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Better Treatment (good + treatment)
Terms modified by Better Treatment Selected AbstractsUrgent care and tight control of rheumatoid arthritis as in diabetes and hypertension: Better treatments but a shortage of rheumatologistsARTHRITIS & RHEUMATISM, Issue 4 2002Theodore Pincus First page of article [source] Quantum-Statistical Equation-of-State Models of Dense Plasmas: High-Pressure Hugoniot Shock AdiabatsCONTRIBUTIONS TO PLASMA PHYSICS, Issue 6 2007J. C. Pain Abstract We present a detailed comparison of two self-consistent equation-of-state models which differ from their electronic contribution: the atom in a spherical cell and the atom in a jellium of charges. It is shown that both models are well suited for the calculation of Hugoniot shock adiabats in the high pressure range (1 Mbar-10 Gbar), and that the atom-in-a-jellium model provides a better treatment of pressure ionization. Comparisons with experimental data are also presented. Shell effects on shock adiabats are reviewed in the light of these models. They lead to additional features not only in the variations of pressure versus density, but also in the variations of shock velocity versus particle velocity. Moreover, such effects are found to be responsible for enhancement of the electronic specific heat. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Exclusion of SMAD4 mutation as an early genetic change in human pancreatic ductal tumorigenesisGENES, CHROMOSOMES AND CANCER, Issue 3 2001Hiroko Inoue Pancreatic ductal carcinoma is one of the malignant diseases with the poorest prognosis. To develop effective methods for better treatment of pancreatic cancer patients, we tried to analyze the course of multistep carcinogenesis of the pancreatic ductal cells. IPMT (intraductal papillary-mucinous tumor) is thought to be one of the premalignant lesions of the pancreas, which would transform into carcinomas. Loss of 18q at the SMAD4 locus is known to be an early genetic change in pancreatic ductal carcinomas. It is not clear, however, whether or not the target gene for inactivation is SMAD4. Using 18 IPMTs, we analyzed LOH at the SMAD4 locus and observed frequent LOH (7/14, 50%). No mutations were observed in any of the tumors. Moreover, the expression level of the SMAD4 protein did not show a reduction in IPMTs. These results suggested that (i) inactivating mutation of the SMAD4 gene is a rather late genetic change in pancreatic carcinogenesis, and (ii) there may be an unknown tumor suppressor gene in 18q, other than SMAD4, that is involved in pancreatic ductal carcinogenesis. © 2001 Wiley-Liss, Inc. [source] Including species interactions in risk assessments for global changeGLOBAL CHANGE BIOLOGY, Issue 9 2007R. W. SUTHERST Abstract Most ecological risk assessments for global change are restricted to the effects of trends in climate or atmospheric carbon dioxide. In order to move beyond investigation of the effects of climate alone, the climexÔ model was extended to investigate the effects of species interactions, in the same or different trophic levels, along environmental gradients on a geographical scale. Specific needs that were revealed during the investigations include: better treatment of the effects of temporal and spatial climatic variation; elucidation of the nature of boundaries of species ranges; data to quantify the role of species traits in interspecies interactions; integrated observational, experimental, and modelling studies on mechanisms of species interactions along environmental gradients; and high-resolution global environmental datasets. Greater acknowledgement of the shared limitations of simplified models and experimental studies is also needed. Above all, use of the scientific method to understand representative species ranges is essential. This requires the use of mechanistic approaches capable of progressive enhancement. [source] Mortality differences among organisms causing septicemia in hemodialysis patientsHEMODIALYSIS INTERNATIONAL, Issue 1 2006Mark D. DANESE Abstract Septicemia is a serious problem in hemodialysis patients because it can lead to life-threatening complications and a persistently elevated risk of death. Most analyses have not examined whether there are differences in mortality risk among the organisms that cause these episodes of septicemia. This study was a retrospective cohort analysis of first septicemia hospitalizations during the first year of hemodialysis. Time to death (both in-hospital and within 12 weeks post-discharge) was compared among the different septicemia-causing organisms based on discharge diagnoses in Medicare billing data from 1996 to 2001. The effect of various complications on mortality risk was also evaluated. There were 22,130 septicemia hospitalizations identified. The most common organism identified was