Non-Hepatic Hyperammonemia: A Potential Therapeutic Target for Sepsis-Associated Encephalopathy

2021 ◽  
Vol 21 ◽  
Author(s):  
Lina Zhao ◽  
Yun Li ◽  
Yunying Wang ◽  
Zengzheng Ge ◽  
Huadong Zhu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factor ◽  
Hepatic Encephalopathy ◽  
Effective Treatment ◽  
Independent Risk Factor ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Common Complication ◽  
Potential Therapeutic Target

: Sepsis-associated encephalopathy (SAE) is a common complication in the acute phase of sepsis, and patients who develop SAE have a higher mortality rate, longer hospital stay, and worse quality of life than other sepsis patients. Although the incidence of SAE is as high as 70% in sepsis patients, no effective treatment is available for this condition. To develop an effective treatment for SAE, it is vital to explore its pathogenesis. It is known that hyperammonemia is a possible factor in the pathogenesis of hepatic encephalopathy as ammonia is a potent neurotoxin. Furthermore, our previous studies indicates that non-hepatic hyperammonemia seems to occur more often in sepsis patients; it was also found that >50% of sepsis patients with non-hepatic hyperammonemia exhibited encephalopathy and delirium. Substatistical analyses indicate that non-hepatic hyperammonemia is an independent risk factor for SAE. This study updates the definition, clinical manifestations, and diagnosis of SAE; it also investigates the possible treatment options available for non-hepatic hyperammonemia in patients with sepsis, and the mechanisms by which non-hepatic hyperammonemia causes encephalopathy.

scholarly journals Primary and Secondary Cone Cell Death Mechanisms in Inherited Retinal Diseases and Potential Treatment Options

2022 ◽  
Vol 23 (2) ◽  
pp. 726
Author(s):  
Alicia A. Brunet ◽  
Alan R. Harvey ◽  
Livia S. Carvalho
Keyword(s):  
Quality Of Life ◽  
Cell Death ◽  
Effective Treatment ◽  
Treatment Options ◽  
Retinal Diseases ◽  
Potential Treatment ◽  
Cone Cell ◽  
Similarities And Differences ◽  
Cell Death Mechanisms

Inherited retinal diseases (IRDs) are a leading cause of blindness. To date, 260 disease-causing genes have been identified, but there is currently a lack of available and effective treatment options. Cone photoreceptors are responsible for daylight vision but are highly susceptible to disease progression, the loss of cone-mediated vision having the highest impact on the quality of life of IRD patients. Cone degeneration can occur either directly via mutations in cone-specific genes (primary cone death), or indirectly via the primary degeneration of rods followed by subsequent degeneration of cones (secondary cone death). How cones degenerate as a result of pathological mutations remains unclear, hindering the development of effective therapies for IRDs. This review aims to highlight similarities and differences between primary and secondary cone cell death in inherited retinal diseases in order to better define cone death mechanisms and further identify potential treatment options.

Comparison of an epicondylitis bandage with a wrist orthosis in patients with lateral epicondylitis

2018 ◽  
Vol 42 (6) ◽  
pp. 599-605 ◽  
Author(s):  
Halil Ekrem Akkurt ◽  
Hilal Kocabaş ◽  
Halim Yılmaz ◽  
Cemile Eser ◽  
Zafer Şen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Visual Analogue Scale ◽  
Functional Status ◽  
Effective Treatment ◽  
Analogue Scale ◽  
Short Form ◽  
Treatment Options ◽  
Lateral Epicondylitis

