Risedronate in the treatment of Murine Chagas’ disease

Risedronate, a bisphosphonate, was used to treat CD-1 mice infected with the Brazil strain of Trypanosoma cruzi. When given by subcutaneous injection 3 times/week, there was a significant reduction in mortality, however, the myocardial pathology and right ventricular dilation was unchanged in these mice compared to control animals. In C57BL/6 mice infected with the Tulahuen strain, there was no change in mortality in response to risedronate treatment. These data suggest that this class of compounds has activity against T. cruzi in vivo and illustrate the utility of imaging and pathologic studies as adjuncts in the evaluation of therapeutic compounds as treatments for experimental Chagas disease. In addition, it underscores the need to use different strains of T. cruzi.     

Which treatment for whom for ADHD? Moderators of treatment response in the MTA

Using receiver operating characteristics, the authors examined outcome predictors (variables associated with outcome regardless of treatment) and moderators (variables identifying subgroups with differential treatment effectiveness) in the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD; MTA). Treatment response was determined using parent- and teacher-reported ADHD and oppositional defiant symptoms, with levels near or within the normal range indicating excellent response. Among 9 baseline child and family characteristics, none predicted but 3 moderated treatment response. In medication management and combined treatments, parental depressive symptoms and severity of child ADHD were associated with decreased rates of excellent response; when these 2 characteristics were present, below-average child IQ was an additional moderator. No predictors or moderators emerged for behavioral and community comparison treatments. The authors discuss conceptual and clinical implications of research on treatment moderators.     

Results of treatment of 62 cases of Hodgkin's disease in Côte d'Ivoire

This study reports the follow-up after 22 years of 62 treated cases of Hodgkin's disease. Complete remission was obtained in 66% of cases versus 31% of incomplete remission and 3% of failures. Overall survival of patients ranged from 10 days to 48 months. Real event-free survival was difficult to estimate given that 40% were completely lost to follow-up. The most frequently encountered disorders were haematologic ones. The difficulties were directly linked to precarious socio-economic conditions for most patients.     

Can we expect progress in the treatment of fibrosis in the course of chronic pancreatitis?

Chronic pancreatitis (CP) is a necroinflammatory process characterized by loss of both exocrine and endocrine function. To date, the disease has been treated symptomatically. Real advances in CP management can be expected once the pathophysiology of the disease is elucidated and individual stages of its development are properly managed. A key role in the CP pathogenesis is played by activation of pancreatic stellate cells (PSCs) that cooperate with the remaining pancreatic cells. All these cells produce cytokines, growth factors, angiotensin and other substances, which paracrinally or autocrinally induce further, persistent activation of PSCs. The activated PSCs are capable of producing and modifying the extracellular matrix. An optimal therapeutic preparation should exert beneficial effects on all the above-mentioned phenomena observed in CP. The most promising treatment modalities include blocking of the renin-angiotensin system (RAS), activation of peroxisome proliferator-activated receptors gamma (PPAR-γ), influence on the remaining PSC signaling pathways, blocking of substances produced by activated PSCs, and antioxidants. The findings of many recent experimental studies are highly encouraging; however, their efficacy should be confirmed in well-designed clinical trials.     

Combined laparoscopy and hysteroscopy in the treatment of tubal infertility

IntroductionInfertilityandsteffotyisoneofworldwideproblemsinmedicalscienceandsocialscience.IiialsoanhapobotgenecolwtaldiseaseandrelatetoObstetiics,Genecology,Sexology,Reproductiveendocrinology,Iryununology,FamilyPlanning,BinlogyandGeneticsetc.ThediagnoshcandtherapeuticlevelofinfechtytreatmentreflectthelevelofthehospitalareaandstatetosomeeXtant.tubalfactorsisabout209,6tO45%thecauseofinfeMity.Achievingpreunderthesecircumstancereqthedetherthemethodofmicros~orrecentlyassistedl.eproductivetecl…     

