Effectiveness Of Treatment Research Articles

Real-world unified airway benefits of mepolizumab: effectiveness in patients with asthma and comorbid nasal polyps

BackgroundNasal polyps (NP) are commonly associated with chronic rhinosinusitis (CRS). In keeping with the unified airway hypothesis, asthma and CRS with NP (CRSwNP) frequently co-occur, share a similar pathophysiology, and are often treated with oral corticosteroids (OCS); however, a need for alternative treatment options for patients with comorbid asthma and CRSwNP remains. ObjectiveThis retrospective cohort study aimed to characterize the short- and long-term dual airway effectiveness of the anti-interleukin-5 monoclonal antibody, mepolizumab, in real-world patients with asthma and comorbid NP. MethodsAdult patients with CRSwNP who initiated mepolizumab from November 1, 2014 to September 30, 2021 were identified from two Merative MarketScan Research Databases. Outcomes were compared for the 12 months pre- and post-mepolizumab initiation and a variable follow-up period. Primary outcomes included: annual rate and proportion of patients with NP- and asthma-related exacerbations; NP surgery occurrences; all-cause OCS claims, number of OCS bursts, and daily OCS dose; all-cause and NP-related healthcare resource utilization (HCRU). ResultsDuring the 12 months post-index, patients experienced fewer NP- and asthma-related exacerbations, required fewer sinus surgeries, and reduced use of OCS, with fewer all-cause OCS claims and OCS bursts. Significant reductions in asthma exacerbation-related and NP-related HCRU were also observed. ConclusionThis study illustrates the near- and long-term real-world effectiveness of mepolizumab treatment, with a focus on dual lower and upper airway benefit from single-agent add-on therapy. These results may aid physicians in clinical decision-making for patients with asthma and comorbid CRSwNP with complex care needs.

Cranial Remolding Orthosis Study on the Use of a Temperature Sensor to Measure Wear Time

ABSTRACT Introduction The effectiveness of cranial remolding orthoses (CROs) in treating nonsynostotic deformational plagiocephaly (DP) is anecdotally related to adherence. Efficacy of CROs has been evaluated but lacks evidence regarding necessary wear time to achieve a positive outcome. A 23 hr/d wear schedule is generally prescribed regardless of presentation. The study compares daily wear time to treatment outcomes. Materials and Methods Subjects Infants aged 3–18 months diagnosed with DP were included with initial cranial vault asymmetry (CVA) > 6 mm or cephalic ratio (CR) > 0.90. Subjects were treated with an Orthomerica STARband CRO. A total of 106 subjects enrolled, with 69 completed. Apparatus A questionnaire assessed caregiver’s reported adherence with the CRO. Maximum Integrated’s iButton temperature loggers (iButtons) recorded objective wear time. Procedures 3D head shape measurements via Orthomerica STARScanner, caregivers’ questionnaires, and iButton data were collected every 5–8 weeks. Data Analysis Descriptive statistics were obtained, and data reported as mean ± SD or median [25th, 75th percentiles]. Nonparametric sign tests were used to assess differences from CRO fabrication scan to subsequent follow-ups. Spearman rank correlations and corresponding 95% confidence intervals and P values between average wear time and change of measurements were obtained. Results Self-reported wear time was 22 (22, 23) hrs/d. Measured wear time was 17–18 (12, 20) hrs/d. Longer average wear time was significantly associated with larger reductions in CVA (P = 0.0054), CR (P = 0.0080), and CVAI (P = 0.0059). Conclusions Results showed longer average daily wear increased effectiveness in CRO treatment of plagiocephaly. Increased sample sizing is required to determine if generalizable to brachycephalic and asymmetrical brachycephalic head shapes. Clinical Relevance A CRO wear schedule of 23 hrs a day is currently recommended, but difficult for families to adhere. The impact of the study may indicate a more realistic wear schedule that would improve adherence while achieving optimal outcomes.

Expanded perspectives: integrating clinicians' insights for comprehensive patient-reported outcomes in value-based healthcare.

The manuscript explores value-based healthcare (VBHC) and its role in assessing healthcare quality beyond clinical metrics. It identifies four value types: personal, technical, allocative, and societal. Emphasizing the integration of diverse stakeholder perspectives, including patients, families, and clinicians, the study highlights the importance of patient- and family-reported measures (PROMs and PREMs) and clinician input. Clinicians' insights on treatment feasibility and effectiveness are crucial for a holistic understanding of healthcare quality. The manuscript advocates for combining machine learning with participatory approaches to enhance data analysis and continuous quality improvement in VBHC, driving better outcomes for patients and communities.

