High Efficacy Rates Research Articles

The no-retina-touch technique: vitrectomy and platelet-rich plasma in the treatment of lamellar macular hole. New insights into pathogenesis.

To explore the use of autologous platelet-rich plasma (PRP) as a potential therapeutic adjuvant strategy for treating degenerative lamellar macular holes (LMHs). A prospective interventional case series. Seven consecutive patients (8 eyes) with a diagnosis of LMH underwent a pars-plana vitrectomy with PRP injection under air tamponade. Anatomical results based on spectral domain optical coherence tomography (SD-OCT) and functional results, in terms of best corrected visual acuity (BCVA) and reading performance, were analyzed. At 12 months postoperatively, 7 out of 8 eyes (88%) presented a complete closure of the LMH. The ellipsoid zone (EZ) was restored in 3 eyes (37.5%). The mean (±SD) postoperative BCVA was 0.39 (±0.56) LogMAR, resulting in a statistically significant visual acuity improvement (p = 0.007). The mean (±SD) maximum reading speed (MaxRS) improved to 133.48 (±41.47) wpm, with a significant increase compared to the baseline (p = 0.029). The mean (±SD) reading acuity score (RA score) resulted in 0.44 (±0.04) LogRAD, with an improvement in reading acuity that did not reach statistical significance (p = 0.129). The utilization of the PRP technique with a no-retina-touch approach safeguards the delicate retinal tissues, minimizing the possibility of iatrogenic trauma or post-operative complications, while maintaining a high rate of efficacy in enabling the improvement of the foveal defect in lamellar macular holes.

The Effects of Numerical Evidence and Message Framing in Communicating Vaccine Efficacy

To examine the effects of numerical evidence and message framing in communicating vaccine efficacy information about infectious diseases, an online experiment presented to U.S. adults different versions of a vaccination promotional message that vary by numerical vaccine efficacy evidence: (low efficacy rate: 60% vs. high efficacy rate: 95%), outcome framing (preventing disease-related infection vs. preventing disease-related severe illness), and gain vs. loss framing, using a factorial between-subjects design. While there was no significant interaction between numerical vaccine efficacy evidence and message framing, findings showed that a higher vaccine efficacy rate increased positive beliefs about vaccination and outcome framing emphasizing infection prevention increased message processing fluency. Given that infectious diseases pose higher risks for severe illness among older adults, follow-up analyses by age showed that only younger adults were sensitive to message framing where outcome framing emphasizing infection prevention increased processing fluency.

Tapering and Sustained Remission of Thrombopoietin Receptor Agonists (TPO-RAs): Is it Time for Paediatric ITP?

Thrombopoietin receptor agonists (TPO-Ras; romiplostim/eltrombopag/avatrombopag) have demonstrated high efficacy rates (59-88%) and a good safety profile in clinical trials with adult patients with immune thrombocytopenia (ITP). Similar efficacy and safety results have been observed with romiplostim and eltrombopag in paediatric cohorts. Continuous treatment with TPO-RAs has shown durable responses with long-term use, up to 3years. The effect of TPO-RAs was generally considered transient, as platelet counts tended to drop to baseline values after a short period of time (about 2weeks), unless treatment was maintained. Several groups have reported successful discontinuation of TPO-RAs without the need for concomitant treatments. This is referred to as sustained remission off treatment (SROT). Both short- and medium-term treatment with TPO-RAs may reduce costs to our healthcare systems and, more importantly, may reduce the potential side effects that may be associated with continuous TPO-RA treatment. The issue of tapering and discontinuation of TPO-RAs in paediatric patients with ITP has received little attention to date. Given that paediatric ITP has much higher rates of spontaneous remission than ITP in adults, we consider that the possibility of SROT of TPO-RAs in paediatric patients with ITP is a neglected but very relevant issue in this subtype of the disease.

Clinical Pharmacist with DEA License: Efforts to Increase Access to Buprenorphine in a Veteran Population.

