Immigration Brings New Pathology with No Standardized Treatment Protocol

2018 ◽  
Vol 108 (6) ◽  
pp. 517-522
Author(s):  
Tara L. Harrington ◽  
Denten Eldredge ◽  
Erica K. Benson
Keyword(s):  
Opportunistic Infections ◽  
Treatment Options ◽  
Treatment Protocol ◽  
Current Treatment ◽  
Foot And Ankle ◽  
Treatment Protocols ◽  
Clinical Presentations ◽  
Standardized Treatment ◽  
Madura Foot ◽  
Antimicrobial Interventions

Madura foot is an uncommon invasive soft-tissue infection that foot and ankle specialists encounter. We present two rare cases of Phialemonium and Phaeoacremonium fungi infections of the foot diagnosed in northern California to inform physicians on the presentation and current treatment options for this unique pathology. The two cases presented outline the clinical presentations, diagnostic data, and surgical and antimicrobial interventions. There is a concentration on the antimicrobial options depending on which of the over 20 species is encountered. The pertinent literature and supporting data are reviewed to create an outline for discussion of treatment protocols when faced with these emerging opportunistic infections.

Equine non-healing corneal ulcers: a retrospective evaluation of 57 cases (2001–2017)

2020 ◽  
Vol 48 (02) ◽  
pp. 92-97
Author(s):  
Vera J. S. Prucha ◽  
Alexander Tichy ◽  
Barbara Nell
Keyword(s):  
Clinical Symptoms ◽  
Treatment Options ◽  
Treatment Protocol ◽  
Healing Time ◽  
Additional Treatment ◽  
Treatment Protocols ◽  
Corneal Ulcers ◽  
Recorded Data ◽  
Inflammatory Drugs

Abstract Background and objectives Non-healing corneal ulcers (NHCU) are a common problem in equine practice and several treatment options are available with different success and healing times. The aim of this retrospective study was to evaluate and to compare treatment protocols, clinical courses, corneal healing time and outcomes of NHCU. Methods From December 2001 to December 2017, a total of 57 horses with NHCU were presented at the Vetmeduni Vienna. Recorded data included affected eye, signalment, clinical symptoms, season of diagnosis, treatment protocols, complications and corneal healing rate. Results Sixty-three eyes were diagnosed with a NHCU. Follow-up information was available for 48/63 eyes. For those treated medically mean corneal healing time was 15.7 days (± SD 12.0). Medical treatment included topical antibiotics, antimycotics, cycloplegics, and systemic anti-inflammatory drugs. Twelve eyes received treatment with a poly-carboxymethylglucose-sulfate regenerating agent (Cacicol®; Thea Pharma GmbH, Wien, Austria). Other common additional treatments included debridement with an iodine drenched cotton tip (48 eyes; 76.2 %) and diamond burr debridement (30 eyes; 47.6 %). A bandage contact lens (BCL) was used for 10 eyes. Each eye received at least one additional treatment, although none of them led to a statistically significant alteration in healing time. Only usage of a BCL significantly increased healing time when compared to not using a BCL (p = 0.035). When all treatments failed, superficial keratectomy with placement of a conjunctival flap was performed. Secondary complications included stromal cellular infiltration, keratomycosis, keratomalacia, and corneal abscess formation. Conclusions Results correlated with those previously described and thus demonstrated the difficulty and complexity of this disease. Further research is needed to determine an optimal treatment protocol for non-healing ulcers in horses. Clinical relevance Since NHCUs are a commonly encountered problem in equine practice a reliable treatment protocol is required. This study reflects the problems with those ulcers and provides several protocols for possible treatments.

scholarly journals Topical and Oral Therapies for Childhood Atopic Dermatitis and Plaque Psoriasis

Children ◽  
2019 ◽  
Vol 6 (11) ◽  
pp. 125
Author(s):  
Travis Frantz ◽  
Ellen G. Wright ◽  
Esther A. Balogh ◽  
Abigail Cline ◽  
Adrienne L. Adler-Neal ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Treatment Guidelines ◽  
Oral Treatment ◽  
Treatment Options ◽  
Current Treatment ◽  
Expert Advice ◽  
Off Label ◽  
Systemic Treatments ◽  
Standardized Treatment

