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Sample records for addition combined treatment

  1. Inactivation of Bacillus subtilis spores using various combinations of ultraviolet treatment with addition of hydrogen peroxide.

    PubMed

    Zhang, Yiqing; Zhou, Lingling; Zhang, Yongji; Tan, Chaoqun

    2014-01-01

    This study aims at comparing the inactivation of Bacillus subtilis spores by various combinations of UV treatment and hydrogen peroxide (H2O2) addition. The combinations included sequential (UV-H2O2, H2O2-UV) and simultaneous (UV/H2O2) processes. Results showed that B. subtilis spores achieved a certain inactivation effect through UV treatment. However, hardly any inactivation effect by H2O2 alone was observed. H2O2 had a significant synergetic effect when combined with UV treatment, while high irradiance and H2O2 concentration both favored the reaction. When treated with 0.60 mm H2O2 and 113.0 μW/cm(2) UV irradiance for 6 min, the simultaneous UV/H2O2 treatment showed significantly improved disinfection effect (4.13 log) compared to that of UV-H2O2 (3.03 log) and H2O2-UV (2.88 log). The relationship between the inactivation effect and the exposure time followed a typical pseudo-first-order kinetics model. The pseudo-first-order rate constants were 0.478, 0.447 and 0.634 min(-1), for the UV-H2O2, H2O2-UV and UV/H2O2 processes, respectively, further confirming the optimal disinfection effect of the UV/H2O2 process. The disinfection could be ascribed to the OH radicals, as verified by the level of para-chlorobenzoic acid (pCBA). PMID:24447294

  2. Combined cetuximab and genistein treatment shows additive anti-cancer effect on oral squamous cell carcinoma.

    PubMed

    Park, Sung-Jin; Kim, Myung-Jin; Kim, Yu-Kyoung; Kim, Soung-Min; Park, Ju-Yong; Myoung, Hoon

    2010-06-01

    The purpose of this study was to evaluate the potency of EGFR pathway inhibition achieved by combining cetuximab, an anti-EGFR monoclonal antibody, and genistein, a tyrosine kinase inhibitor, which target extracellular and intracellular domains of the receptor, respectively, in oral squamous cell carcinoma (OSCC) in vitro and in vivo. Two OSCC cell lines, HSC3 and KB, were treated with cetuximab (C, 0-400mug/ml), genistein (G, 0-80muM), or a combination of both at a range of concentrations. Downstream protein expression of EGFR, p-EGFR, and p-Akt were evaluated by Western blot. Cell proliferation and apoptosis indices were calculated to assess anti-cancer effects in vitro. The in vivo effects of cetuximab and genistein on tumor cell growth were examined using an OSCC xenografted nude mouse model and immunohistochemical analyses of proliferation (PCNA) and microvessel density (CD31). Treatment of cells with dual anti-EGFR agents reduced the expressions of p-EGFR, and p-Akt in HSC3 cell line, but there was no significant difference in downregulation between cetuximab alone and in combination with genistein in KB cells. Both HSC3 and KB cells showed a dose-dependent decrease in cell proliferation significantly with single agent treatment and combination (p<0.05). In low concentration, combined cetuximab and genistein therapy resulted in additive growth inhibition and more apoptosis compared to that achieved with single-agent exposure in both cell lines. A combination of cetuximab and genistein significantly inhibited tumor growth and caused a substantial growth delay in in vivo models of both cell lines while each single-agent exposure caused no delay of tumor growth. Immunohistochemical staining with PCNA revealed that the group receiving combined cetuximab and genistein exhibited the lowest number of proliferating cells and microvessel density (p<0.05). Combined therapy with genistein and cetuximab can add the potency of EGFR signaling inhibition. Because not all

  3. Addition of cetuximab to oxaliplatin-based first-line combination chemotherapy for treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial

    PubMed Central

    Maughan, Timothy S; Adams, Richard A; Smith, Christopher G; Meade, Angela M; Seymour, Matthew T; Wilson, Richard H; Idziaszczyk, Shelley; Harris, Rebecca; Fisher, David; Kenny, Sarah L; Kay, Edward; Mitchell, Jenna K; Madi, Ayman; Jasani, Bharat; James, Michelle D; Bridgewater, John; Kennedy, M John; Claes, Bart; Lambrechts, Diether; Kaplan, Richard; Cheadle, Jeremy P

    2011-01-01

    Summary Background In the Medical Research Council (MRC) COIN trial, the epidermal growth factor receptor (EGFR)-targeted antibody cetuximab was added to standard chemotherapy in first-line treatment of advanced colorectal cancer with the aim of assessing effect on overall survival. Methods In this randomised controlled trial, patients who were fit for but had not received previous chemotherapy for advanced colorectal cancer were randomly assigned to oxaliplatin and fluoropyrimidine chemotherapy (arm A), the same combination plus cetuximab (arm B), or intermittent chemotherapy (arm C). The choice of fluoropyrimidine therapy (capecitabine or infused fluouroracil plus leucovorin) was decided before randomisation. Randomisation was done centrally (via telephone) by the MRC Clinical Trials Unit using minimisation. Treatment allocation was not masked. The comparison of arms A and C is described in a companion paper. Here, we present the comparison of arm A and B, for which the primary outcome was overall survival in patients with KRAS wild-type tumours. Analysis was by intention to treat. Further analyses with respect to NRAS, BRAF, and EGFR status were done. The trial is registered, ISRCTN27286448. Findings 1630 patients were randomly assigned to treatment groups (815 to standard therapy and 815 to addition of cetuximab). Tumour samples from 1316 (81%) patients were used for somatic molecular analyses; 565 (43%) had KRAS mutations. In patients with KRAS wild-type tumours (arm A, n=367; arm B, n=362), overall survival did not differ between treatment groups (median survival 17·9 months [IQR 10·3–29·2] in the control group vs 17·0 months [9·4–30·1] in the cetuximab group; HR 1·04, 95% CI 0·87–1·23, p=0·67). Similarly, there was no effect on progression-free survival (8·6 months [IQR 5·0–12·5] in the control group vs 8·6 months [5·1–13·8] in the cetuximab group; HR 0·96, 0·82–1·12, p=0·60). Overall response rate increased from 57% (n=209

  4. Combined treatment with parathyroid hormone (1-34) and beta-tricalcium phosphate had an additive effect on local bone formation in a rat defect model.

    PubMed

    Tao, Zhou-Shan; Tu, Kai-Kai; Huang, Zheng-Liang; Zhou, Qiang; Sun, Tao; Xu, Hong-Ming; Zhou, Yu-Long; Lv, Yang-Xun; Cui, Wei; Yang, Lei

    2016-09-01

    The objective of this study was to evaluate the effect of following combined treatment with parathyroid hormone (1-34) (PTH) and beta-tricalcium phosphate (β-TCP) on local bone formation in a rat 3-mm critical-size defect at distal femur. Twelve weeks after bilateral ovariectomy (OVX) and sham operation (sham), all animals were randomly divided into four groups: group OVX, group OVX + β-TCP, group sham, and group sham + β-TCP, then all rats underwent bone defect in the bilateral distal femurs, and β-TCP were implanted into critical-sized defects for group OVX + β-TCP and group sham + β-TCP. After defect operation, all animals were received following subcutaneous injections with PTH (60 μg/kg, three times a week) until death at 4 and 8 weeks. The defected area in distal femurs of rats was harvested for evaluation by histology, micro-CT, and biomechanics. The results of our study show that systemic usage of PTH or local usage of β-TCP can increase the healing of defects in OVX or sham rats. Furthermore, treatments with PTH and β-TCP showed a stronger effect on accelerating the local bone formation than used alone. Osteoporosis can limit the function of PTH and/or β-TCP. The results from our study demonstrate that combination of PTH and β-TCP had an additive effect on local bone formation in non-osteoporosis and/or osteoporosis rats. PMID:26429350

  5. Combined dispersant fluid loss control additives

    SciTech Connect

    Villa, J. L.; Zeiner, R. N.

    1985-12-31

    Water soluble polymer compositions containing polyacrylic acid and copolymer of itaconic acid and acrylamide are useful as combined dispersant and fluid loss control additives for aqueous drilling fluids, particularly fresh water, gypsum and seawater muds. An example is a polymer composition containing about 80% by weight polyacrylic acid and about 20% by weight copolymer of itaconic acid and acrylamide in its ammonium salt form.

  6. Object attributes combine additively in visual search.

    PubMed

    Pramod, R T; Arun, S P

    2016-01-01

    We perceive objects as containing a variety of attributes: local features, relations between features, internal details, and global properties. But we know little about how they combine. Here, we report a remarkably simple additive rule that governs how these diverse object attributes combine in vision. The perceived dissimilarity between two objects was accurately explained as a sum of (a) spatially tuned local contour-matching processes modulated by part decomposition; (b) differences in internal details, such as texture; (c) differences in emergent attributes, such as symmetry; and (d) differences in global properties, such as orientation or overall configuration of parts. Our results elucidate an enduring question in object vision by showing that the whole object is not a sum of its parts but a sum of its many attributes. PMID:26967014

  7. Object attributes combine additively in visual search

    PubMed Central

    Pramod, R. T.; Arun, S. P.

    2016-01-01

    We perceive objects as containing a variety of attributes: local features, relations between features, internal details, and global properties. But we know little about how they combine. Here, we report a remarkably simple additive rule that governs how these diverse object attributes combine in vision. The perceived dissimilarity between two objects was accurately explained as a sum of (a) spatially tuned local contour-matching processes modulated by part decomposition; (b) differences in internal details, such as texture; (c) differences in emergent attributes, such as symmetry; and (d) differences in global properties, such as orientation or overall configuration of parts. Our results elucidate an enduring question in object vision by showing that the whole object is not a sum of its parts but a sum of its many attributes. PMID:26967014

  8. Effects of combined treatments of electron-beam irradiation and addition of leek (Allium tuberosum) extract on reduction of pathogens in pork jerky.

    PubMed

    Kang, Mingu; Kim, Hyun-Joo; Jayasena, Dinesh D; Bae, Young Sik; Yong, Hae In; Lee, Mooha; Jo, Cheorun

    2012-12-01

    This study investigated the combined effect of electron-beam irradiation and addition of leek (Allium tuberosum R.) extract on pork jerky inoculated with selected foodborne pathogens. Prepared pork jerky samples (control and samples with 1.0% leek extract) were inoculated with pathogens and subsequently irradiated at 0, 0.5, 1, 2, 3, and 4 kGy doses. In comparison with the control, samples with 1.0% leek extract showed significant reduction in the numbers of Escherichia coli, Listeria monocytogenes, and Salmonella Typhimurium. No viable counts were detected for Salmonella Typhimurium in both control and leek-extract samples, and for E. coli and L. monocytogenes in the leek-extract sample exposed to 3 kGy irradiation dose. The D(10) values for E. coli, L. monocytogenes, and Salmonella Typhimurium observed in the irradiated samples with leek extract were 0.39, 0.34, and 0.32 kGy, while the D(10) values in those without leek extract were 0.65, 0.65, and 0.39 kGy, respectively. Therefore, our results clearly showed that irradiation combined with leek extract was effective in reducing pathogens, suggesting that a low dose of irradiation combined with the addition of a natural antimicrobial agent can enhance the microbial safety and shelf-life of pork jerky. PMID:23199493

  9. [Combined orthodontic and restorative treatment].

    PubMed

    Kuijpers, M A R; Loomans, B

    2015-11-01

    In patients with agenesis or enamel anomalies in anterior teeth combined orthodontic and restorative treatment is often necessary to achieve an optimal aesthetic result. How both can best be achieved, but also how to maintain the result, requires communication between the dentist and the orthodontist. The orthodontic treatment plan needs to be established in cooperation with the dentist who will carry out the restorative treatment while the patient is at a young age. Since with these young patients, who are still growing craniofacially and whose teeth are still developing, possible future restorative and/or orthodontic treatment, as well as the means of orthodontic retention, need to be included in the treatment plan. In cleft palate patients, it is also important that methods of orthodontic retention of maxillary arch width are given timely attention in the restorative treatment plan because it is especially vulnerable to relapse. PMID:26568998

  10. Recent additions in the treatment of cough

    PubMed Central

    Gibson, Peter G.

    2014-01-01

    Background Worldwide, cough is regarded as a challenging clinical problem due to its frequency and often limited therapeutic options. Chronic cough that remains refractory to usual medical treatment causes significant quality of life impairment in people with this problem. Methods We have examined current evidence on recent additions in the treatment of cough, specifically treatment of refractory chronic cough with speech pathology and gabapentin. Relevant randomised control trials, reviews and case reports were identified through a PubMed and SCOPUS search of English-language literature referring to these concepts over the last eight years. Summary Of the one hundred and two articles comprising this review the majority investigated the role of the transient receptor potential (TRP) receptors TRP Vanilloid 1 (TRPV1) and TRPA1 in cough and the potential of TRP antagonists as effective anti-tussives. However, these have only been tested in the laboratory and therefore their clinical effectiveness is unknown. Behavioural treatments such as speech pathology have gained momentum and this was evident in the increasing number of articles investigating its positive effect on cough. Investigation on the effectiveness of neuromodulating medications in the treatment of cough have been supported primarily through case series reports and prospective reviews however; their use (particularly gabapentin) has been significantly advanced through recently conducted randomised controlled trials. Conclusions Recent additions in the treatment of chronic cough have been significant as they consider cough to have a unifying diagnosis of cough hypersensitivity with or without the presence of a neuropathic basis. Primarily, effective treatments for chronic cough target these areas and include behavioural treatment such as speech pathology and pharmaceutical treatment with neuromodulating medications such as gabapentin. PMID:25383209

  11. Combination syndrome symptomatology and treatment.

    PubMed

    Tolstunov, Len

    2011-04-01

    Combination syndrome (CS) is one of the most fascinating oral conditions yet is poorly understood and underappreciated in the literature and clinical practice. This article reviews the most important literature on this subject and analyzes the etiology, symptomatology, diagnosis, and current therapeutic modalities for treatment in an attempt to better understand CS. The syndrome represents an example ofa complex pathologic condition of the entire stomatognathic system with a multitude of hard-tissue, soft-tissue, and occlusal changes. These changes, initiated by a certain sequence of events, beginning with a prolonged period of tooth loss, can lead to severe bone atrophy in different regions of the jaws, loss of masticatory function, and the need for complex treatment. Implant rehabilitation of these patients in a preventative approach with cooperation of the entire dental team is emphasized. PMID:21560744

  12. Additional Treatments Offer Little Benefit for Pancreatic Cancer: Study

    MedlinePlus

    ... 158633.html Additional Treatments Offer Little Benefit for Pancreatic Cancer: Study Neither extra chemotherapy drug nor add-on ... 2016 (HealthDay News) -- Additional treatments for locally advanced pancreatic cancer don't appear to boost survival, a new ...

  13. Treatment shaft for combined sewer overflow detention.

    PubMed

    Wright, Steven J; Ghalib, Saad; Eloubaidy, Aziz

    2010-05-01

    A deep, large-diameter underground shaft to provide detention storage for combined sewer overflow control may be advantageous in urban environments, where space limitations require solutions with a small footprint. An underflow baffle wall is provided at the center of the treatment shaft to prevent short-circuiting of the flow. An additional objective is to maintain low headlosses through the structure. A physical model study was conducted to determine the effect of the bottom elevation of the baffle wall on the headloss and breakthrough curve for dye injected to the inflow. It was found that there is a considerable range of elevations for which the structure behaves acceptably in providing adequate contact time for disinfectant while maintaining small headlosses. PMID:20480764

  14. Combining Biomarkers to Optimize Patient Treatment Recommendations

    PubMed Central

    Kang, Chaeryon; Janes, Holly; Huang, Ying

    2014-01-01

    Summary Markers that predict treatment effect have the potential to improve patient outcomes. For example, the Oncotype DX ® Recurrence Score® has some ability to predict the benefit of adjuvant chemotherapy over and above hormone therapy for the treatment of estrogen-receptor-positive breast cancer, facilitating the provision of chemotherapy to women most likely to benefit from it. Given that the score was originally developed for predicting outcome given hormone therapy alone, it is of interest to develop alternative combinations of the genes comprising the score that are optimized for treatment selection. However most methodology for combining markers is useful when predicting outcome under a single treatment. We propose a method for combining markers for treatment selection which requires modeling the treatment effect as a function of markers. Multiple models of treatment effect are fit iteratively by upweighting or “boosting” subjects potentially misclassified according to treatment benefit at the previous stage. The boosting approach is compared to existing methods in a simulation study based on the change in expected outcome under marker-based treatment. The approach improves upon methods in some settings and has comparable performance in others. Our simulation study also provides insights as to the relative merits of the existing methods. Application of the boosting approach to the breast cancer data, using scaled versions of the original markers, produces marker combinations that may have improved performance for treatment selection. PMID:24889663

  15. REMOVAL OF METALS IN COMBINED TREATMENT SYSTEMS

    EPA Science Inventory

    This project assessed the variables influencing the removal of eight metals through combined industrial-municipal treatment plants. The eight metals investigated were: aluminum, cadmium, chromium, copper, iron, lead, nickel, and zinc. The metals were studied at subtoxic influent ...

  16. 10. Water treatment plant, view to S. 1965 addition is ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. Water treatment plant, view to S. 1965 addition is in the foreground - Fort Benton Water Treatment Plant, Filtration Plant, Lots 9-13 of Block 7, Fort Benton Original Townsite at Missouri River, Fort Benton, Chouteau County, MT

  17. Remediation of metal polluted soils by phytorremediation combined with biochar addition

    NASA Astrophysics Data System (ADS)

    Méndez, Ana; Paz-Ferreiro, Jorge; Gómez-Limón, Dulce; César Arranz, Julio; Saa, Antonio; Gascó, Gabriel

    2016-04-01

    The main objective of this work is to optimize and quantify the treatment of metal polluted soils through phytoremediation techniques combined with the addition of biochar. Biochar is a carbon rich material obtained by thermal treatment of biomass in inert atmosphere. In recent years, it has been attracted considerable interest due to their positive effect after soil addition. The use of biochar also seems appropriate for the treatment of metal-contaminated soils decreasing their mobility. Biochar properties highly depend on the raw material composition and manufacturing conditions. This paper is based on the use of manure wastes, rich in nutrients and therefore interesting raw materials for biochar production, especially when combined with phytoremediation techniques since the biochar act as conditioner and slow release fertilizer. We are very grateful to Ministerio de Economia y Competitividad (Spain) for financial support under Project CGL2014-58322-R.

  18. [Combination treatment in pulmonary arterial hypertension].

    PubMed

    Kramer, Mordechai R

    2011-04-01

    In recent years, there has been a marked improvement in the treatment of pulmonary arterial hypertension (PAH) due to the development of targeted therapies. There are now several treatment options available--oral, inhaled, and those delivered by subcutaneous or intravenous methods. These treatments have greatly improved patient survival, which in the past was 2.5 years on average. Efficient treatment choice generally proceeds from oral therapies--PDE-5 inhibitors (sildenafil) and endothelin receptor antagonists (bosentan or ambrisentan)--to inhaled prostanoids (iloprost) or subcutaneous (treprostinil). Intravenous prostacyclins are used in treating the more severe cases. The different pathways of action of each class of drugs allow a synergistic effect of combination therapy similar to malignancy or patients in congestive heart failure. The updated treatment algorithm includes combinations of therapies that target different pathways. This article will review the literature regarding combination therapy for the treatment of PAH. Combining PAH therapies that target different pathways is now a well-established treatment option, based on numerous international clinical trials, and offers new hope to patients suffering from this severe disease. PMID:22164922

  19. 39 CFR 3050.41 - Treatment of additional financial reports.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Treatment of additional financial reports. 3050.41 Section 3050.41 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.41 Treatment of additional financial reports. (a) For purposes of the reports required by § 3050.40(a)(2),...

  20. Combination Levothyroxine + Liothyronine Treatment in Pregnancy.

    PubMed

    Foeller, Megan E; Silver, Robert M

    2015-09-01

    Hypothyroidism is one of the most common endocrine disorders in young women and affects 3% to 4% of all pregnancies. Inadequately treated maternal hypothyroidism is associated with numerous adverse fetal and maternal outcomes. Because of growing popularity of levothyroxine (L-T4) + liothyronine (L-T3) combination therapy for hypothyroidism in nonpregnant individuals, pregnant women are taking these medications with increasing frequency. This article reviews the theoretical dangers of combination L-T4 + L-T3 treatment during pregnancy by outlining physiological regulation of maternal and fetal thyroid homeostasis, proposed adverse fetal outcomes to combination therapy, and current recommendations on thyroid replacement in pregnancy from professional societies. PMID:26403562

  1. [Combination treatment of hypertension in 2015].

    PubMed

    Špinar, Jindřich; Vítovec, Jiří; Špinarová, Lenka; Bendová, Miroslava

    2015-05-01

    We present an overview of the present views on combination treatment and on fixed combinations in the treatment of hypertension according to guidelines of ESH/ESC and ČSH from 2013. The most frequently recommended dual combinations include a blocker of the renin-angiotensin system (ACEI or sartan) and a calcium channel blocker, and further a blocker of the renin-angiotensin system and a diuretic and a calcium channel blocker and a diuretic. In 2014 a fixed-dose combination of an ACE inhibitor (perindopril), a calcium channel blocker (amlodipine) and an diuretic (indapamide) appeared on the Czech market. Within the PIANIST study including 4 731 insufficiently controlled hypertensives, a fixed-dose triple combination of perindopril, amlodipine and indapamide led to a decrease in blood pressure by 28.3/13.8 mm Hg and to a sufficient control of hypertension in 92 % of patients. The advantage of fixed combinations primarily consists in greater compliance of patients and thereby in a better control of hypertension. About 1/3 of hypertensives need a triple combination for a satisfactory blood pressure control. PMID:26075856

  2. Combining Advanced Oxidation Processes: Assessment Of Process Additivity, Synergism, And Antagonism

    SciTech Connect

    Peters, Robert W.; Sharma, M.P.; Gbadebo Adewuyi, Yusuf

    2007-07-01

    This paper addresses the process interactions from combining integrated processes (such as advanced oxidation processes (AOPs), biological operations, air stripping, etc.). AOPs considered include: Fenton's reagent, ultraviolet light, titanium dioxide, ozone (O{sub 3}), hydrogen peroxide (H{sub 2}O{sub 2}), sonication/acoustic cavitation, among others. A critical review of the technical literature has been performed, and the data has been analyzed in terms of the processes being additive, synergistic, or antagonistic. Predictions based on the individual unit operations are made and compared against the behavior of the combined unit operations. The data reported in this paper focus primarily on treatment of petroleum hydrocarbons and chlorinated solvents. (authors)

  3. Rocket based combined cycle (RBCC) propulsion systems offer additional options

    NASA Astrophysics Data System (ADS)

    Czysz, Paul A.

    The propulsion cycles presented at the 1991 IAF Congress in Montreal, and at The World Hydrogen Conference 1992 in Paris were the subject of an IAF paper for the 1992 World Space Conference in Washington DC. RBCC propulsion systems from several nations were analyzed in terms of a SSTO space launcher with a 7-Mg payload. The RBCC concept emerged from the advanced injector ramjet research of the early 1960s. The performance of the current RBCC propulsion systems such that the specific thrust of a rocket is combined with the specific impulse of an airbreather. This performance offers a new perspective to the options available. In a brief review of the present RBCC the reasons for these options are developed. The spectrum of the system options is presented in three examples, a LACE VTOL SSTO, an HTOL SSTO and a HTOL TSTO. Results using the present RBCC are dramatically different from the past concept of the Conventional Combined Cycle propulsion system, i.e., combinations of separate engines. The integration of the engine cycles into a single thermodynamically integrated system significantly changes the propulsion performance.

  4. Combined therapy in the treatment of dyslipidemia.

    PubMed

    Reiner, Zeljko

    2010-02-01

    This systematic review analyses the efficacy, tolerability and safety of combinations of different medicines used to treat dyslipidemias in clinical practice. A PubMed search up to January 2009, was conducted to identify relevant studies. Criteria used to identify studies included (1) English language, (2) published studies with original data or meta-analyses in peer-reviewed journals. Although statin treatment is a mainstay of dyslipidemia management today, complementary effects of other lipid-lowering and/or HDL-cholesterol-raising therapies might substantially increase the clinical benefits not only in the small minority of patients with severe dyslipidemias but in others as well. These therapies include combinations with bile acid sequestrants (cholestyramine, colestipol, colesevelam), ezetimibe, niacin, plant sterols, fibrates (fenofibrate, bezafibrate, gemfibrozil), and prescription omega-3 fatty acids. Therapeutic approaches which incorporate the use of multiple drugs combinations for dyslipidemia treatment should be more widely adopted since combination therapy might offer a means to increase the number of patients able to meet their lipoprotein goals according to the guidelines. However, it has to be stated that for most of these combination therapies data on cardiovascular outcomes are still lacking. PMID:19682080

  5. Effect of combined herbal feed additives on methane, total gas production and rumen fermentation

    PubMed Central

    Chaturvedi, Indu; Dutta, Tapas Kumar; Singh, Pawan Kumar; Sharma, Ashwani

    2015-01-01

    The present study was to evaluate effect of herbal feed additives on methane and total gas production during the rumen fermentation for environment and animal health concern. Different parts of the five medicinal plants were selected such as leaf and small stems of Ocimum sanctum (Tulsi), roots of Curcuma longa (Haldi), fruits of Emblica officinalis (Amla), leaves of Azadirachta indica (Neem) and leaves and small stem of Clerodendrum phlomidis (Arni) for our study. Addition of different herbal additive combinations did not influence IVDMD and total gas production however methane production (mg/g of substrate DM) was significantly (P<0.05) reduced in Amla: Neem and Neem: Arni combinations. Total nitrogen significantly (P<0.01) increased in the combinations of Tulsi: Haldi and Amla: Neem. TCA–ppt-N is significantly (P<0.01) increased in Tulsi: Haldi, Haldi: Amla, Amla: Neem and Neem: Arni however NH3-N (mg/dl) significantly decreased in all treatments. We conclude that the screening of plant combinations, Amla: Neem and Neem: Arni have potential to decrease methane production and our herbal feed supplements have no side-effects on the ruminant in small amount. PMID:26124571

  6. Effect of combined herbal feed additives on methane, total gas production and rumen fermentation.

    PubMed

    Chaturvedi, Indu; Dutta, Tapas Kumar; Singh, Pawan Kumar; Sharma, Ashwani

    2015-01-01

    The present study was to evaluate effect of herbal feed additives on methane and total gas production during the rumen fermentation for environment and animal health concern. Different parts of the five medicinal plants were selected such as leaf and small stems of Ocimum sanctum (Tulsi), roots of Curcuma longa (Haldi), fruits of Emblica officinalis (Amla), leaves of Azadirachta indica (Neem) and leaves and small stem of Clerodendrum phlomidis (Arni) for our study. Addition of different herbal additive combinations did not influence IVDMD and total gas production however methane production (mg/g of substrate DM) was significantly (P<0.05) reduced in Amla: Neem and Neem: Arni combinations. Total nitrogen significantly (P<0.01) increased in the combinations of Tulsi: Haldi and Amla: Neem. TCA-ppt-N is significantly (P<0.01) increased in Tulsi: Haldi, Haldi: Amla, Amla: Neem and Neem: Arni however NH3-N (mg/dl) significantly decreased in all treatments. We conclude that the screening of plant combinations, Amla: Neem and Neem: Arni have potential to decrease methane production and our herbal feed supplements have no side-effects on the ruminant in small amount. PMID:26124571

  7. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal.

