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Articles Related to Treatment

Novel Alternative Treatment to Plasmapheresis in Evans Syndrome

Evans syndrome is a rare haematological disease characterised by concurrent occurrence of autoimmune haemolytic anaemia (AIHA) and idiopathic thrombocytopenic purpura. The autoimmune haemolysis can lead to hyperbilirubinaemia, profound anaemia and haemodynamic instability. It can be difficult to treat and when refractory to medical treatment it could necessitate emergency splenectomy. Plasmapheresis is used in refractory haemolytic anaemia to aid removal of disease causing autoimmune complexes whilst immunomodulators act to reduce autoantibody response and effectiveness. However, this is an expensive and resource intensive process that is limited to tertiary referral centres. In this case study we present a successful novel alternative for life threatening AIHA in Evans Syndrome using haemofiltration with on-going fresh frozen plasma transfusion when resources are limited or it is not an accessible method.
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Dawn of the Biofilm Disease: Highlights about Biofilm in Bone and Joint & Prosthetic Joint Infections Pathogenesis, Diagnosis and Treatment

I present some key considerations of the biofilm disease as part of two complex pathologies such as bone and joint infections and prosthetic joint infections, taking into account the bacterial pathogenic factors to understand the particular nature of these infections, and to achieve an accurate diagnosis and management beyond the antimicrobial therapy. I mention some personal experience of many years in the medical microbiology laboratory and next to the patient’s bed.
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Tomotherapy Treatment of Chronic Lymphocytic Leukemia and Ocular Lymphoma

A sixty-five-years-old male patient with history of non-Hodgkin’s lymphoma of the right orbit and a fifty-years-old female patient with chronic lymphocytic leukemia with peripheral lymphocytosis were treated on TomoTherapy. In the first case, a 1 cm beam was used for planning a delivery of 30.6 Gy in 17 fractions with a sequential boost of 9 Gy in 5 fractions. Tumor involvement of the ipsilateral lens and lacrimal gland in the planning target volume necessitated a compromise between preserving patient’s vision and delivery of tumoricidal dose to the target. In the second case, 30 Gy in 20 fractions delivery was planned with a 2.5 cm beam. The tumor extended anteriorly and this technique allowed sparing more orbital tissue and required a high modulation factor.
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Successful Treatment of Acquired Amegakaryocytic Thrombocytopenia (AAT) with Cyclosporine and Eltrombopag: A Case Report

Acquired amegakaryocytic thrombocytopenia is an unusual hematological disorder characterized by severe thrombocytopenia in association with a marked decrease, or the absence, of megakaryocytes in bone marrow. Its pathogenesis is not well understood and its clinical course is variable. Several treatments have been used, producing different responses. We present a case that was successfully treated with a calcineurin inhibitor combined with a thrombopoiesis-stimulating agent.
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Management, Clinical Course and Treatment Outcome of Postpartum Uterine Atony

By reporting a case series from a referral hospital we aimed to determine the treatment options and outcomes of one of the serious complications of the labour uterine atony refractory to the medical treatment. In this study, a total of 58 postpartum uterine atony cases refractory to uterotonic treatment and managed with intrauterine balloon tamponade, B-Lynch suture, internal iliac artery ligation or hysterectomy was a retrospectively analyzed. Initially, thirty two cases managed with intrauterine Bakri balloon tamponade and six B-Lynch compression sutures alone, in eight cases both procedures were done together. Eight cases managed with internal iliac artery ligation and four hysterectomies. Our success rate with intrauterine Bakri balloon tamponade, B-Lynch compression suture and internal iliac artery ligation were 84.4%, 83.3%, 75% respectively in stopping postpartum haemorrhage regarding uterine atony and the most successfull rate was obtained with the Bakri balloon tamponade in the combination with B-Lynch compression suture 87.5%. The median estimated blood loss was 2018ml, intraoperative median hemoglobin was 5.8 mg/dl and the median amount of blood transfused was five units, the median volume infused into balloon was 285ml; balloon was in place for a median duration of 36 hours. In 6 cases Bakri balloon tamponade with or without B-Lynch compression sutures failed to stop haemorrhage and hysterectomy required. In two patients Asherman’s syndrome and infertility, in two patients’ amenore were developed and uterine prolapse was observed in 2 patients, one of which was uterine necrosis. No maternal mortality was observed.
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Cognitive-Behavioral Psychotherapy, a Group Psycho-Educational Workshop and a Workshop for Caregivers of Sexually-Abused Children: a Case Study of Two Mexican Male Children

