Search results for: androgen deprivation therapy

Authors: Vijaya Madhuri Devraj, Swarnalatha Guditi, Kiran Kumar Bokara, Gangadhar Taduri

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Cell-based strategies may open therapeutic approaches that promote tolerance through manipulation of macrophages to increase long-term transplant survival rates and minimize side effects of the current immune suppressive regimens. The aim of the present study was, therefore, to test and compare the therapeutic potential of MSC and Tregs on macrophage polarization to develop an alternate cell-based treatment option in kidney transplantation. In the current protocol, macrophages from kidney transplant recipients with graft dysfunction were co-cultured with MSCs and Treg cells with and without cell-cell contact on transwell plates, further to quantitatively assess macrophage polarization in response to MSC and Treg treatment over time, M1 and M2 cell surface markers were used. Additionally, multiple soluble analytes were analyzed in cell supernatant by using bead-based immunoassays. Furthermore, to confirm our findings, gene expression analysis was done. MSCs induced the formation of M2 macrophages more than Tregs when macrophages M0 were cultured in transwell without cell contact. From this, we deduced the mechanism that soluble factors present in the MSCs condition media are involved in skewing of macrophages towards type 2 macrophages; similarly, in co-culture with cell-cell contact, MSCs resulted in more M2 type macrophages than Tregs. And an important finding of this study is the combination of both MSC-Treg showed significantly effective and consistent results in both with and without cell contact setups. Hence, it is suggestive to prefer MSCs over Tregs for secretome-based therapy and a combination of both for either therapy for effective transplantation outcomes. Our findings underline a key role of Tregs and MSCs in promoting macrophage polarization towards anti-inflammatory type. The study has great importance in prolongation of allograft and patient survival without any rejection by cell-based therapy, which induce self-tolerance and controlling infection.

Keywords: graft rejection, graft tolerance, macrophage polarization, mesenchymal stem cells, regulatory T cells, transplant immunology

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Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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Authors: Yang Yang, Luciana Magalhães Rebelo Alencar, Martha Sahylí Ortega Pijeira, Beatriz da Silva Batista, Alefe Roger Silva França, Erick Rafael Dias Rates, Ruana Cardoso Lima, Sara Gemini-Piperni, Ralph Santos-Oliveira

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Radium-²²³ dichloride ([²²³Rₐ]RₐCl₂) is an alpha particle-emitting radiopharmaceutical currently approved for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease. [²²³Rₐ]RₐCl₂ is bone-seeking calcium mimetic that bonds into the newly formed bone stroma, especially osteoblastic or sclerotic metastases, killing the tumor cells by inducing DNA breaks in a potent and localized manner. Nonetheless, the successful therapy of osteosarcoma as primary bone tumors is still a challenge. Nanomicelles are colloidal nanosystems widely used in drug development to improve blood circulation time, bioavailability, and specificity of therapeutic agents, among other applications. In addition, the enhanced permeability and retention effect of the nanosystems, and the renal excretion of the nanomicelles reported in most cases so far, are very attractive to achieve selective and increased accumulation in tumor site as well as to increase the safety of [²²³Rₐ]RₐCl₂ in the clinical routine. In the present work, [²²³Rₐ]RₐCl₂ nanomicelles were produced, characterized, in vitro evaluated, and compared with pure [²²³Rₐ]RₐCl2 solution using SAOS2 osteosarcoma cells. The [²²³Rₐ]RₐCl₂ nanomicelles were prepared using the amphiphilic copolymer Pluronic F127. The dynamic light scattering analysis of freshly produced [²²³Rₐ]RₐCl₂ nanomicelles demonstrated a mean size of 129.4 nm with a polydispersity index (PDI) of 0.303. After one week stored in the refrigerator, the mean size of the [²²³Rₐ]RₐCl₂ nanomicelles increased to 169.4 with a PDI of 0.381. Atomic force microscopy analysis of [223Rₐ]RₐCl₂ nanomicelles exhibited spherical structures whose heights reach 1 µm, suggesting the filling of 127-Pluronic nanomicelles with [²²³Rₐ]RₐCl₂. The viability assay with [²²³Rₐ]RₐCl₂ nanomicelles displayed a dose-dependent response as it was observed using pure [²²³Rₐ]RₐCl2. However, at the same dose, [²²³Rₐ]RₐCl₂ nanomicelles were 20% higher efficient in killing SAOS2 cells when compared with pure [²²³Rₐ]RₐCl₂. These findings demonstrated the effectiveness of the nanosystem validating the application of nanotechnology in targeted alpha therapy with [²²³Ra]RₐCl₂. In addition, the [²²³Rₐ]RaCl₂nanomicelles may be decorated and incorporated with a great variety of agents and compounds (e.g., monoclonal antibodies, aptamers, peptides) to overcome the limited use of [²²³Ra]RₐCl₂.

Keywords: nanomicelles, osteosarcoma, radium dichloride, targeted alpha therapy

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Authors: Arshad Munir, Naseem Akhtar

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The determination of the Sufi is to effort towards unity. His main purpose is to bring humanity, separated as it is into so many different units, closer together in the deeper understanding of life. His mission is to bring about brotherhood among races, nations and faiths and to respect one another's faith, scripture and teacher. Sufi is to confer sympathy on these lives, to impart love, compassion and kindheartedness on all creations. The Sufi message is the resonance of the same Divine message which has always come and will always come to inform humanity. It is the continuation of all the pronounced religions which have come at several times and it is amalgamation of them all, which was the wish of all the prophets. Pakistan, who came into being in the name of Islam unfortunately, have linked with terrorism. It is a disgrace that in contemporary day Pakistan, mullahism and the recent cancer of Talibanisation are gradually eating into what had kept us integral as a society. Terrorism has grown-up to develop a prime safety pressure to the area. The terrorism has deadly caused decrease in overseas and local investment, exports, physical infrastructure, and wealth stock ultimately leading to damage of the socio-economic status of Pakistan. Main reasons are ignorance about the actual teaching of Islam both by Muslim and non-Muslim, exploitation by the religious and political influential, sectarianism and extremism, lack of tolerance and broadmindedness and reaction and retortion by the sufferer. The key treatment and therapy of the abovementioned illnesses exist in the messages of Sufism.

