SECONDARY IMMUNODEFICIENCY STATES IN THE ACTIVITY OF A GENERAL PRACTITIONER – FAMILY MEDICINE AND PHYTOTHERAPEUTICWAYS OF THEIR CORRECTION (LECTURE)

Fitoterapia ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 6-15
Author(s):  
O Voloshуn ◽  
◽  
L Voloshyna ◽  
B Senyuk ◽  
I Prуsyazhnyuk ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Treatment Effectiveness ◽  
Folk Medicine ◽  
Clinical Signs ◽  
Treatment Strategies ◽  
Sources Of Information ◽  
Secondary Immunodeficiency ◽  
Results Of Treatment ◽  
Treatment And Prevention ◽  
Immunodeficiency States

Keywords: secondary immunodeficiency states, diagnosis, treatment, phytoimmunomodulators. Topicality. Secondary immunodeficiency states (SIS) is a fairly common phenomenon in the clinic of internal medicine as an “addition” for many diseases, which has no clear clinical signs, so it is not often diagnosed by primary care physicians. However, untimely detection and correction of SI significantly worsens the overall results of treatment and contributes to recurrence of the underlying disease.There is a prospect of further increase in the prevalence of SI, the success of correction of underlying desease due to doctors’ understanding of their clinical and pathogenetic features and knowledge of treatment strategies and tactics, including the use of phytotherapeutic agents. The aim is to highlight modern approaches to the diagnosis and treatment of SI with the use of phytotherapeutic agents. Materials and methods. Materials of the main domestic and foreign printed sources of information using methods of comparison, analysis and generalization are used. Results. Information on the classification, diagnosis, strategy and tactics of treatment and prevention of SIS depending on their severity with the use of various phytotherapeutic agents, criteria for treatment effectiveness, age and somatic aspects of rehabilitation at the outpatient stage are analyzed. The importance of timely diagnosis of secondary immunodeficiency and the use of phytotherapeutic agents in the context of the “WHO Strategy in the field of folk medicine for 2014-2023” as the latest and most effective approach in the treatment of complex pathological phenomena.

Modern determinants of endometrium hyperplastic processes pathogenesis

2016 ◽  
pp. 137-142
Author(s):  
V.O. Benyuk ◽  
◽  
V.M. Goncharenko ◽  
T.R. Nykoniuk ◽  
◽  
...  
Keyword(s):  
Conservative Therapy ◽  
Solid Phase ◽  
Research Direction ◽  
Immunohistochemical Method ◽  
Results Of Treatment ◽  
Treatment And Prevention ◽  
Receptor Phenotype ◽  
The Relationship ◽  
Endometrial Proliferation

The objective: to еxplore the relationship between the activity of endometrial proliferation and the state of the local immune response in the uterus in the conditions berprestasi process. Patients and methods. Examined 228 women of reproductive and perimenopausal age with endometrial pathology using ultrasound and then performing hysteroresectoscopy. Determination of the concentrations of the cytokines IL-1, IL-2, IL-6 and TNF was performed by solid phase ELISA. Results. Found a trend that confirms the loss of sensitivity to hormones at the stage of malignancy of the endometrium and can be used as diagnostic determinants in determining the nature of intrauterine pathology and criterion of the effectiveness of conservative therapy. Conclusion. Improving etiopatogenetice approach to the therapy of hyperplastic proce.sses of endometrium with determination of receptor phenotype of the endometrium is a research direction in modern gynecology, which will help to improve the results of treatment and prevention of intrauterine pathology. Key words: endometrial hyperplasia,the receptors for progesterone and estrogen, immunohistochemical method.

