Clinical Efficacy In Treatment Research Articles

Exploring the Protective Efficacy of Topical Products for Actinic Keratosis Against Ultraviolet-Induced DNA and Protein Damage: An Experimental, Double-Blind Irradiation Study.

Introduction Numerous studies have delved into the clinical efficacy of different topical treatments for actinic keratosis (AK). However, our understanding remains limited regarding their capacity to prevent DNA and protein damage caused by ultraviolet radiation (UVR). Objectives The aim of this study was to analyze and compare the preventive capabilities of various AK-targeted products in countering DNA and protein alterations in human biopsies following exposure to experimental UVR. Methods Twelve healthy Caucasian volunteers (six men and six women) aged 18 years and above, with Fitzpatrick skin types II-III, participated in an experimental irradiation study. Six topical products, containing various ingredients (DNA repair enzymes, antioxidants, keratolytic agents, cyclooxygenase inhibitors, and/or sunscreens) were tested. The experimental sites were exposed to UVR at six times the minimal erythema dose for eight consecutive days. Each test product was applied 30 to 45 minutes before irradiation at a standard thickness of 2 mg/cm2. A control site was treated with the vehicle alone, serving as a negative control. The study focused on cyclobutane pyrimidine dimers (CPDs) and protein carbonylation (PC) as molecular markers of UVR-induced DNA and protein damage, respectively. Results The efficacy of different AK-targeted topical products showed substantial variation when applied to normal skin before experimental exposure to UVR. While sunscreens, predictably, played a crucial role, additional ingredients (i.e., DNA repair enzymes and antioxidants) also acted as vital protective agents for both the cellular genome and proteome, shielding them against UVR-induced damage. Conclusion In topical products specifically designed for AK, the strategic integration of DNA repair enzymes and antioxidants, in addition to sunscreens, establishes a critical defense mechanism against the detrimental effects of UVR on cellular DNA and proteins.

Efficacy and Safety of Dupilumab in Older Patients (Aged 80 Years and Above) with Atopic Dermatitis: A Prospective Study.

Atopic dermatitis presents unique challenges in the older population owing to age-related changes in skin barrier function and immune regulation. However, there is limited evidence on the efficacy and safety of dupilumab, an anti-interleukin-4Rα monoclonal antibody, in patients with atopic dermatitis aged 80 years and above. We aimed to assess the clinical efficacy and safety of dupilumab treatment in patients with atopic dermatitis aged 80 years and above. Twenty-eight older patients received dupilumab and were evaluated based on several clinical parameters, including the Eczema Area and Severity Index (EASI), Numeric Rating Scale (NRS), Dermatology Life Quality Index (DELI), and AD Control Tool (ACT). Safety assessments and monitoring of concomitant medication use were conducted. Twenty-six patients completed 16 weeks of treatment, 13 completed 28 weeks, and two completed more than 36 weeks. Dupilumab treatment resulted in a significant improvement in atopic dermatitis symptoms after 16 weeks as demonstrated by reduced EASI, NRS, DLQI, and ADCT scores. Dupilumab had no significant impact on underlying diseases or medication use. No common adverse reactions, such as conjunctivitis and erythema of the face and neck, were identified. Among the 26 patients receiving dupilumab treatment during the COVID-19 pandemic, 17 remained uninfected or experienced milder COVID-19 symptoms than experienced in the general population. Dupilumab treatment showed significant efficacy in improving atopic dermatitis symptoms in patients aged 80 years and above with a high level of safety. Larger long-term clinical trials are needed to validate these results and provide further evidence for the use of dupilumab in older patients with atopic dermatitis.

Three-Dimensional Digital Technology: A Powerful Assistant for the Reconstruction of Complex Craniofacial Deformities.

Three-dimensional digital technology has been widely applied in craniofacial surgeries, particularly in conventional procedures such as facial contouring and orthognathic surgery. To some extent, the process has already been standardized. As to reconstruction surgeries of complex craniofacial deformity, however, surgical plans need to be patient-specific. Traditionally, individualized surgical treatment largely relies on the surgeon's clinical experience. The application of digital technology mainly focuses on preoperative planning and postoperative evaluation of surgical outcomes rather than intraoperative patient-specific implants or osteotomy guides. For patients with complex craniofacial deformities, requirements for accurate 3-dimensional digital technology can be much higher. This study presents a favorable surgical reconstruction of the severe craniofacial deformity using 3-dimensional digital technology, providing references for craniofacial surgeons, which could be beneficial to clinical practice and treatment efficacy.