Keywords: sufism, love, Pakistan, terrorism

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Authors: Kalpana Singh, Nikita Katiyar

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This research investigates the impact of Raga Bhairavi, a prominent musical scale in Indian classical music, on the mood and basic physiological parameters of research scholars at the University of Lucknow - India. The study focuses on the potential therapeutic effects of listening to Raga Bhairavi during morning hours. A controlled experimental design is employed, utilizing self-reporting tools for mood assessment and monitoring physiological indicators such as heart rate, oxygen saturation levels, body temperature and blood pressure. The hypothesis posits that exposure to Raga Bhairavi will lead to positive mood modulation and a reduction in physiological stress markers among research scholars. Data collection involves pre and post-exposure measurements, providing insights into the immediate and cumulative effects of the musical intervention. The study aims to contribute valuable information to the growing field of music therapy, offering a potential avenue for enhancing the well-being and productivity of individuals engaged in intense cognitive activities. Results may have implications for the integration of music-based interventions in academic and research environments, fostering a conducive atmosphere for intellectual pursuits.

Keywords: bio-musicology, classical music, mood assessment, music therapy, physiology, Raga Bhairavi

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Authors: Alvin Saputra, Felix Wijovi

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Background: Adults with Autism Spectrum Disorder (ASD) often experience emotional dysregulation and heightened suicidality. Dialectical Behavior Therapy (DBT) and Radically Open DBT (RO-DBT) have shown promise in addressing these challenges, though research on their effectiveness in ASD populations remains limited. This systematic review aims to evaluate the impact of DBT and RO-DBT on emotional regulation, depression, and suicidality in adults with ASD. Methods: A systematic review was conducted by searching databases such as PubMed, PsycINFO, and Scopus for studies published on DBT and RO-DBT interventions in adults with Autism Spectrum Disorder (ASD). Inclusion criteria were peer-reviewed studies that reported on emotional regulation, suicidality, or depression outcomes. Data extraction focused on sample characteristics, intervention details, and outcome measures. Quality assessment was performed using standard systematic review criteria to ensure reliability and relevance of findings. Results: 4 studies comprising a total of 343 participants were included in this study. DBT and RO-DBT interventions demonstrated a medium effect size (Cohen's d = 0.53) in improving emotional regulation for adults with ASD, with ASD participants achieving significantly better outcomes than non-ASD individuals. RO-DBT was particularly effective in reducing maladaptive overcontrol, though high attrition and a predominantly White British sample limited generalizability. At end-of-treatment, DBT significantly reduced suicidal ideation (z = −2.24; p = 0.025) and suicide attempts (z = −3.15; p = 0.002) compared to treatment as usual (TAU), although this effect did not sustain at 12 months. Depression severity decreased with DBT (z = −1.99; p = 0.046), maintaining significance at follow-up (z = −2.46; p = 0.014). No significant effects were observed for social anxiety, and two suicides occurred in the TAU group. Conclusions: DBT and RO-DBT show potential efficacy in reducing emotional dysregulation, suicidality, and depression in adults with ASD, though the effects on suicidality may diminish over time. High dropout rates and limited sample diversity suggest further research is needed to confirm long-term benefits and improve applicability across broader populations.

Keywords: dialectical behaviour therapy, emotional dysregulation, autism spectrum disorder, suicidality

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Authors: Delphine Morales, Florian Lombart, Agathe Truchot, Pauline Maire, Pascale Vigneron, Antoine Galmiche, Catherine Lok, Muriel Vayssade

