scholarly journals Efficacy of infusion chemotherapy in patients with pulmonary tuberculosis with treatment failure and malabsorption syndrome

2020 ◽  
pp. 46-47
Author(s):  
M.M. Kuzhko ◽  
D.O. Butov ◽  
T.V. Tlustova ◽  
L.I. Grechanyk
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Failure ◽  
Clinical Symptoms ◽  
Malabsorption Syndrome ◽  
Newly Diagnosed ◽  
Intensive Phase ◽  
Infusion Chemotherapy ◽  
Healthy Donors ◽  
Group 2 ◽  
Group 1

Objective. To investigate the effectiveness of infusion chemotherapy in patients with pulmonary tuberculosis (TB) with treatment failure and malabsorption syndrome. Materials and methods. We observed 52 patients with newly diagnosed pulmonary TB with treatment failure, who were diagnosed with malabsorption syndrome. Patients were divided into two groups: 1st group (main) included 24 patients who received rifampicin and ethambutol intravenously, pyrazinamide and isoniazid orally; 2nd group (control) – 28 patients who received standard therapy orally. The severity of malabsorption syndrome was determined by a violation of intestinal penetration. Intestinal penetration was determined by the concentration of lactulose and mannitol (lactulose-mannitol test) in urine. The concentration of rifampicin, isoniazid, ethambutol in the serum was determined by liquid chromatography on a chromatograph Perkin Elmer (USA). Results and discussion. The examination revealed a violation of the rate of intestinal penetration in all studied patients, compared with healthy donors. The concentration of anti-TB drugs in the serum was significantly lower than the therapeutic average in group 2 compared with group 1 (p<0,05). In patients of group 1 after the intensive phase of treatment, the disappearance of clinical symptoms of the disease was observed in 22 (91.3±5.8 %) and 17 (60.7±6.3 %) patients (p<0.05), cessation of mycobacterial excretion – in 20 (83.3±4.3 %) and 14 (50.4±4.6 %) (p<0.05), resorption of infiltrative changes and healing of destruction cavities in the lungs – in 12 (50.2±5.3 %) and 10 (35.7±4.7 %) (p<0.05) compared with group 2. Conclusions. In patients with malabsorption syndrome with ineffective treatment and low intestinal penetration, which leads to reduced serum concentrations of anti-TB drugs in the intensive phase of treatment, it is advisable to increase the effectiveness of intravenous rifampicin and ethambutol.

scholarly journals Clinical, laboratory and radiological associations with extending of the intensive phase of treatment in patients with first diagnosed infiltrative pulmonary tuberculosis

2021 ◽  
pp. 15-19
Author(s):  
Vasyl Kushnir
Keyword(s):  
Pulmonary Tuberculosis ◽  
Clinical Laboratory ◽  
Therapy Group ◽  
Hospital Setting ◽  
Blood Concentrations ◽  
Intensive Phase ◽  
Number Of Patients ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Despite the availability of medical services, timely detection of pulmonary tuberculosis, before the appearance of destructive changes, is often difficult. The management of patients with an infiltrative form in a hospital setting does not always guarantee the same positive effect and sometimes requires prolongation of therapy. The effectiveness of therapy can be associated with various factors and is of interest to study. The aim of this work was to study the effectiveness of standard therapy in patients with first diagnosed infiltrative pulmonary tuberculosis, clinical laboratory and radiological associations with prolongation of the intensive phase of treatment. Materials and methods. The study involved 109 men from 18 to 53 years old with first diagnosed infiltrative pulmonary tuberculosis with preserved MBT sensitivity to 1-st line anti-tuberculosis drugs. Patients were examined before and after 60 doses of the intensive phase of treatment, after which two groups were formed. Group 1 included patients with pronounced positive clinical and radiological dynamics, who entered the continuation phase of therapy. Group 2 included patients with insufficient clinical and radiological dynamics, for whom the intensive phase of treatment was extended to 90 doses. Results. Weak dynamics in patients who needed prolongation of treatment was associated with the characteristics of the initial data of patients in this group compared with similar indicators in Group 1. These were a reliably higher frequency of symptoms of intoxication and coughing, a reliably greater number of patients excreting mycobacterium tuberculosis in large quantities in sputum, with reliably high blood concentrations of haptoglobin and ceruloplasmin levels. Conclusions. Patients requiring prolongation of the intensive phase of treatment are characterized by an initially higher prevalence of infiltrative changes in the lungs, a small number of lung lesions limited to 2 segments, the presence of destructive changes in 100 % of cases, and a significant increase in the factors of the systemic inflammatory response