    PubMed

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  8. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal

    PubMed Central

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  9. Combination therapy for the treatment of dyslipidemia.

    PubMed

    Streja, Dan

    2004-03-01

    Statins have been proven to reduce cardiovascular risk, and guidelines for cardiovascular prevention recommend statin therapy in a wide range of patients. However, in spite of the dramatic success in large randomized clinical trials, two thirds of patients administered statins are not protected against cardiovascular events. This has prompted a search for additional targets for therapy. The pandemic of metabolic syndrome and type 2 diabetes has led to a dramatic increase in the prevalence of dyslipidemia. This, in turn, has prompted a resurgence of the search for drugs and algorithms that favorably affect high-density lipoprotein (HDL) and very low-density lipoprotein (VLDL) metabolism and function. Fibrates are the best-studied class of agents to be used as an addition to statins since they have also been proven to reduce clinical events as a monotherapy. However, there is a need for large safety trials of statin-fibrate combination therapy. Statin-niacin combination therapy has proven to be safe and effective in altering lipoprotein pattern. Randomized clinical trials and more research on the mechanism of action of niacin are necessary. Inhibitors of cholesterol ester transfer protein and HDL therapy drugs are in early developmental stages, and are the most promising potential additions to the current arsenal. PMID:15083597

  10. Optical Treatment of Strabismic and Combined Strabismic-Anisometropic Amblyopia

    PubMed Central

    2011-01-01

    Objective To determine visual acuity improvement in children with strabismic and combined strabismic-anisometropic (combined-mechanism) amblyopia treated with optical correction alone and to explore factors associated with improvement. Design Prospective multi-center cohort study Participants 146 children 3 to <7 years old with previously untreated strabismic amblyopia (N=52) or combined-mechanism amblyopia (N=94). Methods Optical treatment was provided as spectacles (prescription based on a cycloplegic refraction) that were worn for the first time at the baseline visit. Visual acuity with spectacles was measured using the Amblyopia Treatment Study HOTV© visual acuity protocol at baseline and every 9 weeks thereafter until no further improvement in visual acuity. Ocular alignment was assessed at each visit. Main outcome measure Visual acuity 18 weeks after baseline. Results Overall, amblyopic eye visual acuity improved a mean of 2.6 lines (95% confidence interval: 2.3 to 3.0), with 75% of children improving ≥2 lines and 54% improving ≥3 lines. Resolution of amblyopia occurred in 32% (95% confidence interval: 24% to 41%) of the children. The treatment effect was greater for strabismic amblyopia than for combined-mechanism amblyopia (3.2 versus 2.3 lines, adjusted P=0.003). Visual acuity improved regardless of whether eye alignment improved. Conclusions Optical treatment alone of strabismic and combined-mechanism amblyopia results in clinically meaningful improvement in amblyopic eye visual acuity for most 3 to <7-year-old children, resolving in at least one quarter without the need for additional treatment. Consideration should be given to prescribing refractive correction as the sole initial treatment for children with strabismic or combined-mechanism amblyopia before initiating other therapies. PMID:21959371

  11. Combined treatment in carcinoma of the nasopharynx

    SciTech Connect

    Souhami, L.; Rabinowits, M.

    1988-08-01

    From October 1982 to August 1984, 30 previously untreated patients with biopsy-proven carcinoma of the nasopharynx, stage III (26.5%) and stage IV (73.5%), received combined radiotherapy (6,000 to 7,000 cGy over a period of 7 to 7.5 weeks) and chemotherapy (mitomycin-C 10 mg/M2, IV; 5-fluorouracil 750 mg/M2, IV; and methotrexate 30 mg/M2, IV) concomitantly. There were 20 males and 10 females, with a median age of 40 years. Minimal follow-up duration was 24 months. Actuarial overall survival rate at 48 months was 49%. Complete local response was achieved in 75% of the patients, with 31% of the cases failing distantly. The complication rate was high and included severe mucositis, xerostomia, and septicemia (fatal in two cases). Despite high local disease control, survival rate did not increase. A randomized trial is urgently needed to establish whether or not combined treatment is of value in advanced carcinoma of the nasopharynx.

  12. Additional Treatment Services in a Cocaine Treatment Study: Level of Services Obtained and Impact on Outcome

    PubMed Central

    Worley, Matthew; Gallop, Robert; Gibbons, Mary Beth Connolly; Ring-Kurtz, Sarah; Present, Julie; Weiss, Roger D.; Crits-Christoph, Paul

    2009-01-01

    The objective of this study was to examine the level of additional treatment services obtained by patients enrolled in the NIDA Cocaine Collaborative Study, a multi-center efficacy trial of four treatments for cocaine dependence, and to determine whether these services impact treatment outcome. Cocaine-dependent patients (N = 487) were recruited at five sites and randomly assigned to six months of one of four psychosocial treatments. Assessments were made at baseline, monthly during treatment, and at follow-ups at 9, 12, 15, and 18 months post-randomization. On average, patients received little or no additional treatment services during active treatment (first 6 months), but the rate of obtaining most services increased during the follow-up phase (month 7 to 18). In general, the treatment groups did not differ in the rates of obtaining non-protocol services. For all treatment groups, patients with greater psychiatric severity received more medical and psychiatric services during active treatment and follow-up. Use of treatment services was unrelated to drug use outcomes during active treatment. However, during the follow-up period, increased use of psychiatric medication, 12-step attendance, and 12-step participation was related to less drug use. The results suggest that during uncontrolled follow-up phases, additional non-protocol services may potentially confound the interpretation of treatment group comparisons in drug use outcomes. PMID:18463998

  13. Censored data treatment using additional information in intelligent medical systems

    NASA Astrophysics Data System (ADS)

    Zenkova, Z. N.

    2015-11-01

    Statistical procedures are a very important and significant part of modern intelligent medical systems. They are used for proceeding, mining and analysis of different types of the data about patients and their diseases; help to make various decisions, regarding the diagnosis, treatment, medication or surgery, etc. In many cases the data can be censored or incomplete. It is a well-known fact that censorship considerably reduces the efficiency of statistical procedures. In this paper the author makes a brief review of the approaches which allow improvement of the procedures using additional information, and describes a modified estimation of an unknown cumulative distribution function involving additional information about a quantile which is known exactly. The additional information is used by applying a projection of a classical estimator to a set of estimators with certain properties. The Kaplan-Meier estimator is considered as an estimator of the unknown cumulative distribution function, the properties of the modified estimator are investigated for a case of a single right censorship by means of simulations.

  14. Combination therapy for hepatocellular carcinoma: Additive preclinical efficacy of the HDAC inhibitor panobinostat with sorafenib

    PubMed Central

    Lachenmayer, Anja; Toffanin, Sara; Cabellos, Laia; Alsinet, Clara; Hoshida, Yujin; Villanueva, Augusto; Minguez, Beatriz; Tsai, Hung-Wen; Ward, Stephen C.; Thung, Swan; Friedman, Scott L.; Llovet, Josep M.

    2012-01-01

    Background & Aims Hepatocellular carcinoma (HCC) is a heterogeneous cancer in which sorafenib is the only approved systemic therapy. Histone deacetylases (HDAC) are commonly dysregulated in cancer and therefore represent promising targets for therapies, however their role in HCC pathogenesis is still unknown. We analyzed the expression of 11 HDACs in human HCCs and assessed the efficacy of the pan-HDAC inhibitor panobinostat alone and in combination with sorafenib in preclinical models of liver cancer. Methods Gene expression and copy number changes were analyzed in a cohort of 334 human HCCs, while the effects of panobinostat and sorafenib were evaluated in 3 liver cancer cell lines and a murine xenograft model. Results Aberrant HDAC expression was identified and validated in 91 and 243 HCCs, respectively. Upregulation of HDAC3 and 5 mRNAs were significantly correlated with DNA copy number gains. Inhibiting HDACs with panobinostat led to strong anti-tumoral effects in vitro and vivo, enhanced by the addition of sorafenib. Cell viability and proliferation declined, while apoptosis and autophagy increased. Panobinostat increased Histone H3 and HSP90 acetylation, downregulated BIRC5 (survivin) and upregulated CDH1. Combination therapy with panobinostat and sorafenib significantly decreased vessel density, and most significantly decreased tumor volume and increased survival in HCC xenografts. Conclusions Aberrant expression of several HDACs and copy number gains of HDAC3 and HDAC5 occur in HCC. Treatment with panobinostat combined with sorafenib demonstrated the highest preclinical efficacy in HCC models, providing the rationale for clinical studies with this novel combination. PMID:22322234

  15. Effective treatment of bipolar depression: monotherapy and combination strategies.

    PubMed

    Manning, J Sloan

    2015-11-01

    Managing patients with bipolar disorder remains a challenge due to its chronic nature. In addition, bipolar depression remains understudied even though patients spend more time in depressive episodes than in manic ones. Effective treatment requires an accurate and timely diagnosis, psychoeducation, psychotherapy, pharmacotherapy, and implementation of elements of the chronic care model. Pharmacologic strategies for treating bipolar depression differ from those for bipolar mania as well as those for unipolar depression and require knowledge of the efficacy and safety of agents including mood stabilizers, atypical antipsychotics, and antidepressants both as monotherapy and in combination. PMID:26646048

  16. Is the Combination of Insecticide and Mating Disruption Synergistic or Additive in Lightbrown Apple Moth, Epiphyas postvittana?

    PubMed

    Suckling, David M; Baker, Greg; Salehi, Latif; Woods, Bill

    2016-01-01

    Pest suppression from combinations of tactics is fundamental to pest management and eradication. Interactions may occur among tactical combinations and affect suppression. The best case is synergistic, where suppression from a combination is greater than the sum of effects from single tactics (AB > A+B). We explored how mating disruption and insecticide interacted at field scale, additively or synergistically. Use of a pheromone delivery formulation (SPLAT™) as either a mating disruption treatment (i.e. a two-component pheromone alone) or as a lure and kill treatment (i.e. the two-component pheromone plus a permethrin insecticide) was compared for efficacy against the lightbrown apple moth Epiphyas postvittana. Next, four point-source densities of the SPLAT™ formulations were compared for communication disruption. Finally, the mating disruption and lure and kill treatments were applied with a broadcast insecticide. Population assessment used virgin female traps and synthetic pheromone in replicated 9-ha vineyard plots compared with untreated controls and insecticide-treated plots, to investigate interactions. Lure and kill and mating disruption provided equivalent suppression; no additional benefit accrued from including permethrin with the pheromone suggesting lack of contact. The highest point-source density tested (625/ha) was most effective. The insect growth regulator methoxyfenoxide applied by broadcast application lowered pest prevalence by 70% for the first ten weeks compared to pre-trial. Pheromone addition suppressed the pest further by an estimated 92.5%, for overall suppression of 97.7% from the treatment combination of insecticide plus mating disruption. This was close to that expected for an additive model of interactivity between insecticide and mating disruption (AB = A+B) estimated from plots with single tactics as 98% suppression in a combination. The results indicate the need to examine other tactical combinations to achieve the potential

  17. Is the Combination of Insecticide and Mating Disruption Synergistic or Additive in Lightbrown Apple Moth, Epiphyas postvittana?

    PubMed Central

    Baker, Greg; Salehi, Latif; Woods, Bill

    2016-01-01

    Pest suppression from combinations of tactics is fundamental to pest management and eradication. Interactions may occur among tactical combinations and affect suppression. The best case is synergistic, where suppression from a combination is greater than the sum of effects from single tactics (AB >> A+B). We explored how mating disruption and insecticide interacted at field scale, additively or synergistically. Use of a pheromone delivery formulation (SPLAT™) as either a mating disruption treatment (i.e. a two-component pheromone alone) or as a lure and kill treatment (i.e. the two-component pheromone plus a permethrin insecticide) was compared for efficacy against the lightbrown apple moth Epiphyas postvittana. Next, four point-source densities of the SPLAT™ formulations were compared for communication disruption. Finally, the mating disruption and lure and kill treatments were applied with a broadcast insecticide. Population assessment used virgin female traps and synthetic pheromone in replicated 9-ha vineyard plots compared with untreated controls and insecticide-treated plots, to investigate interactions. Lure and kill and mating disruption provided equivalent suppression; no additional benefit accrued from including permethrin with the pheromone suggesting lack of contact. The highest point-source density tested (625/ha) was most effective. The insect growth regulator methoxyfenoxide applied by broadcast application lowered pest prevalence by 70% for the first ten weeks compared to pre-trial. Pheromone addition suppressed the pest further by an estimated 92.5%, for overall suppression of 97.7% from the treatment combination of insecticide plus mating disruption. This was close to that expected for an additive model of interactivity between insecticide and mating disruption (AB = A+B) estimated from plots with single tactics as 98% suppression in a combination. The results indicate the need to examine other tactical combinations to achieve the potential

  18. COMBINED-SEWER OVERFLOW CONTROL AND TREATMENT

    EPA Science Inventory

    Combined-sewer overflow (CSO), along with sanitary-sewer overflow and stormwater are significant contributors of contamination to surface waters. During a rain event, the flow in a combined sewer system may exceed the capacity of the intercepting sewer leading to the wastewater t...

  19. Additives

    NASA Technical Reports Server (NTRS)

    Smalheer, C. V.

    1973-01-01

    The chemistry of lubricant additives is discussed to show what the additives are chemically and what functions they perform in the lubrication of various kinds of equipment. Current theories regarding the mode of action of lubricant additives are presented. The additive groups discussed include the following: (1) detergents and dispersants, (2) corrosion inhibitors, (3) antioxidants, (4) viscosity index improvers, (5) pour point depressants, and (6) antifouling agents.

  20. Novel Combination Treatments in Multiple Myeloma.

    PubMed

    Nooka, Ajay K; Lonial, Sagar

    2016-05-01

    The last decade has witnessed the identification of several novel druggable targets in multiple myeloma, leading to identification of novel therapies with clinically proven efficacy, both in the newly diagnosed and relapsed setting. More importantly, a common theme of good outcomes was observed among prospective randomized studies that have utilized combinations of agents with different mechanisms of action. The correlation between achieving a deeper response and the improvement in progression-free survival and overall survival has never been so clear. In this article, we elucidate the rationale for use of novel drug combinations in patients with myeloma, and review current evidence-based data supporting the use of specific combinations in various settings. We also attempt to craft a framework to guide clinicians in optimizing the use of combination therapies, to enable patients to derive maximal benefit. PMID:27188677

  1. Addition of alkali to the hydrothermal-mechanochemical treatment of Eucalyptus enhances its enzymatic saccharification.

    PubMed

    Ishiguro, Maki; Endo, Takashi

    2014-02-01

    The effects of alkali on hydrothermal-mechanochemical treatment (hydrothermal treatment combined with wet-milling) were examined with the aim of improving pretreatment of lignocellulosic biomass before enzymatic saccharification. After enzymatic saccharification, the highest glucose yield was obtained by autoclaving at 170°C in the presence of 20% NaOH per substrate weight. The wood fiber was unraveled into finer nanofibers by hydrothermal-mechanochemical treatment, thus increasing the specific surface area of the substrate from 11 to 132m(2)/g. Adding 20% NaOH to the treatment further increased the specific surface area of the already fibrillated substrate by 76% (232m(2)/g) due to lignin removal and ester bond cleavage between lignin and hemicellulose. This increase in specific surface area was closely related to the increase in enzymatic digestibility; therefore, NaOH addition may have enhanced the effect of hydrothermal-mechanochemical treatment. PMID:24378778

  2. Clozapine combined with different antipsychotic drugs for treatment resistant schizophrenia

    PubMed Central

    Cipriani, Andrea; Boso, Marianna; Barbui, Corrado

    2014-01-01

    the poor quality of the retrieved information (small sample size, heterogeneity of comparisons, flaws in the design, conduct and analysis). Although clinical guidelines recommend a second antipsychotic in addition to clozapine in partially responsive patients with schizophrenia, the present systematic review was not able to show if any particular combination strategy was superior to the others. New, properly conducted, randomised controlled trials independent from the pharmaceutical industry need to recruit many more patients to give a reliable estimate of effect or of no effect of antipsychotics as combination treatment with clozapine in patients who do not have an optimal response to clozapine monotherapy. PMID:19588385

  3. 7 CFR 305.10 - Treatment schedules for combination treatments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... followed. (2) Normal atmospheric pressure must be used for the methyl bromide portion of the treatment. (3... treatment in § 305.15 must be followed. (2) Use normal atmospheric pressure for the methyl bromide...

  4. Chemovirotherapy: combining chemotherapeutic treatment with oncolytic virotherapy

    PubMed Central

    Binz, Eike; Lauer, Ulrich M

    2015-01-01

    Oncolytic virotherapy has made significant progress in recent years, however, widespread approval of virotherapeutics is still limited. Primarily, this is due to the fact that currently available virotherapeutics are mostly tested in monotherapeutic clinical trials exclusively (ie, not in combination with other therapies) and so far have achieved only small and often clinically insignificant responses. Given that the predominantly immunotherapeutic mechanism of virotherapeutics is somewhat time-dependent and rapidly growing tumors therefore exhibit only minor chances of being captured in time, scenarios with combination partners are postulated to be more effective. Combinatory settings would help to achieve a rapid stabilization or even reduction of onset tumor masses while providing enough time (numerous months) for achieving immuno(viro)therapeutic success. For this reason, combination strategies of virotherapy with highly genotoxic regimens, such as chemotherapy, are of major interest. A number of clinical trials bringing the concepts of chemotherapy and virotherapy together have previously been undertaken, but optimal scheduling of chemovirotherapy (maximizing the anti-tumor effect while minimizing the risk of overlapping toxicity) still constitutes a major challenge. Therefore, an overview of published as well as ongoing Phase I–III trials should improve our understanding of current challenges and future developments in this field.

  5. Combination treatment of tamoxifen with risperidone in breast cancer.

    PubMed

    Yeh, Wei-Lan; Lin, Hui-Yi; Wu, Hung-Ming; Chen, Dar-Ren

    2014-01-01

    Tamoxifen has long been used and still is the most commonly used endocrine therapy for treatment of both early and advanced estrogen receptor-positive breast cancer in pre- and post-menopause women. Tamoxifen exerts its cytotoxic effect primarily through cytostasis which is associated with the accumulation of cells in the G0/G1 phase of the cell cycle. Apoptotic activity can also be exerted by tamoxifen which involves cleavage of caspase 9, caspase 7, caspase 3, and poly-ADP-ribose polymerase (PARP). Down-regulation of anti-apoptotic proteins Bcl-2 and Bcl-xL and up-regulation of pro-apoptotic proteins Bax and Bak have also been observed. In addition, stress response protein of GRP 94 and GRP 78 have also been induced by tamoxifen in our study. However, side effects occur during tamoxifen treatment in breast cancer patients. Researching into combination regimen of tamoxifen and drug(s) that relieves tamoxifen-induced hot flushes is important, because drug interactions may decrease tamoxifen efficacy. Risperidone has been shown to be effective in reducing or eliminating hot flushes on women with hormonal variations. In this present study, we demonstrated that combination of tamoxifen with risperidone did not interfered tamoxifen-induced cytotoxic effects in both in vitro and in vivo models, while fluoxetine abrogated the effects of tamoxifen. This is the first paper suggesting the possibility of combination treatment of tamoxifen with risperidone in breast cancer patients, providing a conceivable resolution of tamoxifen-induced side effects without interfering the efficacy of tamoxifen against breast cancer. PMID:24886861

  6. Self-administration of cocaine-antihistamine combinations: super-additive reinforcing effects.

    PubMed

    Wang, Zhixia; Woolverton, William L

    2007-02-28

    Histamine H1 receptor antagonists have some behavioral effects that predict abuse liability. In the present study, diphenhydramine and cocaine each maintained i.v. self-administration under a progressive-ratio schedule in rhesus monkeys. When cocaine and DPH were combined in a 1:1 ratio of the ED50s, the combination was super-additive in all monkeys. The data predict that the combination of cocaine and histamine H1 receptor antagonists would have enhanced potential for abuse relative to either drug alone. PMID:17196194

  7. Dentoalveolar surgery techniques combined with orthodontic treatment: A literature review

    PubMed Central

    Uzuner, F. Deniz; Darendeliler, Nilufer

    2013-01-01

    Surgery on the dentoalveolar process combined with orthodontic treatment was emphasized as an alternative method for reducing the treatment time and improving the orthodontic treatment on post-adolescent and adult patients. This combined treatment facilitates and accelerates orthodontic tooth movement. This article reviews the clinical practice in surgery-assisted orthodontic treatment in relation to historical perspective, indications and biological principles, as well as limitations and risks of dento-osseous surgical techniques, including dento-osseous osteotomy and/or ostectomy, dento-osseous microfracture, dento-osseous corticotomy, and/or corticoectomy, and dental distraction. PMID:24883038

  8. Risk assessment for the combinational effects of food color additives: neural progenitor cells and hippocampal neurogenesis.

    PubMed

    Park, Mikyung; Park, Hee Ra; Kim, So Jung; Kim, Min-Sun; Kong, Kyoung Hye; Kim, Hyun Soo; Gong, Ein Ji; Kim, Mi Eun; Kim, Hyung Sik; Lee, Byung Mu; Lee, Jaewon

    2009-01-01

    In 2006, the Korea Food and Drug Administration reported that combinations of dietary colors such as allura red AC (R40), tartrazine (Y4), sunset yellow FCF (Y5), amaranth (R2), and brilliant blue FCF (B1) are widely used in food manufacturing. Although individual tar food colors are controlled based on acceptable daily intake (ADI), there is no apparent information available for how combinations of these additives affect food safety. In the current study, the potencies of single and combination use of R40, Y4, Y5, R2, and B1 were examined on neural progenitor cell (NPC) toxicity, a biomarker for developmental stage, and neurogenesis, indicative of adult central nervous system (CNS) functions. R40 and R2 reduced NPC proliferation and viability in mouse multipotent NPC, in the developing CNS model. Among several combinations tested in mouse model, combination of Y4 and B1 at 1000-fold higher than average daily intake in Korea significantly decreased numbers of newly generated cells in adult mouse hippocampus, indicating potent adverse actions on hippocampal neurogenesis. However, other combinations including R40 and R2 did not affect adult hippocampal neurogenesis in the dentate gyrus. Evidence indicates that single and combination use of most tar food colors may be safe with respect to risk using developmental NPC and adult hippocampal neurogenesis. However, the response to excessively high dose combination of Y4 and B1 is suggestive of synergistic effects to suppress proliferation of NPC in adult hippocampus. Data indicated that combinations of tar colors may adversely affect both developmental and adult hippocampal neurogenesis; thus, further extensive studies are required to assess the safety of these additive combinations. PMID:20077213

  9. Evidence for Adverse Phonatory Change Following an Inhaled Combination Treatment

    ERIC Educational Resources Information Center

    Erickson, Elizabeth; Sivasankar, Mahalakshmi

    2010-01-01

    Purpose: Voice problems are reported as a frequent side effect of inhaled combination (IC) treatments. The purpose of this experimental study was to investigate whether IC treatments are detrimental to phonation. We hypothesized that IC treatment would significantly increase phonation threshold pressure (PTP) and perceived phonatory effort (PPE),…

  10. Additive protection by LDR and FGF21 treatment against diabetic nephropathy in type 2 diabetes model

    PubMed Central

    Shao, Minglong; Yu, Lechu; Zhang, Fangfang; Lu, Xuemian; Li, Xiaokun; Cheng, Peng; Lin, Xiufei; He, Luqing; Jin, Shunzi; Tan, Yi; Yang, Hong; Cai, Lu

    2015-01-01

    The onset of diabetic nephropathy (DN) is associated with both systemic and renal changes. Fibroblast growth factor (FGF)-21 prevents diabetic complications mainly by improving systemic metabolism. In addition, low-dose radiation (LDR) protects mice from DN directly by preventing renal oxidative stress and inflammation. In the present study, we tried to define whether the combination of FGF21 and LDR could further prevent DN by blocking its systemic and renal pathogeneses. To this end, type 2 diabetes was induced by feeding a high-fat diet for 12 wk followed by a single dose injection of streptozotocin. Diabetic mice were exposed to 50 mGy LDR every other day for 4 wk with and without 1.5 mg/kg FGF21 daily for 8 wk. The changes in systemic parameters, including blood glucose levels, lipid profiles, and insulin resistance, as well as renal pathology, were examined. Diabetic mice exhibited renal dysfunction and pathological abnormalities, all of which were prevented significantly by LDR and/or FGF21; the best effects were observed in the group that received the combination treatment. Our studies revealed that the additive renal protection conferred by the combined treatment against diabetes-induced renal fibrosis, inflammation, and oxidative damage was associated with the systemic improvement of hyperglycemia, hyperlipidemia, and insulin resistance. These results suggest that the combination treatment with LDR and FGF21 prevented DN more efficiently than did either treatment alone. The mechanism behind these protective effects could be attributed to the suppression of both systemic and renal pathways. PMID:25968574

  11. Combined Immune Therapy for the Treatment of Visceral Leishmaniasis.

    PubMed

    Faleiro, Rebecca J; Kumar, Rajiv; Bunn, Patrick T; Singh, Neetu; Chauhan, Shashi Bhushan; Sheel, Meru; Amante, Fiona H; Montes de Oca, Marcela; Edwards, Chelsea L; Ng, Susanna S; Best, Shannon E; Haque, Ashraful; Beattie, Lynette; Hafner, Louise M; Sacks, David; Nylen, Susanne; Sundar, Shyam; Engwerda, Christian R

    2016-02-01

    Chronic disease caused by infections, cancer or autoimmunity can result in profound immune suppression. Immunoregulatory networks are established to prevent tissue damage caused by inflammation. Although these immune checkpoints preserve tissue function, they allow pathogens and tumors to persist, and even expand. Immune checkpoint blockade has recently been successfully employed to treat cancer. This strategy modulates immunoregulatory mechanisms to allow host immune cells to kill or control tumors. However, the utility of this approach for controlling established infections has not been extensively investigated. Here, we examined the potential of modulating glucocorticoid-induced TNF receptor-related protein (GITR) on T cells to improve anti-parasitic immunity in blood and spleen tissue from visceral leishmaniasis (VL) patients infected with Leishmania donovani. We found little effect on parasite growth or parasite-specific IFNγ production. However, this treatment reversed the improved anti-parasitic immunity achieved by IL-10 signaling blockade. Further investigations using an experimental VL model caused by infection of C57BL/6 mice with L. donovani revealed that this negative effect was prominent in the liver, dependent on parasite burden and associated with an accumulation of Th1 cells expressing high levels of KLRG-1. Nevertheless, combined anti-IL-10 and anti-GITR mAb treatment could improve anti-parasitic immunity when used with sub-optimal doses of anti-parasitic drug. However, additional studies with VL patient samples indicated that targeting GITR had no overall benefit over IL-10 signaling blockade alone at improving anti-parasitic immune responses, even with drug treatment cover. These findings identify several important factors that influence the effectiveness of immune modulation, including parasite burden, target tissue and the use of anti-parasitic drug. Critically, these results also highlight potential negative effects of combining different

  12. Combined Immune Therapy for the Treatment of Visceral Leishmaniasis

    PubMed Central

    Bunn, Patrick T.; Singh, Neetu; Chauhan, Shashi Bhushan; Sheel, Meru; Amante, Fiona H.; Montes de Oca, Marcela; Edwards, Chelsea L.; Ng, Susanna S.; Best, Shannon E.; Haque, Ashraful; Beattie, Lynette; Hafner, Louise M.; Sacks, David; Nylen, Susanne; Sundar, Shyam; Engwerda, Christian R.