It has been reported that a large percentage of men and women had experiences of sexual abuse during childhood the effects of which are determined by factors such as age, gender, characteristics of the experience, and cultural aspects, among others. In Mexico, only a limited number of sexual abuse cases are reported to the relevant authorities and even fewer receive adequate care and treatment. This article presents an evaluation of the effectiveness of an individualized cognitive-behavioral treatment involving a group psychoeducational workshop and a workshop for caregivers of two Mexican male children who had experienced sexual abuse. Clinical and cognitive evaluations, pre- and post-test treatment, and follow-up one-and-a-half years later were made. Differences between the two participants were found in all three evaluation periods. Various factors associated with these results are discussed.
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Subacute Facial Nerve Paralysis Following Cyberknife Treatment for Vestibular Schwannoma

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Leriche Syndrome: Percutaneous Treatment with Mechanical Thrombectomy: A Case Report

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The Effect of Different Surface Treatments and Cement Materials on the Bonding between Dentine and Restorative Materials

The aim of this study was to evaluate the effect of different surface treatments and cement materials on the bonding between dentine and restorative materials. In this study, 135 extracted third human molars, three different restorative materials (Cr-Co alloys, composite and zirconia) were used. Acid etching and sandblasting were used the surface of materials and one group was identified to control group. After the surface treatments, restorative materials were bonded to dentine with three cement materials (self-adhesive resin cement, conventional resin cement and glass ionomer cement). The shear bond strength (SBS) test was applied by using a universal testing machine. The statistically analysis of obtained data were performed with use n-way analysis of variance test.The result of n-way analysis of variance test showed that there were statically significant differences either surface treatments or luting cements on the bonding dentine to restorative materials (p=0.001). The results showed that the lowest shear bond value (3.24±3.62 N) was identified in control group of zirconia materials bonded to dentine with glass ionomer cement. The highest shear bond value (94.66±68.36 N) was identified in acid etched composite materials bonded to dentine with conventional resin cement.
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Former Effective Immunotherapy without Adverse Events of Inoperable Epithelial Ovarian Cancers and a Prospect for the Immune Prophylaxis

Current cancer treatments by immune checkpoint blockades are limited due to severe adverse events caused by alteration of the immune system required for homeostasis of normal tissues. Common cancer chemotherapy alters the quality of patients’ lives. Platinum-based treatment can lead to severe neurotoxicity with chronic debilitation. Additionally, survival of patients with epithelial ovarian cancers (EOCs) has remained poor despite extensive cytoreductive surgery, high dose chemotherapy, checkpoint blockades and immunotherapies effective in some other types of cancer. The pathobiology of EOC cancer stem cells (CSCs) is not well understood. Observations demonstrate that EOCs exhibit in vivo two distinct CSC types - perivascular diploid CSCs dividing asymmetrically with the help of the host suicidal CD8+ T cells, and haploid CSCs at the cancer abdominal surface originating from meiosis I cytokinesis of bulk surface cancer cells. The perivascular CSCs contribute to the cancer cell bulk and, via left ovary venous blood, can cause EOC liver metastases. Haploid CSCs released from the bulk cancer surface cause the common pelvic and abdominal EOC spread. Former elimination of the host antibodies blocking T cell effectors by intermittent doses of cyclophosphamide exhibiting significant immunomodulatory anticancer effects, facilitation of the immune system reactivity against alloantigens of cancer cells by blood transfusions, and augmentation of anticancer immunity by bacterial toxins, resulted during the subsequent treatment-free period into rejection of inoperable EOCs without any adverse events during the treatnment. To help prevent cancer relapses, patients treated for advanced primary epithelial cancers should be considered as candidates for continuously stimulating immune anticancer activity by treatments such as daily metformin and weekly lentinan consumptions.
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Assessment of the Efficacy, Safety and Cost-Effectiveness of Micafungin Compared to Caspofungin and Low Dose Liposomal Amphotericin B for the Treatment of Candidaemia and Clinically Diagnosed Invasive Candidiasis: A Retrospective Audit