scholarly journals INSULIN RESISTANCE IN PATIENTS WITH NEWLY DIAGNOSED PULMONARY TUBERCULOSIS WITH DIFFERENT TREATMENT OUTCOME

2019 ◽  
pp. 10-14 ◽  
Author(s):  
R. N. Yasinskyi
Keyword(s):  
Insulin Resistance ◽  
Pulmonary Tuberculosis ◽  
Fasting Glucose ◽  
Negative Impact ◽  
Fasting Insulin ◽  
Newly Diagnosed ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Group 2 ◽  
Group 1

The aim of the study – to evaluate fasting glucose, insulin levels and homeostasis model assessment (HOMA-IR) index in patients with newly diagnosed pulmonary tuberculosis treatment failure (TFT) compared to data of patients who have successfully completed course of treatment (NDT). Materials and methods. 49 newly diagnosed pulmonary tuberculosis patients were examined. Patients were divided into 2 groups. Group 1 included 28 patients with TFT. Group 2 (comparison group) included 21 NDT patients. Blood sampling in the patients was done before treatment, after 3 months of the treatment start and after 2–3 months of treatment of patients in the group 1. Fasting plasma glucose level was determined by the hexokinase method by using Beckman Coulter AU640 biochemical analyzer, Japan. Fasting serum insulin level was determined by electrochemiluminescence method on Cobas e411 analyzer, Switzerland. Insulin resistance index was calculated by HOMA-IR by Matthews et al., 1985. Results. Fasting glucose levels were normal and almost similar in both groups before and after treatment, p˃0.05. Fasting insulin levels were also normal, but they were higher in patients of the group 1 than in the group 2, p˂0.05. It means there was a relative slight hyperinsulinemia in TFT patients. HOMA-IR index was also significantly greater among patients in the group 1, p˂0.05. Fasting glucose levels increase was in 10.7 % of patients in the group 1 and in 4.8 % patient in the group 2. Decrease of glucose levels was in 4.8 % of patients from the group 2. Fasting insulin levels increase was determined in 1 case among the group 1 patients and there were not cases with increased insulin levels among the patients of the group 2; fasting insulin levels reduction was identified in 14.3 % of patients from the group 1 only, p˃0.05. There was HOMA-IR index increase among patients of the group 1 mostly: 9 cases (33.3 %) versus 1 case (4.8 %) in the group 2, p˂0.05. Thus, a relative slight hyperinsulinemia in normal glucose levels and HOMA-IR index increase could be a signs of preclinical disorders of carbohydrate metabolism in patients with TFT. Conclusion. It may indicate negative impact of virulent mycobacteria and more severe clinical and radiological changes on carbohydrate metabolism or/and negative impact of such disorders to prognosis of tuberculosis.

scholarly journals Correction of toxic impact of anti-tuberculosis drugs on the liver in patients with first-time diagnosis of pulmonary tuberculosis

2017 ◽  
Author(s):  
L. A. Hryshchuk ◽  
O. M. Okusok
Keyword(s):  
Liver Function ◽  
Pulmonary Tuberculosis ◽  
Clinical Manifestations ◽  
Newly Diagnosed ◽  
Duration Of Treatment ◽  
Intensive Phase ◽  
Group I ◽  
Healthy Donors ◽  
Hepatotoxic Effect ◽  
Severe Intoxication