Opioid overdoses continue to rise in the United States. In 2021, a record 80,411 reported overdoses occurred in the US alone, nearly double that in 2017. Buprenorphine's pharmacology is ideal for management of patients with opioid use disorder (OUD) with or without chronic pain. Within the VA, clinical pharmacist practitioners (CPP) are uniquely equipped to operate with significant scope of practice to prescribe medications including controlled substances, an opportunity to vastly increase access to care for veterans suffering from OUD, complex opioid dependency or pain. The purpose of this case series is to describe how DEA licensed pain CPP safely and effectively manages 1) Suboxone home inductions to increase access for OUD 2) rotations from traditional full mu opioids to chronic pain buprenorphine products and 3) off label use of Suboxone for pain. Procedures/data/observations: Cases were collected in usual workload for clinical pharmacist. High rate of tolerability and efficacy noted with buprenorphine across all products. DEA licensed Pain CPPs can make an immediate positive impact for veterans with OUD and/or complex pain and may be more comfortable with buprenorphine than many other providers.

Cantharidin (1%), podophyllin (5%), and salicylic acid (30%) formulation in recalcitrant plantar warts: Analysis of 48 patients.

A plantar wart is a benign hyperplasia that appears on the feet due to the human papillomavirus (HPV). One method used for the treatment of recalcitrant plantar warts, those lasting over 2 years or persisting after at least two treatment attempts, is the cantharidin (1%), podophyllin (5%), and salicylic acid (30%) formulation, also known as the CPS formulation. Although this method is in use, there are few studies on it. This study's objective was to ascertain its cure rate. For this retrospective observational study, we reviewed the medical records of patients treated with the CPS formulation at a podiatric clinic specializing in plantar wart treatment. Our sample size was 48 subjects. The CPS formulation had a cure rate of 62.5%. Out of the cured patients, 86.67% (26/30) required one or two applications. There was no observable correlation (p > 0.05) between wart resolution and virus biotype, evolution time, patient's morphological and clinical attributes, location, number of warts, or preceding treatments. The CPS formulation presents a relatively high efficacy rate for treating recalcitrant HPV plantar warts. Still, additional studies are necessary to evaluate its safety and efficiency.

The Efficacy and Safety of Complementary and Alternative Medicine for Depression: An Umbrella Review.

Depression is a major public health problem. Many complementary and alternative medicine (CAM) interventions have been suggested as potential treatments. We comprehensively searched for relevant systematic reviews and meta-analyses in the PubMed, EMBASE, Web of Science, and Cochrane Library databases. We assessed effectiveness based on efficiency and changes in Depression Assessment Scale scores and safety based on adverse events. This umbrella review included twenty-two eligible articles. Yueju antidepressant and Electro-acupuncture (EA) improved depression symptoms better than antidepressants. In addition, omega-3 fatty acids (n-3PUFAs), exercise, manual acupuncture (MA), Hypericum mono-preparations, relaxation, and Vitamin D showed better efficacy than placebo and control. GPD as adjunctive therapies have higher efficacy rates than antidepressant, and MA and Yueju antidepressants have a better safety profile than antidepressants. Our study demonstrated that 10 CAMs can effectively improve the condition of patients with clinical depression.

Effect of SBRT plus immunotherapy on immune status and survival quality of NSCLC patients: A study of combined radiotherapy and immunotherapy.