Application of biomaterial scaffolds in the treatment of spinal cord injury北大核心

BACKGROUND: Due to the weak regeneration ability after spinal cord injury, it is still a difficult medical problem to repair the damaged spinal cord tissue and normalize its function. The rapid development of biological tissue materials and its wide application in medicine provide new therapeutic ideas and methods for spinal cord injury repair. OBJECTIVE: To summarize the research situation of biomaterial scaffolds on nerve tissue regeneration and repair after spinal cord injury, and forecast its development trend, so as to explore the methods of spinal cord injury repair and summarize experience. METHODS: The articles published from January 2011 to January 2021 were retrieved using the advanced retrieval function of PubMed database. The search terms were “spinal cord injury, biomaterials, nerve regeneration, material”. By using the advanced retrieval functions of CNKI, Wanfang, VIP and other databases, relevant articles published from January 2011 to January 2021 were searched, and the search terms were “spinal cord injury, biomaterials, scaffolds”. RESULTS AND CONCLUSION: With further development of the combination of bioengineering research and medicine, biomaterial scaffolds have been widely used in the study of spinal cord injury repair, and the histocompatibility and degradation of biomaterials have been improved. There are many kinds of biomaterials, each of which has its own advantages and disadvantages. It is better to prepare composite scaffolds loaded with seed cells, cytokines or drugs for nerve regeneration. However, how to select the composite scaffold material combination, how to select the seed cells, cytokines or drugs, so as to make the biomaterial scaffold combined with seed cells, cytokines or drugs become the best combination value of in-depth research. In conclusion, biomaterial repair of spinal cord injury is a new idea and may become a breakthrough point to promote the repair of spinal cord injury. © 2022, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

What is the role of rituximab in the treatment of rheumatoid arthritis?

Rituximab is a monoclonal antibody against CD20 that was developed for the treatment of relapsed or refractory B-cell non-Hodgkin's lymphoma (NHL). Recent controlled trials have shown that B cell-targeted therapy with rituximab is effective in RA (which suggest that B lymphocytes may be critical in its pathogenesis of RA) and early exposure data suggest that the tolerability and safety profile of rituximab may be even better in RA than in NHL patients. Rituximab is generally well tolerated, with a low incidence of serious adverse events, including serious infections. Available evidence suggests that its clinical benefits depend on effective B cell depletion, and the fact that its novel mode of action leads to the depletion of B cells makes it distinct from other biological therapies for RA that target T cells and their related cytokines. Although complete peripheral B cell depletion is regularly seen in RA and other autoimmune diseases, especially systemic lupus erythematosus (SLE), incomplete depletion has been reported in a subset of patients, even after full dosing with rituximab.     

Safety of anti-TNFα agents in the treatment of psoriasis and psoriatic arthritis

Context: The efficacy and favorable safety profile of anti-tumor necrosis factor (TNF) agents in the treatment of psoriasis and psoriatic arthritis (PsA) are supported by several randomized controlled studies and meta-analyses. However, some concerns on the long-term safety of these drugs still exist, as these studies generally included small patient numbers and were performed in selected patient populations.

Objective: This review presents and discusses current evidence on the safety of anti-TNFα agents in patients with psoriasis and PsA, with a focus on European registry studies and case reports of particular importance.

Methods: Key studies on the safety of anti-TNFα agents in the treatment of adult patients with psoriasis or PsA were identified by a MEDLINE search (last updated 10 November 2011) based on several interrelated queries, with a focus on European registries. Other studies and case reports were included if deemed relevant. Studies concerning other conditions, such as rheumatoid arthritis (RA), were included as appropriate when data in psoriatic disease were unavailable or insufficient.

Results: Available data on the safety of anti-TNFα agents such as etanercept in psoriasis and PsA appear reassuring, even if some concerns still exist. Most notably, data suggest a higher incidence of infection and lymphoma amongst patients treated with the anti-TNFα monoclonal antibodies infliximab and adalimumab compared with etanercept.

Conclusion: The overall safety profile of monoclonal antibodies in patients with psoriasis, PsA and RA seems less favorable than that of etanercept, particularly in terms of risk of infection and hepatotoxicity.     