    2016-01-01

    Chronic disease caused by infections, cancer or autoimmunity can result in profound immune suppression. Immunoregulatory networks are established to prevent tissue damage caused by inflammation. Although these immune checkpoints preserve tissue function, they allow pathogens and tumors to persist, and even expand. Immune checkpoint blockade has recently been successfully employed to treat cancer. This strategy modulates immunoregulatory mechanisms to allow host immune cells to kill or control tumors. However, the utility of this approach for controlling established infections has not been extensively investigated. Here, we examined the potential of modulating glucocorticoid-induced TNF receptor-related protein (GITR) on T cells to improve anti-parasitic immunity in blood and spleen tissue from visceral leishmaniasis (VL) patients infected with Leishmania donovani. We found little effect on parasite growth or parasite-specific IFNγ production. However, this treatment reversed the improved anti-parasitic immunity achieved by IL-10 signaling blockade. Further investigations using an experimental VL model caused by infection of C57BL/6 mice with L. donovani revealed that this negative effect was prominent in the liver, dependent on parasite burden and associated with an accumulation of Th1 cells expressing high levels of KLRG-1. Nevertheless, combined anti-IL-10 and anti-GITR mAb treatment could improve anti-parasitic immunity when used with sub-optimal doses of anti-parasitic drug. However, additional studies with VL patient samples indicated that targeting GITR had no overall benefit over IL-10 signaling blockade alone at improving anti-parasitic immune responses, even with drug treatment cover. These findings identify several important factors that influence the effectiveness of immune modulation, including parasite burden, target tissue and the use of anti-parasitic drug. Critically, these results also highlight potential negative effects of combining different

  13. Elevated CO2 promotes long-term nitrogen accumulation only in combination with nitrogen addition.

    PubMed

    Pastore, Melissa A; Megonigal, J Patrick; Langley, J Adam

    2016-01-01

    Biogeochemical models that incorporate nitrogen (N) limitation indicate that N availability will control the magnitude of ecosystem carbon uptake in response to rising CO2 . Some models, however, suggest that elevated CO2 may promote ecosystem N accumulation, a feedback that in the long term could circumvent N limitation of the CO2 response while mitigating N pollution. We tested this prediction using a nine-year CO2 xN experiment in a tidal marsh. Although the effects of CO2 are similar between uplands and wetlands in many respects, this experiment offers a greater likelihood of detecting CO2 effects on N retention on a decadal timescale because tidal marshes have a relatively open N cycle and can accrue soil organic matter rapidly. To determine how elevated CO2 affects N dynamics, we assessed the three primary fates of N in a tidal marsh: (1) retention in plants and soil, (2) denitrification to the atmosphere, and (3) tidal export. We assessed changes in N pools and tracked the fate of a (15) N tracer added to each plot in 2006 to quantify the fraction of added N retained in vegetation and soil, and to estimate lateral N movement. Elevated CO2 alone did not increase plant N mass, soil N mass, or (15) N label retention. Unexpectedly, CO2 and N interacted such that the combined N+CO2 treatment increased ecosystem N accumulation despite the stimulation in N losses indicated by reduced (15) N label retention. These findings suggest that in N-limited ecosystems, elevated CO2 is unlikely to increase long-term N accumulation and circumvent progressive N limitation without additional N inputs, which may relieve plant-microbe competition and allow for increased plant N uptake. PMID:26577708

  14. Berberine in Combination with Insulin Has Additive Effects on Titanium Implants Osseointegration in Diabetes Mellitus Rats

    PubMed Central

    Lu, Li; Zhijian, Huang; Lei, Li; Wenchuan, Chen; Zhimin, Zhu

    2015-01-01

    This study evaluated the effects of berberine in combination with insulin on early osseointegration of implants in diabetic rats. Fifty male Sprague-Dawley rats were randomly divided into 5 groups: healthy rats were used as control (HC), and streptozotocin-induced diabetic rats were treated with insulin, berberine, berberine + insulin (IB), or no treatment. Each rat received one machined-surface cp-Ti implant into the right tibia and was given insulin injection and/or gavage feeding with berberine daily for 8 weeks until being sacrificed. Serum levels of alkaline phosphatase (ALP) and bone gamma-carboxyglutamic acid-containing protein (BGP) were analyzed in each group. Peri-implant mineral apposition was marked by fluorochrome double-labeling and osseointegration was histomorphologically examined. The ALP and BGP levels decreased in diabetic rats but were successfully corrected by insulin and berberine combined treatment. Moreover, untreated diabetic rats had less labeled mineral apposition and impaired osseointegration. In contrast, Groups I, B, and IB were observed with increased peri-implant bone formation. The combination treatment of insulin and berberine was more effective than each administrated as a monotherapy. These results suggest that berberine combined with insulin could promote osseointegration in diabetic rats, thereby highlighting its potential application to patients, though further studies are needed. PMID:26783411

  15. 40 CFR 141.711 - Filtered system additional Cryptosporidium treatment requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Treatment for Cryptosporidium Treatment Technique Requirements § 141.711 Filtered system additional Cryptosporidium treatment requirements. (a) Filtered systems must provide the level of additional treatment for....5-log. (b)(1) Filtered systems must use one or more of the treatment and management options...

  16. Transdermal methylphenidate, behavioral, and combined treatment for children with ADHD.

    PubMed

    Pelham, William E; Burrows-Maclean, Lisa; Gnagy, Elizabeth M; Fabiano, Gregory A; Coles, Erika K; Tresco, Katy E; Chacko, Anil; Wymbs, Brian T; Wienke, Amber L; Walker, Kathryn S; Hoffman, Martin T

    2005-05-01

    Stimulant medication and behavioral treatments are evidence-based for children with attention-deficit/hyperactivity disorder, but the combination of the 2 treatments has been understudied. In this investigation, methylphenidate (MPH) was crossed with 2 levels of behavior modification (BMOD) in a summer treatment program. Twenty-seven children with attention-deficit/hyperactivity disorder, aged 6-12, participated. Children received placebo and 3 doses of transdermal MPH (12.5 cm(2), 25.0 cm(2), and 37.5 cm(2)). BMOD was implemented on alternating weeks. Both treatments produced large and significant effects. Combined treatment was superior to either treatment alone. The effects of transdermal MPH were comparable to those found in this setting in previous studies with multiple stimulant medications and formulations. Consistent with other research, low doses of MPH--even lower than in previous studies--yielded enhanced effects in combination with behavior modification. PMID:15943544

  17. Macitentan: An important addition to the treatment of pulmonary arterial hypertension

    PubMed Central

    Khadka, Anjan; Singh Brashier, Dick B; Tejus, Anantharamu; Sharma, Ashok Kumar

    2015-01-01

    Macitentan is an orphan drug for the treatment of pulmonary arterial hypertension (PAH). Endothelin-1 (ET-1) plays a critical role of pathophysiology of PAH. Macitentan, a new dual endothelin receptor antagonist, has reportedly improved prognosis of PAH patients by delaying the progression of disease. It prevents the binding of ET-1 to both endothelin A (ETA) and endothelin B (ETB) receptors. Macitentan displays higher efficacy, lesser adverse effects and drug interactions. It has completed phase III trials in 2012 for treatment of PAH and has been tried for ischemic digital ulcers in systemic sclerosis, recurrent glioblastoma and combination with chemotherapeutic agents against various cancers. Safety data for macitentan were obtained primarily from a placebo-controlled clinical study in 742 patients with PAH. The Food and Drug Administration (FDA) approved the drug on 13 October 2013. It is an important addition to long-term treatment of PAH. PMID:25709357

  18. Polymeric additives for antistatic treatment of sheet molding composites (SMC)

    NASA Astrophysics Data System (ADS)

    Gedan-Smolka, Michaela; Schubert, Katrin; Taeger, Antje; Marks, Hagen

    2016-03-01

    Novel oligomeric/polymeric additives with ionic units were synthesized in a one pot procedure in order to enhance the specific surface resistivity of SMC-materials. In contrast to industrially used inorganic salts or carbon materials, such as carbon black or CNT's, these substances are nearly colorless and matrix compatible and, resulting from that, easy to homogenize with the SMC-matrix. Furthermore, it was found, that additives which can be covalently bonded to the matrix during the molding procedure are preferred compared to physically mixed substances. The effectiveness of chemically bonded substances regarding with the lowering of the specific surface resistivity is higher and selected additives do not change the reactivity and resulting mechanical properties of the molded material.

  19. COMBINED SEWER OVERFLOW CHARACTERISTICS FROM TREATMENT PLANT DATA

    EPA Science Inventory

    This research was undertaken to evaluate the adequacy of using a mass balance technique with daily municipal wastewater treatment plant data to determine combined sewer runoff and overflow characteristics. The bias and variability associated with the mass balance technique togeth...

  20. Combination irradiation treatments for food safety and phytosanitary uses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Combination of irradiation treatment with other preservation techniques is of potential importance in enhancing the effectiveness and reducing the energy or dose requirement for destroying food borne illness and spoilage organisms while retaining or improving product quality. Phytosanitary irradiati...

  1. Hormonal effects on Tetrahymena: change in case of combined treatment.

    PubMed

    Csaba, G; Lajkó, Eszter; Pállinger, Eva

    2010-12-01

    In order to approach their natural conditions, populations of Tetrahymena were kept in Losina-Losinky's salt solution for 1 h, than in the tryptone+yeast medium. During this time they were treated with histamine, serotonin or insulin, or with the combinations of these hormones. Effect of the combined treatments on the production of serotonin (5HT), or adrenocorticotropic hormone (ACTH) or triiodothyronine (T₃) by the cells was compared to the effect of single-hormone treatments. Significant differences were seen between the results obtained following the single or combined treatments. There was no summation of the effects, however an elevation or diminution of the hormone production was observed after the combined treatment, as compared with the untreated controls or with the use of one of the hormones in the samples. The experiments demonstrate that there is a hormonal regulation between the Tetrahymena cells and the hormones influence each other's effect. PMID:21183424

  2. Antimicrobial combinations: Bliss independence and Loewe additivity derived from mechanistic multi-hit models.

    PubMed

    Baeder, Desiree Y; Yu, Guozhi; Hozé, Nathanaël; Rolff, Jens; Regoes, Roland R

    2016-05-26

    Antimicrobial peptides (AMPs) and antibiotics reduce the net growth rate of bacterial populations they target. It is relevant to understand if effects of multiple antimicrobials are synergistic or antagonistic, in particular for AMP responses, because naturally occurring responses involve multiple AMPs. There are several competing proposals describing how multiple types of antimicrobials add up when applied in combination, such as Loewe additivity or Bliss independence. These additivity terms are defined ad hoc from abstract principles explaining the supposed interaction between the antimicrobials. Here, we link these ad hoc combination terms to a mathematical model that represents the dynamics of antimicrobial molecules hitting targets on bacterial cells. In this multi-hit model, bacteria are killed when a certain number of targets are hit by antimicrobials. Using this bottom-up approach reveals that Bliss independence should be the model of choice if no interaction between antimicrobial molecules is expected. Loewe additivity, on the other hand, describes scenarios in which antimicrobials affect the same components of the cell, i.e. are not acting independently. While our approach idealizes the dynamics of antimicrobials, it provides a conceptual underpinning of the additivity terms. The choice of the additivity term is essential to determine synergy or antagonism of antimicrobials.This article is part of the themed issue 'Evolutionary ecology of arthropod antimicrobial peptides'. PMID:27160596

  3. Effect of combinations of additives on the performance of lithium ion batteries

    NASA Astrophysics Data System (ADS)

    Santee, Stuart; Xiao, Ang; Yang, Li; Gnanaraj, Joe; Lucht, Brett L.

    Commercial lithium-ion batteries have excellent performance at room temperature for a few years. However, the calendar life and thermal stability (>50 °C) need to be improved for many applications, including electric vehicles. We have conducted an investigation of the effect of thermal stabilizing additives, including dimethyl acetamide, vinylene carbonate, and lithium bis(oxalato) borate, on the performance of lithium ion batteries stored at 70 °C for one month. The reactions of the lithium hexafluorophosphate/carbonate electrolyte, with and without electrolyte additives, with the surface of the electrodes after initial formation cycling have been analyzed via a combination of IR-ATR and XPS.

  4. Efficacy of a feed-additive antibacterial combination for improving feedlot cattle performance and health.

    PubMed Central

    Gallo, G F; Berg, J L

    1995-01-01

    The effectiveness of a feed-additive antimicrobial combination for improving feedlot performance and health was tested using 4325 high-risk feeder calves randomly allocated to a control group or an experimental group. The experimental group received the conventional ration plus a feed additive containing 700 mg per head/day of chlortetracycline and sulfamethazine from arrival at the feedlot to day 56 of the feeding period. The inclusion of the feed additive to the ration significantly improved average daily gain for days 0-28 (P = 0.0163) and 0-56 (P = 0.0001), and the feed conversion for days 0-28 (P = 0.0061) and 0-56 (P = 0.0004). Additionally, the use of the feed additive significantly reduced the rate of bovine respiratory disease morbidity for days 0-28 (P = 0.0014) and 0-56 (P = 0.0001), the rate of relapses and mortality for days 0-56 (P = 0.0151 and P = 0.0209, respectively), and the rate of animals diagnosed with chronic respiratory disease for days 0-28 and 0-56 (P = 0.0009 and P = 0.0002, respectively). Performance and health improvements produced by the use of the feed additive were cost-effective. PMID:7600512

  5. Combining phytoextraction and biochar addition improves soil biochemical properties in a soil contaminated with Cd.

    PubMed

    Lu, Huanping; Li, Zhian; Fu, Shenglei; Méndez, Ana; Gascó, Gabriel; Paz-Ferreiro, Jorge

    2015-01-01

    The main goal of phytoremediation is to improve ecosystem functioning. Soil biochemical properties are considered as effective indicators of soil quality and are sensitive to various environmental stresses, including heavy metal contamination. The biochemical response in a soil contaminated with cadmium was tested after several treatments aimed to reduce heavy metal availability including liming, biochar addition and phytoextraction using Amaranthus tricolor L. Two biochars were added to the soil: eucalyptus pyrolysed at 600 °C (EB) and poultry litter at 400 °C (PLB). Two liming treatments were chosen with the aim of bringing soil pH to the same values as in the treatments EB and PLB. The properties studied included soil microbial biomass C, soil respiration and the activities of invertase, β-glucosidase, β-glucosaminidase, urease and phosphomonoesterase. Both phytoremediation and biochar addition improved soil biochemical properties, although results were enzyme specific. For biochar addition these changes were partly, but not exclusively, mediated by alterations in soil pH. A careful choice of biochar must be undertaken to optimize the remediation process from the point of view of metal phytoextraction and soil biological activity. PMID:25010741

  6. Combining Locoregional Therapies in the Treatment of Hepatocellular Carcinoma

    PubMed Central

    Higgins, Mikhail C. S. S.; Soulen, Michael C.

    2013-01-01

    In an effort to promote more durable local control of larger lesions, thermal ablation has been combined with chemical ablative techniques and with vaso-occlusive procedures such as chemoembolization and bland embolization in an effort to mitigate the limitations inherent in the use of any single treatment for hepatocellular carcinoma (HCC) >3 cm. The heat-sink effect is the underlying principle for combining vaso-occlusive therapies with ablative techniques. Combination therapies do present viable options for abrogating tumor progression and potentially downsizing tumors to facilitate transplant. We discuss the two most commonly used combination locoregional therapies by the interventionalist and the evidence defining the best techniques in practice. PMID:24436520

  7. Client Evaluation of Treatment for Alcohol Use Disorder in COMBINE.

    PubMed

    Kirouac, Megan; Witkiewitz, Katie; Donovan, Dennis M

    2016-08-01

    Practitioners and researchers across disciplines have been interested in identifying variables that act as indicators of treatment success or failure and one straightforward approach to measuring treatment success is to assess client satisfaction with treatment. Existing measures of treatment satisfaction do not address the specific aspects relevant to alcohol use disorder (AUD) treatment. Researchers in the COMBINE Study developed a new measure of treatment satisfaction to assess satisfaction in AUD treatment: The Evaluation of Treatment (EOT) measure. The aims of the present study were to examine the factor structure of items from the EOT measure and to examine the association between the EOT measure and other measures of client engagement, as well as AUD treatment outcomes. We also extended the model to test for possible mediation effects of treatment evaluation on the relationship between client treatment engagement components and AUD treatment outcomes. Confirmatory factor analyses indicated a 6-factor model with a higher order treatment satisfaction factor provided an excellent fit to the data (χ2 (246)=499.44, p<0.001, CFI=0.99, TLI=0.98, RMSEA =0.040 (90% CI: 0.035, 0.045). Overall, the latent factor of treatment satisfaction was significantly associated with client engagement predictors and treatment evaluation significantly mediated the associations between both working alliance and treatment expectations in the prediction of alcohol-related problems and global severity. Findings suggest that client evaluations of treatment play a substantial role in predicting AUD treatment outcomes and should be considered in future treatment and research. PMID:27296660

  8. Combined treatment with atorvastatin and minocycline suppresses severity of EAE.

    PubMed

    Luccarini, Ilaria; Ballerini, Clara; Biagioli, Tiziana; Biamonte, Filippo; Bellucci, Arianna; Rosi, Maria Cristina; Grossi, Cristina; Massacesi, Luca; Casamenti, Fiorella

    2008-05-01

    Multiple sclerosis (MS) is the most common inflammatory demyelinating disorder of the central nervous system (CNS). An approach to improve MS treatment is to identify a rational combination of new medications or existing therapies that impact different aspects of the disease process. Statins are effective in the treatment of MS animal models and are promising candidates for future treatment. Minocycline ameliorates clinical severity of experimental autoimmune encephalomyelitis (EAE) and exhibits several anti-inflammatory and neuroprotective activities. In this study, we tested whether the combination of these two drugs could produce beneficial effects in EAE mice immunized with myelin oligodendrocyte protein (MOG). Our findings show that combined treatment, compared to using the medications alone, resulted in a significant reduction in disease severity, in both the acute and chronic phases of the disease, along with attenuation of inflammation, demyelination and axonal loss. Stereological analysis revealed that the combined treatment significantly guarded against neuroinflammation and neurodegeneration. Moreover, a significant suppression of anti-MOG antibody production in animals treated with the two medications was found. In conclusion, our findings prove that this combination of drugs is neuroprotective and suppresses the severity of EAE. Furthermore, this pharmacological approach appears to be promising as a future therapeutic strategy to control MS. PMID:18346732

  9. Combined treatment of somatostatin analogues with pegvisomant in acromegaly.

    PubMed

    Franck, S E; Muhammad, A; van der Lely, A J; Neggers, S J C M M

    2016-05-01

    Treatment of acromegaly with monotherapy long-acting somatostatin analogues (LA-SSA) as primary treatment or after neurosurgery can only achieve complete normalization of insulin-like growth factor I (IGF-I) in roughly 40 % of patients. Recently, one of the acromegaly consensus groups has recommended switching to combined treatment of LA-SSA and pegvisomant (PEGV) in patients with partial response to LA-SSAs. This combination of LA-SSA and PEGV, a growth hormone receptor antagonist, can normalize IGF-I levels in virtually all patients, requiring that the adequate dose of PEGV is used. The required PEGV dose varies significantly between individual acromegaly patients. One of the advantages of the combination therapy is that tumor size control or even tumor shrinkage can be observed in a vast majority of patients. The main side effects of the combination treatment are gastrointestinal symptoms, lipohypertrophy and transient elevated liver transaminases. In this review we provide an overview of the efficacy and safety of the combined treatment of LA-SSAs with PEGV. PMID:26661938

  10. Effect of combined treatments on viscosity of whey dispersions

    NASA Astrophysics Data System (ADS)

    Camillo, A.; Sabato, S. F.

    2004-09-01

    Whey proteins, enriched protein fractions from milk, are of great interest as ingredients due to nutritional value associated with its functional properties. These proteins could have their structural properties improved when some treatments are applied, such as thermal and gamma irradiation or when some compounds are added. The current work aimed to study the viscometer behavior of whey dispersions submitted to two different combined treatments: (1) thermal plus irradiation and (2) thermal plus vacuum and N 2 plus irradiation. Dispersions of whey protein in water (5% and 8% protein (w/v) base) and containing proteins and glycerol at ratios 1:1 and 2:1 (protein:glycerol) were submitted to both combined treatments. The irradiation doses were 0, 5, 15 and 25 kGy. The viscosity of the two combined treatments and for four levels of absorbed doses is presented and the combined effects are discussed. The thermal treatment combined with gamma irradiation contributed to increase the viscosity as irradiation doses increases for both (5% and 8%) concentrations of proteins ( p<0.05). For protein and glycerol solutions, the irradiation dose seemed to result in a slightly increase. The vacuum applied before the irradiation showed a small contribution.

  11. Individual and combined in vitro (anti)androgenic effects of certain food additives and cosmetic preservatives.

    PubMed

    Pop, Anca; Drugan, Tudor; Gutleb, Arno C; Lupu, Diana; Cherfan, Julien; Loghin, Felicia; Kiss, Béla

    2016-04-01

    The individual and combined (binary mixtures) (anti)androgenic effect of butylparaben (BuPB), butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT) and propyl gallate (PG) was evaluated using the MDA-kb2 cell line. Exposing these cells to AR agonists results in the expression of the reporter gene (encoding for luciferase) and luminescence can be measured in order to monitor the activity of the reporter protein. In case of the evaluation of the anti-androgenic effect, the individual test compounds or binary mixtures were tested in the presence of a fixed concentration of a strong AR agonist (1000 pM 5-alpha-dihydrotestosterone; DHT). Cell viability was assessed using a resazurin based assay. For PG, this is the first report in the literature concerning its (anti)androgenic activity. In case of both individual and mixture testing none of the compounds or binary combinations showed androgenic activity. When tested in the presence of DHT, BuPB, BHA and BHT proved to be weak anti-androgens and this was confirmed during the evaluation of binary mixtures (BuPB+BHA, BuPB+BHT and BHA+BHT). Besides performing the in vitro testing of the binary combinations, two mathematical models (dose addition and response addition) were evaluated in terms of accuracy of prediction of the anti-androgenic effect of the selected binary mixtures. The dose addition model guaranteed a good correlation between the experimental and predicted data. However, no estimation was possible in case of mixtures containing PG, due to the lack of effect of the compound in case of the individual testing. PMID:26812027

  12. [FEATURES OF DIAGNOSTICS AND TREATMENT OF EXTREMELY SEVERE COMBINED INJURY].