Analysis of the effectiveness and safety of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis: An observational study.

This study is for exploring the effectiveness and security of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis. This retrospective study collected 100 patients with gouty arthritis between February 2022 and February 2023. According to the different treatment methods, the data of patients were divided into control group and experimental group. The control group received routine treatment with benzbromarone, while the experimental group received additional treatment with Xuedu Xiezhuo Yishen Tang on the basis of the control group. The evaluation indicators for the effectiveness of treatment include serum levels of 8-hydroxydeoxyguanosine, 3-NT, interleukin-6, interleukin-10, interleukin-1β, tumor necrosis factor-α, C-reactive protein, erythrocyte sedimentation rate, urea nitrogen, creatinine, evaluation of knee joint function and pain level, traditional Chinese medicine syndrome score, and safety evaluation. After treatment, the overall treatment effect of the experimental group reached 98%, while the control group was 78%. After treatment, the differences in various indicators possessed statistical significance (SS) (P < .05). In the Lysholm score, the improvement in the experimental group was markedly more excellent than the control group, and the difference possessed SS (P < .05). In the NRS score, the experimental group's NRS score decreased from 8.39 to 1.08 before and after treatment, while the control group only decreased to 3.61. In addition, both groups of patients showed significant improvement in the joint score in the Traditional Chinese medicine syndrome sub-items. The experimental group was able to effectively improve symptoms such as joint pain, joint redness and swelling, joint fever, and limited joint mobility. After treatment, the incidence of adverse reactions in the experimental group was only 8%, while the incidence of adverse reactions in the control group was 24%. After statistical analysis of the incidence of adverse reactions during treatment among the participants, it was found that the difference possessed SS (P < .001). The combination treatment of Jiedu Xiezhuo Yishen Tang and benbromarone can effectively improve oxidative stress response and significantly reduce blood uric acid levels. Meanwhile, this combination therapy can effectively inhibit inflammatory reactions, significantly alleviate knee joint pain, and promote the recovery of knee joint function. This treatment regimen has lower toxic side effects and higher safety.

The Comprehensive Impact of Maintenance Hemodialysis Treatment: a Qualitative Study

Objective: To investigate the comprehensive impact of maintenance hemodialysis treatment on patients and their families, in order to improve their quality of life and enhance treatment effectiveness. Method: Colaizzi phenomenological analysis is used to analyze data and extract themes. Results: The comprehensive impact of maintenance hemodialysis treatment can be summarized into five themes: decreased work ability, disease restriction of life freedom, decreased physical function, decreased quality of life, and increased family burden. Conclusion: Hemodialysis has a significant impact on patients and their families, with economic, physical, and psychological impacts, directly reducing their quality of life. It is recommended to adopt multidimensional strategies to improve the quality of life and treatment outcomes of patients.

Effective Application of Biocompatible Magnetite Nanoparticles in the Treatment of Multiple Sclerosis: Results of a Clinical Study

Multiple sclerosis (MS) is a serious neurological disorder due to its widespread prevalence, chronic nature, frequent progression to disability, and tendency to affect young people. The pathogenesis of MS is based on the immunopathogenesis hypothesis. Biocompatible magnetite nanoparticles, which exhibit selective sorption activity towards cell membrane surface proteins, circulating immune com-plexes, lymphocytotoxic antibodies, and the complement system, as well as enhance phagocytic ac-tivity and the completion index of leukocyte phagocytosis, can be effectively used for immunocor-rection. The main goal of the study is to slow the progression of MS, improve the neurological status and overall condition of the patient, and reduce the dynamics of the spread of demyelinating lesions in the brain. Materials and methods: A patient diagnosed with multiple sclerosis, secondary progres-sive type, cerebrospinal form, at the clinical aggravation stage was included in the study. Neurologi-cal status and disability were assessed using the EDSS scale, and brain MRI with contrast enhance-ment was performed. The nanodevice Micromage-B was administered orally as an immunosorbent and immunomodulator. The regimen and dosage of Micromage-B were personalized. Assessments of general condition and neurological status were conducted every 7 days for 6 months, with contrast-enhanced brain MRI performed in the 5th month. Results: The use of Micromage-B in MS treatment led to an objective improvement in neurological status, with reduced stiffness and fatigue in the lower extremities. Gait and coordination improved, hand tremors decreased, depression and concen-tration disorders subsided, appetite was restored, and speech improved. Throughout the treatment period, positive dynamics in the normalization of neurological status were observed. After 6 months, the total score on the EDSS scale decreased from 210 to 45. The most significant improvements were observed in the evaluation of the pyramidal system and coordination, with the EDSS Disability Scale score decreasing from 6.0 to 5.0. For the first time, contrast-enhanced brain MRI showed a reduction in the number of new demyelination foci by the 4th month of Micromage-B administra-tion. The positive changes in neurological status correlated with the MRI results. The recovery of central nervous system activity in MS is likely not only due to the immunosuppressive properties of magnetite nanoparticles but also due to the activation of remyelination mechanisms and oligoden-drocyte differentiation through enzymatic methylation. Conclusion: The use of biocompatible nanodevices in the complex treatment of MS is promising. Further improvement and study of the regimen and method of using biocompatible magnetite nanoparticles to enhance MS treatment effec-tiveness are required.

