Recent advances in alcoholic hepatitis

Alcoholic hepatitis is the severest clinical presentation of alcoholic liver disease. Lacking an effective pharmacologic treatment, alcoholic hepatitis is associated with a poor prognosis and its recovery relies mostly on abstinence. With alcohol use disorder being universally on the rise, the impact of alcoholic hepatitis on society and health-care costs is expected to increase significantly. Prognostic factors and liver biopsy can help with timely diagnosis, to determine eligibility and response to corticosteroids, and for prognostication and transplant referral. Although recent discoveries in the pathophysiology of alcoholic hepatitis are encouraging and could pave the way for novel treatment modalities, a multidisciplinary approach considering timely identification and treatment of liver-related complications, infectious and metabolic disease, malnutrition, and addiction counseling should be emphasized. Apart from proper selection of candidates, transplant programs should provide adequate post-transplant addiction support in order to make of early liver transplantation for alcoholic hepatitis the ultimate sobering experience in the next decade.

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Management of Graves’ hyperthyroidism

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.3202 ◽

2011 ◽

pp. 489-494

Author(s):

Jacques Orgiazzi ◽

Claire Bournaud

Keyword(s):

Treatment Strategy ◽

Multidisciplinary Approach ◽

Symptomatic Treatment ◽

Current Treatment ◽

Treatment Modalities ◽

Antithyroid Drugs ◽

Graves Disease ◽

Therapeutic Approaches ◽

Severity Of The Disease ◽

Selection Of

The treatment strategy for the hyperthyroidism of Graves’ disease remains a matter of controversy for several reasons. Treatment modalities available so far are symptomatic rather than pathophysiological, patients are heterogeneous in the severity and prognosis of the disease, and, in many patients, the disease is lifelong. Even symptomatic treatment should be adapted to the severity of the disease, both in terms of intensity of hyperthyroidism and degree of immunological derangement, an elusive goal so far. Current treatment modalities are medical/conservative with antithyroid drugs, often marred by relapse, and radical/destructive with radio-iodine or surgery with subsequent hypothyroidism. Being controversial, the selection of the treatment strategy also requires the patient’s informed cooperation. Finally, another peculiarity of the management of Graves’ disease is the frequent requirement of a multidisciplinary approach. This chapter will discuss general and specific therapeutic approaches of hyperthyroid Graves’ disease.

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Novel treatment strategies for patients with relapsed classical Hodgkin lymphoma

Hematology ◽

10.1182/asheducation-2009.1.507 ◽

2009 ◽

Vol 2009 (1) ◽

pp. 507-519 ◽

Cited By ~ 37

Author(s):

Anas Younes

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Hodgkin Lymphoma ◽

Cell Transplantation ◽

Treatment Strategies ◽

Treatment Modalities ◽

Classical Hodgkin Lymphoma ◽

Novel Treatment ◽

Novel Treatment Strategies ◽

The Impact

AbstractAlthough classical Hodgkin lymphoma (HL) is considered one of the most curable human cancers, the treatment of patients with relapsed and refractory disease, especially those who relapse after autologous stem cell transplantation, remains challenging. Furthermore, because the median age of the patients is in the mid-30s, the impact of early mortality on the number of years lost from productive life is remarkable. Patients with HL whose disease relapses after stem cell transplantation are rarely cured with current treatment modalities. New drugs and novel treatment strategies that are based on our understanding of the disease biology and signaling pathways are needed to improve treatment outcome for these patients. This review will focus on emerging new treatment modalities that are currently under investigation for patients with relapsed classical HL.

