scholarly journals Lichen Planus and Its Management: An Update and Observation

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Lichen Planus ◽  
Large Scale ◽  
Treatment Options ◽  
Current Treatment ◽  
Evidence Based ◽  
Aggressive Treatment ◽  
Ongoing Trial ◽  
Or Management ◽  
Cutaneous Disease ◽  
Different Types

Lichen planus (LP) is an inflammatory muco-cutaneous disease characterised by shiny, flat-topped papules and plaques. It affects around 1% of the population. The disease is usually self-limiting and benign in nature. However, some varieties of LP may cause considerable discomfort and recalcitrant in nature. So, treatment depends on appreciating the type, severity and nature of the disease. There are a good numbers of options for treating different types of LP. Few types of LP are difficult to treat and needs aggressive treatment to prevent complications like hair or nail loss. Author examined and summarized the published literature involving the treatment or management of LP. It is found that the large scale, evidence based trials are only few in number. At present, it is quite difficult to standardisation of treatment. This review outlines the ongoing trial and current treatment options. It is needed to assimilation and summarization of the recent findings to treat the critical cases in a more effective way

scholarly journals The Arteriovenous Loop: Engineering of Axially Vascularized Tissue

2018 ◽  
Vol 59 (3-4) ◽  
pp. 286-299 ◽  
Author(s):  
Annika Weigand ◽  
Raymund E. Horch ◽  
Anja M. Boos ◽  
Justus P. Beier ◽  
Andreas Arkudas
Keyword(s):  
Tissue Engineering ◽  
Large Scale ◽  
Treatment Options ◽  
Current Treatment ◽  
Loop Model ◽  
Engineering Approach ◽  
In Vivo Tissue Engineering ◽  
Tissue Engineering Approach ◽  
Tissue Defects

Background: Most of the current treatment options for large-scale tissue defects represent a serious burden for the patients, are often not satisfying, and can be associated with significant side effects. Although major achievements have already been made in the field of tissue engineering, the clinical translation in case of extensive tissue defects is only in its early stages. The main challenge and reason for the failure of most tissue engineering approaches is the missing vascularization within large-scale transplants. Summary: The arteriovenous (AV) loop model is an in vivo tissue engineering strategy for generating axially vascularized tissues using the own body as a bioreactor. A superficial artery and vein are anastomosed to create an AV loop. This AV loop is placed into an implantation chamber for prevascularization of the chamber inside, e.g., a scaffold, cells, and growth factors. Subsequently, the generated tissue can be transplanted with its vascular axis into the defect site and anastomosed to the local vasculature. Since the blood supply of the growing tissue is based on the AV loop, it will be immediately perfused with blood in the recipient site leading to optimal healing conditions even in the case of poorly vascularized defects. Using this tissue engineering approach, a multitude of different axially vascularized tissues could be generated, such as bone, skeletal or heart muscle, or lymphatic tissues. Upscaling from the small animal AV loop model into a preclinical large animal model could pave the way for the first successful attempt in clinical application. Key Messages: The AV loop model is a powerful tool for the generation of different axially vascularized replacement tissues. Due to minimal donor site morbidity and the possibility to generate patient-specific tissues variable in type and size, this in vivo tissue engineering approach can be considered as a promising alternative therapy to current treatment options of large-scale defects.

scholarly journals COVID-19 and Cardiovascular System. Part 3. COVID-19 Current Treatment Approaches: Evidence-Based Review

2021 ◽  
Vol 10 (3) ◽  
pp. 438-451
Author(s):  
M. K. Vasilchenko ◽  
A. A. Ivannikov ◽  
A. N. Yesaulenko ◽  
Kh. G. Alidzhanova ◽  
S. S. Petrikov
Keyword(s):  
Clinical Trials ◽  
Cardiovascular System ◽  
Mechanism Of Action ◽  
Treatment Strategy ◽  
Large Scale ◽  
Management Plan ◽  
Current Treatment ◽  
Evidence Based ◽  
Potential Mechanism ◽  
System Part

Unified management plan and treatment strategy for COVID-19 patients are yet to be discovered. Many trials on COVID-19 interventions have been registered or are ongoing. In this article the results of large-scale clinical trials on COVID-19 treatment are presented, the potential mechanism of action of some drugs is discussed, the features of the main pharmacological and non-pharmacological therapeutic options for COVID-19 patients are described.

scholarly journals Evidence-based management of central cord syndrome

2013 ◽  
Vol 35 (1) ◽  
pp. E6 ◽  
Author(s):  
Nader S. Dahdaleh ◽  
Cort D. Lawton ◽  
Tarek Y. El Ahmadieh ◽  
Alexander T. Nixon ◽  
Najib E. El Tecle ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Current Treatment ◽  
Timing Of Surgery ◽  
Evidence Based ◽  
Class Iii ◽  
Medical Subject Headings ◽  
Central Cord Syndrome

