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Lower incisor extraction is a treatment regime since decades with its own advocates and opponents. Even though many pioneers and legends support lower incisor extraction therapy, there is still a dilemma in the orthodontic community which might be due to the fear of certain disadvantages such as formation of black triangles, midline discrepancy, loss of canine guidance, decrease in intercanine width and bite deepening. But proper case selection, treatment planning and treatment mechanics will produce stable and good results with lower incisor extraction therapy. In this article we are illustrating the specific indications of lower incisor extraction with the help of treated cases. Keywords: Mandibular incisor, Extraction, Bolton discrepancy, Adult orthodontics, Black triangle.

In the historical aspect, experimental studies on rabbits conducted after the discovery of penicillin are described in order to develop single doses of the antibiotic and the frequency of its administration. The effectiveness of specific therapy of patients with syphilis with crystalline penicillin, Durant drugs in monotherapy, in combination with bismuth and non-specific therapy was evaluated. Electron microscopic studies that established the mechanism of action of penicillin on Treponema, the appearance of cysts and L-forms of the pathogen, the role of the macroorganism and stimulating therapy in the completion of phagocytosis are highlighted. It reflects the discussions of leading scientists at congresses that contribute to the development of effective treatment regimens for patients with syphilis.

Aim. This study aims to increase the efficiency of the wound process in patients with odontogenic phlegmons of the maxillofacial region by using energotropic and antioxidant agents. Material and methods. The clinical study included 42 patients with odontogenic phlegmons of the maxillofacial region. The patients were divided into two groups: comparison group (patients received traditional treatment) and main group (patients received treatment with Cytoflavin in the treatment regimen). Results. In the main group, the appearance of the first granulations occurred 2.1 times faster (on average on the 3rd day) in comparison with the granulation tissue in patients of the comparison group. Signs of edge epithelialization of wounds appeared almost 3 days earlier (on average on the 6th day) in the main group than in the comparison group; on the 7th day, secondary sutures were already applied, which was 1.6 times faster than the same parameter group 2, clearly suggesting the acceleration of reparative processes. Conclusion. The dynamics of clinical manifestations indicates the comparative effectiveness of using Cytoflavin as part of complex therapy. This finding is confirmed by the accelerated terms of wound healing, the appearance of granulations, epithelialization of the wound edges, and the imposition of secondary sutures.

Hypertensive disease is one of the most common diseases in the world and the leading cause of death and disability from cardiovascular diseases among the population. Recent studies have indicated that patients with hypertension in combination with rheumatoid arthritis have a higher risk of cardiovascular complications and mortality. Ukrainian recommendations for the management of patients with hypertension for 2018 indicated that angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are more effective in regressing left ventricular hypertrophy. The purpose of the study was to compare the effect of long-term therapy with valsartan in combination with indopamide and amlodipine on the structural and functional state of the left ventricular myocardium and the level of blood pressure in patients with arterial hypertension in combination with rheumatoid arthritis. Material and methods. The study included hypertensive patients in combination with rheumatoid arthritis. The patients were divided into 3 groups: the first group consisted of 17 patients with essential hypertension in combination with rheumatoid arthritis who took valsartan at a dose of 80 mg at home. The second group included 17 patients who were transferred to additional administration of the drug indapamide at a dose of 15 mg. The third group consisted of 18 patients whose dose of amlodipine was increased from 5 to 10 mg Results and discussion. In the daily blood pressure profile, the time-averaged values of systolic blood pressure and diastolic blood pressure were calculated for three-time intervals of 24 hours, day and night. Left ventricular remodeling was assessed by the relative left ventricular thickness - the ratio of the sum of the thickness of the interventricular septum and the thickness of the posterior wall to the final diastolic size of the left ventricular. The norms were considered to be an indicator of relative wall thickness

Background. Malaria remains a major cause of morbidity and mortality worldwide and particularly in sub-Saharan Africa where it is endemic. As such, it is important that a proper diagnosis is made before treatment is initiated. Malaria parasite count plays a key role in the diagnosis and management of malaria. Variations in ratings by laboratory personnel can impact negatively on the treatment regimen for malaria-infected patients. The study is thus aimed at evaluating and comparing the proficiency and parasitaemia counts by two different categories of laboratory staff at the LEKMA Hospital, Ghana. Materials and Methods. A total of 200 confirmed malaria-positive samples were used in the study. Six thick and thin films were prepared from each sample and uniquely labelled. Two of the six slides were given to two WHO-accredited malaria microscopists to examine and report their respective parasite count/μl ( parasite count / WBC × 8000 ). These were used as the reference for the two categories of laboratory staffs: rater A being diploma holders (Technical Officers referred to as untrained rater) and rater B being degree holders (Medical Laboratory Scientist referred to as trained rater) at the LEKMA Hospital. Results. In comparison to the expected outcome, the parasite count by the rater group A (190 (151-239)]) and the rater group B (177 (140-224)) demonstrated significant positive correlation ( r = 0.995 , p < 0.0001 vs. r = 0.995 , p < 0.0001 , respectively) with the expected outcome in the cases of heavy parasitaemia. A statistically significant difference ( p < 0.05 ) between counts by the different raters in low parasitemia was observed in this study. A persistent nosedive inter-rater agreement from k = 0.82 to k = 0.40 with increasing density cutoff was observed in this study. Conclusion. The study observed that the degree of inter-rater agreement of parasite density count by various categories of laboratory personnel is almost perfect. However, the parasite count between raters varied significantly with very low levels of parasitemia but better correlated with heavy parasitemia.