Background: Treatment of atopic dermatitis and psoriasis in children is difficult due to lack of standardized treatment guidelines and few FDA-approved treatment options. Treatments approved for adults may be used off-label in pediatric patients. Objective: This review evaluates the topical and oral treatment options available, including off-label uses, and provides a basic therapeutic guideline for pediatric atopic dermatitis and psoriasis. Methods: A PubMed review of topical and systemic treatments for pediatric psoriasis and atopic dermatitis with information regarding age, efficacy, dosing, contra-indications, adverse events, and off-label treatments. Results: The search identified seven topical and five systemic treatments that are routinely employed to treat pediatric atopic dermatitis and psoriasis. Limitations: Standardized guidelines regarding treatment choice, dosing, and long-term safety are scarce. Reviews may be subject to ascertainment bias. Conclusions: Current treatment guidelines are based on clinical experience and expert advice with few treatments officially approved for atopic dermatitis and psoriasis in children.

Dermale Filler: Vaskulärer Verschlüsse nach intra-arterieller Injektion managen

2021 ◽  
pp. 1-2
Author(s):  
Andrea Schulz
Keyword(s):  
Treatment Options ◽  
Treatment Protocol ◽  
Vascular Complications ◽  
Dermal Filler ◽  
Delayed Presentation ◽  
Tissue Necrosis ◽  
Treatment Protocols ◽  
Soft Tissue Necrosis ◽  
Dermale Filler ◽  
Vascular Compromise

<b>Background:</b> Inadvertent intra-arterial injection of dermal fillers including calcium hydroxylapatite (CaHA) can result in serious adverse events including soft tissue necrosis, permanent scarring, visual impairment, and blindness. When intra-arterial injection occurs, immediate action is required for optimal outcomes, but the infrequency of this event means that many physicians may never have experienced this scenario. The aim of this document is to provide evidence-based and expert opinion recommendations for the recognition and management of vascular compromise following inadvertent injection of CaHA. <b>Subjects and methods:</b> An international group of experts with experience in injection of CaHA and management of vascular complications was convened to develop a consensus on the optimal management of vascular compromise following intra-arterial CaHA injection. The consensus members were asked to provide preventative advice for the avoidance of intravascular injection and to produce a treatment protocol for acute and delayed presentation. To ensure all relevant treatment options were included, the recommendations were supplemented with a PubMed search of the literature. <b>Results:</b> For prevention of intra-arterial CaHA injection, consensus members outlined the importance of a thorough knowledge of facial vascular anatomy and patient history, as well as highlighting potential risk zones and optimal injection techniques. Individual sections document how to recognize the symptoms of vascular occlusion leading to vision loss and tissue necrosis as well as detailed treatment protocols for the management of these events. For impending tissue necrosis, recommendations are provided for early and delayed presentations with treatment protocols for acute and follow-up treatment. A separate section details the treatment options for open and closed wounds. <b>Conclusion:</b> All physicians should be prepared for the eventuality of intra-arterial injection of a dermal filler, despite its rarity. These consensus recommendations combine advice from aesthetic experts with the latest reports from the published literature to provide an up-to-date office-based protocol for the prevention and treatment of complications arising from intra-arterial CaHA injection.

Effects of Relative Humidity on Impregnated Filters Used in Measurement of Airborne Sulfur Dioxide

2019 ◽  
Vol 63 (7) ◽  
pp. 806-813
Author(s):  
Chih-Hsiang Chien ◽  
Chufan Zhou ◽  
Simon Yang Sing ◽  
Benjamin Lopez ◽  
Alexandros Theodore ◽  
...  
Keyword(s):  
Sulfur Dioxide ◽  
Relative Humidity ◽  
Occupational Safety ◽  
Treatment Protocol ◽  
Current Treatment ◽  
Breakthrough Time ◽  
Treatment Protocols ◽  
Safety And Health ◽  
Significant Underestimation