The Comprehensive Impact of Maintenance Hemodialysis Treatment: a Qualitative Study

Objective: To investigate the comprehensive impact of maintenance hemodialysis treatment on patients and their families, in order to improve their quality of life and enhance treatment effectiveness. Method: Colaizzi phenomenological analysis is used to analyze data and extract themes. Results: The comprehensive impact of maintenance hemodialysis treatment can be summarized into five themes: decreased work ability, disease restriction of life freedom, decreased physical function, decreased quality of life, and increased family burden. Conclusion: Hemodialysis has a significant impact on patients and their families, with economic, physical, and psychological impacts, directly reducing their quality of life. It is recommended to adopt multidimensional strategies to improve the quality of life and treatment outcomes of patients.

Effective Application of Biocompatible Magnetite Nanoparticles in the Treatment of Multiple Sclerosis: Results of a Clinical Study

Multiple sclerosis (MS) is a serious neurological disorder due to its widespread prevalence, chronic nature, frequent progression to disability, and tendency to affect young people. The pathogenesis of MS is based on the immunopathogenesis hypothesis. Biocompatible magnetite nanoparticles, which exhibit selective sorption activity towards cell membrane surface proteins, circulating immune com-plexes, lymphocytotoxic antibodies, and the complement system, as well as enhance phagocytic ac-tivity and the completion index of leukocyte phagocytosis, can be effectively used for immunocor-rection. The main goal of the study is to slow the progression of MS, improve the neurological status and overall condition of the patient, and reduce the dynamics of the spread of demyelinating lesions in the brain. Materials and methods: A patient diagnosed with multiple sclerosis, secondary progres-sive type, cerebrospinal form, at the clinical aggravation stage was included in the study. Neurologi-cal status and disability were assessed using the EDSS scale, and brain MRI with contrast enhance-ment was performed. The nanodevice Micromage-B was administered orally as an immunosorbent and immunomodulator. The regimen and dosage of Micromage-B were personalized. Assessments of general condition and neurological status were conducted every 7 days for 6 months, with contrast-enhanced brain MRI performed in the 5th month. Results: The use of Micromage-B in MS treatment led to an objective improvement in neurological status, with reduced stiffness and fatigue in the lower extremities. Gait and coordination improved, hand tremors decreased, depression and concen-tration disorders subsided, appetite was restored, and speech improved. Throughout the treatment period, positive dynamics in the normalization of neurological status were observed. After 6 months, the total score on the EDSS scale decreased from 210 to 45. The most significant improvements were observed in the evaluation of the pyramidal system and coordination, with the EDSS Disability Scale score decreasing from 6.0 to 5.0. For the first time, contrast-enhanced brain MRI showed a reduction in the number of new demyelination foci by the 4th month of Micromage-B administra-tion. The positive changes in neurological status correlated with the MRI results. The recovery of central nervous system activity in MS is likely not only due to the immunosuppressive properties of magnetite nanoparticles but also due to the activation of remyelination mechanisms and oligoden-drocyte differentiation through enzymatic methylation. Conclusion: The use of biocompatible nanodevices in the complex treatment of MS is promising. Further improvement and study of the regimen and method of using biocompatible magnetite nanoparticles to enhance MS treatment effec-tiveness are required.