    PubMed

    Tulupov, A N; Besaev, G M; Sinenchenko, G I; Taniya, S Sh; Bagdasar'yants, V G

    2015-01-01

    The data of examination and treatment of 356 victims with extremely severe combined injury and shock of III degree were analyzed. All the patients had a medical unfavorable life prognosis. On the basis of the research, it was proved, that the modern approach of treatment of such trauma should include an adequate anti-shock treatment in conditions of the first-level trauma center. The operative activity should be increased in cases of combined trauma of bones by their early external fixation. The authors recommend an application of up-to-date prevention sepsis treatment, late reconstructive--restorative operation performance after its full relief and nutritive metabolic therapy. This approach allowed reducing of the rate of life-threaten infectious complications on 32.4% and noninfectious--on 31.7%, the lethality--on 24%. PMID:27066655

  13. Aromatase inhibiting and combined estrogenic effects of parabens and estrogenic effects of other additives in cosmetics

    SciTech Connect

    Meeuwen, J.A. van Son, O. van; Piersma, A.H.; Jong, P.C. de; Berg, M. van den

    2008-08-01

    There is concern widely on the increase in human exposure to exogenous (anti)estrogenic compounds. Typical are certain ingredients in cosmetic consumer products such as musks, phthalates and parabens. Monitoring a variety of human samples revealed that these ingredients, including the ones that generally are considered to undergo rapid metabolism, are present at low levels. In this in vitro research individual compounds and combinations of parabens and endogenous estradiol (E{sub 2}) were investigated in the MCF-7 cell proliferation assay. The experimental design applied a concentration addition model (CA). Data were analyzed with the estrogen equivalency (EEQ) and method of isoboles approach. In addition, the catalytic inhibitory properties of parabens on an enzyme involved in a rate limiting step in steroid genesis (aromatase) were studied in human placental microsomes. Our results point to an additive estrogenic effect in a CA model for parabens. In addition, it was found that parabens inhibit aromatase. Noticeably, the effective levels in both our in vitro systems were far higher than the levels detected in human samples. However, estrogenic compounds may contribute in a cumulative way to the circulating estrogen burden. Our calculation for the extra estrogen burden due to exposure to parabens, phthalates and polycyclic musks indicates an insignificant estrogenic load relative to the endogenous or therapeutic estrogen burden.

  14. [Combination therapy in the medical treatment of glaucoma].

    PubMed

    Hommer, A

    2013-02-01

    A combination of antiglaucoma medications is indicated if monotherapy is not sufficient to achieve the predefined target pressure and/or in case of a progression of glaucomatous damage or conversion from ocular hypertension to glaucomatous optic neuropathy. Most recently many fixed combinations with two active compounds have become available for the medical treatment of glaucoma. Compared to non-fixed combinations, these drugs offer a much easier use for the patients. Fixed combinations have to be applied less frequently which may improve adherence. Furthermore, they most likely contain a lower amount of toxic preservatives compared to non-fixed combinations. And finally, fixed combinations may eliminate the risk of a "washout" of the first medication by using the second product of a non-fixed combination too soon after the first drop has been installed. This review aims to examine the most important aspects of IOP-lowering fixed and non-fixed combinations in glaucoma management with a clear focus on the results obtained with fixed combinations. In Germany, fixed combinations with the compositions dorzolamide/timolol (FCDT), brinzolamide/timolol (FCBRINT), latanoprost/timolol (FCLT), travoprost/timolol (FCTT), bimatoprost/timolol (FCBIMT), brimonidine/timolol (FCBT), pilocarpine/timolol (FCPT) and metipranolol/timolol (FCMT) are approved for the medical management of glaucoma and ocular hypertension. The results of clinical studies comparing fixed combinations with their active ingredients and with the corresponding non-fixed combinations will be discussed. Furthermore - if available - the results of direct comparisons of the efficacy and safety of different IOP-lowering fixed combinations are summarised. PMID:23335083

  15. Combination therapies for the endoscopic treatment of gastrointestinal bleeding.

    PubMed

    Hiele, M; Rutgeerts, P

    2000-06-01

    This review discusses the background and analysis of data in the literature regarding the effect of a combination of endoscopic therapies on the treatment of bleeding gastroduodenal ulcers. Although these techniques are commonly used, convincing data to support combinations of injection therapies are scarce, and various studies give somewhat conflicting results. In one study, a combination of the injection of adrenaline and a high dose of thrombin was superior to using adrenaline alone. The combination of injection therapy with a thermal method tends to give better results than injection therapy alone in several studies, but the difference is only statistically significant in one study (which uses the gold probe). The data regarding a combination of injection therapy with haemostatic clips are somewhat discordant regarding the effect of the haemoclip itself, but none of the studies found an advantage of combining the two modalities. Some studies suggest that subgroups may exist, such as ulcers with spurting haemorrhage, in which combined treatment might be more useful. PMID:10952808

  16. [Tulozin in combined treatment of patients with acute urinary retention].

    PubMed

    Avdoshin, V P; Andriukhin, M I; Mikhaĭlikov, T G; Ol'shanskaia, E V; Khunov, A Z

    2009-01-01

    There is much evidence that tulozin promotes recovery of spontaneous urination, Qmax and is effective in combined treatment of patients with acute retention of urine caused by prostatic adenoma. Tulozin produces positive changes in the lower urinary tract symptoms. Rare occurrence of side effects enables long-term treatment and achievement of good therapeutic response. Tulozin is recommended for patients of younger age, with minimal comorbid pathology, hypotonic with orthostatic reactions, history of side effects in the treatment of other alpha-adrenoblockers, in comorbid hypertention, hypercholesterolemia, retrograde ejaculation, low potention, overactive bladder, prostatitis, after prostatic TUR, transvesical adenomectomy. PMID:19824378

  17. CONSIDERATIONS IN GRANULAR ACTIVATED CARBON TREATMENT OF COMBINED INDUSTRIAL WASTEWATERS

    EPA Science Inventory

    The objective of this project was to examine the use of activated carbon in reducing the content of biologically resistant organic compounds in a combined industrial wastewater treatment system. The invvestigation was conducted in two stages: (1) characterize organic priority pol...

  18. TREATMENT OF COMBINED SEWER OVERFLOWS BY HIGH GRADIENT MAGNETIC SEPARATION

    EPA Science Inventory

    Seeded water treatment by high gradient magnetic separation techniques was carried out on combined storm overflows and raw sewage influents. Both bench-type and continuous pilot plant tests were performed to evaluate the effectiveness of the process in purifying waste waters. Cri...

  19. Preservation of material quality with the use of combined treatment

    NASA Astrophysics Data System (ADS)

    Boldyrev, A. A.; Boldyrev, A. I.; Skantsev, V. M.; Smolentsev, E. V.

    2016-04-01

    This research is devoted to some techniques of combined treatment including anodic attack and mechanical impact. The salutary effect of these methods permits one to get the requisite accuracy and quality of work surface. The article contains final results of theoretical and experimental study of metal working for inner apparent surfaces.

  20. Metastatic melanoma treatment: Combining old and new therapies.

    PubMed

    Davey, Ryan J; van der Westhuizen, Andre; Bowden, Nikola A

    2016-02-01

    Metastatic melanoma is an aggressive form of cancer characterised by poor prognosis and a complex etiology. Until 2010, the treatment options for metastatic melanoma were very limited. Largely ineffective dacarbazine, temozolamide or fotemustine were the only agents in use for 35 years. In recent years, the development of molecularly targeted inhibitors in parallel with the development of checkpoint inhibition immunotherapies has rapidly improved the outcomes for metastatic melanoma patients. Despite these new therapies showing initial promise; resistance and poor duration of response have limited their effectiveness as monotherapies. Here we provide an overview of the history of melanoma treatment, as well as the current treatments in development. We also discuss the future of melanoma treatment as we go beyond monotherapies to a combinatorial approach. Combining older therapies with the new molecular and immunotherapies will be the most promising way forward for treatment of metastatic melanoma. PMID:26616525

  1. Antibiotic Combinations with Daptomycin for Treatment of Staphylococcus aureus Infections

    PubMed Central

    Nadrah, Kristina; Strle, Franc

    2011-01-01

    Daptomycin is a lipopeptide antibiotic with a unique mechanism of action on Gram-positive bacteria. It is approved for treatment of skin and soft-tissue infections with Gram-positive bacteria, bacteraemia and right-sided infective endocarditis caused by Staphylococcus aureus. Diminishing susceptibility of S. aureus to daptomycin during treatment of complicated infections and clinical failure have been described. Combinations of daptomycin with other antibiotics including gentamicin, rifampin, beta-lactams, trimethoprim/sulfamethoxazole (TMP-SMX), or clarithromycin present a new approach for therapy. In vitro and animal studies have shown that such combinations may, in some cases, be superior to daptomycin monotherapy. In this paper we focus on the antibiotic combinations for complicated S. aureus infections. PMID:22312555

  2. Combined Endodontic-Periodontal Treatment of a Palatogingival Groove.

    PubMed

    Castelo-Baz, Pablo; Ramos-Barbosa, Isabel; Martín-Biedma, Benjamín; Dablanca-Blanco, Ana Belén; Varela-Patiño, Purificación; Blanco-Carrión, Juan

    2015-11-01

    A palatogingival groove is a developmental anomaly that predisposes the involved tooth to develop a severe periodontal lesion. These grooves often present a clinical challenge because diagnosis and treatment planning require an interdisciplinary approach. This case report describes the successful management of a right maxillary lateral incisor with a deep palatogingival groove in combination with an extensive periodontal pocket and pulp necrosis of the involved tooth. Collaborative management used a combination of endodontic treatment, periodontal therapy, odontoplasty, and a periodontal regenerative procedure using protein complex derived from enamel matrix (Emdogain; Straumann, Basel, Switzerland). Despite a predicted poor prognosis, the tooth lesion healed. This report also discusses the rationale behind the treatment modalities. PMID:26395912

  3. Nanoparticle Based Combination Treatments for Targeting Multiple Hallmarks of Cancer

    PubMed Central

    VanDyke, D; Kyriacopulos, P; Yassini, B; Wright, A; Burkhart, E; Jacek, S; Pratt, M; Peterson, CR; Rai, P

    2016-01-01

    Treatment of cancer remains one of the most challenging tasks facing the healthcare system. Cancer affects the lives of millions of people and is often fatal. Current treatment methods include surgery, chemotherapy, radiation therapies or some combinations of these. However, recurrence is a major problem. These treatments can be invasive with severe side effects. Inefficacies in treatments are a result of the complex and variable biology of cancerous cells. Malignant tumor cells and normal functioning cells share many of the same biological characteristics but the main difference is that in cancer cells there is in an overuse and over expression of these biological characteristics. These pertinent characteristics can be grouped into eight hallmarks, as illustrated by Hanahan and Weinberg. These characteristics include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, activating invasion and metastasis, reprogramming energy metabolism, and evading immune destruction. In order to provide a noninvasive, effective treatment, delivery methods must be explored in order to transport cytotoxic agents used for targeting the hallmarks of cancer in a safer and more effective fashion. The use of nanoparticles as drug delivery carriers provides an effective method in which multiple cytotoxic agents can be safely delivered to cancer tissue to simultaneously target multiple hallmarks. By targeting multiple hallmarks of cancer at once, the efficacy of cancer treatments could be improved drastically. This review explores the uses and efficacy of combination therapies using nanoparticles that can simultaneously target multiple hallmarks of cancer. PMID:27547592

  4. Combined bacterial and viral treatment: a novel anticancer strategy

    PubMed Central

    2015-01-01

    An idea for a new combination therapy will be described herein. It is a proposition to combine viral and bacterial anticancer therapies and make them fight cancer in concert. We analyzed biological anticancer therapies and found overlapping advantages and disadvantages which led us to the conclusion that the combination therapy has the potential to create a new therapeutic quality. It is surprising how many weaknesses of viral anticancer therapy are the strengths of bacterial anticancer therapies and the other way round. We review the facts behind this concept and try to assess its value. We propose a few strategies how to combine these two therapies but as far as the review can go, final answers will have to come from the experiments. This review is the first attempt to describe a new strategy and understand the means for this idea but also to raise new questions and discuss new ways to look at anti-cancer treatment. PMID:26648783

  5. COX-2 inhibitors are contraindicated for treatment of combined injury.

    PubMed

    Jiao, W; Kiang, J G; Cary, L; Elliott, T B; Pellmar, T C; Ledney, G D

    2009-12-01

    Casualties of radiation dispersal devices, nuclear detonation or major ionizing radiation accidents, in addition to radiation exposure, may sustain physical and/or thermal trauma. Radiation exposure plus additional tissue trauma is known as combined injury. There are no definitive therapeutic agents. Cyclooxygenase-2 (COX-2), an inducible enzyme expressed in pathological disorders and radiation injury, plays an important role in inflammation and the production of cytokines and prostaglandin E(2) (PGE(2)) and could therefore affect the outcome for victims of combined injury. The COX-2 inhibitors celecoxib and meloxicam were evaluated for their therapeutic value against combined injury in mice. In survival studies, the COX-2 inhibitors had no beneficial effect on 30-day survival, wound healing or body weight gain after radiation injury alone or after combined injury. Meloxicam accelerated death in both wounded and combined injury mice. These drugs also induced severe hepatic toxicity, exaggerated inflammatory processes, and did not enhance hematopoietic cell regeneration. This study points to potential contraindications for use of COX-2 inhibitors in patients undergoing therapy for radiation injury and combined injury. PMID:19929415

  6. Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

    PubMed

    Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

    2016-07-01

    The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. PMID:27089522

  7. Estimating additive and dominance variances for complex traits in pigs combining genomic and pedigree information.

    PubMed

    Costa, E V; Diniz, D B; Veroneze, R; Resende, M D V; Azevedo, C F; Guimaraes, S E F; Silva, F F; Lopes, P S

    2015-01-01

    Knowledge of dominance effects should improve ge-netic evaluations, provide the accurate selection of purebred animals, and enable better breeding strategies, including the exploitation of het-erosis in crossbreeds. In this study, we combined genomic and pedi-gree data to study the relative importance of additive and dominance genetic variation in growth and carcass traits in an F2 pig population. Two GBLUP models were used, a model without a polygenic effect (ADM) and a model with a polygenic effect (ADMP). Additive effects played a greater role in the control of growth and carcass traits than did dominance effects. However, dominance effects were important for all traits, particularly in backfat thickness. The narrow-sense and broad-sense heritability estimates for growth (0.06 to 0.42, and 0.10 to 0.51, respectively) and carcass traits (0.07 to 0.37, and 0.10 to 0.76, respec-tively) exhibited a wide variation. The inclusion of a polygenic effect in the ADMP model changed the broad-sense heritability estimates only for birth weight and weight at 21 days of age. PMID:26125833

  8. A combined toxicity study of zinc oxide nanoparticles and vitamin C in food additives

    NASA Astrophysics Data System (ADS)

    Wang, Yanli; Yuan, Lulu; Yao, Chenjie; Ding, Lin; Li, Chenchen; Fang, Jie; Sui, Keke; Liu, Yuanfang; Wu, Minghong

    2014-11-01

    At present, safety evaluation standards for nanofood additives are made based on the toxic effects of a single additive. Since the size, surface properties and chemical nature influence the toxicity of nanomaterials, the toxicity may have dramatically changed when nanomaterials are used as food additives in a complex system. Herein, we investigated the combined toxicity of zinc oxide nanoparticles (ZnO NPs) and vitamin C (Vc, ascorbic acid). The results showed that Vc increased the cytotoxicity significantly compared with that of the ZnO only NPs. When the cells were exposed to ZnO NPs at a concentration less than 15 mg L-1, or to Vc at a concentration less than 300 mg L-1, there was no significant cytotoxicity, both in the case of gastric epithelial cell line (GES-1) and neural stem cells (NSCs). However, when 15 mg L-1 of ZnO NPs and 300 mg L-1 of Vc were introduced to cells together, the cell viability decreased sharply indicating significant cytotoxicity. Moreover, the significant increase in toxicity was also shown in the in vivo experiments. The dose of the ZnO NPs and Vc used in the in vivo study was calculated according to the state of food and nutrition enhancer standard. After repeated oral exposure to ZnO NPs plus Vc, the injury of the liver and kidneys in mice has been indicated by the change of these indices. These findings demonstrate that the synergistic toxicity presented in a complex system is essential for the toxicological evaluation and safety assessment of nanofood.At present, safety evaluation standards for nanofood additives are made based on the toxic effects of a single additive. Since the size, surface properties and chemical nature influence the toxicity of nanomaterials, the toxicity may have dramatically changed when nanomaterials are used as food additives in a complex system. Herein, we investigated the combined toxicity of zinc oxide nanoparticles (ZnO NPs) and vitamin C (Vc, ascorbic acid). The results showed that Vc increased the

  9. Amlodipine/ARB fixed-dose combinations for the treatment of hypertension: focus on amlodipine/olmesartan combination.

    PubMed

    Chrysant, Steven G

    2008-06-01

    The incidence of hypertension continues to increase worldwide and, according to recent estimates, its incidence is approximately 30% of the U.S. population. However, the control of blood pressure (BP) to recommended levels of < 140/90 mmHg for uncomplicated hypertension, recommended in the 7th Report of the Joint National Committee (JNC-7) on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, remains low at 36.8%. Because the level of BP is directly related to cardiovascular and stroke morbidity and mortality, aggressive treatment and control of hypertension are strongly indicated. Since monotherapy alone is not effective for the control of stage 2 hypertension, fixed-dose combination therapy with two complementary drugs has been recommended by the JNC-7 guidelines as initial therapy for subjects with diastolic BP > or = 100 mmHg and systolic BP > or = 160 mmHg. There are several fixed-dose combination preparations already available, each with its individual indications. The recently FDA-approved fixed-dose combinations of amlodipine with either olmesartan or valsartan are very effective in treating hypertension and are safe and well tolerated. In addition to reducing BP, these new fixed-dose combinations have also demonstrated significant reductions in the inciendence of edema associated with amlodipine monotherapy, which makes them more acceptable to patients. In addition, due to the metabolic neutrality of both component drugs, these preparations are preferable for the treatment of hypertensive patients with diabetes or the metabolic syndrome, in addition to other cardiovascular risk factors. PMID:18596998

  10. [Severe neurotoxicological reaction by combined treatment with vincristine and fluconazole].

    PubMed

    Hellfritzsch, Maja; Lassen, Pernille; Nielsen, Lars Peter

    2013-04-01

    We describe the case of a woman, aged 41 years, who received a combination chemotherapy including vincristine, doxorubicine, ifosfamide and etoposide due to Ewings sarcoma. She was treated prophylactic with fluconazole to prevent oral candidosis. Unexpectedly, she developed severe neurotoxic side effects. Treatment with multiple substrates of cytochrome P450 3A4 combined with inhibition of the enzyme by fluconazole impairs metabolism and thereby increase plasma concentrations of vincristine, which is considered to be the main reason for the neurotoxic side effects. PMID:23582127

  11. Simple additive effects are rare: a quantitative review of plant biomass and soil process responses to combined manipulations of CO2 and temperature.

    PubMed

    Dieleman, Wouter I J; Vicca, Sara; Dijkstra, Feike A; Hagedorn, Frank; Hovenden, Mark J; Larsen, Klaus S; Morgan, Jack A; Volder, Astrid; Beier, Claus; Dukes, Jeffrey S; King, John; Leuzinger, Sebastian; Linder, Sune; Luo, Yiqi; Oren, Ram; De Angelis, Paolo; Tingey, David; Hoosbeek, Marcel R; Janssens, Ivan A

    2012-09-01

    In recent years, increased awareness of the potential interactions between rising atmospheric CO2 concentrations ([ CO2 ]) and temperature has illustrated the importance of multifactorial ecosystem manipulation experiments for validating Earth System models. To address the urgent need for increased understanding of responses in multifactorial experiments, this article synthesizes how ecosystem productivity and soil processes respond to combined warming and [ CO2 ] manipulation, and compares it with those obtained in single factor [ CO2 ] and temperature manipulation experiments. Across all combined elevated [ CO2 ] and warming experiments, biomass production and soil respiration were typically enhanced. Responses to the combined treatment were more similar to those in the [ CO2 ]-only treatment than to those in the warming-only treatment. In contrast to warming-only experiments, both the combined and the [ CO2 ]-only treatments elicited larger stimulation of fine root biomass than of aboveground biomass, consistently stimulated soil respiration, and decreased foliar nitrogen (N) concentration. Nonetheless, mineral N availability declined less in the combined treatment than in the [ CO2 ]-only treatment, possibly due to the warming-induced acceleration of decomposition, implying that progressive nitrogen limitation (PNL) may not occur as commonly as anticipated from single factor [ CO2 ] treatment studies. Responses of total plant biomass, especially of aboveground biomass, revealed antagonistic interactions between elevated [ CO2 ] and warming, i.e. the response to the combined treatment was usually less-than-additive. This implies that productivity projections might be overestimated when models are parameterized based on single factor responses. Our results highlight the need for more (and especially more long-term) multifactor manipulation experiments. Because single factor CO2 responses often dominated over warming responses in the combined treatments, our

  12. Combination topical therapy in the treatment of acne.

    PubMed

    Del Rosso, James Q

    2006-08-01

    Many medications are available for the management of acne. The armamentarium includes topical retinoids (ie, adapalene, tazarotene, tretinoin), antimicrobial and antibacterial agents (ie, benzoyl peroxide, clindamycin, erythromycin, sulfacetamide with or without sulfur), oral antibiotics (ie, doxycycline, minocycline, tetracycline), hormonal agents (ie, oral contraceptives, spironolactone), and systemic retinoids (ie, isotretinoin). Acne usually is treated with combination therapy to address its multifactorial pathophysiology. The combination of clindamycin 1%-benzoyl peroxide 5% gel, available as a stable formulation in a single tube, is efficacious and well-tolerated. The product's excipients, glycerin and dimethicone, minimize treatment-related irritation, thereby increasing patient compliance. Clindamycin-benzoyl peroxide may be well-tolerated when applied with topical retinoids, creating a more targeted and complete treatment strategy. PMID:17966494

  13. Ultraviolet and pulsed electric field treatments have additive effect on inactivation of E. coli in apple juice.

    PubMed

    Gachovska, T K; Kumar, S; Thippareddi, H; Subbiah, J; Williams, F

    2008-11-01

    Apple juice inoculated with Escherichia coli ATCC 23472 was processed continuously using either ultraviolet (UV), high-voltage pulsed electric field (PEF), or a combination of the PEF and UV treatment systems. Apple juice was pumped through either of the systems at 3 flow rates (8, 14, and 20 mL/min). E. coli was reduced by 3.46 log CFU/mL when exposed in a 50 cm length of UV treatment chamber at 8 mL/min (2.94 s treatment time with a product temperature increase of 13 degrees C). E. coli inactivation of 4.87 log CFU/mL was achieved with a peak electric field strength of 60 kV/cm and 11.3 pulses (average pulse width of 3.5 mus, product temperature increased to 52 degrees C). E. coli reductions resulting from a combination treatment of UV and PEF applied sequentially were evaluated. A maximum E. coli reduction of 5.35 log CFU/mL was achieved using PEF (electrical field strength of 60 kV/cm, specific energy of 162 J/mL, and 11.3 pulses) and UV treatments (length of 50 cm, treatment time of 2.94 s, and flow rate of 8 mL/min). An additive effect was observed for the combination treatments (PEF and UV), regardless of the order of treatment (P > 0.05). E. coli reductions of 5.35 and 5.30 log CFU/mL with PEF treatment (electrical field strength of 60 kV/cm, specific energy of 162 J/mL, and 11.3 pulses) followed by UV (length of 30 cm, treatment time of 1.8 s, and flow rate of 8 mL/min) and UV treatment followed by PEF (same treatment conditions), respectively. No synergistic effect was observed. PMID:19021811

  14. Phosphorus availability from rock phosphate: Combined effect of green waste composting and sulfur addition.

    PubMed

    Bustamante, M A; Ceglie, F G; Aly, A; Mihreteab, H T; Ciaccia, C; Tittarelli, F

    2016-11-01

    Rock phosphate constitutes a natural phosphorus (P) source for organic farming systems, but with a limiting direct agricultural use due to its poor inherent reactivity. Thus, this work studies the effect of the co-composting of rock phosphate with green wastes and elemental sulfur on phosphorus availability. Six composts were prepared combining different green wastes and rock phosphate in three different proportions (0%, 0.27% and 0.54% P fresh mass basis) and elemental sulfur in two proportions (0% and 0.5% S fresh mass basis). During composting, the temperature of the mixtures was monitored, as were physico-chemical and chemical parameters, especially those related to phosphorus. The co-composting of green wastes with rock phosphate improved phosphorus mobilization and also constituted a viable method to manage green wastes, obtaining P-enriched compost for organic farming systems. Sulfur addition favored the composting process and also phosphorus solubilization, especially in the mixture with the lowest proportion of rock phosphate. PMID:27543750

  15. Fixed-dose combination of sitagliptin and metformin for the treatment of type 2 diabetes

    PubMed Central

    Reynolds, Jonathan K

    2009-01-01

    JanumetTM, a fixed dose combination of sitagliptin/metformin HCL manufactured by Merck Pharmaceuticals, has received US Food and Drug Administration approval for treatment of patients with type 2 diabetes, that are inadequately controlled, either by sitagliptin or metformin alone or together in free-dose combination form. Sitagliptin, an inhibitor of the enzyme DDP-4, assists patients with type 2 diabetes mellitus to achieve glycemic control. It has been shown to be safe and effective at 100 mg daily doses. The effect of giving sitagliptin in combination with metformin is thought to have a complimentary and possibly additive effect on glycemic control. PMID:21437126

  16. Clay-starch combination for micropollutants removal from wastewater treatment plant effluent.

    PubMed

    Mohd Amin, M F; Heijman, S G J; Rietveld, L C

    2016-01-01

    In this study, a new, more effective and cost-effective treatment alternative is investigated for the removal of pharmaceuticals from wastewater treatment plant effluent (WWTP-eff). The potential of combining clay with biodegradable polymeric flocculants is further highlighted. Flocculation is viewed as the best method to get the optimum outcome from clay. In addition, flocculation with cationic starch increases the biodegradability and cost of the treatment. Clay is naturally abundantly available and relatively inexpensive compared to conventional adsorbents. Experimental studies were carried out with existing naturally occurring pharmaceutical concentrations found and measured in WWTP-eff with atrazine spiking for comparison between the demineralised water and WWTP-eff matrix. Around 70% of the total measured pharmaceutical compounds were removable by the clay-starch combination. The effect of clay with and without starch addition was also highlighted. PMID:27054745

