Traditional Treatment Regimens Research Articles

Research advances in the molecular classification of gastric cancer.

Gastric cancer (GC) is a malignant tumor with one of the lowest five-year survival rates. Traditional first-line treatment regimens, such as platinum drugs, have limited therapeutic efficacy in treating advanced GC and significant side effects, greatly reducing patient quality of life. In contrast, trastuzumab and other immune checkpoint inhibitors, such as nivolumab and pembrolizumab, have demonstrated consistent and reliable efficacy in treating GC. Here, we discuss the intrinsic characteristics of GC from a molecular perspective and provide a comprehensive review of classification and treatment advances in the disease. Finally, we suggest several strategies based on the intrinsic molecular characteristics of GC to aid in overcoming clinical challenges in the development of precision medicine and improve patient prognosis.

Cerebral oxymetry in patients with ischemic stroke and concomitant obstructive sleep apnea syndrome

Cerebral stroke is an important medical and social problem of our time and the most common cause of permanent disability. In patients with brain damage due to ischemic stroke and concomitant obstructive sleep apnoea, numerous episodes of hypoventilation and apnoea cause significant «failures» in saturation and changes in cerebral perfusion, which negatively affects immediate and long-term treatment outcomes. Cerebral oximetry is widely used in clinical practice in various fields of surgery (cardiovascular, paediatric, neurosurgery, etc.), but its potential as a method of monitoring secondary brain damage and controlling treatment in patients with ischaemic cerebral stroke is poorly understood. Objective — to evaluate the effect of non-invasive CPAP support (Continuous Positive Airway Pressure — a method of non-invasive respiratory support in which positive pressure is created in the patient’s airways) on cerebral oximetry in the treatment of patients with ischaemic stroke and concomitant obstructive sleep apnoea syndrome. Materials and methods. Patients with verified mild to moderate ischaemic stroke underwent screening diagnostics to confirm the presence of obstructive sleep apnoea syndrome (SomnoChek micro, Weinman, Germany). We studied 60 patients with obstructive sleep apnoea in the setting of ischemic stroke, who were divided into two groups depending on the treatment method: control (n = 30), in which only conventional stroke treatment was used, and experimental (n = 30), in which the traditional treatment regimen and respiratory support (auto-SAPP) during night sleep with the ResMed Air Sencei apparatus (Australia) were used. To monitor the effectiveness of respiratory support, along with other methods of objective control, cerebral oximetry was used using the Masimo Root apparatus (Masimo, USA). The average rSO2 values on the side of the stroke-affected hemisphere were recorded at the following times: at the beginning of the study, on the 3rd, 5th and 7th day of treatment. The data obtained were processed statistically. Results. The initial average values of rSO2 of the affected by stroke hemisphere in patients of groups I and II were in the range of pathological values, and were (49.27 ± 4.98) and (50.60 ± 5.40) %, respectively, that is, the groups at the beginning of the study were compared to each other. It was found, that in group I patients statistically significant changes in rSO2 % in the intervals of the 1st and 3rd days, the 3rd and 5th days, and the 5th and 7th days — were not observed. Only during the 7th day of observation we’ve recorded statistically significant rSO2 growth at 15.6 % compared to the initial values up to the mark of (57.03 ± 7.01) %. Instead, the rSO2 changes in patients of group II (who were performed СРАР-support at night against the traditional treatment of a stroke), were dynamic and statistically probable: a controlled index during the 3rd day of observation has increased at 12.2 %, during the 5th day — at 26.5 %, during the 7th day — at 33.6 % compared to the initial values up to the level of (67.64 ± 3.02) % compared to the initial values. Conclusions. Standardized medicinal therapy and early rehabilitation of patients with ischemic stroke does not affect the course and severity of concomitant obstructive sleep apnea syndrome and requires a supplement with the methods of non-invasive respiratory support during night sleep. Patients with ischemic stroke against the background of autoCPAP-therapy, were recorded positive dynamics in terms of correction of obstructive sleep apnea syndrome and stable normalization of cerebral oxymetry.

Neuromodulation's Role in Functional Restoration in Paraplegic and Quadriplegic Patients.