Staphylococcus aureus (27%), with no other organism having an incidence >10%. The overall unadjusted death rate from admission through 12 weeks of follow-up was 34%. During the first hospitalization, the death rate was 14%, and during the 12-week period after the hospitalization it was 20%. In adjusted analyses, S. aureus was associated with a 20% higher risk of death both during the in-hospital period and the 12-week post-discharge period, when compared with all other specified organisms. Hospitalizations complicated by meningitis, stroke, or endocarditis were also associated with increased risk of mortality, independent of the organism causing septicemia. Septicemia hospitalizations are associated with a high mortality rate,both during the initial hospitalization and after discharge. Meningitis, stroke, and endocarditis represent particularly serious complications. Overall, septicemia hospitalizations (especially for S. aureus) are serious events, and patients would benefit from better treatment and prevention. [source] Decreased pyruvate kinase M2 activity linked to cisplatin resistance in human gastric carcinoma cell linesINTERNATIONAL JOURNAL OF CANCER, Issue 4 2004Byong Chul Yoo Abstract Resistance to anticancer drugs is a major obstacle preventing effective treatment of disseminated cancers. Understanding the molecular basis to chemoresistance is likely to provide better treatment. Cell lines resistant to cisplatin or 5-fluorouracil (5-FU) were established from human gastric carcinoma cell lines SNU-638 and SNU-620. Comparative proteomics involving 2-dimensional gel electrophoresis (2-DE) and matrix-associated laser desorption ionization-mass spectroscopy (MALDI-MS) was performed on protein extracts from these parental and drug-resistant derivative lines to screen drug resistance-related proteins. Pyruvate kinase M2 (PK-M2) was identified as a protein showing lower expression in cisplatin-resistant cells compared to parental cells. Consistent with this finding, PK-M2 activity was also lower in cisplatin-resistant cells. Suppression of PK-M2 expression by antisense oligonucleotide resulted in acquired cisplatin resistance in SNU-638 cells. Furthermore, PK-M2 activity in 11 individual human gastric carcinoma cell lines positively correlated with cisplatin sensitivity. Taken together, PK-M2 protein and activity levels were lower in cisplatin-resistant human gastric carcinoma cell lines compared to their parental cell lines. Furthermore, suppression of PK-M2 expression using antisense oligonucleotides increased cisplatin resistance. These data clearly link PK-M2 and cisplatin resistance mechanisms. © 2003 Wiley-Liss, Inc. [source] Review of comparative studies between conventional and liposomal amphotericin B (Ambisome®) in neutropenic patients with fever of unknown origin and patients with systemic mycosisMYCOSES, Issue 9-10 2000I. W. Blau Summary Fungal infections are an important cause of morbidity and mortality in immunocompromised patients. Treatment with amphotericin B is the main therapeutic approach. However, this treatment is limited by the substantial toxicity. We present the data of the first randomized prospective comparative trial in adults (134 patients with fever of unknown origin) with conventional amphotericin B and a liposomal formulation of amphotericin B (AmBisome®, published in 1997 by Prentice et al. (Br. J. Haematol. 98, 711,718) and the data of adults with documented fungal infections (59 patients), treated in this trial. Patients received either conventional amphotericin B 1 mg kg,1 per day, liposomal amphotericin B 1 mg kg,1 per day or liposomal amphotericin B 3 mg kg,1 per day. Patients were entered if they had fever of unknown origin (FUO), defined as temperature of 38 °C or more, not responding to 96 h of systemic broad-spectrum antibiotic treatment, and neutropenia (<0.5×109 l,1). Efficacy of treatment was assessed, with success defined as resolution of fever for three consecutive days (<38 °C) in the group of patients with FUO and the freedom of clinical signs and/or the elimination of fungus in the group of patients with documented fungal infections. The safety of treatment and renal and hepatic toxicity of liposomal and conventional amphotericin B were compared. No statistically significant difference was found in the treatment efficacy in the three study arms. However, there is a tendency of better treatment results in the two groups of patients, who received liposomal amphotericin B. Thirty-five per cent of patients with documented fungal infections and 46% of patients with FUO responded to amphotericin B. In the patients group, that received 1 mg kg,1 liposomal amphotericin B it was 63 and 49%, in the group of patients that received 3 mg kg,1 liposomal amphotericin B it was 47 and 64%. Evidence of toxicity due to amphotericin B was seen in 50 patients (83%), toxicity