A multi-centric, single-blinded, randomized, parallel-group study to evaluate the effectiveness of nasoalveolar moulding treatment in non-syndromic patients with complete unilateral cleft lip, alveolus and palate (NAMUC study): a study protocol for a randomized controlled trial

BackgroundCleft lip and palate (CLP) are among the most common congenital anomaly that affects up to 33,000 newborns in India every year. Nasoalveolar moulding (NAM) is a non-surgical treatment performed between 0 and 6 months of age to reduce the cleft and improve nasal aesthetics prior to lip surgery. The NAM treatment has been a controversial treatment option with 51% of the cleft teams in Europe, 37% of teams in the USA and 25 of cleft teams in India adopting this methodology. This treatment adds to the already existing high burden of care for these patients. Furthermore, the supporting evidence for this technique is limited with no high-quality long-term clinical trials available on the effectiveness of this treatment.MethodThe NAMUC study is an investigator-initiated, multi-centre, single-blinded randomized controlled trial with a parallel group design. The study will compare the effectiveness of NAM treatment provided prior to lip surgery against the no-treatment control group in 274 patients with non-syndromic unilateral complete cleft lip and palate. The primary endpoint of the trial is the nasolabial aesthetics measured using the Asher McDade index at 5 years of age. The secondary outcomes include dentofacial development, speech, hearing, cost-effectiveness, quality of life, patient perception, feeding and intangible benefits. Randomization will be carried out via central online system and stratified based on cleft width, birth weight and clinical trial site.DiscussionWe expect the results from this study on the effectiveness of treatment with NAM appliance in the long term along with the cost-effectiveness evaluation can eliminate the dilemma and differences in clinical care across the globe.Trial registrationClinicalTrials.gov CTRI/2022/11/047426 (Clinical Trials Registry India). Registered on 18 November 2022. The first patient was recruited on 11 December 2022. CTR India does not pick up on Google search with just the trial number. The following steps have to be carried out to pick up.How to search: (https://ctri.nic.in/Clinicaltrials/advsearch.php—use the search boxes by entering the following details: Interventional trial > November 2022 > NAMUC).

Results of Treatment of Patients with Multiple Drug Resistant Tuberculosis among Key Populations during the COVID-19 Pandemic in Dushanbe, Tajikistan

The objective: to identify changes in effectiveness of treatment of multiple drug resistant tuberculosis among key populations in Dushanbe, including the period of the COVID-19 pandemic.Subjects and Methods. Retrospective study of medical records of 431 MDR TB patients registered for treatment in Dushanbe was conducted (2017-2019 - Group 1 and 2020-2021 - Group 2 (the COVID-19 pandemic period)).Results. The duration of treatment was 15.4±6.9 months in Group 1, and 10.8±4.3 months in Group 2, which was due to the introduction of short-course regimens in that group. At the same time, in Group 2 there was an increase in effectiveness of MDR TB treatment to 85% versus 80% in Group 1, which was due to the use of new drugs and regimens containing them. In Group 1, a statistically significant association was found between MDR TB treatment failure and the following parameters: male gender (RR=2.3 (1.36-4.04), p=0.002), positive HIV status (RR=2.35 (1.37-4.05), p=0.011), hepatitis C infection (RR=3.0 (1.87-4.8), p &lt;0.001), alcohol (RR=3.2 (1.96-5.2), p&lt;0.001) and substances abuse (RR=3.99 (2.5-6.2), p&lt;0.001), previous imprisonment (RR=2.6 (1.48-4.6), p&lt;0.001), unemployment (RR=3.5 (1.8-6.7), p &lt;0.001), and homelessness (RR=5.0 (3.9-6.5), p=0.0011). In Group 2, failure of MDR TB treatment was statistically significantly associated with hepatitis C (RR=3.3 (1.5-7.2), p=0.02), alcohol and drug abuse (RR= 4.4 ( 1.95-10.1). p =0.026), as well as (unlike Group 1) labor migration (RR=3.0 (1.45-6.2), p=0.0068), in-patient treatment (RR=3.8 (1.36-10.64), p=0.0056), while there was no association with HIV status.

Clinical value of 68Ga-pentixafor PET/CT in patients with primary aldosteronism and bilateral lesions: preliminary results of a single-centre study