non-small cell lung cancer (NSCLC) accounts for more than 80% of all lung cancer populations. Stereotactic radiotherapy (SBRT) is mainly suitable for early NSCLC patients who are not suitable for surgery or refuse surgery. To analyze the effects of stereotactic radiotherapy (SBRT) plus immunotherapy for non-small cell lung cancer (NSCLC) patients on their immune status and survival quality. NSCLC patients admitted to our hospital from 2019-2022 were divided into 61 cases in control group (SBRT) and 60 cases in observation group (SBRT plus immunotherapy) by the randomized numerical table method to compare the efficacy, the level of tumor markers in the serum, the level and activity of the immune cells in the peripheral blood and the Kahlil's functional status (KPS) scores. The observation group had a higher efficacy rate than that of the control group (P< 0.05). There was no statistical difference between the two groups in serum tumor marker content, immune cell level and activity in peripheral blood and KPS score before treatment (P> 0.05). After treatment, serum tumor markers were lower than those in control group, and immune cell level, NK cell-related activity and KPS score were higher than those in control group (P< 0.05). SBRT plus immunotherapy can reduce the level of various tumor markers, improve the immune status and quality of survival for NSCLC patients.

Analysis of Pain and Effectiveness in Digital Block of the First Toe Using Syringe vs. Carpule: Frost's H vs. Modified Frost's H Randomized Clinical Trial.

Background: Currently, there is no scientific evidence regarding pain in the anesthetic block of the first toe according to the method of application. However, clinical evidence has highlighted the use of the carpule due to the low pain it causes during the administration of the anesthetic. Most studies on anesthesia and pain, especially using the carpule and distraction methods, belong to the field of dentistry. Objective: To compare the pain and effectiveness between the anesthetic block of the first toe using a carpule and syringe with Frost's H technique and the modified Frost's H technique. Method: A total of 564 subjects were selected and divided into four groups. Subjects were subjected to experimental conditions (randomization through the Random Allocation Software program 2.0), and divided into group 1 = 138 subjects, corresponding to the block with syringe and Frost's H, group 2 = 141 subjects, corresponding to the syringe group and modified Frost's H, group 3 = 141 subjects, corresponding to the carpule group and modified Frost's H, and group 4 = 144 subjects, corresponding to the carpule group and Frost's H. The same researcher generated the random allocation sequence, enrolled the participants, and assigned them to the interventions. Each subject was unaware of the anesthetic procedure assigned by the researcher. Outcome parameters were pain after anesthetic infiltration and its effectiveness. Results: The anesthetic block with carpule showed a lower pain score compared to the anesthetic block with syringe (2.8 vs. 5.3; p < 0.001). However, when analyzing effectiveness, a higher efficacy rate was obtained in the anesthetic blocks performed using the modified Frost's H technique (97.5% vs. 88.1%; p < 0.001). Conclusions: The anesthetic block with carpule and the modified Frost's H technique is less painful and more effective than the traditional anesthetic block.

De-escalation treatment of patients with HPV-positive oropharyngeal squamous cell carcinoma.

e18052 Background: According to Globocan in 2020 were identified 98 412 new cases of oropharyngeal squamous cell carcinoma in the world. It was proved that the human papillomavirus (HPV) is a favorable prognostic factor. Patients with HPV-positive oropharynx cancer have higher indicators of progression-free survival (PFS) and overall survival (OS). As induction chemotherapy, the only TPF regimen (cisplatin/ docetaxel/ 5-fluorouracil) has been approved which has high toxic profile. Published results of randomized trials demonstrate the possibility of de-escalation CRT without reduction OS and PFS, but there is no data about safety of de-escalated IC regimen. Given the high toxicity of the standard regimen, as well as the presence of a favorable prognostic factor (HPV infection), since 2021 has started a prospective trial, investigating the possibility of use the dual-component IC regimen according to the TP scheme (cisplatin/ docetaxel). Objective: Improve the results of treatment of patients with locally advanced HPV- positive squamous cell carcinoma of the oropharynx by optimizing the scheme IC. Methods: In the prospective trial included 68 patients with p16-positive oropharyngeal squamous cell carcinoma (T3-4N0-1M0, or T1-4N2-3M0), who were divided into 2 equal groups. The research group received 3 cycles of IC to the de-escalated TP regimen and the control group according to the standard three-component TPF regimen. After completion IC patients of both groups had a standard CRT 70 Gy with carboplatin AUC 2.0 weekly. The primary endpoints were the assessment of objective response rate after the IC and toxicity. The Secondary endpoints: 1-year OS and PFS. Results: Complete response (CR) was achieved in 3 patients (8,8%), a partial response (PR) in 22 (64,7%), stable disease (SD) in 8 (23,5%) patients in the research arm. In the control arm: CR 4 patients (11,8%), PR 24 (70,6%), SD 6 (17,6%) patients. Both IC regimens demonstrated high efficacy rates, and there was no statistically significant ORR in the group (p=0,2133).Toxic manifestations were often observed in the arm of standard IC. The higher incidence of mucositis in the control group was statistically significant (p=0,025). The effect of IC regimen on subsequent CRT was also assessed. In the research arm, the time before the start of CRT was statistically significantly less than in the control arm (30 days vs 63 days, p=0,0035.). And the period of development mucositis of CRT in the TP group was longer than in the TPF group (34G vs 32G, p=0,0298). 1 year - PFS 94%, 1 year - OS 100% in the research group and 92% and 100% in the control arm. There was no statistically significant 1 year – PFS and 1 year - OS in the group (р=0,6547). Conclusions: The research scheme of IC demonstrated high results of an objective response, 1-year OS and 1 year - PFS, comparable to the standard TPF scheme, against the background of better tolerance.