Neuromodulation is an alternative, minimally invasive treatment option that, at times, is used as a last resort for chronic pain conditions that are often refractory to other treatment modalities. Moreover, it offers promising prospects for individuals grappling with the formidable challenges posed by paraplegia and quadriplegia resulting from spinal cord injuries. This review article provides a comprehensive assessment of current treatment modalities specifically tailored for paraplegic and quadriplegic patients. We aim to evaluate the existing surgical and non-surgical interventions while delving into the role of neuromodulation in the restoration of function for individuals afflicted with these debilitating conditions. Additionally, we review the efficacy, limitations, and comparative outcomes of diverse treatment strategies available for the management of paraplegia and quadriplegia. Emphasizing the critical need for effective interventions beyond the initial 24 h surgical window, we elucidate the challenges associated with conventional therapies and their limited success in achieving comprehensive functional restoration. Central to this review is an in-depth exploration of neuromodulation's transformative potential in ameliorating the deficits caused by spinal cord injuries. With a particular focus on spinal cord stimulation (SCS), we analyze and compare the outcomes of neuromodulation modalities and traditional treatment regimens, shedding light on the promising strides made in fostering sensory perception, motor function, and patient satisfaction.

New opportunities for correction of hormonal disorders and oxidative stress in women with genital endometriosis

Background. Genital endometriosis is one of the most urgent problems of modern gynecology. Considering oxidative stress as a pathogenetic link of endometriosis, we believe it reasonable to use a combined drug containing superoxide dismutase, resveratrol, and zinc. The purpose of the work was to evaluate the effectiveness of the treatment for genital endometriosis supplemented with the use of superoxide dismutase, resveratrol, and zinc, taking into account the leading pathophysiological links of the pathology. Materials and methods. Thirty-seven women of reproductive age with genital endometriosis were under observation. Treatment in the first group was carried out in accordance with the Guideline Development Group recommendations. Thirty-nine women of the second group additionally received a drug containing superoxide dismutase, resveratrol, and zinc. The control group included 30 healthy women. The state of lipid peroxidation processes was assessed by the level of diene conjugates and malondialdehyde in the blood serum and the antioxidant defense system by the content of superoxide dismutase and glutathione peroxidase. To monitor the patients’ quality of life, pain syndrome was studied using the Visual Analogue Scale. Statistical processing of the obtained data was carried out by means of the standard StatSoft Statistica for Windows 13.0 program pac­kage. Results. The assessment of the pain syndrome in the second group showed that it completely disappeared in women with the first stage of the disease. Among patients with the second stage, pain disappeared in 8 cases, 3 patients had a decrease from severe to mild pain. At the third stage, pain disappeared completely in 5 women, in 4 cases, it decreased from severe to mild, and in one woman, the pain decreased from unbearable to mild. All patients of the second group noted a decrease in pain during intercourse, and in the first stage — its absence, an increase in work capacity (r = 0.64, p < 0.01), a decrease in irritability and anxiety in the perimenstrual period (r = –0.59, p < 0.05) and overall satisfaction with the treatment result. Side effects were not noted in any of the patients. Conclusions. Improving treatment for genital endometriosis by supplementing therapy with superoxide dismutase, resveratrol, and zinc is pathogenetically justified, as it has a significant positive effect on the lipid peroxidation and antioxidant defense system, compared to the traditional treatment regimen.

Safety and Efficacy of Bone Marrow Mesenchymal Stem Cells in the Treatment of Ischemic Stroke: A Meta-Analysis.

We aimed to systematically evaluate the efficacy and safety of bone marrow mesenchymal stem cells (BMMSCs) in the treatment of ischemic stroke. Six Chinese and English databases were searched for related randomized controlled trials from the establishment of the databases to 28 February 2023. Two investigators performed screening and a comprehensive analysis and evaluated the quality of the studies. They extracted information from the included studies, and managed and analzsed the data using RevMan 5.4.1 software (The First College of Clinical Medical Science, China Three Gorges University). Finally, they performed meta and heterogeneity analyses and created a risk-of-bias map. A total of 13 high-quality articles were included. The National Institute of Health Stroke Scale (NIHSS) scores of the experimental group differed significantly from those of the control group at 3 months (I2 <50%, mean difference [MD] = -2.88, P < 0.001) after treatment. The Fugl-Meyer assessment (FMA) scores of the experimental group varied significantly from that of the control group at 1 month (I2 >50%, MD = 15.94, P < 0.001), 3 months (I2 >50%, MD = 12.71, P < 0.001), and 6 months (I2 >50%, MD = 13.76, P < 0.001) after treatment, and the overall difference (I2 >50%, MD = 14.38, P ≤ 0.001) was significant. The functional independence measure (FIM) scores were significantly different from that of the control group at 1 month (I2 >50%, MD = 20.04, P = 0.02), 3 months (I2 >50%, MD = 15.51, P < 0.001), and 6 months (I2 >50%, MD = 13.46, P = 0.03). There was no significant increase in adverse events compared with the traditional treatment regimen. To some extent, BMMSC transplantation can improve the neurological deficit, motor function, and daily living ability of patients with ischemic stroke.

РЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ ПРЕПАРАТА НАПРАВЛЕННОЙ БИОКОРРЕКЦИИ И ПРЕПАРАТА, СОДЕРЖАЩЕГО ЛАКТОФЕРРИН, В КОМПЛЕКСНОМ ЛЕЧЕНИИ ХРОНИЧЕСКОГО ГЕНЕРАЛИЗОВАННОГО ПАРОДОНТИТА У ПАЦИЕНТОВ С ПЕРВИЧНЫМ ГИПОТИРЕОЗОМ

Subject In the traditional complex treatment of inflammatory periodontal diseases, antibacterial, antiseptic and anti-inflammatory agents are of paramount importance. These products allow you to obtain not only a positive clinical result, but can also manifest their negative properties, having an ambiguous effect on the microbiome of the oral cavity and periodontal tissue. The use of targeted biocorrection drugs and immunocorrectors has a significant local anti-inflammatory effect with minimal side effects. Their use in the complex treatment of chronic generalized periodontitis has not been studied enough.&#x0D; Aim. To evaluate the effectiveness of using a targeted biocorrection drug and a phytocomplex with lactoferrin in the complex treatment of chronic generalized periodontitis in patients with primary hypothyroidism.&#x0D; Material and methods. We observed 90 patients with the main diagnosis of primary hypothyroidism aged 44–59. The patients were divided into 3 groups: in group No. 1, 30 patients received traditional primary periodontal therapy, in group No. 2, 30 patients in whom this therapy was combined with a directed biocorrection drug, in group No. 3, 30 people for whom traditional primary periodontal therapy was combined with a directed biocorrection drug and a drug containing lactoferrin. The comparison group included 30 gender and age-matched patients with chronic generalized periodontitis without thyroid pathology. All patients underwent clinical, X-ray and index evaluation of periodontal tissues. &#x0D; Results. In patients of group No. 1, after traditional treatment, clinical and index evaluation data indicated the persistence of inflammatory processes in periodontal tissues. In groups No. 2 and No. 3 on the background of traditional treatment and additionally administered.&#x0D; Conclusions. The addition of a traditional treatment regimen for chronic generalized periodontitis with a targeted biocorrection drug and a drug containing lactoferrin is justified and effective.

Fermented milk product “Narineh” with Lactobacillus acidophilus in sequential and classical therapy for Helicobacter pylori-associated peptic ulcers

Background: In recent years, there has been a growing dissatisfaction with the classical schemes of the eradication of Helicobacter pylori in ulcerative disease among physicians due to frequent failures in eradication therapy, mostly due to antibiotic resistance. It is a known fact that the Lactobacillus acidophilus inhibits the growth of Helicobacter pylori. Objective: Our main goal was to investigate the ability of the fermented milk product "Narineh,” as a functional food, containing Lactobacillus acidophilus to evaluate the efficiency and incidence of adverse effects in addition to the standard triple scheme of eradication therapy with colloidal bismuth substrate. Methods: The patients with peptic ulcer were divided into 2 groups: control (42 patients) received traditional treatment regimens, including 7 days proton pump inhibitor (PPI) + amoxicillin (A) and clarithromycin (C) in the standard doses and subsequent 14 day De-nol (colloidal bismuth subcitrate); experimental (44 patients) received in addition to this standard conventional scheme "Narineh" - 200g, containing 2x109 Lactobacillus acidophilus one time a day starting from the 8-th day for 4 weeks. The results of the eradication in patients were evaluated after 4 -5 weeks, 6 months, and 12 months after completion of treatment using the C13 respiratory urea test (RUT). Repeated endoscopy with histological biopsies was carried out together with RUT in 4-5 weeks after the completion of treatment, and later (6-12 months) for the identification of recurrent ulcer. Results: The treatment with “Narineh” added to the standard regimen significantly reduces the percentage of reinfection and relapse of the disease with a statistical difference (P&lt;0,05). The combination of fermentation milk product “Narineh”, containing Lactobacillus acidophilus with bismuth subcitrate, doesn’t cause a violation of biocenosis of the large intestine, in contrast to the PPI and antibiotics with a statistical difference (P&lt;0,05). In addition, it provides the normalization of gut biocenosis and reduces the frequency of antibiotic-associated diarrhea and other side effects. Conclusion: The treatment with “Narineh” added to the standard scheme is more effective for eradication of Helicobacter pylori infection and significantly reduces the percentage of reinfection and relapse of the disease and lessens the side effects of medications. Keywords: peptic ulcer, eradication Helicobacter pylori, side effects reinfection, fermented milk product “Narineh”, Lactobacillus acidophilus, functional foods

