Synergy Publishers Journal System
Not a member yet
557 research outputs found
Sort by
IBD – Impact of Colonic pH, Onset of Action and other Factors in Modern Therapeutic Approach
No full textInflammatory bowel disease (IBD) is an idiopathic disease. The current treatment methods are based on various conventional dosage forms. Treatment method includes corticosteroids, 5-ASA compounds, Immunosuppressant monoclonal antibodies etc. In recent years the IBD therapy go through great transformation in treatment methods. The novel drug delivery and colon targeted drug delivery systems are widely prescribed by the physicians around the world. Mesacol, cosacol are the few marketed widely prescribed brands worldwide. This review mainly focuses on the modern IBD treatment methods. The review also recommends the clinicians to understand the crucial parameters such as drug release mechanism, various drawbacks of the drug candidates used in the treatment of IBD, importance of onset of action and characteristics of various polymers in designing colon targeted drug delivery system to treat IBD. Â
The Impact of HIV to Intimacy and Sexual Behaviours of Gay Couples in Serodiscordant Relationships in Taiwan: a Qualitative Pilot Study
No full textPurpose: This study aims to understand the impact of one partner’s seroconversion to intimacy and sexual relationships of gay couples, and the adaptive methods taken by both partners.Method: Qualitative analyses were performed on the contents of counselling sessions with 6 consented HIV serodiscordant gay couples.Findings: 1) The main challenge by HIV to couple are sexual and intimate relationship. Both partners tend to conceal, or be vague, in communicating their sero-status, prior sexual history, feelings and emotions and their understanding of HIV. 2) HIV replaces prior commitments within relationships. New rules of conduct are established and both partners demands ‘transparency’ within relationship. Care-taking becomes a way of intimacy expression, and new forms of commitments are established in order to rebuild dyad relationships. 3) Various methods are taken by gay couples to reduce the risks of HIV transmission, such as reducing the frequency of sexual activities, or terminating relationships, finding sexual partners who are also seropositive, or engaging in extra-partnership sexual activities; 4) Safe sex and intimacy appear to be in conflict with each other.Conclusions: HIV/AIDS interventions include helping clients to reinterpret and reconstruct the meaning of ‘HIV-related issues’, to establish new roles and connections within partner relationship, to improve ways of communication, and to advocacy of safe sex with risk-management or risk reduction practices discussed in the study, for example changing sexual positions, reducing acts involving insertions, ejaculation outside of body
Treatment of Recurrent Mixed Infected Laryngocele with Extramucosal Thyrotomy Around Theurepatic Dilemma
No full textLaryngopyocele is a fairly rare disease which is a complication of laryngocele. It is a emergency situation so it needs fast differential diagnosis and treatment. Management of laryngopyoceles include observation, endoscopic resection and resection via an external approach. An external approach is indicated for large or external laryngoceles. The incidence of association between laryngocele and laryngeal carcinoma varies from 1% to 10%. Extramucosal thyrotomy to thyroid cartilage lamina provides adequate visibility of the laryngocele sac
Treatment Options in Behcet’s Disease
No full textBehçet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology with the clinical features of mucocutaneous lesions, ocular, vascular, articular, gastrointestinal, urogenital, pulmonary, and neurologic involvement. Mucocutaneous lesions figure prominently in the presentation and diagnosis, and may be considered the hallmarks of BD. Therefore, their recognition may permit earlier diagnosis and treatment. Although, the treatment has become much more effective in recent years, BD is still associated with severe morbidity and considerable mortality. The main aim of the treatment should be the prevention of irreversible organ damage. Therefore, close monitoring, early and appropriate treatment is mandatory to reduce morbidity and mortality. Traditional and current treatments with topical, paraocular and systemic