BackgroundSubtype diagnosis of primary aldosteronism (PA) is used to determine treatment, and the potential utility of 68Ga-pentixafor PET/CT for investigation of PA has long been recognized. The study aimed to evaluate the clinical value of 68Ga-pentixafor PET/CT in the diagnosis and prognosis of patients with bilateral lesions identified by CT.MethodsIn total, 25 patients with PA and bilateral lesions on CT were retrospectively evaluated. All patients underwent 68Ga-Pentixafor PET/CT and adrenal vein sampling. The analysis focused on establishing the relationship between bilateral adrenal lesions SUVmax and the ratio of bilateral adrenal lesions SUVmax (CON) and clinical diagnosis, treatment outcomes, and KCNJ5 gene status.ResultsThe concordance rate between 68Ga-Pentixafor PET/CT and adrenal venous sampling was 65.2% (15/23). The lateralization results of 68Ga-pentixafor PET/CT supported the clinical decisions of 20 patients with PA, 90% of whom showed effectiveness in treatment. The SUVmax on the dominant side of the surgically treated patients was higher than that of patients treated with drugs. The SUVmax of the KCNJ5 mutant group was higher than that of the KCNJ5 wild group, and 68Ga-Pentixafor uptake was correlated with KCNJ5 gene status.Conclusions68Ga-Pentixafor PET/CT proves beneficial for patients with PA with bilateral lesions on CT. The treatment is generally effective based on the results of PET lateralization. Simultaneously, a certain relationship exists between 68Ga-Pentixafor PET/CT and KCNJ5 gene status, warranting further analysis.

Results of Treatment of Patients with Multiple Drug Resistant Tuberculosis among Key Populations during the COVID-19 Pandemic in Dushanbe, Tajikistan

The objective: to identify changes in effectiveness of treatment of multiple drug resistant tuberculosis among key populations in Dushanbe, including the period of the COVID-19 pandemic.Subjects and Methods. Retrospective study of medical records of 431 MDR TB patients registered for treatment in Dushanbe was conducted (2017-2019 - Group 1 and 2020-2021 - Group 2 (the COVID-19 pandemic period)).Results. The duration of treatment was 15.4±6.9 months in Group 1, and 10.8±4.3 months in Group 2, which was due to the introduction of short-course regimens in that group. At the same time, in Group 2 there was an increase in effectiveness of MDR TB treatment to 85% versus 80% in Group 1, which was due to the use of new drugs and regimens containing them. In Group 1, a statistically significant association was found between MDR TB treatment failure and the following parameters: male gender (RR=2.3 (1.36-4.04), p=0.002), positive HIV status (RR=2.35 (1.37-4.05), p=0.011), hepatitis C infection (RR=3.0 (1.87-4.8), p &lt;0.001), alcohol (RR=3.2 (1.96-5.2), p&lt;0.001) and substances abuse (RR=3.99 (2.5-6.2), p&lt;0.001), previous imprisonment (RR=2.6 (1.48-4.6), p&lt;0.001), unemployment (RR=3.5 (1.8-6.7), p &lt;0.001), and homelessness (RR=5.0 (3.9-6.5), p=0.0011). In Group 2, failure of MDR TB treatment was statistically significantly associated with hepatitis C (RR=3.3 (1.5-7.2), p=0.02), alcohol and drug abuse (RR= 4.4 ( 1.95-10.1). p =0.026), as well as (unlike Group 1) labor migration (RR=3.0 (1.45-6.2), p=0.0068), in-patient treatment (RR=3.8 (1.36-10.64), p=0.0056), while there was no association with HIV status.

A scoping review of the evidence on pharmacological and non-pharmacological interventions for idiopathic hypersomnia.

Idiopathic hypersomnia (IH) is characterized by excessive sleepiness during the day, prolonged sleep at night, and difficulty waking up. The true prevalence of IH is uncertain. ICSD provides criteria for diagnosing IH; however, the definition has evolved. Managing IH involves using pharmacologic and non-pharmacologic approaches, although the most effective strategies are still unclear. The objective of this scoping review was to identify the extent, range, and nature of the available evidence, identify research gaps, and discuss the implications for clinical practice and policy. To conduct this review, a comprehensive search was conducted across scientific databases, without any restrictions on the date or study type. Eligible studies examined the effectiveness of pharmacologic and non-pharmacologic treatments for IH and reported the outcomes of these interventions. Data from the studies were screened, analyzed, and synthesized to provide an overview of the available literature landscape. 51 studies were included in this review, which used various methods and interventions. Pharmacological treatments, particularly modafinil, have been frequently studied and have yielded positive results. There is also emerging evidence for alternative medications such as low-sodium oxybate and pitolisant. Non-pharmacological approaches, such as CBT-H and tDCS have also shown promise in managing IH. This review highlights the complexity of managing IH management and emphasizes the need for personalized multidisciplinary approaches. Pharmacological interventions are important in managing IH and can be complemented by non-medication strategies. Larger-scale studies are necessary to advance our understanding of IH and to improve treatment outcomes.

