Home About us Contact
|
Home About us Contact | ||
|
|
||
Different Therapies (different + therapy)
Selected AbstractsUremic Toxins: Removal with Different TherapiesHEMODIALYSIS INTERNATIONAL, Issue 2 2003Raymond C. Vanholder A convenient way to classify uremic solutes is to subdivide them according to the physicochemical characteristics influencing their dialytic removal into small water-soluble compounds (<500 Da), protein-bound compounds, and middle molecules (>500 Da). The prototype of small water-soluble solutes remains urea although the proof of its toxicity is scanty. Only a few other water-soluble compounds exert toxicity (e.g., the guanidines, the purines), but most of these are characterized by an intra-dialytic behavior, which is different from that of urea. In addition, the protein-bound compounds and the middle molecules behave in a different way from urea, due to their protein binding and their molecular weights, respectively. Because of these specific removal patterns, it is suggested that new approaches of influencing uremic solute concentration should be explored, such as specific adsorptive systems, alternative dialytic timeframes, removal by intestinal adsorption, modification of toxin, or general metabolism by drug administration. Middle molecule removal has been improved by the introduction of large pore, high-flux membranes, but this approach seems to have come close to its maximal removal capacity, whereas multicompartmental behavior might become an additional factor hampering attempts to decrease toxin concentration. Hence, further enhancement of uremic toxin removal should be pursued by the introduction of alternative concepts of elimination. [source] Advanced glycation end products-induced apoptosis attenuated by PPAR, activation and epigallocatechin gallate through NF-,B pathway in human embryonic kidney cells and human mesangial cellsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 5 2010Yao-Jen Liang Abstract Background Diabetic nephropathy has attracted many researchers' attention. Because of the emerging evidence about the effects of advanced glycation end products (AGEs) and receptor of AGE (RAGE) on the progression of diabetic nephropathy, a number of different therapies to inhibit AGE or RAGE are under investigation. The purpose of the present study was to examine whether peroxisome proliferator-activated receptor , (PPAR,) agonist (L-165041) or epigallocatechin gallate (EGCG) alters AGE-induced pro-inflammatory gene expression and apoptosis in human embryonic kidney cells (HEK293) and human mesangial cells (HMCs). Methods The HEK cells and HMC were separated into the following groups: 100 µg/mL AGE alone for 18 h; AGE treated with 1 µM L-165041 or 10 µM EGCG, and untreated cells. Inflammatory cytokines, nuclear factor-,B pathway, RAGE expression, superoxide dismutase and cell apoptosis were determined. Results AGE significantly increased tumour necrosis factor-, (TNF-,), a major pro-inflammatory cytokine. The mRNA and protein expression of RAGE were up-regulated. These effects were significantly attenuated by pre-treatment with L-165041 or EGCG. AGE-induced nuclear factor-,B pathway activation and both cells apoptosis were also inhibited by L-165041 or EGCG. Furthermore, both L-165041 and EGCG increased superoxide dismutase levels in AGE-treated HEK cells and HMC. Conclusions This study demonstrated that PPAR, agonist and EGCG decreased the AGE-induced kidney cell inflammation and apoptosis. This study provides important insights into the molecular mechanisms of EGCG and PPAR, agonist in attenuation of kidney cell inflammation and may serve as a therapeutic modality to treat patients with diabetic nephropathy. Copyright © 2010 John Wiley & Sons, Ltd. [source] Improvement of Chronic Pain by Treatment of Erectile DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2008Jalil Arabkheradmand MD ABSTRACT Introduction., Pain specialists, who do not routinely examine patients regarding their sexual medicine problems, need to be aware that sexual problems can and do aggravate the patient's pain. Patients may refuse to admit suffering from erectile dysfunction (ED) but complain about continuous or progressive severe pain. These patients may be best managed by the combined team effort of a sexual medicine specialist and pain specialist. Aim., This report documents the management of three cases with long-term intractable pain after severe trauma. Treatment of occult ED led to significant improvement of their pain. Main Outcome Measures., The association of the treatment of uncovered ED and improvement of chronic severe pain. Methods., Three case reports of patients with severe pain who attended a pain clinic in an academic medical center. Results., Three men suffering from chronic pain due to severe trauma were observed for several years by different physicians as well as pain specialists. In spite of different treatments, including administration of several analgesics, psychotherapy, and