Synergistic Antitumor Effect of 5-Fluorouracil Combined with Constituents from Pleurospermum lindleyanum in Hepatocellular carcinoma SMMC-7721 Cells

2020 ◽  
Vol 20 ◽  
Author(s):  
Xiao-Feng Zhu ◽  
Xiao-Jin Li ◽  
Zhong-Lian Cao ◽  
Xiu-Jie Liu ◽  
Ping Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Effectiveness ◽  
Synergistic Effects ◽  
Folk Medicine ◽  
Inhibitory Effect ◽  
Caspase 9 ◽  
Whole Plant ◽  
Anti Cancer ◽  
Induced Apoptosis

Background: A Chinese folk medicine plant Pleurospermum lindleyanum possesses pharmacological activities of heat-clearing, detoxifying and preventing from hepatopathy, coronary heart disease, hypertension, and high altitude sickness. We isolated and characterized its constituents to investigate its synergistic effects against human hepatoma SMMC-7721 cells. Objective: The aim of this study was to explore the synergistic anti-cancer activities of isolates from P. lindleyanum with 5-FU on hepatoma SMMC-7721 cells in vitro and their primary mechanisms. Methods: Sequential chromatographic techniques were conducted for the isolation studies. The isolates structures were established by spectroscopic analysis as well as X-ray crystallographic diffraction. Growth inhibition was detected by MTT assay. The isobologram method was used to assess the effect of drug combinations. Flow cytometry and western blot were used to examine apoptosis and protein expression. Results: A new coumarin (16), along with sixteen known compounds, were isolated from the whole plant of P. lindleyanum and their structures were elucidated by spectroscopic methods. Four coumarins (2, 3, 5, and 16), two flavonoids (8 and 9) and three phytosterols and triterpenes (12-14) were found to synergistically enhance the inhibitory effect of 5-FU against SMMC-7721 cells. Among them, compounds 3 and 16 exhibited the best synergistic effects with IC50 of 5-FU reduced by 16-fold and 22-fold possessing the minimum Combination Index (CI) 0.34 and 0.27. The mechanism of action of combinations might be through synergistic arresting for the cell cycle at G1 phases and the induction of apoptosis. Moreover, western blotting and molecular docking revealed that compounds 3 or 5 might promote 5-FU-induced apoptosis by regulating the expression of Caspase 9 and PARP. Conclusion: Constituents from P. lindleyanum may improve the treatment effectiveness of 5-FU against hepatocellular carcinoma cells.

scholarly journals Clinician-Reported Patient Awareness of Symptoms and Severity of Tardive Dyskinesia in Patients Prescribed VMAT2 Inhibitors

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 151-151
Author(s):  
Jonathan M. Meyer ◽  
Ericha Franey ◽  
Leslie Lundt ◽  
Betsy Benning ◽  
Edward Goldberg ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Symptom Severity ◽  
Primary Care Physicians ◽  
Additional Data ◽  
Treatment Strategies ◽  
Vesicular Monoamine Transporter ◽  
Patient Awareness ◽  
Patient Demographics ◽  
The Past ◽  
Body Regions

AbstractObjectiveVesicular monoamine transporter 2 (VMAT2) inhibitors including valbenazine are first-line therapies for tardive dyskinesia (TD), a persistent movement disorder associated with antipsychotic exposure. This real-world study was performed to assess the association between patient awareness of TD symptoms and clinician-assessed symptom severity.MethodsClinicians who treated antipsychotic-induced TD with a VMAT2 inhibitor within the past 24 months were asked to extract demographic/clinical data from patients charts and complete a survey for additional data, including patient awareness of TD (yes/no) and TD symptom severity (mild/moderate/severe).ResultsData for 601 patients were provided by 163 clinicians (113 psychiatrists; 46 neurologists; 4 primary care physicians). Patient demographics: 50% male; mean age 50.6 years; 55% schizophrenia/schizoaffective disorder; 29% bipolar disorder; 16% other psychiatric diagnoses. Positive relationships were seen between patient awareness and clinician-assessed symptom severity. Awareness was highest in patients with severe symptoms in specific body regions: face (88% vs 78%/69% [awareness by severe vs moderate/mild symptoms]); jaw (90% vs 80%/67%); wrists (90% vs 69%/63%). In other regions, awareness was similar in patients with severe or moderate symptoms: lips (85%/86% vs 68% [severe/moderate vs mild]); tongue (81%/80% vs 73%); neck (80%/78% vs 68%); arms (67%/66% vs 62%); knees (67%/67% vs 53%).ConclusionsIn patients prescribed a VMAT2 inhibitor for TD, patient awareness was generally higher in those determined to have moderate-to-severe symptom severity as assessed by the clinician. More research is needed to understand how awareness and severity contribute to TD burden, and whether different treatment strategies are needed based on these factors.FundingNeurocrine Biosciences, Inc.