Introduction. The liver, being the main organ of detoxification, is experiencing the greatest burden in the process of chemotherapy. Disorders of the liver function in patients with respiratory tuberculosis can occur due to various factors, leading to the development of toxic reactions up to acute and chronic hepatitis. Numerous studies point to pronounced hepatotoxic effect of all anti-TB drugs and development of toxic hepatitis in patients treated with these drugs. This suggests the need to use hepatotropic drugs in complex treatment of TB.The aim of the study – to learn biochemical markers of liver function abnormalities in patients with newly diagnosed pulmonary tuberculosis and with severe intoxication syndrome before and two months after TB inpatient treatment, and the feasibility of using domestically-produced “Antral“ medication to treat functional disorders of the liver in these patients.Research methods. Two groups of people were involved in the study. Group I (control) consisted of evidently healthy donors, 27 individuals; Group II (31 individuals) consisted of patients with newly diagnosed pulmonary tuberculosis and with severe intoxication syndrome before and two months after of anti-TB therapy. This group was randomly divided into two subgroups: IIA(15 individuals), patients that only received standard anti-TB treatment and IIB (16 individuals), patients along with the standard anti-TB therapy received “Antral“ medication in the dose of 200 mg 3 times a day for the duration of treatment intensive phase. Results and Discussion. Results of the study indicate that when examining patients with pulmonary tuberculosis and severe intoxication syndrome markers of cytolysis and cholestasis should be measured prior to start of the treatment. With the increase of such indicators, in particular, ALT, AST, general and direct bilirubin, LDH, GGTP should be appointed hepatoprotector, in particular "Antral" drug. The use of this drug during the intensive phase of treatment normalizes the parameters of not only cytolytic but also cholestatic syndromes of liver function disorders in patients. Use of this medication in the treatment of tuberculosis contributed to ceasing release of the bacteria after intensive phase of treatment in 71.2 % of cases in subgroup IIB (43.9 % in subgroup IIA), and disappearance of clinical manifestations of intoxication in subgroup IIB in 79.8 % of cases (49.6 % in subgroup IIA). Significant reduction in markers of cytolysis and cholestasis was observed in patients that received “Antral“ medication during intensive phase of the treatment.Conclusions. Patients with newly-detected pulmonary tuberculosis and severe intoxication syndrome had significantly increased markers of cytolysis and cholestasis even before start of the treatment. “Antral“ is a medication with hepatoprotective action. Use of this medication alongside with the complex therapy of pulmonary tuberculosis contributed to normalization of liver function, significant reduction in the markers of cytolysis and cholestasis, faster termination of bacterial release and disappearance of clinical manifestations of intoxication.

scholarly journals Features of infusion chemotherapy with first-line drugs in patients with tuberculous meningitis and HIV

2020 ◽  
pp. 14-15
Author(s):  
D.O. Butov ◽  
M.M. Kuzhko ◽  
M.I. Gumeniuk ◽  
T.S. Butova
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Tuberculous Meningitis ◽  
Clinical Symptoms ◽  
Oral Treatment ◽  
Control Group ◽  
First Line ◽  
Infusion Chemotherapy ◽  
Sputum Conversion ◽  
Group 2 ◽  
Group 1

Objective. To investigate the effectiveness of first-line intravenous drugs (isoniazid and ethambutol) in patients with tuberculous meningitis and HIV during the intensive phase of chemotherapy. Materials and methods. 54 patients with newly diagnosed infiltrative pulmonary tuberculosis, tuberculous meningitis, and HIV were included in this study. The presence of Mycobacterium tuberculosis in sputum was observed in all patients. Group 1 consisted of 23 patients receiving ethambutol and isoniazid intravenously, and rifampicin and pyrazinamide were administered orally. Group 2 consisted of 31 patients treated with first-line oral anti-tuberculosis drugs. Serum isoniazid and ethambutol concentrations were determined by chromatographic method. Results. There was a greater improvement in clinical symptoms and radiographic evidence in patients receiving intravenous isoniazid and ethambutol compared with group 2. Positivity of sputum Mycobacterium tuberculosis was observed during the second month of treatment in 25.0 % of patients in group 1 and 76.1 % of patients in the control group (p=0.003). In addition, 9 (39.1 %) patients died before 6 months when isoniazid and ethambutol were administered intravenously compared with 22 (70.9 %) in group 2 (p=0.023). Conclusions. In tuberculous meningitis and HIV, intravenous treatment with isoniazid and ethambutol was more effective than oral treatment for 2 months of intensive treatment in the form of faster sputum conversion, clinical improvement, and higher mean concentrations of isoniazid and ethambut blood. In addition, mortality was lower with intravenous isoniazid and ethambutol compared with oral treatment.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

scholarly journals Pro-atherogenic lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance

2021 ◽  
Vol 8 (2) ◽  
pp. 111-114
Author(s):  
Olga Shvets ◽  
Olga Shevchenko ◽  
Zoriana Piskur ◽  
Hanna Stepanenko ◽  
Olha Pohorielova
Keyword(s):  
Insulin Resistance ◽  
Lipid Metabolism ◽  
Pulmonary Tuberculosis ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Tuberculosis Patients ◽  
Group 2 ◽  
Group 1

Background. The problem of studying lipid metabolism in patients with tuberculosis is of interest to scientists around the world. The purpose of the study - to investigate lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance. Materials and methods. Forty-one patients with pulmonary tuberculosis were examined. Insulin resistance index (HOMA-IR), total cholesterol level (TC), triglycerides (TG) level, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol and atherogenic index (AI) were measured. Results. Group 1 - 26 patients with tuberculosis and insulin resistance (HOMA-IR ˃ 2.7); Group 2 – 15 patients with tuberculosis without insulin resistance (HOMA-IR ˂ 2.7). Group 1 patients had severe course of TB with fever, severe fatigue and weakness, profuse sweating, weight loss, cough and shortness of breath. Median TC indices differed at significant level (p = 0.012): group 1 - 4.82 mmol/l, group 2 - 4.25 mmol/l. TG level was higher in group 1 patients - 1.32 mmol/l than in group 2 patients - 1.28 mmol/l. LDL cholesterol values were higher in group 1 patients - 3.2 mmol/l vs 2.5 mmol/l in group 2. The AI was higher in group1 (p = 0.005): 3.9 units against 2.8 units in group 2 patients. Conclusions. Insulin resistance in pulmonary tuberculosis patients was associated with severe course of the disease, severe clinical manifestations and impaired external respiration. Pro-atherogenic disorders of lipid metabolism in pulmonary tuberculosis patients with concurrent insulin resistance can be considered as the degree of endogenous intoxication.

The Relation Between Epicardial Fat Tissue Thickness and TSH Receptor Antibody in Hyperthyroidism

2018 ◽  
Vol 6 (01) ◽  
pp. 37-40
Author(s):  
Rıza Altunbaş ◽  
Mehmet Eren ◽  
İbrahim Altıparmak ◽  
Hüseyin Karaaslan ◽  
Tevfik Sabuncu
Keyword(s):  
Tsh Receptor ◽  
Newly Diagnosed ◽  
Fat Tissue ◽  
Tissue Thickness ◽  
Receptor Antibody ◽  
Tsh Receptor Antibody ◽  
Epicardial Fat Tissue ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Although hyperthyroidism may be associated with atherosclerosis, its pathogenesis is not well known. TSH receptor antibody (TRAb) has been shown to be responsible for increased orbital fat tissue in Graves ophthalmopathy. Epicardial fat tissue thickness (EFT) has been found to be increased in case of overt hyperthyroidism. In our study, we aimed to investigate if TRAb is associated with the increased EFT in newly diagnosed hyperthyroidism. Methods Twenty six TRAb positive (group 1) and 26 TRAb negative (group 2) newly diagnosed patients with hyperthyroidism, and 26 healthy control subjects (group 3) were enrolled. EFT was measured by the same cardiologist using an echocardiography device. Serum TRAb levels were measured by the radio-receptor assay and levels above 1.75 IU/L were considered as positive. Results There was no difference among groups in terms of age, gender and body mass index. Although there was no significant difference between group 1 and 2, both group 1 (0.38±0.15 cm) and group 2 (0.4±0.17 cm) had significantly higher EFT levels when compared to group 3 (0.25±0.06 cm) (p=0.004 and p=0.001, respectively). However we did not find any correlation between TRAb and EFT levels. Conclusion The results of our study suggested that EFT was increased in hyperthyroidism and this increasing was not dependent of TRAb level. EFT elevation might be depending directly to the cardiovascular effects of hyperthyroidism.