The use of an ultrasonic device in periodontal practice in elderly and senile people

The majority of periodontal visits in dental care to the population are made up of patients in the elderly age group (according to the WHO classification, these include persons 60–74 years old). Features of periodontal treatment of elderly people require a new approach to standard treatment regimens. In recent years, treatment with the «Vector» device (Dürr Dental, Germany) has found widespread use in periodontal consultations. The purpose of the study is to determine the volume of periodontal care for the elderly population in the State Medical Institution of the RO «SP» in Rostov-on-Don in dynamics from 2020 to 2022 using the «Vector» device. Results of the study: periodontal doctors performed ultrasonic removal of supragingival and subgingival dental plaque in the area of one tooth (using the Vector apparatus) in 2020, 1825 services, and in 2022 2562, which is 737 services more than in 2020, At the same time, 1241 services were performed for elderly people in 2020, and in 2022 there were 552 more services.Conclusion: the use of the «Vector» device in addition to traditional treatment regimens for chronic generalized periodontitis in elderly patients accelerates periodontal recovery time.

Immunocorrecting therapy in patients with odontogenous phlegmon of the maxillofacial region

The article is devoted to the problem of increasing the effectiveness of complex treatment of odontogenic phlegmon of the maxillofacial region in patients of older age groups. The results of clinical, immunological examination and treatment of 86 elderly and senile patients with odontogenic phlegmon of the maxillofacial region are presented. Revealed secondary depression of links of general and local immunity. It has been shown that the inclusion of the polyoxidonium immunomodulator in the traditional treatment regimen for this pathology allows one to accelerate the normalization of immune status indicators, increase treatment efficiency, and reduce the length of hospital stay of patients.

Emerging perspectives: unraveling the anticancer potential of vitamin D3.

Vitamin D3, a fat-soluble vitamin known for its critical function in calcium homeostasis and bone health, is gaining interest for its anticancer properties. Observational studies have suggested a negative relationship between vitamin D levels and the incidence of some malignancies throughout the years, prompting substantial investigation to find its anticancer effects. The purpose of this comprehensive review is to investigate the diverse function of vitamin D3 in cancer prevention and therapy. We explored the molecular mechanism underlying its effects on cancer cells, which range from cell cycle control and death to angiogenesis and immune response modulation. Insights from in vitro and in vivo studies provide valuable evidence supporting its anticancer potential. Furthermore, we look at epidemiological and clinical studies that investigate the relationship between vitamin D3 levels and cancer risk or treatment results. Vitamin D3 supplementation's safety profile and cost-effectiveness increase its attractiveness as an adjuvant therapy in conjunction with traditional treatment regimens. Our critical review of the current literature provides an in-depth understanding of vitamin D3's anticancer effect, covering the obstacles and possibilities in realizing its promise for cancer prevention and therapy. The findings of this study might pave the way for the development of innovative treatment techniques that take use of the advantages of vitamin D3 to fight cancer and improve patient care. As research progresses, a better understanding of vitamin D3's anticancer processes will surely simplify its incorporation into personalized cancer care techniques, hence enhancing patient outcomes in the battle against cancer.