Linking environmental pressures and trait emotional intelligence to eating symptomatology: the mediating role of unhealthy body self-perceptions

ABSTRACT Objective Research showed that trait emotional intelligence (trait EI), pressures from family, peers and media, and problematic perceptions of one’s body, are plausible antecedents for variation in the severity of eating disorders. This study examined the hypothesis that an association between pressures from one’s environment (peers, family, media), trait EI and eating pathology would be mediated by body uneasiness and appearance concern for one’s body. Method This online cross-sectional study enrolled a sample of 546 participants aged 18–24 years (M = 21.58; SD = 2.05), self-report questionnaires were administered to measure trait EI, environmental pressure, body uneasiness, appearance concern and eating disorder symptomatology. Results The results showed significant associations among trait EI, body uneasiness and appearance concern. Furthermore, significant links were found between environmental pressures, body uneasiness, appearance concern and eating disorders. Moreover, there was a significant association between body uneasiness and eating disorders and between appearance concern and eating disorders. Finally, indirect associations were found from trait EI to eating disorders by body uneasiness and appearance concern, and from environmental pressures to eating disorders by body uneasiness and appearance concern. Conclusions The study’s hypothesis was confirmed and suggested the importance of targeting image disturbances to improve the clinical efficacy of treatments for eating disorders.

Ménière's disease is a disorder of the inner ear.

Ménière's disease is a disorder characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and pressure in the ear. Its pathogenesis and optimal management continue to be the subject of ongoing debate. Although it is classically believed to be a primary disorder of the inner ear, some clinicians have hypothesized that it is a form of vestibular migraine. Evidence supporting vestibular migraine in the differential of Ménière's disease includes overlap of symptoms, high prevalence of migraines in patients with Ménière's disease, and the efficacy of migraine treatments for symptoms of Ménière's disease in some patients. However, there is far more evidence to support Ménière's disease as a disorder of the inner ear, including genetic and histologic changes of hydrops, imaging studies showing hydropic changes, predominance of low-frequency hearing loss, clinical efficacy of treatments targeted at inflammatory change/hydrops, and clinical efficacy of ablating the vestibular end-organ. Although there is conflicting evidence regarding the cause and treatment of Ménière's disease, current evidence favors it as a disorder of the inner ear. Further research is needed to fully understand the mechanisms of Ménière's disease and how to improve diagnosis and treatment outcomes.

Anti-inflammatory and biologic drugs for atopic dermatitis: a therapeutic approach in children and adolescents.

Atopic dermatitis (AD) is a chronic inflammatory disease with a heterogeneous pathogenesis correlated with dysregulation of the immune system and a prevalence of the T2-mediated immune pathway. Recent understanding of the pathogenesis of AD has allowed the development of new drugs targeting different mechanisms and cytokines that have changed the treatment approach. The aim of this review is to update knowledge on the standard of care and recent advancements in the control of skin inflammation. In light of recent guidelines, we report on the clinical efficacy of novel treatments, with special attention to situations where biologics and small molecules are involved.

A Novel Piezoelectric-Assisted Non-Surgical Periodontal Treatment: A Prospective Case Series.