Retrospective comparative study of efficacy, safety and outcome of percutaneous intervention for Budd-Chiari syndrome patients with bilirubin less than 3 and 3–6 mg/dl

2021 ◽  
Vol 94 (1120) ◽  
pp. 20201157
Author(s):  
Yashwant Patidar ◽  
Chandan Kumar Pal ◽  
Amar Mukund ◽  
Guresh Kumar ◽  
Shiv Kumar Sarin
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Clinical Symptoms ◽  
Percutaneous Intervention ◽  
Technical Success ◽  
Budd Chiari Syndrome ◽  
Related Complication ◽  
Chiari Syndrome ◽  
Group 2 ◽  
Group 1

Objective: Comparing the efficacy, safety and outcome of percutaneous intrervention for Budd-Chiari Syndrome (BCS) patients with bilirubin less than 3 and 3–6 mg dl−1. Methods and materials: 188 BCS patients having serum bilirubin ≤6 mg dl−1 and underwent percutaneous interventions were divided into two groups based on bilirubin level: 151 patients having bilirubin <3 mg dl−1 were included in Group 1; and 37 patients having bilirubin 3–6 mg dl−1 were included in Group 2. Both group were compare for technical success (successful recanalization of hepatic venous stenosis or creation of portocaval shunt with post-procedure gradient ≤5 mm of Hg), Safety (procedure-related mortality/morbidity or patient required transplantation) and outcome (resolution of clinical symptoms and survival). Results: Technical success was 94.7% in Group 1–89.1% in Group 2 with overall success rate was 93.6%. No significant differences observed between the two groups in regards to procedure related complication. Overall transplant-free survival at 1 and 5 years after intervention in both groups was 96.3 and 91.2% respectively. 1-year and 5-year survivals in Group 1 was 96.7%, and 93.1%, whereas Group 2 was 94.6 and 90.1% with no statically significantly difference between the two groups (p = 0.59). Percutaneous intervention results are good in patients having bilirubin up to 6 mg dl−1, i.e. mild to moderate liver dysfunctions. Conclusion: Technical success, survival and outcome of percutaneous intervention in BCS patients having serum bilirubin 3–6 mg dl−1 was comparable to patients having bilirubin level <3 mg dl−1. Advances in knowledge: Percutaneous intervention treatment is suitable for treatment for symptomatic BCS patients having bilirubin up to 6 mg  dl−1.

Treatment of Adult T-ALL with a Pediatric Asparaginase-Intensive Protocol Results in Survival Benefit When Compared to Other Adult Based Protocols

