Treatment Of Inflammatory Complications Research Articles

Computer tomography in diagnostics and treatment of inflammatory complications of diverticular disease of the colon

AIM: to evaluate the role of computed tomography (CT) in the treatment and diagnostic algorithm in patients with complicated diverticular disease (CDD).PATIENTS AND METHODS: during the period from 2014 to 2020, 165 hospitalized patients with complications of CDD included in the study. Fifteen (9.1%) patients were hospitalized for elective indications and 150 (90.9%) as emergencies. The indications for hospitalization were inflammatory complications of CDD. Computed tomography with intravenous contrast was performed in 89 (53.9%) patients. The study was performed on a 64-slice CT “Philips Brilliance 64” with intravenous bolus injection of a low-osmolar iodine-containing contrast agent. The absence of the CT in the remaining patients is due to the presence of classical symptoms of acute diverticulitis with a previously verified diagnosis of CDD, the presence of an informative transabdominal ultrasound, as well as the refusal of patients from CT.RESULTS: the CT allowed to verify the presence of diverticula in the patients, to reveal the distinctive CT signs and pathognomonic symptoms of inflammatory complications of CDD, as well as to establish the severity of the complications that occurred. The specific signs of the destruction of the diverticulum and the complications developed were abdominal mass, abscess, peritonitis, and fistula. Besides the diagnostic value, CT scan permitted to choose the treatment approach and to clarify indications for surgery. Besides that, some CDD complications revealed by CT were considered as a predictor of ineffectiveness of conservative treatment, which requires surgery.CONCLUSION: CT is a valuable diagnostic method for CDD which allows to determine timely the clinical form of inflammatory complication, to find out indications for surgery and to predict high risk of recurrence.

Dynamics of the clinical state of patients with peri-implantitis under conditions of complex application of physiotherapy technologies

The article presents the results of the treatment of inflammatory complications in patients with orthopedic constructions on dental implants using the course complex application of low-intensity infrared laser therapy and low-frequency electrostatic therapy. It has been shown that under the influence of a complex of physiotherapeutic factors, a more pronounced inverse dynamics of the clinical manifestations of peri-implantitis is observed in comparison with the standard treatment regimen, which has a positive effect on the indicators of the secondary stability of the implants themselves. The mechanisms of realization of the therapeutic efficiency of a low-intensity laser and a low-frequency electrostatic field are considered from the medical and biological point of view. The analysis of the study allows concluding that the course complex application of physiotherapeutic technologies in the treatment of post-prosthetic inflammatory complications during dental implantation is highly effective. The addition of the standard treatment regimen with the combined use of a low-frequency electrostatic field and laser therapy has a positive effect on the regression of the clinical manifestations of peri-implantitis and on the index indicators of the patients’ dental status. The increase in therapeutic efficiency observed when using a low-frequency electrostatic field in combination with an infrared laser of the complex is realized due to the potentiating type of interaction of physical factors, which is based on various points of application and the mechanisms of their corrective activity.

СРАВНИТЕЛЬНАЯ ХАРАКТЕРИСТИКА ФИЗИКО-ХИМИЧЕСКИХ СВОЙСТВ ПРЕПАРАТОВ МЕСТНОГО ПРИМЕНЕНИЯ ДЛЯ ПРОФИЛАКТИКИ ОСЛОЖНЕНИЙ ОПЕРАЦИИ ПО УДАЛЕНИЮ ЗУБА

Background. A comparative study of the dynamics of iodine desorption from drugs containing iodoform and used after tooth extraction to preserve blood clots and prevention, treatment of inflammatory complications. This took into account the type and form of drugs. The content and desorption of iodine determine the duration of local exposure to the drug on the tissues of the tooth well. Objectives. To study the physico-chemical properties of iodoform containing topical preparations for the prevention and treatment of alveolitis of the jaw. Methods. The objects of the study were complex multicomponent preparations of domestic production, presented in the dental market in the form of gauze bandage, collagen sponge, paste, powder containing iodoform. A standard titrimetric method was used to quantify the iodine content in aqueous systems. For the analysis of changes of iodine content in aqueous model systems applied to the spectrophotometric method in which the concentration of a substance was assessed according to the calibration chart from 0 minutes to 48 hours. In the model solution, the albumin and pH were changed, iodine concentration was determined in 1, 15 and 30 min. Results. Medications significantly differed in both the number of iodoform and desorption in the aquatic environment of the iodine. However, the content of iodoform in the preparations did not exceed the maximum permissible concentration. Desorption of iodine from the bandage after 15 minutes is significantly less than from the viscose flagellum. Desorption of iodine from the collagen sponge remains constant for 24 hours., but increases after 48 hours. Desorption of iodine from the powder is reduced after 45 minutes. Desorption of iodine from the paste gradually increases, reaches a maximum of 105 minutes and persists after 48 hours. In the albumin-bound state, iodine is more easily desorbed in an acidic medium, and at low concentrations of iodine, desorption in a neutral medium is significantly less. Conclusions. The duration of action of iodoform when applied topically affect the dosage form of the carrier (fiber, sponge, paste, powder), the concentration of the drug, the pH and albumin content in the aqueous medium.