The purpose of this study was to evaluate the clinical efficacy of a non-surgical periodontal treatment using a piezoelectric power-driven device with a novel insert. Plaque index (PlI), bleeding on probing (BoP), probing depth (PD), recession depth (Rec) and clinical attachment level (CAL) were assessed at 6 weeks, 3 months and 6 months. Furthermore, tooth mobility and furcation involvement were recorded and chewing discomfort and dental hypersensitivity were evaluated. Eighteen stage I to IV periodontitis patients providing 437 teeth and 2622 sites in total were analyzed. At six weeks, CAL gain (0.4; p < 0.0001), PD reduction (0.4; p < 0.0001) and Rec increase (0.1; p = 0.0029) were statistically significant. Similarly, the mean number of sites with PD > 4 mm and absence of BoP significantly decreased between baseline and 6 weeks (-12.7; p < 0.0001). At this time point, the patient's chewing discomfort was also significantly diminished (1.4; p = 0.0172). Conversely, no statistically significant changes were observed between 6 weeks and 3 months and between 3 months and 6 months for any of the clinical variables evaluated. In conclusion, within the limitation of this study, mechanical piezo-assisted non-surgical periodontal treatment in conjunction with an innovative tip resulted significantly efficacious to reduce pathological periodontal pockets, to gain clinical attachment and to reduce gingival inflammation.

Clinical efficacy in one-year treatment with Artemisia annua-SLIT drops in monosensitized and polysensitized individuals

PurposeSeasonal allergic rhinoconjunctivitis (SARC) caused by Artemisia seriously affects patients' quality of life in northern China. This study aimed to estimate further the efficacy and safety of a one-year course of Artemisia annua-sublingual immunotherapy (SLIT) on SARC patients. Materials and methodsThis was an open-label, randomized, controlled, single-centre study involving 150 SARC patients induced by Artemisia, randomized to SLIT group (n = 75, SLIT along with pharmacotherapy) or control group (n = 75, pharmacotherapy only). According to the skin prick test (SPT) results, the SLIT group was divided into monosensitized and polysensitized groups to analyze the influence of sensitization status on the efficacy of Artemisia annua-SLIT. The clinical indicators of this study were total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), combined scores of medication and rhinoconjunctivitis symptom (CSMRS), and score of visual analog scale (VAS). Safety was evaluated by the occurrence of adverse events (AEs). Daily administration of the drops was recorded in diaries by the patients. ResultsAfter nearly one year of treatment and follow-ups, there was a significant decline in TRSS, TMS, CSMRS, and VAS from the baseline scores in the SLIT group (p < 0.001). However, as pollen counts increased in 2022, indicators above in the control group increased significantly during the peak pollen phase (PPP) in 2022 grass pollen season (GPS) compared to the baseline. Meanwhile, we found no significant difference in TRSS, TMS, CSMRS, and VAS between the monosensitized and polysensitized groups (p > 0.05). Moreover, the result indicated that the clinical improvement in TRSS, TMS, CSMRS, and VAS was still observed in polysensitized patients who were allergic to Artemisia pollen and sensitized to house dust mite (HDM) (n = 15) in PPP of 2022, compared to the baseline value (p < 0.001). ConclusionArtemisia annua-SLIT was proven effective, tolerable and safe in patients with SARC after nearly one year of treatment, whether monosensitization or polysensitization.

Posterior endoscopic decompression combined with anterior cervical discectomy and fusion versus posterior laminectomy and fusion for multilevel cervical spondylotic myelopathy: a retrospective case-control study

ObjectiveTo compare the clinical efficacy of surgical treatment for multilevel cervical spondylotic myelopathy (MCSM) between the hybrid procedure, posterior endoscopic decompression (PED) combined with anterior cervical discectomy fusion (ACDF), and posterior cervical laminectomy and fusion (PCLF).MethodsA retrospective analysis was performed on 38 patients who received surgical treatment for MCSM from January 2018 to December 2021, including 19 cases in hybrid procedure group (13 males and 6 females), followed up for 10 to 22 (12.8 ± 10.3) months, and 19 cases in PCLF group (15 males and 4 females), followed up for 10 to 21 (11.7 ± 8.9) months. Perioperative information, including operation time, intraoperative blood loss, length of hospitalization, and complications, were compared between two groups. Visual analogue scale (VAS) of pain, neck disability index (NDI) and Japanese Orthopaedic Association (JOA) score were recorded to evaluate clinical efficacy. Cervical lordosis was calculated by radiographic examination.ResultsIntraoperative blood loss, length of hospital stay were less in hybrid group than PCLF group, while operation time is longer in hybrid group, with a statistically significant difference (p < 0.05). Increased lordosis was better in hybrid group. There was no significant difference in preoperative VAS, JOA and NDI at pre-operation and final follow-up between two groups. But at post-operation and final follow-up, VAS was less in hybrid group than PCLF group (p < 0.05). There were 2 cases of neurostimulation symptoms in hybrid group, 2 cases of C5 nerve root palsy, 2 cases of subcutaneous fat necrosis and 1 case of dural tear in PCLF group, and all patients relieved with symptomatic treatment.ConclusionThe hybrid procedure of PED combined with ACDF showed satisfied clinical outcome, with less intraoperative blood loss, shorter length of hospitalization and lower post-operative neck pain than PCLF. It is an effective surgical treatment for MCSM.