Background Successful delivery and completion of tuberculosis preventive treatment are necessary for tuberculosis elimination. Shorter preventive treatment regimens currently have higher medication costs, but patients spend less time in care and are more likely to complete treatment. It is unknown how economic costs of successful delivery differ between longer and shorter regimens in high-tuberculosis-burden settings. Methods We developed survey instruments to collect costs from program and patient sources, considering costs incurred from when household contacts first entered the health system. We compared the cost per completed course of preventive treatment with either 6 months of daily isoniazid (6H) or 3 months of weekly isoniazid and rifapentine (3HP), delivered by the Indus Health Network tuberculosis program in Karachi, Pakistan, between October 2016 and February 2018. Results During this period, 459 individuals initiated 6H and 643 initiated 3HP; 39% and 61% completed treatment, respectively. Considering costs to both the program and care recipients, the cost per completed course was 394 US dollars (USD) for 6H and 333 USD for 3HP. Using a new 2020 price for rifapentine reduced the cost per completed course of 3HP to 290 USD. Under varying assumptions about drug prices and costs incurred by care recipients, the cost per completed course was lower for 3HP in all scenarios, and the largest cost drivers were the salaries of clinical staff. Conclusions In a high-burden setting, the cost of successful delivery of 3HP was lower than that of 6H, driven by higher completion., In a tuberculosis-preventive treatment program in Karachi, Pakistan, the cost per completed course was lower for 12-dose isoniazid and rifapentine than for 6 months of daily isoniazid.

The ongoing outbreak of the coronavirus disease 2019 (COVID-19), as named by the World Health Organization, has millions of confirmed cases worldwide and has claimed hundreds of thousands of lives. The virus was named SARS-CoV-2 in February by the International Committee on Taxonomy of Viruses. COVID-19 presents as fever, dry cough, dyspnea, headache, and pneumonia. In a small subset of severe cases, the disease quickly progresses to respiratory failure and even death. This study aimed to know the effects of clinical and laboratory features on investigated death. The diagnosis was based on typical findings in thoracic computed tomography (CT) and positive results of the Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) SARS-CoV-2. The demographic characteristics of COVID-19 patients treated, accompanying comorbid conditions and laboratory criteria (blood lymphocyte counts, C Reactive Protein (CRP), D-dimer, Interleukin 6 (IL-6), blood neutrophil count/lymphocyte counts) were collected retrospectively. The results show that 121 cases, 66 (54.54%) were male, 55 (45.46%) were female, and the mean age was ± Std (Min-Max), 59.63 ± 17.4 (22-91). Neutrophil percentage (p = 0.027), neutrophil / lymphocyte ratio (NE / LE) (p = 0.028), CRP (p =

"Trials evaluating tocolytic use in preterm premature rupture of membranes (PPROM) have been small and lacked adequate power to evaluate uncommon outcomes. There still is much controversy on the benefit, length of use, route, and drug of choice among clinicians treating patients with PPROM. Most professional medical societies would propose to consider the use of tocolytics for 48 hours to allow for corticosteroid administration or to allow for maternal transfer to a higher level of care. Longer treatment regimens may lead to adverse maternal and perinatal outcomes. Insufficient data are available to make stronger and more definitive recommendations."

Multidrug-resistant Mycobacterium tuberculosis remains a major public health threat; its management poses a significant economic burden. Treatment requires a programmatic approach with access to laboratory services, second-line medications, and adequate clinical resources. In recent years, we have seen rapid developments in diagnostic techniques with whole genome sequencing-based drug susceptibility prediction now in reach, an array of new drugs that transform treatment regimens to purely oral formulations, and a steady stream of multinational trials that inform us about most efficient combinations. Our hope is that the current momentum keeps the ambitious goal to end tuberculosis in 2030 in reach.

To compare the outcomes of two different antivascular endothelial growth factor treatment regimens for treatment-naive eyes with neovascular age-related macular degeneration in routine clinical care at 12 and 24 months in Spain. Observational study using the Fight Retinal Blindness (FRB) outcomes registry platform. Eyes were treated with fixed bimonthly (FB) aflibercept group at one center and a treat-and-extend (TAE) regimen using either aflibercept or ranibizumab at the other center. We included 192 eyes. Of these, 160 eyes (83%) completed 12 months (86 TAE and 74 FB) and 79 (41%) completed 24 months (46 for TAE and 33 for FB) of follow-up. No statistically significant differences (p > 0.05) were found regarding mean visual acuity (VA, logMAR letters) at baseline (12 month cohort TAE 59.6 vs FB 57.9; 24 month cohort TAE 61.7 vs FB 62.6), final mean VA (12 month cohort TAE 61.1 vs FB 63.0; 24 month cohort TAE 64.8 vs FB 66.4), and median number of injections (12 months TAE 7 vs FB 7; 24 months TAE 11 vs FB 12). However, the distribution of injection frequencies for the TAE group was larger, with 35% of TAE eyes receiving ≤ 6 injections at 12 months compared with only 19% of FB eyes (p = 0.024). Similar VA results were observed with TAE and FB regimens, with no differences in the median number of injections. However, the TAE approach seemed to deliver a wider distribution of injection frequencies due to its individualized approach, which may help reduce the burden of injections in some eyes.

The formation of bonding between Al and Fe after the initial compound casting and during a heat treatment regime is investigated. No significant bonding was observed between the two metals after th...