Antimicrobial effect of Streptococcus salivarius outer membrane-coated nanocomplexes against Candida albicans and oral candidiasis

Oral mucosal infection, especially oral candidiasis, is currently the most common oral mucosal disease. Traditional drug treatment regimens have difficulty adhering to mucous membranes, coupled with the unique anatomical and physiological characteristics of the oral cavity, thus reducing drug availability and limiting the effective time of drug action. Inspired by cell membrane-coated nanoparticles, this study aimed to construct a bionic adherent oral mucosal drug delivery system and investigated its therapeutic potential for oral candidiasis. The system was obtained by encapsulating Streptococcus salivarius K12 membranes on triclosan-loaded PLGA nanoparticles using an extrusion method. The constructed nanocomplexes (K12/TCS@PLGA-NPs) inherited the properties of the source cell membrane, bionically adhering to the oral mucosa and binding to the candida albicans hypha. Our in vitro and in vivo experiments have confirmed that K12/TCS@PLGA-NPs nanocomplexes significantly inhibits the formation of C. albicans biofilms and the development of oral candidiasis by enhancing the accumulation of drugs in lesions, optimizing drug efficacy. Furthermore, the biomimetic nanocomplexes could be considered safe and effective drug delivery systems, which hold considerable therapeutic promise for oral mucosal infections including candidiasis.

Lipid composition of blood plasma and epithelium of the jejunal mucosa in calves with dyspepsia and its correction

Enteropathology in newborn ruminants significantly affects the functional formation of the digestive tract, which induces complications in other organs and systems, reducing the resistance and productivity in recovered animals. It is also characterized by metabolic disorders, particularly lipids, which adversely affects the regenerative processes at the cellular level. The material for the study was 2-day-old calves, from which 3 groups of 6 animals each were formed. 1st group – control was made up of clinically healthy animals, 2nd group – calves with toxic dyspepsia which received traditional treatment and 3rd group – calves which were additionally orally administered a liposomal form of a 1% solution of BAD "FLP-MD". The lipid composition of blood plasma and the epithelium of the mucous membrane of the jejunum of calves was studied by the method of thin-layer chromatography on standard Silufol plates. The lipidogram of blood plasma in 30-day-old calves recovered from dyspepsia under traditional treatment regimen was characterized by dyslipidemia, which was manifested by an increase in total lipid content by 10.0% amid hypercholesterolemia and hypertriacylglycerolemia and a decrease in free fatty acids by 24.6% and phospholipids by 11.8%. Also, phosphatidylcholine and sphingomyelin content decreasesd in the blood plasma. In epithelium of the jejunal mucosa, total lipid content decreased due to total cholesterol, triacylglycerols, and phospholipids. The restoration of total lipid content and individual fractions was found in blood plasma of calves that received additionally phospholipid-containing bio-additive "FLP-MD". Among the individual phospholipids phosphatidylcholine, phosphatidylethanolamine and phosphatidylserine prevailed. In these calves, most of the lipid components in the epithelium of the jejunal mucosa were stabilized. In the future, we plan to investigate the content of total lipids in the blood and mucous membrane of the small intestine of calves.

CLINICAL EFFECTIVENESS OF DIARRHEA TREATMENT IN CHILDREN WITH HIV INFECTION

to study the clinical efficacy of the treatment of diarrhea in HIV-infected children in a comparative aspect. 261 HIV-infected children with infectious diarrhea under the age of 18 were divided into 2 groups. The main group included 118 children who received the traditional treatment regimen plus Saccharomyces boulardii 2 sachets 2 times a day for 5 days, and the control group included 143 children who received only traditional therapy. Treatment of acute diarrhea in HIV-infected children with Saccharomyces boulardii preparations significantly reduces the daily amount and duration of diarrhea, which leads to a significant disappearance of dehydration symptoms, especially the severity of dehydration decreases by almost 2.4 times after the 5th day of treatment compared with the values before treatment ( P&lt;0.05).

