The effectiveness of tamsulosin hydrochloride with terazosin combination therapy for chronic prostatitis Type-III b

Objectives: To study the therapeutic effects of combined tamsulosin hydrochloride and terazosin treatment for patients with chronic prostatitis Type-III b. Methods: This study involved 180 patients with chronic prostatitis Type-III b treated between January 2018 and December 2020 conducted at Nanhua Hospital Affiliated to Nanhua University. Patients were randomly divided into two equal groups: one receiving oral terazosin hydrochloride tablets only (control group), and one orally receiving both tamsulosin hydrochloride sustained-release tablets and terazosin hydrochloride tablets (observation group). Outcome measurements included symptom scoring, inflammatory cytokine levels, as well as white blood cell and lecithin body counts in the prostatic fluid. Results: After 30 days of treatment, the observation group showed greater treatment effectiveness (86.67% vs. 73.33%, P<0.05). QLS, USS, PS, and NIH-CPSI symptom scores were lower in the observation group than the control group (P<0.05). No differences in adverse event distribution and incidence were noted. EPS IL-2 increased more in the observation group, while PGE-2, MIP-1α, and MIP-2 decreased more in the observation group. WBC levels decreased more in the observation group, while lecithin body levels increased more in the observation group. Conclusion: The combination of tamsulosin hydrochloride and terazosin for the treatment of patients with chronic prostatitis Type-III b has a significant effect. This approach reduced patient symptoms, lowered inflammatory biomarkers, and generally improved quality of life. This approach appears to have clinical value worthy of future investigation. doi: https://doi.org/10.12669/pjms.38.3.4931 How to cite this:Duan B, Wang X. The effectiveness of tamsulosin hydrochloride with terazosin combination therapy for chronic prostatitis Type-III b. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4931 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prediction of Prognosis in Adult Patients With Carbapenem-Resistant Klebsiella pneumoniae Infection

ObjectiveCarbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with poor patient outcomes. We aimed to analyze the clinical information of adult patients with CRKP infection in order to establish a nomogram for mortality risk as well as to determine the treatment effectiveness of different antimicrobial regimens.MethodsAdult patients diagnosed with CRKP infection in a tertiary hospital in Shanghai between September 2019 and March 2021 were included. The clinical characteristics and clinical outcomes of these patients were analyzed.ResultsA total of 199 cases of CRKP infection were examined. Five factors, namely age ≥65 years, respiratory failure, Sequential Organ Failure Assessment score, serum procalcitonin ≥5 ng/mL, and appropriate treatments in 3 days, were found to be associated with 30-day mortality. Upon incorporating these factors, the nomogram achieved good concordance indexes of 0.85 (95% confidence interval [CI]: 0.80–0.90) and well-fitted calibration curves. Receiver-operating characteristic curves for 7-, 15-, and 30-day survival had areas under the curve of 0.90, 0.87, and 0.88, respectively. Three-drug combination therapy was observed to be associated with lower mortality in the high-risk group (adjusted hazard ratio = 0.24, 95% CI: 0.06–0.99) but not in the low-risk group. Ceftazidime–avibactam, fosfomycin, and amikacin were effective against infections caused by CRKP. Tigecycline improved the treatment efficiency in 7 days, but a trend toward increased mortality was seen (HR, 1.69; 95% CI: 0.98–2.94; P = 0.061).ConclusionThe antimicrobial regimen efficacy data and the predictive nomogram established in this study can help clinicians in identifying high-risk adult patients with CRKP infection, improving the therapeutic effect, and reducing mortality.

