Therapeutic Group Research Articles

Potential of cinnamaldehyde essential oil as a possible antimicrobial against fowl typhoid in layers.

Fowl typhoid (FT) is an economically significant bacterial disease of layers leading to a drastic drop in egg production. Due to increased public health concerns about antibiotics in poultry feed, a search for new safe antimicrobials for treating fowl typhoid is crucial. The antimicrobial effect of cinnamaldehyde essential oil (CnEO) against fowl typhoid in layers was investigated in this experiment. The 60-week-old BV300-layer birds (n = 100) were divided into five groups: the non-challenged control group A, only cinnamaldehyde-treated group B (CnEO @ 1:8000 dilutions through drinking water for 60days), the challenged group C, challenged plus cinnamaldehyde therapy group D (CnEO @ 1:8000 dilutions through drinking water from 16 to 30 dpi), and challenged plus antibiotic therapy group E (chloramphenicol @ 1 gm/5lit through drinking water from 16 to 30 dpi). Hens from all challenged groups were challenged with Salmonella Gallinarum (VTCCBAA588) @ 1 × 108CFU/ml orally. Various parameters such as clinical signs, mortality, egg production and egg weight, colony-forming unit (CFU) count of cecal content, eggshell surface, and egg yolk were evaluated all through 60days of an experimental trial. Results indicated that, in the case of the cinnamaldehyde therapeutic group, there was a significant improvement in egg production, mild clinical signs, lower feed conversion ratio (FCR), and a significantly lower bacterial count in ceca and on the eggshell surface compared to the control challenge group. Thus, CnEO @ 1:8000 dilutions through drinking water can be a potential antimicrobial for controlling fowl typhoid.

Effects of Radiofrequency Diathermy Plus Therapeutic Exercises on Pain and Functionality of Patients with Patellofemoral Pain Syndrome: A Randomized Controlled Trial

Although consensus has been reached about the use of therapeutic exercise in patellofemoral pain syndrome, several techniques used worldwide such as radiofrequency diathermy could be useful as complementary therapy. The objective of this randomized controlled trial was to compare the effects of adding radiofrequency diathermy to therapeutic exercises in patients with patellofemoral pain syndrome. Fifty-six participants were randomly assigned either to radiofrequency diathermy plus therapeutic exercises group (n = 29) or therapeutic exercises group (n = 27). Both groups received the same therapeutic exercises, and the diathermy group additionally received monopolar dielectric diathermy for three weeks (5-3-2 weekly sessions). Data related to intensity of pain, probability of neuropathic pain, functionality, and range of movement of the knee were measured at baseline and three weeks after the intervention. Comparing pre-treatment and values obtained at the third week, significant improvements were found in intensity of pain, neuropathic pain, functionality, and range of motion in both groups (p < 0.05). The diathermy plus exercises group had significantly better intensity of pain than the control group at the end of the three weeks (p < 0.01). The addition of diathermy by emission of radiofrequency to the therapeutic knee exercise protocol is more effective than a therapeutic exercise protocol alone in the relief of intensity of pain in patients with patellofemoral pain in the immediate post-treatment follow-up compared with baseline scores.

Comparative Analysis of Solifenacin Plus Desmopressin Versus Desmopressin Alone in the Treatment of Primary Mono Symptomatic Nocturnal Enuresis

ObjectivesTo compare the efficacy and tolerability of Solifenacin plus Desmopressin and Desmopressin alone in the treatment of primary monosymptomatic nocturnal enuresis (PMNE). MethodsA total of 88 children, 5–14 years old, diagnosed with PMNE were enrolled in this randomized control trial (RCT) from June 2017 to June 2020. After informed written consent patients were randomized to one of the two therapeutic groups. Group 1 received one puff of desmopressin nasal spray 1 h before bedtime every night. Group 2 received one pill of solifenacin 5 mg plus one puff of desmopressin nasal spray 1 h before bedtime every night. All patients were evaluated after three months for their response to treatment and drug side effects. ResultsThe mean age in desmopressin alone group and solifenacin plus desmopressin group was 8.1 ± 2.2 (5–14) and 7.9 ± 2.2 (5–14) years respectively (p-value >0.05). In group 2, 37/44 (84.09%) patients achieved complete response after three months of treatment in comparison to group 1 in which 27/44 (61.36%) patients showed complete response (p-value <0.05). In group 1, 8/44 (18.18%) patients developed treatment related side effects whereas in group 2, 12/44 (27.27%) patients developed side effects (p-value >0.05). No case of discontinuation of treatment due to side effects was observed in any of the two groups. The recurrence rate was also significantly lower in group 2 in comparison to group 1 (8.1% vs 33.3%, p-value <0.05). ConclusionOur study demonstrated that the combination of Solifenacin plus Desmopressin is more effective than desmopressin monotherapy in the treatment of PMNE with an acceptable tolerability profile. Level of EvidenceLevel I.

