scholarly journals Combined treatment of diffuse sclerosing osteomyelitis of mandible in children

2019 ◽  
Vol 18 (3) ◽  
pp. 46-53
Author(s):  
A. Yu. Kugushev ◽  
A. V. Lopatin ◽  
S. A. Yasonov ◽  
D. S. Sinitsyn
Keyword(s):  
Side Effects ◽  
Antibacterial Therapy ◽  
Combined Treatment ◽  
Treatment Algorithm ◽  
Treatment Protocol ◽  
Ethics Committee ◽  
Treatment Protocols ◽  
Clinical Hospital

Diffuse sclerosing osteomyelitis of the jaw (DSO) is a rare and poorly understood disease. Nowadays treatment protocols (steroid or painkillers, corticotomy) do not capable of to get good and stabile results or are associated with the development of potentially serious side effects. The treatment algorithm developed by us, including the course treatment with bisphosphonates, was well tolerated and capable of to get clinical and radiological remission in the case of previous decortication and antibacterial therapy was done. For these reasons, this treatment protocol is not without interest and need of further investigates. The study was approved by the Local Ethics Committee of Russian Children's Clinical Hospital.

scholarly journals The History and Current Status of Surgery in the Treatment of Laryngeal Cancer

2008 ◽  
Vol 51 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Aleš Čoček
Keyword(s):  
Total Laryngectomy ◽  
Combined Treatment ◽  
Treatment Algorithm ◽  
Treatment Protocol ◽  
Point Of View ◽  
Current Status ◽  
Current Phase ◽  
Surgical Methods ◽  
Carcinoma Of The Larynx ◽  
The 19Th Century

The roots of surgery of the larynx reach into the 19th century. After the gaining of initial experiences, a period of radical surgery followed when most tumours were treated with a total laryngectomy. The middle of the 20th century can be characterised as a period of partial laryngectomies. The mutilation of patients caused by a total laryngectomy was and is one of the main impulses that led to the development of the current phase – combined treatment (radiotherapy, systematic cytostatic chemotherapy, biological treatment, surgery as an emergency treatment). The aim is to treat carcinoma of the larynx without the actual removal of the larynx itself and with the same oncological results as would be reached in cases treated with a total laryngectomy. Despite the development of non-surgical methods, surgery of carcinoma of the larynx remains a significant part of the treatment protocol. This work covers the development of surgery of carcinoma of the larynx from a historical point of view; it also describes current types of operations and discusses the position of surgery in today’s treatment algorithm.

COMBINATION OF POTASSIUM PERCHLORATE AND PROPYLTHIOURACIL IN THE TREATMENT OF THYROTOXICOSIS

1968 ◽  
Vol 57 (4) ◽  
pp. 565-577 ◽  
Author(s):  
K. E. Røkke ◽  
J. H. Vogt
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Metabolic Rate ◽  
Total Cholesterol ◽  
Basal Metabolic Rate ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Control Measures ◽  
Potassium Perchlorate ◽  
Plasma Total Cholesterol

ABSTRACT A report is given on 95 thyrotoxic patients treated with a combination of 400 mg propylthiouracil and 400 mg of potassium perchlorate. Perchlorate was stopped when a marked remission of symptoms was obtained, on an average after less than 7 weeks. Euthyroidism was found on an average after 7.2 weeks. The basal metabolic rate, PBI, plasma total cholesterol and weight showed a fairly rapid normalization. Thirteen of the 95 patients were given radio-iodine therapy shortly before drug therapy was started. The remaining 82 cases were grouped together with the 23 cases previously reported. Of the total of 105 cases, 96 became euthyroid on combined therapy. For the frequency of side-effects, the thirteen cases mentioned above were included, giving a total of 118 cases. Eight cases showed an increase in goitre size and 15 cases had other side-effects, of which three were granulocytopenia due to propylthiouracil. The possibility of a higher frequency of mainly minor side-effects on combined therapy has to be balanced against the seemingly rapid and reliable therapeutic effect. Combined treatment, perhaps with even smaller doses than reported here, can be recommended in selected cases of thyrotoxicosis where a shortening of the thyrotoxic state seems of importance, or possibly where difficulties due to iodine exposure may be anticipated, provided adequate control measures are taken.