corticosteroids, colchicine, dapsone, cyclosporine, azathioprine, methotrexate, cyclophosphamide and chlorambucil are summarized and recent insights into the pharmacology and effects of thalidomide, tacrolimus (FK-506), interferon-α, anti-TNF-α blocking monoclonal autoantibody (infliximab) and soluble TNF receptor (etanercept) are reviewed. We reviewed the current state of knowledge regarding the therapeutic approaches for BD and designed a stepwise, symptom-based, algorithmic approach, mainly based on controlled studies and our clinical experience in this field to provide a rational framework for selecting the appropriate therapy along the various treatment choices. Key clinical investigations with the status of ongoing clinical trials aimed at addressing the drug’s efficacy, surgical care, and studies that have raised the possibility of new therapeutic uses are also presented. The challenges posed by the drug’s teratogenicity and adverse effects are also considered, if present
Association of Demodex Folliculorum in Acne/Rosacea and Folliculitis and the Efficacy of Combined Therapy (Metronidazole and Benzyl Benzoate)
No full textPurpose: The aim of the study was the evaluation of the role of Demodex infestation in acne/rosacea, folliculitis, perioral dermatitis.Patients and Method: One hundred and forty-eight outpatients were enrolled and the direct microscopic examination of the lesions was done.Results: 83% of patients were women. The mean age was 31.21 years (SD=14.2). 84% of patients had positive results for Demodex folliculorum. The presence of pets could be a risk for infestation, but 33% of patients had no contact with animals. Oral metronidazole for 10 days and a month of topical benzyl benzoate mixture (6.5%-12.5%) added with a metronidazole mixture had significant favorable effects. The treatment was repeated for another month. Negative microscopic exams were obtained after two months. There was a low risk of recurrence or re-infection.Conclusion: Demodex folliculorum infestation has to be considered in resistant acne/folliculitis, in lower face and cervical acne lesions or in rosacea. It is important to clean the parasitic infection for a better effect of classical therapy of acne
Gaps in Clinical Studies in Patients with Critical Congenital Heart Disease
No full textThe purpose of this study was to assess the potential clinical examination in the early diagnosis of patients with CCHD.Patients and Methods: Retrospectively were followed 272 newborns and infants up to 3 months of age with CCHD for 25 years (1987-2011) from the region of North-East Bulgaria. The cardiac malformations were divided into 3 groups: obstructive lesions of the systemic circulation (OLSC) – 103 children, obstructive lesions of the pulmonary circulation (OLPC) – 64 children and non-obstructive mixing cardiopathies (NMCP) – 105 children. It were analyzed the initial clinical symptoms, place and manner of the disease detection, the discharged neonates without established heart disease and those with placed wrong or incomplete primary diagnosis.Results: The incidence of the CCHD was 12.5% of CHD. The mean time of the initial clinical manifestation was 3.45 days, which is shorter in newborns with OLPC – 1.8 days, and the longest is in OLSC – 4.5 days (p<0.05). In 44.4% initial clinical symptoms were established during the first day, and by day 4 – in 81.7%. Most often the first clinical symptom is cyanosis – 65%. In 21% of cases there was no significant murmur. The average age of diagnosis is 8.5 days and was significantly lower in OLPC – 4.2 days, compared to OLSC – 9.5 days and NMCP – 10 days (p<0.05). By day 4 were diagnosed 54% of CCHD and 27.7% of the infants with manifested initial symptoms (81.7%) remained without diagnosis. Usually the initial diagnosis is put in the children’s hospitals – 60% and only 30% in the neonatology units. Without established heart disease are discharged 15.8% of newborns, primarily with coarctation of the aorta, total anomalous pulmonary venous return and transposition of the great arteries. Initial diagnosis was incorrect in 22%.Conclusion: The physical examination in newborn CCHD is unsatisfactory and the diagnosis is often delayed, especially in the cases of OLSC and same of NMCP. That is why screening programs are needed for early detection of these patients to improve their prognosis
Benefits and Shortcomings of Cochlear Implantation in Children: Parental Reports from India.