Prevention of premature birth in female patients with bacterial vaginosis using a complex of natural antimicrobial peptides and cytokines

Introduction. The prevalence of bacterial vaginosis (BV) comprises 23–29 %, which in pregnant women is a known risk factor for premature birth (PB) that rates increases by 2.9-fold. BV treatment with antibiotics has no effect PB incidence, therefore stressing a need to search for alternative remedies.Aim: to evaluate the effectiveness of treatment, including antibacterial therapy and a complex preparation containing natural antimicrobial peptides and cytokines, to reduce the incidence of birth defects in pregnant women with BV.Materials and Methods. Design: a prospective open comparative cohort study in parallel groups was conducted with 101 pregnant women: Group I (n = 69) received the antibiotic Metronidazole, 500 mg tablets orally twice a day for 7 days, and a complex preparation containing exogenous natural antimicrobial peptides and cytokines (Superlymph®) suppositories per 25 IU once a day vaginally in the evening for 20 days; Group II (n = 32) received Metronidazole alone (the same regimen). Patient examination was carried out using approaches included clinical methods, accepted in obstetrics, and laboratory tests – microscopy of vaginal content smears, real-time polymerase chain reaction (PCR).Results. The PB (within 240–366 weeks) incidence in Group I was significantly lower than in Group II and comprised 2.9 % vs. 21.9 %, respectively (p = 0.004), with an 8-fold decline in developing PB risk (relative risk (RR) = 0.13; 95 % confidence interval (CI) = 0.03–0.60), whereas inter-group percentage of pregnant women with high risk (PB history) was comparable (p = 0.39) so that PB incidence did not differ from pregnant women without former PB. Microbiological recovery after treatment for BV was achieved in 85.5 % of patients from Group I vs. 56.3 % in Group II (RR = 1.52; 95 % CI = 1.10–2.10; p = 0.002) based on real-time PCR data. The persistence of anaerobic flora after treatment was significantly lower in Group I vs. Group II reaching 7.2 and 34.4 % (p &lt; 0.001), respectively, with a 5-fold lower PB risk (RR = 0.21; 95 % CI = 0.08–0.56). Cessation of viral shedding compared to the number of patients with initial viral shedding was achieved in 94.6 % vs. 8.3 % of patients, respectively, with a 50-fold decline in risk (RR = 0.02; 95 % CI = 0.005–0.08; p &lt; 0.001). The number of newborns weighing less than 2500 g was significantly lower from paired mothers who received Superlymph® + Metronidazole comprising 2.9 % vs. 15.6 % treated with Metronidazole alone (p = 0.03), whereas a risk of low birth weight neonates was decreased by 6-fold (RR = 0.16; 95 % CI = 0.03–0.88). The condition of the neonates assessed by birth Apgar score was comparable.Conclusion. The use of a complex preparation Superlymph® (suppositories per 25 IU once an day vaginally, for 20 days) along with oral antibiotic Мetronidazole in pregnant women with BV facilitates a decline in PB incidence down to 2.9 % at gestational age of 240–366 weeks lowering a risk of PB exceeding that of antibacterial therapy by 8-fold, including patients with former PB.

Diagnosis of Drug Resistance of M. tuberculosis in the Regions of the Siberian Federal District

The objective: to assess possibilities for timely diagnosis of drug resistance of M. tuberculosis in the regions of the Siberian Federal District (SFD) with a high burden of drug resistant tuberculosis.Subjects and Methods. The retrospective analysis included federal and sectorial statistical reporting data (Form no. 33, Form no. 8, Form no. 30, Form no. 7-TB, Form no. 8-TB), forms of non-recurrent statistical surveillance VR-5MLU, Form no. 68, data from Visit Reports by specialists of Novosibirsk Tuberculosis Research Institute by the Russian Ministry of Health for 2021 – 9 months of 2023.Results. All laboratories of TB units in the regions of the Siberian Federal District are equipped with equipment for rapid molecular genetic diagnosis of M. tuberculosis, however, the majority of laboratories have no possibility to conduct rapid molecular genetic DST to fluoroquinolones. In a number of regions no DST to levofloxacin and moxifloxacin is performed. Susceptibility testing to linezolid and bedaquiline is conducted extremely rarely. Susceptibility testing to delamanid is performed in single cases and only in one region. To achieve treatment effectiveness rates defined in Edict no. 19 by Russian Ministry of Health dated February 07, 2023, it is necessary to equip TB units with modern equipment for rapid DST, organize an uninterrupted supply of consumables, as well as train laboratory personnel in the shortest possible time.