Abstract LB099: Organoid-based drug efficacy evaluation model for immunotherapy

Abstract The endogenous immune system of patients are known to be activated through immuno-oncology drug, which activates the patient’s own immune system to target and attack tumors. Due to the relatively low occurrence of side effects and sustained success, these therapeutic techniques have gradually replaced the traditional cancer treatment regimen. The creation of an in-vitro screening platform for pre-evaluating the efficacy of immunotherapeutic drug candidates was highly essential despite the fact that many of the new emerging therapies had failed clinical trials.An in-vitro platform mirroring the interaction between a patient's unique Major Histocompatibility Complex (MHC) and T-cell receptor (TCR) is necessary for predicting the precise efficacy of immunotherapies. The tumor cells' MHC antigen molecule attaches to the T-cell receptor (TCR), allowing T-cells to manifest their tumor-killing activities as a result. The link between immunological checkpoint (ICP) in tumor cells and their receptors in T cells allows tumor cells to evade the effects of T-cell-mediated tumor death.We would like to introduce our "ODISEI" platform, a robust efficacy evaluation tool that enables the recapitulation of a patient's unique immune system, utilizing tumor organoids and PBMC from the same donors. Using PD-1/PD-L1 inhibiting antibodies, the enhanced functionality of our ODISEI platform as an effective evaluation platform for immunotherapy drugs was thoroughly examined. Additionally, we created several ODISEI platforms in order to recreate the precise interactions between tumor organoids and various immune sub-populations (T-cells, macrophages, regulatory T-cells, and dendritic cells). Our ODISEI platforms were validated by utilizing a variety of different drug candidates and evaluating their ability to eradicate tumors upon interaction with various reactive immune cells and tumors. As a result, our highly innovative ODISEI platform can be used to screen a variety of different immunotherapeutic drug candidates and distinguish their precise efficacy. Citation Format: Boeun Lee, Woo Kyeom Yang, Sarang Kim, Hee-Ra Lee, Donghyeon Kim, Jongman Yoo. Organoid-based drug efficacy evaluation model for immunotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB099.

MP75-14 ANTIHYPERTENSIVE CHOICES IN BLACK MEN CONTRIBUTE TO WORSENED RATES OF ED AND POOR HYPERTENSION CONTROL

You have accessJournal of UrologyCME1 Apr 2023MP75-14 ANTIHYPERTENSIVE CHOICES IN BLACK MEN CONTRIBUTE TO WORSENED RATES OF ED AND POOR HYPERTENSION CONTROL Denise Asafu-Adjei, Olivia Copelan, Cara Joyce, and Milan Patel Denise Asafu-AdjeiDenise Asafu-Adjei More articles by this author , Olivia CopelanOlivia Copelan More articles by this author , Cara JoyceCara Joyce More articles by this author , and Milan PatelMilan Patel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003349.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cardiovascular disease (CVD) is the leading cause of death in Black men in the U.S. Erectile dysfunction (ED) serves as an indicator of CVD. CVD disproportionately affects Black men, with hypertension being the leading contributor. Several studies have cited ED side effects as a major factor in antihypertensive noncompliance in Black men, further exacerbating hypertension and ED. For decades, guidelines have recommended thiazides and calcium channel blockers as first line therapies for hypertension in Blacks, despite these options being associated with increased rates of ED. A 2022 retrospective study by Holt et al showed that race-based hypertension guidelines yielded no clear benefits in patient outcomes. We aimed to assess the clinical characteristics and treatment patterns of hypertensive men with ED at an academic medical center. METHODS: All men presenting for an initial visit for ED (primary ICD-10 code N52.9) between October 2015-July 2022 were included for analysis. The electronic health record was queried for patient demographics, provider type, comorbidities, and major drug classes of antihypertensives. Adjusted odds ratios were estimated from multivariable logistic regression (any CVD and any medications) and ordinal logistic regression (number of CVD comorbidities) analyses. RESULTS: Of 2020 men who presented for ED, the mean age was 55±14, 49.7% were White (n=987, 49.7%), 24.8% Black (n=493), and 18.9% Hispanic (n=375). The most common cardiovascular comorbidity was hypertension (n=960, 47.5%). Underlying cardiovascular disease burden was generally higher among Black men. Black men had higher odds of being prescribed an antihypertensive (aOR vs White: 1.50, 95% CI: 1.16-1.93; aOR vs Hispanic: 1.96, 95% CI: 1.45-2.67). However, Black men were prescribed beta blockers and thiazides significantly more than White and Hispanic men. White men were prescribed angiotensin receptor blockers (ARBs) significantly more than Black and Hispanic men. CONCLUSIONS: This study mirrors the effects of race-based hypertension guidelines. ARBs have typically been more favorable antihypertensives when considering sexual function. In this study, we showed that Black men were prescribed ARBs at significantly lower rates compared to White and Hispanic men. Given the significant ED side effects has on hypertension compliance, shifting traditional treatment regimens could lead to improved rates of hypertension control and erectile function. ED sits in a unique position to impact how we solve the CVD crisis. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1085 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Denise Asafu-Adjei More articles by this author Olivia Copelan More articles by this author Cara Joyce More articles by this author Milan Patel More articles by this author Expand All Advertisement PDF downloadLoading ...