Object Evidence-based medicine is used to examine the current treatment options, timing of surgical intervention, and prognostic factors in the management of patients with traumatic central cord syndrome (TCCS). Methods A computerized literature search of the National Library of Medicine database, Cochrane database, and Google Scholar was performed for published material between January 1966 and February 2013 using key words and Medical Subject Headings. Abstracts were reviewed and selected, with the articles segregated into 3 main categories: surgical versus conservative management, timing of surgery, and prognostic factors. Evidentiary tables were then assembled, summarizing data and quality of evidence (Classes I–III) for papers included in this review. Results The authors compiled 3 evidentiary tables summarizing 16 studies, all of which were retrospective in design. Regarding surgical intervention versus conservative management, there was Class III evidence to support the superiority of surgery for patients presenting with TCCS. In regards to timing of surgery, most Class III evidence demonstrated no difference in early versus late surgical management. Most Class III studies agreed that older age, especially age greater than 60–70 years, correlated with worse outcomes. Conclusions No Class I or Class II evidence was available to determine the efficacy of surgery, timing of surgical intervention, or prognostic factors in patients managed for TCCS. Hence, there is a need to perform well-controlled prospective studies and randomized controlled clinical trials to further investigate the optimal management (surgical vs conservative) and timing of surgical intervention in patients suffering from TCCS.

scholarly journals CUBES: A practical toolkit to measure enablers and barriers to behavior for effective intervention design

2020 ◽  
Vol 3 ◽  
pp. 886
Author(s):  
Elisabeth Engl ◽  
Sema K. Sgaier
Keyword(s):  
Decision Aid ◽  
Market Research ◽  
Large Scale ◽  
Evidence Based ◽  
Development Programs ◽  
Global Development ◽  
Effective Interventions ◽  
Behavior Change Interventions ◽  
Different Types ◽  
Practical Tool

A pressing goal in global development and other sectors is often to understand what drives people’s behaviors, and how to influence them. Yet designing behavior change interventions is often an unsystematic process, hobbled by insufficient understanding of contextual and perceptual behavioral drivers and a narrow focus on limited research methods to assess them. We propose a toolkit (CUBES) of two solutions to help programs arrive at more effective interventions. First, we introduce a novel framework of behavior, which is a practical tool for programs to structure potential drivers and match corresponding interventions. This evidence-based framework was developed through extensive cross-sectoral literature research and refined through application in large-scale global development programs. Second, we propose a set of descriptive, experimental, and simulation approaches that can enhance and expand the methods commonly used in global development. Since not all methods are equally suited to capture the different types of drivers of behavior, we present a decision aid for method selection. We recommend that existing commonly used methods, such as observations and surveys, use CUBES as a scaffold and incorporate validated measures of specific types of drivers in order to comprehensively test all the potential components of a target behavior. We also recommend under-used methods from sectors such as market research, experimental psychology, and decision science, which programs can use to extend their toolkit and test the importance and impact of key enablers and barriers. The CUBES toolkit enables programs across sectors to streamline the process of conceptualizing, designing, and optimizing interventions, and ultimately to change behaviors and achieve targeted outcomes.

scholarly journals CUBES: A practical toolkit to measure enablers and barriers to behavior for effective intervention design

2019 ◽  
Vol 3 ◽  
pp. 886 ◽  
Author(s):  
Elisabeth Engl ◽  
Sema K. Sgaier
Keyword(s):  
Decision Aid ◽  
Market Research ◽  
Large Scale ◽  
Evidence Based ◽  
Development Programs ◽  
Global Development ◽  
Effective Interventions ◽  
Behavior Change Interventions ◽  
Different Types ◽  
Practical Tool

A pressing goal in global development and other sectors is often to understand what drives people’s behaviors, and how to influence them. Yet designing behavior change interventions is often an unsystematic process, hobbled by insufficient understanding of contextual and perceptual behavioral drivers and a narrow focus on limited research methods to assess them. We propose a toolkit (CUBES) of two solutions to help programs arrive at more effective interventions. First, we introduce a novel framework of behavior, which is a practical tool for programs to structure potential drivers and match corresponding interventions. This evidence-based framework was developed through extensive cross-sectoral literature research and refined through application in large-scale global development programs. Second, we propose a set of descriptive, experimental, and simulation approaches that can enhance and expand the methods commonly used in global development. Since not all methods are equally suited to capture the different types of drivers of behavior, we present a decision aid for method selection. We recommend that existing commonly used methods, such as observations and surveys, use CUBES as a scaffold and incorporate validated measures of specific types of drivers in order to comprehensively test all the potential components of a target behavior. We also recommend under-used methods from sectors such as market research, experimental psychology, and decision science, which programs can use to extend their toolkit and test the importance and impact of key enablers and barriers. The CUBES toolkit enables programs across sectors to streamline the process of conceptualizing, designing, and optimizing interventions, and ultimately to change behaviors and achieve targeted outcomes.