due to liposomal amphotericin B, 1 mg kg,1, was seen in 35 patients (50%), and due to liposomal amphotericin B 3 mg kg,1 in 34 patients (54%). This was a statistically significant difference (P=0.001). It was concluded that liposomal amphotericin B was safer than conventional amphotericin B, but both formulations are equivalent in treatment efficacy. The prophylactic use of amphotericin B in these immunocompromised patients is discussed. [source] Neural mechanisms of cutaneous nociceptive pain. (Department of Neurology, University of Würzburg, Germany) Clin J Pain 2000;16:S131,S138.PAIN PRACTICE, Issue 2 2001Martin Koltzenburg: Acute mechanical, thermal, and chemically induced pains in the skin are signaled by a set of specific nociceptive afferents, which encode the magnitude of the perceived pain by their discharge intensity. After tissue injury or inflammation, a number of changes in their properties of the primary afferent occur parallel to profound changes in the central nervous system. Primary hyperalgesia (within the area of tissue injury) is best explained by changes of the properties of primary nociceptive afferents, whereas secondary hyperalgesia (increased pain sensitivity outside the area of tissue injury) critically requires functional changes in the central nervous system. Collectively, these changes are the basis for many forms of hyperalgesia that can present clinically as incident pain. Knowledge of the various types of hyperalgesia and their underlying mechanisms is required for better treatment of this challenging aspect of chronic pain. [source] Stephen Clark's Green HolismTHE HEYTHROP JOURNAL, Issue 4 2002Seth Crook S.R.L. Clark is a prominent defender of environmental holism and an advocate of the better treatment of other species. Not coincidentally, he is also a defender of a Neoplatonic Theism which holds that (a) the presuppositions of reason have theistic implications and (b) the point of the world is to exemplify beauty, or all the forms of beauty. Here I examine certain aspects of his view. I do so because I'm drawn to his main holist conclusion: we should live according to those rules that will allow as many creatures as possible, of as many kinds, their best chance of living a satisfactory life according to their kind. However, I express doubts about his general route to the principle. [source] Toward full restoration of synaptic and terminal function of the dopaminergic system in Parkinson's disease by stem cellsANNALS OF NEUROLOGY, Issue S3 2003Ole Isacson DrMedSci New therapeutic nonpharmacological methodology in Parkinson's disease (PD) involves cell and synaptic renewal or replacement to restore function of neuronal systems, including the dopaminergic (DA) system. Using fetal DA cell therapy in PD patients and laboratory models, it has been demonstrated that functional motor deficits associated with parkinsonism can be reduced. Similar results have been observed in animal models with stem cell-derived DA neurons. Evidence obtained from transplanted PD patients further shows that the underlying disease process does not destroy transplanted fetal DA cells, although degeneration of the host nigrostriatal system continues. The optimal DA cell regeneration system would reconstitute a normal neuronal network capable of restoring feedback-controlled release of DA in the nigrostriatal system. The success of cell therapy for PD is limited by access to preparation and development of highly specialized dopaminergic neurons found in the A9 and A10 region of the substantia nigra pars compacta as well as the technical and surgical steps associated with the transplantation procedure. Recent laboratory work has focused on using stem cells as a starting point for deriving the optimal DA cells to restore the nigrostriatal system. Ultimately, understanding the cell biological principles necessary for generating functional DA neurons can provide many new avenues for better treatment of patients with PD. Ann Neurol 2003;53 (suppl 3):S135,S148 [source] Response Adaptive Designs with a Variance-penalized CriterionBIOMETRICAL JOURNAL, Issue 5 2009Yanqing Yi Abstract We consider a response adaptive design of clinical trials with a variance-penalized criterion. It is shown that this criterion evaluates the performance of a response adaptive design based on both the number of patients assigned to the better treatment and the power of the statistical test. A new proportion of treatment allocation is proposed and the doubly biased coin procedure is used to target the proposed proportion. Under reasonable assumptions, the proposed design is demonstrated to generate an asymptotic variance of allocation proportions, which is smaller than that of the drop-the-loser design. Simulation comparisons of the proposed design with some existing designs are presented. [source] Inference for