  17. Aliskiren-hydrochlorothiazide combination for the treatment of hypertension.

    PubMed

    Chrysant, Steven G

    2008-03-01

    Hypertension is a major risk factor for cardiovascular morbidity and mortality and currently has been estimated at 30% of the US population. Of these, only 36.8% have their blood pressure reduced to recommended levels of lower than 140/90 mmHg for uncomplicated hypertension, or less than 130/80 mmHg for patients with diabetes mellitus or renal disease. Since monotherapy controls blood pressure in less than 50% of treated hypertensive patients, combination therapy is often required to bring blood pressure to the recommended levels of the 7th Joint National Committee report. One of the most effective and widely used combinations is the combination of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker with hydrochlorothiazide (HCTZ). Aliskiren, a new blocker of the renin-angiotensin system has been developed and approved by the US FDA on 18th January 2008 for the treatment of hypertension. Aliskiren is a direct inhibitor of renin, the rate-limiting enzyme for the production of angiotensin II, a powerful vasoconstrictive peptide. Several randomized clinical trials have demonstrated that aliskiren administered in single daily doses of 150, 300 or 600 mg alone and in combination with HCTZ 12.5 and 25 mg is effective in lowering blood pressure, and is safe and well tolerated. In this article, the pharmacokinetic and pharmacodynamic profile and the clinical application of aliskiren alone and in combination with HCTZ will be discussed. PMID:18327992

  18. Treatment of hypothyroidism with levothyroxine or a combination of levothyroxine plus L-triiodothyronine.

    PubMed

    Escobar-Morreale, Héctor F; Botella-Carretero, José I; Morreale de Escobar, Gabriella

    2015-01-01

    At present, the drug of choice for the treatment of hypothyroidism is levothyroxine sodium, even though the thyroid gland secretes both thyroxine and 3',3,5-triiodothyronine; the latter is the more active of the two at the cellular level because of its higher affinity for the nuclear thyroid hormone receptors. To date, combined levothyroxine plus liothyronine treatment for hypothyroidism has been evaluated in 15 clinical trials in humans. In two studies, combined therapy seemed to have beneficial effects on mood, quality of life, and psychometric performance of patients, compared with levothyroxine alone; in some of these studies, the patients preferred levothyroxine plus liothyronine combinations. This preference should be balanced against the possibility of adverse events resulting from the addition of liothyronine to levothyroxine. Until clear advantages of levothyroxine plus liothyronine are demonstrated, the administration of levothyroxine alone should remain the treatment of choice for replacement therapy of hypothyroidism. PMID:25617173

  19. Substitution of Nickel by Combined Addition of Cobalt and Zirconium in Alloy A 332

    NASA Astrophysics Data System (ADS)

    Wüstenhagen, Andreas; Tonn, Babette

    2011-01-01

    Due to the increasing international competition and the resulting pricing pressure it is imperative to avoid the use of expensive alloying elements during the production of aluminium castings. The piston alloy A 332 shows an optimum combination of mechanical and casting properties and an attractive cost-performance ratio whereas nickel is the most expensive alloying element. A substitution of nickel by a combined addition of low contents of cobalt and zirconium has the potential capacitiy to increase the mechanical properties and reduce the costs of the alloy. At Clausthal University of Technology Thermo-Calc simulations and casting experiments were carried out to investigate the effect of the nickel subtitution. Thermo-Calc-simulations were made to analyze the intermetallic phases in these alloys. These simulations were evaluated by observations under optical microscope and SEM of specimens poured into permanent moulds. The size and morphology of the intermetallic phases and the primary silicon was analyzed by the use of image analysis software. The mechanical properties of the alloys were determined by tensile tests at room temperature, 250° C and 350° C. The tensile specimens were tested in as-cast and pre-aged condition. The effect on the castability was characterized by determining the flow length and the susceptibility to form shrinkages and hot cracks. The standard alloy A 332 and the new piston alloy with cobalt and zirconium were compared. The new alloy AlSi12,6Cu1Mg1CoZr exhibits a yield strength of 115 MPa and a tensile strength of 171 MPa at 250° C in pre-aged condition (250° C/100 h). At 350° C the new alloy displays a yield strength of 57 MPa and a tensile strength of 85 MPa in pre-aged condition (350° C/100h). Compared to the reference alloy AlSi12,6Cu1Ni1Mg1 the yield strength at 250° C was improved about 25% and the yield strength at 350° C about 7%. The favorable castability of the reference alloy is not affected by the substitution of

  20. Combined Treatment with Botulinum Toxin and 595-nm Pulsed Dye Laser for Traumatic Scarring.

    PubMed

    Lee, Sang Ju; Jeong, Se Yeong; No, Yeon A; Park, Kui Young; Kim, Beom Joo

    2015-12-01

    Traumatic scars on skin covering areas of high movement, especially areas on the face, can be stressful for patients. We report two cases of traumatic scars that occurred on the chin, and that were successfully treated with a combined therapy of 595-nm pulsed dye laser (PDL) and intramuscular injection of botulinum toxin. After the treatment, good cosmetic results were achieved in both patients. The only adverse effect during and after the treatments was mild pain, which resolved within several days without any additional treatment. In conclusion, the combination of 595-nm PDL and intramuscular botulinum toxin injection was shown to be a safe and effective treatment for traumatic scars on the mobile chin area in Korean patients. PMID:26719648

  1. Exhaust emissions reduction from diesel engine using combined Annona-Eucalyptus oil blends and antioxidant additive

    NASA Astrophysics Data System (ADS)

    Senthil, R.; Silambarasan, R.; Pranesh, G.

    2016-07-01

    The limited resources, rising petroleum prices and depletion of fossil fuel have now become a matter of great concern. Hence, there is an urgent need for researchers to find some alternate fuels which are capable of substituting partly or wholly the higher demanded conventional diesel fuel. Lot of research work has been conducted on diesel engine using biodiesel and its blends with diesel as an alternate fuel. Very few works have been done with combination of biodiesel-Eucalypts oil without neat diesel and this leads to lots of scope in this area. The aim of the present study is to analyze the performance and emission characteristics of a single cylinder, direct injection, compression ignition engine using eucalyptus oil-biodiesel as fuel. The presence of eucalyptus oil in the blend reduces the viscosity and improves the volatility of the blends. The methyl ester of Annona oil is blended with eucalypts oil in 10, 20, 30, 40 and 50 %. The performance and emission characteristics are evaluated by operating the engine at different loads. The performance characteristics such as brake thermal efficiency, brake specific fuel consumption and exhaust gas temperature are evaluated. The emission constituents measured are Carbon monoxide (CO), unburned hydrocarbons (HC), Oxides of nitrogen (NOx) and Smoke. It is found that A50-Eu50 (50 Annona + 50 % Eucalyptus oil) blend showed better performance and reduction in exhaust emissions. But, it showed a very marginal increase in NOx emission when compared to that of diesel. Therefore, in order to reduce the NOx emission, antioxidant additive (A-tocopherol acetate) is mixed with Annona-Eucalyptus oil blends in various proportions by which NOx emission is reduced. Hence, A50-Eu50 blend can be used as an alternate fuel for diesel engine without any modifications.

  2. Naltrexone and buprenorphine combination in the treatment of opioid dependence.

    PubMed

    Gerra, G; Fantoma, A; Zaimovic, A

    2006-11-01

    Naltrexone treatment has demonstrated some advantages for special populations of heroin addicted individuals, but patients' compliance seems to be very poor, with a low adherence and low retention rate. Kappa-opioid system overdrive seems to contribute to opioid protracted abstinence syndrome, with dysphoria and psychosomatic symptoms during naltrexone treatment. The objective of this observational study was to determine the effectiveness of a functional k antagonist in improving naltrexone treatment outcome. A partial mu agonist/kappa antagonist (buprenorphine) and a mu antagonist (naltrexone) were combined during a 12 weeks protocol, theoretically leaving k antagonism as the major medication effect. Sixty patients were submitted to outpatient rapid detoxification utilizing buprenorphine and opioid antagonists. Starting on the fifth day, 30 patients (group A) received naltrexone alone. Alternatively, 30 patients (group B) received naltrexone (50mg oral dose) plus buprenorphine (4 mg sublingual) for the 12 weeks of the observational study. The endpoints of the study were: retention in treatment, negative urinalyses, changes in psychological symptoms (Symptom Checklist-90 Revised: SCL-90) and craving scores (visual analysis scale (VAS)). Thirty-four subjects (56.67%) completed the 12 weeks study. Twenty-one patients (35.0%) had all urine samples negative for opiates and cocaine. nine subjects (15.0%) had urine samples negative for cocaine and opiates for the last 4 weeks of the study. five subjects (8.3%) continued to use cocaine during the 12 weeks of the study. No significant change in pupillary diameter after buprenorphine administration was evidenced during clinical observations from baseline across the weekly measurements. Retention rates in group A (naltrexone) and group B (naltrexone + buprenorphine) at week 12 were respectively 40% (12 patients) and 73.33% (22 patients), with a significant difference in favour of group B (p= 0.018). Patients treated with

  3. Evaluation of effluents from bench-scale treatment combinations for landfill leachate in Ibadan, Nigeria.

    PubMed

    Aluko, Olufemi Oludare; Sridhar, Mkc

    2014-01-01

    The removal of pollutants in landfill leachate was investigated using constructed wetlands, a trickling filter, alum flocculation and coagulation, and a sequencing batch reactor in various combinations. Thirteen combined operations were investigated involving three out of the four unit treatment methods in series. The study was conducted because unit operations, though achieved reductions in pollutants concentrations had effluent values above the national regulatory guideline values. The suspended solids of effluents were permissible in most treatment processes, while reductions in 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD) and ammonia (NH3) of leachates ranged from 80% to 97%; 86% to 97% and 92% to 98% respectively. However, there were significant increases in nitrate (85%) and dissolved oxygen of treatment (218%). In addition, the characteristics of the recommended treatment sequence, involving constructed wetlands, alum and trickling filter produced effluents with reductions in colour (97%), alkalinity (97%), BOD (97%), COD (97%) and NH3 (98%), and in metals, except nickel (29% reduction from the influent values). The recommended treatment combination is suitable for effective leachate management at the landfill. The cost of constructing and operating the recommended treatment combination at the facility, for 5 years, would be NGN6,009,750.00 ($38,036.39). The performance should be monitored on site prior to full adoption if effluent characteristics remain consistently low over dry and wet seasons. PMID:24396038

  4. Combination biological and microwave treatments of used rubber products

    DOEpatents

    Fliermans, Carl B.; Wicks, George G.

    2002-01-01

    A process and resulting product is provided in which a vulcanized solid particulate, such as vulcanized crumb rubber, has select chemical bonds altered by biotreatment with thermophillic microorganisms selected from natural isolates from hot sulfur springs. Following the biotreatment, microwave radiation is used to further treat the surface and to treat the bulk interior of the crumb rubber. The resulting combined treatments render the treated crumb rubber more suitable for use in new rubber formulations. As a result, larger loading levels and sizes of the treated crumb rubber can be used in new rubber mixtures and good properties obtained from the new recycled products.

  5. The neurovascular unit and combination treatment strategies for stroke

    PubMed Central

    Zhang, Li; Zhang, Zhang Gang; Chopp, Michael

    2012-01-01

    Tissue plasminogen activator (tPA) administered within 4.5 hours of symptom onset restores cerebral blood flow and promotes neurological recovery of stroke patients. However, the narrow therapeutic time window and the risk of intracerebral hemorrhage after tPA treatment pose major hurdles to its clinical usage. In light of the failures of neuroprotective therapies in clinical trials, emerging concepts suggest that neuroprotection alone without restoration of tissue perfusion and vascular integrity may not be adequate for treatment of acute stroke. Here we review evidence of the use of adjuvant pharmacological agents to extend the therapeutic window for tPA via targeting the neurovascular unit and the underlying mechanisms of the combination therapy in experimental stroke. PMID:22595494

  6. Combining an amyloid-beta (Aβ) cleaving enzyme inhibitor with a γ-secretase modulator results in an additive reduction of Aβ production.

    PubMed

    Strömberg, Kia; Eketjäll, Susanna; Georgievska, Biljana; Tunblad, Karin; Eliason, Kristina; Olsson, Fredrik; Radesäter, Ann-Cathrin; Klintenberg, Rebecka; Arvidsson, Per I; von Berg, Stefan; Fälting, Johanna; Cowburn, Richard F; Dabrowski, Michael

    2015-01-01

    A major hallmark of Alzheimer's disease (AD) is the deposition of amyloid-β (Aβ) peptides in amyloid plaques. Aβ peptides are produced by sequential cleavage of the amyloid precursor protein by the β amyloid cleaving enzyme (BACE) and the γ-secretase (γ-sec) complex. Pharmacological treatments that decrease brain levels of in particular the toxic Aβ42 peptide are thought to be promising approaches for AD disease modification. Potent and selective BACE1 inhibitors as well as γ-sec modulators (GSMs) have been designed. Pharmacological intervention of secretase function is not without risks of either on- or off-target adverse effects. One way of improving the therapeutic window could be to combine treatment on multiple targets, using smaller individual doses and thereby minimizing adverse effect liability. We show that combined treatment of primary cortical neurons with a BACE1 inhibitor and a GSM gives an additive effect on Aβ42 level change compared with the individual treatments. We extend this finding to C57BL/6 mice, where the combined treatment results in reduction of brain Aβ42 levels reflecting the sum of the individual treatment efficacies. These results show that pharmacological targeting of two amyloid precursor protein processing steps is feasible without negatively interfering with the mechanism of action on individual targets. We conclude that targeting Aβ production by combining a BACE inhibitor and a GSM could be a viable approach for therapeutic intervention in AD modification. PMID:25303711

  7. Biological black water treatment combined with membrane separation.

    PubMed

    van Voorthuizen, Ellen; Zwijnenburg, Arie; van der Meer, Walter; Temmink, Hardy

    2008-10-01

    Separate treatment of black (toilet) water offers the possibility to recover energy and nutrients. In this study three combinations of biological treatment and membrane filtration were compared for their biological and membrane performance and nutrient conservation: a UASB followed by effluent membrane filtration, an anaerobic MBR and an aerobic MBR. Methane production in the anaerobic systems was lower than expected. Sludge production was highest in the aerobic MBR, followed by the anaerobic MBR and the UASB-membrane system. The level of nutrient conservation in the effluent was high in all three treatment systems, which is beneficial for their recovery from the effluent. Membrane treatment guaranteed an effluent which is free of suspended and colloidal matter. However, the concentration of soluble COD in the effluent still was relatively high and this may seriously hamper subsequent nutrient recovery by physical-chemical processes. The membrane filtration behaviour of the three systems was very different, and seemed to be dominated by the concentration of colloidals in the membrane feed. In general, membrane fouling was the lowest in the aerobic MBR, followed by the membranes used for UASB effluent filtration and the anaerobic MBR. PMID:18774157

  8. Impact of Age, Gender, and Addition of Probiotics on Treatment Success for Helicobacter pylori in Children

    PubMed Central

    Weiner, Noam; Shaoul, Ron

    2015-01-01

    The primary objective of this study was to evaluate the effect of age, gender, and the use of probiotics with standard treatment regimen on Helicobacter pylori eradication. Based on endoscopic findings and clinical presentation, selected patients were treated with standard triple therapy (omeprazole, clarithromycin, and amoxicillin). Those who failed were offered a repeat treatment with omeprazole, metronidazole, and amoxicillin. After the publications of the possible advantages of probiotic treatment on H pylori eradication, the probiotic agent “Probiotica Forte” was routinely added to the treatment. Eradication was noted for 94/130 patients (72%) and for 128/197 patients (65%) with or without probiotic agent, respectively (P = .23). For second-line treatment eradication was noted in 33/46 (72%) and in 9/20 (45%) with or without probiotic agent, respectively (P = .053). The addition of probiotics may improve eradication success especially in addition to second-line treatment. PMID:27335981

  9. Methylphenidate and desipramine combined treatment improves PTSD symptomatology in a rat model

    PubMed Central

    Aga-Mizrachi, S; Cymerblit-Sabba, A; Gurman, O; Balan, A; Shwam, G; Deshe, R; Miller, L; Gorodetsky, N; Heinrich, N; Tzezana, O; Zubedat, S; Grinstein, D; Avital, A

    2014-01-01

    Antidepressant medication constitutes the first line pharmacological treatment for posttraumatic stress disorder (PTSD), however, because many patients display no beneficial drug effects it has been suggested that combinations of antidepressants with additional drugs may be necessary. The defining symptoms of PTSD include re-experiencing, avoidance and hyperarousal. In addition, PTSD patients were shown to become easily distracted and often suffer from poor concentration together with indications of comorbidity with attention-deficit hyperactivity disorder (ADHD). Methylphenidate (MPH) is the most common and effective drug treatment for ADHD, thus we aimed to investigate the effects of MPH treatment, by itself or in combination with the antidepressants fluoxetine (FLU) or desipramine (DES). We modified an animal model of PTSD by exposing rats to chronic stress and evaluating the subsequent development of behavioral PTSD-like symptoms, as well as the effects on proinflammatory cytokines, which were implicated in PTSD. We report that while FLU or DES had a beneficial effect on avoidance and hyperarousal symptoms, MPH improved all three symptoms. Moreover, the combination of MPH with DES produced the most dramatic beneficial effects. Serum levels of interleukin-1β (IL-1β) and IL-6 were elevated in the PTSD-like group compared with the control group, and were decreased by MPH, FLU, DES or the combination drug treatments, with the combination of DES+MPH producing the most complete rescue of the inflammatory response. Considering the versatile symptoms of PTSD, our results suggest a new combined treatment for PTSD comprising the antidepressant DES and the psychostimulant MPH. PMID:25247592

  10. 40 CFR 141.711 - Filtered system additional Cryptosporidium treatment requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Filtered system additional Cryptosporidium treatment requirements. 141.711 Section 141.711 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Treatment for Cryptosporidium...

  11. Combined photo-Fenton-SBR process for antibiotic wastewater treatment.

    PubMed

    Elmolla, Emad S; Chaudhuri, Malay

    2011-09-15

    The study examined combined photo-Fenton-SBR treatment of an antibiotic wastewater containing amoxicillin and cloxacillin. Optimum H(2)O(2)/COD and H(2)O(2)/Fe(2+) molar ratio of the photo-Fenton pretreatment were observed to be 2.5 and 20, respectively. Complete degradation of the antibiotics occurred in one min. The sequencing batch reactor (SBR) was operated at different hydraulic retention times (HRTs) with the wastewater treated under different photo-Fenton operating conditions (H(2)O(2)/COD and H(2)O(2)/Fe(2+) molar ratio). The SBR performance was found to be very sensitive to BOD(5)/COD ratio of the photo-Fenton treated wastewater. Statistical analysis of the results indicated that it was possible to reduce the Fe(2+) dose and increase the irradiation time of the photo-Fenton pretreatment. The best operating conditions of the combined photo-Fenton-SBR treatment were observed to be H(2)O(2)/COD molar ratio 2, H(2)O(2)/Fe(2+) molar ratio 150, irradiation time 90 min and HRT of 12h. Under the best operating conditions, 89% removal of sCOD with complete nitrification was achieved and the SBR effluent met the discharge standards. PMID:21767911

  12. Optical Imaging, Photodynamic Therapy and Optically-Triggered Combination Treatments

    PubMed Central

    Hasan, Tayyaba

    2015-01-01

    Optical imaging is becoming increasingly promising for real-time image-guided resections and combined with photodynamic therapy (PDT), a photochemistry-based treatment modality, optical approaches can be intrinsically “theranostic”. Challenges in PDT include precise light delivery, dosimetry and photosensitizer tumor localization to establish tumor selectivity, and like all other modalities, incomplete treatment and subsequent activation of molecular escape pathways are often attributable to tumor heterogeneity. Key advances in molecular imaging, target-activatable photosensitizers and optically active nanoparticles that provide both cytotoxicity and a drug release mechanism, have opened exciting avenues to meet these challenges. The focus of the review is optical imaging in the context of PDT but the general principles presented are applicable to many of the conventional approaches to cancer management. We highlight the role of optical imaging in providing structural, functional and molecular information regarding photodynamic mechanisms of action, thereby advancing PDT and PDT-based combination therapies of cancer. These advances represent a PDT renaissance with increasing applications of clinical PDT as a frontline cancer therapy working in concert with fluorescence-guided surgery, chemotherapy and radiation. PMID:26049699

  13. Treatment of indolent lymphomas: watchful waiting v aggressive combined modality treatment

    SciTech Connect

    Young, R.C.; Longo, D.L.; Glatstein, E.; Ihde, D.C.; Jaffe, E.S.; DeVita, V.T. Jr.

    1988-04-01

    Patients with advanced indolent lymphoma often have long survival (median, 4 to 8 years) in spite of frequent relapses. The inability of combination chemotherapy or radiation therapy (RT) to render patients disease free has led to radically divergent treatment approaches. Initial treatment may vary from aggressive combined modality therapy to no initial treatment. We sought to evaluate these two divergent approaches in a randomized trial of advanced indolent lymphomas (nodular, poorly differentiated lymphocytic; nodular mixed; diffuse, well-differentiated lymphocytic; diffuse, intermediately differentiated lymphocytic; and diffuse, poorly differentiated lymphocytic). A total of 104 patients were entered: 44 were randomly assigned to watch and wait in which only carefully defined, limited RT was administered if necessary; 45 were randomly assigned to aggressive combined modality treatment with prednisone, methotrexate, doxorubicin, cyclophosphamide, plus etoposide plus mechlorethamine, vincristine, procarbazine, prednisone (ProMACE-MOPP), followed by total nodal irradiation (TNI); and 15, with symptoms requiring initial therapy, received the identical combined treatment but were not randomly assigned. Of 41 evaluable patients on watch and wait, 23 (56%) have still not required systemic therapy, although 16 (39%) have received limited RT. Median time to crossover was 34 months. Of 18 patients crossed over, seven of the 16 who completed therapy (43%) achieved CR; two (11%) have relapsed. Histologic progression was seen in six (15%) of 41 patients on watch and wait without intervening chemotherapy. Of 45 patients randomly assigned to chemotherapy, 37 (82%) have completed induction therapy, and 29 of the 37 (78%) achieved CR.

  14. Influence of attrition scrubbing, ultrasonic treatment, and oxidant additions on uranium removal from contaminated soils

    SciTech Connect

    Timpson, M.E.; Elless, M.P.; Francis, C.W.

    1994-06-01

    As part of the Uranium in Soils Integrated Demonstration Project being conducted by the US Department of Energy, bench-scale investigations of selective leaching of uranium from soils at the Fernald Environmental Management Project site in Ohio were conducted at Oak Ridge National Laboratory. Two soils (storage pad soil and incinerator soil), representing the major contaminant sources at the site, were extracted using carbonate- and citric acid-based lixiviants. Physical and chemical processes were used in combination with the two extractants to increase the rate of uranium release from these soils. Attrition scrubbing and ultrasonic dispersion were the two physical processes utilized. Potassium permanganate was used as an oxidizing agent to transform tetravalent uranium to the hexavalent state. Hexavalent uranium is easily complexed in solution by the carbonate radical. Attrition scrubbing increased the rate of uranium release from both soils when compared with rotary shaking. At equivalent extraction times and solids loadings, however, attrition scrubbing proved effective only on the incinerator soil. Ultrasonic treatments on the incinerator soil removed 71% of the uranium contamination in a single extraction. Multiple extractions of the same sample removed up to 90% of the uranium. Additions of potassium permanganate to the carbonate extractant resulted in significant changes in the extractability of uranium from the incinerator soil but had no effect on the storage pad soil.

  15. Combined treatment with lisofylline and exendin-4 reverses autoimmune diabetes

    SciTech Connect

    Yang Zandong . E-mail: zandong_yang@merck.com; Chen Meng; Carter, Jeffrey D.; Nunemaker, Craig S.; Garmey, James C.; Kimble, Sarah D.; Nadler, Jerry L. . E-mail: jln2n@virginia.edu

    2006-06-09

    Type 1 diabetes mellitus (T1DM) is an autoimmune disease leading to near complete pancreatic {beta}-cell destruction. New evidence suggests that {beta}-cell regeneration is possible, but ongoing autoimmune damage prevents restoration of {beta}-cell mass. We tested the hypothesis that simultaneously blocking autoimmune cytokine damage and supplying a growth-promoting stimulus for {beta}-cells would provide a novel approach to reverse T1DM. Therefore, in this study we combined lisofylline to suppress autoimmunity and exendin-4 to enhance {beta}-cell proliferation for treating autoimmune-mediated diabetes in the non-obese diabetic (NOD) mouse model. We found that this combined therapy effectively reversed new-onset diabetes within a week of therapy, and even maintained euglycemia up to 145 days after treatment withdrawal. The therapeutic effect of this regimen was associated with improved {beta}-cell metabolism and insulin secretion, while reducing {beta}-cell apoptosis. It is possible that such combined therapy could become a new strategy to defeat T1DM in humans.

  16. INDUSTRIAL EFFLUENT TREATMENT USING IONIZING RADIATION COMBINED TO TITANIUM DIOXIDE

    SciTech Connect

    Duarte, C.L.; Oikawa, H.; Mori, M.N.; Sampa, M.H.O.