Oral nutritional supplements improve clinical outcomes and are cost-effective for hospitalized patients in China

ObjectiveThis study assessed the therapeutic benefits and modeled the cost-effectiveness of oral nutritional supplements (ONS) in China. MethodsData were collected from 27 152 adult inpatients between January 1, 2018, and December 31, 2020. Propensity score matching was used for balancing the baseline characteristics between the ONS group and non-ONS group. A decision-tree model was developed to assess the cost-effectiveness of ONS for patients with nutritional risk, and the incremental cost-effectiveness ratio was the metric to determine the most cost-effective strategy. One-way sensitivity and probabilistic sensitivity analyses were conducted to assess the model's stability. In addition, subgroup analysis was conducted based on clinical characteristics. Differences in clinical outcomes between the groups were compared using Student's t test, Mann–Whitney U test, or chi-square test. ResultsThe ONS group displayed significantly lower levels of prealbumin, albumin, hemoglobin, and BMI than the non-ONS group at admission. The incidence of malignant tumors, intestinal obstruction, and inflammatory bowel disease was significantly higher in the ONS group than the non-ONS group. The ONS group had a significantly higher effective rate than the non-ONS group (51.7% versus 50.3%, P < 0.05). Analysis of the decision-tree model revealed that the ONS group experienced an increase in cost of 19 850.96 yuan but achieved an additional 1.3406 effectiveness rate, resulting in an incremental cost-effectiveness ratio of 14 807.51, which fell below China's 2020 per capita gross domestic product of 71 965 yuan. Sensitivity analysis further confirmed the robustness of the model. ConclusionsONS are demonstrated a high rate of efficacy, although patients currently using ONS are typically in a severe disease state. In addition, ONS is cost-effective. We suggest that the reimbursement coverage of ONS be expanded to include in-hospital patients who are at high nutritional risk.

A Systematic Review of Loco-Sedative Anesthesia for Urologic Surgery

ObjectiveTo perform a systematic review of the characteristics and outcomes of conscious sedation and local anesthesia for various urologic procedures. Urologic care has much to gain from the routine integration of ambulatory surgery via loco-sedative anesthetic techniques for both surgeon and patient. MethodsA comprehensive systematic literature search was conducted on PubMed, and Scopus databases following PRISMA criteria from June to August 2021. Articles were included if they were English, prospective, randomized, or non-randomized controlled trials that used local anesthetic or conscious sedation for urologic interventions in adult patients. Additionally, included studies provided primary data on the use loco-sedative anesthesia and the efficacy and complications. All studies included were further reviewed to assess the biases and conflicts of interests. Results32 studies with 6897 patients were included in the review. Mean patient age was 46.4 years. The most common anesthetic and analgesic relief was the use of local anesthetic with 1% lidocaine. The majority used lidocaine as an injection, whereas the second most common route of administration was a topical cream. However, there was significant heterogeneity in the type of local or conscious sedation method and whether a combination was used. 44.4% of the studies used the visual analog scale as their primary endpoint. All the studies reported an 83% to 100% successful procedure rate without note of significant sedation-related complications. ConclusionsGiven the high efficacy rates, loco-sedative anesthesia is a promising technique for urologic interventions and should be further investigated to determine whether it may become be the standard of care.