The treatment of patients with early breast cancer has always been characterised by escalation by new therapies and de-escalation through identification of better treatment regimens or introduction of better tools to estimate prognosis. Efforts in some of these areas in the last few years have led to solid data. The results of the large studies of de-escalation through use of multi-gene tests are available, as are the results of some studies that investigated the new anti-HER2 substances T-DM1 and pertuzumab in the early treatment situation. Several large-scale studies examining the role of CDK4/6 inhibitors will soon be concluded so innovations can be anticipated in this area also. This review article will summarise and classify the results of the latest publications.

With increasing subspecialised experience in radical cytoreductive surgery and intra-abdominal chemotherapy for peritoneal malignancy, outcomes have improved significantly in selected patients. The surgery and the treatment regimens are radical and therefore correct patient selection is critical. The radiologist plays a central role in this process by estimating, as precisely as possible, the pre-treatment disease burden. Because of the nature of the disease process, accurate staging is not an easy task. Tumour deposits may be very small and in locations where they are very difficult to detect. It must be acknowledged that no form of modern day imaging has the capability of detecting the smallest peritoneal nodules, which may only be visible to direct inspection or histopathological evaluation. Nonetheless, it behoves the radiologist to be as exact and precise as possible in the reporting of this disease process. This is both to select patients who are likely to benefit from radical treatment, and just as importantly, to identify patients who are unlikely to achieve adequate cytoreductive outcomes. In this review, we outline the patterns of spread of disease and the anatomic basis for this, as well as the essential aspects of reporting abdominal studies in this patient group. We provide an evidence-based update on the relative strengths and limitations of our available multimodality imaging techniques namely CT, MRI and positron emission tomography/CT.

El prurigo nodular crónico se caracteriza por un ciclo de prurito y excoriación en el que intervienen mecanismos neurodérmicos, asociado a diversas enfermedades. Se manifiesta con placas o nódulos hiperqueratósicos cupuliformes. El tratamiento, enfocado en reducir el prurito, representa un desafío por la frecuente resistencia a las terapéuticas habituales. Se describe el caso de un hombre de 72 años, con antecedentes psiquiátricos, que presentó una dermatosis pruriginosa recalcitrante refractaria a múltiples esquemas de tratamiento.

Introduction: In Nigeria, patients accessing Directory Observed Therapy (DOTS) treatment are exposed to resistance to anti-TB drugs, hence is considered a priority, only few studies have focused on the relevant risk factors, Factors leading to development of drug resistance need to be understood to develop appropriate control strategies for national programsMethod: The study was a cross sectional study design. Multistage sampling technique was employed in the selection of 403 tuberculosis patients in Ibadan North Local Government Area of Oyo State. Data were collected using self-administered structured questionnaire, and analyzed using SPSS version 25. Level of significance was set at P0.05). Education and Occupation shows a significant association with MDR-TB, (χ2=24.640, p =0.007) and (χ2=14.416, p = 0.006) respectively,risk factors such asprevious TB treatment and Adherence with treatment regimen (r=0.270, p 0,05). L'éducation et la profession montrent une association significative avec la TB-MR, (χ2 = 24,640, p = 0,007) et (χ2 = 14,416, p = 0,006) respectivement, des facteurs de risque tels que le traitement antituberculeux antérieur et l'observance du schéma thérapeutique (r =0,270, p

The paper summarizes the results of studies regarding the most significant causes of ineffective treatment of patients with newly diagnosed pulmonary tuberculosis. It is proven that the effectiveness of treatment depends from the maximum concentration of antituberculosis drugs in blood serum, tissues and foci of affected lungs, depending on the method of administration of drugs and the presence of concomitant pathology from hepatobiliary and gastrointestinal system tract. Recommendations are given regarding the prevention of ineffective treatment of patients with pulmonary tuberculosis by improving diagnosis and developing new treatment regimens.

Multiple myeloma treatment has evolved with approvals of new immunomodulatory imide drugs (IMiDs), monoclonal antibodies (MoABs), and proteasome inhibitors (PIs). We characterized U.S. treatment trends and survival from 2011 to 2019 using Flatiron data from multiple myeloma patients followed from treatment index until death/end of data. Patients (

Alzheimer’s disease (AD) was first described in 1907 and got its name after Alois Alzheimer, a German psychiatrist and neuropathologist. This disease starts slow, increasing gradually to worsen in the due course of time. AD is mainly characterized by the associated dementia, which is a decline of cognitive effects such as memory, praxis, and orientation. The dementia is further highlighted by the presence of psychological and behavioral symptoms. Additionally, AD is also associated with the multiple interconnected pathways linked neuropathological changes such as the formation of neurofibrillary tangles and amyloid-β plaques inside the brain. AD therapeutics have been of prime concern over the decades, resulting in the elucidation of promising therapeutic targets. The requirement of AD stage dependent optimized conditions has necessitated a combinatorial approach toward treatment. The priority in AD research has remained to develop disease-modifying and development-reducing drugs for treatment regimens followed during the early and later stages, respectively.