Predicting the clinical efficacy of JAK inhibitor treatment for patients with rheumatoid arthritis based on Fas+ T cell subsets.

Rheumatoid arthritis (RA) is a common autoimmune disease. Janus kinase inhibitors (JAKi) have been approved for the treatment of RA; however, the impact of JAKi on immune cells remains inconclusive. This study investigated the response of immune cells to JAKi treatment to identify biomarkers by which to evaluate and predict clinical outcomes. Blood samples were collected from RA patients before and after JAKi treatment for the analysis of immunophenotypes. Our results revealed that JAKi mainly inhibited Fas+ T cell subsets. The percentage changes of Th Fas+ and Naive Th Fas+ cells were positively correlated with the 28-joint Disease Activity Score with erythrocyte sedimentation rate (DAS28-ESR) values. Following treatment, moderate response (MR) RA patients presented a decrease in the number of Naive Th Fas+ cells (p = 0.0001). Initial percentages of 14 T cell and 20 B cell subsets were correlated with percentage changes in DAS28-ESR. Overall, 16 cell subsets presented significant differences between the non-response (NR) and MR groups. Excluding the multicollinearity of the immune cells, we constructed a JAKi treatment response prediction index (JRPI) using 5 subsets of T/B cells, the results of which were strongly correlated with percentage changes in DAS28-ESR (receiver operating characteristic curve of 1). Note that the NR group was clearly distinguished from the MR group (p = 0.0167). In conclusion, the efficacy of JAKi can be attributed mainly to the suppression of Fas+ T cell subsets. A positive correlation was shown between the therapeutic efficacy of JAKi and the percentage changes in both Th Fas+ cells and Naive Th Fas+ cells. Furthermore, the proposed JRPI could potentially be used as an indicator to predict the efficacy of JAKi prior to treatment in RA patients. These findings may contribute to the development of personalized treatment strategies for RA patients using JAKi.

Inflammatory myofibroblastic tumors: recent progress and future of targeted therapy.

An inflammatory myofibroblastic tumor is a rare component of bone and soft-tissue sarcomas that has distinct pathological features as a lymphoplasmacytic inflammatory infiltrate. As is the case for other non-small round cell sarcomas, surgical resection remains the standard treatment strategy for inflammatory myofibroblastic tumors, but recurrence is possible. Concerning systemic therapy, the available data for conventional chemotherapy (such as those of doxorubicin-based regimens) are limited, and case reports of anti-inflammatory inflammatory myofibroblastic tumor treatments describe some degree of symptom relief and efficacy against tumor progression. However, as more information about cancer genomics accumulates, the potential for molecularly targeted therapies for inflammatory myofibroblastic tumors has become more promising. Approximately half of inflammatory myofibroblastic tumors harbor anaplastic lymphoma kinase (ALK) fusion genes, and the other half could have potentially targetable fusion genes or mutations such as ROS1, NTRK and RET; case reports demonstrating the clinical efficacy of treatments targeted to inflammatory myofibroblastic tumor have been published, as have several prospective clinical trials. Few drugs are approved for the treatment of inflammatory myofibroblastic tumor, and most of them were approved for tumor-agnostic indications. Drugs that could be used for pediatric indications and dosing in inflammatory myofibroblastic tumor have also not been established. To provide effective targeted therapy for rare diseases such as inflammatory myofibroblastic tumor, it is necessary to obtain clinical evidence by designing and performing clinical trials and to find a path toward regulatory approval.

