scholarly journals Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan

2021 ◽  
Vol 11 (6) ◽  
pp. 478
Author(s):  
Ching Chang ◽  
Chien-Hao Huang ◽  
Hsiao-Jung Tseng ◽  
Fang-Chen Yang ◽  
Rong-Nan Chien
Keyword(s):  
Hepatic Encephalopathy ◽  
Real World ◽  
Ammonia Level ◽  
Decompensated Cirrhosis ◽  
Control Group ◽  
Multivariable Logistic Regression Model ◽  
Before And After ◽  
One Year ◽  
The One ◽  
Serum Ammonia

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Therefore, the aim of this study is to evaluate the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission in Taiwan. Methods: We conducted a real-world single-center retrospective cohort study to compare the long-term efficacy of rifaximin add-on to lactulose (group R + L) versus lactulose alone (group L, control group). Furthermore, the treatment efficacy before and after rifaximin add-on to lactulose was also analyzed. The primary endpoint of our study was time to first HE recurrence (Conn score ≥ 2). All patients were followed up every three months until death, and censored at one year if still alive. Results and Conclusions: 12 patients were enrolled in group R + L. Another 31 patients were stratified into group L. Sex, comorbidity, ammonia level, and ascites grade were matched while age, HE grade, and model for end-stage liver disease (MELD) score were adjusted in the multivariable logistic regression model. Compared with group L, significant improvement in the maintenance of HE remission and decreased episodes and days of HE-related hospitalizations were demonstrated in group R + L. The serum ammonia levels were significantly lower at the 3rd and 6th month in group 1. Concerning changes before and after rifaximin add-on in group R + L, mini-mental status examination (MMSE), episodes of hospitalization, and variceal bleeding also improved at 6 and 12 months. Days of hospitalization, serum ammonia levels also improved at 6th month. Except for concern over price, no patients discontinued rifaximin due to adverse events or complications. The above results provide evidence for the one-year use of rifaximin add-on to lactulose in reducing HE recurrence and HE-related hospitalization for patients with decompensated cirrhosis.

Gut Microbiota and Urine Metabonomics Alterations in Constitution after Chinese Medicine and Lifestyle Intervention

2021 ◽  
pp. 1-29
Author(s):  
Yuan Jing ◽  
Shuangshuang Han ◽  
Jieyu Chen ◽  
Yigui Lai ◽  
Jingru Cheng ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Gut Microbiota ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Urinary Metabolites ◽  
Control Group ◽  
Human Beings ◽  
Before And After ◽  
One Year ◽  
The One

Traditional Chinese Medicine Constitution (TCMC) divides human beings into balanced (ping-he) constitution (PH) and unbalanced constitution. Yang-deficiency (yang-xu) constitution (YAX) is one of the most common unbalanced constitutions in Chinese general population, and it causes susceptibility to particular diseases. However, unbalanced constitutions can be regulated by Chinese medicine and lifestyle intervention in clinical practice. Gui-fu-di-huang-wan (GFDHW) is a well-known Chinese medicine with yang-invigorating activity and is regarded as improving YAX. In this study, 60 healthy YAX students selected from a prospective population of 5185 were enrolled in a randomized clinical trial and completed the study. We compared the gut microbiota and urinary metabolome between individuals with PH and those with YAX before and after one-month-intervention. Compared with the control group, the health status of the intervention group improved significantly, the YAX symptom score was reduced, and the efficacy remained high at the one-year follow-up. The gut microbiota of the healthy PH exhibited greater diversity, and significantly higher species were identified.[Formula: see text]Compared to PH group, YAX individuals showed increased abundance of Bacteroidetes and Bacteroides,also had higher levels of gut microbial-derived urinary metabolites. After one-month-intervention, both GFDHW treatment and lifestyle intervention enriched the diversity and modulated the structure in YAX. The intervention group also partially restored the microbiome and metabolome to healthy PH-like levels. Further, a microbiota co-occurrence network analysis showed that the metabolites enriched in YAX were correlated with microbial community structure. Taken together, our results suggest that Chinese medicine combined with lifestyle intervention benefits YAX individuals. Gut microbiota/metabolite crosstalk might be involved in the Chinese medicine-mediated effects.