Effectiveness of secukinumab in patients with psoriasis and psoriatic arthritis in a Saudi real-world setting

IntroductionPsoriasis (PsO) is an immune-mediated chronic inflammatory disease that results in severe outcomes that impact the patient’s quality of life and work productivity. We investigated the effectiveness of secukinumab in patients with chronic plaque psoriasis and psoriatic arthritis (PsA) over a 12-month period.MethodsThis was a longitudinal, retrospective study of the medical records of 81 patients with psoriasis and/or psoriatic arthritis who had been treated with secukinumab for at least 12 weeks.ResultsThe Psoriasis Area Severity Index (PASI), Body Surface Area (BSA) percentage, and Dermatology Quality of Life Index (DLQI) among patients with PsO and PsO-PsA showed a statistically significant decrease from baseline over 12 months by approximately 9.86, 19.3%, and 9.7, respectively (p values < 0.001 for each). Moreover, there was a statistically significant decrease in the overall Disease Activity in Psoriatic Arthritis score (DAPSA) by approximately 22.35 from baseline over 12 months of treatment (p < 0.001). Considering the patients who started secukinumab 12 months or more prior to the study cutoff date, the 12-month retention rate was 85%.ConclusionIn a Saudi real-world setting, secukinumab proved to be an efficient medication with high efficacy and retention rates.

Exploring the Effectiveness of Pre-Exposure Prophylaxis (PrEP) Use for HIV Prevention among High-Risk Populations

Addressing the global burden of HIV requires effective preventative measures that have been shown to have high efficacy rates. PrEP is one of the preventative measures that is effective in preventing HIV. Different clinical trials and population studies have shown PrEPto have an efficacy rate of 40% to 90% when it comes to preventing HIV. Due to its high efficacy, PrEPcan reduce new HIV infections populations considered to be high risk. However, for efficacy to be high, there is a need to increase medication adherence and address the existing barriers that limit uptake. Some of these barriers are lack of knowledge, inadequate access, stigma,lack of trust in service providers, low perception of HIV risk, cost, and fear of side effects. Addressing these barriers can increase PrEP uptake and help in reducing HIV’s risk among high-risk populations. Some of the measures that can be put in place to address these barriers are providing education and training, allocating enough resources, leveraging technology, lowering PrEP costs, increasing insurance coverage, and improving communication among the targeted population.

Molecular Detection of Macrolide-Induced Clindamycin Resistance Among Clinical Isolates of Staphylococcus aureus from Selected Hospitals in Katsina Metropolis

