optimized treatment
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2022 ◽  
pp. 169-193
Author(s):  
Sonia Singh ◽  
Yogesh Murti ◽  
Nitin Agrawal

Tuberculosis is commonly called TB and considered to be the most contagious disease. This disease is caused by a causative agent known as Mycobacterium tuberculosis within the host body cells. Emergence incidence of XDR and MDR of tuberculosis are due to high dose intake and prolonged treatment of antibiotics. In this era, only one vaccine called as BCG is available which is ineffective against infected tuberculosis adults. Though several antibiotics have been produced to overcome drug resistance and even enhance the patient compliance towards treatment and reduce the treatment regimen, we require a novel strategy that can improve the potency of therapeutic synthetic drugs. This approach can be achieved by the application of nanotechnology associated with conventional therapy. Nanotechnology has attributed the promising effects associated with optimized treatment against chronic diseases. This novel technology has the ability to reduce the dose frequency and even resolves the poor patient compliance.


2021 ◽  
Vol 187 (Supplement_1) ◽  
pp. 18-24
Author(s):  
Jesse DeLuca ◽  
Thomas Oliver ◽  
Chad Hulsopple ◽  
Daniel Selig ◽  
Elaine Por ◽  
...  

ABSTRACT Pharmacogenomics is a pillar of personalized medicine that has the potential to deliver optimized treatment in many medical settings. Military medicine in the deployed setting is unique and therefore warrants separate assessment pertaining to its potential capabilities and impact. Pharmacogenomics for United States Active Duty Service Members medical care in the deployed setting has not, to our knowledge, been previously reviewed. We present potential applications of pharmacogenomics to forward medical care through two comprehensive references for deployed medical care, the Tactical Combat Casualty Care Guidelines (TCCC) and Emergency War Surgery (EWS) fifth edition. All drugs within the deployment manuals, TCCC guidelines and EWS book, were identified and the list was cross-referenced to the Clinical Pharmacogenetics Implementation Consortium guidelines and genes–drugs interactions list as well as the Food and Drug Administration Table of Pharmacogenomics Biomarkers in Drug Labeling. Ten pharmacologic categories were identified, consisting of 15 drugs, along with the classes, aminogylcosides, beta-blockers, and volatile anesthetics. Drugs and pharmacogenomics liabilities were tabulated. Eight specific drugs or classes are expounded upon given the belief of the authors of their potential for impacting future treatment on the battlefield in the setting of prolonged field care. This review outlines several genes with liabilities in the prolonged field care setting and areas that may produce improved care with further study.


2021 ◽  
Vol 3 ◽  
Author(s):  
Bhagyashree Tiwari ◽  
Yassine Ouarda ◽  
Patrick Drogui ◽  
Rajeshwar D. Tyagi ◽  
Marc Antoine Vaudreuil ◽  
...  

The fate of 12 pharmaceutical pollutants was investigated to understand their removal mechanism during hospital wastewater (HWW) treatment in submerged membrane bioreactor (SMBR). High concentrations of anti-depressant (venlafaxine and desvenlafaxine), analgesic (ibuprofen and hydroxy-ibuprofen), and caffeine were detected in the HWW during the entire study period. The SMBR showed high removal >70% of antibiotics (sulfamethoxazole and clarithromycin), beta-blocker (acebutolol), hormone (estrone), and caffeine via biodegradation. The partial degradation of diclofenac, venlafaxine, and desvenlafaxine in SMBR indicates the growth promoter or agent requirement, which could facilitate the metabolism and co-metabolism of these pharmaceuticals by microorganisms. The study demonstrated that the major removal mechanism of pharmaceuticals in SMBR at optimized treatment conditions was biodegradation for the majority of examined pharmaceuticals. The assessment of SMBR performance at the low temperature of 15 and 10°C resulted in the drop of biodegradation efficiency of SMBR, affecting overall pharmaceuticals removal.


2021 ◽  
pp. 1-8

OBJECTIVE Cranioplasty (CP) is a crucial procedure after decompressive craniectomy and has a significant impact on neurological improvement. Although CP is considered a standard neurosurgical procedure, inconsistent data on surgery-related complications after CP are available. To address this topic, the authors analyzed 502 patients in a prospective multicenter database (German Cranial Reconstruction Registry) with regard to early surgery-related complications. METHODS Early complications within 30 days, medical history, mortality rates, and neurological outcome at discharge according to the modified Rankin Scale (mRS) were evaluated. The primary endpoint was death or surgical revision within the first 30 days after CP. Independent factors for the occurrence of complications with or without surgical revision were identified using a logistic regression model. RESULTS Traumatic brain injury (TBI) and ischemic stroke were the most common underlying diagnoses that required CP. In 230 patients (45.8%), an autologous bone flap was utilized for CP; the most common engineered materials were titanium (80 patients [15.9%]), polyetheretherketone (57 [11.4%]), and polymethylmethacrylate (57 [11.4%]). Surgical revision was necessary in 45 patients (9.0%), and the overall mortality rate was 0.8% (4 patients). The cause of death was related to ischemia in 2 patients, diffuse intraparenchymal hemorrhage in 1 patient, and cardiac complications in 1 patient. The most frequent causes of surgical revision were epidural hematoma (40.0% of all revisions), new hydrocephalus (22.0%), and subdural hematoma (13.3%). Preoperatively increased mRS score (OR 1.46, 95% CI 1.08–1.97, p = 0.014) and American Society of Anesthesiologists Physical Status Classification System score (OR 2.89, 95% CI 1.42–5.89, p = 0.003) were independent predictors of surgical revision. Ischemic stroke, as the underlying diagnosis, was associated with a minor rate of revisions compared with TBI (OR 0.18, 95% CI 0.06–0.57, p = 0.004). CONCLUSIONS The authors have presented class II evidence–based data on surgery-related complications after CP and have identified specific preexisting risk factors. These results may provide additional guidance for optimized treatment of these patients.