Local Protocol of Antibacterial Therapy in the Surgical Units of the Clinical Hospital «Feofaniia»

2016 ◽  
Vol 0 (3.74) ◽  
pp. 166
Author(s):  
A.M. Strokan ◽  
L.V. Shevchenko ◽  
M.M. Pylypenko ◽  
L.A. Kharchenko
Keyword(s):  
Antibacterial Therapy ◽  
Clinical Hospital ◽  
Surgical Units ◽  
Local Protocol

scholarly journals Simplified treatment algorithm for the management of trauma-induced hemorrhage without viscoelastic testing

2021 ◽  
Vol 6 (1) ◽  
pp. e000779
Author(s):  
Sebastian Casu
Keyword(s):  
Major Trauma ◽  
Point Of Care ◽  
Treatment Algorithm ◽  
Standard Of Care ◽  
Trauma Team ◽  
Trauma Patients ◽  
Treatment Protocols ◽  
Treatment Algorithms ◽  
Number Of Treatment ◽  
Uncontrolled Bleeding

Uncontrolled bleeding after major trauma remains a significant cause of death, with up to a third of trauma patients presenting with signs of coagulopathy at hospital admission. Rapid correction of coagulopathy is therefore vital to improve mortality rates and patient outcomes in this population. Early and repeated monitoring of coagulation parameters followed by clear protocols to correct hemostasis is the recommended standard of care for bleeding trauma patients. However, although a number of treatment algorithms are available, these are frequently complex and can rely on the use of viscoelastic testing, which is not available in all treatment centers. We therefore set out to develop a concise and pragmatic algorithm to guide treatment of bleeding trauma patients without the use of point-of-care viscoelastic testing. The algorithm we present here is based on published guidelines and research, includes recommendations regarding treatment and dosing, and is simple and clear enough for even an inexperienced physician to follow. In this way, we have demonstrated that treatment protocols can be developed and adapted to the resources available, to offer clear and relevant guidance to the entire trauma team.

scholarly journals Repositioning metformin and propranolol for colorectal and triple negative breast cancers treatment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. E. Anselmino ◽  
M. V. Baglioni ◽  
F. Malizia ◽  
N. Cesatti Laluce ◽  
C. Borini Etichetti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Triple Negative ◽  
Epithelial Mesenchymal Transition ◽  
Drug Repositioning ◽  
Combined Treatment ◽  
Alternative Therapy ◽  
Breast Cancers ◽  
Mesenchymal Transition ◽  
Tumor Types

AbstractDrug repositioning refers to new uses for existing drugs outside the scope of the original medical indications. This approach fastens the process of drug development allowing finding effective drugs with reduced side effects and lower costs. Colorectal cancer (CRC) is often diagnosed at advanced stages, when the probability of chemotherapy resistance is higher. Triple negative breast cancer (TNBC) is the most aggressive type of breast cancer, highly metastatic and difficult to treat. For both tumor types, available treatments are generally associated to severe side effects. In our work, we explored the effect of combining metformin and propranolol, two repositioned drugs, in both tumor types. We demonstrate that treatment affects viability, epithelial-mesenchymal transition and migratory potential of CRC cells as we described before for TNBC. We show that combined treatment affects different steps leading to metastasis in TNBC. Moreover, combined treatment is also effective preventing the development of 5-FU resistant CRC. Our data suggest that combination of metformin and propranolol could be useful as a putative adjuvant treatment for both TNBC and CRC and an alternative for chemo-resistant CRC, providing a low-cost alternative therapy without associated toxicity.

scholarly journals Plasmapheresis in the treatment of myasthenia gravis: retrospective study of 26 patients

2004 ◽  
Vol 62 (2b) ◽  
pp. 391-395 ◽  
Author(s):  
Rosana Carandina-Maffeis ◽  
Anamarli Nucci ◽  
José F.C. Marques Jr ◽  
Eduardo G. Roveri ◽  
Beatriz H.M. Pfeilsticker ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Mortality Rates ◽  
Motor Deficit ◽  
Myasthenic Crisis ◽  
Clinical Hospital ◽  
The Mean ◽  
Mean Time