scholarly journals Systematic Review of Recurrent Osteosarcoma Systemic Therapy

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1757
Author(s):  
Ioanna Gazouli ◽  
Anastasios Kyriazoglou ◽  
Ioannis Kotsantis ◽  
Maria Anastasiou ◽  
Anastasios Pantazopoulos ◽  
...  
Keyword(s):  
Clinical Evidence ◽  
Treatment Effectiveness ◽  
Treatment Strategies ◽  
Bone Cancer ◽  
Predictive Biomarkers ◽  
Mtor Inhibitors ◽  
Cytotoxic Chemotherapy ◽  
Driver Mutations ◽  
Preclinical Research ◽  
Primary Bone

Osteosarcoma is the most frequent primary bone cancer, mainly affecting those of young ages. Although surgery combined with cytotoxic chemotherapy has significantly increased the chances of cure, recurrent and refractory disease still impose a tough therapeutic challenge. We performed a systematic literature review of the available clinical evidence, regarding treatment of recurrent and/or refractory osteosarcoma over the last two decades. Among the 72 eligible studies, there were 56 prospective clinical trials, primarily multicentric, single arm, phase I or II and non-randomized. Evaluated treatment strategies included cytotoxic chemotherapy, tyrosine kinase and mTOR inhibitors and other targeted agents, as well as immunotherapy and combinatorial approaches. Unfortunately, most treatments have failed to induce objective responses, albeit some of them may sustain disease control. No driver mutations have been recognized, to serve as effective treatment targets, and predictive biomarkers of potential treatment effectiveness are lacking. Hopefully, ongoing and future clinical and preclinical research will unlock the underlying biologic mechanisms of recurrent and refractory osteosarcoma, expanding the therapeutic choices available to pre-treated osteosarcoma patients.

scholarly journals Animal Coronavirus Diseases: Parallels with COVID-19 in Humans

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1507
Author(s):  
Chao-Nan Lin ◽  
Kuan Rong Chan ◽  
Eng Eong Ooi ◽  
Ming-Tang Chiou ◽  
Minh Hoang ◽  
...  
Keyword(s):  
Genome Organization ◽  
Clinical Signs ◽  
Feline Infectious Peritonitis ◽  
Viral Shedding ◽  
Related Disease ◽  
The Past ◽  
Treatment And Prevention ◽  
Historical Archives ◽  
Huge Impact ◽  
Novel Coronavirus

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus in humans, has expanded globally over the past year. COVID-19 remains an important subject of intensive research owing to its huge impact on economic and public health globally. Based on historical archives, the first coronavirus-related disease recorded was possibly animal-related, a case of feline infectious peritonitis described as early as 1912. Despite over a century of documented coronaviruses in animals, the global animal industry still suffers from outbreaks. Knowledge and experience handling animal coronaviruses provide a valuable tool to complement our understanding of the ongoing COVID-19 pandemic. In this review, we present an overview of coronaviruses, clinical signs, COVID-19 in animals, genome organization and recombination, immunopathogenesis, transmission, viral shedding, diagnosis, treatment, and prevention. By drawing parallels between COVID-19 in animals and humans, we provide perspectives on the pathophysiological mechanisms by which coronaviruses cause diseases in both animals and humans, providing a critical basis for the development of effective vaccines and therapeutics against these deadly viruses.

