRISPR technologies have revolutionized medicine by enabling targeted genome editing through RNA-guided introduction of DNA double-strand breaks 4,5. Here, we show that CRISPR-Cas9 mediated genome fragmentation through targeting of highly repetitive loci, termed “genome shredding”, enables rapid and robust elimination of GBM cells. We characterized genome shredding across mammalian and vertebrate cells, and identified optimal repetitive pan-vertebrate and species-specific loci. Genome shredding is equally effective in temozolomide (TMZ)-sensitive and -resistant GBM cells, and multi-cycle treatment regimens are feasible. Importantly, when deployed in intracerebral GBM xenografts through local delivery, CRISPR-Cas9 genome shredding efficiently eliminated all targeted cells. Together, genome shredding enables the rapid and efficient fragmentation of a target cell’s genome and subsequent DNA damage-induced cell death. This provides an innovative treatment paradigm that is independent of a tumor’s mutational and epigenetic profile and leverages CRISPR-Cas9 as a breakthrough therapeutic modality for GBM.

AN OBSERVATIONAL STUDY OF THE CLINICAL PROFILE AND OUTCOMES OF PATIENTS WITH MILIARY TUBERCULOSIS (TB).

2021 ◽  
pp. 11-14
Author(s):  
Rajeev Tandon ◽  
Prabhat Kumar ◽  
Pradeep Nirala ◽  
Ansha Sinha
Keyword(s):  
Mortality Rate ◽  
Observational Study ◽  
Clinical Symptoms ◽  
Treatment Success ◽  
Miliary Tuberculosis ◽  
Time Duration ◽  
Drug Induced ◽  
Treatment Regimens ◽  
Standardized Treatment ◽  
Almost All

Objectives: This study aimed to evaluate the clinical prole and outcome of the patients with miliary tuberculosis (TB). Methods: This was a retrospective observational study which involved evaluation of medical records of 44 patients with miliary TB in the department of respiratory medicine and internal medicine from 2016-2019. Miliary TB in these patients had been diagnosed on the basis of clinical symptoms, radiology and microbiology. The clinical prole of the patients in terms of age, gender, clinical presentations were recorded. Time duration for resolution of symptoms was noted. Radiological outcome was also studied. Final outcome was treatment success and mortality. Results: The mean age of the patients were 37.07 years with 27 males. Most common complaints were fever (86.36%), cough (72.73%), expectoration (65.91%) and anorexia (45.45%). Laboratory ndings showed hypertransaminasemia, anemia, and hyponatremia in 75.00%, 70.45%, and 43.18% patients, respectively. Standardized treatment (RHEZ) was given in 70.45% patients, and non-standardized treatment in 29.55% patients. Median duration of fever was relieved in 15 days. Mortality rate was 11.36% and drug induced liver injury (DILI) was seen in 4(9.09%) patients. Radiological resolution was seen in almost all of the patients except in 3 and in majority of patients clearing was seen within the rst two months of initiation of treatment. Among all variables, hyperbilirubinemia showed signicant association with mortality (OR=14.6, 95% CI 1.86 to 114.615, P=0.013). Conclusion: In conclusion, in our series miliary TB presents most commonly in the third decade of life and is predominant among males. The clinical features were similar to pulmonary tuberculosis. There was frequent association with derangements in liver function, electrolyte, and hemoglobin. Hyperbilirubinemia was associated with signicantly increased the odds of mortality. Non-standardized treatment regimens were associated with poorer outcome. Mortality rate in miliary TB was as high as 11.3% in our series.

scholarly journals Complete Genome Sequences of Gram-Negative Opportunistic Pathogens Isolated in Hospitals in Almaty, Kazakhstan

2021 ◽  
Vol 10 (46) ◽  
Author(s):  
Ilya S. Korotetskiy ◽  
Ardak B. Jumagaziyeva ◽  
Bahkytzhan Kerimzhanova ◽  
Oleg N. Reva ◽  
Sergey V. Shilov ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Study Drug ◽  
Immunosuppressive Drugs ◽  
Opportunistic Pathogens ◽  
Genome Sequences ◽  
Drug Induced ◽  
Gram Negative ◽  
Content Type ◽  
Treatment Regimens ◽  
New Treatment

The problem of nosocomial infections is growing due to the introduction of new treatment regimens involving immunosuppressive drugs. The genomes of seven Gram-negative clinical isolates of Escherichia , Klebsiella , and Pseudomonas were sequenced and analyzed in this study to serve as model microorganisms to study drug-induced antibiotic resistance reversion.

scholarly journals Drug-induced liver injury in cancer patients

2020 ◽  
Vol 15 (3) ◽  
pp. 80-94
Author(s):  
V. T. Ivashkin ◽  
K. L. Raikhelson ◽  
L. K. Palgova ◽  
M. V. Maevskaya ◽  
O. A. Gerasimova ◽  
...  
Keyword(s):  
Liver Injury ◽  
Epidemiological Data ◽  
Drug Induced ◽  
Anticancer Chemotherapy ◽  
Drug Induced Liver Injury ◽  
Treatment Regimens ◽  
Diagnosis And Prognosis ◽  
Development Feature ◽  
Prevention And Treatment ◽  
Practical Recommendations