A Qualitative Assessment of the Treatment Needs of Women with Concurrent Eating and Substance Use Disorders in a Residential Setting

Objectives: Eating and substance use disorders (SUD) are generally treated separately, leaving eating disorders (ED) overlooked within substance use treatment. The frequent co-occurrence of SUD and ED is well documented. Despite their many similarities and frequent co-occurrence, these two disorder types continue to be largely treated separately–either sequentially, with the most severe disorder addressed first, or concurrently but in separate programs. Our study, therefore, responds to this lacuna of data on patient and provider treatment needs for integrated ED and SUD treatment, centering the perspectives of women with lived experience of ED and SUD to support the development of therapeutic groups for women in treatment programs. Methods: This study was designed as a needs and assets assessment to determine the needs and priorities of women with concurrent ED and SUD for developing group programs. Participants for the needs assessment included both staff members (n = 10) and women receiving treatment (n = 10) who were recruited from a 90-day residential treatment program for women with SUD in British Columbia, Canada. Interviews and focus groups conducted with participants were audio-recorded and transcribed verbatim. Data were thematically analyzed and coded using Dedoose software. Results: Six key themes emerged from the qualitative data and were organized into sections with sub themes. An overarching premise from both staff and program participants was the need for concurrent therapeutic programming, nutritional support, and medical monitoring. The six discrete themes that were elicited included the similarities between ED and SUD, gaps in treatment, community support, family involvement, program participant treatment suggestions, staff treatment suggestions, and family involvement. Conclusions: Throughout this qualitative study, the need for screening and assessment of both disorders along with integrated treatment was stressed by participants, both program participants and staff alike. These findings complement current literature and suggest that pursuing concurrent treatment design may be helpful in addressing unmet program participant needs and could provide a more holistic framework for recovery.

The Covid-19 Pandemic: Mourning In Brazilian Families

This article reports the experience of two therapeutic group projects carried out during the Covid-19 pandemic in Brazil, coordinated by the working and research group Faces do Traumático [Faces of Trauma] at the Department of Psychoanalysis, Sedes Sapientiae Institute, São Paulo, Brazil. The groups were composed of people who lost family members as a result of Covid-19. We aim to demonstrate, using clinical vignettes and quotes from the participants, the importance of group interactions in the process of psychic elaboration of those losses, which took place in the broader context of social trauma that affected us all, through the recognition of suffering and the possibility of naming and giving voice to feelings that had remained silenced.

The effect of anti-coagulation dosage on the outcome of hospitalized COVID-19 patients in Ethiopia: a multi-center retrospective cohort study