Constrained Estimation of Tumor Size DistributionsBIOMETRICS, Issue 4 2008Debashis Ghosh Summary In order to develop better treatment and screening programs for cancer prevention programs, it is important to be able to understand the natural history of the disease and what factors affect its progression. We focus on a particular framework first outlined by Kimmel and Flehinger (1991, Biometrics, 47, 987,1004) and in particular one of their limiting scenarios for analysis. Using an equivalence with a binary regression model, we characterize the nonparametric maximum likelihood estimation procedure for estimation of the tumor size distribution function and give associated asymptotic results. Extensions to semiparametric models and missing data are also described. Application to data from two cancer studies is used to illustrate the finite-sample behavior of the procedure. [source] Efficacy of laser treatment of tattoos using lasers emitting wavelengths of 532 nm, 755 nm and 1064 nmBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2004B.M. Prinz Summary Background Multifunctional laser devices can be used to treat tattoos successfully. Objectives To report the efficacy of laser treatment in professional, amateur, accidental and permanent make-up tattoos from our own experience and to compare it with the literature. Methods We retrospectively studied 74 consecutive patients with professional, amateur, make-up and accidental tattoos between June 1998 and November 2000. Patients were treated with a Q-switched Nd:YAG laser (wavelengths of 532 nm and 1064 nm), a Q-switched alexandrite laser (755 nm) and a variable pulse Nd:YAG laser (532 nm). Results Fourteen patients (19%) achieved a complete response (> 95% lightening of treated tattoos), 23 (31%) an excellent response (76,95% lightening) and 21 (28%) a good response (51,75% lightening). Sixteen patients (22%) showed only a slight improvement (, 50% lightening). Make-up tattoos and blue,black professional tattoos were most successfully treated. Multicoloured professional tattoos needed more treatments (mean ± SD 5·7 ± 5·4) in comparison with single-colour tattoos (3·5 ± 2·0). The amateur tattoos needed fewer treatments (2·8 ± 1·1) in comparison with professional tattoos. With accidental tattoos the results depended on the particles which had penetrated the skin. In contrast to literature reports, newer tattoos showed a trend to better treatment results than older tattoos. Conclusions Using modern Q-switched lasers, tattoos are removed successfully with minimal risk of scarring and permanent pigmentary alterations. Even multicoloured tattoos can be treated successfully and with a low rate of side-effects. [source] Histamine H1 receptor blockade predominantly impairs sensory processes in human sensorimotor performanceBRITISH JOURNAL OF PHARMACOLOGY, Issue 1 2009P Van Ruitenbeek Background and purpose:, Centrally active antihistamines impair cognitive performance, particularly sensorimotor performance. The aim of the present study was to further elucidate the scarcely studied subprocesses involved in sensorimotor performance, which may be affected by H1 receptor blockade. Better knowledge about the cognitive deficits associated with histamine dysfunction can contribute to better treatment of clinical disorders in which histamine hypofunction may be a contributing factor, such as in schizophrenia. Experimental approach:, Interactions of dexchlorpheniramine with specific task manipulations in a choice reaction time task were studied. Task demands were increased at the level of sensory subprocesses by decreasing stimulus quality, and at the level of motor subprocesses by increasing response complexity. A total of 18 healthy volunteers (9 female) aged between 18 and 45 years participated in a three-way, double-blind, crossover design. Treatments were single oral doses of 4 mg dexchlorpheniramine, 1 mg lorazepam and placebo. Behavioural effects were assessed by measuring reaction times and effects on brain activity by event-related potentials. Key results:, Dexchlorpheniramine significantly slowed reaction times, but did not significantly interact with task manipulations. However, it did significantly interact with stimulus quality, as measured by event-related potentials. Lorazepam slowed reaction times and interacted with perceptual manipulations, as shown by effects on reaction times. Conclusions and implications:, The results confirm that the histamine system is involved in sensory information processing and show that H1 blockade does not affect motoric information processing. Histamine hypofunction in clinical disorders may cause impaired sensory processing, which may be a drug target. [source] Allergic rhinitis in children: environmental factorsCLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 1 2004Y. Okamoto Summary Increasing numbers of patients