Safety Study of AAV hTert and Klotho Gene Transfer Therapy for Dementia

2021 ◽  
Author(s):  
Patrick E Sewell
Keyword(s):  
Gene Transfer ◽  
Randomized Study ◽  
Control Group ◽  
Response Data ◽  
Cognitive Improvement ◽  
Moderate Dementia ◽  
Before And After ◽  
Transfer Method ◽  
One Year ◽  
The One

A sponsored, interventional, non-randomized study without a control group using a novel and proprietary central nervous system gene transfer method to deliver AAV hTert and Klotho genes to five patients with mild or moderate dementia was performed to primarily evaluate safety. Clinical response data was gathered as a secondary interest. The therapy demonstrated a very high safety profile with no serious adverse effects identified. Clinical evaluation of the patients over the course of the one year follow up yielded significant findings with all five patients demonstrating evident reversal of Dementia symptoms such as sustained cognitive improvement as measured by the Folstein exam. Telomere analysis was performed before and after the therapy. A measurable elongation of the participants telomeres was identified, and biological age was reduced as chronological age increased.

Abstract 722: Treatment of Acute and Chronic Limb Ischemia with Intermedin (IMD) in Mouse Models

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Luyu Yao ◽  
Honglin Dong ◽  
Allen Gu ◽  
Xin Gu ◽  
Kai Yao ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Blood Perfusion ◽  
Limb Ischemia ◽  
Control Group ◽  
Silk Suture ◽  
Hindlimb Ischemia ◽  
Occlusion Model ◽  
Before And After ◽  
Artery Disease ◽  
The One

Objectives: This experiment proposes a novel mouse model to simulate long-term chronic ischemia caused by peripheral artery disease (PAD) using a partial ligation method to narrow down the femoral artery lumen in C57Bl/6 mice. This model will be compared to the typical occlusion model while testing Intermedin (IMD) as a possible treatment for ischemia. Methods: Partial hindlimb ligation technique: we use a strand of 11-0 nylon sutures to pierce the middle of the artery and suture half of the artery shut at both the proximal and distal end of the femoral artery. The typical occlusion model: we use a 7-0 silk suture to completely ligate the distal and proximal femoral artery. Hindlimb blood flow was monitored daily by Laser Doppler perfusion monitor before and after the surgery. IMD was administered at 150 μg/kg, ip, immediately following ligation and twice daily afterwards for up to one week, while in the control group saline was injected instead of IMD. Gastrocnemius muscle samples were collected at day 3 and day 7 for histology and molecular biology study. Results: Ischemic/non-ischemic leg blood perfusion ratio in the partial ligation model is significantly higher than in the typical model. It is also significantly increased in IMD-treated groups in both models. Compared to the tissue in complete ligation models, it is apparent that partial ligation model tissue is less severely affected upon initial ligation but maintains ischemia over the one week testing period as would be expected. Compared to the untreated ischemia groups in acute and chronic hindlimb ischemia models, IMD-treated animals had less severe ischemic injuries. Conclusion: Our study indicates that our chronic hindlimb ischemia model was successful with expected less ischemia status than complete occlusion. The partial occlusion model presented here more closely mimics human PAD, where atherosclerotic plaque builds up slowly, resulting in a lower pressure difference between the proximal and distal artery preventing adequate shunting of the blood into collateral circulation. Moreover, our study suggests that IMD has promise as a therapeutic treatment in acute and chronic hindlimb ischemia models to prevent necrosis in muscle tissue following ischemic events.