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Targeted therapy molecules are used as a first-line treatment for metastatic melanoma with B-Raf mutation. Nevertheless, these molecules can cause side effects to patients and are efficient on 50 to 60 % of them. Indeed, melanoma cell sensitivity to targeted therapy molecules is dependent on tumor microenvironment (cell-cell and cell-extracellular matrix interactions). To better unravel factors modulating cell sensitivity to B-Raf inhibitor, we have developed and compared several melanoma models: from metastatic melanoma cells cultured as monolayer (2D) to a co-culture in a 3D dermal equivalent. Cell response was studied in different melanoma cell lines such as SK-MEL-28 (mutant B-Raf (V600E), sensitive to Vemurafenib), SK-MEL-3 (mutant B-Raf (V600E), resistant to Vemurafenib) and a primary culture of dermal human fibroblasts (HDFn). Assays have initially been performed in a monolayer cell culture (2D), then a second time on a 3D dermal equivalent (dermal human fibroblasts embedded in a collagen gel). All cell lines were treated with Vemurafenib (a B-Raf inhibitor) for 48 hours at various concentrations. Cell sensitivity to treatment was assessed under various aspects: Cell proliferation (cell counting, EdU incorporation, MTS assay), MAPK signaling pathway analysis (Western-Blotting), Apoptosis (TUNEL), Cytokine release (IL-6, IL-1α, HGF, TGF-β, TNF-α) upon Vemurafenib treatment (ELISA) and histology for 3D models. In 2D configuration, the inhibitory effect of Vemurafenib on cell proliferation was confirmed on SK-MEL-28 cells (IC50=0.5 µM), and not on the SK-MEL-3 cell line. No apoptotic signal was detected in SK-MEL-28-treated cells, suggesting a cytostatic effect of the Vemurafenib rather than a cytotoxic one. The inhibition of SK-MEL-28 cell proliferation upon treatment was correlated with a strong expression decrease of phosphorylated proteins involved in the MAPK pathway (ERK, MEK, and AKT/PKB). Vemurafenib (from 5 µM to 10 µM) also slowed down HDFn proliferation, whatever cell culture configuration (monolayer or 3D dermal equivalent). SK-MEL-28 cells cultured in the dermal equivalent were still sensitive to high Vemurafenib concentrations. To better characterize all cell population impacts (melanoma cells, dermal fibroblasts) on Vemurafenib efficacy, cytokine release is being studied in 2D and 3D models. We have successfully developed and validated a relevant 3D model, mimicking cutaneous metastatic melanoma and tumor microenvironment. This 3D melanoma model will become more complex by adding a third cell population, keratinocytes, allowing us to characterize the epidermis influence on the melanoma cell sensitivity to Vemurafenib. In the long run, the establishment of more relevant 3D melanoma models with patients’ cells might be useful for personalized therapy development. The authors would like to thank the Picardie region and the European Regional Development Fund (ERDF) 2014/2020 for the funding of this work and Oise committee of "La ligue contre le cancer".

Keywords: 3D human skin model, melanoma, tissue engineering, vemurafenib efficiency

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Authors: Rudinë Fetahaj, Flaka Isufi, Kristina Hansson

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While evidence shows that in most European countries’ multilingualism is rising, unfortunately, the focus of Speech and Language Therapy (SLT) is still monolingualism. Furthermore, there is sparse information on how the needs of multilingual children with language disorders such as Developmental Language Disorder (DLD) are being met and which factors affect the intervention approach of SLTs when treating DLD. This study aims to examine the relationship and correlation between the number of languages SLTs speak, years of experience, and length of education with the advice they give to parents of multilingual children with DLD regarding which language to be spoken. This is a cross-sectional study where a survey was completed online by 2608 SLTs across Europe and data has been used from a 2017 COST-action project. IBM-SPSS-28 was used where descriptive analysis, correlation and Kruskal-Wallis test were performed.SLTs mainly advise the parents of multilingual children with DLD to speak their native language at home. Besides years of experience, language status and the level of education showed to have no association with the type of advice SLTs give. Results showed a non-significant moderate positive correlation between SLTs years of experience and their advice regarding the native language, whereas language status and length of education showed no correlation with the advice SLTs give to parents.

Keywords: quantitative study, developmental language disorders, multilingualism, speech and language therapy, children, European context

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Authors: Radwa R. El-Saadany , Medhat Abu Zeid, Tarek Omar, Marwa S. Maqsoud

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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by attention deficit, hyperactivity, and impulsivity. Neurofeedback (NF) is one of the neurotherapy treatments that cause brain wave changes. Method: The current pseudo-experimental study with a pre–post-test design was conducted on a population of children with attention deficit hyperactivity disorder (ADHD).The sample size comprised of (30) children selected by random sampling method and assigned to two therapeutic groups: First therapeutic group received a neurofeedback program. Based on QEEG, it reached (10) children. The second therapeutic group received an organization skills training program, it reached (10) and the control group that did not receive programs, it reached (10) children. Results: There are significant differences between pre- and post-assessments among therapeutic groups in reducing the three core symptoms of ADHD in favor of post measurement. There are no significant differences between post-assessment and follow up measurement of the therapeutic groups.

Keywords: QEEG-based neurofeedback therapy program, organizational skills training program, attention deficit hyperactivity disorder

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Authors: K. R. Thabethe, G. A. Adefolaju, M. J. Hosie

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Cervical cancer is the third most commonly diagnosed cancer globally and it is one of three AIDS defining malignancies. Highly active antiretroviral therapy (HAART) is a combination of three or more antiretroviral drugs and has been shown to play a significant role in reducing the incidence of some AIDS defining malignancies, although its effect on cervical cancer is still unclear. The aim of this study was to investigate the relationship between cervical cancer and HAART. This was achieved by studying the expression of two signalling molecules expressed in cervical cancer; MUC1 and P65. Following the 24 hour treatment of a cervical cancer cell line, HCS-2, with drugs which are commonly used as part of HAART at their clinical plasma concentrations, real-time qPCR and immunofluorescence were used in order to study gene and protein expression. A one way ANOVA followed by a Tukey Kramer Post Hoc test was conducted using JMP 11 software on both sets of data. The drug classified as a protease inhibitor (PI) (i.e. LPV/r) reduced MUC1 and P65 gene and protein expression more than the other drug tested. PIs are known to play a significant role in cell death, therefore the cells were thought to be more susceptible to cell death following treatment with PIs. In conclusion, the drugs used, especially the PI showed some anticancer effects by facilitating cell death through decreased gene and protein expression of MUC1 and P65 and present promising agents for cancer treatment.