Infant Sleep Position: Pediatricians' Advice to Parents

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 55-58
Author(s):  
Bonnie B. Hudak ◽  
Jane O'Donnell ◽  
Nadine Mazyrka
Keyword(s):  
Primary Care ◽  
New York ◽  
Primary Care Physicians ◽  
Sleep Position ◽  
Infant Sleep ◽  
Sources Of Information ◽  
Professional Literature ◽  
Infant Sleep Position ◽  
Supine Sleep ◽  
Question Survey

Objective. The American Academy of Pediatrics' (AAP) recommendation for side or supine sleep position in healthy babies has generated much controversy. We surveyed primary care physicians to determine the effect of the AAP statement on physician attitude toward infant sleep position and advice to parents. Methods. We sent a 23-question survey to 194 physicians in Western New York. The survey addressed their attitude toward the AAP recommendations and its impact on their advice to parents. Results. Of the 149 physicians treating newborns, 121 (82%) completed the questionnaire; 98% were aware of the AAP statement. The most common sources of information were the AAP (86%) and professional literature (77%). Of the respondents, 79% agreed with the AAP statement. Reasons for reservation were lack of data (64%), potential adverse consequences of supine position (52%), and their own experience (47%). Gender, years in practice, and type of reimbursement did not influence attitude toward the AAP recommendation. The AAP statement increased the frequency with which physicians routinely discussed sleep position from 34 to 70% (P < .02). Physicians recommending the prone position decreased from 57 to 7% (P < .001), while those recommending supine sleep position increased from 10 to 42% (P < .001). Conclusions. Most physicians agreed with the AAP statement and more frequently discussed sleep position following the AAP recommendations. However, they did not routinely recommend supine sleep position. The majority (69%) recommended the side position even though it is unstable. Although the AAP statement has increased discussion of infant sleep position by primary care physicians in WNY, only a minority recommend that infants sleep supine.

scholarly journals Drug-Induced Heart Failure (Part 2: Mechanisms of Development, Clinical Signs, Differential Diagnosis, Risk Factors, Treatment and Prevention)

2020 ◽  
Vol 8 (2) ◽  
pp. 57-65
Author(s):  
O. D. Ostroumova ◽  
I. V. Goloborodova
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Channel Blockers ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Developing Heart

Heart failure is a complex clinical syndrome caused by an impaired pumping function of the heart muscle, etiologically associated with cardiovascular disease and, in the vast majority of cases, requiring complex therapeutic regimens and simultaneous prescription of several drugs. To date, we know several classes of drugs (including those used for heart failure) which can induce development/progression of heart failure in both patients with left ventricular dysfunction, and in patients who do not have cardiovascular diseases. The aim of the study was to analyse and systematize data on development mechanisms, as well as methods of prevention and treatment of drug-induced heart failure when using diff erent groups of drugs. It has been established that drug-induced heart failure is most often associated with the use of calcium channel blockers (verapamil, diltiazem, nifedipine), beta-blockers, antiarrhythmic drugs (disopyramide, fl ecainide, propafenone, amiodarone, ibutilide, dofetilide, dronedarone), anthracyclines (doxorubicin) and other antitumor drugs (trastuzumab, bevacizumab, infl iximab), hypoglycemic drugs (thiazolidinediones, saxagliptin, alogliptin), and nonsteroidal anti-infl ammatory drugs, including selective cyclooxygenase-2 inhibitors. The study revealed various mechanisms of heart failure development following drug treatment. In some patients, heart failure development is associated with the cardiotoxic eff ect of a particular drug, in others with adverse eff ects on hemodynamics. Much depends on risks of developing heart failure, including specifi c risks attributable to groups of drugs and individual drugs. The identifi cation of drugs that can contribute to the development/ progression of heart failure, and possible clinical manifestations of drug-induced heart failure, as well as provision of timely information to physicians, and engagement of clinical pharmacologists with the aim of optimizing treatment of patients can facilitate timely diagnosis, treatment and prevention of drug-induced heart failure. 

scholarly journals From CPAP to tailored therapy for obstructive sleep apnoea

2018 ◽  
Vol 13 ◽  
Author(s):  
Peter A. Cistulli ◽  
Kate Sutherland ◽  
Kristina Kairaitis ◽  
Brendon J. Yee
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Treatment Effectiveness ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Sleep Apnoea ◽  
Patient Acceptance ◽  
Cpap Therapy ◽  
Individual Level ◽  
Obstructive Sleep ◽  
The Individual