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The Impact of Novel Treatment Modalities on the Therapeutic Approach of Cardiovascular Diseases

Angiology ◽

10.1177/0003319708328923 ◽

2008 ◽

Vol 60 (1) ◽

pp. 5-7 ◽

Cited By ~ 1

Author(s):

Kosmas I. Paraskevas ◽

Chrisovalantis Psathas ◽

Theodoros Dragios ◽

Dimitrios G. Chatzis ◽

Dimitri P. Mikhailidis ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Therapeutic Approach ◽

Treatment Modalities ◽

Novel Treatment ◽

The Impact

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Transcranial Direct Current Stimulation: a potential novel treatment for alcohol addiction and abuse

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v17i1.35272 ◽

2018 ◽

Vol 17 (1) ◽

pp. 7-15

Author(s):

Amandeep Bhandal ◽

Tania Sultana ◽

Khurram Janjua

Keyword(s):

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Alcohol Use Disorder ◽

Medical Science ◽

Alcohol Addiction ◽

Health Concern ◽

Treatment Modalities ◽

Direct Current Stimulation ◽

Novel Treatment ◽

Dorsolateral Prefrontal

Alcohol use disorder (AUD) is a major global health concern. Many treatment modalities have been used in past to help decrease the use of alcohol. Recently, a growing interest has been seen in neuromodulation as a novel treatment means to reduce alcohol addiction behavior. Studies on the effect of Transcranial Direct Current Stimulation (tDCS), especially over dorsolateral prefrontal cortex (DLPFC) have been conducted that have shown to reduce craving and relapse behavior in AUD. Adverse effects associated with tDCS are found to be minor and are temporary in nature. However, the results are preliminary as only few studies are done. More research on AUD done using tDCS will help improve our knowledge and understanding on the various factors involved in AUD besides helping to prevent the cycle of craving, relapse and abstinent.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.7-15

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Review of Treatment of Reflex Sympathetic Dystrophy

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v11i3.11714 ◽

2012 ◽

Vol 11 (3) ◽

pp. 160-164

Author(s):

JC Ghosh ◽

SC Hazra ◽

ME Haque ◽

PS Ghamsari ◽

SK Singha

Keyword(s):

Reflex Sympathetic Dystrophy ◽

Clinical Presentation ◽

Medical Science ◽

Preventive Measure ◽

Treatment Modalities ◽

Standardized Protocol ◽

Management Protocol ◽

Review Study ◽

Pharmacological Method ◽

Selection Of

A review study was done by searching literature through PubMed. Reflex sympathetic dystrophy is a life altering disease pathogenesis of which are not yet clearly known likewise its management protocol has not been established. Treatment of longstanding Reflex sympathetic dystrophy is empirical and of limited efficacy. This disease may lead to dreadful squeal which may need amputation for their management and few of these patients may even develop suicidal tendency. Patient with Reflex sympathetic dystrophy usually present late. It was found that the clinical presentation of RSD are too much variable, although different modalities of treatment are used either alone or in combination, the outcomes are often unpredictable and of variable efficacy. Understanding of the treatment modalities and proper selection of treatment option are essential for best outcome. Preventive measure does play a role in management of these patients. Option of treatment includes pharmacological method, sympathetic nervous system interruption, use of calcitonin and bisphosphonate. More study is required to find out the mechanism that triggers the pain and other clinical manifestation so that a standardized protocol for its management can be developed DOI: http://dx.doi.org/10.3329/bjms.v11i3.11714 Bangladesh Journal of Medical Science Vol. 11 No. 03 July12

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Current Strategies in the Management of Spinal Metastatic Disease

Swiss Surgery ◽

10.1024/1023-9332.9.2.55 ◽

2003 ◽

Vol 9 (2) ◽

pp. 55-62 ◽

Cited By ~ 7

Author(s):

Bartanusz ◽

Porchet

Keyword(s):

Spinal Cord ◽

Surgical Techniques ◽

Cord Compression ◽

Treatment Modalities ◽

Surgical Approaches ◽

Spinal Stabilization ◽

Management Algorithm ◽

Specific Manner ◽

Extensive Surgery ◽

Selection Of

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.