This review includes information about epidemiological data, development feature, phenotypes, principles of classification, diagnosis, and prognosis for drug-induced liver injury (DILI). Actual clinical recommendations regarding management of the DILI arising in the chemotherapy of cancer discussed. Drugs that can influence on individual pathogenetic mechanisms of growth and symptoms DILI are considered. Clinical studies for the prophylaxis and treatment of DILI associated with anticancer chemotherapy analyzed in detail. The prevention and treatment regimens for DILI in patients receiving chemotherapy and immunotherapy various localizations of cancer given both in research and in practical recommendations.

scholarly journals Eribulin and Confusion: A Previously Unknown Drug Side-Effect

2020 ◽  
Author(s):  
Abu Baker Sheikh ◽  
Abhilash Perisetti ◽  
Nismat Javed ◽  
Rahul Shekhar
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Antineoplastic Agent ◽  
Advanced Breast ◽  
Central Nervous System Drug ◽  
Drug Induced ◽  
Steroid Administration ◽  
Treatment Regimens ◽  
Aged Woman ◽  
Middle Aged Woman

Eribulin is an antineoplastic agent used in advanced breast cancer refractory to anthracycline and taxane treatment regimens. A wide variety of side effects with unclear mechanisms have been noted, but encephalopathy has not been widely reported. Here we describe the case of a middle-aged woman treated with eribulin for advanced breast cancer who subsequently developed central nervous system drug-induced toxicity but improved promptly with steroid administration.

Hemophilia Treatment - A Model for Appropriate Cost Control.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3942-3942
Author(s):  
Louis M. Aledort ◽  
James G. Coates
Keyword(s):  
Cost Control ◽  
Third Party ◽  
Therapeutic Modality ◽  
Systematic Evaluation ◽  
Evaluation Program ◽  
Treatment Regimens ◽  
On Demand ◽  
The Past ◽  
Costs Of Care ◽  
Annual Visit

Abstract Hemophilia patients consume large quantities of biologicals. Many are on prophylactic regimens which cost substantially more and have better outcomes as compared to on-demand treatment. In either situation, 95% of costs of care are biologics. As costs are high, third-party payers frequently challenge various treatment regimens. Aetna Inc., working with nurses and a hemophilia treater, initiated a systematic evaluation program of 400 members with hemophilia enrolled in HMO plans to investigate whether these costs could be appropriately controlled. Several caveats were agreed to: No therapeutic modality would be changed unless medically indicated. Patients would be supported to have an annual visit to a comprehensive center, if they were not already followed by one. Changes where biologics were purchased were only done with physician and client agreement. Over the past three years, substantial savings have been accomplished PMPM (per member / per month fully-insured HMO member). The annual spending PMPM for biologics PMPM Total dollars Before program 2003 $0.66 25,650,021 Year 1 2004 $0.60 23,832,539 Year 2 2005 $0.54 21,309,444 Year 3 2006 $0.54 19,395,661 The savings were attributable, in the main, to simply shifting how and where biologics were purchased and could not have been accomplished without the federal PHS pricing program. In three years’ time, annual savings per patient were substantial. The savings per subscriber encouraged Aetna, Inc. to continue this program.

Iron metabolism in tuberculosis and iron-containing chemotherapeutic drugs for its treatment

2020 ◽  
Vol 5 (3) ◽  
pp. 193-196
Author(s):  
Boris E. Borodulin ◽  
Elena V. Yakovleva ◽  
Elena A. Borodulina ◽  
Oksana G. Komissarova
Keyword(s):  
Iron Deficiency ◽  
Iron Metabolism ◽  
Literature Search ◽  
Adverse Reactions ◽  
Web Of Science ◽  
Chemotherapeutic Drugs ◽  
Drug Induced ◽  
Treatment Regimens ◽  
The Past ◽  
Absolute Iron Deficiency

This review included the Russian and international articles on the iron metabolism in tuberculosis and the use of iron-containing drugs in the treatment of tuberculosis over the past 20 years. The main topics covered by the researchers include the features of iron metabolism in mycobacteria, the varieties and pathogenesis of anemia that can develop in tuberculosis: iron deficiency (absolute iron deficiency), associated with a chronic disease (relative iron deficiency) or drug-induced anemia (siderohrestic, hemolytic, aplastic). The possible correction of treatment regimens for tuberculosis is analyzed with the introduction of a complex compound of iron with isoniazid in order to reduce undesirable adverse reactions to isoniazid . The literature search for this review was performed using the RSCI, CyberLeninka, Scopus, Web of Science, MedLine, PubMed databases.

