Home About us Contact
|
Home About us Contact | ||
|
|
||
Multidrug Therapy (multidrug + therapy)
Selected AbstractsA state-dependent Riccati equation-based estimator approach for HIV feedback controlOPTIMAL CONTROL APPLICATIONS AND METHODS, Issue 2 2006H. T. Banks Abstract We consider optimal dynamic multidrug therapies for human immunodeficiency virus (HIV) type 1 infection. In this context, we describe an optimal tracking problem attempting to drive the states of the system to a stationary state in which the viral load is low and the immune response is strong. We consider optimal feedback control with full-state as well as with partial-state measurements. In the case of partial-state measurement, a state estimator is constructed based on viral load and T-cell count measurements. We demonstrate by numerical simulations that by anticipation of and response to the disease progression, the dynamic multidrug strategy reduces the viral load, increases the CD4+ T-cell count and improves the immune response. Copyright © 2006 John Wiley & Sons, Ltd. [source] Multimodal Analgesia for Chronic Pain: Rationale and Future DirectionsPAIN MEDICINE, Issue S2 2009Charles E. Argoff MD ABSTRACT Chronic pain is a multifaceted disease requiring multimodal treatment. Clinicians routinely employ various combinations of pharmacologic, interventional, cognitive,behavioral, rehabilitative, and other nonmedical therapies despite the paucity of robust evidence in support of such an approach. Therapies are selected consistent with the biopsychosocial model of chronic pain, reflecting the subjective nature of the pain complaint, and the myriad stressors that shape it. Elucidating mechanisms that govern normal sensation in the periphery has provided insights into the biochemical, molecular, and neuroanatomic correlates of chronic pain, an understanding of which is leading increasingly to mechanism-specific multidrug therapies. Peripheral and central neuroplastic reorganization underlying the disease of chronic pain is influenced by patient-specific emotions, cognition, and memories, further impairing function and idiosyncratically defining the illness of chronic pain. Clinical perceptions of these and related subjective elements associated with the suffering of chronic pain drive psychosocial treatments, including, among other options, relaxation therapies, coping skills development, and cognitive,behavioral therapy. Treatment selection is thus guided by comprehensive assessment of the phenomenology and inferred pathophysiology of the pain syndrome; patient goals, preferences, and expectations; behavioral, cognitive, and physical function; and level of risk. Experiential, practice-based evidence may be necessary for improving patient care, but it is insufficient; certainly, well-designed studies are needed to support therapeutic decision making. This review will discuss the biochemical basis of pain, factors that govern its severity and chronicity, and foundational elements for current and emerging multimodal treatment strategies. [source] Is there a role for multidrug therapy in active Crohn's disease?INFLAMMATORY BOWEL DISEASES, Issue S2 2008Alastair Forbes BSc No abstract is available for this article. [source] Type I reaction in a borderline leprosy case successfully treated with multidrug therapy and ofloxacinINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2008Daniel Asz-Sigall MD No abstract is available for this article. [source] Leprosy in type I reaction and diabetes mellitus in a patient with HIV infectionINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2002Alamengada D. Belliappa MBBS A 24-year-old man was referred to our department with history of a pale red raised lesion over the right side of the face with impaired sensation of 3 months' duration. He also had generalized weakness and increased thirst for the past 1 month. He had been treated with multidrug therapy for leprosy for 3 months and oral prednisolone for 1 month by his general practitioner. He also presented with a history of multiple sexual exposures with commercial sex workers and an ulcer over the penis 2 years ago, which healed spontaneously. [source] Cutaneous cryptococcosis associated with lepromatous leprosyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2001Rubem David Azulay MD A 65-year-old Brazilian man presented with an erythematous nodular lesion on the left forearm (Fig. 1). The patient had been treated with multidrug therapy for 8 months for lepromatous leprosy. During therapy, he developed recurrent episodes of reactions which were treated with high doses of prednisone and thalidomide. The histopathology of the cutaneous nodular lesion showed a granulomatous inflammatory infiltrate; some histiocytes contained vacuolations and others demonstrated oval-like or coma-like structures (Fig. 2). The specimen was cultivated in Sabouraud agar at room temperature. The colonies were transferred to Petri dishes containing Niger Seed Agar (NSA) (Fig. 3). The confirmed diagnosis was Cryptococcus neoformans var. neoformans based on microscopy and physiology, including the canavanine,glycine,bromothymol blue (CGB) medium (Lazéra MS, Pires FDA, Camillo-Coura L et al. Natural habitat of Cryptococcus neoformans var. neoformans in decaying wood forming hollows in living trees. J Med Vet Mycol 1996; 34: 127,131). The liquor culture was negative. Hemoculture and urine culture were also negative. Latex agglutination test was blood positive and liquor negative. Figure 1. Erythematous nodular lesion on the left forearm measuring 9 cm in diameter Figure 2. Granulomatous infiltrate presenting oval-like or coma-like structures inside the histiocytes (mucicarmine stain, ×,100) Figure 3. Petri dishes with Niger Seed Agar containing numerous colonies of Cryptococcus neoformans var. neoformans The patient's hemogram revealed normocytic anemia and normal total and differential white blood count. The CD4 count was 189/m3 and the CD8 count was 141/m3. Serology for anti-human immunodeficiency virus-I (anti-HIV-I) antibodies was negative. The X-ray of the lungs showed an areolar image in the superior lobe of the right lung. Therapy with prednisone was suspended and fluconazole (300 mg/day) was prescribed. The nodular cutaneous lesion regressed completely after 90 days. The patient was submitted to a second skin biopsy for treatment control. The culture of the specimen taken was still positive and the histopathology showed the same picture as before treatment. After 5 months of continued therapy with fluconazole, another biopsy was performed but no fungus was recovered from the specimen. [source] Design and evaluation of compound metformin/glipizide elementary osmotic pump tabletsJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 7 2005Defang Ouyang A simple elementary osmotic pump (EOP) system that could deliver metformin hydrochloride (MT) and glipizide (GZ) simultaneously for extended periods of time was developed in order to reduce the problems associated with multidrug therapy of type 2 non-insulin-dependent diabetes mellitus. In general, both highly and poorly water-soluble drugs are not good candidates for elementary osmotic delivery. However, MT is a highly soluble drug with a high dose (500 mg) while GZ is a water-insoluble drug with a low dose (5 mg) so it is a great challenge to pharmacists to provide satisfactory extended release of MT and GZ. In this paper sodium carbonate was used to modulate the solubility of GZ within the core and MT was not only one of the active ingredients but also the osmotic agent. The optimal EOP was found to deliver both drugs at a rate of approximately zero order for up to 10h in pH 6.8, independent of environment media. In-vivo evaluation was performed relative to the equivalent dose of conventional MT tablet and GZ tablet by a cross-study in six Beagle dogs. The EOP had a good sustained effect in comparison with the conventional product. The prototype design of the system could be applied to other combinations of drugs used for cardiovascular diseases, diabetes, etc. [source] Dapsone-induced photosensitivity: a rare clinical presentationPHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 5 2008Bikash Ranjan Kar Dapsone is an efficient anti-inflammatory and antimycobacterial agent. It is one of the main constituents of multidrug therapy (MDT). It acts by interference with folate metabolism. Dapsone-induced photosensitivity is a rare, non-dose-related adverse effect of the sulfone and can occur in patients with inflammatory skin disorders treated with dapsone. So far, only 12 cases seem to have been reported in the literature. We report a case of dapsone-induced photosensitivity in an Indian patient with leprosy. [source] | ||||||||||