Study’s Novelty/Excerpt This study investigates the prevalence and characteristics of inducible clindamycin resistance in Staphylococcus aureus isolates from clinical specimens in Katsina Metropolis, Nigeria, highlighting its significant clinical challenge. Antibiogram profiling revealed high efficacy rates for chloramphenicol (87.8%), clindamycin (79.6%), tetracycline (69.4%), and azithromycin (67.3%), while cefoxitin, ciprofloxacin, and trimethoprim-sulfamethoxazole showed the highest resistance levels. The D-test identified the Macrolide Lincosamide Streptogramin B (MLSB) phenotypes, with the ermC gene predominant among D-test-positive isolates expressing the inducible MLSB (iMLSB) phenotype, underscoring the need for targeted treatment strategies and continuous surveillance to manage antimicrobial resistance in this region. Full Abstract The emergence of inducible clindamycin resistance presents a significant challenge in treating Staphylococcus aureus (S. aureus) infections. This phenotype, evading routine susceptibility testing, compromises treatment efficacy and prolongs patient illness. Despite its clinical importance, limited data exist on its prevalence in Katsina Metropolis, Nigeria. This study aims to assess its prevalence and evaluate the phenotypic and genotypic characteristics among clinical isolates collected from selected hospitals in Katsina Metropolis. S. aureus isolates from various clinical specimens were obtained from three hospitals and identified using standard bacteriological methods. Antibiogram profiles were determined following CLSI guidelines, revealing varying efficacy among commonly prescribed antibiotics. Notably, chloramphenicol (87.8%), clindamycin (79.6%), tetracycline (69.4%), and azithromycin (67.3%) demonstrated high efficacy rates, while cefoxitin, ciprofloxacin, and trimethoprim-sulfamethoxazole exhibited the highest resistance level of (44.9%), (42.9%), and (40.8%) respectively. Prevalence of Macrolide Lincosamide Streptogramin B (MLSB) phenotypes was assessed using the D-test, unveiling specific resistance phenotypes among the isolates. Polymerase chain reaction detected the ermC gene as predominant among D-test-positive isolates, all expressing the iMLSB phenotype. These findings shed light on the prevalence and mechanisms of inducible clindamycin resistance in S. aureus clinical isolates in Katsina Metropolis, emphasizing the importance of tailored treatment strategies and ongoing surveillance in combating antimicrobial resistance effectively

(O-26) INITIAL EXPERIENCE IN IMPLEMENTING AN INTRACAVERNOSAL INJECTABLE THERAPY PROGRAM FOR THE TREATMENT OF ERECTILE DYSFUNCTION IN PATIENTS AT A PUBLIC HOSPITAL

Abstract Introduction Intracavernous injectable therapy (IIT) has been considered a second-line therapy for the treatment of erectile dysfunction (ED) since the emergence of phosphodiesterase type 5 inhibitors (IPDE-5) for oral use in the late 1990s. The ease of access to IPDE-5, with increasingly accessible costs, in addition to the safety and efficacy with the use of these medications, caused IIT to fall into disuse for a good period. In turn, about 30% of men with ED do not respond satisfactorily to the oral use of IPDE-5, needing to resort to some other form of treatment. Materials and Method Patients with ED unresponsive to oral IPDE-5 were referred for IIT. Subsequently, they were submitted to a questionnaire to evaluate the results. Results Eight men answered the applied questionnaire. The mean age of patients was 61 years (44-75 years). All patients reported that their partner was aware of the treatment used, and 75% of patients reported the presence of some comorbidity. The response to the test was considered satisfactory in 75% of the patients, with full erection (EHS 4) in 37.5%, and partial erection with penetration (EHS 3) in 37.5%. Only one patient (12.5%) reported not having adapted to the proposed treatment, despite having a satisfactory erection. After a 12-month follow-up, only one patient (12.5%) continues to use IIT, 3 (37.5%) opted for penile prosthesis implantation, while the others chose not to adhere to any subsequent treatment. In 62.5% of patients there was no report of any side effect. Conclusion Despite high rates of efficacy and satisfaction reported in the literature, our initial experience showed a low rate of adherence to IIT. The team's lack of experience and difficulty in following up patients probably contributed to these results, revealing a need for better team training and patient guidance. Financing No conflict.