    2004-10-04

    The Advanced Oxidation Process (AOP) with OH radicals are the most efficient to mineralize organic compounds, and there are various methods to generate OH radicals as the use of ozone, hydrogen peroxide and ultra-violet radiation and ionizing radiation. The irradiation of aqueous solutions with high-energy electrons results in the excitation and ionizing of the molecules and rapid (10{sup -14} - 10{sup -9} s) formation of reactive intermediates. These reactive species will react with organic compounds present in industrial effluent inducing their decomposition. Titanium dioxide (TiO{sub 2}) catalyzed photoreaction is used to remove a wide range of pollutants in air and water media, combined to UV/VIS light, FeO{sub 2}, and H{sub 2}O{sub 2}, but as far as known there is no report on the combination with ionizing radiation. In some recent studies, the removal of organic pollutants in industrial effluent, such as Benzene, Toluene, and Xylene from petroleum production using ionizing radiation was investigated. It has been ob served that none of the methods can be used individually in wastewater treatment applications with good economics and high degree of energy efficiency. In the present work, the efficiency of ionizing radiation in presence of TiO{sub 2} to treat industrial effluent was evaluated. The main aim to combine these technologies is to improve the efficiency for very hard effluents and to reduce the processing cost for future implementation to large-scale design.

  17. Landfill Leachate Toxicity Removal in Combined Treatment with Municipal Wastewater

    PubMed Central

    Kalka, J.

    2012-01-01

    Combined treatment of landfill leachate and municipal wastewater was performed in order to investigate the changes of leachate toxicity during biological treatment. Three laboratory A2O lab-scale reactors were operating under the same parameters (Q-8.5–10 L/d; HRT-1.4–1.6 d; MLSS 1.6–2.5 g/L) except for the influent characteristic and load. The influent of reactor I consisted of municipal wastewater amended with leachate from postclosure landfill; influent of reactor II consisted of leachate collected from transient landfill and municipal wastewater; reactor III served as a control and its influent consisted of municipal wastewater only. Toxicity of raw and treated wastewater was determinted by four acute toxicity tests with Daphnia magna, Thamnocephalus platyurus, Vibrio fischeri, and Raphidocelis subcapitata. Landfill leachate increased initial toxicity of wastewater. During biological treatment, significant decline of acute toxicity was observed, but still mixture of leachate and wastewater was harmful to all tested organisms. PMID:22623882

  18. Treatment dilemmas of cetuximab combined with chemotherapy for metastatic colorectal cancer

    PubMed Central

    Wen, Feng; Li, Qiu

    2016-01-01

    Although monoclonal antibodies (mAbs) against epidermal growth factor receptor (EGFR) have largely enriched the available therapeutic choices for colorectal cancer (CRC), the understanding and management of their associated clinical toxicities are limited. In addition, the combined strategies of administering EGFR mAbs and traditional cytotoxic agents, such as 5-fluorouracil, oxaliplatin and irinotecan, have resulted in a more complicated management of CRC treatment-related side effects compared with EGFR mAb monotherapy. We believe that a thorough recognition of the toxicities of EGFR mAb drugs is essential for physicians to increase the therapeutic index in the treatment of CRC. This review aims to summarize the existing information regarding the treatment dilemmas of cetuximab combined with chemotherapy in the management of metastatic CRC. PMID:27340349

  19. Treatment dilemmas of cetuximab combined with chemotherapy for metastatic colorectal cancer.

    PubMed

    Wen, Feng; Li, Qiu

    2016-06-21

    Although monoclonal antibodies (mAbs) against epidermal growth factor receptor (EGFR) have largely enriched the available therapeutic choices for colorectal cancer (CRC), the understanding and management of their associated clinical toxicities are limited. In addition, the combined strategies of administering EGFR mAbs and traditional cytotoxic agents, such as 5-fluorouracil, oxaliplatin and irinotecan, have resulted in a more complicated management of CRC treatment-related side effects compared with EGFR mAb monotherapy. We believe that a thorough recognition of the toxicities of EGFR mAb drugs is essential for physicians to increase the therapeutic index in the treatment of CRC. This review aims to summarize the existing information regarding the treatment dilemmas of cetuximab combined with chemotherapy in the management of metastatic CRC. PMID:27340349

  20. Single-pill triple-combination therapy: an alternative to multiple-drug treatment of hypertension.

    PubMed

    Chrysant, Steven G

    2011-11-01

    Hypertension (HTN) affects an estimated 76.4 million US adults. Despite improvements in blood pressure (BP) control rates and the availability of effective antihypertensive agents, only 50% of these individuals achieve BP control. It is now recognized that many patients will require ≥ 2 antihypertensive agents to achieve BP control. Both the current US and reappraisal of the 2007 European guidelines include dual-combination regimens among recommended treatments for initial HTN therapy. For patients requiring 3 drugs, the combination of agents with complementary mechanisms of action (ie, renin-angiotensin-aldosterone system blocker, calcium channel blocker, and diuretic) has been recognized as rational and effective. Three single-pill triple-drug combinations have recently been approved for use in HTN in the United States: valsartan (VAL)/amlodipine (AML)/hydrochlorothiazide (HCTZ); olmesartan medoxomil (OM)/AML/HCTZ; and aliskiren (ALI)/VAL/HCTZ. Triple-combination regimens have resulted in a greater proportion of patients achieving BP control compared with dual-combination regimens, with significantly lower BP levels documented after only 2 weeks at maximum doses. Single-pill combinations offer convenience to address barriers to BP control such as poor adherence to therapy and therapeutic inertia. Additional benefits of combining antihypertensive agents from different classes include improved efficacy, safety, and reduction of cardiovascular risk. In patients with essential HTN for whom dual therapy is inadequate, single-pill triple-drug therapy can offer a simplified and effective treatment strategy. PMID:22104451

  1. New developments in the treatment of metastatic melanoma – role of dabrafenib–trametinib combination therapy

    PubMed Central

    Luke, Jason J; Ott, Patrick A

    2014-01-01

    Development of selective inhibitors of BRAF has improved the survival of patients with BRAF-mutant melanoma. The progression-free survival after treatment with a BRAF inhibitor is modest, however, and BRAF inhibitors induce cutaneous toxicity, likely due to paradoxical activation of the mitogen-activated protein kinase pathway. Combining selective BRAF and MEK inhibition, such as the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib, has been shown to improve the response rate and progression-free survival in patients with advanced melanoma while significantly alleviating the paradoxical activation of mitogen-activated protein kinase. This combination treatment results in a reduction in skin toxicity relative to that seen with a BRAF inhibitor alone; however, addition of the MEK inhibitor adds other toxicities, such as pyrexia and gastrointestinal or ocular toxicity. While combined BRAF–MEK inhibition appears primed to become a standard molecular approach for BRAF-mutant melanoma, the utility of the combination has to be considered in the rapidly changing landscape of immunotherapeutics, such as immune checkpoint blockade using anti-cytotoxic T lymphocyte antigen-4 and anti-programmed death-1/programmed death-L1 antibodies. Here we review the development of the dabrafenib plus trametinib combination, the characteristics of each drug and the combination, and the role of this combination in the management of patients with BRAF-mutant melanoma. PMID:25018652

  2. Role of the addition of cabergoline to the management of acromegalic patients resistant to longterm treatment with octreotide LAR.

    PubMed

    Vilar, Lucio; Azevedo, Monalisa F; Naves, Luciana Ansaneli; Casulari, Luiz Augusto; Albuquerque, José Luciano; Montenegro, Renan M; Montenegro, Renan M; Figueiredo, Patricia; Nascimento, Gilvan C; Faria, Manuel S

    2011-06-01

    The aim of this prospective open trial was to evaluate the efficacy in normalizing IGF-I levels of the addition of cabergoline to the treatment of acromegalic patients partially responsive to Octreotide-LAR (OCT-LAR), a long acting somatotastin analog (SSA). Fifty-two patients who did not achieve hormonal control after longterm therapy (at least, 12 months) with OCT-LAR (30 mg every 28 days intramuscularly) were given cabergoline in addition to the SSA treatment. Normalization of IGF-I levels was achieved in 40.4% of patients by 6 months after the addition of cabergoline (1.0-3.0 mg/week; mean, 2.19 ± 0.64), and these patients were considered responsive. Compared to non-responsive subjects, responsive patients had significantly lower mean %ULNR-IGF-I and GH levels. However, the rate of hyperprolactinemia and positive immunohistochemical staining for PRL was similar in both groups, before the addition of cabergoline. Responsive patients were followed for at least 12 months on combination treatment and persisted with normal IGF-I levels. Patients with baseline %ULNR IGF-I up to 220% and/or GH up to 5 ng/ml were those who benefited the most from combination treatment. No patients with %ULNR-IGF-I>250% reached normalization of IGF-I levels. Our findings demonstrated that the addition of cabergoline, even at relatively low doses, is effective in both short- and long-term control of IGF-I levels in acromegalic patients partially responsive to octreotide LAR, particularly in those with mild/moderately elevated GH/IGF-levels, irrespective of prolactin status. PMID:21104199

  3. Combined pharmacotherapy and cognitive behavior therapy in the treatment of panic disorder.

    PubMed

    Gelder, M G

    1998-12-01

    Cognitive behavior therapy (CBT) has been combined with pharmacotherapy in the treatment of panic disorder in three ways: (1) to treat agoraphobic symptoms in the condition of panic with agoraphobia; (2) to reduce withdrawal effects during drug taper; and (3) to treat panic attacks. Exposure treatment and pharmacotherapy have a modest additive effect, although more patients drop out of exposure therapy combined with imipramine treatment compared with exposure therapy alone. CBT reduces symptoms of withdrawal from alprazolam and other benzodiazepines and improves the outcome of drug treatment. At present, sufficient data are not available to determine whether the effects of CBT combined with drug therapy are additive in treating panic disorder. The results of a large trial are awaited. Current CBT consists of 12 sessions and is not widely offered to patients because of cost considerations. Efforts are being made to decrease the number of sessions necessary by improving cognitive techniques. One of these models is the subject of an ongoing trial. Finally, efforts to educate and counsel patients in the clinical setting regarding the psychopathology of panic attacks may improve the outcome of pharmacotherapy. PMID:9872706

  4. Quantification of Treatment Effect Modification on Both an Additive and Multiplicative Scale

    PubMed Central

    Girerd, Nicolas; Rabilloud, Muriel; Pibarot, Philippe; Mathieu, Patrick; Roy, Pascal

    2016-01-01

    Background In both observational and randomized studies, associations with overall survival are by and large assessed on a multiplicative scale using the Cox model. However, clinicians and clinical researchers have an ardent interest in assessing absolute benefit associated with treatments. In older patients, some studies have reported lower relative treatment effect, which might translate into similar or even greater absolute treatment effect given their high baseline hazard for clinical events. Methods The effect of treatment and the effect modification of treatment were respectively assessed using a multiplicative and an additive hazard model in an analysis adjusted for propensity score in the context of coronary surgery. Results The multiplicative model yielded a lower relative hazard reduction with bilateral internal thoracic artery grafting in older patients (Hazard ratio for interaction/year = 1.03, 95%CI: 1.00 to 1.06, p = 0.05) whereas the additive model reported a similar absolute hazard reduction with increasing age (Delta for interaction/year = 0.10, 95%CI: -0.27 to 0.46, p = 0.61). The number needed to treat derived from the propensity score-adjusted multiplicative model was remarkably similar at the end of the follow-up in patients aged < = 60 and in patients >70. Conclusions The present example demonstrates that a lower treatment effect in older patients on a relative scale can conversely translate into a similar treatment effect on an additive scale due to large baseline hazard differences. Importantly, absolute risk reduction, either crude or adjusted, can be calculated from multiplicative survival models. We advocate for a wider use of the absolute scale, especially using additive hazard models, to assess treatment effect and treatment effect modification. PMID:27045168

  5. Additive Antinociceptive Effects of a Combination of Vitamin C and Vitamin E after Peripheral Nerve Injury

    PubMed Central

    Lu, Ruirui; Kallenborn-Gerhardt, Wiebke; Geisslinger, Gerd; Schmidtko, Achim

    2011-01-01

    Accumulating evidence indicates that increased generation of reactive oxygen species (ROS) contributes to the development of exaggerated pain hypersensitivity during persistent pain. In the present study, we investigated the antinociceptive efficacy of the antioxidants vitamin C and vitamin E in mouse models of inflammatory and neuropathic pain. We show that systemic administration of a combination of vitamins C and E inhibited the early behavioral responses to formalin injection and the neuropathic pain behavior after peripheral nerve injury, but not the inflammatory pain behavior induced by Complete Freund's Adjuvant. In contrast, vitamin C or vitamin E given alone failed to affect the nociceptive behavior in all tested models. The attenuated neuropathic pain behavior induced by the vitamin C and E combination was paralleled by a reduced p38 phosphorylation in the spinal cord and in dorsal root ganglia, and was also observed after intrathecal injection of the vitamins. Moreover, the vitamin C and E combination ameliorated the allodynia induced by an intrathecally delivered ROS donor. Our results suggest that administration of vitamins C and E in combination may exert synergistic antinociceptive effects, and further indicate that ROS essentially contribute to nociceptive processing in special pain states. PMID:22195029

  6. Fixed-combination treatments for intraocular hypertension in Chinese patients – focus on bimatoprost-timolol

    PubMed Central

    Fang, Yuan; Ling, Zhihong; Sun, Xinghuai

    2015-01-01

    Glaucoma is a common eye disease that can lead to irreversible vision loss if left untreated. The early diagnosis and treatment of primary open-angle glaucoma is challenging, and visual impairment in Chinese glaucoma patients is a serious concern. Most of these patients need more than one topical antiglaucoma agent to control their intraocular pressures (IOPs). In the People’s Republic of China, the daily cost of different glaucoma medication varies greatly, and the treatment habits differ throughout the country. Prostaglandin analogs (PGAs) are recommended as first-line monotherapy, because of their efficacy and low risk of systemic side effects. Fixed-combination drops, particularly PGA-based fixed combinations, have recently been developed and used in patients with progression or who have failed to achieve their target IOPs. Here, we reviewed the current literature on the use of bimatoprost-timolol fixed combination (BTFC) in the People’s Republic of China. BTFC has achieved good efficacy and tolerability in Chinese clinical trials. In addition, BTFC is more cost effective compared with other fixed combinations available in the People’s Republic of China. Fixed-combination drops may offer benefits, such as keeping the ocular surface healthy, convenience of administration, and improvement in long-term adherence and quality of life. Therefore, BTFC has great potential for the treatment of Chinese glaucoma patients. However, the long-term efficacy of BTFC, comparisons of BTFC with other fixed-combination drugs, and treatment adherence and persistence with treatment in Chinese patients are unknown and will require further study. PMID:25999695

  7. Fixed-combination treatments for intraocular hypertension in Chinese patients - focus on bimatoprost-timolol.

    PubMed

    Fang, Yuan; Ling, Zhihong; Sun, Xinghuai

    2015-01-01

    Glaucoma is a common eye disease that can lead to irreversible vision loss if left untreated. The early diagnosis and treatment of primary open-angle glaucoma is challenging, and visual impairment in Chinese glaucoma patients is a serious concern. Most of these patients need more than one topical antiglaucoma agent to control their intraocular pressures (IOPs). In the People's Republic of China, the daily cost of different glaucoma medication varies greatly, and the treatment habits differ throughout the country. Prostaglandin analogs (PGAs) are recommended as first-line monotherapy, because of their efficacy and low risk of systemic side effects. Fixed-combination drops, particularly PGA-based fixed combinations, have recently been developed and used in patients with progression or who have failed to achieve their target IOPs. Here, we reviewed the current literature on the use of bimatoprost-timolol fixed combination (BTFC) in the People's Republic of China. BTFC has achieved good efficacy and tolerability in Chinese clinical trials. In addition, BTFC is more cost effective compared with other fixed combinations available in the People's Republic of China. Fixed-combination drops may offer benefits, such as keeping the ocular surface healthy, convenience of administration, and improvement in long-term adherence and quality of life. Therefore, BTFC has great potential for the treatment of Chinese glaucoma patients. However, the long-term efficacy of BTFC, comparisons of BTFC with other fixed-combination drugs, and treatment adherence and persistence with treatment in Chinese patients are unknown and will require further study. PMID:25999695

  8. Systemic but No Local Effects of Combined Zoledronate and Parathyroid Hormone Treatment in Experimental Autoimmune Arthritis

    PubMed Central

    Keller, Kresten Krarup; Thomsen, Jesper Skovhus; Stengaard-Pedersen, Kristian; Hauge, Ellen-Margrethe

    2014-01-01

    Introduction Local bone erosions and osteoporosis in rheumatoid arthritis (RA) are the result of a more pronounced bone resorption than bone formation. Present treatment strategies for RA inhibit inflammation, but do not directly target bone erosions. The aim of the study was in experimental arthritis to investigate the juxtaarticular and systemic effects of simultaneous osteoclast inhibition with zoledronate (ZLN) and osteoblast stimulation with parathyroid hormone (PTH). Methods Arthritis was induced in 36 SKG mice. The mice were randomized to three treatment groups and an untreated group: ZLN, PTH, PTH+ZLN, and untreated. Arthritis score and ankle width measurements were performed. Histological sections were cut from the right hind paw, and design-based stereological estimators were used to quantify histological variables of bone volume and bone formation and resorption. The femora were DXA- and μCT-scanned, and the bone strength was determined at the femoral neck and mid-diaphysis. Results Locally, we found no differences in arthritis score or ankle width throughout the study. Similarly, none of the treatments inhibited bone erosions or stimulated bone formation in the paw. Systemically, all treatments improved bone mineral density, strength of the femoral neck and mid-diaphysis, and μCT parameters of both cortical and trabecular bone. In addition, there was an additive effect of combination treatment compared with single treatments for most trabecular parameters including bone mineral density and bone volume fraction. Conclusions No local effect on bone was found by the combined action of inhibiting bone resorption and stimulating bone formation. However, a clear systemic effect of the combination treatment was demonstrated. PMID:24637846

  9. Combining Motivational Interviewing with Cognitive-Behavioral Treatments for Substance Abuse: Lessons from the COMBINE Research Project

    ERIC Educational Resources Information Center

    Moyers, Theresa B.; Houck, Jon

    2011-01-01

    Motivational Interviewing began as a treatment for substance misuse and has strong empirical support as an intervention for these disorders. It is very common for MI to be combined with other types of treatment when it is used for substance abuse, and this article focuses on one example of this: the COMBINE Research Project. We examine the…

  10. Combined modality treatment of localized unresectable adenocarcinoma of the pancreas

    SciTech Connect

    Mohiuddin, M.; Cantor, R.J.; Biermann, W.; Weiss, S.M.; Barbot, D.; Rosato, F.E.

    1988-01-01

    Since 1978, 86 patients with unresectable localized adenocarcinoma of the pancreas have been treated with a combined modality program using radioactive iodine 125-Implantation, external beam radiation, and systemic chemotherapy. Three treatment approaches were used with sequential modifications of the technique based on the course of disease and patterns of failure. Group 1 was comprised of 13 patients treated with a combination of implantation followed by a planned external radiation dose of 5000 to 6000 cGy delivered in 6 weeks. Group 2 included patients treated as in Group 1 followed by adjuvant chemotherapy. The most recent group of 54 patients, Group 3, has been treated since 1981 with implantation into the tumor of radioactive Iodine 125 seeds (12000 cGy minimal peripheral dose), perioperative chemotherapy (5-FU, Mito-C), and external beam irradiation (5000-5500 cGy) followed by further chemotherapy. Incidence of perioperative mortality has been reduced from 31% (10/32) in Groups 1 and 2 to 7% (4/54) in Group 3. Clinical local control of tumor has been excellent in all three groups (84%). Analysis of the Group 3 results indicate that the problem of distant metastasis, in spite of adjuvant chemotherapy, still remains overwhelming (64%)--especially to the liver--and requires development of more effective regimens. Median survival in the three groups of patients is 5.5, 11.3, and 12.5 months. The 2-year survival is 0, 15, and 22%, retrospectively in the three groups.

  11. Aerobic composting leachate treatment by the combination of membrane processes.

    PubMed

    Çakmakci, Mehmet; Özyaka, Vahide Seyda

    2013-02-01

    The main product of the conversion process of organic wastes to a useful organic fertilizer, known as compost, has gained an increasing interest in management of organic wastes recently. One of the main problems arising in the composting facilities is the high organic loaded leachate. In this study, a treatability experiment for composting leachate from a full-scale composting facility was carried out with the combination of membrane processes. The parameters such as chemical oxygen demand, total organic carbon, Cl⁻ and NH₄⁺ were analysed to evaluate the membrane treatment performances of single and combined membrane systems consisting centrifuge, cartridge filter, ultrafiltration and nanofiltration membranes. The removal efficiencies of all pollutants were observed between 4.4 and 98%. The highest removal efficiencies were observed with the nanofiltration membrane (NF90) having a lower molecular weight cut-off than the others used in this study. It was observed that the effluent of NF90 membrane did not exceed the allowed maximum COD value. PMID:23076267

  12. Slaughterhouse Wastewater Treatment by Combined Chemical Coagulation and Electrocoagulation Process

    PubMed Central

    Bazrafshan, Edris; Kord Mostafapour, Ferdos; Farzadkia, Mehdi; Ownagh, Kamal Aldin; Mahvi, Amir Hossein

    2012-01-01

    Slaughterhouse wastewater contains various and high amounts of organic matter (e.g., proteins, blood, fat and lard). In order to produce an effluent suitable for stream discharge, chemical coagulation and electrocoagulation techniques have been particularly explored at the laboratory pilot scale for organic compounds removal from slaughterhouse effluent. The purpose of this work was to investigate the feasibility of treating cattle-slaughterhouse wastewater by combined chemical coagulation and electrocoagulation process to achieve the required standards. The influence of the operating variables such as coagulant dose, electrical potential and reaction time on the removal efficiencies of major pollutants was determined. The rate of removal of pollutants linearly increased with increasing doses of PACl and applied voltage. COD and BOD5 removal of more than 99% was obtained by adding 100 mg/L PACl and applied voltage 40 V. The experiments demonstrated the effectiveness of chemical and electrochemical techniques for the treatment of slaughterhouse wastewaters. Consequently, combined processes are inferred to be superior to electrocoagulation alone for the removal of both organic and inorganic compounds from cattle-slaughterhouse wastewater. PMID:22768233

  13. Tramadol/paracetamol fixed-dose combination in the treatment of moderate to severe pain

    PubMed Central

    Pergolizzi, Joseph V; van de Laar, Mart; Langford, Richard; Mellinghoff, Hans-Ulrich; Merchante, Ignacio Morón; Nalamachu, Srinivas; O’Brien, Joanne; Perrot, Serge; Raffa, Robert B

    2012-01-01

    Pain is the most common reason patients seek medical attention and pain relief has been put forward as an ethical obligation of clinicians and a fundamental human right. However, pain management is challenging because the pathophysiology of pain is complex and not completely understood. Widely used analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen) have been associated with adverse events. Adverse event rates are of concern, especially in long-term treatment or at high doses. Paracetamol and NSAIDs are available by prescription, over the counter, and in combination preparations. Patients may be unaware of the risk associated with high dosages or long-term use of paracetamol and NSAIDs. Clinicians should encourage patients to disclose all medications they take in a “do ask, do tell” approach that includes patient education about the risks and benefits of common pain relievers. The ideal pain reliever would have few risks and enhanced analgesic efficacy. Fixed-dose combination analgesics with two or more agents may offer additive or synergistic benefits to treat the multiple mechanisms of pain. Therefore, pain may be effectively treated while toxicity is reduced due to lower doses. One recent fixed-dose combination analgesic product combines tramadol, a centrally acting weak opioid analgesic, with low-dose paracetamol. Evidence-based guidelines recognize the potential value of combination analgesics in specific situations. The current guideline-based paradigm for pain treatment recommends NSAIDs for ongoing use with analgesics such as opioids to manage flares. However, the treatment model should evolve how to use low-dose combination products to manage pain with occasional use of NSAIDs for flares to avoid long-term and high-dose treatment with these analgesics. A next step in pain management guidelines should be targeted therapy when possible, or low-dose combination therapy or both, to achieve maximal efficacy with

  14. Stabilized landfill leachate treatment by combined physicochemical-nanofiltration processes.

    PubMed

    Trebouet, D; Schlumpf, J P; Jaouen, P; Quemeneur, F

    2001-08-01

    Landfill leachate is a complex wastewater which the composition and concentration of contaminants are influenced by the type of waste deposited and the age of landfill. In the last years, several processes or process combinations were developed and tested to reach requirements for the discharge of leachate. Among the new processes, membrane processes are considered as promising: reverse osmosis is one of the most widely used treatment in the Northwestern European countries and nanofiltration is gained in popularity during the last 5 years. Successful application of membrane technology for the treatment of landfill leachates, requires efficient control of membrane fouling. Two organic membranes of nanofiltration were used for pilot-scale testing. Leachates were subject to several pretreatments (pH modification, prefiltration and coagulation with FeCl3) to remove potential foulants including dissolved organic and inorganic substances, colloidal and suspended particles. These pretreatments do not enhance the performances (retention and permeation flux) of membranes because the pH range and the presence of Fe3+ ions contribute greatly to change the characteristics of organic matter and the surface charges of membranes. However, the results show that nanofiltration is sufficient to eliminate refractory COD, the permeates have a COD lower than the requirements for discharge. PMID:11471693

  15. Oilfield wastewater treatment by combined microfiltration and biological processes.

    PubMed

    Campos, J C; Borges, R M H; Oliveira Filho, A M; Nobrega, R; Sant'Anna, G L

    2002-01-01

    This work deals with the treatment of offshore oilfield wastewater from the Campos Basin (Rio de Janeiro State, Brazil). After coarse filtration, this high saline wastewater was microfiltrated through mixed cellulose ester (MCE) membranes, resulting in average removals of COD, TOC, O&G and phenols of 35%, 25%, 92% and 35%, respectively. The permeate effluent was fed into a 1-L air-lift reactor containing polystyrene particles of 2mm diameter, used as support material. This reactor was operated for 210 days, at three hydraulic retention times (HRT): 48, 24 and 12h. Even when operated at the lowest HRT (12 h), removal efficiencies of 65% COD, 80% TOC, 65% phenols and 40% ammonium were attained. The final effluent presented COD and TOC values of 230 and 55 mg/L, respectively. Results obtained by gas chromatography analyses and toxicity tests with Artemia salina showed that a significant improvement in the effluent's quality was achieved after treatment by the combined (microfiltration/biological) process. PMID:11767743