Keywords: cervical cancer, haart, MUC1, P65

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Authors: Jamboor K. Vishwanatha

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Among the potent anti-cancer agents, curcumin has been found to be very efficacious against various cancer cells. Despite multiple medicinal benefits of curcumin, poor water solubility, poor physiochemical properties and low bioavailability continue to pose major challenges in developing a formulation for clinical efficacy. To improve its potential application in the clinical area, we formulated poly lactic-co-glycolic acid (PLGA) nanoparticles. The PLGA nanoparticles were formulated using solid-oil/water emulsion solvent evaporation method and then characterized for percent yield, encapsulation efficiency, surface morphology, particle size, drug distribution within nanoparticles and drug polymer interaction. Our studies showed the successful formation of smooth and spherical curcumin loaded PLGA nanoparticles with a high percent yield of about 92.01±0.13% and an encapsulation efficiency of 90.88±0.14%. The mean particle size of the nanoparticles was found to be 145nm. The in vitro drug release profile showed 55-60% drug release from the nanoparticles over a period of 24 hours with continued sustained release over a period of 8 days. Exposure to curcumin loaded nanoparticles resulted in reduced cell viability of cancer cells compared to normal cells. We used a novel non-covalent insertion of a homo-bifunctional spacer for targeted delivery of curcumin to various cancer cells. Functionalized nanoparticles for antibody/targeting agent conjugation was prepared using a cross-linking ligand, bis(sulfosuccinimidyl) suberate (BS3), which has reactive carboxyl group to conjugate efficiently to the primary amino groups of the targeting agents. In our studies, we demonstrated successful conjugation of antibodies, Annexin A2 or prostate specific membrane antigen (PSMA), to curcumin loaded PLGA nanoparticles for targeting to prostate and breast cancer cells. The percent antibody attachment to PLGA nanoparticles was found to be 92.8%. Efficient intra-cellular uptake of the targeted nanoparticles was observed in the cancer cells. These results have emphasized the potential of our multifunctional curcumin nanoparticles to improve the clinical efficacy of curcumin therapy in patients with cancer.

Keywords: polymeric nanoparticles, cancer therapy, sustained release, curcumin

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Authors: Ridwaan N. Milase, Leonardo J. Van Zyl, Marla Trindade

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American foulbrood (AFB) is the world’s most devastating honeybee disease that has drastically reduced the population of Apis mellifera capensis since 2009. The outbreak has jeopardized the South African bee keeping industry as well as the agricultural sector dependent on honeybees for honey production and pollination, leading to significant economic losses. AFB is caused by Paenibacillus larvae, a spore-forming, Gram positive facultative anaerobic and flagellated bacterium. The use of antibiotics within beehives has selected for resistant strains of P. larvae, while the current practice of burning spore contaminated beehives and equipment contributes to the economic losses in the honeybee-keeping industry. Therefore, phage therapy is proposed as a promising alternative to combat P. larvae strains affecting A. mellifera capensis. The genomes of two P. larvae strains isolated from infected combs in the Western Cape have been sequenced and annotated using bioinformatics tools. Genome analyses has revealed that these P. larvae strains are lysogens to more than 6 different prophages and possess different type of clustered regularly interspaced short palindromic repeat (CRISPRs) regions per strain. Active prophages from one of the two P. larvae strains were detected and identified using PCR. Electron microscopy was used to determine the family of the identified active prophages. Lytic bacteriophages that specifically target the two P. larvae strains were purified from sewage wastewater, beehive materials, and soil samples to investigate their potential development as anti-P. larvae agents. Another alternative treatment being investigated is the development of a prophage endolysin cocktail. Endolysin genes of the prophages have been targeted, cloned and expressed in Escherichia coli. The heterologously expressed endolysins have been purified and are currently being assessed for their lytic activity against P. larvae strains and other commensal microorganisms that compose the honeybee larvae microbiota. The study has shown that phage therapy and endolysins have a great potential as alternative control methods for AFB disease affecting A. mellifera capensis.

Keywords: American foulbrood, bacteriophage, honeybee, Paenibacillus larvae

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Authors: Madeline Foster

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Since the COVID-19 pandemic, telehealth usage for the delivery of psychotherapy has surged. The evidence base evaluating the success of telehealth interventions continues to grow, with both benefits as well as potential risks identified. This study compared two recent randomized clinical trials (RCTs) from Sweden that looked at the effectiveness of Cognitive Behavioral Therapy (CBT) delivered via telehealth (TH) versus face-to-face (FTF) for individuals with Obsessive Compulsive Disorder (OCD). The papers had mixed results. The first paper by Aspvall and colleagues compared the effect of a therapist-supported, internet-delivered stepped-care CBT program for children and adolescents aged 7 to 17 with face-to-face CBT (2021). In Aspvall’s study, the control scored a mean Y-BOCS of 10.57 and the TH intervention group scored a mean Y-BOCS of 11.57. The mean difference (0.91) met the criteria for noninferiority (p = 0.03). The second study by Lundström and colleagues also compared therapist-supported, internet-based CBT with FTF CBT for the treatment of those with DSM-5-diagnosed OCD. Conversely, while Lundström’s study reported improved symptoms across all groups, at follow up the difference in symptom severity between FTF and TH was clinically significant, with 77% of FTF participants responding to treatment compared to only 45% of TH participants. Due to the methodological limitations of Lundström’s study, it was concluded that Aspvall’s paper made a stronger scientific argument.

Keywords: telehealth, Sweden, RCT, cognitive-behavioral therapy, obsessive-compulsive disorder

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Authors: Sheila R. Pai, N. K. Subbalakshmi, C. Vidya

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Background: Accumulating evidence from prospective studies suggests an increased risk of type 2 diabetes associated with sleep deprivation and sleep disorders. Shift work by disrupting the circadian rhythm, could possibly cause metabolic disturbances. Objective: To investigate the influence of shift work on fasting blood glucose in hospital workers population. Materials and Methods: This was a cross-sectional study including 90 night shift workers (study group) and 90 day workers (controls) drawn from paramedical personnel. Night shift work was on a forward rotation basis, with an average of one night shift every 4 weeks. Each night shift rotation was for a period of 7 days, with a total of 8 hours of shift work per night. In the entire subjects body mass index (BMI) and fasting blood sugar (FBS) was measured. Statistical analysis included unpaired t test, Mann-Whitney ‘U’ test and Chi-square test. P value less than 0.05 was considered significant. Result: The study and control groups were comparable with regard to age, sex distribution and duration of employment. FBS was higher in study group compared to controls (p < 0.0001). There was no significant difference in BMI between control and study group. Conclusion: Shift work may adversely influence glucose metabolism.