Purpose This study provides an overview of the prognosis of intravascular large B cell lymphoma (IVLBCL) over the past 10 years and analyzes the possible relevant factors. Patients and methods We conducted a literature search of case reports, case series, and retrospective studies of IVLBCL published from January 2008 to July 2018. After excluding inappropriate data, 103 publications were selected for the analysis. Statistical analyses of different treatment modalities, the effect of blood-brain barrier (BBB)-penetrating drugs, and prognostic factors for outcomes were performed. Results In total, 182 pathologically confirmed cases of IVLBCL were included in our study. The results revealed that the 1- and 3-year overall survival rates were 42.3 and 11.5%, respectively, whereas the median overall survival was 340 days. Overall survival (450 days vs 180 days) and progression-free survival (420 days vs 150 days) were significantly longer in patients who received rituximab-containing regimens than in those treated with other regimens. For IVLBCL involving the CNS, regimens containing BBB-penetrating drugs failed to provide an additional survival benefit. In addition, lactic dehydrogenase levels ≥700 U/L, CNS involvement, and hemophagocytic syndrome were identified as unfavorable risk factors in patients with IVLBCL, whereas skin involvement appeared to be a protective factor. Conclusion Rituximab-containing chemotherapy can improve the outcomes of patients with IVLBCL, but the prognosis remains unsatisfactory. Treatment regimens containing BBB-penetrating drugs failed to improve outcomes in patients with CNS-involved IVLBCL. Several factors affect the prognosis of patients with IVLBCL, and further research on the underlying mechanisms is needed.

Radiology has an essential role in diagnosis, staging, and management in all subspecialties related to oncology. It has a broad utility from its use as an initial screening tool for cancer detection, followed by staging and surveillance of disease as well as the delivery of appropriate treatment regimens. In order to plan a treatment, the use of different modalities of radiological imaging are a key factor for pre-treatment planning and staging of the extent of disease in accordance with tumor-node-metastasis (TNM) system for highly conformal treatments, such as brachytherapy (BT). In this work, we present an overview of main modalities of imaging and principles of their application especially in head and neck cancer, with its diagnosis, treatment, follow-up with post-treatment changes, and overall management.

Objective: To investigate, through a systematic review, the effects of the use of highly diluted drugs in the treatment of experimental infection with Trypanosoma cruzi. Design: The authors searched for scientific publications in the databases PubMed, Web of Science, SCOPUS, LILACS, and the Google Scholar search system, from 2000 to 2018, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. According to the criteria established, a total of 22 studies were included. Settings/Location: The study took place at the State University of Maringa, Maringa, PR, Brazil. Subjects: Male mice (Mus musculus) or rats (Rattus norvegicus). Interventions: Highly diluted drugs. Outcome measures: The parameters evaluated in the studies were parasitological, clinical, immunological, histopathological and hematological. Results: The studies demonstrated that the effects of highly diluted drugs are related to their dynamizations, treatment regimen, and host susceptibility to T. cruzi infection, and depend on the initial information transmitted to the treated organism, making this information the "model" of how the treated organism will react. Regardless of the mechanism of action, these drugs provide a decrease in inflammation, which is one of the central phenomena of the pathogenesis of T. cruzi infection. Conclusions: This systematic review brings out the importance of the T. cruzi infection model as a reliable and valid model for studying different effects produced by highly diluted drugs. Considering the findings and in a broader perspective, this study contributes to considering these drugs as a possible way of dealing with "treatment" in general, presents the need to reexamine the biochemical model and develop a model for the effect of high dilutions in general, as well as for the treatment of parasitic infections.

Introduction. Atopic dermatitis (AD) is one of the most common skin diseases. The prevalence of atopic dermatitis among children is up to 20%, among adults - 2-8%. According to the form, there are mild, moderate and severe AD. Over the past decades, there has been an increase in the incidence of AD, its course is becoming more complicated, and the outcome is becoming more difficult. In this regard, the search for new successful treatment methods, as well as a detailed analysis of the currently used treatment regimens, is an urgent task. Goal. Measure the distribution of patients with AD by type of course (mild, moderate, severe) with a description of the patient's path, including the most important moments of decision-making, drivers of switching, changes in therapy, the main groups of influence and identify the main information requests/needs of patients with AD.Materials and methods. The study involved 700 patients, including 96 patients with moderate to severe form and 116 with severe form. All patients were diagnosed with AD and had at least one exacerbation in the last year. The age of the patients was 18-60 years. Results. The data obtained show that patients with moderate to severe AD make up about 25% of all patients with AD, including patients with severe ad - about 5%. Antihistamines are most often used by patients with AD, and the drug in this category is most often referred to by patients as the “main” drug for AD. More than half of patients (60%) with moderate to severe AD have used systemic steroids and/or cyclosporins over the past year. Patients with severe AD are significantly more likely than other groups to use steroids and immunosuppressants. The recommendation of a doctor (most often - a dermatologist in a municipal clinic or a skin and venereal clinic) is the most significant factor determining the choice of a drug for the treatment of atopic dermatitis. Conclusions. The data obtained indicate the need to conduct special educational activities with patients such as “schools of atopic dermatitis”, informing patients about the features of lifestyle in AD, theoretical aspects of treatment and skin care.

Background Infantile haemangiomas are the most common benign tumours affecting infants. Over time, the tumours may involute to some extent. However, sequelae, such as telangiectasia or fibrofatty tissue, often occur following this condition, which may cause disfigurement and influence patients' psychosocial development. Objective This prospective, randomized, self-controlled study aimed to assess the effects of topical timolol (0.5%) on involuting infantile haemangiomas. Materials & methods Each involuting superficial infantile haemangioma (n = 29) was randomly divided into two regions; one region was treated with topical timolol (0.5%) cream, three times daily, and the other region was untreated. The comparative treatments continued for three months. Five independent assessors, blinded to the treatment regimen, judged the treated and untreated regions by comparing photographs before and after treatment. Results The topical timolol-treated tumour sections showed no difference compared with the untreated sites (p = 0.355) after three months of treatment, and by the end of the treatment, the untreated lesions showed significant differences relative to pre-treatment (p Conclusion Topical timolol was not observed to have any effect on the regression of infantile haemangiomas in the involuting phase.