Clinical efficacy and imaging analysis for the surgical treatment of thoracolumbar infections in elderly patients: a retrospective study

Few reports have been conducted to comparing surgical results and safety evaluations between the different types of infections in geriatric patients with thoracolumbar infections. The aim of this study is to investigate the safety and efficacy of surgical treatment for thoracolumbar infections in elderly patients. 21 patients with pyogenic spondylodiscitis (PS) and 26 patients with tuberculous spondylodiscitis (TS) were enrolled in the study. All patients were treated using one-stage posterior debridement, decompression, and pedicle screw fixation. Comparison of operative safety parameters between the two groups. Clinical efficacy was evaluated using visual analogue scale (VAS) score, the American Spinal Injury Association (ASIA) grade, the short form (SF)-36 survey and Oswestry disability index (ODI) to determine patient quality of life pre- and post-operatively. Hospitalisation and intensive care unit duration in the PS group were significantly shorter than in the TS group (P < 0.05). The total incidence of post-operative complications for both groups was 44.7%. More complications occurred in the TS group, but the difference was not significant. The scores of VAS, ODI and SF-36 of all 47 patients were significantly improved compared with those before operation.The VAS and SF-36 scores (physical component) were significantly better in the PS group 6 months post-operatively, and the SF-36 (mental component) scores were significantly better in the PS group at the 1-year follow-up. Neurological status in both groups improved post-operatively, and 83% of patients reported satisfactory results based on the modified MacNab standard. Imaging results showed that bone graft fusion improved in both groups at 6 months, 1 year and at the final follow-up. One-stage posterior debridement, decompression, interbody fusion, and internal fixation can be considered a safe and effective method of treating spinal infections in the elderly. This method can improve nerve function, reconstruct spinal stability, and enhance the quality of life of elderly patients. Both PS and TS who underwent surgery achieve similar clinical and radiological results.

Retracted: Chemotherapy with a TP Regimen in Combination with Stereotactic Radiotherapy Could Significantly Optimize the Clinical Efficacy of NSCLC Treatment.

[This retracts the article DOI: 10.1155/2022/8495452.].

101-LB: Phase 3 Trial to Evaluate Efficacy and Safety of Gemigliptin and Dapagliflozin Dual Add-on Therapy to Metformin—SOLUTION 2 Study

Background: Type 2 diabetes mellitus (T2DM) patients inadequately controlled with metformin alone require an addition of other medications with complementary mechanism of action. Gemigliptin, a dipeptidyl peptidase-4 inhibitor, and Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, can be considered as additional options. In this clinical trial, efficacy and safety of treatment of gemigliptin and dapagliflozin were evaluated in T2DM patients inadequately controlled with metformin monotherapy. Method: Total 469 T2DM patients receiving treatment with stable metformin for ≥ 8 weeks before screening were randomized to gemigliptin and dapagliflozin (n=157) or gemigliptin (n =156) or dapagliflozin (n =156), respectively. The primary endpoint was the change in HbA1c at 24 weeks from baseline. Results: At 24-week treatment, the HbA1c change from baseline in dual add-on of gemigliptin and dapagliflozin showed a significant reduction (LS Mean -1.34%) compared to gemigliptin add on (-0.90%; difference -0.44% [95% CI -0.58% to -0.31%]) and dapagliflozin add on (-0.78%; difference -0.56% [95% CI -0.69% to -0.42%]). Most of the reported adverse events were mild with no episodes of severe hypoglycemia. Conclusion: This study demonstrated that triple therapy of gemigliptin and dapagliflozin dual add-on to metformin was effective and well tolerated in T2DM patients. Disclosure K. Park: None. K. Han: None. Y. Hwang: None. S. Moon: None. H. Cho: None. H. Yoo: None. S. Choi: None. S. Chon: None. K. Kim: None. T. Kim: None. J. Kang: None. C. Park: None. J. Won: None. S. Lee: Advisory Panel; LG Chem. Speaker's Bureau; Dong-A Pharm. Advisory Panel; CKD Pharm. Speaker's Bureau; Novo Nordisk, Lilly. Advisory Panel; Daiichi Sankyo. Speaker's Bureau; Boehringer Ingelheim Inc. N. Kim: None. E. Kang: None. D. Kim: None. S. Kim: None.