  16. The future of cancer treatment: immunomodulation, CARs and combination immunotherapy.

    PubMed

    Khalil, Danny N; Smith, Eric L; Brentjens, Renier J; Wolchok, Jedd D

    2016-05-01

    In the past decade, advances in the use of monoclonal antibodies (mAbs) and adoptive cellular therapy to treat cancer by modulating the immune response have led to unprecedented responses in patients with advanced-stage tumours that would otherwise have been fatal. To date, three immune-checkpoint-blocking mAbs have been approved in the USA for the treatment of patients with several types of cancer, and more patients will benefit from immunomodulatory mAb therapy in the months and years ahead. Concurrently, the adoptive transfer of genetically modified lymphocytes to treat patients with haematological malignancies has yielded dramatic results, and we anticipate that this approach will rapidly become the standard of care for an increasing number of patients. In this Review, we highlight the latest advances in immunotherapy and discuss the role that it will have in the future of cancer treatment, including settings for which testing combination strategies and 'armoured' CAR T cells are recommended. PMID:26977780

  17. Treatment of combined sewer overflows using ferrate (VI).

    PubMed

    Gandhi, Rohan; Ray, Ajay K; Sharma, Virender K; Nakhla, George

    2014-11-01

    This paper presents the results of a study conducted on the treatment of combined sewer overflows using ferrate (VI) [Fe (VI)]. At a Fe (VI) dose of 0.24 mg/L, total chemical oxygen demand (TCOD), soluble chemical oxygen demand (SCOD), total biochemical oxygen demand (TBOD5), soluble biochemical oxygen demand (SBOD5), total suspended solids (TSS), volatile suspended solids (VSS), total phosphorus (TP), total nitrogen (TN), and soluble TN removal efficiencies of 71, 75, 69, 68, 72, 83, 64, 38, and 36%, respectively, were achieved. Kinetic studies revealed that a contact time of only 15 minutes is sufficient to achieve secondary effluent criteria. An innovative technique of using primary sludge (PS) and thickened waste activated sludge as a source for the in situ synthesis of ferrate was developed. A comparative study of treatment efficiencies achieved by Fe (VI) generated from different sources was done. At 0.1 mg/L dose of Fe (VI) synthesized from PS, TCOD, SCOD, TSS, VSS, TP, and TN removal efficiencies of 60, 62, 63, 67, 30, and 25%, respectively, were achieved. PMID:25509525

  18. Psychosocial evaluation and combination treatment of men with erectile dysfunction.

    PubMed

    Perelman, Michael A

    2005-11-01

    The Sexual Tipping Point forms the foundation of a biopsychosocial model to help conceptualize a combination treatment, where sex coaching and sexual pharmaceuticals are integrated into a clinical approach, which addresses organic, psychologic, and cultural issues for men with erectile dysfunction (ED). At any moment in the intervention pro-cess, the clinician determines the most elegant solution, which focuses the majority of effort on fixing the predominant factor while not ignoring the others. Clinicians using this model, can fully conceptualize ED by understanding the predisposing, precipitating,and maintaining psychosocial aspects of their patient's diagnosis and management, as well as organic causes and risk factors. The sex status or focused sex history, and continuous reassessment based on follow-up are the core elements of this method. Restoration of lasting and satisfying sexual function requires a multidimensional understanding of all of the forces that created the dysfunction, whether a solo clinician or multidisciplinary team approach is used. Each clinician needs to carefully evaluate their own competence and interests when considering the treatment of a man's ED, so that regardless of the modality used, the patient receives optimized care to restore sexual function and satisfaction. PMID:16291035

  19. Combined laser and photodynamic treatment in extensive purulent wounds

    NASA Astrophysics Data System (ADS)

    Solovieva, A. B.; Tolstih, P. I.; Melik-Nubarov, N. S.; Zhientaev, T. M.; Kuleshov, I. G.; Glagolev, N. N.; Ivanov, A. V.; Karahanov, G. I.; Tolstih, M. P.; Timashev, P. S.

    2010-05-01

    Recently, photodynamic therapy (PDT) has been used for the treatment of festering wounds and trophic ulcers. An important advantage of PDT is its ability to affect bacterial cultures that are resistant to antibiotics. However the use of PDT alone does not usually guarantee a stable antiseptic effect and cannot prevent an external infection of wounds and burns. In this work attention is focused on the healing of the extensive soft tissues wounds with combined laser therapy (LT) and PDT treatment. At the first stage of this process festering tissues (for example spacious purulent wounds with area more than 100 cm2) were illuminated with high-energy laser beam (with power 20 W) in continues routine. The second stage involves “softer” PDT affect, which along with the completion stages of destruction pathological cells, stimulating the process of wound granulation and epithelization. Also, according to our previous results, photosensitizer (photoditazin) is introduced inside the wound with different amphiphilic polymers for increasing the PDT efficacy.

  20. A combination treatment with DNA methyltransferase inhibitors and suramin decreases invasiveness of breast cancer cells

    PubMed Central

    Borges, Sahra; Döppler, Heike R.

    2014-01-01

    The treatment of patients with invasive breast cancer remains a major issue because of the acquisition of drug resistance to conventional chemotherapy. Here we propose a new therapeutic strategy by combining DNA methyltransferase inhibitors (DMTIs) with suramin. Cytotoxic effects of suramin or combination treatment with DMTIs were determined in highly invasive breast cancer cell lines MDA-MB-231, BT-20 and HCC1954, or control cells. In addition, effects on cell invasion were determined in 3-dimensional cell culture assays. DMTI-mediated upregulation of Protein Kinase D1 (PKD1) expression was shown by Western blotting. Effects of suramin on PKD1 activity was determined in vitro and in cells. The importance of PKD1 in mediating the effects of such combination treatment in cell invasion was demonstrated using 3D cell culture assays. A proof of principal animal experiment was performed showing that PKD1 is critical for breast cancer growth. We show that when used in combination, suramin and DMTIs impair the invasive phenotype of breast cancer cells. We show that PKD1, a kinase that previously has been described as a suppressor of tumor cell invasion, is an interface for both FDA-approved drugs, since the additive effects observed are due to DMTI-mediated re-expression and suramin-induced activation of PKD1. Our data reveal a mechanism of how a combination treatment with non-toxic doses of suramin and DMTIs may be of therapeutic benefit for patients with aggressive, multi-drug resistant breast cancer. PMID:24510012

  1. Combining Stimulants and Monoamine Oxidase Inhibitors: A Reexamination of the Literature and a Report of a New Treatment Combination

    PubMed Central

    Israel, Joshua A.

    2015-01-01

    This report reviews the medical literature on combining stimulants with monoamine oxidase inhibitors. A case is also presented documenting successful treatment of major depressive disorder and comorbid attention-deficit/hyperactivity disorder using the previously undocumented combination of transdermal selegiline and lisdexamfetamine. This combination should be used cautiously and with ongoing monitoring of heart rate and blood pressure. PMID:27057401

  2. Combining Stimulants and Monoamine Oxidase Inhibitors: A Reexamination of the Literature and a Report of a New Treatment Combination.

    PubMed

    Israel, Joshua A

    2015-01-01

    This report reviews the medical literature on combining stimulants with monoamine oxidase inhibitors. A case is also presented documenting successful treatment of major depressive disorder and comorbid attention-deficit/hyperactivity disorder using the previously undocumented combination of transdermal selegiline and lisdexamfetamine. This combination should be used cautiously and with ongoing monitoring of heart rate and blood pressure. PMID:27057401

  3. Comparison of combined application treatment with one-visit varnish treatments in an orthodontic population

    PubMed Central

    Tuzuner, Tamer; Ozel, Mehmet B.; Bostanoglu, Ozge

    2013-01-01

    Objective: To evaluate the effect of chlorhexidine-thymol varnish alone, its combination with chlorhexidine-fluoride containing dentifrice and fluoride varnish on oral hygiene and caries prevention in orthodontic patients. Study design: Sixty patients, aged 12-18, with orthodontic fixed appliances were randomly assigned into three groups as follows: Group 1 (n=20): 1% chlorhexidine and 1% thymol varnish (Cervitec®Plus); Group 2 (n=20): Cervitec®Plus+ 0.2% chlorhexidine and 0.2% sodium fluoride (900 ppm fluoride) (Cervitec®Gel)); and Group 3 (n=20): 0.1% fluoride varnish (Fluor Protector®). Mutans streptococci (MS), lactobacilli (LB) levels, buffering capacity (BC), visible plaque index (VPI), and gingival bleeding index (GBI) scores were evaluated at four stages: T0, before orthodontic bonding; T1, one week after orthodontic bonding; T2, one week; and T3, four weeks after the first application, respectively. Inter and intra group comparisons were made by the Kruskal-Wallis, Mann-Whitney U, Friedman and Wilcoxon Signed-Rank tests with Bonferroni step-down correction (P<0.017). Results: Significantly lower MS and LB levels were found in Group 2 than Group 1 (T2) and 3 (T2, T3) (P<0.017). Groups 1-2 (T2) showed significantly higher BC (P<0.017) and lower VPI and GBI (P<0.017) scores compared with Group 3. Decreased MS levels at T2 (P<0.017) and T3 (P>0.017) were found in Group1-2 compared with T0. Significantly lower LB levels were recorded in Group 2 at T2 compared with T0 (P<0.017) while no significant differences were seen in Group 1 and 3 (P>0.017). Conclusions: Addition of Cervitec®Plus+Cervitec®Gel combination to the standard oral hygiene regimen may be beneficial for orthodontic patients for maintaining oral health by reducing bacterial colonisation and gingivitis. Key words:Chlorhexidine, flouride, mutans streptococci, lactobacilli, antibacterial effect, plaque, gingivitis, orthodontic treatment. PMID:23385499

  4. Rainfall estimation by rain gauge-radar combination: A concurrent multiplicative-additive approach

    NASA Astrophysics Data System (ADS)

    GarcíA-Pintado, Javier; Barberá, Gonzalo G.; Erena, Manuel; Castillo, Victor M.

    2009-01-01

    A procedure (concurrent multiplicative-additive objective analysis scheme [CMA-OAS]) is proposed for operational rainfall estimation using rain gauges and radar data. On the basis of a concurrent multiplicative-additive (CMA) decomposition of the spatially nonuniform radar bias, within-storm variability of rainfall and fractional coverage of rainfall are taken into account. Thus both spatially nonuniform radar bias, given that rainfall is detected, and bias in radar detection of rainfall are handled. The interpolation procedure of CMA-OAS is built on Barnes' objective analysis scheme (OAS), whose purpose is to estimate a filtered spatial field of the variable of interest through a successive correction of residuals resulting from a Gaussian kernel smoother applied on spatial samples. The CMA-OAS, first, poses an optimization problem at each gauge-radar support point to obtain both a local multiplicative-additive radar bias decomposition and a regionalization parameter. Second, local biases and regionalization parameters are integrated into an OAS to estimate the multisensor rainfall at the ground level. The procedure is suited to relatively sparse rain gauge networks. To show the procedure, six storms are analyzed at hourly steps over 10,663 km2. Results generally indicated an improved quality with respect to other methods evaluated: a standard mean-field bias adjustment, a spatially variable adjustment with multiplicative factors, and ordinary cokriging.

  5. Effectiveness of additional supervised exercises compared with conventional treatment alone in patients with acute lateral ankle sprains: systematic review

    PubMed Central

    van Ochten, John; Luijsterburg, Pim A J; van Middelkoop, Marienke; Koes, Bart W; Bierma-Zeinstra, Sita M A

    2010-01-01

    Objective To summarise the effectiveness of adding supervised exercises to conventional treatment compared with conventional treatment alone in patients with acute lateral ankle sprains. Design Systematic review. Data sources Medline, Embase, Cochrane Central Register of Controlled Trials, Cinahl, and reference screening. Study selection Included studies were randomised controlled trials, quasi-randomised controlled trials, or clinical trials. Patients were adolescents or adults with an acute lateral ankle sprain. The treatment options were conventional treatment alone or conventional treatment combined with supervised exercises. Two reviewers independently assessed the risk of bias, and one reviewer extracted data. Because of clinical heterogeneity we analysed the data using a best evidence synthesis. Follow-up was classified as short term (up to two weeks), intermediate (two weeks to three months), and long term (more than three months). Results 11 studies were included. There was limited to moderate evidence to suggest that the addition of supervised exercises to conventional treatment leads to faster and better recovery and a faster return to sport at short term follow-up than conventional treatment alone. In specific populations (athletes, soldiers, and patients with severe injuries) this evidence was restricted to a faster return to work and sport only. There was no strong evidence of effectiveness for any of the outcome measures. Most of the included studies had a high risk of bias, with few having adequate statistical power to detect clinically relevant differences. Conclusion Additional supervised exercises compared with conventional treatment alone have some benefit for recovery and return to sport in patients with ankle sprain, though the evidence is limited or moderate and many studies are subject to bias. PMID:20978065

  6. Targeted Therapy and Checkpoint Immunotherapy Combinations for the Treatment of Cancer.

    PubMed

    Hughes, Paul E; Caenepeel, Sean; Wu, Lawren C

    2016-07-01

    Many advances in the treatment of cancer have been driven by the development of targeted therapies that inhibit oncogenic signaling pathways and tumor-associated angiogenesis, as well as by the recent development of therapies that activate a patient's immune system to unleash antitumor immunity. Some targeted therapies can have effects on host immune responses, in addition to their effects on tumor biology. These immune-modulating effects, such as increasing tumor antigenicity or promoting intratumoral T cell infiltration, provide a rationale for combining these targeted therapies with immunotherapies. Here, we discuss the immune-modulating effects of targeted therapies against the MAPK and VEGF signaling pathways, and how they may synergize with immunomodulatory antibodies that target PD1/PDL1 and CTLA4. We critically examine the rationale in support of these combinations in light of the current understanding of the underlying mechanisms of action of these therapies. We also discuss the available preclinical and clinical data for these combination approaches and their implications regarding mechanisms of action. Insights from these studies provide a framework for considering additional combinations of targeted therapies and immunotherapies for the treatment of cancer. PMID:27216414

  7. Characterization of a new acne vulgaris treatment device combining light and thermal treatment methods

    PubMed Central

    Joo, Yeail; Kang, Heesung; Choi, Eung Ho; Nelson, J. Stuart; Jung, Byungjo

    2012-01-01

    Background/purpose Conventional treatment methods for acne vulgaris have various side effects such as the development of bacterial resistance, phototoxicity, vertigo, gastro-intestinal problems, and drug eruptions. To minimize such side effects, light and thermal methods have been alternately suggested. This study characterized a new acne vulgaris treatment device (AVTD) that combines both light and thermal methods and evaluated its clinical efficacy. Methods We characterized the thermal and light properties of the AVTD itself and evaluated its thermal characteristics in ex vivo porcine skin samples. The Arrhenius equation was used to calculate the skin thermal injury coefficient to confirm the skin safety of the AVTD. Finally, the clinical efficacy of the AVDT was evaluated by analyzing cross-polarization and erythema index images, which were obtained from 13 volunteers undergoing treatment with the AVTD. Results The temperature of the AVTD itself was maintained at 49.1 °C on the tip and 39.7 °C in the porcine skin samples. The peak intensity of the light-emitting diode (LED) light was observed at 468 nm. The skin safety of the AVTD was confirmed and 84.2% of the volunteers presented positive treatment results. Conclusion The treatment of acne using the AVTD resulted in a high treatment rate in a clinical study, minimizing side effects. On the basis of these results, we can be sure that the AVTD may be effectively used for the treatment of acne vulgaris. PMID:21585558

  8. Combined treatment with dabrafenib and trametinib with immune-stimulating antibodies for BRAF mutant melanoma

    PubMed Central

    Homet Moreno, Blanca; Mok, Stephen; Comin-Anduix, Begonya; Hu-Lieskovan, Siwen; Ribas, Antoni

    2016-01-01

    The combination of targeted therapy with BRAF and MEK inhibitors has become the standard of care in patients with BRAFV600E mutant melanoma, but responses are not durable. In addition, the impressive clinical benefits with anti-PD-1 and anti-PD-L1 antibodies (Ab) in patients with heavily pretreated metastatic melanoma and the synergistic effect of dabrafenib, trametinib and anti-PD-1 compared with single therapy alone groups support the idea that combining dabrafenib, trametinib and immunotherapy based on PD-1 blockade could be an interesting approach in the treatment of metastatic melanoma. With our mouse model of syngeneic BRAFV600E driven melanoma (SM1), we tested whether the addition of an immunostimulatory Ab targeting CD137 (4-1BB) and/or CD134 (OX40) would enhance the antitumor effect of dabrafenib, trametinib and anti-PD-1 or anti-PD-L1 therapy. In vitro studies showed that the combination group of dabrafenib, trametinib and anti-PD-1 increases CD8+ tumor infiltrating lymphocytes (TILs), as well as CD4+ T cells and tumor-associated macrophages (TAMs). An upregulation of PD-L1 was observed in the combination of dabrafenib, trametinib and anti-PD-1 therapy. Combination of dabrafenib, trametinib and anti-PD-1, with either anti-CD137 or anti-CD134, showed a superior antitumor effect, but the five-agent combination was not superior to the four-agent combinations. In conclusion, the combination of dabrafenib, trametinib, anti-PD1 or anti-PD-L1 therapy results in robust antitumor activity, which is further improved by adding the immune-stimulating Ab anti-CD137 or anti-CD134. Our findings support the testing of these combinations in patients with BRAFV600E mutant metastatic melanoma. PMID:27622011

  9. Combined treatment with dabrafenib and trametinib with immune-stimulating antibodies for BRAF mutant melanoma.

    PubMed

    Homet Moreno, Blanca; Mok, Stephen; Comin-Anduix, Begonya; Hu-Lieskovan, Siwen; Ribas, Antoni

    2016-07-01

    The combination of targeted therapy with BRAF and MEK inhibitors has become the standard of care in patients with BRAF (V600E) mutant melanoma, but responses are not durable. In addition, the impressive clinical benefits with anti-PD-1 and anti-PD-L1 antibodies (Ab) in patients with heavily pretreated metastatic melanoma and the synergistic effect of dabrafenib, trametinib and anti-PD-1 compared with single therapy alone groups support the idea that combining dabrafenib, trametinib and immunotherapy based on PD-1 blockade could be an interesting approach in the treatment of metastatic melanoma. With our mouse model of syngeneic BRAF (V600E) driven melanoma (SM1), we tested whether the addition of an immunostimulatory Ab targeting CD137 (4-1BB) and/or CD134 (OX40) would enhance the antitumor effect of dabrafenib, trametinib and anti-PD-1 or anti-PD-L1 therapy. In vitro studies showed that the combination group of dabrafenib, trametinib and anti-PD-1 increases CD8(+) tumor infiltrating lymphocytes (TILs), as well as CD4(+) T cells and tumor-associated macrophages (TAMs). An upregulation of PD-L1 was observed in the combination of dabrafenib, trametinib and anti-PD-1 therapy. Combination of dabrafenib, trametinib and anti-PD-1, with either anti-CD137 or anti-CD134, showed a superior antitumor effect, but the five-agent combination was not superior to the four-agent combinations. In conclusion, the combination of dabrafenib, trametinib, anti-PD1 or anti-PD-L1 therapy results in robust antitumor activity, which is further improved by adding the immune-stimulating Ab anti-CD137 or anti-CD134. Our findings support the testing of these combinations in patients with BRAF (V600E) mutant metastatic melanoma. PMID:27622011

  10. Pre-treatment factors associated with detecting additional brain metastases at stereotactic radiosurgery.

    PubMed

    Wardak, Zabi; Augustyn, Alexander; Zhu, Hong; Mickey, Bruce E; Whitworth, Louis A; Madden, Christopher J; Barnett, Samuel L; Abdulrahman, Ramzi E; Nedzi, Lucien A; Timmerman, Robert D; Choe, Kevin S

    2016-06-01

    The number of brain metastases identified on diagnostic magnetic resonance imaging (MRI) is a key factor in consideration of stereotactic radiosurgery (SRS). However, additional lesions are often detected on high-resolution SRS-planning MRI. We investigated pre-treatment clinical characteristics that are associated with finding additional metastases at SRS. Patients treated with SRS for brain metastases between the years of 2009-2014 comprised the study cohort. All patients underwent frame-fixed, 1 mm thick MRI on the day of SRS. Patient, tumor, and treatment characteristics were analyzed for an association with increase in number of metastases identified on SRS-planning MRI. 289 consecutive SRS cases were analyzed. 725 metastases were identified on pre-treatment MRI and 1062 metastases were identified on SRS-planning MRI. An increase in the number of metastases occurred in 34 % of the cases. On univariate analysis, more than four metastases and the diameter of the largest lesion were significantly associated with an increase in number of metastases on SRS-planning MRI. When stratified by the diameter of the largest lesion into <2, 2-3, or ≥3 cm, additional metastases were identified in 37, 29, and 18 %, respectively. While this increase in the number of metastases is largely due to the difference in imaging technique, the number and size of the metastases were also associated with finding additional lesions. These clinical factors may be considered when determining treatment options for brain metastases. PMID:26966096

  11. Potential of Hazardous Waste Encapsulation in Concrete Compound Combination with Coal Ash and Quarry Fine Additives.

    PubMed

    Lieberman, Roy Nir; Anker, Yaakov; Font, Oriol; Querol, Xavier; Mastai, Yitzhak; Knop, Yaniv; Cohen, Haim

    2015-12-15

    Coal power plants are producing huge amounts of coal ash that may be applied to a variety of secondary uses. Class F fly ash may act as an excellent scrubber and fixation reagent for highly acidic wastes, which might also contain several toxic trace elements. This paper evaluates the potential of using Class F fly ashes (<20% CaO), in combination with excessive fines from the limestone quarry industry as a fixation reagent. The analysis included leaching experiments (EN12457-2) and several analytical techniques (ICP, SEM, XRD, etc.), which were used in order to investigate the fixation procedure. The fine sludge is used as a partial substitute in concrete that can be used in civil engineering projects, as it an environmentally safe product. PMID:26510011

  12. Sex coaching for physicians: combination treatment for patient and partner.

    PubMed

    Perelman, M A

    2003-10-01

    Physicians dealing with sexual dysfunction (SD) must consider the psychological and behavioral aspects of their patient's diagnosis and management, as well as organic causes and risk factors. Integrating sex therapy and other psychological techniques into their office practice will improve effectiveness in treating SD. This presentation provides information about the psychological forces of patient and partner resistance, which impact patient compliance and sex lives beyond organic illness and mere performance anxiety. Four key areas are reviewed: (1). 'Sex coaching for physicians' uses the 'Cornell Model' for conceptualizing and treating SD. A 5-min 'sex status,' manages 'time crunch' by rapidly identifying common causes of sexual dysfunction (insufficient stimulation, depression, etc). (2). Augmenting pharmacotherapy with sex therapy when treating erectile dysfunction (ED) specifically, or SD generally is stressed. Sex therapy is useful as a monotherapy or an adjunctive treatment and is often the 'combination therapy' of choice when treating SD. The following therapeutic integrations are highlighted: modifying patient's initial expectations; sexual pharmaceuticals use as a therapeutic probe; 'follow-up' to manage noncompliance and improve outcome; relapse prevention. (3). Issues specific to the role of the partner of the ED patient are described. The physician must appreciate the role of couple's issues in causing and/or exacerbating the ED and the impact of the ED on the patient/partner relationship. Successful treatment requires a supportive available sexual partner, yet partner cooperation may be independent of partner attendance during the office visit. Preliminary data from a survey of SMSNA members practice patterns, regarding partner issues, is presented and discussed. The importance of evoking partner support and cooperation independent of actual attendance during office visits is emphasized. (4). Finally, the need for more patient and partner educational

  13. Acipimox in combination with low dose cholestyramine for the treatment of type II hyperlipidaemia.

    PubMed Central

    Series, J J; Gaw, A; Kilday, C; Bedford, D K; Lorimer, A R; Packard, C J; Shepherd, J

    1990-01-01

    1. This study was designed to examine the effects of acipimox 250 mg three times daily and cholestyramine 4 g three times daily on plasma lipids and lipoproteins in 28 hypercholesterolaemic individuals in a prospective double-blind placebo controlled parallel group fashion. 2. Combined treatment with the two agents produced a mean reduction of 27% in plasma total cholesterol and a 32% fall in LDL cholesterol. Plasma triglyceride was reduced by 13% due to a 38% decrement in VLDL cholesterol. 3. In comparison treatment with cholestyramine alone resulted in a 12% fall in plasma cholesterol and a 15% fall in LDL cholesterol. In this group triglycerides and VLDL showed no significant change. 4. Studies of HDL subfraction mass showed that the addition of acipimox to resin therapy produced a mean increment of 45% in HDL2. 5. These results demonstrate the effectiveness of such a well tolerated low dosage combination therapy. PMID:2390432

  14. Sintering and properties of Si3N4 with and without additives by HIP treatment

    NASA Technical Reports Server (NTRS)

    Kuratani, S.; Shimada, M.; Koizumi, M.

    1986-01-01

    Hot Isostatic Pressing (HIP) of Si3N4 powders with and without additives was performed using a glass container, and various kinds of pressureless-sintered Si3N4 were HIP'ed without a container. The effects of HIP treatment on density, microstructure, flexural strength, microhardness, and fracture toughness on Si3N4 ceramics were studied. Using a glass container it was difficult to reach theoretical density. The microhardness of HIP'ed Si3N4 without additives was low, and the fracture toughness of HIP'ed Si3N4 with and without additives was 22 to 25 W/m-K, and it decreased with increasing the amount of additives. The density and flexural strength, and hardness of pressureless-sintered Si3N4 which contained Al2O and Y2O3 as oxide additives were remarkably improved by HIP treatment using nitrogen as a pressure transmitting gas. It is very important to select the sintering conditions for fabricating the presintered body of Si3N4 in order to improve the mechanical properties of Si3N4 by HIP treatment.