We analyzed the experience of Unicamp Clinical Hospital with plasma exchange (PE) therapy in myasthenia gravis (MG). About 17.8 % of a totality of MG patients had PE performed: 26 cases, 19 women and seven men. The mean age-onset of MG was 28 years, extremes 11 and 69. Minimum deficit observed in the group was graded IIb (O & G) or IIIa (MGFA scale). One patient had prethymectomy PE. In seven the procedures were performed due to myasthenic crisis and in 18 patients due to severe myasthenic symptoms or exacerbation of previous motor deficit. Two patients were also submitted to chronic PE considering refractoriness to other treatments. Twenty-six patients had 44 cycles of PE and 171 sessions. The mean number of sessions was 3.9 (SD ± 1.4) each cycle; median 5, extremes 2 and 6. The mean time by session was 106,5 minutes (SD ± 35.2); median 100.5 (extremes of 55 and 215). The mean volume of plasma exchanged in each session was 2396 ml (SD ± 561); median 2225 (extremes 1512 and 4500). Side effects occurred: reversible hypotension (seven cases), mild tremor or paresthesias (seven cases). Infection and mortality rates due to PE were zero. All patients had immediate benefit of each PE cycle and usually they also received prednisone or other immunosuppressors. Good acceptance of the procedure was observed in 80.7% of patients.

The Efficacy and Tolerability of Combined Antidepressant Treatment in Different Depressive Subgroups

1993 ◽  
Vol 162 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Sinead O'brien ◽  
Patrick McKeon ◽  
Myra O'regan
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Major Depression ◽  
Orthostatic Hypotension ◽  
Antidepressant Treatment ◽  
Combined Treatment ◽  
Endogenous Depression ◽  
Double Blind Study ◽  
Double Blind ◽  
Global Improvement

Eighty patients admitted to hospital with major depression were randomly allocated to six weeks of treatment with tranylcypromine, amitriptyline, or tranylcypromine and amitriptyline in combination, in a double-blind study. Scores on the HRSD improved significantly in all three groups, but there were no differences between the three groups. Patients on tranylcypromine and amitriptyline combined improved more according to their self-ratings after six weeks, and response was earlier as measured by a clinical global improvement scale. Those with endogenous depression improved more than those with neurotic depression, irrespective of treatment group. Combined treatment was less well tolerated than single treatments and gave rise to more side-effects, although there was no serious toxicity. Orthostatic hypotension was observed more frequently in patients on combined treatment. This group also experienced a significant increase in weight and prolongation of the P-R interval on ECG.

scholarly journals Analysis of consumption trends of antibacterial and antivirus medicines in pharmacies during COVID-19 pandemic in Ukraine

2021 ◽  
pp. 43-54
Author(s):  
О. М. Заліська ◽  
О. М. Семенов ◽  
Н. М. Максимович ◽  
З. О. Заболотня ◽  
Б. М. Заліський ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Content Analysis ◽  
Side Effects ◽  
Pharmaceutical Care ◽  
Cost Minimization ◽  
Pharmacoeconomic Analysis ◽  
Symptomatic Treatment ◽  
Analysis Data ◽  
Treatment Protocols ◽  
Trade Names

Rational pharmacotherapy of COVID-19 in the world, treatment protocols, prescriptions of antibacterial (AB), antiviral (AV) medicines have been systematically improved due to updated data of evidence-based medicine. The study aim was to analyze the trends of  AB, AV consumption for outpatients with confirmed COVID-19: to study the reasons of the growing demand for AB, AV; optimization of pharmaceutical care directions for rational cost-effectiveness use, prevention antibiotic resistance. Methods – the survey on consumption trends of AB and AV, side effects of AB; survey data of 205 pharmacists, 5 regions of Ukraine; pharmacoeconomic analysis «cost-minimization», content analysis of instructions, side effects. Analysis of surveys showed that the demand on AB, AV increased by 50.1% to 2019, such groups: beta-lactams, respiratory fluoroquinolones, macrolides. We found the most often were released: azithromycin, cefoperazone, cefipime, piperacillin with tazobactam, meropenem. Pharmacists noted that patients often used AB, AV without a prescriptions, it complicates the release from pharmacies. So it is necessary to implement e-prescriptions for AB, AV for monitoring of effectiveness, side effects, to prevent antibiotic resistance in pandemic. We found 53.7% of pharmacists noted about insufficient of  trade names, stocks of AB and AV. It is the difficulties to provide outpatients with covid-19. Content-analysis data showed the most common side effects during AB course. We identified the main directions of information pharmacist providing to prevent side effects, antibiotic resistance. We conducted the demand for AV, AV medicines increased by 50.1% vs to 2019. It was identified the AB groups, trade names in high demand. Used pharmacoeconomic analysis «cost-minimization», we established that depending on the manufacturer, an antibiotic course costs differ by 15.1 times. The necessity of including in the list of the reimbursement program «Affordable Medicines» the essential AB, AV, to reduce costs for COVID-19 outpatients was substantiated. We showed 83,1% of pharmacists consider the need of approval, implementation of «Protocol for symptomatic treatment of uncomplicated forms of COVID-19». It will improve the results of pharmaceutical care for COVID-19 patients due to GPP requirements.