Keywords: shift work, fasting blood sugar, sleep disturbances, diabetes

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Authors: Magdy I. A. Alshourbagi

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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.

Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)

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Authors: K. W. Lee, C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, L. Y. Chan, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

Abstract:

QR (Quick Response) Code is a matrix barcode. It enables users to open websites, photos and other information with mobile devices by just snapping the code. In usual Long Term Oxygen Therapy arrangement, piles of LTOT related information like leaflets from different oxygen service providers are given to patients to choose an appropriate plan according to their needs. If these printed materials are transformed into electronic format (QR Code), it would be more environmentally-friendly. More importantly, electronic materials including LTOT equipment operation and dyspnoea relieving techniques also empower patients in long-term disease management. The objective to this study is to investigate the effect of QR code in patient education on new LTOT users. This study was carried out in medical wards of North District Hospital. Adult patients and relatives who followed commands, were able to use smartphones with internet services and required LTOT arrangement on hospital discharge were recruited. In LTOT arrangement, apart from the usual LTOT education booklets which included patients’ personal information (e.g. oxygen titration and six-minute walk test results etc.), extra leaflets consisted of 1. QR codes of LTOT plans from different oxygen service providers, 2. Education materials of dyspnoea management and 3. Instructions on LTOT equipment operation were given. Upon completion of LTOT arrangement, a questionnaire about the use of QR code on patient education was filled in by patients or relatives. A total of 10 new LTOT users were recruited from November 2017 to January 2018. Initially, 70% of them did not know anything about the QR code, but all of them understood its operation after a simple demonstration. 70% of them agreed that it was convenient to use (20% strongly agree, 40% agree, 10% somewhat agree). 80% of them agreed that QR code could facilitate the retrieval of more LTOT related information (10% strongly agree, 70% agree) while 90% agreed that we should continue delivering QR code leaflets to new LTOT users in the future (30% strongly agree, 40% agree, 20% somewhat agree). It is proven that QR code is a convenient and environmentally-friendly tool to deliver information. It is also relatively easy to be introduced to new users. It has received welcoming feedbacks from current users.

Keywords: long-term oxygen therapy, physiotherapy, patient education, QR code

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Authors: B. B. S. Pereira, M. O. Souza, L. P. Zanetti, L. C. S. Oliveira, J. R. P. Moreno, M. P. Souza, V. R. Colturato, C. M. Machado

Abstract:

Background: The introduction of prophylactic or preemptive therapies has effectively decreased the CMV mortality rates after hematopoietic stem cell transplantation (HSCT). CMV antigenemia (pp65) or quantitative PCR are methods currently approved for CMV surveillance in pre-emptive strategies. Commercial assays are preferred as cut-off levels defined by in-house assays may vary among different protocols and in general show low reproducibility. Moreover, comparison of published data among different centers is only possible if international standards of quantification are included in the assays. Recently, the World Health Organization (WHO) established the first international standard for CMV detection. The real time PCR COBAS Ampliprep/ CobasTaqMan (CAP/CTM) (Roche®) was developed using the WHO standard for CMV quantification. However, the cut-off for the introduction of antiviral has not been determined yet. Methods: We conducted a retrospective study to determine: 1) the sensitivity and specificity of the new CMV CAP/CTM test in comparison with pp65 antigenemia to detect episodes of CMV infection/reactivation, and 2) the cut-off of viral load for introduction of ganciclovir (GCV). Pp65 antigenemia was performed and the corresponding plasma samples were stored at -20°C for further CMV detection by CAP/CTM. Comparison of tests was performed by kappa index. The appearance of positive antigenemia was considered the state variable to determine the cut-off of CMV viral load by ROC curve. Statistical analysis was performed using SPSS software version 19 (SPSS, Chicago, IL, USA.). Results: Thirty-eight patients were included and followed from August 2014 through May 2015. The antigenemia test detected 53 episodes of CMV infection in 34 patients (89.5%), while CAP/CTM detected 37 episodes in 33 patients (86.8%). AG and PCR results were compared in 431 samples and Kappa index was 30.9%. The median time for first AG detection was 42 (28-140) days, while CAP/CTM detected at a median of 7 days earlier (34 days, ranging from 7 to 110 days). The optimum cut-off value of CMV DNA was 34.25 IU/mL to detect positive antigenemia with 88.2% of sensibility, 100% of specificity and AUC of 0.91. This cut-off value is below the limit of detection and quantification of the equipment which is 56 IU/mL. According to CMV recurrence definition, 16 episodes of CMV recurrence were detected by antigenemia (47.1%) and 4 (12.1%) by CAP/CTM. The duration of viremia as detected by antigenemia was shorter (60.5% of the episodes lasted ≤ 7 days) in comparison to CAP/CTM (57.9% of the episodes lasting 15 days or more). This data suggests that the use of antigenemia to define the duration of GCV therapy might prompt early interruption of antiviral, which may favor CMV reactivation. The CAP/CTM PCR could possibly provide a safer information concerning the duration of GCV therapy. As prolonged treatment may increase the risk of toxicity, this hypothesis should be confirmed in prospective trials. Conclusions: Even though CAP/CTM by ROCHE showed great qualitative correlation with the antigenemia technique, the fully automated CAP/CTM did not demonstrate increased sensitivity. The cut-off value below the limit of detection and quantification may result in delayed introduction of pre-emptive therapy.