Very Early-Onset Inflammatory Manifestations of X-Linked Chronic Granulomatous Disease.

Chronic granulomatous disease (CGD) is a rare primary immune deficiency caused by mutations in genes coding for components of the nicotinamide adenine dinucleotide phosphate oxidase, characterized by severe and recurrent bacterial and fungal infections, together with inflammatory complications. Dysregulation of inflammatory responses are often present in this disease and may lead to granulomatous lesions, most often affecting the gastrointestinal (GI) and urinary tracts. Treatment of inflammatory complications usually includes corticosteroids, whereas antimicrobial prophylaxis is used for infection prevention. Curative treatment of both infectious susceptibility and inflammatory disease can be achieved by hematopoietic stem cell transplantation. We report herein three patients with the same mutation of the CYBB gene who presented with very early-onset and severe GI manifestations of X-linked CGD. The most severely affected patient had evidence of antenatal inflammatory involvement of the GI and urinary tracts. Extreme hyperleukocytosis with eosinophilia and high inflammatory markers were observed in all three patients. A Mycobacterium avium lung infection and an unidentified fungal lung infection occurred in two patients both during their first year of life, which is indicative of the severity of the disease. All three patients underwent bone marrow transplantation and recovered fully from their initial symptoms. To our knowledge, these are the first reports of patients with such an early-onset and severe inflammatory manifestations of CGD.

The unusual association of inverse retinitis pigmentosa and Fuchs\u2019 heterochromic iridocyclitis

BackgroundClassic retinitis pigmentosa (RP) and other syndromic variants have previously been associated to Fuchs’ heterochromic iridocyclitis (FHI). Common immunogenic and inflammatory pathways have been proposed to explain the higher incidence of this uveitic phenomenon in patients with retinal dystrophies without definitive answers. Infrequent variants of RP such as inverse RP have not been previously reported in association with FHI. We believe that finding the way these entities connect can shed some light into their complex pathogenesis and help find ways to foresee and prevent the appearance of complications such as cataract and macular edema.Case presentationWe present a 15 year old mexican male with history of nyctalopia and rapid, progressive visual loss since infancy who had profound hyper and hypopigmented retinal pigment epithelium changes in the posterior pole together with pigment clumping in the macula of both eyes and an electroretinogram pattern consistent of rod-cone dystrophy. He was diagnosed with inverse RP. Three years after his first visit he was found to have a mild asymptomatic non granulomatous anterior uveitis in the right eye with fine stellate keratic precipitates and subtle iris stromal atrophy not associated with iris synechiae and without evidence of posterior uveitis or findings consistent with infectious etiology. Findings were consistent with FHI. As the patient was normotensive, the lens was transparent and there was no clinical evidence of macular edema, the patient was kept under observation without treatment.ConclusionsPatients with RP are prone to develop chronic, low grade inflammation responses similar to the ones present in FHI. This association makes us believe that immunogenetic pathways involved in the degenerative process that leads to photoreceptor loss may become a target in the prevention and treatment of inflammatory complications in RP and disease progression. It also suggests FHI may be a triggered response predisposed by an unidentified genetic factor that may be related to genes affected in RP and thus be identified before irreversible complications such as glaucoma occur.

Diagnostics and treatment of inflammatory complications of thromboembolism of pulmonary arteries

Diagnostics and treatment of inflammatory complications of thromboembolism of pulmonary arteries

Dissecting Inflammatory Complications in Critically Injured Patients by Within-Patient Gene Expression Changes: A Longitudinal Clinical Genomics Study

Trauma is the number one killer of individuals 1-44 y of age in the United States. The prognosis and treatment of inflammatory complications in critically injured patients continue to be challenging, with a history of failed clinical trials and poorly understood biology. New approaches are therefore needed to improve our ability to diagnose and treat this clinical condition. We conducted a large-scale study on 168 blunt-force trauma patients over 28 d, measuring ∼400 clinical variables and longitudinally profiling leukocyte gene expression with ∼800 microarrays. Marshall MOF (multiple organ failure) clinical score trajectories were first utilized to organize the patients into five categories of increasingly poor outcomes. We then developed an analysis framework modeling early within-patient expression changes to produce a robust characterization of the genomic response to trauma. A quarter of the genome shows early expression changes associated with longer-term post-injury complications, captured by at least five dynamic co-expression modules of functionally related genes. In particular, early down-regulation of MHC-class II genes and up-regulation of p38 MAPK signaling pathway were found to strongly associate with longer-term post-injury complications, providing discrimination among patient outcomes from expression changes during the 40-80 h window post-injury. The genomic characterization provided here substantially expands the scope by which the molecular response to trauma may be characterized and understood. These results may be instrumental in furthering our understanding of the disease process and identifying potential targets for therapeutic intervention. Additionally, the quantitative approach we have introduced is potentially applicable to future genomics studies of rapidly progressing clinical conditions. ClinicalTrials.gov NCT00257231