Efficacy of Kelamidium® in the prevention and treatment of Trypanosoma brucei brucei infection in albino rats

The efficacy of Kelamidium® in the prevention and treatment of experimental Trypanosoma brucei brucei infection of albino rats was studied. Adult albino rats (55) weighing between 147 and 240 g were used for the study. The rats were kept in metal cages in a fly-proof house and were adequately fed and given water ad libitum. Two experiments were carried out. In experiment I (chemotherapy), 30 adult albino rats were divided into six groups of five rats each, whereas in experiment II (chemoprophylaxis), 25 adult albino rats were divided into five groups of five rats each. In both experiments, groups I and II were uninfected control and infected untreated control, respectively. In experiment I, rats in groups III and V were each infected with 5.0?×?10⁵ trypanosomes and were later treated with 0.5 mg/kg of Kelamidium® (low-dose treatment), and rats in groups IV and VI were infected with 5.0?×?10⁵ trypanosomes and treated with 1.0 mg/kg of Kelamidium® (high-dose treatment). Treatment was given to rats in groups III and IV at day 7 postinfection (PI; early treatment), whereas groups V and VI were treated at day 10 PI (late treatment). In experiment II, rats in groups III, IV, and V were each treated with 2.0 mg/kg of Kelamidium® at day 0 and were later infected at days 14, 28, and 42 PI, respectively, with 5.0?×?10⁵ trypanosomes. Parasites were detectable in the blood of the infected rats in all the infected groups in experiment I and in group II in experiment II, 4–7 days PI. Parasitemia, however, was not recorded in the remaining groups in experiment II. The drug cleared the parasites from the blood of the infected rats in experiment I, 2–7 days posttreatment (PT). Relapse of infection, however, occurred in all the infected treated groups. It was thus concluded that Kelamidium® may be more useful as a prophylactic agent than as a chemotherapeutic agent in the management of animal trypanosomosis.     

Combination of monoclonal antibodies and DPP-IV inhibitors in the treatment of type 1 diabetes: A plausible treatment modality?

Regulatory T cells (Tregs) are crucial for the maintenance of immunological tolerance. Type 1 diabetes (T1D) occurs when the immune-regulatory mechanism fails. In fact, T1D is reversed by islet transplantation but is associated with hostile effects of persistent immune suppression. T1D is believed to be dependent on the activation of type-1 helper T (Th1) cells. Immune tolerance is liable for the activation of the Th1 cells. The important role of Th1 cells in pathology of T1D entails the depletion of CD4⁺ T cells, which initiated the use of monoclonal antibodies (mAbs) against CD4⁺ T cells to interfere with induction of T1D. Prevention of autoimmunity is not only a step forward for the treatment of T1D, but could also restore the β-cell mass. Glucagon-like peptide (GLP)-1 stimulates β-cell proliferation and also has anti-apoptotic effects on them. However, the potential use of GLP-1 as a possible method to restore pancreatic β-cells is limited due to rapid degradation by dipeptidyl peptidase (DPP)-IV. We hypothesize that treatment with combination of CD4 mAbs and DPP-IV inhibitors could prevent/reverse T1D. CD4 mAbs have the ability to induce immune tolerance, thereby arresting further progression of T1D; DPP-IV inhibitors have the capability to regenerate the β-cell mass. Consequently, the combination of CD4 mAbs and DPP-IV inhibitor could avoid or at least minimize the constraints of intensive subcutaneous insulin therapy. We presume that if this hypothesis proves correct, it may become one of the plausible therapeutic options for T1D.     

