Different Methods Of Treatment Research Articles

Comparative study of different therapeutic methods on autoimmune

To investigate the effects of different methods of treatment, including tonifying the kidney, activating blood and soothing the liver, on mice with autoimmune premature ovarian failure (POF). After preparing ovarian antigen with the ovarian tissue of female BALB/C mice, POF in female BALB/C mice was induced by immunization injection of the ovarian antigen on multiple subcutaneous sites and two posterior soles. The mice were treated with Liuwei Dihuang Pill, Shaofu Zhuyu Granule, Chaihu Shugan Pill respectively after the third immunization. Levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E(2)), prolactin (PRL), testosterone (T), anti-ovarian antibodies (AOAb) and anti-zona pellucida antibody (aZP) in sera were analyzed by enzyme-linked immunosorbent assay. Compared with the normal group, the levels of serum FSH and LH were increased and the level of E(2) was decreased in the untreated group. AOAb and aZP positive rates in the untreated group were obviously higher than those in the normal group. Liuwei Dihuang Pill could significantly reduce the levels of FSH and LH and increase the level of E(2) as compared with the untreated group, but there were no significant differences in the AOAb and aZP positive rates. Shaofu Zhuyu Granule and Chaihu Shugan Pill could significantly reduce the positive rates of AOAb and aZP as compared with the untreated group, but no significant effect on the levels of FSH, LH and E(2) were observed. The drugs had no effects on serum contents of PRL and T. Tonifying the kidney method can recover the ovarian function in POF mice mainly by regulating the hormone levels. Activating blood and soothing the liver methods can improve the humoral immune function in POF mice.

Zwężenie podgłośniowe w ziarniniakowatości Wegenera – problem diagnostyczny i terapeutyczny

Wegener's granulomatosis (WG) is a disease caused by necrotising vasculitis of small and middle blood vessels of upper and lower respiratory tract and kidneys of unknown etiology. ENT symptoms develop in more than 90% of patients and tracheobronchial involvement occurs in about 20% of patients, most often as a subglottic stenosis. Subglottic stenosis occurs usually as a late complication of disease, but sometimes it may be an early isolated symptom. It is usually irregular, no longer than 2-4 cm and affects mucosa and submucosa but sometimes also cartilage. The diagnosis is based on clinical symptoms, X-ray of the chest, urine analysis, c-ANCA detection and histological examination of the granulation from the stenosis. The main treatment of subglottic stenosis in WG is a causal immunosuppressive treatment, however an equally important is a preservation of respiratory tract passage, because a dominant symptom in this form of WG is problem with breathing or even dyspnoea. In this publication basing on literature review different methods of treatment of laryngotracheal stenosis and its importance in WG are described and discussed. In literature presently less invasive operations are recommended. The treatment of choice is endoscopic treatment with repeated dilatations and injections of steroid into the stenosis. In big stenosis in immunologically active disease patient sometimes requires tracheotomy and after remission of disease and maturation of the subglottic scar laryngotracheal resection can be considered.

Treatment of visceral leishmaniasis

The available treatment options for visceral leishmaniasis (VL) have problems relating to efficacy, adverse effects and cost, making treatment a complex issue. We review the evidence relating to the different methods of treatment in relation to - efficacy and toxicity of the drugs in different areas of the world; ability to monitor side effects, length of treatment; ability of patients to pay for and stay safe during treatment, ability of the healthcare services to give intramuscular, intravenous or oral therapy; the sex and child-bearing potential of the patient and the immune status of the patient. The high mortality of untreated/ poorly treated VL infection makes the decisions paramount, but a unified and coordinated response by each area is likely to be more effective and informative to future policies than an ad hoc response. For patients in resource-rich countries, liposomal amphotericin B appears to be the optimal treatment. In South Asia, miltefosine is being used; the combination of single dose liposomal amphotericin B and short course miltefosine looks encouraging but has the problem of potential reproductive toxicities in females. In Africa, the evidence to switch from SSG is not yet compelling. The need to monitor and plan for evolving drug failure, secondary to leishmania parasite resistance, is paramount. With a few drugs the options may be limited; however, we await key ongoing trials in both Africa and India to explore the effects of combination treatment. If safe and reliable combinations are revealed by the ongoing studies, it is far from clear as to whether this will avoid leishmania parasite resistance. The development of new drugs to add to the armamentarium is paramount. Lessons can be learnt from the management of diseases such as tuberculosis and malaria in terms of planning the switch to combination treatment. As important as establishing the best choice for specific antileishmanial agent is ensuring treatment centers, which can best manage the problems encountered during treatment, specifically malnutrition, bleeding, intercurrent infections, drug side effects and detecting and treating underlying immunosuppression.