Obstructive Sleep Apnoea (OSA) is a common sleep disorder that is associated with daytime symptoms and a range of comorbidity and mortality. Continuous Positive Airway Pressure (CPAP) therapy is highly efficacious at preventing OSA when in use and has long been the standard treatment for newly diagnosed patients. However, CPAP therapy has well recognised limitations in real world effectiveness due to issues with patient acceptance and suboptimal usage. There is a clear need to enhance OSA treatment strategies and options. Although there are a range of alternative treatments (e.g. weight loss, oral appliances, positional devices, surgery, and emerging therapies such as sedatives and oxygen), generally there are individual differences in efficacy and often OSA will not be completely eliminated. There is increasing recognition that OSA is a heterogeneous disorder in terms of risk factors, clinical presentation, pathophysiology and comorbidity. Better characterisation of OSA heterogeneity will enable tailored approaches to therapy to ensure treatment effectiveness. Tools to elucidate individual anatomical and pathophysiological phenotypes in clinical practice are receiving attention. Additionally, recognising patient preferences, treatment enhancement strategies and broader assessment of treatment effectiveness are part of tailoring therapy at the individual level. This review provides a narrative of current treatment approaches and limitations and the future potential for individual tailoring to enhance treatment effectiveness.

scholarly journals Chemotherapy induced liver toxicity in children with malignant diseases

2018 ◽  
Vol 91 (1) ◽  
pp. 37-41
Author(s):  
Horváth Adrienne ◽  
Papp Zsuzsanna Erzsébet
Keyword(s):  
Liver Injury ◽  
Maintenance Therapy ◽  
Esophageal Varices ◽  
Liver Toxicity ◽  
Lymphoblastic Leukemia ◽  
Treatment Options ◽  
Clinical Signs ◽  
Treatment Strategies ◽  
Malignant Diseases ◽  
Drug Induced

Abstract A broad spectrum of chemotherapy is being used in the therapy of childhood cancers, which may induce liver injury, impairing quality of life and efficacy of the treatment. History of, especially viral, liver diseases may increase toxicity. The aim of the paper is to assess the incidence, type and grade, predisposing factors and treatment options of drug-induced liver injury in children with malignant diseases under cytostatic therapy at the Hemato-Oncology Department of the Pediatric Clinic 2 from Targu-Mures, over a time period spanning from 2012 to 2017. The results of the study may serve as a foundation for such treatment strategies which would enable optimal outcomes with fewer cases of liver toxicity. During this period, we treated 26 patients with acute lymphoblastic leukemia (ALL), two patients with acute myeloblastic leukemia (AML), one patient with lymphoma and seven with solid tumors. We found liver toxicity in 77% of the patients treated for ALL, mainly during the maintenance therapy (65%) with oral 6-mercaptopurine and methotrexate. The most common clinical signs were anorexia, nausea, vomiting, abdominal pain and faltering weight gain. Cholestasis developed in two patients, while hepatocytolysis was the most common observed event (n = 24). Liver fibrosis, hypersplenism, portal hypertension and esophageal varices were found in two patients. One patient required endoscopic ligation of esophageal varices. Elevation of serum bilirubin appeared in two patients, while hypoproteinemia was observed in nine patients. None of the patients developed acute liver failure. We treated liver toxicity with hydration, alkalinization, i.v. Aspatofort, Aminosteril-N Hepa 8%, oral acetylcysteine, silymarin, ursodeoxycholic acid, Liv-52, Sargenor, and Essentiale forte. We found hepatotoxicity in 77% of the ALL patients undergoing chemotherapy, similar results have been published by other authors. Hepatotoxicity may develop through direct hepatic effects of cytostatics, or a preexisting liver disease impairs the metabolism and excretion of the drug, increasing its toxic effects. In our patients hepatotoxicity can be explained mainly by direct liver-injury, previous infections with hepatotropic viruses, such as cytomegalovirus, were detected only in three patients. Liver injury appeared in 77% of our ALL patients; 65% occurred during maintenance therapy with oral 6-mercaptopurine and methotrexate. Close followup of liver function during chemotherapy is mandatory for optimal results.

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