384 Ruxolitinib 1.5% cream efficacy data for moderate-to-severe chronic hand dermatitis: open-label trial 4-weeks interim analysis

Abstract Chronic hand dermatitis (CHD) is a common condition with a profound negative effect on patients’ quality of life (QoL) presenting with a wide range of clinical manifestations often involving a combination of erythema, edema, scaling, vesicles and fissuring with intense pruritus and pain. (i) The clinical heterogeneity reflects the complex, multifactorial pathophysiology, with irritant/allergic contact dermatitis and atopic dermatitis as predominant etiological subtypes. (ii) Treatment of CHD remains challenging with no FDA-approved medications; routine treatment options include avoidance of relevant allergens/irritants, emollients, topical corticosteroids, calcineurin inhibitors, phototherapy and systemic immunosuppressive medications. (iii) Providers and patients are often frustrated with unsatisfactory treatment options for CHD. (iv) Topical ruxolitinib, currently FDA-approved for vitiligo and AD, is a Jak1/Jak2 inhibitor that blocks the signaling pathway of several cytokines with a potential to block critical inflammation in CHD. An investigator-initiated, open-label, single-site study (NCT05293717) is currently ongoing to assess the clinical efficacy of 12-weeks treatment with ruxolitinib cream 1.5% in recalcitrant CHD. Here we report the results of an interim analysis after 4 weeks of treatment. This is the first study evaluating the efficacy of ruxolitinib on CHD. This study aims to investigate clinical efficacy and impact on quality of life after 4 weeks of treatment with ruxolitinib 1.5% in moderate-severe CHD. This is an open-label investigator-initiated trial in subjects with recalcitrant CHD. After a washout period, subjects (n = 15, age 18–75) applied ruxolitinib twice daily to the entire hands. Moisturizers were allowed if consistently used before and during the study. Subjects with positive PATCH test that could not avoid the antigen and subjects that reported prolonged contact with water were excluded. Subjects were not permitted to treat skin lesions outside of the hands with prohibited medications or the study drug. Clinical assessments include Investigator Global Assessment (IGA, 5-point scale: clear, almost clear, mild, moderate and severe), Hand Eczema Severity Index (HECSI, a validated scoring system that incorporates both the severity and extent of the disease across fingers, palms, dorsal hands and wrists [5]), Itch Numerical Rating Scale (NRS, average itch over the past 24 h) and change in QoL were assessed with Dermatology Life Quality Index (DLQI). The study drug diary, a prepopulated calendar for each month, records AM/PM drug application and average and worst itch on a scale of 0–10 over the past 24 h. Fourteen subjects (eight female; mean age 50 years) completed the first 4 weeks of treatment. Notably, all the subjects had previously failed topicals (corticosteroid and/or calcineurin inhibitors) and in some cases systemic (e.g. oral steroids, methotrexate and phototherapy) treatments. At baseline, all subjects had an IGA score ≥2 and moderate to severe HECSI score (mean ± SD: 55.7 ± 23.2). The average itch at baseline was moderate (NRS, mean ± SD: 5.5 ± 3.39). After 4 weeks of treatment, 79% of subjects had a ≥2-point reduction in IGA. One hundred percent subjects reached HECSI-50%, and 64% reached a HECSI-75 with a mean reduction in HECSI of 44 (P &amp;lt; 0.01). Seventy-one percent of subjects had a ≥2-point reduction and 57% of subjects had a ≥4-point improvement in average itch (NRS; P &amp;lt; 0.01). Interestingly, 75% of the subjects had a ≥2-point reduction in reported worst daily itch within the first week as noted in their study drug diary. The DLQI was significantly reduced (P &amp;lt; 0.01) in the first month. No treatment-related adverse events were reported, and no rescue medication was needed. Data from 4 weeks interim analysis are encouraging and suggest that ruxolitinib 1.5% may be an effective and well-tolerated treatment for moderate-severe CHD with significant impact on subject’s quality of life. Trial is ongoing to evaluate clinical outcomes at 12 weeks.