BackgroundStudies have indicated that hospitalized COVID-19 patients benefit from anticoagulation therapy in terms of survival; however, there is an ongoing controversy over the optimum anticoagulant dosage. This study aimed to compare clinical outcomes between patients who received prophylactic anticoagulation and those who received therapeutic anticoagulation.MethodsA multi-center retrospective cohort study was conducted to determine the impact of anticoagulation dosage in hospitalized COVID-19 patients in Ethiopia. The primary outcome measure was in-hospital mortality, and it was assessed using multivariable binary logistic regression and covariate-adjusted Cox Proportional Hazard model. For critical and severe COVID-19 patients, subgroup analyses were performed using multivariable binary logistic regression model and multivariable Cox regression models.ResultA total of 472 hospitalized COVID-19 patients were included in this study, of whom 235 (49.8%) received therapeutic anticoagulation and 237 (50.2%) received prophylactic dose. The demographic and baseline clinical characteristics were roughly similar between the groups. After adjustment for several confounders, in critical COVID-19 subgroup, therapeutic dose of anticoagulation was significantly associated with a higher inpatient mortality (AOR 2.27, 95% CI, 1.18—4.35, p = 0.013), whereas in severe COVID-19 subgroup, anticoagulation dosage was not associated with inpatient mortality (OR, 1.02, 95% CI, 0.45 – 2.33, p = 0.958). In severe COVID-19 patient group however, the incidence of thrombosis was slightly lower in the therapeutic group as compared with prophylactic group although the difference was not statistically significant (AOR 0.15, 95% CI, 0.02 – 1.20, p = 0.073). Although there were only six major bleeding events in this study, all these were recorded from patients in the therapeutic subgroup, making the difference statistically significant (p = 0.013).ConclusionAlthough this study is limited by its observational design, our results are not consistent with current recommendations on anti-coagulation dose for hospitalized patients with COVID-19, necessitating the need for RCT in resource limited settings.

An Evaluation of MINDFIT—A Student Therapeutic Running Group as a Multi-Layered Intervention in the United Kingdom

Mental health is an ever-increasing concern for UK Universities and is underreported. Creative and dynamic approaches to tackle student wellbeing are important. In 2018, Sheffield Hallam University (SHU) Student Wellbeing Service initiated a pilot study of a therapeutic running programme 'MINDFIT' that combined physical activity, led by a counsellor, alongside a psychoeducation approach to support student mental health. Mixed methods were used which included the Patient Health Questionnaire-9 (PHQ-9), evaluating low mood and depression, and Generalized Anxiety Disorder Scale-7 (GAD-7), evaluating levels of anxiety. A total of 28 students were triaged onto a weekly programme over three semesters. Overall, 86% of the participants completed the programme. A promising reduction in the scores for PHQ-9 and GAD-7 was found at the end of the programme. Focus groups, with student participants, were held to gather qualitative data for analysis. After thematic analysis, three main themes emerged: "Creating a safe community", "Making progress" and "Pathways to success". MINDFIT was an effective and engaging multi-layered therapeutic approach. Recommendations identified the importance and effectiveness of the triage process in recruiting students and sustainability of the programme through the continued engagement of students post programme. More research is required to identify the long-term effects of the MINDFIT approach and how applicable it is to higher education contexts.

Home blood pressure-lowering effect of digital therapeutics in hypertension: impact of body weight and salt intake.

Lifestyle modifications, including body weight reduction and salt restriction, help reduce blood pressure (BP). This study investigated the effects of body mass index (BMI) and salt intake on home BP reductions in unmedicated patients with hypertension receiving guideline-based lifestyle modification from doctors (control group) or with the addition of a digital therapeutics intervention. Data from the HERB Digital Hypertension 1 (HERB-DH1) pivotal trial were analyzed. Home BP was measured for 7 days before each study visit (baseline, and 4/8/12 weeks). Body weight was measured at each visit and salt intake questionnaire was answered at baseline and 12 weeks. This analysis included 302 patients with sufficient home BP monitoring data (digital therapeutics: 156; control group: 146). The reduction in morning home SBP from baseline to 12 weeks was significantly greater in the digital therapeutics vs. control group for patients with baseline BMI ≥ 25 kg/m2 and higher salt intake group (self-reported salt intake score ≥ 14) (-5.1 mmHg, p < 0.01). Patients in the digital therapeutics group who experienced a reduction in BMI and an improvement in salt intake score during the 12-week study also had a significantly greater reduction in morning home SBP compared with patients in the control group (-7.2 mmHg, p < 0.01). The digital therapeutic intervention reduced home BP the most in unmedicated patients with hypertension with high baseline BMI and salt intake score. Those with improvements in both BMI and salt intake during the digital therapeutics intervention achieved the greatest reduction in home BP vs. control.Clinical trial registration: Japan Registry of Clinical Trials (jRCT2032190148).