scholarly journals New wavelength calibration of the HARPS spectrograph

2019 ◽  
Vol 629 ◽  
pp. A27 ◽  
Author(s):  
A. Coffinet ◽  
C. Lovis ◽  
X. Dumusque ◽  
F. Pepe
Keyword(s):  
Radial Velocity ◽  
Frequency Comb ◽  
Light Emitting Diode ◽  
Laser Frequency ◽  
Wavelength Calibration ◽  
Light Emitting ◽  
Before And After ◽  
Doppler Spectroscopy ◽  
One Year ◽  
The One

Context. Doppler spectroscopy has been used in astronomy for more than 150 yr. In particular, it has permitted us to detect hundreds of exoplanets over the past 20 yr, and the goal today of detecting Earth-like planets requires a precision around 0.1 m s−1 or better. Doppler spectroscopy has also been and will be of major importance for other studies such as the variability of fundamental constants and cosmological studies. For all these applications, it is crucial to have the best possible wavelength calibration. Despite the fact that the HARPS spectrograph has been operational at the 3.6-m ESO telescope for more than 15 yr, and that it provides among the most precise Doppler measurements, improvements are still possible. One known problem, for instance, is the non-fully regular block-stitching of the charge-coupled devices (CCDs), which in some cases introduces one-year period parasitic signals in the measured radial velocity. Aims. The aim of the presented work is to improve the wavelength calibration of the HARPS spectrograph to push further its planet-detection capabilities. Methods. The properties of the CCD stitching-induced pixel-size anomalies were determined with light-emitting-diode (LED) flat-field frames, and then a physical, gap-corrected map of the CCDs is used for the fitting model of the spectral orders. We also used a new thorium line list, based on much higher-accuracy measurements than the one used up to now. We derive new wavelength solutions for the 15 yr of HARPS data, both before and after the fibre upgrade that took place in 2015. Results. We demonstrate that we do indeed correct the gap anomalies by computing the wavelength solutions of laser frequency comb exposures, known to have a very low dispersion, both with and without taking the gap correction into account. By comparing the rms of the most stable stars of the HARPS sample, we show that we globally decrease the radial velocity (RV) dispersion of the data, especially for the data acquired after the change of fibres of 2015. Finally, the comparative analysis of several individual systems shows that we manage to attenuate the periodogram power at one year in most cases. The analysis of the RVs derived from individual stellar lines also shows that we indeed correct the stitching-induced RV variation. Conclusions. This improved calibration of the HARPS spectrograph allows to go deeper in the search for low-amplitude radial-velocity signals. This new calibration process will be further improved by combining the thorium calibration spectra with laser frequency comb and Fabry–Perot calibration spectra, and this will not only be used for HARPS but notably also for HARPS-N and the new ESPRESSO spectrograph.

scholarly journals Meniscus Repair Outcomes with and without Bone Marrow Aspiration Concentrate

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0028 ◽  
Author(s):  
Patrick Allan Massey ◽  
Andrew Zhang ◽  
Christine Bayt Stairs ◽  
Stephen Hoge ◽  
Trevor Carroll ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Meniscus Repair ◽  
Control Group ◽  
Pain Level ◽  
Average Pain ◽  
The Mean ◽  
One Year ◽  
The One