2021 ◽  
Vol 25 (3 (99)) ◽  
pp. 3-11
Author(s):  
T. Antofiichuk ◽  
O. Khukhlina ◽  
M. Antofiichuk

The prospective study of patients with alcoholic steatohepatitis (ASH) showed that 40 % of patients with ASH were diagnosed with anaemic conditions (AC), among which vitamin B12-deficiency anaemia was registered - in 17.5% of cases, anaemia of chronic disease (ACD) – in 10.0% of cases and hemolytic anemia (HA) - in 12.5% of cases. In patients with SH of mixed (including alcoholic) etiology AC was found in 32.0%: vitamin B12 - deficient - in 16.0%, ACD - in 8.0% and hemolytic - in 8.0 % of patients. In patients with ASH, H. pylori contamination was present in 32 (80.0%) individuals, including 100% of patients with B12-deficient anaemia. Among patients with SH of mixed (including alcoholic) etiology, H. pylori was detected in 100.0% of people with AS. The use of Hepadif in the complex therapy of ASH contributed to the elimination or reduction of the intensity of the main clinical syndromes (astheno-vegetative, dyspeptic, cholestatic, hepato-, splenomegaly, hepatic steatosis) and biochemical syndromes (mesenchymal-inflammatory cholestasis, hepatocellular insufficiency), in the range of 1.3-4.3 times (p <0.05), as well as higher efficiency of treatment of patients with ASH with anaemic syndrome in 6.0 times (p <0.05). The efficiency of eradication of H. pylori in the main and control groups accompanied by the use of the 3-component programme of the first line according to the stool test was the same (85.7% and 84.2% (p> 0.05), respectively), but in 57.9 % of patients in the control group, the symptoms of dyspepsia increased or appeared on the background of antibacterial therapy, while no side effects of the drug were found during the study in the main group.


2021 ◽  
Vol 19 ◽  
Author(s):  
Jean-Jacques Monsuez ◽  
Marilucy Lopez-Sublet

: Persons living with HIV infection (PLWH) have been recognized to have an increased risk of sudden cardiac death (SCD). Prevention of this risk should theoretically be included in their long-term management. However, only a few approaches have been proposed to optimize such interventions. Targeting detection of the commonly associated conditions such as coronary artery disease, left ventricular dysfunction, heart failure, QT interval prolongation and ventricular arrhythmias is the first step of this prevention. However, although detection of the risk of SCD is a suitable challenge in PLWH, it remains uncertain whether optimized treatment of the identified risks would unequivocally translate into a decrease in SCD rates.


2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Junjie Li ◽  
Qiunan Chen ◽  
Xiaocheng Huang ◽  
Gen Zou ◽  
Jiazheng Deng

Karst landscape is a general term for earth surfaces and underground patterns that have been formed by the dissolution of soluble rock. Karst landscapes are widely distributed throughout China—particularly in the Guangxi and Guangdong provinces. The main features of karst landscapes are typically reflected in karst caverns, sinkholes, and other geographical phenomena. During tunnel construction in karst areas, various forms of karst caverns may appear on the construction route, and they can cause hazards—such as water inrush and collapse—during tunnel construction. These hazards affect the tunnel construction process. As such, it is necessary to propose a treatment for karst caverns. In this work, a case study of the tunnels on the Hechi-Baise expressway is presented. A comprehensive pretreatment method suitable for this tunnel is proposed. On the premise of prioritizing the safety and timeline of construction, an optimized treatment scheme for the karst caverns of Hebai tunnel is followed. The optimized treatment scheme primarily includes calculation of safe thickness of tunnel face, strengthening the initial support and increasing the thickness of the second lining, increasing the reserved deformation, and grouting. The proposed scheme achieved favorable results in the treatment of a karst cavern in the Hebai tunnels.


2021 ◽  
Vol 11 (9) ◽  
pp. 1202
Author(s):  
Silvia Perzolli ◽  
Arianna Bentenuto ◽  
Giulio Bertamini ◽  
Simona de Falco ◽  
Paola Venuti

Studies on parental interaction in the context of ASD has mainly focused on mothers, even if fathers and their children seem to form close and supportive relationships that may have unique effects on child development. Given the impact of ASD symptoms on a child’s ability to interact with significant others, recent findings strengthen the importance of including caregivers during treatment to guarantee a better adaptation to the child’s impairments. Despite this, fathers are scarcely involved, and interventions seem to not be tailored to their interactive characteristics and needs. For this reason, a systematic review was conducted to investigate fathers and children with ASD behaviors during interaction. This review found 12 observational studies that identified social, cognitive, and affective interactive modalities in father–child dyads through three psychology-focused journal databases: PubMed, PsycINFO and Scopus. The significant variation in both sample size and in the measures used to assess dyadic outcomes limits the ability of this work to make robust recommendations for intervention. Despite this, the results revealed characteristic behaviors of this dyad that consequently allow specific targets to be worked on during intervention. In fact, from fathers’ individual strengths and weaknesses, it is possible to implement interventions that are complementary with maternal characteristics from the perspective of personalized and optimized treatment.


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