Occurrence, bioconcentration, and human health risks of pharmaceuticals in biota in the Sea of Marmara, Türkiye

The presence, bioconcentration, and health risk via seafood consumption of 11 pharmaceutical compounds belonging to different therapeutic groups (anti-inflammatory, antiepileptic, lipid regulators, and hormones) were investigated in the muscle tissues of fish and the meat of shrimp in the Sea of Marmara. Six biota species (Merlangius merlangus, Trachurus meditterraneus, Serranus hepatus, Pomatomus saltatrix, Parapenaeus longirostris, Spratus sprattus) were collected from the five stations in October and April 2019. Ultrasonic extraction method followed by solid phase extraction was used for extraction of pharmaceutical compounds from biota samples and then analyzed using high-performance liquid chromatography. Of the 11 compounds, 10 were detected in biota species. Ibuprofen was the most frequently detected pharmaceutical in the biota tissues at high concentrations (<3.0–1225 ng/g, dw). The other widely detected compounds were fenoprofen (<3.6–323 ng/g, dw), gemfibrozil (<3.2–480 ng/g, dw), 17α-ethynylestradiol (<2.0–462 ng/g, dw), and carbamazepine (<7.6–222 ng/g, dw). The bioconcentration factors of the selected pharmaceuticals calculated in various aquatic organisms ranged from 9 to 2324 L/kg. The estimated daily intakes of anti-inflammatories, antiepileptics, lipid regulators, and hormones via seafood consumption were 0.37–568, 1.1–324, 8.5–197, 3–340 ng/kg bw. Day, respectively. Based on hazard quotients, estrone, 17β-estradiol, and 17α-ethynylestradiol may pose a health risk to humans through the consumption of this seafood.

Effects of compound prebiotics as prophylactic and therapeutic supplementation in a mouse model of acute colitis.

Compound prebiotics (CP) have been explored in modulation of intestinal microbiota and remission of inflammatory responses in the acute colitis (AC). Yet, research on the roles of simultaneous prophylactic and therapeutic CP intervention in relation to AC remains lacking. Here, CP were pre-fed to examine preventive effects. CP, CP combined with mesalazine (5-aminosalicylic acid) (CPM), and mesalazine were used to evaluate therapeutic effects on the dextran sulfate sodium (DSS)-induced AC. Results showed that prophylactic CP and therapeutic CPM alleviated AC, evidenced by variations of body weight, colon length, spleen index, disease activity index score, histological score, and intestinal mucosa. Ruminococcus and Bifidobacterium were detected in significant abundance in the prophylactic CP and therapeutic CPM groups, respectively. Phylogenetic ecological network analysis revealed that therapeutic CPM probably had the strongest coupling between microbes in changing intestinal microbiota to influence treatment. However, changes in short-chain fatty acids (SCFAs) seemed to have no persuasive results, probably due to reduced SCFA level in feces and variability in transit, absorption, and utilization. Furthermore, therapeutic CP exerted higher value in terms of observed species and Shannon diversity, as well as a more concentrated distribution by principal coordinates analysis. Together, the favorable roles of CP in colitis provide directions for prebiotics in designing effective prophylactic functional diets and treatment strategies. KEY POINTS: • Prebiotics as prophylactic intervention effectively inhibited acute colitis. • Prebiotics as prophylactic and therapeutic interventions had distinct effects on gut microbiota. • Prebiotics combined with drug intervention had higher efficacy in treating acute colitis.

The Effectiveness of Choline Alfoscerate in the Treatment of Patients with Amnestic Mild Cognitive Impairment: A Comparative Prospective Study