Operative Behandlung traumatischer Frakturen der Brust- und Lendenwirbelsäule

Operative Behandlung traumatischer Frakturen der Brust- und Lendenwirbelsäule

LAPAROSCOPIC APPENDECTOMY BECOMES THE METHOD OF CHOICE IN THE TREATMENT OF ACUTE APPENDICITIS

Introduction: Laparoscopic appendectomy becomes a usual method in the treatment of acute appendicitis, although its advantage over open appendectomy has been proven. In Bosnia and Herzegovina, a few medical centers are introducing laparoscopic appendectomy as a method of treatment of acute appendicitis. In this study we want to compare different methods of treatment of acute appendicitis. Patients and Methods: During 20 months we have analyzed 498 patients operated due to acute appendicitis. We followed the duration of operation, total hospitalization stay, complications of surgical procedure and reasons of conversion in patients operated by laparoscopic approach. Results: The duration of operation was 96 minutes in the group operated by open approach and 107 minutes in the group operated by laparoscopic approach. Total hospitalization stay was 3.9. days in the group operated by open approach and 2.3. days in the group operated by laparoscopic approach. The most frequent complication in the group operated by open approach was infection of the operative wound (56/452) and ileus (5/452), and in the group operated by laparosocopic approach ileus (1/46) was the most frequent complication. Conclusion: The patients operated by laparoscopic approach have fewer risk of wound infection, and the hospital stay is shorter. With the increase of surgeon’s experience this method of treatment of acute appendicitis will become a method of choice.

PECVD SiO2/Si3N4 double layers electrets on glass substrate

SiO2/Si3N4 double layers electrets have been investigated for their long-term charge stability and compatibility to micro technology. This paper first reports SiO2/Si3N4 double layers electrets both prepared by plasma enhanced chemical vapor deposition (PECVD) on glass substrates. Charging time, charging temperature and annealing process were studied for their influence on electrets properties. Different methods of treatment, such as hexamethyldisilazane (HMDS) coating, heat treatment at 250degC, 02 plasma treatment and their combinations, were employed to improve charge stability under high humidity conditions. The experimental results show that PECVD prepared SiO2/Si3N4 double layers exhibit high performance in charge storage under different environmental conditions. The surface potential did not decay obviously at room temperatures during more than two months. The samples lose less than 20% of the surface potential at 250degC for more than 10 h. The surface potential could be kept more than 90% at 95% RH by heat treatment combined with HMDS process or O2 plasma treatment.

Comparison of 3 internal fixations for fresh Tossy III acromioclavicular dislocation

Objective To analyze 3 different methods for treatment of Tossy Ⅲ acromioclavicular dislocation. Methods Sixty-two patients with Tossy Ⅲ acromioclavieular dislocation who had been treated by 3 different treatment methods in our department were analyzed. Of them, 18 cases were treated with Kirschner wire and tension wire fixation plus repair of coracoacromial and acromioelavicular ligaments(Group A), 21 with clavicle claw steel plate fixation plus repair of acromioelavicular ligament (Group B ), and 23 with intersecting Kirschner wire plus repair and strengthening of acromioclavieular ligament(Group C). Results After follow-ups for 9 to 24 months (with an average of 15. 6), therapeutic effect(by Karlsson system), operation duration, intraoperative blood loss and cost were evaluated for all the pa-tients. The differences in the therapeutic effect between all groups were not significant ( P ＞ 0.05 ). Group C needed less operation time and had less bleeding than groupA ( P ＜ 0. 05), and group C needed less oper-ation time and cost and had less bleeding than group B ( P ＜ 0. 05). Conclusion Intersecting Kirsehner wire plus repair and strengthening of aeromioclavieular ligament is an efficient, convenient and less costly method for treatment of TossyⅢ aeromioclavicular dislocation. Key words: Acromioclavicular joint; Dislocations; Surgical procedures,operative