Objectives: The purpose of the current study is to review the results of meniscus repairs with and without bone marrow aspiration concentrate (BMAC). It is hypothesized that with BMAC, meniscus repair outcomes will be improved when compared to without BMAC at 1 year after surgery. Methods: This is a prospective case control study performed from August 2014 until August 2017. Patients were included if they had a meniscus repair performed with no history of prior meniscus surgery to the operative knee. Patients were excluded if there was a full thickness cartilage tear or International Cartilage Repair Society (ICRS) Grade IV cartilage tear not treated in a single staged surgery. Patients were also excluded if they did not reach the one year follow-up, had a multi-ligamentous knee injury requiring multiple staged procedures. From August 2014 until November 2015, patients had meniscus repair without BMA. Menisci were all repaired arthroscopically using inside-out, outside-in and all-inside techniques. After November 2015, all meniscus repairs were augmented with BMAC. In the BMAC group, all bone marrow was obtained from the ipsilateral femur during the time of surgery. The Biocue BMAC system (Zimmer Biomet, Warsaw Indiana) was used for bone marrow aspiration and BMAC was injected directly into the tear site after repair. Numerical data such as VAS, lysholm and IKDC was analyzed using a 2 sample T-test. Categorical data such as sex, tear location, type of tear and zone of tear were analyzed using a chi-square. Results: A total of 150 patients were initially included in the study. The average age in the control group was 26.3 versus 29.4 in the BMAC group (P=0.27). Thirty seven percent of the control group had an ACL reconstruction versus 40% in the BMAC group (P= .77). The control group improved from an average pain level of 6.1 to 1.2 and the BMAC group improved from an average pain level of 5.9 to 0.7 at the 1 year end point. Both the control group and BMAC group improved with respect to pain with no difference at the 1 year end point (P=.19). There was, however a significantly larger reduction in pain at the 6 week and 3 month time point with BMAC compared to the control group (P=.02 and P=.02 respectively). At the 1-year follow-up, the mean lysholm score improved from 43 to 92 in the control group and 43 to 90 in the BMAC group. The mean IKDC score improved from 37 to 87 in the control group and 36 to 83 in the BMAC group at the one year follow-up. Conclusion: Meniscus repair outcomes were improved at 6 weeks and 3 months post-operatively, when BMAC is used to augment meniscus repair compared to repair without BMAC. Both groups, control group and BMAC meniscus repair group had improved outcomes at 1 year post-operatively with respect to VAS, lysholm and IKDC, with no difference in complication rate.

Efficacy of cognitive-behavioral therapy and deep relaxation for children with attention-deficit hyperactivity disorder

2019 ◽  
pp. 19-26
Author(s):  
Nawel Abdesslem ◽  
Sabeur Hamrouni ◽  
Roy Jesse Shephard ◽  
Mohamed Souhaiel Chelly
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cognitive Behavioral Therapy ◽  
Attention Deficit ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Hyperactivity Disorder ◽  
Before And After ◽  
Physically Based ◽  
One Year

Objective: This study made a preliminary exploration of the efficacy of physically-based cognitive-behavioral therapy and deep relaxation for children with attention-deficit hyperactivity disorder (ADHD). Methods: ADHD behavior and cognitive functions were assessed by test D2 and Conner’s scale before and after a one-year physically-based training program. The reliability of test scores was assessed by repeat testing of a control group (CG) of 10 students who did not have ADHD. Children (10 per group) with ADHD were assigned to physically-based cognitive-behavioral therapy and deep relaxation (E1) or physically-based cognitive-behavioral alone (E2). Results: After 52 weeks of treatment, an intra-group comparison showed that E1 and E2 had improved their scores on the test D2, whereas CG showed no significant change. In addition, most participants with ADHD showed a remarkable improvement in their attentional behavior, with group E1 responding better to treatment than group E2. Conclusions: Physically-based cognitive behavioral therapy appears to improve function and social competence in children with ADHD, and should be recommended as an alternative or supplement to pharmaceutical treatment.

Robot-Asssisted Laparoscopic Radical Prostatectomy (Ralp). Oncological and Functional Findings after 90 Cases

2009 ◽  
Vol 76 (2) ◽  
pp. 87-89 ◽  
Author(s):  
C. Giberti ◽  
M. Schenone ◽  
P. Cortese ◽  
F. Gallo ◽  
E Gastaldi ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Functional Results ◽  
Modern Technology ◽  
Nerve Sparing ◽  
Number Of Patients ◽  
Before And After ◽  
Disease Free Survival Rate ◽  
One Year ◽  
The One