Background: the issues of early diagnosis and therapy of cognitive disorders that do not reach the degree of dementia remain relevant.The purpose of the research was to study the immediate and long-term effects of course cholinergic therapy (choline alfoscerate, CA) in patients with an amnestic mild cognitive impairment (aMCI).Patients and methods: in the course of an open comparative prospective study, the dynamics of cognitive functioning indicators were analyzed in 150 patients with aMCI who received infusion or oral course therapy in comparison with the control group (without treatment). All patients were divided into 3 groups. The first group of patients received an infusion course of CA (Gliatilin), the second group received an oral course of the drug (Gliatilin), the third group (control) did not receive treatment. MRI, clinical-psychological, psychometric, statistical methods were used in the study.Results: it has been shown that course therapy with CA has a positive effect on cognitive functioning in patients with aMCI in both therapeutic groups. The greatest effectiveness was observed in group 1 patients who underwent an infusion course of therapy for a month. In group 2 patients who took CA orally for 2 months, there was also an improvement in cognitive functions, however, in the control group there was a statistically significant decrease in cognitive functioning after 90 days of follow-up, in two cases (4%). This trend continued after a year of follow up. The indicators of improvement of cognitive status compared to the baseline level remained in 41% of cases in patients of group 1 and only in 28% and 2% in patients of group 2 and 3 respectively. Only in group 3 Alzheimer’s disease was diagnosed in 2 patients (4%) after a year of follow-up.Conclusion: the long-term positive effect of CA on cognitive functioning allows us to consider the drug as a possible model of therapy aimed at preventing the progression of cognitive deficits and the development of dementia in people with aMCI.

Memory Enhancing and Neurogenesis Activity of Honey Bee Venom in the Symptoms of Amnesia: Using Rats with Amnesia-like Alzheimer's Disease as a Model.

Alzheimer's disease (AD) is mainly characterized by amnesia that affects millions of people worldwide. This study aims to explore the effectiveness capacities of bee venom (BV) for the enhancement of the memory process in a rat model with amnesia-like AD. The study protocol contains two successive phases, nootropic and therapeutic, in which two BV doses (D1; 0.25 and D2: 0.5 mg/kg i.p.) were used. In the nootropic phase, treatment groups were compared statistically with a normal group. Meanwhile, in the therapeutic phase, BV was administered to scopolamine (1mg/kg) to induce amnesia-like AD in a rat model in which therapeutic groups were compared with a positive group (donepezil; 1mg/kg i.p.). Behavioral analysis was performed after each phase by Working Memory (WM) and Long-Term Memory (LTM) assessments using radial arm maze (RAM) and passive avoidance tests (PAT). Neurogenic factors; Brain-derived neurotrophic factor (BDNF), and Doublecortin (DCX) were measured in plasma using ELISA and Immunohistochemistry analysis of hippocampal tissues, respectively. During the nootropic phase, treatment groups demonstrated a significant (P < 0.05) reduction in RAM latency times, spatial WM errors, and spatial reference errors compared with the normal group. In addition, the PA test revealed a significant (P < 0.05) enhancement of LTM after 72 hours in both treatment groups; D1 and D2. In the therapeutic phase, treatment groups reflected a significant (P < 0.05) potent enhancement in the memory process compared with the positive group; less spatial WM errors, spatial reference errors, and latency time during the RAM test, and more latency time after 72 hours in the light room. Moreover, results presented a marked increase in the plasma level of BDNF, as well as increased hippocampal DCX-positive data in the sub-granular zone within the D1 and D2 groups compared with the negative group (P < 0.05) in a dose-dependent manner. This study revealed that injecting BV enhances and increases the performance of both WM and LTM. Conclusively, BV has a potential nootropic and therapeutic activity that enhances hippocampal growth and plasticity, which in turn improves WM and LTM. Given that this research was conducted using scopolamine-induced amnesia-like AD in rats, it suggests that BV has a potential therapeutic activity for the enhancement of memory in AD patients in a dose-dependent manner but further investigations are needed.

"Let’s Pivot": Co-leading Organizational Group Therapy in a Nonprofit Setting

The increase in racialized violence against Black, Asian, and other People of Color was concurrent with the deadly COVID-19 pandemic in 2020. The national Black Lives Matter protests that coalesced after the murder of George Floyd resulted in demands for racial literacy consultation and group support for companies across the United States. Traditionally, diversity, equity, and inclusion organizational consultants have focused on didactic approaches and consciousness raising. What is the best response when a significant rupture has occurred across racial lines that affects the experience of community within a workplace? This article examines group principles that informed the process of co-leading a multisession combined didactic and therapeutic racial literacy group. In collaboration with corporate leaders, an intentional, group therapeutic approach was taken, which focused on interpersonal dynamics and behavior change to address systemic racism. It was developed to facilitate healing for all staff in a nonprofit organization. Centering group principles of leader transparency, establishing group agreements, intentionality, and racial sensitivity, the authors collaborated and made several key decisions that created a learning and healing environment for group members. The authors examine their assumptions, modifications, missteps, and successes in a group process that occurred over a six-month period. This article also provides insights and recommendations for group leaders who wish to provide group therapy and consultation in traditionally nontherapeutic spaces.