No full textObjective: The aim of the study was to understand the rationale for choosing cochlear implantation as a rehabilitation option and the benefits and shortcomings of cochlear implants in children as reported by their parents.Method: Ninety parents of children with cochlear implants from various parts of India completed open-ended questionnaires.Results: The main reasons for choosing cochlear implantation include: no benefit from hearing aids, the expectation that children would have better hearing and develop age appropriate speech and language abilities. Most of the participants reported benefits of cochlear implantation in a home setting but not in school and other social settings. Most participants reported shortcomings in a home setting but only less than half reported in school and other social settings.Conclusions: Not all respondents reported benefits and shortcomings in all settings, particularly school and other social settings. This may raise some questions about knowledge of parents about what to expect from their child’s performance with a cochlear implant in different settings
High Levels of HbA1c from T2DM Patients Positively Correlated with Increased of Oxidative Stress Biomarker and IL-6 Levels
No full textObjective: To determine the association between Type 2 diabetes mellitus (T2DM) and inflammation based on the plasma levels of pro-inflammatory cytokines (IL-1b, IL-6, TNF-a and IFN-g), lipid peroxidation (malonaldehyde), vascular endothelial growth factor (VEGF) and C-reactive protein (CRP) associated with glycated hemoglobin (HbA1c).Methods: The expression of oxidative stress markers and the plasma levels of angiogenic factor and inflammatory cytokines were determined in 51 T2DM patients compared with 38 healthy controls. The levels of cytokines (IL-1b, IL-6, TNF-a and IFN-g), angiogenic factor (VEGF) and CRP were measured using ELISA. Lipid peroxidation (oxidative stress biomarker) was determined through malonaldehyde (MDA) levels using the TBARS assay, and HPLC was used to measure the HbA1c levels.Results: Correlation studies of the glycemic control (HbA1c levels) versus IL-6 levels and the HbA1c concentration versus MDA levels indicated a high positive correlation for T2DM patients (r = 0.68 and r = 0.67, respectively), but not for healthy controls (r = 0.32 and r = 0.16, respectively). The results also revealed higher plasma levels of IL-6, TNF-a, IL-1β, VEGF and MDA in T2DM patients compared with healthy controls (p<0.05); however, the plasma levels of IFN-g and CRP were similar between these groups (p>0.05).Conclusion: The results of this study show that the combined association of biomarkers for glycemic control (HbA1c) with pro-inflammatory cytokine (IL-6) and oxidative stress biomarker (MDA) might be a promising tool for the follow-up and evaluation of diabetes complications, although further studies are needed
Outline of an Action-Oriented Classification of Mental Disorders: A Hypothetical Model
No full textThe outline of an action-oriented classification of mental disorders is mainly theoretically proposed. Based on the discussion and interpretation of the “Schichtenregel†(three-layer-rule) by the German psychiatrist Karl Jaspers, a synaptic model is elaborated for the pathophysiology of depression, mania and schizophrenia. According to a logic of balance, synapses may be balanced, underbalanced (depression), overbalanced (mania), or unbalanced (schizophrenia). From a psychological point of view, patients with a major depression are hyperintentional, patients with mania are hypointentional, and in the case of schizophrenia they are dysintentional. Decisive in the synaptic model proposed is the number of receptors for neurotransmitters expressed in the membranes of astrocytes. A normal or disturbed balance of behavior can be described as variables of the intentional programs and as values of the description of their feasibility. This enables a computer supported classification of an action-oriented diagnostic manual. The future realization of this procedure may improve psychiatric research and especially clinical practice
Ischemic Preconditioning Attenuates Myocardial Apoptosis through Regulation of Hypoxia Inducible Factor-1αand Heat Shock Protein 70
No full textIschemic preconditioning (IPC) increases expression of several cardioprotective genes and attenuates myocardial dysfunction after ischemia-reperfusion (IR) injury. However, the precise cellular mechanisms by which IPC confers myocardial protection are incompletely understood. We hypothesized that the beneficial effect of IPC in the heart is due to upregulation of two key transcription factors, Hypoxia Inducible Factor-1α (HIF-1α) and Heat Shock Protein 70 (HSP70). In this study, neonatal rat cardiomyoblasts (H9c2 cells) were subjected to IPC (four cycles of 15-min hypoxia/15-min reoxygenation), followed by 12-hr hypoxia-reoxygenation (HR). HIF-1α and HSP70 expression were measured by ELISA and immunoblot. Apoptosis was assessed by DNA fragmentation and caspase-3 activity. The results showed that IPC induced HIF-1α and HSP70 expression and attenuated apoptosis after 12-hr HR. Pretreatment with DMOG, an HIF-1α activator, showed a similar protective effect as IPC. An HIF-1α inhibitor (CAY10585) or HSP70 inhibitor (KNK437) decreased IPC-induced HIF-1α or HSP70 expression, respectively, and abrogated the anti-apoptotic effect of IPC. In summary, IPC is associated with increased HIF-1α and HSP70 expression and a subsequent decreased apoptosis in neonatal cardiomyoblasts exposed to HR. These results suggest that HIF-1α and HSP70play important roles in IPC-induced cardioprotection, and these endogenous transcription factors may provide a novel therapeutic target to prevent myocardial IR injury in vivo