The RALP is the most modern technology available for the treatment of intracapsular prostate cancer (CaP), which can produce a shorter learning curve and better results than the traditional techniques. Methods Between March 2005 and March 2008, 90 patients (64.3 ys, range 52–71) with intracapsular CaP underwent RALP at our institute. Before surgery the patients underwent routine examinations and filled in IIEF, IPSS and EORTC-QLQC30/PR 25 questionnaires. Patients were followed up with PSA assay, physical examination and compilation of the questionnaires. Median follow-up was 12.5 months (range 1–35 months). Results Mean operative time was 230 min. Discharge and catheter removal were at day 7.4 and 8.2, respectively, after surgery. Pathological staging reported pT2 and pT3 in 57 (63%) and 33 patients (37%), respectively. Positive surgical margins were assessed in 30 patients (33%), particularly 8.7% in pT2 tumors. The one-year biochemical disease-free survival rate was 90%. Regarding the functional results, 81 patients (90%) were perfectly continent while a mild and a moderate incontinence were reported in 7 (8%) and 2 (2%) patients, respectively. Mean IPSS score decreased from 8 to 4; among the patients who underwent bilateral nerve sparing RALP and no adjuvant therapy, 31 (70.4%) reported satisfactory sexual intercourses. Concerning postoperative quality of life, mean EORTC-QLQC30/PR 25 questionnaires scores were very similar before and after RALP. Conclusions After 90 cases of RALP the oncological and functional results are definitely promising. However, a wider number of patients and a greater follow-up are needed to confirm these data particularly as regards the functional results.

Collagen metabolites in the prediction of response to GH therapy in short children

1997 ◽  
pp. 621-625 ◽  
Author(s):  
P Tapanainen ◽  
M Knip ◽  
L Risteli ◽  
L Kemppainen ◽  
ML Kaar ◽  
...  
Keyword(s):  
Bone Age ◽  
Type I ◽  
Gh Therapy ◽  
Gh Treatment ◽  
Type I Procollagen ◽  
Short Children ◽  
Before And After ◽  
The Absolute ◽  
One Year ◽  
The One

To evaluate the role of collagen metabolites in the prediction of the response to GH treatment we measured the serum concentrations of the C-terminal propeptide of type I procollagen (PICP) and the N-terminal propeptide of type III procollagen (PIIINP) with specific RIAs in 35 short children (16 boys) before and after 5 days, 5 weeks and 3 months of GH therapy. The mean age of the children was 10.3 years (range 1.9-16.4 years) and the bone age ranged from 1.2 to 12.5 years (mean 7.6 years). The initial mean relative height (RH) was -3.6 SDS (range -6.6 to -2.4 S.D.). Nineteen children were found to have GH deficiency (GHD; peak GH responses in two pharmacological tests < 10 micrograms/l), while the remaining 16 were considered to have undefined short stature (USS). The children were treated with recombinant human GH (0.1 U/kg given subcutaneously at bedtime 6-7 times/week). The increases in RHI over the first 6 and 12 months of therapy were used as response measures. There was already a significant increase (P < 0.001) in both the serum PICP and PIIINP levels at 5 days, and the concentrations continued to rise up to 3 months, PICP levels rising less than the PIIINP levels. In the whole group the RHI over 6 months correlated most strongly with the absolute PICP concentrations at 3 months (rS = 0.59; P < 0.05), while the absolute PIIINP concentrations at 3 months showed the strongest relation to the one year RHI (rS = 0.69; P < 0.001). In the GHD group the 6 month RHI was most strongly related to the absolute PICP concentration at 3 months (rS = 0.59; P < 0.05). In the USS group the absolute PICP concentrations at 3 months correlated most strongly with the one year RHI (rS = 0.82; P < 0.01). Significant correlations were also observed between the absolute PIIINP levels at 3 months and the 6 month RHI (rS = 0.60; P < 0.05) and 12 month RHI (rS = 0.76; P < 0.01) in this group. These results show that GH therapy results in an unequivocal increase in circulating concentrations of PICP and PIIINP. The serum PICP and PIIINP concentrations may be of value in the prediction of the long-term response to GH therapy.