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Methods for Restricting Maximum Exposure Rate in Computerized Adaptative Testing

Methodology ◽

10.1027/1614-2241.3.1.14 ◽

2007 ◽

Vol 3 (1) ◽

pp. 14-23 ◽

Cited By ~ 9

Author(s):

Juan Ramon Barrada ◽

Julio Olea ◽

Vicente Ponsoda

Keyword(s):

Measurement Accuracy ◽

Computerized Adaptive Testing ◽

Computation Time ◽

Adaptive Testing ◽

Exposure Rate ◽

Control Parameters ◽

The Impact ◽

Two Alternatives ◽

Selection Of ◽

Maximum Exposure

Abstract. The Sympson-Hetter (1985) method provides a means of controlling maximum exposure rate of items in Computerized Adaptive Testing. Through a series of simulations, control parameters are set that mark the probability of administration of an item on being selected. This method presents two main problems: it requires a long computation time for calculating the parameters and the maximum exposure rate is slightly above the fixed limit. Van der Linden (2003) presented two alternatives which appear to solve both of the problems. The impact of these methods in the measurement accuracy has not been tested yet. We show how these methods over-restrict the exposure of some highly discriminating items and, thus, the accuracy is decreased. It also shown that, when the desired maximum exposure rate is near the minimum possible value, these methods offer an empirical maximum exposure rate clearly above the goal. A new method, based on the initial estimation of the probability of administration and the probability of selection of the items with the restricted method ( Revuelta & Ponsoda, 1998 ), is presented in this paper. It can be used with the Sympson-Hetter method and with the two van der Linden's methods. This option, when used with Sympson-Hetter, speeds the convergence of the control parameters without decreasing the accuracy.

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Novel treatment opportunities in Graves’ orbitopathy

Orvosi Hetilap ◽

10.1556/oh.2014.29963 ◽

2014 ◽

Vol 155 (33) ◽

pp. 1295-1300

Author(s):

Annamária Erdei ◽

Annamária Gazdag ◽

Miklós Bodor ◽

Eszter Berta ◽

Mónika Katkó ◽

...

Keyword(s):

Clinical Experience ◽

Clinical Course ◽

Treatment Protocol ◽

Treatment Modalities ◽

Graves Disease ◽

Novel Treatment ◽

Graves Orbitopathy ◽

Cd20 Antibody ◽

Anti Cd20 ◽

Novel Therapeutic

Graves’ orbitopathy is the most common extrathyroidal manifestation of Graves’ disease. Up to now, curative treatment modalities for the most severe sight-threatening cases have not been developed. Here the authors summarize the treatment protocol of Graves’ orbitopathy and review novel therapeutic options. They review the literature on this topic and present their own clinical experience. The authors point out that anti-CD20 antibody could positively influence the clinical course of Graves’ orbitopathy. Selenium is efficient in mild cases. Further prospective investigations are warranted. Orv. Hetil., 2014, 155(33), 1295–1300.

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Alteraciones sistémicas y metabólicas producidas por lesión medular

Latin american journal of clinical sciences and medical technology ◽

10.34141/ljcs6429407 ◽

2019 ◽

Vol 1 (1) ◽

pp. 59-75

Author(s):

Gabriel Guízar Sahagún

Keyword(s):

Spinal Cord ◽

Daily Living ◽

Autonomic Function ◽

Clinical Presentation ◽

Scientific Literature ◽

International Standards ◽

Therapeutic Approaches ◽

Cord Injury ◽

Life Threatening ◽

The Impact

Besides the well-known loss of motor and sensory capabilities, people with spinal cord injury (SCI) experience a broad range of systemic and metabolic abnormalities including, among others, dysfunction of cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems. These alterations are a significant challenge for patients with SCI because such disorders severely interfere with their daily living and can be potentially life-threatening. Most of these disorders are associated with impairment of regulation of the autonomic nervous system, arising from disruption of connections between higher brain centers and the spinal cord caudal to the injured zone. Thus, the higher and more complete the lesion, the greater the autonomic dysfunction and the severity of complications.This article summarizes the medical scientific literature on key systemic and metabolic alterations derived of SCI. It provides information primarily focused on the pathophysiology and clinical presentation of these disorders, as well as some guides to prevent and alleviate such complications. Due to the impact of these alterations, this topic must be a priority and diffuse to those involved with the care of people with SCI, including the patient himself/herself. We consider that any collaborative effort should be supported, like the development of international standards, to evaluate autonomic function after SCI, as well as the development of novel therapeutic approaches.

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