Infliximab-induced autoimmune hepatitis

2021 ◽  
Vol 14 (5) ◽  
pp. e239944
Author(s):  
Alexander Jenkins ◽  
Amy Austin ◽  
Kathryn Hughes ◽  
Brett Sadowski ◽  
Dawn Torres
Keyword(s):  
Autoimmune Hepatitis ◽  
Wide Spectrum ◽  
Inflammatory Disorder ◽  
Drug Induced ◽  
Necrosis Factor Alpha ◽  
Treatment Regimens ◽  
Circulating Antibodies ◽  
Inflammatory Bowel ◽  
Factor Alpha ◽  
Necrosis Factor

Autoimmune hepatitis (AIH) is an inflammatory disorder of the liver with a wide spectrum of disease presentation, from asymptomatic elevations in liver-associated enzymes to acute liver failure. AIH is classically associated with elevated immunoglobulins and autoantibodies, although approximately 20% of patients with features of AIH lack circulating antibodies. Recently, tumour necrosis factor alpha inhibitors have been implicated in several cases of drug-induced AIH which impact treatment regimens for patients with inflammatory bowel disease (IBD). We present a case of infliximab-induced seronegative AIH responding to budesonide therapy with successful alteration of IBD treatment regimen to vedolizumab.

scholarly journals The Information from Medical Data Based: Prevalence and Expected Median Survival Time of Drug-Induced Hepatotoxicity Among Thai Patients with TB

2021 ◽  
Author(s):  
Santisith Khiewkhern ◽  
Nuchnapa Pratumchai ◽  
Parichart Sattayarak ◽  
Patcharin Phuwilert ◽  
Supattra Noo-In ◽  
...  
Keyword(s):  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Liver Function Tests ◽  
Survival Times ◽  
Hospital Data ◽  
Drug Induced ◽  
Cross Sectional ◽  
Treatment Regimens ◽  
Kaplan Meier

Background: Hepatotoxicity is very frequent and is a dangerously adverse effect of anti-TB medications. This effect can reduce the effectiveness of the treatment by compromising treatment regimens. Among these first-line quadruple therapy drugs (INH, RMP, PZA, and EMB), INH, RMP, and PZA are metabolized mostly by the liver, and due to this, are likely hepatotoxic. However, the survival times of hepatotoxicity among patients with TB in Thailand are currently not available. The aims of the present study were to assess the prevalence and survival time of drug-induced hepatotoxicity in patients with TB. Methods: A cross-sectional retrospective study was performed to explore the survival time of the development of drug-induced hepatotoxicity among 327 patients with TB who received standard drug treatment at the TB clinic in Phichit Hospital. Data was collected from the HOSxP program and medical records from 2016 to 2018. Kaplan-Meier and Cox’s regressions were used for data analysis. Results: The results showed that prevalence of drug-induced hepatotoxicity was 6.42% and confirmed that patients with TB who were <50 years of age will be a median survival time on drug-induced hepatotoxicity is 17 days and 30 days for those who age group ≥50 years. Conclusion: The median survival time of drug-induced hepatotoxicity among patients with TB who were <50 years of age is 17 days. So, patients with TB whose ages are less than 50 years should receive liver function tests such as AST and ALT and investigate risk behavior before receiving the anti- TB treatment.

scholarly journals Cancer Immunotherapy Comes of Age

2011 ◽  
Vol 29 (36) ◽  
pp. 4828-4836 ◽  
Author(s):  
Suzanne L. Topalian ◽  
George J. Weiner ◽  
Drew M. Pardoll
Keyword(s):  
Cancer Immunotherapy ◽  
Antitumor Immunity ◽  
Ex Vivo ◽  
Adaptive Immune System ◽  
Therapeutic Modality ◽  
Immune Memory ◽  
Immune Checkpoints ◽  
Cancer Therapies ◽  
Treatment Regimens ◽  
Antitumor Antibodies

Cancer immunotherapy comprises a variety of treatment approaches, incorporating the tremendous specificity of the adaptive immune system (T cells and antibodies) as well as the diverse and potent cytotoxic weaponry of both adaptive and innate immunity. Immunotherapy strategies include antitumor monoclonal antibodies, cancer vaccines, adoptive transfer of ex vivo activated T and natural killer cells, and administration of antibodies or recombinant proteins that either costimulate immune cells or block immune inhibitory pathways (so-called immune checkpoints). Although clear clinical efficacy has been demonstrated with antitumor antibodies since the late 1990s, other immunotherapies had not been shown to be effective until recently, when a spate of successes established the broad potential of this therapeutic modality. These successes are based on fundamental scientific advances demonstrating the toleragenic nature of cancer and the pivotal role of the tumor immune microenvironment in suppressing antitumor immunity. New therapies based on a sophisticated knowledge of immune-suppressive cells, soluble factors, and signaling pathways are designed to break tolerance and reactivate antitumor immunity to induce potent, long-lasting responses. Preclinical models indicate the importance of a complex integrated immune response in eliminating established tumors and validate the exploration of combinatorial treatment regimens, which are anticipated to be far more effective than monotherapies. Unlike conventional cancer therapies, most immunotherapies are active and dynamic, capable of inducing immune memory to propagate a successful rebalancing of the equilibrium between tumor and host.

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