The relationship between serum ammonia level and neurologic complications in patients with acute glufosinate ammonium poisoning: A prospective observational study

2017 ◽  
Vol 37 (6) ◽  
pp. 571-579 ◽  
Author(s):  
YS Cha ◽  
H Kim ◽  
Y Lee ◽  
EH Choi ◽  
HI Kim ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Latency Period ◽  
Ammonia Level ◽  
Control Group ◽  
Neurologic Complication ◽  
Neurologic Complications ◽  
Glufosinate Ammonium ◽  
Serum Ammonia Level ◽  
Serum Ammonia

Glufosinate ammonium poisoning can cause neurological complications even after a symptom-free period. We prospectively investigated the predictors of neurologic complications in acute glufosinate ammonium poisoning and the change of serum ammonia level as a predictor of patient’s presence and recovery of neurologic complication. This prospective observational study collected data from consecutive patients diagnosed with acute glufosinate ammonium poisoning between September 2014 and June 2016. Serum ammonia was serially measured. The patients were divided into two groups: the neurologic complication group and the nonneurologic complication group. We also defined 25 other insecticide- or herbicide-poisoned patients as controls. The neurologic complication group included 18 patients (72.0%). The latency period for neurologic complications was within 48-h postingestion. The peak ammonia level was statistically higher in the neurologic complication group than in the control group ( p < 0.001) and the nonneurologic complication groups ( p = 0.001). There was a statistical difference between the nonneurologic complication group and the neurologic complication group ( p = 0.0085) in terms of ingested amount. The peak ammonia was the only predictor for the development of neurologic complications (the optimal cutoff: 90 μg/dL). In patients with mental changes, the mean serum ammonia levels before and after recovery of the mental changes were statistically different ( p = 0.0019). In acute glufosinate ammonium poisoning, serial serum ammonia level measurements are needed and a serum peak ammonia level greater than 90 μg/dL is a predictor of neurologic complications. Also, it is important to treat the hyperammonemia in acute glufosinate ammonium poisoning.

scholarly journals The Parkinsonian Gait Spatiotemporal Parameters Quantified by a Single Inertial Sensor before and after Automated Mechanical Peripheral Stimulation Treatment

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ana Kleiner ◽  
Manuela Galli ◽  
Maria Gaglione ◽  
Daniela Hildebrand ◽  
Patrizio Sale ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Stride Length ◽  
Inertial Sensor ◽  
Gait Velocity ◽  
Control Group ◽  
Peripheral Stimulation ◽  
Before And After ◽  
Spatiotemporal Parameters ◽  
The One ◽  
One Way Anova

This study aims to evaluate the change in gait spatiotemporal parameters in subjects with Parkinson’s disease (PD) before and after Automated Mechanical Peripheral Stimulation (AMPS) treatment. Thirty-five subjects with PD and 35 healthy age-matched subjects took part in this study. A dedicated medical device (Gondola) was used to administer the AMPS. All patients with PD were treated in off levodopa phase and their gait performances were evaluated by an inertial measurement system before and after the intervention. The one-way ANOVA for repeated measures was performed to assess the differences between pre- and post-AMPS and the one-way ANOVA to assess the differences between PD patients and the control group. Spearman’s correlations assessed the associations between patients with PD clinical status (H&Y) and the percentage of improvement of the gait variables after AMPS (α<0.05for all tests). The PD group had an improvement of 14.85% in the stride length; 14.77% in the gait velocity; and 29.91% in the gait propulsion. The correlation results showed that the higher the H&Y classification, the higher the stride length percentage of improvement. The treatment based on AMPS intervention seems to induce a better performance in the gait pattern of PD patients, mainly in intermediate and advanced stages of the condition.

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