Fluid strategy is the key to the successful management of patients with sepsis. However, previous studies failed to consider individualized treatment strategy, and clinical trials typically included patients with sepsis as a homogeneous study population. We aimed to develop sequential decision rules for managing fluid intake in patients with sepsis by using the dynamic treatment regimen (DTR) model. A retrospective analysis of the eICU Collaborative Research Database comprising highly granular data collected from 335 units at 208 hospitals was performed. The DTR model used a backward induction algorithm to estimate the sequence of optimal rules. 22,868 patients who had sepsis according to the Acute Physiology and Chronic Health Evaluation (APACHE) IV diagnosis group were included. Optimal fluid management (liberal [> 40 ml/kg/d] versus restricted [

This review includes information about epidemiological data, development feature, phenotypes, principles of classification, diagnosis, and prognosis for drug-induced liver injury (DILI). Actual clinical recommendations regarding management of the DILI arising in the chemotherapy of cancer discussed. Drugs that can influence on individual pathogenetic mechanisms of growth and symptoms DILI are considered. Clinical studies for the prophylaxis and treatment of DILI associated with anticancer chemotherapy analyzed in detail. The prevention and treatment regimens for DILI in patients receiving chemotherapy and immunotherapy various localizations of cancer given both in research and in practical recommendations.

Dysphagia, defined as difficulty swallowing, is a common symptom negatively impacting millions of adults annually. Estimated prevalence ranges from 14 to 33 percent in those over age 65 to over 70 percent in a nursing home setting. The elderly, those with neurodegenerative diseases, head and neck cancer patients, and those with autoimmune conditions such as Sjögren's syndrome are disproportionately affected. Oropharyngeal dysphagia refers specifically to difficulty in initiating a swallow due to dysfunction at or above the upper esophageal sphincter, and represents a large proportion of dysphagia cases. Current treatments are limited and are often ineffective. Stem cell therapy is a new and novel advancement that may fill a much-needed role in our treatment regimen. Here, we review the current literature regarding stem cell treatments for oropharyngeal dysphagia. Topics discussed include tissue regeneration advancements as a whole and translation of these principles into research surrounding tongue dysfunction, xerostomia, cricopharyngeal dysfunction, and finally an overview of the challenges and future directions for investigation. Although this field of study remains in its early stages, initial promising results show potential for the use of stem cell-based therapies to treat oropharyngeal dysphagia and warrant further research.

Introduction Prostate cancer is recognized as the leading cause of malignancy-related incidence and mortality in the male population. The treatment regimens have long-term effects detrimental to the patient's quality of life. Hence, this review was aimed to determine the overall HRQOL and its associated among prostate cancer patients. Methods The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The databases searched were PubMed, Embase, Google Scholar and Cumulative Index to the Nursing and Allied Literature (CINAHL), which provided articles that were critically examined, yielding 52 studies that met the inclusion criteria for the systematic review. Results Out of 52 studies, 30 studies reported poor overall HRQOL in various domains after prostate cancer treatment. Contrastingly, 15 studies reported good overall quality of life after treatment. Among the various domains, sexual function was the most grossly affected functional score by the treatment modalities of prostate cancer. Nonetheless, seven studies showed that the absence of a significant change in the overall quality of life after treatment. According to the studies, older age, comorbidities, higher clinical stage, higher Gleason score, greater cancer severity, African American race, impaired mental health, neoadjuvant hormonal therapy and lower level of education were the major poor predictors of HRQOL among prostate cancer patients. Conclusion The overall HRQOL in prostate cancer patients was generally poor in various functional domains after treatment. Among the various domains, sexual function was the most grossly affected functional score by the treatment modalities of prostate cancer.

Introduction: Nowadays an increase in the amount of information creates the need to replace and update data processing technologies. One of the tasks of clinical pharmacology is to create the right combination of drugs for the treatment of a particular disease. It takes months and even years to create a treatment regimen. Using machine learning (in silico) allows predicting how to get the right combination of drugs and skip the experimental steps in a study that take a lot of time and financial expenses. Gradual preparation is needed for the Deep Learning of Drug Synergy, starting from creating a base of drugs, their characteristics and ways of interacting. Aim: Our review aims to draw attention to the prospect of the introduction of Deep Learning technology to predict possible combinations of drugs for the treatment of various diseases. Materials and methods: Literary review of articles based on the PUBMED project and related bibliographic resources over the past 5 years (2015–2019). Results and discussion: In the analyzed articles, Machine or Deep Learning completed the assigned tasks. It was able to determine the most appropriate combinations for the treatment of certain diseases, select the necessary regimen and doses. In addition, using this technology, new combinations have been identified that may be further involved in preclinical studies. Conclusions: From the analysis of the articles, we obtained evidence of the positive effects of Deep Learning to select “key” combinations for further stages of preclinical research.

