Successful Therapy
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E Carter ◽  
U Iroegbu ◽  
W Baig ◽  
JAT Sandoe

Background: There is a paucity of evidence regarding optimal management of Pasteurella spp. endocarditis. The authors report the first case of Pasteurella spp. endocarditis with septic arthritis and review the literature. Case Description: A 79-year-old patient with significant comorbidities, including prosthetic aortic valve, was admitted with left knee swelling, fever, and confusion, having been scratched by a cat 2-weeks prior. At presentation, there was a metallic click, a Grade 3 pan-systolic murmur and Grade 1 flow murmur audible on auscultation. Blood and synovial fluid cultures both isolated Pasteurella multocida, identified by matrix-assisted laser desorption ionisation–time of flight, which was sensitive to penicillin according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST); minimum inhibitory concentration: 0.094). The patient underwent joint washout and received intravenous piperacillin/tazobactam for 3 days before switching to benzylpenicillin once sensitivities were known. Due to continued pyrexia, a transthoracic echocardiogram was obtained, which revealed a small mobile mass on a thickened mitral valve suspicious for a vegetation. On review by the Infective Endocarditis team, conservative management was deemed best, given the presence of comorbidities. Despite requiring further joint washout due to persistent knee pain, the patient was successfully treated with 8 weeks of antibiotic therapy (24 days of benzylpenicillin monotherapy, 2 weeks of benzylpenicillin and ciprofloxacin, and 15 days ciprofloxacin monotherapy). Discussion: Previous literature reviews report a higher mortality of Pasteurella spp. endocarditis when managed without cardiac surgery, thus recommending surgery in all cases. The authors found these to have confounding factors, including inadequate duration of antimicrobials, aortic root abscess, and rapid progression to death. The authors’ case of Pasteurella spp. endocarditis, complicated by septic arthritis, showed successful therapy without cardiac surgery.

2021 ◽  
Vol 10 (22) ◽  
pp. 5353
Lisa Goudman ◽  
Ann De Smedt ◽  
René Huygens ◽  
Marc Noppen ◽  
Maria Vanschoenwinkel ◽  

Continuous Intrathecal Drug Delivery through an implanted pump is a well-known therapeutic option for the management of chronic pain and severe disabling spasticity. To have a successful therapy, pump refills need to be performed at regular time intervals after implantation. In line with the increased applications of Hospital at Home, these refill procedures might be performed at the patient’s home. The aim of this pilot study is to evaluate the feasibility, safety, and effectiveness of intrathecal pump refill procedures at home. Twenty patients were included whereby pump refill procedures were conducted at the patient’s home. To enable contact with the hospital, a video connection was set-up. Tele-ultrasound was used as post-refill verification. All procedures were successfully performed with complete patient satisfaction. Ninety-five percent of the patients felt safe during the procedure, and 95% of the procedures felt safe according to the physician. All patients indicated that they preferred their next refill at home. The median time consumption for the physician/nurse at the patient’s home was 26 min and for the researcher at the hospital 15 min. In light of quality enhancement programs and personalized care, it is important to continue urgent pain management procedures in a safe way, even during a pandemic.

2021 ◽  
Vol 3 (9) ◽  
pp. 01-02
Hayriye Alp

Obesity is a disease defined by excessive fat storage in the body. It is an energy balance problem; the increase in body fat is caused by an imbalance between energy intake and energy expenditure. The practice of acupuncture views the body as a combination of the soul and the body, not merely as a physical structure. This interpretation can lead to a successful therapy for the treatment of chronic pain. One of the factors for its success is the concept of the functional evaluation of the organ. According to acupuncture, the organs are alive and vitality is provided by the energy of life called ‘’qi’’ Pathogens that interrupt and obstruct the flow of qi form diseases. Acupuncture needles are inserted at specific points on the Bonghan channels and the qi stream is regulated by electron transfer. The present study was a cross-sectional study conducted in 2019 in xxx University’s GETAT Center. Patients aged between 18–65 years with a BMI > 25 were included in the study. Acupuncture was shown to be effective not only in the obese groups but also in the control groups. Therefore, it could be beneficial in preventing weight gain. Both ear and body acupuncture points were used effectively in obesity patients. Therefore, acupuncture may be recommended as an effective adjunct in the treatment of obesity. Acupuncture can reduce the stress of patients on diets and increase patient compliance.