Using Applied Theater to Promote Social-Emotional Health in Adolescents

Applied theater offers an innovative blend of art, psychoeducation, and nontraditional therapeutic group facilitation to activate social-emotional learning. Through theater-based programming, groups become engaged, identify with characters, and participate in stimulating discussions related to emotionally charged topics. One applied theater organization, InterACT New York, uses trained actors to enact improvised scenarios for groups of adolescents. The scenarios cover sensitive topics relevant to the everyday issues facing today’s youths, such as bullying, cyberbullying, prejudice, racism, sexual assault, anxiety, self-harm, and depression. After each scenario, group participants interact with the actors by asking questions, making comments, and proposing solutions related to enacted scenes. Actors respond while remaining in character, and with the aid of a trained social work facilitator, illuminating group discussions ensue. This article describes the positive prosocial responses of adolescents engaged in an applied theater program focused on cyberbullying. It highlights one online group experience involving InterACT New York and a diverse group of suburban middle school students.

The potential role of exosome-derived mesenchymal stem cells and Balanites aegyptiaca in diabetic nephropathy amelioration in rats.

The utilization of mesenchymal stem cell (MSC)-derived exosomes, which include numerous growth factors, cytokines, and microRNAs, is the primary aspect of the novel MSC activity models. The current research aims to: (i) identify the morphology of exosomes; (ii) determine exosomes secreted into MSCs conditioned cell culture medium; and (iii) perform a comprehensive characterization of isolated exosomes and elucidate their protective role in the diabetic nephropathy animal model. Ultracentrifugation was performed by utilizing the culture supernatant of MSCs. Transmission electron microscopy, nanoparticle tracking analysis, as well as Western blot, were utilized for isolated exosome characterization. The purified exosomes were used for in vivo implantation in a diabetic nephropathy animal model. The present research was carried out on 70 adult male albino rats weighing 180 to 200 grams. Rats were classified into seven groups: Group I: negative control group; Group II: diabetic nephropathy group; Group III: Balanites therapeutic group; Group IV: Balanites + MSCs therapeutic group; Group V: Balanites + exosome therapeutic group; Group VI: MSCs therapeutic group; and Group VII: exosome therapeutic group. By the end of the study period, total antioxidant capacity (TAC), malondialdehyde (MDA), and the histology of pancreatic tissue were assessed. Isolated exosomes with sizes ranging from 30 to 150 nm demonstrated the typical cup-shaped morphology. Additionally, exosome criteria were demonstrated by the exosome surface proteins CD81 and CD63, which were expressed by exosome marker proteins. Treatment with exosomes along with Balanites induced a significant reduction in pancreatic MDA with a substantial elevation in pancreatic TAC. Furthermore, treatment with exosomes and Balanites demonstrated normal pancreatic parenchyma and pancreatic lobules with normal pancreatic acini and acinar cells. These findings strongly suggest that ultracentrifugation is the most efficient tool for isolating exosomes. Also, these findings demonstrated that Balanites and exosomes had synergistic effects on one another, with more potent renoprotective activities in rats.

Comparison of the Determination of Some Antihypertensive Drugs in Clinical Human Plasma Samples by Solvent Front Position Extraction and Precipitation Modes.