Некоторые аспекты эпизоотологии, патогенеза и лечения парвовирусного энтерита собак

The nosoprofile of infectious pathology in dogs is widespread in the conditions of the Klintsovskaya veterinary hospital. The most common disease was bordetellosis, which tended to decrease. Draws attention to the susceptibility of dogs to parvovirus enteritis, the incidence of which was consistently high for 3 years (22,4–23,2 %). The lowest rate of diseased animals was observed from such viral infections as dog distemper, coronavirus enteritis and rotavirus infection. In the age aspect, the nosoprofile of parvovirus enteritis is more common in young dogs under 1 year old, they account for 69,6 % of all cases. In seasonal dynamics, the disease is most often recorded in the spring-summer period. In the blood of dogs with parvovirus enteritis, the morphological composition was characterized by a decrease in erythrocytes and leukocytes, but there was an increase in hemoglobin concentration. On the 1st and 8th days of the experiment, there was a decrease in erythrocytes compared to the control by 47,7 and 33,2 %, respectively, and the content of leukocytes in this period was lower than the control values by 2,6 and 1,3 times. The hemoglobin concentration was higher than the control analogues by 37,3 and 20,8 %. The leukoformula showed an increase in stab neutrophils and lymphocytes. In the blood of dogs with parvovirus enteritis, a decrease in the content of total protein, glucose and cholesterol was recorded. Thus, the total protein on the 1st and 8th days tended to decrease throughout the experiment by 19,1 and 28,1 %, respectively. Glucose had a downward trend, this was especially noticeable on the 8th day of the study (33,3 %). The decrease in cholesterol was most marked on the 1st day of the experiment (31,1 %). The applied complex therapy using the probiotic lactobifadol forte contributed to the normalization of the clinical status on the 7th day, while in the control group using the traditional treatment regimen it ended on the 9th day.

Dupilumab for Recurrent Prurigo Nodularis: A Case Report and Review of the Literature

Prurigo nodularis (PN) is a chronic inflammatory skin disease that affects the quality of life of patients and is classified in the ICD-10 as a group of chronic lichen simplex and itchy skin diseases (ICD-10/L28) with an incidence of approximately 36.7-148.53 per 100,000 people. The pathogenesis of PN is closely related to type 2 inflammatory response. There are no standardized treatment guidelines for this disease, and traditional anti-pruritic treatment regimens often fail to control the vicious pruritic-scratch cycle in PN and have a poor safety profile. Traditional treatment options for PN include oral antihistamines, thalidomide, and topical hormones, calcium phosphatase inhibitors, and other treatments. However, traditional treatment options often suffer from poor pruritus control and high side effects. A patient with prurigo nodularis was admitted to our hospital who responded poorly to routine topical glucocorticoids and other drug therapies and relapsed after discharge from treatment. After readmission, the patient was successfully treated with dupilumab, a biological agent targeting interleukin-4/13. The patient's rash was significantly flattened, and the pruritus NRS score was significantly decreased. In this case, successful treatment of refractory PN with dupilumab could provide new ideas for treatment.

Apoptosis induction and anti-inflammatory activity of polyherbal drug AS20 on cervical cancer cell lines

Cancer occurs when normal cells convert into tumor cells as a result of the interaction between a patient’s genes and physical, chemical, or biological carcinogens. There are more than 100 types of cancer and each type requires a specific treatment regimen. The traditional treatment regimen for most types of cancer includes surgery, radiotherapy, and chemotherapy. However, treatment methods such as chemotherapy not only kill the cancer cells but also kill healthy cells that divide quickly. Chemotherapy induces widespread senescence, which contributes to local and systemic inflammation. To overcome these problems herbal drug treatments can be used as complementary and alternative medicines (CAMs). We obtained the polyherbal drug AS20 using Amaranthus spinosus leaves and inflorescences, which contain phytochemicals such as saponins, polyphenols, flavonoids, and alkaloids that are known to have anticancer and anti-oxidant activities. We hypothesized that AS20 would show anti-inflammation and induce DNA fragmentation, which is a hallmark of apoptosis in HeLa cells. Furthermore, this study explored the effects of AS20 on the expression of COX2, a marker of inflammation. We found that treatment with AS20 suppressed phorbol 12-myristate 13-acetate (PMA) and 5-flurouracil (5-FU) induction of COX2 expression. We also observed AS20 treated cells showed DNA fragmentation in HeLa cells. This research looks into AS20's possible anti-inflammatory effect on cervical cancer cell lines and its capacity to trigger apoptosis, a programmed cell death mechanism that can restrict cancer cell proliferation. These elements are examined in order to offer light on the therapeutic potential of AS20 and aiding the development of safer and more efficient cervical cancer treatment plans.