with allergic rhinitis are being noted on a global scale. Over 90% of Japanese patients with perennial allergic rhinitis show allergic reaction to the mite antigen and major pollen allergens such as Japanese cedar and Japanese cypress, which are carried long distances (> 100 km) by wind and hence can produce substantial harmful effects even in metropolitan areas. This situation is distinct from that in the West, where the most common anemophilous allergen, ragweed, travels much shorter distances of up to only several hundred metres. Environmental factors such as increased antigen, air pollution, diet, intestinal microflora, decreased incidence of infections, smoking, breastfeeding and vaccination may play important roles in the development and manifestation of allergic rhinitis in genetically predisposed subjects. In particular, in newborn infants, who carry the Th2 predominant state, environmental factors may greatly affect the development of balanced production of Th1 and Th2 cytokines. However, the contribution of any environmental factor to the postnatal development of allergic rhinitis has not been sufficiently determined. A better understanding of the processes involved may lead directly to better treatment or cure of allergic rhinitis. [source] Pharmacological treatment of negative symptoms of schizophrenia: therapeutic opportunity or Cul-de-sac?ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2007P. F. Buckley Objective:, Negative symptoms of schizophrenia are debilitating and they contribute to poor outcome in schizophrenia. Initial enthusiasm that second-generation antipsychotics would prove to be powerful agents to improve negative symptoms has given way to relative pessimism that the effects of current pharmacological treatments are at best modest. Method:, A review of the current ,state-of-play' of pharmacological treatments for negative symptoms in schizophrenia. Results:, Treatment results to date have been largely disappointing. The evidence for efficacy of second-generation antipsychotics is reviewed. Conclusion:, The measurement and treatment trials methodology for the evaluation of negative symptoms need additional refinement before therapeutic optimism that better treatments for negative symptoms can be realized. [source] Negative symptoms of schizophrenia: a problem that will not go awayACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2007S. M. Stahl Objective:, Negative symptoms of schizophrenia are a common, enduring, and debilitating component of the psychopathology of schizophrenia. Although efforts thus far to elucidate a distinct schizophrenia subtype based upon negative symptoms have yielded mixed results, there are nevertheless neurobiological correlates of the negative symptom typology. Method:, A review of nosology, typology, and assessment tools for determining core negative symptoms in schizophrenia. Results:, Negative symptoms can be difficult to evaluate objectively. Current rating scales ,capture' key domains of negative symptoms, in spite of considerable overlap between these domains. However, each objective assessment trades off methodological rigor and detail against brevity of assessment and ease of use. Conclusion:, The description of new methods for measuring these devastating symptoms, coupled with the ongoing development of novel antipsychotics and agents that augment antipsychotics have fuelled renewed interest in the evaluation of negative symptoms and optimism that better treatments for negative symptoms can be found. [source] Results, Rhetoric, and Randomized Trials: The Case of DonepezilJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008John R. Gilstad MD Whether donepezil provides meaningful benefit to patients with Alzheimer's disease (AD) is controversial, but drug sales annually total billions of dollars. A review of data from published randomized clinical trials (RCTs) found rhetorical patterns that may encourage use of this drug. To create a reproducible observation, the sentences occurring at five specific text sites in all 18 RCTs of donepezil for AD were tabulated, as were study design, sources of financial support, and outcomes that could be compared between trials. Rhetoric in the 13 vendor-supported trials (15 publications) was strongly positive. Three early trials used the motif "efficacious (or effective) , treating , symptoms" four times. "Well-tolerated and efficacious" or an equivalent motif appeared 11 times in five RCTs. Nine RCTs referred 15 times to previously proven effectiveness. Seven trials encourage off-label use, for "early" cognitive impairment, severe dementia in advance of the Food and Drug Administration labeling change, or behavioral symptoms. These rhetorical motifs and themes appeared only in the vendor-supported trials. Trials without vendor support described the drug's effects as "small" or