scholarly journals Challenges in Steroid and Anticoagulant Therapy in Severe COVID-19 Pneumonia: A Prospective Study

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1214
Author(s):  
Alaa Thabet Hassan ◽  
Alaa E. Abd Elmoniem ◽  
Marwa Mahmoud Abdelrady ◽  
Mona Embarek Mohamed ◽  
Mohamed A. Mokhtar ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
Severe Pneumonia ◽  
High Risk Group ◽  
University Hospital ◽  
Treatment Protocols ◽  
Neutrophil Lymphocyte Ratio ◽  
Treatment Type ◽  
Acute Kidney Disease ◽  
Significant Difference ◽  
Group B

Background: As COVID-19 has neither a standard treatment protocol nor guidelines, there are many treatment protocols for anti-inflammatory corticosteroids and anti-coagulations for severe COVID-19 pneumonia patients. This study aimed to assess the most suitable modality in this high-risk group. Methods: A prospective, experimental study design was adopted that included 123 severe COVID-19 pneumonia patients admitted at Assiut University Hospital. Patients were divided into three groups according to a combined corticosteroid and anticoagulants therapy protocol. Group A included 32 patients, group B included 45 patients, and group C included 46 patients. Assessment of cases was conducted according to the treatment type and duration, weaning duration from oxygen therapy, length of hospital and ICU stay, and complications during treatment. Three months follow-up after discharge was performed. Results: the three patient groups showed significant differences regarding the 3-month outcome, whereas Group C showed the highest cure rate, lowest lung fibrosis, and lowest mortality rate over the other two groups. The in-hospital outcome, the development of pulmonary embolism, bleeding, hematoma, acute kidney disease, and myocardial infarction showed a significant difference between groups (p values < 0.05). Mortality predictors among severe COVID-19 patients by multivariable Cox hazard regression included treatment modality, history of comorbid diseases, increased C reactive protein, high neutrophil-lymphocyte ratio, and shorter ICU and hospital stay. Conclusion: the use of combined methylprednisolone and therapeutic Enoxaparin, according to a flexible protocol for COVID-19 patients with severe pneumonia, had two benefits; the prevention of disease complications and improved clinical outcome.

Outcomes of Steroid Therapy in Combination with Endoscopic Optic Nerve Decompression Surgery for Direct Traumatic Optic Neuropathy: A Case-Series

2021 ◽  
Vol 104 (7) ◽  
pp. 1166-1171
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Poor Prognosis ◽  
Combined Treatment ◽  
Treatment Protocol ◽  
Case Series ◽  
Light Perception ◽  
Traumatic Optic Neuropathy ◽  
Nerve Decompression

Background: Direct traumatic optic neuropathy (TON) carries a poor prognosis. However, the outcome of this injury is diverse and is related to time to treatment and treatment protocol. Objective: To evaluate the outcomes of the combined treatment protocol in patients with direct TON. Materials and Methods: The authors retrospectively reviewed the medical records of patients between January 2015 and August 2019. Main outcome was visual acuity (VA) improvement after the treatment. Results: Thirteen patients (15 eyes) were included. The mean age was 38.61 years with a range of 13 to 65 years. Initial VA varied from no light perception (NPL) in seven eyes of six patients, light perception (PL) in one eye, counting fingers in two eyes, 20/200 in three eyes, and 20/60 in two eyes. Average timing to treatment was 2.8 days (range 0 to 7 days). There were no side effects of high-dose corticosteroids treatment in all patients. During a follow-up period of three months, six of 13 patients (46.1%) had VA improvement. Conclusion: Despite poor prognosis of direct TON, the combined treatment protocol provides a favorable successful rate with most patients on having stable vision, and some having visual improvement from reducing intracanalicular pressure of the optic nerve. Keywords: Endoscopic optic nerve decompression; Traumatic optic neuropathy; Visual acuity; Case series

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