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3956-3956
Author(s):  
Murtadha K. Al-Khabori ◽  
Mark Minden ◽  
Vikas Gupta ◽  
Aaron D. Schimmer ◽  
Andre C. Schuh ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Treatment Regimen ◽  
Lymphoblastic Leukemia ◽  
Remission Induction ◽  
Entire Group ◽  
Induction Phase ◽  
Newly Diagnosed ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract T cell acute lymphoblastic leukemia (T-ALL) accounts for 14–22% of adult ALL. No prospective comparisons between different chemotherapy protocols have been done. Since 2000 a modified DFCI protocol (Silverman et al, Blood2001;97:121–1218) has been used as standard treatment for all newly diagnosed patients with T-ALL at Princess Margaret Hospital (PMH). This protocol includes a remission induction phase, a CNS prophylaxis phase with intrathecal chemotherapy and 12 Gy cranial irradiation, a 30-week intensification phase including weekly asparaginase, and a 72-week maintenance phase. We compared outcomes using this regimen to previous results for all newly diagnosed T-ALL from 1990 – 2000 at PMH using the standard institutional protocol in use at the time. Between 1990–2000, 44 patients (Group 1) were treated with a variety of protocols, including 9203ALL PMH protocol (11 patients), L10 (2 pts), Protocol C (7 pts), HyperCVAD (15 pts) and ECOG E2993 (9 pts). From 2000–2007, 33 T-ALL patients were treated with modified DFCI protocol (Group 2). The median age for all patients was 31 years (range 14–69 years). There was no significant difference between the two groups with respect to age at diagnosis, presenting WBC (median or percent &gt; 100 ×109/L), CSF positivity, or cytogenetics. More patients from Group 1 underwent allogeneic stem cell transplantation (BMT) in CR-1 (54%) as compared to those in Group 2 (54% vs. 14%, P = 0.001), primarily due to a change in BMT policy in 2002. The median follow up was 23 months (range 1–161 months) for the entire group and 53 months (range 14–161 months) for the surviving patients. Sixty-nine patients (90%) achieved complete remission, and 37 patients have relapsed. The CR rates were not significantly different between the two groups. The 3-year failure-free survival (FFS) was significantly higher in Group 2 (DFCI protocol) as compared with Group 1 (other protocols) (89% vs. 27%, P = 0.0001). Multivariate analysis using Cox proportional hazard model showed only the treatment regimen received (DFCI vs. others) to have a statistically significant impact on FFS (P = 0.0001). The 3-year overall survival (OS) was significantly higher in the DFCI group compared to the group receiving the other protocols (81% vs. 45%, P = 0.0006). On multivariate analysis, only the treatment regimen received (P=0.001) and the CSF status (P=0.014) had a significant impact on OS; BMT did not have a significant impact on OS. When patients were censored at the time of transplant, the FFS and OS analyses still showed statistically significant benefit for patients treated on DFCI protocol (P = 0.0001 and 0.03, respectively). In summary, treatment outcomes have markedly improved from 2000 onward as compared to the previous decade. Although improvements in supportive care and reduced use of allogeneic BMT may have been factors, it is likely that the institution of the DFCI pediatric protocol was the primary factor in the improved outcome. These results support the use of such pediatric asparaginase-intensive pediatric protocols for adult T-ALL.

Contemporary aspects of pathogenetically substantiated therapy of adenomyosis

2016 ◽  
Vol 7 (3) ◽  
pp. 92-97 ◽  
Author(s):  
Arutyun F Arutyunyan ◽  
Sergey N Gaydukov ◽  
Vitaly N Kustarov
Keyword(s):  
Blood Flow ◽  
Conservative Treatment ◽  
Survey Data ◽  
Clinical Symptoms ◽  
Uterine Blood Flow ◽  
Uterine Arteries ◽  
Group 3 ◽  
Group 2 ◽  
Pathogenic Effects ◽  
Group 1

The purpose of our study was to assess the effectiveness of the use of drugs containing indole-3-carbinol and epigallocatechin-3 gallate in combination with effective natural methods (TES-therapy and hirudotherapy) depending on the degree of morphological adenomyosis. The study involved 205 women with diffuse adenomyosis. Based on survey data from 205 women surveyed in 67 verified adenomyosis first degree (Group 1), 79 - second degree adenomyosis (group 2), and 59 - third degree adenomyosis (group 3). Doppler results showed that in patients with adenomyosis first degree nizkorezistentny uterine blood flow was observed. Improvement of clinical symptoms of the disease, increasing the numerical values of R & D in the uterine arteries at the first degree adenomyosis indicates pathogenic effects of the proposed treatment. At the same time in patients with adenomyosis II-III degree was observed with highly bloodstream, indicating the deterioration of blood flow in the uterine vascular basin, as evidenced by some of hemostasis. Thus, studies have provided credible evidence pathogenesis mediated relations between the characteristics of the circulation of the uterus, the processes of neoangiogenesis, proliferation in the myometrium and the extent of spread of the disease, which will choose the appropriate methods of conservative treatment. Using drugs and Indinol epigallat affecting the basic pathogenetic mechanisms of adenomyosis, opens a new direction in the treatment of this disease, and effective natural methods - new opportunities in the treatment of adenomyosis.

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