Interferon-γ for treatment of severe atopic eczema in two children

Two 4- and 5-year-old children suffering from refractory atopic dermatitis were treated with recombinant interferon- (rIFN-). rIFN- was injected at 50 g subcutaneously three times a week in the first child for 3 weeks, followed by three times 25 g in week 4. In the other child two treatment courses of 4 weeks were given after a break of 2 weeks. Therapy was well tolerated. In child one reductions in eczematous body surface and severity of lesions were observed, while no beneficial effect was seen in the other. Clinical chemistry data remained unchanged. Immunological studies performed in parallel showed a decrease in total serum IgE of 50% in child 1, a decrease in spontaneous in vitro IgE production, an increase in in vitro production of interleukin-6, and a normalization of previously decreased in vitro lymphocyte responses to several mitogens. While marked immunological changes were noted during IFN- treatment, clinical benefits were not encouraging. Diminished IFN- production has been claimed to be a major pathogenic factor in atopic eczema. Our results indicate that the pathogenesis is more complex. Clinically, we were unable to confirm previous observations in adults. Further studies are needed before IFN- can be recommended for therapy of pediatric atopic eczema.Abbreviations IFN- interferon- - IL interleukin     

Coaxil (tianeptine) in the treatment of depression in Parkinson’s disease

An open, non-comparative clinical study was performed to assess the efficacy and safety of tianeptine (Coaxil) in Parkinson’s disease (PD). A total of 18 patients with PD were used whose clinical state increased moderately severe and more profound depression (assessed on the Hamilton and Beck scales). After three months of treatment, depression on the Hamilton depression scale was decreased by 34% and on the Beck scale by 31% compared with baseline data (_p < 0.05). Improvements in mental status were noted in 14 of 18 patients (77%); eight patients (44%) showed more than 50% reductions on the Hamilton scale. Analysis of the structure of depressive symptomatology showed that improvement occurred because of decreases in anxiety and the severity of somatoform symptoms and, to a lesser extent, in melancholy and sleep disturbance. There was no significant change in apathy. The decrease in the severity of depression was accompanied by an improvement in the quality of life. The efficacy of Coaxil was greater in patients with less marked depressive and motor symptoms, shorter durations of illness, and less marked cognitive impairments. Coaxil was well tolerated by the patients. The data obtained here provide grounds for recommending the use of Coaxil in the treatment of depression in PD. __________ Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 106, No. 3, pp. 20–25, March, 2006.     

Analysis of the course and treatment of toxocariasis in children—a long-term observation

Toxocariasis is a helminthozoonotic disease caused by ascarid larvae of Toxocara genus: Toxocara canis and Toxocara cati. In the reported study, the clinical course of toxocariasis and administered therapy were evaluated in 103 children. The majority of the children (68.9%) were from the rural environment, with a prevalence of boys (62.1%). At diagnosis of infection, 36 (35%) children reported recurrent abdominal pain, 19 (18.4%) headache, 6 (5.8%) loss of appetite, 2 subfebrile conditions, and 2 arthralgia, Moreover, 23 (22.3%) children demonstrated symptoms of atopic diseases; in 30 (29.1%) children, moderate enlargement of lymphatic nodes was noted. In five children (4.9%), ophthalmic examination revealed unilateral changes in the eye: in two cases retinitis; in one case fibrotic lesions in the vitreous body, complicated 1 year from diagnosis by retinal detachment; and in other children parafoveal lesions and cataract. Only two children with ocular changes at diagnosis reported visual disorders. In 64.3% of children, eosinophilia was observed. A covert form of the disease was diagnosed in 95.1% of the children and an ocular form in 4.9%. In all the children, antiparasitic treatment was implemented, repeated several times in some of them. After therapy, the mean titer of specific antibodies, the number of children with abdominal pains and enlarged lymphatic nodes were decreased, while headaches maintained at unchanged levels. In approximately one fourth of the children with negative results of antibodies after the therapy, the symptoms of the disease were still reported. Evaluation of the efficacy of treatment is not easy due to non-characteristic symptoms and low kinetics of specific anti Toxocara IgG decrease; however, high IgG titers suggest non-effective treatment of concomitant infection requiring subsequent therapy. Due to risk of ocular form, which may develop in any stage of the disease, irrespectively of specific antibodies concentrations, it seems justified to implement antiparasitic treatment in all children infected with T. canis.     