Quality of life measurement in assessing treatment effectiveness in urticaria: European experts position statement.

In this study, the European Academy of Dermatology and Venereology (EADV) Task Forces on Quality of Life and Patient-Oriented Outcomes and Urticaria and Angioedema has examined the Health-Related Quality of Life (HRQoL) measurement in the treatment of urticaria. The Dermatology Life Quality Index was the most frequently used HRQoL instrument in clinical trials on urticaria. Many reports of clinical trials of urticaria gave no exact numeric results related to HRQoL changes, making clear conclusions and comparisons with other studies impossible. The interpretation of HRQoL impairment data is more difficult when assessed by instruments without severity stratification systems. The minimal clinically significant difference (MCID) is a more clinically oriented and relevant parameter than depending on statistically significant changes in HRQoL scores. Therefore, using HRQoL instruments with established MCID data in clinical trials and clinical practice is preferred.

Diagnosis of Drug Resistance of M. tuberculosis in the Regions of the Siberian Federal District

The objective: to assess possibilities for timely diagnosis of drug resistance of M. tuberculosis in the regions of the Siberian Federal District (SFD) with a high burden of drug resistant tuberculosis.Subjects and Methods. The retrospective analysis included federal and sectorial statistical reporting data (Form no. 33, Form no. 8, Form no. 30, Form no. 7-TB, Form no. 8-TB), forms of non-recurrent statistical surveillance VR-5MLU, Form no. 68, data from Visit Reports by specialists of Novosibirsk Tuberculosis Research Institute by the Russian Ministry of Health for 2021 – 9 months of 2023.Results. All laboratories of TB units in the regions of the Siberian Federal District are equipped with equipment for rapid molecular genetic diagnosis of M. tuberculosis, however, the majority of laboratories have no possibility to conduct rapid molecular genetic DST to fluoroquinolones. In a number of regions no DST to levofloxacin and moxifloxacin is performed. Susceptibility testing to linezolid and bedaquiline is conducted extremely rarely. Susceptibility testing to delamanid is performed in single cases and only in one region. To achieve treatment effectiveness rates defined in Edict no. 19 by Russian Ministry of Health dated February 07, 2023, it is necessary to equip TB units with modern equipment for rapid DST, organize an uninterrupted supply of consumables, as well as train laboratory personnel in the shortest possible time.

Utilizing a Pathomics Biomarker to Predict the Effectiveness of Bevacizumab in Ovarian Cancer Treatment

The purpose of this investigation is to develop and initially assess a quantitative image analysis scheme that utilizes histopathological images to predict the treatment effectiveness of bevacizumab therapy in ovarian cancer patients. As a widely accessible diagnostic tool, histopathological slides contain copious information regarding underlying tumor progression that is associated with tumor prognosis. However, this information cannot be readily identified by conventional visual examination. This study utilizes novel pathomics technology to quantify this meaningful information for treatment effectiveness prediction. Accordingly, a total of 9828 features were extracted from segmented tumor tissue, cell nuclei, and cell cytoplasm, which were categorized into geometric, intensity, texture, and subcellular structure features. Next, the best performing features were selected as the input for SVM (support vector machine)-based prediction models. These models were evaluated on an open dataset containing a total of 78 patients and 288 whole slides images. The results indicated that the sufficiently optimized, best-performing model yielded an area under the receiver operating characteristic (ROC) curve of 0.8312. When examining the best model’s confusion matrix, 37 and 25 cases were correctly predicted as responders and non-responders, respectively, achieving an overall accuracy of 0.7848. This investigation initially validated the feasibility of utilizing pathomics techniques to predict tumor responses to chemotherapy at an early stage.

Efficacy of cognitive behavioral therapy for anxiety and depression in Parkinson's disease patients: an updated systematic review and meta-analysis.