INTRODUCTION: There was no evidence concerning the prophylaxis with hydroxychloroquine, and only low-grade evidence regarding the use of hydroxychloroquine as a treatment for COVID-19 patients We performed a survey among Romanian physicians in order to see how many of them would administer prophylactically hydroxychloroquine to themselves or to people close to them, and if they would participate to a randomized controlled trial METHODS: Between March 30 and April 02, 2020, a 16-item questionnaire was shared in a Romanian Facebook group of 2645 physicians dedicated to COVID-19 information, asking to be completed by physicians who could be directly involved in the care of these patients RESULTS: A total of 785 answers were collected Nine physicians (1 1%) thought that there was clear evidence on prescribing hydroxychloroquine prophylaxis, 375 (48%) considered the evidence acceptable, 348 (44 3%) considered it weak, whereas 53 (6 8%) answered there was no evidence 59 (7 5%) respondents were determined to take it (of which 31 = 4% already took), 192 (24 5%) were inclined to take, 271 (34 5%) were not decided yet 175 (22 3%) of respondents declared they (would) give the treatment to their close ones, and this decision was associated with a higher age (P = 0 003), and the opinion that there was evidence (P

Цель исследования - оценка способности гимантана (N-(2-адамантил)-гексаметиленимина гидрохлорида) в наружной гелевой лекарственной форме ослаблять у крыс неспецифическую воспалительную реакцию, вызванную полным адъювантом Фрейнда (ПАФ). Методика. Воспалительный процесс моделировали субплантарным введением ПАФ в левую заднюю лапу аутбредных крыс. Оценивали степень отёчности лапы животных по изменению диаметра стопы и голеностопного сустава до и после введения ПАФ. Гимантан в виде 5% гелевой лекарственной формы и препарат сравнения диклофенак в виде 1% гелевой лекарственной формы наносили ежедневно на повреждённую конечность крыс в течение 14 сут. Эксперимент проводили в 2 этапа. На 1-м этапе исследования препараты начинали наносить за 1 сут до индукции воспаления; на 2-м этапе препарат наносили ежедневно спустя 2 нед после индукции воспаления. Во время 1-го этапа работы на 4-е сут после введения ПАФ у животных регистрировали «Opto-Varimex» (Columbus Instruments, США). Результаты. Установлено, что на 1-м этапе (на 3-и и 7-е сут после индукции воспаления) гель гимантана значимо снижает отёчность стопы и голеностопного сустава поврежденной лапы животных, по эффективности не уступая гелю диклофенака; на 14-е сут после введения ПАФ значимого влияния на выраженность отёка повреждённой конечности не зафиксировано. На 4-е сут после введения ПАФ у животных с моделью воспаления наблюдается снижение на 34,03% числа горизонтальных перемещений в актометре «Opto-Varimex»; 5% гель гимантана и 1% гель диклофенака улучшают координацию движений крыс соответственно на 52,35% и 45,72%. На 2-м этапе исследования установлено, что 5% гель гимантана уменьшает отёчность стопы животных с экспериментальным воспалением через 7 и 14 сут применения препарата, 1% гель диклофенака значимого влияния не оказывает. Заключение. Курсовое ежедневное применение гимантана в наружной гелевой лекарственной форме снижает выраженность отёчного синдрома у аутбредных крыс с неспецифической воспалительной реакцией, вызванной субплантарным введением в левую заднюю лапу животных флогогенного агента. Эффективность лечения гимантаном, начатого как за 1 сут до введения ПАФ, так и через 2 нед после индукции воспаления, не уступает диклофенаку, применяемому в наружной лекарственной форме. The aim of the study was to evaluate the ability of different once-daily treatment regimens with N-(2-adamantyl) hexamethyleneimine hydrochloride (hemantane) topical gel vs. diclofenac topical gel to reduce nonspecific inflammation in rats induced with complete Freund’s adjuvant. Methods. Inflammation was induced by a subplantar injection of complete Freund’s adjuvant into the left hind paw of outbred rats. Edema of the left hind paw was measured. 5% hemantane gel (provided by the Laboratory of Finished Dosage Forms, V.V. Zakusov Institute of Pharmacology) and 1% diclofenac gel (produced by Hemofarm) were applied daily to the affected rat limb for 14 days. The experiment was performed in two stages. At the first stage, the drugs in the form of topical gels were applied to the left hind paw daily starting one day before the induction of inflammation. At the second stage, the topical gel formulations were applied daily starting two weeks after the induction of inflammation. At the first stage of the investigation, on day 4 after the injection of complete Freund’s adjuvant, coordination disorder of rats induced by the experimental pathology was evaluated using an Opto-Varimex actometer (Columbus Instruments, USA). Results. At the first stage of the study, hemantane gel significantly reduced edema of the foot and ankle joint of the left hind paw on days 3 and 7 after the induction of inflammation and was non-inferior to diclofenac gel. On day 14 after the injection of complete Freund’s adjuvant into the rat hind paw, the drugs had no significant effect on edema of the paw. On day 4 after the injection, the number of horizontal movements decreased by 34.03% as indicated by the Opto-Varimex actometer; 5% hemantane gel and 1% diclofenac gel improved coordination in rats by 52.35% and 45.72%, respectively. At the second stage of the study, 5% hemantane gel reduced foot edema in the model of inflammation after 7 and 14 days of treatment, whereas 1% diclofenac gel exerted no significant effect. Conclusion. Hemantane as a topical formulation reduces edema in outbred rats with nonspecific inflammation induced by the subplantar injection of complete Freund’s adjuvant into the left hind paw when applied daily, starting either one day before the induction of inflammation or two weeks after the complete Freund’s adjuvant administration, and its efficacy was not inferior to diclofenac as a topical formulation.

To investigate potential factors influencing initial length of hospital stay (LOS) for infants with neonatal abstinence syndrome (NAS) in Florida. The study population included 2984 term, singleton live births in 33 Florida hospitals. We used hierarchical linear modeling to evaluate the association of community, hospital, and individual factors with LOS. The average LOS of infants diagnosed with NAS varied significantly across hospitals. Individual-level factors associated with increased LOS for NAS included event year (P

The paper is based on laboratory experiments of heat treatments applied to samples of A537/A537M steel. The work continues other previous works aimed at modifying structures and properties of this steel, including through surface treatments. The experiments were performed using Taguchi methods from Quality Engineering. A number of four factors were selected as influencing the structure after heat treatment: heating temperature for hardening, cooling rate on hardening, time and tempering temperature. A number of nine experiments were performed using an L9 orthogonal matrix. Objective function was changed to maximum hardness after the heat treatment regime. The results show that the tempering temperature has the greatest influence on the final hardness of the A537 steel samples.