MANAGEMENT OF RETINAL DETACHMENT IN COATS DISEASE

To correlate the final outcome with the initial presentation and treatment in Coats disease retinal detachment. The records of 15 patients with retinal detachment were evaluated retrospectively regarding the age at the time of diagnosis, initial presentation, methods of treatment, visual and anatomic results, and complications. Changes in vision and retinal status were noted and correlated with the different methods of treatment to propose a therapeutic strategy. In 15 patients (15 eyes), with a mean follow-up of 28 months (range, 6 months to 7 years), Coats disease was diagnosed at a mean age of 3.4 years (range 3 months to 15 years). Primary management was laser photocoagulation in seven patients, cryotherapy in two, and vitreoretinal surgery in six. Additional treatment was necessary in nine patients of whom six had laser photocoagulation, one had cryotherapy, and two had vitreoretinal surgery. Visual stability was achieved in 12 cases. Anatomic improvement was achieved in 12 eyes (3 cases of phthisis bulbi). No enucleation was ultimately necessary. Carefully selected treatment can improve almost each eye with Coats disease complicated by retinal detachment. Although visual outcome is poor, anatomic improvement or stability is the main goal of the management.

Attitudes toward coercive treatment in West and East: a review

Physician-patient relationship has been undergoing significant change in recent decades in the Western countries. Based upon a client-centered approach, society has given more autonomy and liberty to the patient. The patient has been regarded as a consumer who is looking for the best and most scientific approach and has freedom to choose among different methods for treatment. The role of the physician is only a guiding role. In other side, in the Eastern countries, we still face a parent-child relationship in the therapeutic setting. Eastern patients expect direct advices from their physician and the family has an important role in decision making. An approach considered coercive in the Western countries, could still be a useful and acceptable one in the Eastern cultures. The main goal of the authors is to compare attitudes toward this topic in Eastern and Western cultures.

Massive odontogenic keratocyst – a case report

Objectives: Different methods of treatment of Odontogenic Keratocyst (OKC) have been recommended, with the purpose of complete removal of the pathologic entity, prevention of recurrent lesions and less morbidity to the patient. Materials and methods: A 65-year-old female patient with left side of mandible swelling was treated for OKC extending from left subcondylar region to right parasymphysis region after a clinical, radiological and pathological diagnosis with enucleation followed by application of Carnoy's solution.

Simple elbow dislocation among adults: A comparative study of two different methods of treatment

Post-manipulation treatment of elbow dislocation includes plaster of Paris immobilisation for a mean of 2 weeks followed by physiotherapy, or sling support followed by early mobilisation. This study retrospectively reviewed 42 simple elbow dislocations. The management of 20 patients by the plaster of Paris method and 22 by the sling method was assessed after a minimum follow-up of 2 years using Mayo Elbow Performance Index (MEPI) scores, the Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and time off work. The final functional outcome in the plaster of Paris group showed 10 excellent, 2 good, 5 fair and 3 poor results, compared with 19 excellent, 1 good and 2 fair results in the sling group. The mean times to return to work in plaster of Paris group and sling group were 6.6 and 3.2 weeks, respectively (p<0.001). Early mobilisation did not result in redislocation or late instability of the elbow. Thus the final functional outcome of the sling and early mobilisation group was significantly better than in the plaster of Paris immobilisation group.

Cancer free survival after CIN treatment: Comparisons of treatment methods and histology

Cervical cancer is one of the most lethal cancers among women worldwide. Women are treated and followed-up in several different manners. Long-term studies of cancer or death risks after different methods of treatment or after different initial histology are scarce. A retrospective cohort study with 7466 women treated of CIN between 1974 and 2001 in Helsinki University Hospital followed-up until the end of 2003. The Cox model was used to determine differences in cancer free or overall survival between women treated of CIN with different methods or after different initial grade of CIN. Twenty-two cases of invasive cervical cancer (ICC) and 57 cases of CIN 3 after treatment of CIN were observed. There were no statistically significant differences in ICC free survival between different treatment methods or initial grade of CIN. In CIN 3 free survival, the hazard ratios for the 57 cases of CIN 3, when cold knife coagulation (CKC) was set as the reference, were 0.22 for laser, 0.55 for cryotherapy and 0.31 for LEEP. In CIN 3+ (CIN 3 or ICC) free survival, the hazard ratios of 79 CIN 3+ cases (CKC reference) were 0.25 for laser, 0.50 for cryotherapy and 0.27 for LEEP. There were no differences in overall survival between different grades of initial CIN. The CKC seems to be the least favorable in terms of both further cancer and CIN 3 risk. The follow-up has to be well organized because the post-treatment cancer risk is independent of the initial grade of CIN.