Parkinson's disease (PD) patients often experience non-motor symptoms like depression and anxiety, significantly impacting their quality of life. With the limited effectiveness of pharmacological treatments, effective non-pharmacological interventions are needed. This systematic review and meta-analysis aimed to evaluate the efficacy of cognitive-behavioral therapy (CBT) in reducing depression and anxiety symptoms in PD patients. Randomized controlled trials (RCTs) exploring CBT's effectiveness for depression and anxiety in PD patients were included. Studies published until April 2023 were identified from PubMed, Web of Science, and Scopus. Methodological quality was assessed using the Risk of Bias-2 (ROB-2) tool. Statistical analysis involved calculating the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) using Review Manager 5.4.1. The systematic review included 12 studies involving 241 PD patients. CBT led to a substantial reduction in anxiety (SMD -0.95, 95% CI [-1.15 to -0.74], P < 0.00001) and depression (SMD -1.02, 95% CI [-1.39 to -0.65], P < 0.0001). Both traditional CBT and tele-CBT (administered over the phone or internet) were effective in treating depression and anxiety. Traditional CBT improved depression (SMD -1.16, 95% CI [-1.83 to -0.49], P < 0.00001), while tele-CBT showed comparable results (SMD -0.90, 95% CI [-1.31 to -0.48], P < 0.00001). For anxiety, both traditional CBT (SMD -0.94, 95% CI [-1.25 to -0.63], P < 0.00001) and tele-CBT (SMD -0.95, 95% CI [-1.22 to -0.67], P < 0.00001) significantly reduced symptoms. In conclusion, this systematic review and meta-analysis demonstrated the efficacy of CBT in reducing depression and anxiety in PD patients. Healthcare providers are encouraged to integrate CBT into their treatment protocols. However, additional high-quality studies with longer-term follow-up assessments are needed to further enhance understanding in this area. CRD42023424758.

P-281 Surgery and IVF for diagnosed ovarian endometriosis and deep infiltrative endometriosis

Abstract Study question To evaluate the effectiveness of surgical treatment of endometrioid cysts and deep infiltrative endometriosis before an IVF program Summary answer Laparoscopic excision of deep infiltrative endometriosis has a positive effect on the reproductive function of women What is known already One of the most severe and aggressive manifestations of endometriosis is deep infiltrative endometriosis. Endometriosis is a socially significant disease that reduces a woman’s quality of life and affects reproductive health. Women with endometriosis often experience severe menstrual and non-menstrual pain affecting the lower abdomen, pelvis or lumbosacral region, profound dyspareunia, dyschezia and dysuria (Uimari et al., 2021) and infertility in 30–50% of cases (Prescott et al.., 2016). Patients with endometriosis suffer from chronic fatigue (Ramin-Wright et al., 2018) and have a higher risk of mental health problems (56.4%) than patients without endometriosis (43.6%) (Pope et al., 2015) Study design, size, duration The our institute is conducting a controlled, non-randomized, retro- and prospective study on genital endometriosis. The study period is from 2012 to the present. Participants/materials, setting, methods The study included 450 women with deep infiltrating endometriosis in combination with infertility All patients were divided into 4 groups Group 1 – 128 patients with deep infiltrative endometriosis, sent for IVF without surgery Group 2 – 297 patients with deep infiltrative endometriosis, initially referred for surgery Group 2a – 156 patients with ovarian cysts, sent for preliminary collection of eggs before surgery Group 2c – 141 patients with ovarian cysts, referred for surgery without prior egg retrieval Main results and the role of chance In group 1, the number of pregnancies occurred was 65.6% (84 women), in group 2a - 71.7% (112 women), in group 2 - 53.9% (76 women). Pregnancy occurred spontaneously in 18 (4.2%) women from group 2 after surgery. In group 2, four women, after three unsuccessful attempts at in vitro fertilization, became pregnant after using donor eggs - the results were excluded from the final pregnancy calculations. In terms of pregnancy, IVF with preliminary surgery (Me: 2.10; Q1-Q-3:0) had a statistically significant advantage compared to IVF without surgery (Me: 5.00; Q1-Q-3:0), and IVF with surgery without egg retrieval (Me:3.0; Q1-Q-3:0). The lowest statistically significant pregnancy rate was recorded during laparoscopic surgery without prior egg retrieval (Me: 6.95; Q1-Q-3:1). When performing a post-hoc analysis, a statistically significant shorter pregnancy time was also found when performing IVF with preliminary laparoscopy and egg freezing: group 1 (M: 126.25; SD111.1), group 2a (M: 79.97; SD: 19.785 ), group 2c (M: 130.50; SD: 82.149) (p = 0.000). During the period of observation of women for twelve years after surgery, 93% of patients noted an improvement in the quality of life and 63.7% of women on average achieved reproductive function after the IVF program for endometriosis. Limitations, reasons for caution no restrictions Wider implications of the findings The results of the IVF program for deep infiltrative endometriosis are statistically higher after surgery, but with preliminary cryopreservation of oocytes. The question of radical resection of the rectum in comparison with shaving when planning an IVF program remains open, which forms the planning of further research in this area. Trial registration number not applicable