absent; two emphasized the need for better treatments. RCT results were highly consistent in all trials; the small differences do not explain differences in rhetoric. At these text sites in the primary research literature on donepezil for AD, uniformly positive rhetoric is present in all vendor-supported RCTs. Reference to the limited benefit of donepezil is confined to RCTs without vendor support. Data in the trials are highly consistent. This observation generates the hypothesis that rhetoric in vendor-supported published RCTs may promote vendors' products. [source] Expression of major vault protein gene in osteosarcoma patientsJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2007Cristiane Arruda Dalla-Torre Abstract Osteosarcoma (OS) is a primary malignant tumor of bone. Despite the successful use of multiple chemotherapeutic agents in the treatment of OS, more than 30% of OS tumors remain resistant to treatment. Elucidation of cellular resistance mechanisms may lead to better treatments for cancer patients. In this study, we used the low-density expression cDNA array, GEArray Q Series Human Cancer Drug Resistance and Metabolism Gene Array to screen genes related to drug resistance in 15 OS tumors. Expression patterns of the MPV gene were validated by real time PCR on 45 OS patient tumor samples and correlated with clinical and pathological data. Major vault protein (MVP) expression was present in 24 (53%) tumor samples and absent in 21 (47%). Samples from surgery showed correlation between the expression of MVP, metastatic disease at diagnosis and event free survival (EFS). The MVP gene expression correlates with metastatic disease at diagnosis after neoadjuvant chemotherapy (p,=,0.048), and is also associated with worse EFS (p,=,0.036). These findings suggest that MVP expression is involved in one of the mechanisms of drug resistance in OS and is induced by chemotherapy. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:958,963, 2007 [source] Pediatric systemic lupus erythematosus: Management issues in primary practiceJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2006FNP (Instructor), Tiwaporn Pongmarutani MSN Abstract Purpose: To provide nurse practitioners (NPs) with an update on pediatric systemic lupus erythematosus (SLE) with an emphasis on management considerations for primary care practitioners. Data sources: An extensive literature review was conducted using both Medline and CINAHL databases. Research articles reflecting the most compelling findings were included in this review. Conclusions: NPs who care for children with SLE may be able to prevent or delay the morbidities associated with this disease and its treatments, if they keep abreast of the new information evolving in this realm of rheumatologic diseases. Implications for practice: As more is learned about pediatric SLE, better treatments have evolved such that the survival rates have increased. The primary care of pediatric SLE patients that is focused on preventing or delaying SLE morbidities may help to restore, maintain, or improve the quality of life for these patients. [source] Combining pharmacotherapy with cognitive behavioral therapy: Traditional and new approachesJOURNAL OF TRAUMATIC STRESS, Issue 5 2006Michael Davis Given the ever-increasing sources of trauma both nationally and globally, it is imperative to develop new and better treatments for anxiety disorders such as posttraumatic stress disorder (PTSD). This review is a collection of presentations that seek to do just that, either by using pharmacotherapy to try to prevent or erase the formation of traumatic fear memories, or to enhance exposure-based cognitive,behavioral therapy using pharmacological agents that have been effective in enhanced extinction of fear in rodents. [source] Schizophrenia and Pathological GamblingTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2007Laurence Borras MD High rates of pathological gambling are found in psychiatric populations, including those with mood or substance use disorders. The extent to which individuals with schizophrenia exhibit the symptoms of pathological gambling has not been adequately investigated. This paper examines the case of a 40-year-old schizophrenic female with a four-year history of gambling. The characteristics of possible interactions between pathological gambling and schizophrenic symptom profiles are outlined in order to propose better treatments for this group of patients. [source] Amelioration of alphavirus-induced arthritis and myositis in a mouse model by treatment with bindarit, an inhibitor of monocyte chemotactic proteinsARTHRITIS & RHEUMATISM, Issue 8 2009Nestor E. Rulli Objective Alphaviruses such as chikungunya virus, Sindbis virus, o'nyong-nyong virus, Mayaro virus, and Ross River virus (RRV), are commonly associated with arthralgias and overt arthritides