Despite several studies having highlighted that candidaemia and invasive fungal disease (IFD) are associated with high mortality and increased costs, there are currently few published studies which provide an insight into real-life practice of invasive candidal diseases. In a medium-sized district general hospital in the UK we sought to compare the efficacy, safety and treatment cost of micafungin versus caspofungin and low dose of liposomal amphotericin B (L-AmB) 1mg/kg/day for the treatment of confirmed candidaemia or clinically diagnosed invasive fungal disease (CDIFD). In the present retrospective audit, a total of 126 patients with candidaemia or CDIFD were reviewed from hospital records and 94 were included in our audit.
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Sustaining HIV Prevention, Care and Treatment Programmes for the Youths in Chipata Districts through Youth Leadership

Comprehensive HIV prevention information, access and utilization of Sexual and Reproductive Health(SRH) services, is low among the migrants mobile and displaced populations of our catchment area namely Katete, Chadiza and Chipata in district in the eastern province of Zambia. This is one of the provinces with a highest number of, migrants; sex workers truck drivers and cross border traders due to the economical Nacala corridors that bring the three countries namely Zambia, Malawi and Mozambique, also the traditional ceremonies that bring the three countries together each year has seen high numbers of people migrate between the three countries this has led to high numbers of STIs, HIV and unsafe abortions. Alcohol and substance abuse, peer pressure among this population.
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Labetalol in Comparison to Methyl Dopa in Treatment of Gestational Hypertension, A Randomized Trial

To evaluate the value and safety of labetalol in comparison to Alfa methyldopa in treatment of pregnant women with pregnancy-induced hypertension (PIH). 264 patients with PIH were randomly distributed to take either methyldopa (group 1) labetalol (group 2). or Intake of medications with respect to Age, gravidity, Blood Pressure measurement, albumin in urine measurement Levels, Side Effects, dose of the drug, increasing duration of pregnancy, mode of delivery, Perinatal safety and APGAR scores were studied. The statistical level of significance was taken at P<0.05.
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Neuropsycological Function, Insight, and Treatment Adherence among Patients with Schizophrenia

Research has suggested that poor insight in patients with schizophrenia is associated with poorer treatment compliance. One factor ontributing to poor insight may be neurocognitive deficits. The aim of the current study is to explore the relationship between cognitive insight, clinical insight, treatment adherence, executive functions and sustained attention within patients with schizophrenia. The study was conducted on 41 patients with schizophrenia using the Beck cognitive insight scale, the schedule for assessment of insight, the drug attitude inventory and two neuropsychological tests.
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Infantile Acute Generalized Pustular Psoriasis: A Case Report

Generalized pustular psoriasis (GPP) is an acute and uncommon form of psoriasis, representing about 3% of all psoriasis cases. Triggers may include streptococcical infections, emotional stress, vaccinations and exposure to medications such as penicillin. Systemic therapy is often necessary for GPP, since it may rapidly evolve, leading to significant and potentially fatal complications. Here, we describe the case of a 5-year-old male presenting with diffuse erythema, confluent scaly plaques and painful pustules localized on the trunk and limbs. Systemic manifestations such as fever, general lymphadenopathy and arthritis were also observed. To date, no standardized treatment guideline exists for infantile acute generalized pustular psoriasis. Our patient responded successfully to cyclosporine treatment within 4 weeks without any side effects. Thus, cyclosporine could be considered a useful agent in cases of pediatric GPP, keeping in mind its side effect profile in child population.
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Editorial Board Members Related to Treatment

Antonio Sanchez-Pozo

Professor
Department of Biochemistry and Molecular Biology II
University of Granada
Spain

Fuu –Jen Tsai

Professor
Department of Medical Genetics
School of Chinese Medicine
China

Luis Ulloa

Associate Professor
Department of Surgery
Rutgers New Jersey Medical School
United States

ILANA B. ADDIS

Associate Professor
Department of Obstetrics and Gynecology
University of Arizona College of Medicine
United States

DENISE J ESTAFAN

Associate Professor
College of Dentistry
New York University
United States

Kelly Sullivan

Assistant Professor
Department of Neurology
University of South Florida
United States

Guey-Jen Lee-Chen

Professor
Department of Life Science
National Taiwan Normal University
Taiwan

Barbara Anne Curbow

Professor
Department of Behavioral and Community Health
School of Public Health
University of Maryland
United States

RYSZARD PLUTA

Professor
Mossakowski Medical Research Centre
Polish Academy of Sciences
Poland

Emmanuel Ho

Assistant Professor
Department of Immunology
University of Manitoba
Canada
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