Management of Chlorine Gas-Related Injuries From the Graniteville, South Carolina, Train Derailment

2014 ◽  
Vol 8 (5) ◽  
pp. 411-416 ◽  
Author(s):  
Emily Mackie ◽  
Erik Svendsen ◽  
Stephen Grant ◽  
Jill E. Michels ◽  
William H. Richardson
Keyword(s):  
South Carolina ◽  
Large Scale ◽  
Treatment Options ◽  
Current Treatment ◽  
Automotive Electronics ◽  
Metal Production ◽  
Train Derailment ◽  
Randomized Controlled ◽  
Persistent Inflammation ◽  
Chlorine Gas

AbstractA widely produced chemical, chlorine is used in various industries including automotive, electronics, disinfectants, metal production, and many others. Chlorine is usually produced and transported as a pressurized liquid; however, as a gas it is a significant pulmonary irritant. Thousands of people are exposed to chlorine gas every year, and while large-scale exposures are uncommon, they are not rare. Symptoms are usually related to the concentration and length of exposure, and although treatment is largely supportive, certain specific therapies have yet to be validated with randomized controlled trials. The majority of those exposed completely recover with supportive care; however, studies have shown the potential for persistent inflammation and chronic hyperreactivity. This case report describes an incident that occurred in Graniteville, South Carolina, when a train derailment exposed hundreds of people to chlorine gas. This report reviews the events of January 6, 2005, and the current treatment options for chlorine gas exposure.(Disaster Med Public Health Preparedness. 2014;0:1-6)

scholarly journals Biologicals in Atopic Dermatitis

2021 ◽  
Author(s):  
Suvarna Samudrala
Keyword(s):  
Atopic Dermatitis ◽  
Large Scale ◽  
Treatment Options ◽  
Current Treatment ◽  
Phase 2 ◽  
Near Future ◽  
Larger Sample ◽  
Long Term Adverse Effects

Atopic dermatitis (AD) is a debilitating condition, and its management in both children and adults can be challenging for clinicians and patients alike. The current treatment options approved by the Food and Drug Administration (FDA) have variable efficacies, and long-term adverse effects, which further complicate the plan of management. There has been considerable progress towards the use of targeted medicines like biologicals and small molecular agents for atopic dermatitis. Various molecules targeting the TH2 pathway, JAK/STAT pathway, cAMP, IL-22, Il-12/IL-23 and IgE, have been developed, and are being studied extensively in both adults and pediatric patients of atopic dermatitis. Currently, only Dupilumab is approved by the FDA for the treatment of moderate to severe refractory atopic dermatitis. The other biological agents are currently in phase 2 or phase 3 trials. There is a paucity of multicentric, large-scale studies on the above drugs, along with a lack of comparative studies with the existing modalities of treatment. Therefore, more studies with a larger sample size and longer follow up periods are needed to determine their efficacy and long-term safety profiles. Overall, these agents are likely to be a part of the therapeutic armamentarium for atopic dermatitis in the near future.

Pediatric Gliomas: Current Concepts on Diagnosis, Biology, and Clinical Management

2017 ◽  
Vol 35 (21) ◽  
pp. 2370-2377 ◽  
Author(s):  
Dominik Sturm ◽  
Stefan M. Pfister ◽  
David T.W. Jones
Keyword(s):  
Large Scale ◽  
Treatment Options ◽  
Tumor Biology ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Cns Tumors ◽  
Low Grade ◽  
Who Grade ◽  
Short Period ◽  
Life Threatening

Gliomas are the most common CNS tumors in children and adolescents, and they show an extremely broad range of clinical behavior. The majority of pediatric gliomas present as benign, slow-growing lesions classified as grade I or II by the WHO classification of CNS tumors. These pediatric low-grade gliomas (LGGs) are fundamentally different from IDH-mutant LGGs occurring in adults, because they rarely undergo malignant transformation and show excellent overall survival under current treatment strategies. However, a significant fraction of gliomas develop over a short period of time and progress rapidly and are therefore classified as WHO grade III or IV high-grade gliomas (HGGs). Despite all therapeutic efforts, they remain largely incurable, with the most aggressive forms being lethal within months. Thus, the intentions of neurosurgeons, pediatric oncologists, and radiotherapists to improve care for pediatric patients with glioma range from increasing quality of life and preventing long-term sequelae in what is often a chronic, but rarely life-threatening disease (LGG), to uncovering effective treatment options to prolong patient survival in an almost universally fatal setting (HGG). The last decade has seen unprecedented progress in understanding the molecular biology underlying pediatric gliomas, fueling hopes to achieve both goals. Large-scale collaborative studies around the globe have cataloged genomic and epigenomic alterations in gliomas across ages, grades, and histologies. These studies have revealed biologic subgroups characterized by distinct molecular, pathologic, and clinical features, with clear relevance for patient management. In this review, we summarize hallmark discoveries that have expanded our knowledge in pediatric LGGs and HGGs, explain their role in tumor biology, and convey our current concepts on how these findings may be translated into novel therapeutic approaches.

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