worldwide. Understanding the processes by which arthritogenic viruses cause disease is a prerequisite in the quest for better treatments. In this regard, we have recently established that monocyte/macrophages are mediators of alphavirus-induced arthritis in mice. We hypothesized that chemokines associated with monocyte/macrophage recruitment may play an important role in disease. The aim of the present investigations was to determine whether bindarit, an inhibitor of monocyte chemotactic protein (MCP) synthesis, could ameliorate alphavirus-induced rheumatic disease in mice. Methods Using our recently developed mouse model of RRV-induced arthritis, which has many characteristics of RRV disease (RRVD) in humans, the effects of bindarit treatment on RRVD in mice were determined via histologic analyses, immunohistochemistry, flow cytometry, real-time polymerase chain reaction analysis, enzyme-linked immunosorbent assay, and electrophoretic mobility shift assay. Results Bindarit-treated RRV-infected mice developed mild disease and had substantially reduced tissue destruction and inflammatory cell recruitment as compared with untreated RRV-infected mice. The virus load in the tissues was not affected by bindarit treatment. Bindarit exhibited its activity by down-regulating MCPs, which in turn led to inhibition of cell infiltration and lower production of NF-,B and tumor necrosis factor ,, which are involved in mediating tissue damage. Conclusion Our data support the use of inhibitors of MCP production in the treatment of arthritogenic alphavirus syndromes and suggest that bindarit may be useful in treating RRVD and other alphavirus-induced arthritides in humans. [source] Hepatectomy for pyogenic liver abscessHPB, Issue 2 2003RW Strong Background Commensurate with the advances in diagnostic and therapeutic radiology in the past two decades, percutaneous needle aspiration and catheter drainage have replaced open operation as the first choice of treatment for both single and multiple pyogenic liver abscesses. There has been little written on the place of surgical resection in the treatment of pyogenic liver abscess due to underlying hepatobiliary pathology or after failure of non-operative management. Methods The medical records of patients who underwent resection for pyogenic liver abscess over a 15-year period were retrospectively reviewed. The demographics, time from onset of symptoms to medical treatment and operation, site of abscess, organisms cultured, aetiology, reason for operation, type of resection and outcome were analysed. There were 49 patients in whom the abscesses were either single (19), single but multiloculated (11) or multiple (19). The median time from onset of symptoms to medical treatment was 21 days and from treatment to operation was 12 days. The indications for operation were underlying hepatobiliary pathology in 20% and failed non-operative treatment in 76%. Two patients presented with peritonitis from a ruptured abscess. Results The resections performed were anatomic (44) and non-anatomic (5). No patient suffered a recurrent abscess or required surgical or radiological intervention for any abdominal collection. Antibiotics were ceased within 5 days of operation in all but one patient. The median postoperative stay was 10 days. There were two deaths (4%), both following rupture of the abscess. Discussion Except for an initial presentation with intraperitoneal rupture and, possibly, cases of hepatobiliary pathology causing multiple abscesses above an obstructed duct system that cannot be negotiated non-operatively, primary surgical treatment of pyogenic liver abscess is not indicated. Non-operative management with antibiotics and percutaneous aspiration/drainage will be successful in most patients. If non-operative treatment fails, different physical characteristics of the abscesses are likely to be present and partial hepatectomy of the involved portion of liver is good treatment when performed by an experienced surgeon. [source] Endodontic management of a fused mandibular third molar and distomolar: A case reportAUSTRALIAN ENDODONTIC JOURNAL, Issue 1 2010Ali Zeylabi dds Abstract Careful management of fused teeth is essential as abnormal morphology can predispose a tooth to caries and periodontal disease. In this paper, a rare case of successful endodontic management of unilateral mandibular third molar fused to a distomolar is reported. Caries was removed from the tooth complex under local anaesthesia. The pulp chambers of the third molar and supernumerary tooth were accessed and the root canals were prepared using rotary instrumentation and copious irrigation with 2.5% sodium hypochlorite. Obturation using the lateral condensation technique with gutta-percha and AH26 sealer was subsequently performed. A 1-year recall showed a good treatment result. [source] | ||||||||||||||||||||||||||||