Development and application of an analytical protocol for evaluation of treatment processes for landfill leachates. II. Evaluation of leachate treatment efficiency of different steps in a constructed pilot plant

Different methods for treatment of leachate from a municipal solid waste (MSW) landfill were tested in a pilot plant. Raw leachate was pre-treated with aeration and sedimentation, followed by several parallel individual steps such as bioremediation, chemical oxidation, ozonation, and geo-bed filters. The efficiency of different treatment steps was evaluated according to one previously developed protocol, which includes measurements of several parameters such as conductivity, pH, nutrients, chloride, metals, organic compounds, and acute toxicity before and after a treatment step. The treatment steps which showed the highest efficiency towards organic pollutants in leachate were ozone treatment and chemical oxidation. The use of an adsorption filter, a geo-bed with a mixture of peat and bottom ash with ca 10% remaining carbon, also had good effects. A combination of pre-treatment and a geo-bed filter with peat and carbon ash gave the best overall treatment results when water-quality parameters such as total organic carbon and ammonia-nitrogen were also considered.

Long-term results of surgical treatment for recurrent respiratory papillomatosis

Conclusions. The presented results add further support to the observation that laser microsurgery is the preferential surgical treatment for recurrent respiratory papillomatosis (RRP). A meticulous follow-up for early recognition of local recurrence and malignant transformation is recommended. Objectives. Endoscopic microsurgery continues to be the treatment of choice for RRP. The aim of this study was to evaluate the outcome of patients treated surgically. We focused on demographic data, recurrence rates, and treatment-related complications. Patients and methods. The charts of 194 patients treated at our institution between 1963 and 1993 were analyzed retrospectively. Results. In all, 64 patients (33%) underwent a total of 137 operations using the CO2 laser; 130 patients (67%) underwent a total of 565 microlaryngeal operations by surgery with cold instruments. Five percent of the patients treated with conventional microlaryngeal surgery and none of the patients treated with laser surgery required tracheostomy (p<0.05). Postoperative glottic webs and scar formations were found in 6% of all patients after laser surgery and 20% after conventional surgery (p<0.05). The different methods of treatment did not affect the rate of recurrence (p=0.61) Malignant transformation or secondary airway carcinoma were observed in 4% of all patients.

Eficácia do AlCl3 e etanol na prevenção da calcificação de fragmentos da parede aórtica porcina fixados em GDA

OBJETIVO: Avaliar a eficácia do cloreto de alumínio, isoladamente ou em associação com o etanol, na prevenção da calcificação e da resposta inflamatória de fragmentos de parede aórtica porcina fixada em glutaraldeído (GDA), implantados no tecido subcutâneo de ratos jovens. MÉTODO: Utilizaram-se 15 ratos da linhagem Sprague-Dawley, em cujas telas subcutâneas foram implantados fragmentos de parede aórtica porcina, submetidos a três diferentes métodos de tratamento [grupos: I (GDA), II (GDA+alumínio), III (GDA+etanol+alumínio)]. Os explantes foram realizados com 15, 30 e 60 dias após as operações. Foram realizadas análises histológicas pelas colorações de hematoxilina & eosina (HE) e de alizarina, nos pHs de 4,2 e 7,0, e a dosagem de cálcio feita por espectroscopia de absorção atômica. RESULTADOS: Pelo HE, constatou-se que a matriz extracelular das paredes aórticas ficaram melhor preservadas nos explantes do grupo III. A intensidade da reação inflamatória intensa foi menor nesse grupo. Pela alizarina pH 4,2, o grupo II e III tiveram menores índices de calcificação comparado ao controle. Pela alizarina pH 7,0, o grupo III teve menor índice de calcificação comparado aos grupos I e II. Pela espectroscopia de absorção atômica, os níveis de cálcio foram semelhantes para os grupos II e III, mas significativamente menores do que os do grupo I. CONCLUSÃO: O tratamento com cloreto de alumínio diminuiu a calcificação dos fragmentos de parede aórtica porcina. O uso combinado do etanol com cloreto de alumínio foi ainda mais eficiente em inibir a calcificação, e também em diminuir a reação inflamatória.