The current work assesses the efficacy of a course of intramuscular administration of dexamethasone at doses of 1 or 4 mg/kg when modelling sulphur mustard aerosol inhalation injury. To this end, the average lethal doses, the median death time and the protection coefficients were calculated for rats with sulphur mustard inhalation injury induced by a micro-sprayer. In the treatment regimen used, dexamethasone showed low levels of efficacy, possibly due to its pleiotropic effect on the immune system.

Heart Failure causes an enormous individual and societal burden of disease with severe symptoms, a reduction in activities of daily life, frequent hospitalizations and poor prognosis. The field of heart failure with reduced ejection fraction has seen substantial innovation in the past years. Novel and successful treatment regimens were established, the pharmaceutical treatment options for heart failure with preserved ejection fraction remains limited to date. Yet, promising concepts are emerging. Today we have only symptoms and risk factors-based therapeutic options, and include basically diuretics, RAAsi, and antidiabetics, respectively. A causal therapy is still missing.

Aim: Trypanosomosis is a vital protozoan disease of man and animals with devastating consequences in the tropical parts of the world, necessitating the investigation of the effects of diminazene aceturate (DA) and arteether (AR) on Trypanosoma brucei brucei experimental infection in rats. Materials and Methods: We used a total of 98 rats, which were divided into 14 groups (A-N) of seven rats each over 36 days after acclimatizing them. We administered 1×106 trypanosomes to the infected groups (B-N) with Group A as the unexposed control rats. Groups C-F became the infected and treated rats with 3.5 mg/kg, 7.0 mg/kg, 10.5 mg/kg, and 14.0 mg/kg of DA while Groups G-J became the infected and treated rats with 0.01 ml/kg, 0.02 ml/kg, 0.03 ml/kg, and 0.04 ml/kg of AR. Groups K-N became infected and treated rats with DA and AR combinations at similar doses. Results: Parasitemia suppression occurred in Groups G-J only but became cleared in Groups C-F and K-N. Survival time varied significantly (p

The purpose of the study was to investigate the degree to which chronic patients adhered to medication regimens during the economic crisis in Greece. It is a quantitative cross-sectional study, with a convenience sample of 1,009 residents of Western and Northern Greece, aged ≥ 18 years, with chronic health problems. The survey was conducted between February and June 2016. Data were collected via a structured questionnaire with closed-ended questions, filled out during face to face interviews with all participants. The vast majority of respondents (94.5 %) said that they were able to buy prescribed drugs but had to economise in other ways (for example, by cutting back on clothing and travel) to cope with essential household expenses, including medication. Only 71 % of participants said they remembered to take their prescribed medications every day, following all of their physicians' recommendations. Almost 70 % of participants said that using generic medications made it easier to adhere to their treatment regimens. The results of a correlation analysis showed that patients experiencing financial hardships as a result of health problems were less likely to adhere to pharmaceutical care regiments than those who were not experiencing financial difficulties (p = 0.026). Men had a higher level of adherence than women (p = 0.001).

During the processing of Ti6Al4V alloy by a 3D printing method SLM (selective laser melting), high internal stresses are developed in the material as a result of high temperature gradients between microvolumes of the powder melted at a given time and the already solidified material. Cooling rates thus reach up to the order of 108 °C·s-1. At such rates, a diffusionless martensitic transformation occurs, which also contributes to internal stresses in the material. High internal stresses can be a problem already during production; they can manifest themselves by cracking of products, deformations of thin parts, etc. Even in defectless products, internal stresses negatively affect their properties; in particular, they reduce ductility. Therefore, it is desirable to include a heat treatment after the 3D printing, which would reduce the stresses and transform the metastable martensitic structure into a stable one. As a result of the heat treatment, the ductility increases at the expense of strength. The subject of this paper is to find such heat treatment regime that provides the best combination of mechanical properties.

Background The aim of this study was to evaluate the association of bruxism and treatment regimens among remitted bipolar patients. Subjects and methods The total case group included 222 adult patients with BD. Diagnosis of bruxism was based upon the on 'self-reports' plus the outcome from the clinical examinations. Results The sample consisted of 112 (50.5%) bipolar patients with bruxism and 110 (49.5%) without bruxism. Remitted bipolar patients who were on mood stabilizer plus atypical antipsychotic treatment had lower bruxism rates than patients on other than bipolar patients on mood stabilizer treatment regimen (p=0.04) and bipolar patients on polypharmacy (p=0.01). Conclusion Our findings have supported the existence of psychotropic drug-bruxism relation and atypical antipsychotic related therapeutic effect among bipolar patients.