The determination of the selected antihypertensive drugs in human plasma samples with the novel solvent front position extraction (SFPE) technique is presented. The SFPE procedure combined with LC-MS/MS analysis was used for the first time to prepare a clinical sample containing the drugs mentioned above from different therapeutic groups. The effectiveness of our approach was compared with the precipitation method. The latter technique is usually used to prepare biological samples in routine laboratories. During the experiments, the substances of interest and the internal standard were separated from other matrix components using a prototype horizontal chamber for thin-layer chromatography/high-performance thin-layer chromatography (TLC/HPTLC) with a moving pipette powered by a 3D mechanism, which distributed the solvent on the adsorbent layer. Detection of the six antihypertensive drugs was performed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) in multiple reaction monitoring (MRM) mode. Results obtained by SFPE were very satisfactory (linearity R2 ≥ 0.981; %RSD ≤ 6%; LOD and LOQ were in the range of 0.06-9.78 ng/mL and 0.17-29.64 ng/mL, respectively). The recovery was in the range of 79.88-120.36%. Intra-day and inter-day precision had a percentage coefficient of variation (CV) in the range of 1.10-9.74%. The procedure is simple and highly effective. It includes the automation of TLC chromatogram development, which significantly reduced the number of manual operations performed, the time of sample preparation and solvent consumption.

Systematic review and meta-analysis of positive long-term effects after intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis.

Equine veterinarians face challenges in treating horses with osteoarthritic joint pain in routine veterinary practice. All common treatment options aim to reduce the clinical consequences of osteoarthritis (OA) characterized by persistent synovitis and progressive degradation of articular cartilage. A range of joint-associated cell types and extracellular matrices are involved in the not yet entirely understood chronic inflammatory process. Regeneration of articular tissues to re-establish joint hemostasis is the future perspective when fundamental healing of OA is the long-term goal. The use of intra-articular applied biologic therapeutics derived from blood or mesenchymal stroma cell (MSC) sources is nowadays a well-accepted treatment option. Although this group of therapeutics is not totally consistent due to the lack of clear definitions and compositions, they all share a potential regenerative effect on articular tissues as described in in vivo and in vitro studies. However, the current stage of science in regenerative medicine needs to be supported by clinical reports as in fact, in vitro studies as well as studies using induced OA models still represent a fragment of the complex pathomechanism of naturally occurring OA. This systemic review aims to determine the long-term effect of orthobiologic therapeutics in horses suffering naturally occurring OA. Thereby, a meta-analysis of randomized controlled trials (RCTs) is conducted to describe the efficiency and safety of intra-articular applied orthobiologics in terms of lameness reduction in the long-term. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, thirteen studies met the inclusion criteria for the systemic review. Four of those studies have further been evaluated by the meta-analysis comparing the long-term effect in lameness reduction. Each study was examined for risk of bias. For data evaluation, a random-effects model was used, describing the overall outcome in a forest plot. The I2 statistic was used to assess heterogeneity. Results indicate, that orthobiologic therapies represent an effective long-term and safe OA treatment option. Due to the inhomogeneity of included studies, no statements are provided addressing specific orthobiologic therapies, affected joints, OA stage and horse's intended use. Future clinical trials should follow standardized study designs to provide comparable data.

Retrospective evaluation of fresh platelet concentrate administration in dogs: Patient characteristics, outcomes, and transfusion practices in 189 transfusion episodes (2008-2019).

To describe patient characteristics, underlying disease processes, clinical outcomes, transfusion dose and type (therapeutic or prophylactic), platelet count changes, and adverse events associated with platelet concentrate (PC) administration in dogs. Retrospective study. University teaching hospital. A total of 149 dogs, representing 189 PC transfusion episodes. None. In this population, 39 of 149 dogs (26.2%) were diagnosed with primary immune-mediated thrombocytopenia, 22 of 149 (14.8%) had decreased bone marrow production, 12 of 149 (8.0%) received PC during a massive transfusion, 3 of 149 (2.0%) had congenital thrombocytopathia, 59 of 149 (39.6%) had severe thrombocytopenia of other causes, and 14 of 149 (9.4%) underwent transfusion for miscellaneous causes without a documented severe thrombocytopenia. In 117 of 149 dogs (78.5%), >1 site of hemorrhage was noted. The most common sites of hemorrhage were the gastrointestinal (GI) tract in 89 of 149 (59.7%) and the skin in 78 of 149 (52.3%). Overall survival to discharge was 59.1% (88/149). The median PC dose was 0.8 units per 10kg of body weight per transfusion episode (range: 0.2-6.7). Of 189 episodes, 29 of 189 (15.7%) were prophylactic, and 158 of 189 (83.6%) were therapeutic. For 99 of 189 transfusion episodes, paired pre- and postplatelet counts were available within 24hours. The median platelet count change was 5.0×109 /L (5000/μL; range: -115×109 /L to 158×109 /L [-115,000 to 158,000/μL]); the posttransfusion platelet count was significantly higher than pretransfusion (P<0.0001). The increase in platelet count after transfusion was greater in the prophylactic group than the therapeutic group (P=0.0167). Transfusion reactions were suspected during 2 of 168 episodes (1.2%). Immune-mediated thrombocytopenia was the most common disease process that resulted in PC transfusion. PC was more frequently administered to animals with active hemorrhage rather than prophylactically, and most dogs had evidence of hemorrhage in multiple organ systems, particularly the GI tract and skin. PC transfusions typically appeared safe, and the median platelet count increased after transfusion.