Quality of life of patients without teeth, which are prosthetized

BACKGROUND: High-quality rehabilitation of patients without teeth is one of the urgent problems in dentistry today. Owing to the growing number of older patients and the need for quality treatment, the most physiologically accurate complete removable dentures that meet the needs of patients and reduce negative effects after treatment must be manufactured.&#x0D; AIM: To determine and compare the effect of complete removable dentures, made by computer-aided design and computer-aided manufacturing methods, on the quality of life of patients without teeth.&#x0D; MATERIALS AND METHODS: The clinical study involved 60 older patients (aged 60 years) without upper and lower teeth. These patients were randomly divided into two equal groups. In the first group, removable dentures were manufactured using digital technologies. In the second group, removable dentures were made by traditional technology. The quality of life of all patients before and after treatment was evaluated using the OHIP-14 questionnaire.&#x0D; RESULTS: More positive assessments were noted in the change in the state after prosthetics with full removable dentures made by digital technology. With approximately total equal indicators of the questionnaire, the best values of the clinical effect were found in the digital technology for making prostheses with 3.74 versus 1.19. When comparing individual categories, eating problems, communication problems, everyday living problems, and clinical performance were markedly higher with digital manufacturing technology.&#x0D; CONCLUSION: The clinical efficacy of treatment with prostheses made using digital technology is on average approximately 3.14 times higher (p 0.001) than that in orthopedic rehabilitation using prostheses made by analog traditional technology. Thus, better clinical results are obtained in patients using prostheses made by the proposed technology for making complete removable dentures.

Efficacy of Chinese and Western Medicine on Endometritis in Dairy Cows: A Systematic Review and Meta-analysis

Endometritis is a frequent postpartum disease of dairy cows and inflicts considerable distress on the animals and costs to the dairy industry. This study evaluated the clinical efficacy of Chinese and Western Medicine combination treatments for dairy cow endometritis to provide a reference for the prevention and treatment of these infections. This analysis provides new information for veterinary medical research. We used the keywords ‘Chinese and Western Medicine, Traditional and Western Medicine, Chinese herbs, Traditional Chinese Medicine Traditional Medicine, Chinese, Zhong Yi Xue, Chinese Traditional Medicine, Chinese Medicine, Traditional, Endometritis, Metritis and Cow to assess relevant literature sources collected in CNKI, Wanfang, Vepsa, China Patent Information Network, PubMed, Web of Science and other domestic and foreign databases. We utilized Cochrane system instructions to perform a meta-analysis using RevMan 5. 3 and Stata 16.0 software. We identified 13 randomized clinical trials (RCT) involving 847 dairy cows including cows 435 treated with a combination of Chinese and Western Medicine and 412 cows treated with the Western Medicine approach. The effectiveness for the combination therapy was better than that of the control (antibiotic only) where the relative risk was 1.19 with 95% CI (1.12, 1.26) and Z =5.96, P less than 0.01. We found no significant heterogeneity between these studies (I2=0 less than 50%, P =0.50 less than 0.1) and publication bias was absent as investigated through funnel plots and the Egger regression model (P=0.197 greater than 0.05). These results indicated that although the Chinese herbal preparations differed between studies (n=13), when coupled with Western antibiotic treatments the animals recovered faster than did the control Western antibiotic treatments. These randomized control studies indicated that the efficacy of Chinese and Western Medicine on endometritis in dairy cows is greater than that of Western Medicine treatments.

Elexacaftor-tezacaftor-ivacaftor in patients with cystic fibrosis ineligible for clinical trials: a 24-week observational study.