To evaluate, in a combined treatment strategy for treatment-warranted retinopathy of prematurity (ROP), which of the two is a better treatment sequence, peripheral laser photocoagulation (LPC-IVB) first or intravitreal bevacizumab (IVB-LPC) first. Twenty-two babies (44 eyes) with ROP were recruited from 1 July 2014 to 30 March 2016. All the right eyes received LPC on day one followed by IVB on day four (LPC-IVB group). In all left eyes, IVB was injected on day one followed by LPC on day four (IVB-LPC group). The primary outcome measure was the proportion of eyes that had complete ROP regression with no additional treatment within 2 weeks of the onset of therapy. Retinal photography and drawings were used at each visit to document disease course. In LPC-IVB group, 72.7% (16/22) eyes had complete ROP regression with no additional treatment within 2 weeks of the onset of therapy. In the IVB-LPC group, 95.5% (21/22 eyes) had complete regression within 2 weeks. Additional laser had complete regression in all eyes in each group. One baby (two eyes, one from each group) had late recurrence at 5 months. The combined therapy strategy was successful for ROP management. Administration of anti-vascular endothelial growth factor injection before the peripheral laser was better than the reverse strategy of laser first. Late recurrences and adverse events were low.

Life of any living thing starts with the breath and ends with breathlessness. Health is defined as a state of equilibrium of normal functions of Dosha, Dhatu, and Agni with body, mind and soul. Health has not given importance until someone becomes sick. Due to intake of improper diet, lack of exercise, stress, & global warming, pollution the health status of an individual is decreasing day by day & they are getting easily prone to infectious disease. It comes with significant challenges & creating a burden over medical & health care system. Ayurveda is an ancient science which has already described such communicable disease with their causes, mode of transmission, prevention as well as treatment. Charak has explained about Janapadodhwansa & its four reasons(Air, water, time, and region). Sushruta has already mentioned Aupsargikarogas that are infectious diseases. By adopting Ayurvedic measures such as following proper Dincharaya, Rutucharya, Sadvritta, Panchakarma, Shaman Cikitsa & Rasayana, both physical and mental health, can be maintained. The main aim of this paper is to highlight the airborne disease mentioned in Ayurveda. This review has been done by compiling information from classic Ayurvedic texts – Charak Samhita, Sushruta Samhita, and Astanga Hirdaya. Apart from this, modern books, journals & websites on preventive & social medicine were also searched for this study. After extensive search, specific causative factors, pathology, symptoms & various treatment regime has been narrated in scattered form by our Ancient Acharyas. The different Ayurvedic Samhitas serves as a source of getting knowledge about the airborne disease and ways to prevent it and cure it. By using these basic principles in this ancient science in a rational way, we can avoid & overcome many clinical conditions described in contemporary science which has its self-limitations in treatment modalities.

Volatile substance dependence is a relatively rare form of substance use disorders. It is predominantly noted in the adolescent age group. Higher prevalence is also seen in individuals from the lower socio-economic strata. These agents induce a rapid mood change by altering the levels of central neurotransmitters. Here we present a unique case of volatile substance dependence in a middle aged female with iron deficiency anemia. We managed this with the SSRIs and parenteral iron preparations which led to recovery. This emphasizes the fact that any treatment regimen must address all the factors, co-morbidities and patient characteristics for complete recovery.

Purpose . To evaluate the clinical-ophthalmic effectiveness of using of autologous platelet-rich plasma as part of a comprehensive treatment regimen for uveitis associated with systemic diseases and accompanied by macular edema. Material and methods . The study included 120 people (176 eyes) from 18 to 50 years old with uveitis associated with systemic diseases, accompanied by macular edema: 46 men, 74 women. Patients were divided into 2 groups: the main group consisted of patients receiving antiinflammatory treatment and autologous platelet-rich plasma application; control group consisted of patients receiving anti-inflammatory treatment. All patients underwent a comprehensive ophthalmological examination. Results . It was found that autologous platelet-rich plasma application during anti-inflammatory treatment for patients with uveitis associated with systemic diseases and accompanied by macular edema improves best-corrected visual acuity, statistically significant decrease in retinal thickness in fovea and increase in retinal photosensitivity relative to the data obtained in the control group. Conclusion . The use of autologous platelet-rich plasma in combination with anti-inflammatory treatment decreases incidence of relapse of uveitis associated with systemic diseases, contributes to reducing macular edema and improving functional performance.

Background: Identifying the factors associated with the adherence to treatment regimen is a useful guide for health care providers to provide appropriate treatment regimens and promote the adherence to treatment. Objectives: The aim of this study was to determine the status of adherence to treatment regimen and its related factors in patients undergoing coronary artery revascularization therapies (CART) in selected hospitals of Zanjan in 2017. Methods: This correlational study was conducted in Zanjan, Iran in 2017. In total, 318 patients who had undergone CART were selected by systematic random sampling to participate in the study. The study tools included demographic factors, factors related to the disease, and the Nayeri et al questionnaire of adherence to treatment regimen. Descriptive and inferential statistics were used to analyze the data through SPSS software version 23. Results: Results of this study showed that, the mean score of adherence to treatment regimen by the patients was 128.12±7.51 and the status of adherence to treatment regimen was at moderate level. Multiple linear regressions showed that variables such as type of treatment, duration of disease, age, and gender were associated with the adherence to treatment regimen. So that, with the increasing age (p=0.002) and the duration of the disease (p=0.034), adherence to treatment regimen was also increased. Furthermore, the score of adherence to treatment regimen was better in patients who had coronary artery bypass surgery (CABG) (p=0.002) than angioplasty procedure, and also it was better in women (p=0.032) than men. Conclusion: About half of the patients with CART do not adhere to their treatment regimen. Age, gender, level of education, duration of illness and type of treatment are the predictors of adherence to treatment regimen. Understanding these factors can be used as a guide in designing interventions and conducting further studies to improve the adherence to treatment regimen. Adherence to treatment regimen is not only a complicated variable that has many determinants, but also is a continuous process.