Abstract Impregnated filters treated with alkali and humectant were first used as collection media to assess occupational exposure to sulfur dioxide (SO2), as outlined in the National Institute for Occupational Safety and Health Method 6004 in 1979. Since then, updated treatment protocols have been proposed with decreased amounts of alkali and glycerol, which claim the same filtering capacity. However, there has been no report on how the collection of SO2 on such impregnated media is influenced by relative humidity (RH). This study investigated the role of glycerol (G) amount on impregnated filters (G2 and G10, referring to 2 and 10% glycerol, respectively) in the collection of SO2 (100 l of 10 ppm at 1 l per minute) under low, medium, and high RHs. The testing results show that RH significantly impacted G2 filters with respect to breakthrough time, capacity, and recovery. At low RH, the 5% breakthrough time was less than 10 min and its recovery was merely 42%; at medium and high RHs, although the recovery was satisfactory, the 5% breakthrough time was still less than 100 min. By contrast, G10 filters illustrated nearly 100% recovery and evaluation by analysis of variance showed no significant effect of RH on recovery. In summary, the current treatment protocol of 2% glycerol leads to a significant underestimation of the exposure to SO2 in a low-RH environment; increasing the glycerol content can be an effective alternative to compensating for the effect of RH.

scholarly journals Covid-19: A pandemic here to stay!

2020 ◽  
Vol 5 (1) ◽  
pp. e000249
Author(s):  
Shamshad Khan ◽  
Ashitha Nair ◽  
Md Imran Hossain ◽  
Abhinaya Shivakumar ◽  
Shabnam Cyclewala ◽  
...  
Keyword(s):  
Review Paper ◽  
Treatment Options ◽  
Current Treatment ◽  
Treatment Protocols ◽  
Experimental Drugs ◽  
Current Review ◽  
Global Pandemic ◽  
The World

Since December 2019, SARS-CoV-2 has spread to more than 200 countries and has become a global pandemic. There have been more than 49 million confirmed cases of Covid-19 as of 1st of November, 2020 with over 1.2 million case fatalities all over the world. The current review paper gives an update on the epidemiology, investigations modalities and treatment options including the various current treatment protocols, vaccines in development and experimental drugs in research.

scholarly journals Investigating the Role of Everolimus in mTOR Inhibition and Autophagy Promotion as a Potential Host-Directed Therapeutic Target in Mycobacterium tuberculosis Infection

2019 ◽  
Vol 8 (2) ◽  
pp. 232 ◽  
Author(s):  
Stephen Cerni ◽  
Dylan Shafer ◽  
Kimberly To ◽  
Vishwanath Venketaraman
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Mammalian Target Of Rapamycin ◽  
Treatment Protocol ◽  
Current Treatment ◽  
Current Therapy ◽  
Mycobacterium Tuberculosis Infection ◽  
Novel Therapy ◽  
Mtor Inhibition ◽  
Treatment Protocols ◽  
Tb Treatment

Tuberculosis (TB) is a serious infectious disease caused by the pathogen Mycobacterium tuberculosis (Mtb). The current therapy consists of a combination of antibiotics over the course of four months. Current treatment protocols run into problems due to the growing antibiotic resistance of Mtb and poor compliance to the multi-drug-resistant TB treatment protocol. New treatments are being investigated that target host intracellular processes that could be effective in fighting Mtb infections. Autophagy is an intracellular process that is involved in eliminating cellular debris, as well as intracellular pathogens. Mammalian target of rapamycin (mTOR) is an enzyme involved in inhibiting this pathway. Modulation of mTOR and the autophagy cellular machinery are being investigated as potential therapeutic targets for novel Mtb treatments. In this review, we discuss the background of Mtb pathogenesis, including its interaction with the innate and adaptive immune systems, the mTOR and autophagy pathways, the interaction of Mtb with these pathways, and finally, the drug everolimus, which targets these pathways and is a potential novel therapy for TB treatment.