Treatment of flexion contractures following burns in extremities

In order to release and cover defects in burn contractures over joints, several surgical procedures have been proposed. Skin grafting is easy to do, but it requires immobilization, and tends to contract again, different types of flaps without skin grafting are alternatives. These flaps have their specific indications, limitations and some disadvantages such as a bulky, unattractive appearance in donor or recipient sites, partial necrosis, and sometimes patients dissatisfaction. Considering these points, the authors proposed a new technique composed of a Y-V advancement in the middle and two scar releases proximal and distal to the joint which were covered with full thickness skin grafts. This seems to have some advantages in both case of technique and more patients satisfaction. In the current study, the authors presented their results with different methods of treatment, which they performed for burn flexion contractures in limbs. Ninety-one operations were performed in 74 patients, the method of reconstruction included skin grafting in 43 contractures, local flaps in 16, pediculated flaps in 11, and the new combined approach in 21 cases. Width of scar was one of the main factors for selection of choice option. This proposed technique is especially appropriate for scars which cover 10–60% of joint surface area. Advantages of this combined technique are coverage of joint area with a pretty normal skin flap, and enough scar lengthening due to combination of Y-V advancement and skin grafted released areas.

CONTEMPORARY METHODS OF TREATMENT AND MEDICAL REHABILITATION OF PATIENTS WITH BENIGN PROSTATE HYPERPLASIA

The article dwells upon contemporary methods of treatment and medical rehabilitation of patients with benign prostate hyperplasia. Epidemiological data, peculiarities and advantages of different methods of treatment of patients with this pathology are shown. The author pays special attention to transurethral radio wave hypothermia indicated to patients with high operation risk at somatic pathology.

The effect of various methods of psoriasis treatment on somatotrophin axis hormones in serum

To investigate the effect of pharmacotherapy and phototherapy on the concentration of hormones of the somatotrophin axis [growth hormone (GH), insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3)] in the serum of patients with psoriasis in exacerbation and remission. GH and IGFBP-3 in serum were determined by immunoradiometric assay (IRMA), and IGF-I concentrations - by radioimmunological assay (RIA). The dermatological state was assessed by the psoriasis area and severity index (PASI). There was no significant difference in the GH concentrations in patients both in exacerbation and remission, irrespective of therapy applied. However, in the group treated by phototherapy a significant increase in IGFBP-3 secretion was observed, whereas in the group treated with cyclosporin A - a significant increase in IGF-I secretion was observed in remission. Different methods of treatment have different effects on the secretion of somatotrophin axis hormones, but generally the hormone concentrations do not return to the values observed in healthy people. The therapeutic actions of the drugs concerned are not fully known and require further investigations.

Dissociation of bipolar hemiarthroplasty of the hip after dislocation: A report of five different cases and review of literature

Little information is available about the rare but serious disadvantage of dissociation of modular components during dislocation or after close reduction in the bipolar hemiarthroplasty of the hip. In most cases, simple dislocation after primary bipolar hemiarthroplasty can safely be reduced by close methods. Dissociation leads almost always to reoperation and possible revision of the prosthesis. To avoid this complication, strict adherence to the surgical technique during the initial procedure and extra precaution during close reduction are recommended, in order to provide enhanced security over component disassembly. In the five cases presented in this study, dissociation is reported at different circumstances, along with the different methods of treatment required in each patient.

Surgical Repair of Varicocele: a Comparative Study of the Retroperitoneal Approach of Palomo, the Modified Palomo Technique and the Microsurgical Inguinal Approach of Ivanisseivich's Technique

Purpose: We wanted to compare our experience and results with three different methods of treatment for varicocele. Materials and Methods: Between January 1995 and December 2005, 154 patients with varicocele were retrospectively assigned into three groups according to the method of treatment. Group 1 included 73 patients who were treated by the retroperitoneal approach of Palomo's technique. Group 2 consisted of 37 patients who were treated by the retroperitoneal approach and who also underwent the internal spermatic artery preserving technique, and in group 3, 44 patients were treated by the microscopic inguinal approach of Ivanissevich's technique. We analyzed the operation time, recurrence, complications, the effect of surgical treatment and the results according to the surgical techniques. Results: The mean operative time of group 3 was significantly longer among the three groups. The recurrence rate at follow-up was not significantly different among the three groups. The recurrence rate increased progressively with the increase of varicocles size from grade I to grade III for all the groups. The overall incidence of postoperative complications was significantly lower among the patients in group III. The postoperative spermiogram showed an increase in motility and sperm count for all the groups. There were no differences in the three techniques for resolution of pain, the duration of recovery and the spermiogram results. Conclusions: There was no significant difference in the rate of relapse after the surgery between the three different treatment techniques, and the factors involved in relapse were more related to the size and severity of the varicocele. Microsurgical varicocelectomy had a disadvantage of a prolonged operation time. However, there was a low rate of postoperative complications for all three techniques. (Korean J Urol 2006;47:1086-1092)