Keywords: antigenemia, CMV COBAS/TAQMAN, cytomegalovirus, antiviral cut-off

Procedia PDF Downloads 192

Authors: Lik Hang Gary Wong

Abstract:

Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

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Authors: Trevor R. Higgins

Abstract:

To speed/enhance recovery from sport, cold water immersion (CWI) and contrast water therapy (CWT) have become common practice within the high-level team sport. Initially, research into CWI and CWT protocols and recovery was sparse; athletes relied solely upon an anecdotal support. However, an increase into recovery research has occurred. A number of reviews have subsequently been conducted to clarify scientific evidence. However, as the nature of physiological stress and training status of participants will impact on results, an opportunity existed to narrow the focus to a more exacting review evaluating hydrotherapy for recovery in a team sport. A Boolean logic [AND] keyword search of databases was conducted: SPORTDiscus; AMED; CINAHL; MEDLINE. Data was extracted and the standardized mean differences were calculated with 95% CI. The analysis of pooled data was conducted using a random-effect model, with Heterogeneity assessed using I2. 23 peer reviewed papers (n=606) met the criteria. Meta-analyses results indicated CWI was likely beneficial for recovery at 24h (Countermovement Jump (CMJ): p= 0.05, CI -0.004 to 0.578; All-out sprint: p=0.02, -0.056 to 0.801; DOMS: p=0.08, CI -0.092 to 1.936) and at 72h (accumulated sprinting: p=0.07, CI -0.062 to 1.209; DOMS: p=0.09, CI -0.121 to 1.555) following team sport. Whereas CWT was likely beneficial for recovery at 1h (CMJ: p= 0.07, CI -0.004 to 0.863) and at 48h (fatigue: p=0.04, CI 0.013 to 0.942) following team sport. Athlete’s perceptions of muscle soreness and fatigue are enhanced with CWI and/or CWT, however even though CWI and CWT were beneficial in attenuating decrements in neuromuscular performance 24 hours following team sport, indications are those benefits were no longer Sydney evident 48 hours following team sport.

Keywords: cold water immersion, contrast water therapy, recovery, team sport

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Authors: Baratali Monfaredraz

Abstract:

The concept of justice has been able to occupy a lot of people’s minds and speeches for a long time. Justice has various dimensions such as economic justice, judicial justice, political justice, educational justice, ethnical justice and etc. Educational justice as one of the most basic dimensions of justice can alter our education in every field and it can flourish the talents and capabilities on macro level. One of the most efficient ways for social justice realization is to provide equal opportunities for all people in the society to be able to access equally to education as their human rights since today how progress occurs in education is regarded as the index of social development. On this basis, especially developing countries try to provide equal opportunities for all people in terms of access to education, specifically in higher education. At present, private education system violates the principles of conducting effort, meeting the needs and in part realizing the capabilities and so it cannot be justified to be a fair conductance. It seems that providing higher quality education in public schools and lowering role of teacher and educational facilities in educational achievement can be considered as a proper way to remove the discrimination in terms of unequal distribution of educational facilities. In addition, higher education development in deprived regions can initialize social activities among the inhabitants of these regions. Justice in educational field can result in access of all people to economic and social situations and job opportunities in future.

Keywords: educational justice, deprivation, private schools, higher education, job opportunities

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Authors: Laura Ulitzky, Dougbeh-Chris Nyan, Manuel M. Lafer, Erica Silberstein, Nicoleta Cehan, Deborah R. Taylor

Abstract:

Hepatitis C virus (HCV)-associated hepatocellular carcinoma, fibrosis and cirrhosis are more frequent in men and postmenopausal women than in premenopausal women and women receiving hormone replacement therapy, suggesting that β-estradiol (estrogen) plays an innate role in preventing viral infection and liver disease. Estrogen classically acts through nuclear estrogen receptors or, alternatively, through the membrane-bound G-protein-coupled estrogen receptor (GPR30 or GPER). We observed a marked decrease in detectable virus when HCV-infected human hepatoma cells were treated with estrogen. The effect was mimicked by both Tamoxifen (Tam) and G1, a GPR30-specific agonist, and was reversed by the GPR30-specific antagonist, G15. Through GPR30, estrogen-mediated the down-regulation of occludin; a tight junction protein and HCV receptor, by promoting activation of matrix metalloproteinases (MMPs). Activated MMP-9 was secreted in response to estrogen, cleaving occludin in the extracellular Domain D, the motif required for HCV entry and spread. This pathway gives new insight into a novel innate immune pathway and the disparate host-virus responses to HCV demonstrated by the two sexes. Moreover, these data suggest that hormone replacement therapy may have beneficial antiviral properties for HCV-infected postmenopausal women and show promise for new antiviral treatments for both men and women.