Nail Psoriasis: A Review of Treatment Options

2017 ◽  
Vol 2 (4) ◽  
pp. 85-91
Author(s):  
Madison Grinnell ◽  
Lauren Bonomo ◽  
Morgan Rabach
Keyword(s):  
Quality Of Life ◽  
Plaque Psoriasis ◽  
Treatment Options ◽  
Structure And Function ◽  
Treatment Protocols ◽  
Nail Psoriasis ◽  
Clinical Presentations ◽  
And Function ◽  
Topical Medications

Nail psoriasis is often found in patients with plaque psoriasis and can greatly impact quality of life. This is particularly true in more severe cases, as it affects the structure and function of the patient's nail. Treatment for nail psoriasis is often challenging, involving topical medications, injections, and systematic therapies. This article aims to give an overview of the varied clinical presentations of nail psoriasis and the current treatments available for patients with this condition. Risks and efficacies of these treatments will be evaluated to determine the best treatment protocols.

scholarly journals Lessons from Randomised Clinical Trials for Triiodothyronine Treatment of Hypothyroidism: Have They Achieved Their Objectives?

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Rudolf Hoermann ◽  
John E. M. Midgley ◽  
Rolf Larisch ◽  
Johannes W. Dietrich
Keyword(s):  
Clinical Trials ◽  
Statistical Power ◽  
Treatment Options ◽  
Drug Efficacy ◽  
Experimental Treatment ◽  
Current Treatment ◽  
Treatment Protocols ◽  
Novel Studies ◽  
Randomised Controlled ◽  
Based Medicine

Randomised controlled trials are deemed to be the strongest class of evidence in evidence-based medicine. Failure of trials to prove superiority of T3/T4 combination therapy over standard LT4 monotherapy has greatly influenced guidelines, while not resolving the ongoing debate. Novel studies have recently produced more evidence from the examination of homeostatic equilibria in humans and experimental treatment protocols in animals. This has exacerbated a serious disagreement with evidence from the clinical trials. We contrasted the weight of statistical evidence against strong physiological counterarguments. Revisiting this controversy, we identify areas of improvement for trial design related to validation and sensitivity of QoL instruments, patient selection, statistical power, collider stratification bias, and response heterogeneity to treatment. Given the high individuality expressed by thyroid hormones, their interrelationships, and shifted comfort zones, the response to LT4 treatment produces a statistical amalgamation bias (Simpson’s paradox), which has a key influence on interpretation. In addition to drug efficacy, as tested by RCTs, efficiency in clinical practice and safety profiles requires reevaluation. Accordingly, results from RCTs remain ambiguous and should therefore not prevail over physiologically based counterarguments. In giving more weight to other forms of valid evidence which contradict key assumptions of historic trials, current treatment options should remain open and rely on personalised biochemical treatment targets. Optimal treatment choices should be guided by strict requirements of organizations such as the FDA, demanding treatment effects to be estimated under actual conditions of use. Various improvements in design and analysis are recommended for future randomised controlled T3/T4 combination trials.

Establishing a Group Educational Session for Hyperacusis Patients

2019 ◽  
Vol 28 (2) ◽  
pp. 245-250
Author(s):  
Ann E. Perreau ◽  
Richard S. Tyler ◽  
Patricia C. Mancini ◽  
Shelley Witt ◽  
Mohamed Salah Elgandy
Keyword(s):  
Therapeutic Process ◽  
Treatment Options ◽  
Clinical Group ◽  
Education Session ◽  
Group Approach ◽  
Treatment Protocols ◽  
Educational Session ◽  
Evidence Based Treatment ◽  
Relationship Of ◽  
The Relationship

Purpose Audiologists should be treating hyperacusis patients. However, it can be difficult to know where to begin because treatment protocols and evidence-based treatment studies are lacking. A good place to start in any tinnitus and hyperacusis clinic is to incorporate a group educational session. Method Here, we outline our approach to establishing a hyperacusis group educational session that includes specific aspects of getting to know each patient to best meet their needs, understanding the problems associated with hyperacusis, explaining the auditory system and the relationship of hyperacusis to hearing loss and tinnitus, describing the influence of hyperacusis on daily life, and introducing treatment options. Subjective responses from 11 adults with hyperacusis, who participated in a recent clinical group education session, were discussed to illustrate examples from actual patients. Conclusions Due to the devastating nature of hyperacusis, patients need to be reassured that they are not alone and that they can rely on audiologists to provide support and guidance. A group approach can facilitate the therapeutic process by connecting patients with others who are also affected by hyperacusis, and by educating patients and significant others on hyperacusis and its treatment options. Supplemental Material https://doi.org/10.23641/asha.8121197

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

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