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1025
Virginia Fancello ◽  
Silvia Palma ◽  
Daniele Monzani ◽  
Stefano Pelucchi ◽  
Elisabetta Genovese ◽  

Background: Vertigo and dizziness are relatively infrequent in paediatric patients, but specific data on the prevalence of these disorders are limited and influenced by various factors, including the age of the examined population. These conditions often have a significant impact on patients’ and parents’ quality of life. The aim of this paper is to investigate the prevalence of different aetiologies of vertigo in the paediatric population through a systematic review. Methods: According to PRISMA guidelines, a systematic review of the literature was performed. Medline and Embase were searched from January 2011 through to 10 September 2021. The search yielded 1094 manuscripts, which were reduced to 7 upon the application of inclusion criteria. Results: A total of 2470 paediatric patients were evaluated by the selected papers. Vestibular Migraine was the most frequently diagnosed condition, occurring alone or in association with other diseases. Overall, audio-vestibular disorders represented the second cause of vertigo, and the prevalence appears to increase according to age growth. Over the years, even though we assisted in the amelioration of diagnostic rates, partially related to an improvement in diagnostic tools, the aetiology of vertigo remains still unclear in a variable percentage of patients. Conclusion: Vertigo in children, despite being an uncommon symptom, requires a multidisciplinary approach, often involving Paediatricians, Neurologists and Otorhinolaryngologists. A comprehensive evaluation of children suffering from vertigo is crucial for establishing a successful therapy and reducing parental worries.

2021 ◽  
Wei-ping Zeng

Abstract Pulmonary inflammation is a common pathological feature of a variety of diseases, of which successful therapy with currently available anti-inflammatory drugs is limited by resistance and adverse side effects. Using the ovalbumin-induced mouse allergic asthma model, the present study shows that treatments with pH modifiers, particularly simple acids such as acetate or hydrochloric acid, effectively depleted inflammatory cells in the lungs and blood as well as hyperplastic lung tissue cells while preserving the structure of the blood vessels and lung parenchyma. The acid treatments also suppressed mucus hypersecretion. These results demonstrated pH modifiers as a new class of broad-spectrum anti-inflammatory agents with anti-proliferation and mucus suppression activities.

Pharmaceutics ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 1867
Adityanarayan Mohapatra ◽  
Padmanaban Sathiyamoorthy ◽  
In-Kyu Park

Cancer immunotherapy strategies leveraging the body’s own immune system against cancer cells have gained significant attention due to their remarkable therapeutic efficacy. Several immune therapies have been approved for clinical use while expanding the modalities of cancer therapy. However, they are still not effective in a broad range of cancer patients because of the typical immunosuppressive microenvironment and limited antitumor immunity achieved with the current treatment. Novel approaches, such as nanoparticle-mediated cancer immunotherapies, are being developed to overcome these challenges. Various types of nanoparticles, including liposomal, polymeric, and metallic nanoparticles, are reported for the development of effective cancer therapeutics. Metallic nanoparticles (MNPs) are one of the promising candidates for anticancer therapy due to their unique theranostic properties and are thus explored as both imaging and therapeutic agents. In addition, MNPs offer a dense surface functionalization to target tumor tissue and deliver genetic, therapeutic, and immunomodulatory agents. Furthermore, MNPs interact with the tumor microenvironment (TME) and regulate the levels of tumor hypoxia, glutathione (GSH), and reactive oxygen species (ROS) for remodulation of TME for successful therapy. In this review, we discuss the role of nanoparticles in tumor microenvironment modulation and anticancer therapy. In particular, we evaluated the response of MNP-mediated immune cells, such as dendritic cells, macrophages, T cells and NK cells, against tumor cells and analyzed the role of MNP-based cancer therapies in regulating the immunosuppressive environment.