Introduction: Seminal clinical trials with the triple combination of elexacaftor-tezacaftor-ivacaftor (ETI) demonstrated clinical efficacy in people with cystic fibrosis (pwCF) who carry at least one F508del mutation. However, due to exclusion criteria of these clinical trials, the effect of ETI was not studied in a substantial number of pwCF. Thus, we ran a single center trial to evaluate a clinical efficacy of ETI treatment in adult pwCF who were ineligible for enrollment in registration studies. Methods: PwCF on ETI with prior lumacaftor-ivacaftor therapy, severe airway obstruction, well-preserved lung function, or with airway infection with pathogens at risk of more rapid decline in lung function formed the study group, while all the others on ETI formed the control group. Lung function, nutritional status and sweat chloride concentration were assessed before and after initialization of ETI therapy over a 6-month period. Results: Approximately a half of the ETI-treated pwCF at the adult Prague CF center (49 of 96) were assigned to the study group. Their mean changes in body mass index ( + 1.04kg/m2) and in sweat chloride concentration (-48.4mmol/L) were similar to the control group ( + 1.02kg/m2; -49.7mmol/L), while the mean change in percent predicted forced expiratory volume in 1s (ppFEV1; + 10.3 points) was significantly lower than in the control group ( + 15.8 points) (p = 0.0015). In the subgroup analysis, pwCF with severe airway obstruction (ppFEV1 <40) and pwCF with well-preserved lung function (ppFEV1 >90) showed a less potential for improvement in lung function during the ETI treatment than controls (median change in ppFEV1 + 4.9 points and + 9.5 points, respectively). Conclusion: PwCF not eligible for inclusion in clinical trials demonstrated improvement in lung function and nutritional status following the initiation of treatment with the ETI combination. Moderate increase in ppFEV1 was observed in those with severe airway obstruction or well-preserved lung function.

Analysis of the Efficacy of Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation with Different Types/Grades of Modic Changes.

Percutaneous endoscopic interlaminar discectomy (PEID), one of the main techniques of spinal endoscopy, has achieved excellent results in treating lumbar disc herniation (LDH). However, its efficacy has not been systematically described in patients with LDH accompanied by Modic changes (MC). The purpose of this study was to observe the clinical efficacy of PEID treatment of LDH accompanied by MC. A total of 207 patients who underwent PEID surgery for LDH were selected. According to the existence and type of MC on preoperative lumbar magnetic resonance images (MRI), they were divided into normal group (no MC, n=117), M1 group (MC I, n=23), and M2 group (MC II, n=67). According to the severity of MC, they were divided into MA group (grade A, n=45) and MBC group (grade B and C, n=45). The visual analog scale (VAS) score, Oswestry disability index (ODI) score, Disc height index (DHI), Lumbar lordosis angle (LL) and modified Macnab criteria were used to assess clinical outcomes. Postoperative back pain and leg pain VAS scores and ODI scores were significantly improved in all groups compared with preoperative scores. Patients with MC showed a deterioration in postoperative back pain VAS scores and ODI scores as time went by, and postoperative DHI decreased significantly compared with preoperative. Postoperative LL did not change significantly in each group. There was no significant difference in complications, recurrence rate and excellent rate between the groups. Whether accompanied by MC or not, the efficacy of PEID for LDH was significant. However, postoperative back pain and functional status of patients with MC tend to deteriorate as time went by, especially those with type I or severe MC.

Возможности терапии острого оптического неврита, ассоциированного с герпесвирусной инфекцией

Purpose. To study the clinical efficacy of complex treatment of optic neuritis (ON) associated with herpesvirus infection (HVI), including immunotherapy methods. Material and methods. The study included 37 people (37 eyes) with acute ON associated with HVI. The scheme of treatment of patients included the supply of solutions to the optic nerve: dexamethasone in a decreasing pattern, Emoxypin 1 % 0.5 ml and Dicinon 12.5 % 0.5 ml through an irrigation system implanted in the retrobulbar space, in combination with the appointment neuroprotection drugs (Pikamilon and Semax) for 10 days. All patients were divided into 2 groups. The 1st group consisted of 17 patients who were treated only according to the method described above. The 2nd group consisted of 20 patients who additionally received Imunofan intramuscularly in the regimen and doses according to the manufacturer's instructions. Immunotherapy was carried out for 10–12 days. Results. Data analysis showed that the most significant positive dynamics was observed in patients of the 2nd group. Conclusion. The developed scheme of etiotropic and pathogenetic immunotherapy for herpesvirus ON allows to reduce the recovery time and improve the functional results of treatment in the absence of recurrence of the disease within 1 year of observation. Keywords: optic neuritis, herpes virus infection, corticosteroid therapy, immunotherapy