EARLY OPERATIVE MANAGEMENT OF COMPLICATED APPENDICITIS IS ASSOCIATED WITH IMPROVED SURGICAL OUTCOMES IN ADULTS: A COMPREHENSIVE SYSTEMATIC REVIEW

Background: The management of appendicitis has been surgical over the years with high significant efficacy and low complication rate, and is recommended for the treatment of appendicitis in those cases in which there is a dilatation of more than 13 mm of the appendix, mass effect or presence of appendicolith in imaging. However, recent evidence from different series has proposed medical management for this condition in specific high surgical risk populations. The aim: The aim of this study to show about early operative management of complicated appendicitis is associated with improved surgical outcomes in adults. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. This search approach, publications that came out between 2014 and 2024 were taken into account. Several different online reference sources, like Pubmed, SagePub, and Google Scholar were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search get 23 articles, whereas the results of our search on SagePub get 151 articles, on Google Scholar 2840 articles. Records remove before screening are 2110, so we get 904 articles fos screening. After we screened based on record exclude, we compiled a total of 10 papers. We included five research that met the criteria. Conclusion: Laparoscopic appendicectomy is becoming the gold standard for the treatment of appendicitis. However, the advantages of the innovations in minimally invasive and endoscopic surgery are unlikely to render formal open appendicectomy obsolete. Nonoperative management with antibiotics may suffice in selected cases with uncomplicated appendicitis.

A review of fecal microbiota, live-jslm for the prevention of recurrent Clostridioides difficile infection.

To review the composition, preparation, proposed mechanism of action, safety, efficacy, and current place in therapy of Rebyota (fecal microbiota, live-jslm). As the first agent in a new class of drugs, live biotherapeutic products (LBPs), fecal microbiota, live-jslm offers another therapeutic approach for the prevention of recurrent Clostridioides difficile infection (rCDI). LBPs are given following antibiotic therapy for C. difficile to reintroduce certain bacteria present in the normal microbiome, as a means to reconstitute the microbiome of infected individuals. This review provides a summary of phase 2 and 3 clinical trials, product information, discussion of data limitations, and recommendations for place in therapy. High efficacy rates compared to placebo with sustained response up to 24 months after administration have been reported. The majority of adverse events identified were mild to moderate without significant safety signals. Fecal microbiota, live-jslm has consistently been shown in randomized trials to be safe and effective in reducing rCDI. Its approval marks the culmination of decades of work to identify, characterize, and refine the intestinal microbiome to create pharmaceutical products.

Drug dialysis through a semipermeable membrane as a preliminary efficacy assessment of a promising parasitocidal drug

The purpose of the research is to analyze the dynamics of fenbendazole (FBZ) and niclozamide (NZM) release from their solid dispersions (SD) of various compositions by dialysis through various semipermeable membranes in model systems that correspond to stomach and intestine environments. To evaluate the parasitocidal activity of experimental mixture compositions.Materials and methods. The study used substances of FBZ and NZM, and the polymer, polyvinylpyrrolidone (PVP). Mechanical processes were carried out in a LE-101 roller mill and an AGO-2 orbital centrifugal mill at different power density levels. The resulting SD of various compositions were studied for solubility. The dynamics of FBZ and NZM substance release from the SD were studied in a laboratory setup consisting of a temperature controlled glass with buffer solutions with pH = 9.18 (intestinal environment) and pH = 1.0 (stomach environment). The substance concentration in the dialysate was determined by HPLC and UV spectroscopy. The resulting complex SD of FBZ and NZM were studied for cestodocidal activity in a laboratory model of hymenolepiosis of white mice.Results and discussion. It was found that the substances release into a buffer solution with pH = 9.18 from the SD obtained in the roller mill is higher than that of the SD obtained in the AGO activator. The dialysis of the experimental compounds in a model system with a gastric juice medium observed only FBZ substance penetration through the membrane, which can be explained by protonation of the FBZ molecule which is a weak base. The NZM molecule, being a neutral molecule, does not penetrate through the semi-permeable partition into the hydrochloric acid environment; it remains entirely inside the dialysis bag. High anthelmintic efficacy rates (up to 100%) of SD complex FBZ : NZM : PVP obtained in the AGO activator and in the roller mill were recorded for the SD of composition 2 : 20 : 78 in the mice with hymenolepiosis. The activity of the base drug, the niclozamide substance, was 27.69%, which is 3 times lower than the activity of the resulting complex dispersions.