Background: Lateral epicondylitis is one of the most common causes of elbow pain. It is generally observed in people between the ages of 40 and 50 years, and the dominant extremity is more frequently affected. Various noninvasive methods are frequently used; however, studies investigating the effectiveness of the orthoses are limited and with controversial outcomes. Objective: To investigate the effectiveness of a hand-wrist resting orthosis and an epicondylitis bandage in lateral epicondylitis. Study design: Randomized controlled trial. Methods: In total, 82 patients diagnosed with unilateral lateral epicondylitis were enrolled into the study. Hand-wrist resting orthosis was applied to 45 patients and epicondylitis bandage was applied to 41 patients. Patients were evaluated before treatment and at 6 weeks after treatment with a Visual Analogue Scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form 36; and a determination of hand grasping force. Results: Both groups were similar in terms of age, body mass index, gender, frequency of lateral epicondylitis on the dominant side, dominant extremity, and duration of complaints ( p > 0.05). A statistically significant recovery was detected in both groups between the pre-therapy values and the values at the sixth week in terms of Visual Analogue Scale scores; Disabilities of the Arm, Shoulder, and Hand questionnarie scores; hand grasping forces; and the Short Form 36 mental and physical component scores ( p < 0.05). However, there were no significant differences detected between the two therapy methods before the therapy and at the sixth week of treatment in all parameter values ( p > 0.05). Conclusion: Our results suggest that both epicondylitis bandage and hand-wrist resting orthosis are effective treatment options for lateral epicondylitis–induced pain, functional status, muscle strength, and quality of life. Furthermore, neither treatment option was superior to the other. Large, randomized studies are necessary for more clear statements. Clinical relevance Epicondylitis bandage and hand-wrist resting orthosis are equally effective treatment options for lateral epicondylitis–induced pain, functional status, muscle strength, and quality of life.

What is effective care for varicose veins?

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 80-87 ◽  
Author(s):  
Mark H Meissner
Keyword(s):  
Quality Of Life ◽  
Effective Treatment ◽  
Varicose Veins ◽  
Treatment Options ◽  
Cost Effective ◽  
Symptom Improvement ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Cyanoacrylate Glue

Varicose veins affect one-quarter to one-third of Western adult populations and consume an increasing amount of health care resources. Much of this increased utilization has been driven by the advent of minimally invasive technology including endovenous thermal ablation, foam sclerotherapy, and more recently mechanicochemical and cyanoacrylate glue ablation. This has largely been driven by patient and physician preferences in the absence of robust evidence that one therapy is truly superior to another. This partially arises from misunderstandings about appropriate outcomes measures and what truly constitutes effective treatment of varicose veins. Technical outcomes, such as saphenous closure rates, have frequently been used as surrogates for effective treatment but are poorly correlated with symptom improvement, quality of life, and risk of recurrence. Although there does appear to be a trend towards higher recurrence with ultrasound-guided foam sclerotherapy, the data are occasionally conflicting and there does not appear to be substantial differences between the various modalities. Similarly, there do not appear to be major differences in late quality of life measures between these treatment options. As long-term differences in recurrence and quality of life are small, overall cost effectiveness is driven primarily by initial treatment costs and ultrasound-guided foam sclerotherapy is the most cost-effective strategy in many models. However, there continues to be substantial uncertainty surrounding cost estimates and other factors of importance to the patient may ultimately drive treatment decisions. The benefits of some adjuncts to the treatment of axial superficial reflux, such as the concurrent versus staged management of tributary varicosities, remain ill-defined while that of others, such as routine post-procedural ultrasound surveillance and compression, need critical re-evaluation.

scholarly journals Erectile dysfunction in men with diabetes (literature review) Part 1

2021 ◽  
Vol 17 (5) ◽  
pp. 426-434
Author(s):  
E.V. Luchytskyy ◽  
V.Ye. Luchytskiy
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Risk Factor ◽  
Erectile Dysfunction ◽  
Rating Scale ◽  
Sexual Experience ◽  
Clinical Manifestations ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Patients With Diabetes