679. Traditional vs. Alternative Agents in Patients with Lower Respiratory Tract Infections Caused by Carbapenem-Resistant Pseudomonas aeruginosa Susceptible to Traditional Agents

Abstract Background Comparative effectiveness studies to guide treatment decisions for infections caused by carbapenem-resistant P. aeruginosa (CRPA) susceptible to traditional agents (non-carbapenem β-lactams and fluoroquinolones) are unavailable. This study aims to compare clinical outcomes between patients treated with traditional and alternative treatment regimens for lower respiratory tract infection (LRTI) caused by CRPA that remain susceptible to traditional agents. Methods Multi-center, retrospective cohort from January 2016 to December 2019. We included adults with CRPA (resistant to ≥ 1 carbapenem; meropenem or imipenem) that were susceptible to ≥1 traditional agent (piperacillin-tazobactam, cefepime, ceftazidime, ciprofloxacin, or aztreonam) by CLSI breakpoints isolated from an LRTI sample. All other antibiotics were considered alternative agents. We excluded patients with known colonization, cystic fibrosis, or who expired ≤24 hours after antibiotic receipt. Primary outcome was 30-day mortality and secondary outcomes included 30-day readmission and 30-day recurrence. Results In total, 87 patients, ‘traditional’ treatment (n=53) and ‘alternative’ treatment (n=34), were included from 2 institutions in Detroit, MI, USA: median(IQR) age 59(20) years, 64.4% male, and 59.8% African American. Median(IQR) APACHE II and Charlson Comorbidity index scores were 24(10) and 4(5), respectively. Most patients received traditional therapy (n=53), most commonly with cefepime (60.4%) or piperacillin-tazobactam (41.5%). While 34(39.0%) were treated with alternative agents, most commonly ceftolozane-tazobactam (64.7%) or an aminoglycoside (29.4%) alone or in combination. Thirty-day mortality was not significantly different between traditional and alternative therapy groups (22.6% and 11.8%), respectively. There was no significant difference between 30-day recurrence (17.0% and 20.6%) or 30-day readmission (22.6% and 17.6%) between groups. Conclusion Clinical outcomes did not differ significantly between patients receiving traditional vs. alternative agents for LRTI caused by CRPA susceptible to traditional agents. Traditional agents may be considered for these infections. Further comparative studies are needed to guide treatment decisions for CRPA. Disclosures All Authors: No reported disclosures.

Hot topics on fecal microbiota transplantation for the treatment of inflammatory bowel disease.

Inflammatory bowel disease (IBD) is a chronic intestinal mucosal inflammatory disease with complex etiology. Traditional anti-inflammatory treatment regimens have yielded unsatisfactory results. As research continues to deepen, it has been found that the gut microbiota of patients with IBD is generally altered. The presence of microorganisms in the human gastrointestinal tract is inextricably linked to the regulation of health and disease. Disruption of the microbiotic balance of microbiota in the gastrointestinal tract is called dysbiosis, which leads to disease. Therefore, in recent years, the exploration of therapeutic methods to restore the homeostasis of the gut microbiota has attracted attention. Moreover, the use of the well-established fecal microbiota transplantation (FMT) regimen for the treatment of Clostridioides difficile infection has attracted the interest of IBD researchers. Therefore, there are an increasing number of clinical studies regarding FMT for IBD treatment. However, a series of questions regarding FMT in the treatment of IBD warrants further investigation and discussion. By reviewing published studies, this review explored hot topics such as the efficacy, safety, and administration protocol flow of FMT in the treatment of IBD. Different administration protocols have generally shown reassuring results with significant efficacy and safety. However, the FMT treatment regimen needs to be further optimized. We believe that in the future, individual customized or standard FMT implementation will further enhance the relevance of FMT in the treatment of IBD.