physical therapy, pain was not alleviated. After finding ED problems, patients were referred to the family health clinic. Using different therapies such as psychosexual therapy, correction of sexual misconceptions, relaxation training, treatment of interpersonal difficulties, and pharmacological intervention ED was cured. Treatment of ED was accompanied by a significant reduction of chronic pain in all three patients. Conclusion., The present report indicates that uncovered ED in patients suffering from chronic pain may trigger their somatic pain or reduce its threshold. Significant improvement in sexual functioning may improve the pain and reduce its complications. Arabkheradmand J, Foroutan SK, Ranjbar S, Abbasi T, Hessami S, and Gorji A. Improvement of chronic pain by treatment of erectile dysfunction. J Sex Med **;**:**,**. [source] The LUNDEX, a new index of drug efficacy in clinical practice: Results of a five-year observational study of treatment with infliximab and etanercept among rheumatoid arthritis patients in southern SwedenARTHRITIS & RHEUMATISM, Issue 2 2006Lars Erik Kristensen Objective To describe the use of the LUNDEX, a new index for comparing the long-term efficacy and tolerability of biologic therapies in rheumatoid arthritis (RA) patients treated in clinical practice. Methods Patients (n = 949) with active RA that had not responded to at least 2 disease-modifying antirheumatic drugs (DMARDs) including methotrexate, in whom biologic therapy was being initiated, were included in a structured clinical followup protocol. The protocol included collection of data on diagnosis, disease duration, previous and ongoing DMARD treatment, and dates on which biologic treatment was started and terminated. In addition, data on efficacy measures used for calculating validated response criteria, i.e., the European League Against Rheumatism and American College of Rheumatology response criteria, were collected at fixed time points. Data were prospectively registered from March 1999 through January 2004. The LUNDEX, a new index combining the proportion of patients fulfilling a selected response criteria set with the proportion of patients adhering to a particular therapy, was designed to compare the efficacy of the different therapies. Results Etanercept had higher overall LUNDEX values compared with infliximab, mostly because of a lower rate of adherence to therapy with infliximab. The relationship between the drugs was consistent irrespective of the response criteria used. Conclusion The LUNDEX is a valuable tool for evaluating drug efficacy in observational studies. It has the advantage of integrating clinical response as well as adherence to therapy in a composite value. Moreover, the LUNDEX has a practical and potentially universal application independent of diagnosis and response criteria. [source] Combining Information from Cancer Registry and Medical Records Data to Improve Analyses of Adjuvant Cancer TherapiesBIOMETRICS, Issue 3 2009Yulei He Summary Cancer registry records contain valuable data on provision of adjuvant therapies for cancer patients. Previous studies, however, have shown that these therapies are underreported in registry systems. Hence direct use of the registry data may lead to invalid analysis results. We propose first to impute correct treatment status, borrowing information from an additional source such as medical records data collected in a validation sample, and then to analyze the multiply imputed data, as in Yucel and Zaslavsky (2005,,Journal of the American Statistical Association,100, 1123,1132). We extend their models to multiple therapies using multivariate probit models with random effects. Our model takes into account the associations among different therapies in both administration and probability of reporting, as well as the multilevel structure (patients clustered within hospitals) of registry data. We use Gibbs sampling to estimate model parameters and impute treatment status. The proposed methodology is applied to the data from the Quality of Cancer Care project, in which stage II or III colorectal cancer patients were eligible to receive adjuvant chemotherapy and radiation therapy. [source] Impetigo: incidence and treatment in Dutch general practice in 1987 and 2001,results from two national surveysBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2006S. Koning Summary Background, Impetigo is a common skin infection in children. The epidemiology is relatively unknown, and the choice of treatment is subject to debate. Objective, The objective of our study was to determine the incidence and treatment of impetigo in Dutch general practice, and to assess trends between 1987 and 2001. Methods, We used data from the first (1987) and second (2001) Dutch national surveys of general practice. All diagnoses, prescriptions and referrals were registered by the participating general practitioners (GPs), 161 and 195, respectively. Results, The incidence rate of impetigo increased