The first part of the review article highlights modern views on the prevalence, etiology and features of the pathogenesis of erectile dysfunction (ED) in men with diabetes mellitus. Google Scholar and PubMed databases were used to search for literature sources. The role of comorbid diseases in the development of ED in men with diabetes mellitus has been shown. The generalized data on the main clinical manifestations of erectile dysfunction, methods of its diagnosis and treatment are given. A number of epidemiological studies over the past 20 years have found that erectile dysfunction in men with diabetes may be an early marker of cardiovascular complications. Thus, in the algorithm for ED diagnosis in patients with diabetes it is necessary to conduct a thorough examination of the cardiovascular system. Numerous literature sources indicate an important role in the correction of androgen deficiency in men with type 2 diabetes, in order to enhance the effectiveness of phosphodiesterase type 5 inhibitors. Erectile dysfunction involves a change in any of the components of an erectile response. ED can negatively affect a man’s quality of life because most patients experience symptoms of depression and anxiety related to their sexual capabilities. These symptoms also affect a partner’s sexual experience and the couple’s quality of life. Clinical features of ED have many key features in the anamnesis, including some physical signs during examination depending on a type of diabetes. With age, comorbid conditions play an increasing role in the development of ED. Diabetes mellitus, cardiovascular diseases, obesity can lead to the development of ED before accelerated deterioration of erectile function and disorders at the molecular level of the mechanisms underlying erection. Patients with diabetes and ED have higher scores on the depression rating scale, and poorer overall health and quality of life. Early detection of ED in individuals with diabetes can improve the overall health and quality of life of patients. Patients with diabetes with poor glycemic control and older age are more likely to develop severe ED, which further exacerbates an already compromised health and quality of life. According to the National Health and Nutrition Examination Survey (2001–2002), diabetes mellitus is a modified risk factor independently associated with the development of ED (odds ratio (OR) 2.69), obesity (OR 1.60), smoking (OR 1.74) and hypertension (OR 1.56). Erectile dysfunction is a common complication of diabetes, and diabetes is a risk factor for ED; men with diabetes are three times more likely to have ED.

scholarly journals Post Stroke Pain: Identification, Assessment, and Therapy

2015 ◽  
Vol 39 (3-4) ◽  
pp. 190-201 ◽  
Author(s):  
Rebecca A. Harrison ◽  
Thalia S. Field
Keyword(s):  
Quality Of Life ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Current Treatment ◽  
Best Interests ◽  
Common Complication ◽  
Post Stroke ◽  
Pain Syndromes ◽  
And Function

Background: Pain is a common complication after stroke and is associated with the presence of depression, cognitive dysfunction, and impaired quality of life. It remains underdiagnosed and undertreated, despite evidence that effective treatment of pain may improve function and quality of life. Summary: We provide an overview of the means for clinical assessment and risk factors for the development of post-stroke pain, then review the newest available literature regarding the commonest post-stroke pain syndromes, including central post-stroke pain, complex regional pain syndrome, musculoskeletal pain including shoulder subluxation, spasticity-related pain, and post-stroke headache, as well as the available epidemiology and current treatment options. Key Messages: In the best interests of optimizing quality of life and function after stroke, clinicians should be aware of pain as a common complication after stroke, identify those patients at highest risk, directly inquire as to the presence and characteristics of pain, and should be aware of the options for treatment for the various pain syndromes.

Anxiety disorders in patients with cardiac diseases

2021 ◽  
Vol 14 (3) ◽  
pp. 234-238
Author(s):  
Dominika Dudek
Keyword(s):  
Quality Of Life ◽  
Differential Diagnosis ◽  
Anxiety Disorders ◽  
Cardiovascular System ◽  
Effective Treatment ◽  
Treatment Options ◽  
Cardiac Diseases ◽  
Family Doctors ◽  
Proper Diagnosis

Anxiety disorders are a common problem in cardiac patients. They can be the basic condition with heart symptoms, or they can be associated with a disease of the cardiovascular system. Hence, their symptomatology and differential diagnosis is of interest not only to psychiatrists, but also family doctors, internists and cardiologists. Proper diagnosis and treatment affects not only the quality of life, but also cardiological prognosis. One of the safe and effective treatment options is pregabalin.

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