Keywords: HCV, estrogen, occludin, MMPs

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Authors: S. Wiak, L. Szymanski, Z. Kolacinski, G. Raniszewski, L. Pietrzak, Z. Staniszewska

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The term ‘cancer’ is given to a collection of related diseases that may affect any part of the human body. It is a pathological behaviour of cells with the potential to undergo abnormal breakdown in the processes that control cell proliferation, differentiation, and death of particular cells. Although cancer is commonly considered as modern disease, there are beliefs that drastically growing number of new cases can be linked to the extensively prolonged life expectancy and enhanced techniques for cancer diagnosis. Magnetic hyperthermia therapy is a novel approach to cancer treatment, which may greatly contribute to higher efficiency of the therapy. Employing carbon nanotubes as nanocarriers for magnetic particles, it is possible to decrease toxicity and invasiveness of the treatment by surface functionalisation. Despite appearing in recent years, magnetic particle hyperthermia has already become of the highest interest in the scientific and medical environment. The reason why hyperthermia therapy brings so much hope for future treatment of cancer lays in the effect that it produces in malignant cells. Subjecting them to thermal shock results in activation of numerous degradation processes inside and outside the cell. The heating process initiates mechanisms of DNA destruction, protein denaturation and induction of cell apoptosis, which may lead to tumour shrinkage, and in some cases, it may even cause complete disappearance of cancer. The factors which have the major impact on the final efficiency of the treatment include temperatures generated inside the tissues, time of exposure to the heating process, and the character of an individual cancer cell type. The vast majority of cancer cells is characterised by lower pH, persistent hypoxia and lack of nutrients, which can be associated to abnormal microvasculature. Since in healthy tissues we cannot observe presence of these conditions, they should not be seriously affected by elevation of the temperature. The aim of this work is to investigate the influence of iron content in iron filled Carbon Nanotubes on the desired nanoparticles for cancer therapy. In the article, the development and demonstration of the method and the model device for hyperthermic selective destruction of cancer cells are presented. This method was based on the synthesis and functionalization of carbon nanotubes serving as ferromagnetic material nanocontainers. The methodology of the production carbon- ferromagnetic nanocontainers (FNCs) includes the synthesis of carbon nanotubes, chemical, and physical characterization, increasing the content of a ferromagnetic material and biochemical functionalization involving the attachment of the key addresses. The ferromagnetic nanocontainers were synthesised in CVD and microwave plasma system. The research work has been financed from the budget of science as a research project No. PBS2/A5/31/2013.

Keywords: hyperthermia, carbon nanotubes, cancer colon cells, radio frequency field

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Authors: Zeinab. Shahrokhifar, Abolfazl Meshkini, Seyed Ali. Alavi

Abstract:

Considering the different dimensions of deprivation, housing supply is noted as a basic requirement in Iran after 1979 (coming to work of the new government). The government had built the constitution and obliged to meet this need in the form of five-year development programs in Iran’s provinces. This study focused on the adaptive analysis of housing policies in these five development programs in Kermanshah province located in western Iran. Our research is divided into two different analytical sections. In the first section, we collected the documentary information using approved plans and field studies. In the second section, a questionnaire was prepared and designed for the elite community (30) to support the documentary analysis. The results showed that various projects adopted in the form of strategic plans and implemented the policies included both quantitative and qualitative housing in Kermanshah province after 1979. The quality of housing, from the first to the fifth development plans has improved the situation in the housing indicators. The quantity of housing units for households has also been implemented through various policies that has desired results. The sequences of housing policies and plans do not overlap in the five development programs. According to the radar graph, the development programs overlapped in some policies, which shows the continuation of the previous policies, but this overlap is not perfect.

Keywords: law enforcement policy, housing policy, development programs, housing indicators, the city of Kermanshah

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Authors: Amany Mohamed, Alaa Balbaa, Magdoline Mishel

Abstract:

Background: Pain in the neck or scapular region is one of the most frequent symptoms in cervical radiculopathy, which is commonly caused by degenerative process in the spine. Purpose: To determine the effect of scapular stabilization exercises in the treatment of chronic neck pain regarding pain and disability and limitation in the range of motion. Patients and Methods: Thirty male and female patients with chronic neck pain were involved. Aged between 30-50 years old. They were randomly assigned into two groups. In group (A), patients received physical therapy program in the form of infrared, transcutaneous electrical nerve stimulation (TENS), Stretching and cervical stabilization exercises. In group (B), patients received scapular stabilization exercises in addition to the same physical therapy program. Treatment was given 3 times a week for 4 weeks. Range of motion of the cervical spine, range of motion of the scapula, neck pain and disability were assessed before and after treatment. Results: There was significant improvement in both groups (A and B) in cervical range of motion, pain and disability. Group (B) showed more significant improvement than group (A) in cervical range of motion and pain and disability. There was no significant improvement in both groups in scapular range of motion. Conclusion: Scapular stabilization exercises should be used as an integral part in the rehabilitation program

Keywords: Neck pain, neck stabilization exercise, scapular stabilization exercise, chronic neck pain

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Authors: Amina Omer, Ikram Elsiddig

Abstract:

Arctostaphylos uvaursi is a plant of the family Ericaceae, it’s used in skin care products mostly for its depigmenting action, due to the presence of hydroquinones that are well known inhibitors of tyrosinase, an enzyme involved in melanin biosynthesis in humans. The main hydroquinone found within the A. uvaursi is arbutin, which is found with varying percentage within the plant depending on the season, and area from which the plant is harvested. An in vitro experiment has shown that the arbutin found within the bearberry leaf extract inhibited the biosynthesis of melanin in human melanoma cells and in three-dimensional human skin model. Madurella mycetomatis is filamentous fungus that causes the fungal form of mycetoma known as eumycetoma, with existing anti-fungals and surgery, only 35% of people living eumycetoma are treated, M. mycetomatis has been found to shield itself against the antifungal therapy through the production of melanin decreasing the effectiveness of the therapy, therefore there is a need for a new and more effective therapy. The aim of the study was to investigate and compare the effect of arbutin powder and aqueous extract of A. uvaursi containing arbutin on the biosynthesis of melanin by M. mycetomatis. The experiment was carried out by culturing M. mycetomatis on minimal media composed of 2% agar, 15 mM glucose, 10 mM MgSO4, 29.4 mM KH2PO4, 13 mM glycin and 80mg/l gentamicin, the media was supplied with different concentration of arbutin solution (5, 25 50,and 75mg) and aqueous extract of A. uvaursi to contain arbutin with concentrations (5, 25 50,and 75mg), the plates were incubated for two month and the result was observed by the naked eye. The results revealed that the arbutin powder had an inhibitory effect on melanin synthesis by M. mycetomatis that correlated with its established inhibitory effect on melanin synthesis in humans. The inhibitory effect of arbutin on melanin synthesis by M. mycetomatis was found to be dose dependent. A. uvaursi aqueous leaf extract containing arbutin was also found to decrease melanin production by M. mycetomatis, however plates containing high concentrations of aqueous extract couldn’t be assessed for its melanin inhibitory effect due to the high content of carbohydrates in the extract that promoted the growth of fungi Asperigullus niger rendering the plates unsuitable for visual inspection. In conclusion inhibition of melanin synthesis was observed on the arbutin powder as well as the aqueous extract containing arbutin. A. uvaursi is known to exhibit anti-inflammatory activity, which can aid in wound healing that is beneficial in the chronic inflammation caused by M. mycetomatis.

Keywords: arbutin, arctostaphylos, Madurella, melanin

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Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

Abstract:

Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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Authors: Chro Kavian

Abstract:

The studies conducted show that cancer is a disease caused by populations of microbes, a notion gaining traction as the interaction between the human microbiome and the tumor microenvironment (TME) increasingly shows how environment and microbes dictate the progress and treatment of neoplastic diseases. A person’s human microbiome is defined as a collection of bacteria, fungi, viruses, and other microorganisms whose structure and composition influence biological processes like immune system modulation and nutrient metabolism, which, in turn, affect how susceptible a person is to neoplastic diseases, and response to different therapies. Recent reports demonstrated the influence specific microbiome bacterial populations have on the TME, thereby altering tumoral behaviors and the TME’s contributing factors that impact patients' lives. In addition, gut microbes and their SCFA products are important determinants of the inflammatory landscape of tumors and augment anti-tumor immunity, which can influence immunotherapy outcomes. Studies have also found that dysbiosis, or microbial imbalance, correlates with biological processes such as cancer progression, metastasis, and therapy resistance, leading scientists to explore the use of microbiome deficiencies as adjunctive approaches to chemotherapy and other, more traditional treatments. Nonetheless, mental health practitioners struggling to comprehend the existent gap between cancer patients with pronounced resolutive capabilities and the profound clinical impact Microbiome-targeted cancer therapy has been proven to possess.

Keywords: microbiome, cancer, tumor, immune system

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Authors: Roni Rachel Mendelson, Caileigh Pudela

Abstract:

Bacillus cereus is a toxin-producing, facultatively anaerobic gram-positive bacterium that is widely distributed environmentally. It can quickly multiply at room temperature with an abundantly present preformed toxin. When ingested, this toxin can cause gastrointestinal illness, which is the commonly known manifestation of the disease. Bacillus cereus sepsis is a disease that is mostly concerning in the population of the immunocompromised patients. One of them is acute lymphoblastic leukemia’s patients during induction. Pediatric acute lymphoblastic leukemia is a common pediatric hematologic malignancy. It is characterized by the rapid proliferation of poorly differentiated lymphoid progenitor cells inside the bone marrow. We present here a 21-month-old boy undergoing induction chemotherapy for acute lymphoblastic leukemia who developed bacillus sepsis bacteremia and, as a result, multi organ failure leading to seizures and multiple strokes. Our case report highlights the extensive overall and neurological damage that can be caused because of bacillus cereus bacteremia, which can lead to higher mortality rate and decreased in survivorship in a highly curable disease. It is very subtle and difficult to recognize and appears to be deteriorating extremely fast. There should be a low threshold for work up and empiric coverage for neutropenic patients during acute lymphoblastic leukemia induction therapy.

Keywords: acute lymphoblastic leukemia, bacillus cereus, immunocompromised, sepsis

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Authors: Izabela Zielinska

Abstract:

Kinesio Taping is classified as physiotherapy method supporting rehabilitation and modulating some physiological processes. It is commonly used in sports medicine and orthopedics. This sensory method has influence on muscle function, pain sensation, intensifies lymphatic system as well as improves microcirculation. The aim of this study was to assess the effect of Kinesio Taping in patients with ongoing treatment of peripheral artery disease (PAD). The study group comprised 60 patients (stadium II B at Fontain's scale). All patients were divided into two groups (30 person/each), where 12 weeks long treadmill training was administrated. In the second group, the Kinesio Taping was applied to support the function of the gastrocnemius muscle. The measurements of distance and time until claudication pain, blood flow of arteries in lower limbs and ankle brachial index were taken under evaluation. Examination performed after Kinesio Taping therapy showed statistically significant increase in gait parameters and muscle strength in patients with intermittent claudication. The Kinesio Taping method has clinically significant effects on enhancement of pain-free distance and time until claudication pain in patients with peripheral artery disease. Kinesio Taping application can be used to support non-invasive treatment in patients with intermittent claudication. Kinesio Taping can be employed as an alternative way of therapy for patients with orthopedic or cardiac contraindications to be treated with treadmill training.

Keywords: intermittent claudication, kinesiotaping, peripheral artery disease, treadmill training

Procedia PDF Downloads 206