A Novel Approach for Mucosal and Bulbar Olfactory Ensheathing Cells Isolation Based on the Non-adherent Subculture Technique.

Olfactory ensheathing cells (OECs) are widely used in transplantation studies. The high purification of this unique cell type is valuable for medical applications. Although recent improvements in OECs isolation procedures opened a new era in this field, the high purification efficacy and viability rate are still of concern. The most widely used OECs isolation techniques can be broadly classified based on adherence properties, particularly in olfactory bulb-derived OEC isolation. Considering the invasive nature of harvesting OECs from human olfactory bulbs, a highly efficient purification of these cells from olfactory mucosa can benefit clinical trials. In this study, we isolated OECs from rats' olfactory bulbs and mucosa due to their differential adherence properties and compared them. Cell preparations were characterized by NGFR p75 and S100β antibodies, the specific markers for OECs, using immunocytochemistry and western blot analysis, respectively. OECs morphology and viability were monitored over time by microscopy and MTT (3-[4,5-dimethylthiazol2-yl]-2,5-diphenyltetrazolium bromide) assay. We found that OECs could be purified from the olfactory mucosa using our suggested method as efficiently as the olfactory bulb. Both derived OECs showed high levels of NGFR p75 and S100β expression, although the S100β expression was higher in olfactory mucosa-derived OECs preparations (P<0.05). Moreover, there was no significant difference between the two sources in cell viability in our suggested protocol. Due to the non-invasive harvesting method, olfactory mucosa-derived OECs are preferred from a clinical point of view in transplantation studies.

Stereotactic Body Radiation Therapy for Sacral Metastases: Deviation From Recommended Target Volume Delineation Increases the Risk of Local Failure

PurposeAlthough spine stereotactic body radiotherapy (SBRT) is considered a standard of care in the mobile spine, mature evidence reporting outcomes specific to sacral metastases is lacking. Furthermore, there is a need to validate the existing sacral SBRT international consensus contouring guidelines to define the optimal contouring approach. We report mature rates of local failure (LF), adverse events, and the impact of contouring deviations in the largest experience to date specific to sacrum SBRT. Methods/MaterialsConsecutive patients who underwent sacral SBRT from 2010-2021 were retrospectively reviewed. Primary endpoint was magnetic resonance imaging-based LF with a specific focus on adherence to target volume contouring recommendations. Secondary endpoints included vertebral compression fracture (VCF) and neural toxicity. ResultsOf the 215 sacrum segments treated in 112 patients, most received 30 Gy/4 fractions (51%), 24 Gy/2 fractions (31%), or 30 Gy/5 fractions (10%). Sixteen percent of segments were non-adherent to the consensus guideline with a more restricted target volume (under-contoured). The median follow-up was 21.4 months (range, 1.5-116.9). The cumulative incidence of LF at 1 and 2 years was 18.4% and 23.1%, respectively. In those with guideline adherent vs. non-adherent contours, the LF rate at 1 year was 15.1% vs. 31.4% and at 2 years 18.8% vs. 40.0% (HR=2.5, 95% CI 1.4-4.6, p=0.003), respectively. On multivariable analysis, guideline non-adherence (HR=2.4, 95% CI 1.3-4.7, p=0.008), radioresistant histology (HR=2.4, 95% CI 1.4-4.1, p<0.001), and extraosseous extension (HR=2.5, 95% CI 1.3-4.7, p=0.005) predicted for an increased risk of LF. The cumulative incidence of VCF was 7.1% at 1 year and 12.3% at 2 years. Seven patients (6.3%) developed peripheral nerve toxicity, of which 4/7 had been previously radiated. ConclusionsSacral SBRT is associated with high efficacy rates and an acceptable toxicity profile. Adhering to consensus guidelines for target volume delineation is recommended to reduce the risk of LF.