Solidification performances of contaminants by red mud-based cementitious paste filling material and leaching behavior of contaminants in different pH and redox potential environments

Considering the urgent need for disposal of red mud and the comprehensive treatment of coal mined-out areas, this paper presented red mud-based cementitious paste filling material (RMFM) to achieve the purpose of green filling treatment. However, the solidification performance of alkaline RMFM for contaminants can be affected when in contact with acid goaf water in practice, which may in turn causes secondary pollution to the surroundings. The leaching tests of RMFM under different pH and redox potential (Eh) conditions were designed to investigate the effects of environmental elements on the solidification performance of RMFM, and primarily investigated the treatment effectiveness of RMFM on goaf water. The test results manifest that the acidic and oxidizing environments could damage the hydration products generated by alkali and sulfate activation, thus affecting the solidification performance, while the alkaline and reducing environments could effectively prevent the release of the contaminants by enhancing the degree of alkali activation and inhibiting oxidation acid forming process. In the possible exposure environment, RMFM could effectively stabilize its own pollutants without secondary pollution. In addition, the powder RMFM samples had significant removal effects on heavy metals, the values of Cu, Pb, and As removal efficiency all reached more than 96.15%.

A Three-Generation Muckle-Wells Syndrome Family: Detailed Family History, Physical Examination, and Inter-Departmental Collaboration

Cryopyrin-associated periodic syndrome (CAPS) is a rare inherited autoinflammatory disease caused by gain-of-function mutations in the NLRP3 gene, with a genotype-phenotype correlation. The clinical presentation of each mutation has been previously studied. However, very few studies have reported on the clinical characteristics and treatment effectiveness across different generations within a family with the same mutation. A detailed investigation of family members of patients with CAPS may help in the appropriate diagnosis and treatment of undiagnosed CAPS. Herein, we report a 2-year-old boy (proband), his father, and his grandmother who presented with several symptoms of CAPS, such as persistently positive inflammatory reactions and hearing impairment. All three patients had the same pathogenic mutation in the NLRP3 gene (c.1049C&gt;T (p.Thr350Met) heterozygous mutation) and were diagnosed with CAPS. With canakinumab treatment, the laboratory data of all three patients improved, the proband and father’s skin rash disappeared, and his grandmother’s arthropathy improved. The proband’s hearing also showed slight improvement, but not in his father or grandmother. Among the various non-specific symptoms associated with CAPS, chronic ocular hyperemia is a finding that can be easily identified by non-ophthalmologists. Diagnosis of CAPS should be considered when eye symptoms are present in a combination of hyperinflammatory response, arthropathy, or skin symptoms. Thorough family history records, physical examinations, and close collaboration between pediatricians and adult rheumatologists are important for prompt diagnosis and appropriate treatment of inherited autoinflammatory diseases.

The importance of the size of the trunk inclination angle in the early detection of scoliosis in children

Background Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature. Methods The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results In the age groups 6–9, 10–12 and 13–17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, significantly more frequent misdiagnoses (p < 0.05) were related to the lumbar and thoracolumbar (regions) sections of the spine in the groups aged 6–9 and 10–12 for ATI ≥ 7°; while no significant relationship was found at ATI ≥ 5°. For both ATI levels, the most frequent cases of mis- or undiagnosed scoliosis were observed among children with a Cobb angle of 10°-14° (p = 0.004). Conclusion A low predictive ATI value was demonstrated regarding scoliosis detection for the ATI 7° criterion in children aged 6–9 and 10–12 years, particularly for the lumbar and thoracolumbar locations. Adoption of the threshold of ATI 5° in screening tests for children aged 6–12 years, as well as for lower locations of scoliosis, may be more effective in the early detection of scoliosis. Trial registration. This study was approved by the Jan Dlugosz University in Czestochowa Ethics Committee KE-U/7/2021, and conducted under the Declaration of Helsinki.

Effectiveness of antimicrobial therapy for community-acquired pneumonia in real clinical practice