Multilevel proteomic analyses reveal molecular diversity between diffuse-type and intestinal-type gastric cancer

Diffuse-type gastric cancer (DGC) and intestinal-type gastric cancer (IGC) are the major histological types of gastric cancer (GC). The molecular mechanism underlying DGC and IGC differences are poorly understood. In this research, we carry out multilevel proteomic analyses, including proteome, phospho-proteome, and transcription factor (TF) activity profiles, of 196 cases covering DGC and IGC in Chinese patients. Integrative proteogenomic analysis reveals ARIDIA mutation associated with opposite prognostic effects between DGC and IGC, via diverse influences on their corresponding proteomes. Systematical comparison and consensus clustering analysis identify three subtypes of DGC and IGC, respectively, based on distinct patterns of the cell cycle, extracellular matrix organization, and immune response-related proteins expression. TF activity-based subtypes demonstrate that the disease progressions of DGC and IGC were regulated by SWI/SNF and NFKB complexes. Furthermore, inferred immune cell infiltration and immune clustering show Th1/Th2 ratio is an indicator for immunotherapeutic effectiveness, which is validated in an independent GC anti-PD1 therapeutic patient group. Our multilevel proteomic analyses enable a more comprehensive understanding of GC and can further advance the precision medicine.

Effectiveness of Virtual Rehabilitation Versus Therapeutic Exercises in the Balance Training of Lower Limb Among Post-Stroke Patients

Background: Stroke is the major source of death and disability and leads to impaired balance in post-stroke patients. Balance training is one of the main components of stroke rehabilitation. Virtual rehabilitation is gaining more popularity as it engages the patients attention in training. Objective: To evaluate the effects of virtual rehabilitation versus therapeutic exercises to improve the balance in patients with stroke. Methods: This randomized controlled trial conducted at Abdullah Hospital, Lalamusa from August to December 2022. The sample size of 30 participants was randomly divided into two groups virtual therapy group versus therapeutic exercises group, after taking their informed consent. Participants were recruited through the non-probability purposive sampling, between the age of 35 to 55 years, post-stroke survivors after 3 months and were able to stand up with or without assistive devices. Participants with auditory or visual dysfunction, a history of deep venous thrombosis, lower limb amputation, severe receptive or expressive aphasia, significant cognitive impairments and unstable hypertension were excluded. The data was collected from the patients by using Berg Balance Scale (BSS) at three different time frames: baseline, mid-intervention and post-intervention. The Shapiro-Wilk test was applied to calculate the normality of the data. For descriptive analysis, quantitative variables were calculated by mean and standard deviation whereas, for qualitative variables, frequency and percentages were used. To find significance an independent sample t-test was applied for between-group analysis and two-way repeated measure ANOVA was used to measure within-group analysis. Results: Both groups improved their balance after six months of intervention. Comparative analysis showed a significant improvement with p-value≤0.05 in both groups. The mean and standard deviation after six weeks of intervention in the virtual training group was 55.4±0.82 and the therapeutic exercise group was 54.47±1.3. This showed that the virtual rehabilitation group had improved balance in patients with stroke. Conclusion: Virtual rehabilitation was found to be effective in improving the balance of patients with stroke. It not only improves balance but also engages the patient in the treatment protocol. This rehabilitation is effective for the balance training of post-stroke patients.