2021 ◽  
Xiao-Hui Liao ◽  
Pablo Avalos ◽  
Shelest Oksana ◽  
Raz Ofan ◽  
Michael Shilo ◽  

Allan-Herndon-Dudley syndrome (AHDS) is a severe X-linked intellectual and psychomotor disability disorder accompanied by abnormal thyroid hormone (TH) levels. AHDS is caused by inactivating mutations in the monocarboxylate transporter 8 (MCT8), a specific TH transporter widely expressed in the central nervous system. MCT8 gene mutations cause impaired transport of TH across brain barriers, leading to insufficient neural TH supply. There is currently no successful therapy for the neurological symptoms. AAV9-based gene therapy is a promising approach to treat monogenic neurological disorders. Here, the potential of this approach was tested in the well-established double knockout (dKO) Mct8-/y; Organic anion-transporting polypeptide 1c1 (Oatp1c1)-/- mouse model of AHDS, which displays disease-relevant neurological and TH phenotypes. Systemic intravenous delivery of adeno-associated virus serotype 9 (AAV9)-MCT8 at a juvenile stage led to improved locomotor and cognitive function, as well as rescue of T3-brain content and T3-related gene expression. This preclinical study indicates that this gene therapy may improve the neurological symptoms of AHDS patients.

Bayad Jaza Mahmood

Background: Facial plastic surgeries are usually associated with various post-surgical unde- sirable symptoms, particularly pain, Swelling, and ecchymosis. Depending on the nature of the procedures, these symptoms could last for days, sometimes over a week or more. Considering the optimal efficacy of Bromelain, this study is used to justify the benefits of pre-operative use of Bro- melain found in pineapple using fresh pineapple juice to reduce such complications. Materials and Methods: A randomized clinical study was performed among 100 patients undergoing various facial surgical operations; the patients were randomly divided into two groups; fifty patients received the pre-operative fresh pineapple juice (350ml glass) twice every day, a week before and continued for seven days after surgery. The pain level was determined using a visual an- alog scale, Swelling, and ecchymosis judged by visual inspection. Average scores for all symptoms were added to obtain the clinical sum score for each visit. Results: Pre-operative use of fresh pineapple juice was significantly reduced post-surgical pain, swelling, and ecchymosis with statistically significant results (p<0.005) in each pineapple groups. Conclusion: Bromelain found in pineapple fruit can be used as a successful therapy before var- ious facial surgical procedures to minimize and provide faster recovery from undesirable post-op- erative symptoms.

2021 ◽  
Vol 22 (21) ◽  
pp. 11488
Michael Torzewski

Atherosclerosis research typically focuses on the evolution of intermediate or advanced atherosclerotic lesions rather than on prelesional stages of atherogenesis. Yet these early events may provide decisive leads on the triggers of the pathologic process, before lesions become clinically overt. Thereby, it is mandatory to consider extracellular lipoprotein deposition at this stage as the prerequisite of foam cell formation leading to a remarkable accumulation of LDL (Low Density Lipoproteins). As progression of atherosclerosis displays the characteristic features of a chronic inflammatory process on the one hand and native LDL lacks inflammatory properties on the other hand, the lipoprotein must undergo biochemical modification to become atherogenic. During the last 25 years, evidence was accumulated in support of a different concept on atherogenesis proposing that modification of native LDL occurs through the action of ubiquitous hydrolytic enzymes (enzymatically modified LDL or eLDL) rather than oxidation and contending that the physiological events leading to macrophage uptake and reverse transport of eLDL first occur without inflammation (initiation with reversion). Preventing or reversing initial atherosclerotic lesions would avoid the later stages and therefore prevent clinical manifestations. This concept is in accordance with the response to retention hypothesis directly supporting the strategy of lowering plasma levels of atherogenic lipoproteins as the most successful therapy for atherosclerosis and its sequelae. Apart from but unquestionable closely related to this concept, there are several other hypotheses on atherosclerotic lesion initiation favoring an initiating role of the immune system (‘vascular-associated lymphoid tissue’ (VALT)), defining foam cell formation as a variant of lysosomal storage disease, relating to the concept of the inflammasome with crystalline cholesterol and/or mitochondrial DAMPs (damage-associated molecular patterns) being mandatory in driving arterial inflammation and, last but not least, pointing to miRNAs (micro RNAs) as pivotal players. However, direct anti-inflammatory therapies may prove successful as adjuvant components but will likely never be used in the absence of strategies to lower plasma levels of atherogenic lipoproteins, the key point of the perception that atherosclerosis is not simply an inevitable result of senescence. In particular, given the importance of chemical modifications for lipoprotein atherogenicity, regulation of the enzymes involved might be a tempting target for pharmacological research.

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