Background. Community-acquired pneumonia (CAP) remains one of the most common infectious diseases, occupying an important place in the structure of mortality worldwide.Aim. To evaluate the effectiveness of antimicrobial therapy for community-acquired pneumonia in hospitalized patients in real clinical practice.Materials and methods. A retrospective, observational study was conducted, which included 236 patients hospitalized for community-acquired pneumonia at the Regional Clinical Hospital in Ryazan in 2019. Based on these case histories, an analysis of the effectiveness of the initial empiric antimicrobial therapy was performed.Results. The initial empiric antimicrobial therapy in 73% of cases included administration of ceftriaxone, in 45% of cases – levofloxacin, in 14% of cases – azithromycin. It was found that initial antimicrobial therapy was effective in 58% of patients who did not require replacement for the antibiotic. A need for a change in the treatment regimen was significantly associated with an increase in the length of hospitalization (p < 0.001), heart rate upon admission (p = 0.032), myelocyte count in the complete blood count (p < 0.001), and urea and blood creatinine levels (p = 0.004 and p = 0.044, respectively). The selected antimicrobial therapy regimen was significantly associated with the expected treatment effectiveness (p = 0.039). The choice of levofloxacin in monotherapy or in combination with ceftriaxone was accompanied by a decrease in the relative risk of replacing the antimicrobial, compared with other treatment regimens (odds ratio (OR) = 0.86 (95% confidence interval (CI): 0.55–1.34) and OR = 0.57 (95% CI: 0.37–0.87), respectively).Conclusion. Empiric antimicrobial therapy for community-acquired pneumonia in real clinical practice complies with current recommendations, however, at the same time, its ineffectiveness persists. Respiratory fluoroquinolones are most effective in treating pneumonia in hospitalized patients.

An Exploratory Content Analysis of Human Resources Management in Healthcare Organizations

Human resource experts suggest unveiling future trends should invite practitioners to focus on evolving human resource management (HRM) roles, target deficiencies, and present solutions leveraging abilities to converge, employees, leaders, and stakeholders committed to advance opportunities for professional development. This chapter provides a detailed analysis of human resources management (HRM) roles that affect employee management changes to explore human resource (HR) accountability, competency management, employee abilities, and organizational capabilities around treatment effectiveness and reduction of errors in healthcare delivery. Explorations on HRM's future impact on career development, succession and replacement planning, and development provoked examinations on goals and future career aspirations in healthcare.

To Be, or Not to Be Healthy

This chapter, as the starting point of the book, (re)constructs the substantive setting and puzzle of health communication, being a reflection and discussion based on the literature review on fundamentals and practices of health communication and the contributions and implications of informative and persuasive messages and communication practices to health. The literature review results show the essential role that communication has assumed in the context of health, having several positive effects, such as the treatment effectiveness, the improvement of the therapeutic relationship and health literacy, the penetration of certain health issues in the public agenda. It has also highlighted the need to strengthen and rethink, in the name of individual and social well-being, the relationship between health and communication. Particularly, in the therapeutic relationship, the need for the health professional to have adequate communication competences to interact with patients is emphasized. Additionally, the media prove to be a versatile tool in the achievement of health promotion aims.

Neurological Markers of Maladaptive Brain Activity in Fibromyalgia and their Relationship with Treatment Effectiveness

Chronic pain (CP) is estimated to affect at least one-third of the population in the United Kingdom. Fibromyalgia (FM) is one of the most disabling CP conditions. Epidemiological research suggests its global prevalence to be between 2-8%. The unknown pathogenesis, lack of biological markers to monitor its development, and lack of successful treatment make FM a crucial target of pre-clinical research.The goal of this project is twofold. The project aims to 1) identify robust neurological markers (i.e., electrochemical brain activity) by applying a combination of advanced electroencephalography (EEG) signal processing (i.e., functional connectivity of oscillatory activity) and neuroinflammatory (NI) responses (i.e., estimation of pro-inflammatory cytokines intake), through which 2) characterizing successfully and unsuccessfully treated FM patients (compared to age-matched healthy controls). These measures, seldom combined, have been successfully applied to the study of psychiatric conditions and sleep. Crucially, the identification of neurological markers at rest and during arousing sensory stimulation will allow us to estimate the relationship between these neurological markers and treatment effectiveness. This proposal is important because it aims to generate a robust pre-clinical neurological tool to identify FM and its relationship with measures of treatment effectiveness. The successful identification of neurological markers will improve the assessment of the development of maladaptive changes in FM and will kick-start further research on treatment effectiveness.This project is of great medical relevance as it will identify pathological signatures of FM that can then inform research on etiology and treatment of this condition.