Evaluation of the therapeutic efficacy of amodiaquine versus chloroquine in the treatment of uncomplicated malaria in Abie, Côte-d'Ivoire

The WHO 14-days' test and an in vitro survey were carried out to study the efficacy of amodiaquine versus chloroquine in Abie, a hyperendemic village in the southern forest area of C?te-d'Ivoire. One hundred and nineteen children less than 15 years old suffering from uncomplicated malaria were randomised. Among these, 62 were given amodiaquine treatment and 57 chloroquine treatment. both 4-aminoquinoleines were administered at the same dose of 30 mg/kg spread over three days by 10 mg/kg/day. Before the drug was administered, parasites were taken from some patients of each group and were evaluated in vitro to both drugs. In vivo, the amodiaquine treatment shows 95% of clinical success, 2% of early clinical failures and 3% of late clinical failures. For the chloroquine treatment, the rates are respectively. 79%, 7% and 14%. However, some patients still had a level of parasitaemia for both treatments but were asymptomatic. These parasites were found to be resistant in vitro. The authors recommend that the treatment to be used in Abie must be firstly amodiaquine followed by sulfadoxine-pyrimethamine in cases where there is persistent asymptomatic parasitemia.     

Efficacy of cilostazol for the treatment of Raynaud’s phenomenon in systemic sclerosis patients

Cilostazol is a selective inhibitor of phosphodiesterase-III with antiplatelet, antithrombotic and vasodilating properties. The aim of our study was to evaluate the effect of the drug on vasculopathy and Raynaud’s phenomenon (RP), in a series of patients with systemic sclerosis (SSc), before and after cilostazol treatment. Twenty-one consecutive SSc patients with moderate or severe RP were enrolled in an open-label study. Cilostazol was administered at the dose of 100 mg twice a day, for 12 months. Evaluations included: daily RP attack diary documenting the frequency and duration of RP episodes, Health Assessment Questionnaire-Disability Index, scleroderma visual analogue scales (VAS), flow-mediated dilation and immunological status, including endothelin 1 and interleukin 6 plasma levels. Thirteen patients completed the study. RP duration and daily number episodes recorded over a 3-week period significantly decreased after cilostazol treatment (p = 0.0049 and p = 0.0067, respectively). VAS score indicated a significant amelioration of the patients’ perception of RP (p = 0.0117), and both baseline and post-ischemic brachial artery diameters were significantly increased after cilostazol treatment, as compared with basal values (p = 0.0119 and p = 0.0076, respectively). None of the patients developed digital ulcers during the study. A significant clinical improvement of RP was recorded in SSc patients undergoing cilostazol treatment. Study results indicate a potential role of cilostazol as oral maintenance therapy in SSc patients with RP.     

Application and characteristics of bone graft materials in the treatment of spinal tuberculosis北大核心

BACKGROUND: Thorough removal of local necrotic lesions and one-stage use of bone repair materials can significantly promote local bony fusion, avoid recurrence of tuberculosis in the middle and long terms and reconstruct spinal stability in the surgical treatment of spinal tuberculosis. OBJECTIVE: To review the application of bone graft materials in the treatment of spinal tuberculosis. METHODS: The first author searched the articles related to bone graft materials of spinal tuberculosis in Bailian, CNKI, and Natures databases published from 2001 to 2020. The priority was the articles published recently or in authoritative journals. The search keywords were “bone graft materials, bone tissue engineering; spinal tuberculosis; titanium mesh; autogenous bone” in Chinese and English. RESULTS AND CONCLUSION: At present, bone graft materials have been widely used in clinic, but each has its own disadvantages. For example, the amount of autologous bone is limited, and the transplantation of autologous bone will cause bleeding and potential complications of donor site; allogeneic bone will lead to delayed healing and infection; titanium mesh has the problems of postoperative subsidence and kyphosis correction angle loss; the organic polymer materials such as polylactic acid and polymethyl methacrylate are lack of bone induction performance. Although Ca/P-based ceramic materials can be used as carrier materials of antituberculosis drugs, their biomechanical properties cannot fully meet the clinical needs. In view of the shortcomings of the above materials, it is necessary to find a composite bone tissue engineering material, which can meet the requirements of good biocompatibility, mechanical properties, degradation properties, osteogenic activity, and drug release performance. © 2022, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.