from 16·5 (1987) to 20·6 (2001) per 1000 person years under 18 years old (P < 0·01). In both years, the incidence was significantly higher in summer, in rural areas and in the southern region of the Netherlands, compared with winter, urban areas and northern region, respectively. Socioeconomic status was not associated with the incidence rate. From 1987 to 2001, there was a trend towards treatment with a topical antibiotic (from 43% to 64%), especially fusidic acid cream and mupirocin cream. Treatment with oral antibiotics (from 31% to 14%) and antiseptics (from 11% to 3%) was prescribed less often. Conclusions, We have shown an increased incidence of impetigo in the past decade, which may be the result of an increased tendency to seek help, or increased antibiotic resistance and virulence of Staphylococcus aureus. Further microbiological research on the marked regional difference in incidence may contribute to understanding the factors that determine the spread of impetigo. Trends in prescribing for impetigo generally follow evidence-based knowledge on the effectiveness of different therapies, rather than the national practice guideline. [source] The thymidylate synthase tandem repeat promoter polymorphism: A predictor for tumor-related survival in neoadjuvant treated locally advanced gastric cancerINTERNATIONAL JOURNAL OF CANCER, Issue 12 2006Katja Ott Abstract We evaluated DNA polymorphisms in the thymidylate synthase (TS) and 5,10- methylene-tetrahydrofolate reductase (MTHFR) genes for an association with response and survival in locally advanced gastric cancer treated with 5-FU based preoperative chemotherapy (CTx). DNA of 238 patients (CTx-group: total n = 135, completely resected (R0) n = 102; without CTx: R0 n = 103) was isolated from blood or from nontumorous tissues. In the CTx-group, genotyping of the tandem repeat and the G/C polymorphism in the triple repeat in the promoter region of the TS gene and of the C677T polymorphism of the MTHFR gene was performed. None of the TS or MTHFR genotypes were associated with histopathological response and only the TS tandem repeat polymorphism was significantly related to survival (all patients n = 135, p = 0.002; R0 resected patients n = 102, p = 0.007; log-rank test). Multivariate analysis revealed ypN (p < 0.001) and the TS tandem repeat polymorphism as independent prognostic factors in the CTx-R0-group (p = 0.003). Analyzing the prognostic significance of the TS polymorphisms in the R0-group without CTx, TS genotypes were not significantly associated with survival. Comparing survival between R0 patients with and without CTx in the respective TS genotype groups of the tandem repeat polymorphism, a significant survival benefit for the patients with CTx was found for the 2rpt/2rpt (n = 49; p = 0.002) and 2rpt/3rpt genotypes (n = 99; p = 0.004), but not for the 3rpt/3rpt genotype (n = 57; p = 0.93). Patients' survival after CTx was associated with the TS tandem repeat polymorphism. CTx did not improve survival of patients with the 3rpt/3rpt genotype. Thus, a different therapy might be more appropriate for these patients. © 2006 Wiley-Liss, Inc. [source] A second cycle of tamsulosin in patients with distal ureteric stones: a prospective randomized trialBJU INTERNATIONAL, Issue 12 2009Francesco Porpiglia OBJECTIVE To evaluate, in a prospective randomized pilot study, the effectiveness and safety of tamsulosin, administered in patients with distal ureteric stones and who have already undergone an unsuccessful first cycle of medical expulsive therapy (MET). PATIENTS AND METHODS We evaluated the effectiveness and safety of tamsulosin, administered as a further therapy, in patients previously unsuccessfully treated with combined expulsive 10-day therapy (tamsulosin + deflazacort) for distal ureteric stones. Ninety-one patients were enrolled and randomized into two groups, each receiving a different therapy for 10 days. Group A (46 patients) received a further cycle of tamsulosin (0.4 mg daily), and group B (45) did not. Age, gender, stone size, time to expulsion, number of acute episodes of colic during treatment and analgesic consumption were recorded. Patients who were not stone-free after the study period had ureteroscopy. The results were compared statistically using Student's t -, chi-square test and Fisher's exact test. RESULTS The groups were comparable inage, gender and stone size (5.93 mm for group A and 6.03 mm for group B). The expulsion rate was significantly higher in group A (80%) than in group B (49%) (P < 0.01), whilst there were no differences between the groups in the number of colic episodes and analgesic use. There were no reported side-effects of medical therapy. CONCLUSIONS A second cycle of 10 days of MET with tamsulosin in nonresponders to a 10-day first cycle of MET with tamsulosin and deflazacort is safe and effective, and therefore should be considered as an option in the management of uncomplicated distal ureteric stones. [source] | ||||||||||