  15. Likely Additive Ergogenic Effects of Combined Preexercise Dietary Nitrate and Caffeine Ingestion in Trained Cyclists

    PubMed Central

    Handzlik, Michal K.

    2013-01-01

    Aims. To evaluate the possible additive effects of beetroot juice plus caffeine on exercise performance. Methods. In a randomized, double-blinded study design, fourteen healthy well-trained men aged 22 ± 3 years performed four trials on different occasions following preexercise ingestion of placebo (PLA), PLA plus 5 mg/kg caffeine (PLA+C), beetroot juice providing 8 mmol of nitrate (BR), and beetroot juice plus caffeine (BR+C). Participants cycled at 60% maximal oxygen uptake (V˙O2max) for 30 min followed by a time to exhaustion (TTE) trial at 80% V˙O2max. Saliva was collected before supplement ingestion, before exercise, and after the TTE trial for salivary nitrate, nitrite, and cortisol analysis. Results. In beetroot trials, saliva nitrate and nitrite increased >10-fold before exercise compared with preingestion (P ≤ 0.002). TTE in BR+C was 46% higher than in PLA (P = 0.096) and 18% and 27% nonsignificant TTE improvements were observed on BR+C compared with BR and PLA+C alone, respectively. Lower ratings of perceived exertion during TTE were found during 80% V˙O2max on BR+C compared with PLA and PLA+C (P < 0.05 for both). Conclusions. Acute preexercise beetroot juice coingestion with caffeine likely has additive effects on exercise performance compared with either beetroot or caffeine alone. PMID:24967257

  16. THE COMBINED CARCINOGENIC RISK FOR EXPOSURE TO MIXTURES OF DRINKING WATER DISINFECTION BY-PRODUCTS MAY BE LESS THAN ADDITIVE

    EPA Science Inventory

    The Combined Carcinogenic Risk for Exposure to Mixtures of Drinking Water Disinfection By-Products May be Less Than Additive

    Risk assessment methods for chemical mixtures in drinking water are not well defined. Current default risk assessments for chemical mixtures assume...

  17. Comparison of clinical efficacies of sodium ascorbyl phosphate, retinol and their combination in acne treatment.

    PubMed

    Ruamrak, C; Lourith, N; Natakankitkul, S

    2009-02-01

    Acne vulgaris impairs the appearance of an individual and causes psychological irritation. Inflammatory acne lesion is caused by multifactor incorporates in each step of acne pathogenesis. In an attempt to archive inflammatory lesion treatment with the promise of prevention of acne vulgaris, randomized and double-blind studies on the comparison of the efficacies of topical formulations containing 5% sodium ascorbyl phosphate (SAP) and 0.2% retinol, separately as well as in combination application, were conducted. The resulting data showed that SAP reduced the inflammatory lesion by 20.14% and 48.82% within 4 and 8 weeks respectively. Application of the formulation containing retinol slightly improved the treatment efficacy as the lesion reduced by 21.79% and 49.50% after 4 and 8 weeks respectively. The combination treatment significantly reduced the inflammatory lesion by 29.28% after 4 weeks and 63.10% after 8 weeks of application. The most effective treatment was by using the combination of 5% SAP and 0.2% retinol, which incorporated the synergistic effects on lipid peroxidation and sebaceous gland function in addition to the enhancement of SAP permeability by the desquamation of stratum corneum influenced by retinol, keratin plug removal and anti-inflammatory effect of retinol. This study promises for the development of cosmetic products to overcome aesthetic and psychological problems caused by acne vulgaris. PMID:19134126

  18. Dose combinations of exendin-4 and salmon calcitonin produce additive and synergistic reductions in food intake in nonhuman primates

    PubMed Central

    Kemm, Matthew H.; Ofeldt, Erica M.; Moran, Timothy H.

    2010-01-01

    Glucagon-like peptide-1 (GLP-1) and amylin mediate the feedback control of eating by seemingly separate, but overlapping mechanisms. This study examined the effects of combined doses of the GLP-1 agonist, exendin-4 (Ex-4), and the amylin analog, salmon calcitonin (sCT), on food intake and meal patterns in adult male rhesus monkeys. Monkeys received intramuscular injections of Ex-4 (0, 0.1, 0.32, or 0.56 μg/kg), sCT (0, 0.1, or 0.32 μg/kg), or combinations thereof before a 6-h daily access to food. Dose combinations produced reductions in food intake that were significantly greater than those produced by the individual doses. Surface plots of the hourly intake indicated a synergistic interaction at lower doses of Ex-4 and sCT during the first 4 h of feeding and additive effects at hours 5 and 6. Meal pattern analysis revealed the combinational doses reduced average meal size and meal frequency by additive interactions, whereas infra-additive effects were apparent at lower doses for first meal size. Combinational doses were further characterized by administration of repeated daily injections of 0.56 μg/kg Ex-4 + 0.32 μg/kg sCT for 5 days. This resulted in sustained reductions in daily food intake (>70% from saline baseline) for 5 days with residual reductions (∼48% from saline baseline) persisting on day 1 following the injections. In contrast, when pair-fed an identical amount of daily food, there was a compensatory food intake increase on day 1 following the pair-feeding (∼132% of saline baseline). Such data suggest Ex-4 and sCT interact in an overall additive fashion to reduce food intake and further the understanding of how GLP-1 and amylin agonist combinations influence feeding behavior. PMID:20554932

  19. Austenite Grain Growth and Precipitate Evolution in a Carburizing Steel with Combined Niobium and Molybdenum Additions

    NASA Astrophysics Data System (ADS)

    Enloe, Charles M.; Findley, Kip O.; Speer, John G.

    2015-11-01

    Austenite grain growth and microalloy precipitate size and composition evolution during thermal processing were investigated in a carburizing steel containing various additions of niobium and molybdenum. Molybdenum delayed the onset of abnormal austenite grain growth and reduced the coarsening of niobium-rich precipitates during isothermal soaking at 1323 K, 1373 K, and 1423 K (1050 °C, 1100 °C, and 1150 °C). Possible mechanisms for the retardation of niobium-rich precipitate coarsening in austenite due to molybdenum are considered. The amount of Nb in solution and in precipitates at 1373 K (1100 °C) did not vary over the holding times evaluated. In contrast, the amount of molybdenum in (Nb,Mo)C precipitates decreased with time, due to rejection of Mo into austenite and/or dissolution of fine Mo-rich precipitates. In hot-rolled alloys, soaking in the austenite regime resulted in coarsening of the niobium-rich precipitates at a rate that exceeded that predicted by the Lifshitz-Slyozov-Wagner relation for volume-diffusion-controlled coarsening. This behavior is attributed to an initial bimodal precipitate size distribution in hot-rolled alloys that results in accelerated coarsening rates during soaking. Modification of the initial precipitate size distribution by thermal processing significantly lowered precipitate coarsening rates during soaking and delayed the associated onset of abnormal austenite grain growth.

  20. Dephenolization, dearomatization and detoxification of olive mill wastewater with sonication combined with additives and radical scavengers.

    PubMed

    Sponza, Delia Teresa; Oztekin, Rukiye

    2014-05-01

    In this study, the effects of some additives [manganese (III) oxide (Mn3O4), Cu(+2), Fe(0) and potassium iodate (KIO3)] and some radical scavengers [sodium carbonate (Na2CO3), perfluorohexane (C6F14) and t-butyl alcohol (C4H10O)] on the sonication of olive mill effluent wastewater (OMW) were investigated since the wastewaters of this industry are removed with low efficiencies. The maximum total phenol and total aromatic amines (TAAs) removal efficiencies were 88% and 79%, respectively, at 60°C with only 150 min sonication. The maximum phenol removal was found as 98% with 19 mg L(-1) perfluorohexane and 5 mg L(-1) Fe(0) while the maximum TAAs removal was 99% with 16 mg L(-1) KIO3. Catechol, tyrosol, quercetin, caffeic acid, 4-methyl catechol, 2-phenylphenol (2-PHE) and 3-phenyl phenol (3-PHE) were detected as phenol intermediates while trimethlyaniline, aniline, o-toluidine, o-anisidine, dimethylaniline, ethylbenzene and durene were identified as TAAs in the OMW. The maximum acute toxicity removals were 96% and 99% in Vibrio fischeri and Daphnia magna, respectively. Total phenol, TAAs and the toxicity in an OMW were removed efficiently and cost-effectively through sonication. PMID:24315030

  1. Treatment of biomass gasification wastewater using a combined wet air oxidation/activated sludge process

    SciTech Connect

    English, C.J.; Petty, S.E.; Sklarew, D.S.

    1983-02-01

    A lab-scale treatability study for using thermal and biological oxidation to treat a biomass gasification wastewater (BGW) having a chemical oxygen demand (COD) of 46,000 mg/l is described. Wet air oxidation (WA0) at 300/sup 0/C and 13.8 MPa (2000 psi) was used to initially treat the BGW and resulted in a COD reduction of 74%. This was followed by conventional activated sludge treatment using operating conditions typical of municipal sewage treatment plants. This resulted in an additional 95% COD removal. Overall COD reduction for the combined process was 99%. A detailed chemical analysis of the raw BGW and thermal and biological effluents was performed using gas chromatography/mass spectrometry (GC/MS). These results showed a 97% decrease in total extractable organics with WA0 and a 99.6% decrease for combined WA0 and activated sludge treatment. Components of the treated waters tended to be fewer in number and more highly oxidized. An experiment was conducted to determine the amount of COD reduction caused by volatilization during biological treatment. Unfortunately, this did not yield conclusive results. Treatment of BGW using WA0 followed by activated sludge appears to be very effective and investigations at a larger scale are recommended.

  2. Combination of photodynamic and ultrasonic therapy for treatment of infected wounds in animal model

    NASA Astrophysics Data System (ADS)

    Menyaev, Yulian A.; Zharov, Vladimir P.

    2006-02-01

    One of the important problems of modern medicine is treatment of infected wounds. There are many diversified expedients of treatment, but none of them obey the modern physician completely. The aim of this study is to develop and test a new combined method of photodynamic ultrasonic therapy (PDUST) for treatment of infected wounds with focus on experimental trials. PDUST is based on a combination of two methods: photodynamic (PD) therapy (PDT) with photosensitizer and low frequency ultrasonic (US) therapy with antibiotic as tools for treatment of wounds and effectively killing bacteria. The main parameters are: US frequency - 26.5 kHz; US tip elongation - 40+/-20 μm wavelength of light emitting diodes (LED) array - 660+/-10 nm; light intensity on biotissue surface - 1-2 mW/cm2; photosensitizer - an aluminum disulfonated phtalocyanine dissolved in a physiological solution in concentration 10 mg/l. The experiments were carried out with 70 male chinchilla rabbits divided into 7 groups, thus the dynamics of wounds healing were studied in different modes of PDUST. The PD and US methods supplement each other and in conjunction provide additive and especially synergetic effects. The experimental data demonstrated advantages of new technology in comparison with conventional methods in cases of treatment of extended suppurative inflammatory and profound wounds. The more detailed study of PDUST method's mechanism, which is based on low intensity of LED light, PD therapy and US influence is required.

  3. Olive oil mill wastewater purification by combination of coagulation- flocculation and biological treatments.

    PubMed

    Jaouani, A; Vanthournhout, M; Penninckx, M J

    2005-06-01

    In order to define an efficient pre-treatment of Olive Oil Mill Wastewater (OOMW) to overcome major obstacles to biological treatment, various organic and mineral coagulants have been tested. In particular, the application of quicklime until a pH around 12 - 12.4 was reached, allowed the reduction of almost 37% of the initial COD, and approximately 88% and 71% of the colour and phenolic content of the waste. Hence, further biological treatments with an adapted aerobic consortium (AC) and a white rot fungus (WRF) strain were improved. The WRF Coriolopsis polyzona was more efficient than AC to reduce colour and polyphenols when the waste was prior diluted or pre-treated; however, it was less effective in COD removal. The combined treatment: lime - AC of OOMW having initial COD of 102 g l(-1) led to the elimination of about 77, 91 and 63%, of the COD, phenols and colour, respectively. Interestingly, the opposite combination AC - lime permitted better COD, phenols and colour reduction to respectively, 21, 11 and 11% of the initial values. This latter condition is technically recommended since only one step separation was needed and no pH correction was necessary before undergoing aerobic treatment. Moreover, the process would produce a sludge potentially rich in organic matter, and consequently, useful as an agricultural amendment or/and as an additive in animal nutrition. PMID:16035656

  4. Propranolol and prednisolone combination for the treatment of segmental haemangioma in PHACES syndrome.

    PubMed

    Gnarra, M; Solman, L; Harper, J; Batul Syed, S

    2015-07-01

    Posterior fossa malformations-haemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe syndrome (also known as PHACES syndrome) is a rare neurocutaneous disorder. Children presenting with these manifestations need careful ophthalmological, cardiac and neurological assessment. They may have one or more of these extracutaneous manifestations, the most common being cerebral and cardiovascular anomalies. There is controversy about treating these children with propranolol especially if they have cerebrovascular involvement with narrow, dysplastic or absent blood vessels. The concern with propranolol is that hypotension may lead to reduced cerebral blood flow and neurological consequences. Prior to propranolol the systemic treatment for haemangiomas was prednisolone and then the concern was the opposite, namely hypertension. Our proposal was whether a combination of these two drugs would provide a safer and faster recovery. We report three retrospective cases of PHACES syndrome, each of whom received treatment with a combination of propranolol and prednisolone: two children were started on prednisolone and propranolol was added because the haemangiomas failed to respond adequately; the third child was started on propranolol and developed peripheral ischaemia and ulceration necessitating a reduction in dose addition of a low dose of prednisolone. All three patients, who failed on the one treatment, responded well to combination therapy without any significant complications. These outcomes suggest that for some patients with PHACES syndrome the use of combination treatment with propranolol and prednisolone could be advantageous, potentially allowing for the introduction of low doses of each with an enhanced combined effect. The doses can be increased gradually depending on the magnetic resonance imaging findings. PMID:25639889

  5. Previous hospital admissions and disease severity predict the use of antipsychotic combination treatment in patients with schizophrenia

    PubMed Central

    2011-01-01

    Background Although not recommended in treatment guidelines, previous studies have shown a frequent use of more than one antipsychotic agent among patients with schizophrenia. The main aims of the present study were to explore the antipsychotic treatment regimen among patients with schizophrenia in a catchment area-based sample and to investigate clinical characteristics associated with antipsychotic combination treatment. Methods The study included 329 patients diagnosed with schizophrenia using antipsychotic medication. Patients were recruited from all psychiatric hospitals in Oslo. Diagnoses were obtained by use of the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Additionally, Global Assessment of Functioning (GAF), Positive and Negative Syndrome Scale (PANSS) and number of hospitalisations and pharmacological treatment were assessed. Results Multiple hospital admissions, low GAF scores and high PANSS scores, were significantly associated with the prescription of combination treatment with two or more antipsychotics. The use of combination treatment increased significantly from the second hospital admission. Combination therapy was not significantly associated with age or gender. Regression models confirmed that an increasing number of hospital admission was the strongest predictor of the use of two or more antipsychotics. Conclusions Previous hospital admissions and disease severity measured by high PANSS scores and low GAF scores, predict the use of antipsychotic combination treatment in patients with schizophrenia. Future studies should further explore the use of antipsychotic drug treatment in clinical practice and partly based on such data establish more robust treatment guidelines for patients with persistently high symptom load. PMID:21812996

  6. Pediatric Bipolar Disorder: Combination Pharmacotherapy, Adverse Effects, and Treatment of High-Risk Youth.

    PubMed

    Chang, Kiki D

    2016-01-01

    Treating bipolar disorder in pediatric patients is challenging because data from rigorous trials of pharmacotherapy in this population are still not plentiful enough. Furthermore, the treatment of children and adolescents is complicated by the frequent need to combine pharmacotherapies to address all bipolar symptoms as well as this population's elevated risk for experiencing side effects. Additionally, young patients with depressive episodes who are at high risk for developing bipolar disorder need careful treatment to prevent or delay the emergence of mania. Despite these challenges, clinicians should evaluate the existing pediatric literature, extrapolate evidence obtained from adult patients, and draw from clinical experience to guide treatment decisions for children and adolescents with bipolar disorder. PMID:27570929

  7. [Combined treatment of arteriovenous malformations of the head and neck].

    PubMed

    Galich, S P; Dabizha, A Iu; Gindich, O A; Ogorodnik, Ia P; Al'tman, I V; Gomoliako, I V; Guch, A A

    2015-01-01

    An arteriovenous malformation (AVM) is a vascular developmental abnormality conditioned by impaired embryonic morphogenesis and characterized by the development of an abnormal connection between arteries and veins. More than 50% of the total number of patients suffering from this pathology are those having the pathological foci localizing in the area of the head and neck. At present, a combined method is both a generally accepted and the most radical one used for treatment for AVM. However, in the majority of cases, excision of the malformation leaves an extensive and complicated defect of tissues, whose direct closure leads to coarse cicatricious deformities. Over the period from 2004 to 2012, we followed up a total of 37 patients presenting with arteriovenous malformations of the head and neck. At admission the patients underwent preoperative examination including clinical tests, ultrasound duplex scanning, arteriography, MRT, and computed tomography. 24-72 hours prior to the operative intervention the patients were subjected to embolisation of the main vessels supplying the vascular malformation. Excision of the AVM was in 8 cases followed by primary closure of the postoperative wound, in 17 patients the defect was closed by transposition of the axial flaps, and 12 subjects underwent free transplantation of composite complexes of tissues. Relapse of the disease was revealed in 17 patients. In the majority of cases, relapses developed during the first year after the operative intervention (10 cases). The control of the disease's course was obtained in 20 patients. In 8 of the 12 patients with free transplantation of flaps we managed to obtain long-term control over the disease's course (more than 5 years). Hence, free microsurgical transplantation of compound complexes of tissues may be considered as a method of choice for closing the defect after excising an AVM in the area of the head and neck. Replacement of the defect with a well-vascularized tissue complex

  8. Effectiveness of the combinational treatment of Laminaria japonica and Cistanche tubulosa extracts in hair growth

    PubMed Central

    Shin, Kyungha; Kim, Tae-Su; Kyung, Jangbeen; Kim, Dajeong; Park, Dongsun; Choi, Ehn-Kyoung; Lee, Sung-Pyo; Yang, Woong-Suk; Kang, Myung-Hwa

    2015-01-01

    Since scalp hair loss has increased recently even in young people, seriously affecting individual's quality of life, the hair growth-stimulating effects of Laminaria japonica extract (LJE) and Cistanche tubulosa extract (CTE) were investigated. After confirming anagen phase of follicles under shaving, male C57BL/6 mice were dermally applied with 3% Minoxidil or orally administered with the combinations of LJE and CTE for 21 days. Minoxidil promoted the hair regrowth and increased γ-glutamyl transpeptidase (γ-GTP) and alkaline phosphatase (ALP) activities. In addition, Minoxidil up-regulated epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) levels. Co-administration of LJE and CTE at 54 mg/kg LJE plus 162 mg/kg CTE exerted synergistic promoting effects on the hair regrowth, comparable to 3% Minoxidil. LJE preferentially enhanced ALP activity, while CTE increased both γ-GTP and ALP activities as well as EGF and VEGF expressions. In vivo air pouch inflammation model, carrageenan-induced vascular exudation and increased nitric oxide and prostaglandin E2 concentrations in the exudates were synergistically suppressed by co-administration of LJE and CTE. In addition, inflammatory cell infiltration was substantially inhibited by the combinational treatment. The results suggest that combinational oral treatment with LJE and CTE in appropriate doses and ratios prevent hair loss and improve alopecia, which might be in part mediated by their anti-inflammatory activities. PMID:25806080

  9. Effectiveness of the combinational treatment of Laminaria japonica and Cistanche tubulosa extracts in hair growth.

    PubMed

    Shin, Kyungha; Kim, Tae-Su; Kyung, Jangbeen; Kim, Dajeong; Park, Dongsun; Choi, Ehn-Kyoung; Lee, Sung-Pyo; Yang, Woong-Suk; Kang, Myung-Hwa; Kim, Yun-Bae

    2015-03-01

    Since scalp hair loss has increased recently even in young people, seriously affecting individual's quality of life, the hair growth-stimulating effects of Laminaria japonica extract (LJE) and Cistanche tubulosa extract (CTE) were investigated. After confirming anagen phase of follicles under shaving, male C57BL/6 mice were dermally applied with 3% Minoxidil or orally administered with the combinations of LJE and CTE for 21 days. Minoxidil promoted the hair regrowth and increased γ-glutamyl transpeptidase (γ-GTP) and alkaline phosphatase (ALP) activities. In addition, Minoxidil up-regulated epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) levels. Co-administration of LJE and CTE at 54 mg/kg LJE plus 162 mg/kg CTE exerted synergistic promoting effects on the hair regrowth, comparable to 3% Minoxidil. LJE preferentially enhanced ALP activity, while CTE increased both γ-GTP and ALP activities as well as EGF and VEGF expressions. In vivo air pouch inflammation model, carrageenan-induced vascular exudation and increased nitric oxide and prostaglandin E2 concentrations in the exudates were synergistically suppressed by co-administration of LJE and CTE. In addition, inflammatory cell infiltration was substantially inhibited by the combinational treatment. The results suggest that combinational oral treatment with LJE and CTE in appropriate doses and ratios prevent hair loss and improve alopecia, which might be in part mediated by their anti-inflammatory activities. PMID:25806080

  10. PHYSICAL CHEMICAL TREATMENT OF A COMBINED SEWER IMPACTED SECONDARY EFFLUENT

    EPA Science Inventory

    Physical-chemical treatment of conventional biological secondary effluent for the removal of organic and inorganic pollutants is used and considered applicable in areas where secondary treatment alone is incapable of producing satisfactory effluent quality. This report describes ...

  11. Sanitising black water by auto-thermal aerobic digestion (ATAD) combined with ammonia treatment.

    PubMed

    Nordin, Annika C; Vinnerås, Björn

    2015-01-01

    The effect of a two-step process on the concentration of pathogens and indicator microorganisms in black water (0.9-1% total solids) was studied. The treatment combined auto-thermal aerobic digestion (ATAD) and ammonia sanitisation. First, the temperature of the black water was increased through ATAD and when a targeted temperature was reached (33, 41 and 45.5 °C studied), urea was added to a 0.5% concentration (total ammonia nitrogen >2.9 g L⁻¹). Escherichia coli and Salmonella spp. were reduced to non-detectable levels within 3 days following urea addition at temperatures above 40 °C, whereas when urea was added at 33 °C E. coli was still present after 8 days. By adding urea at temperatures of 40 °C and above, a 5 log10 reduction in Enterococcus spp. and a 3 log10 reduction in Ascaris suum eggs was achieved 1 week after the addition. With combined ATAD and ammonia treatment using 0.5% ww urea added at an aerobic digestion temperature >40 °C, black water was sanitised regarding the pathogens studied in 2 weeks of total treatment time. PMID:26675998

  12. Cystamine and Intrabody Co-treatment Confers Additional Benefits in a Fly Model of Huntington’s Disease

    PubMed Central

    Bortvedt, S. F.; McLear, J. A.; Messer, A.; Ahern-Rindell, A. J.; Wolfgang, W. J.

    2010-01-01

    Huntington’s disease (HD) is a lethal, neurodegenerative disorder caused by expansion of the polyglutamine repeat in the Huntingtin gene (HTT), leading to mutant protein misfolding, aggregation, and neuronal death. Feeding a Drosophila HD-model cystamine, or expressing a transgene encoding the anti-htt intracellular antibody (intrabody) C4-scFv in the nervous system, demonstrated therapeutic potential, but suppression of pathology was incomplete. We hypothesized that a combinatorial approach entailing drug and intrabody administration could enhance rescue of HD pathology in flies and that timing of treatment would affect outcomes. Feeding cystamine to adult HD flies expressing the intrabody resulted in a significant, additional rescue of photoreceptor neurodegeneration, but no additional benefit in longevity. Feeding cystamine during both larval and adult stages produced the converse result: longevity was significantly improved, but increased photoreceptor survival was not. We conclude that cystamine-intrabody combination therapies can be effective, reducing neurodegeneration and prolonging survival, depending on administration protocols. PMID:20399860

  13. Effects of combined treatment with diethyldithiocarbamate and diethylenetriaminepentaacetate on organ distribution and excretion of cadmium

    SciTech Connect

    Gale, G.R.; Atkins, L.M.; Walker, E.M. Jr.; Smith, A.B.

    1983-09-01

    Diethyldithiocarbamate (DDTC) and diethylenetriaminepentaacetate (DTPA) were assessed to determine if combination treatment with these two chelators of different chemical classes would enhance mobilization and excretion of metallothionein-bound cadmium (Cd) from selected organs of mice which had earlier received 0.03 mg of CdCl/sub 2/ . 2.5 H/sub 2/O along with 1.0 microCi of /sup 109/Cd. In addition to measuring individual organ radioactivity after seven and after 13 injections of each compound individually as well as in combination, whole body Cd burden was measured, and the routes and rates of Cd excretion were determined. When used alone, DDTC was effective in mobilizing Cd from kidney, liver, intestine, and spleen. The DTPA when used alone was not consistently effective in reducing Cd burdens in any of the organs assessed. Co-administration of DDTC and DTPA promoted an enhancement of Cd mobilization from liver, kidney, spleen, and intestine over that which was observed with DDTC alone. When DTPA was administered with DDTC, it did not prevent accumulation of Cd in lung and brain which was observed upon treatment with DDTC alone. Combined treatment did produce a more marked depletion of total body /sup 109/Cd burden than did the administration of DDTC alone. A more rapid rate of both fecal and urinary excretion of Cd was observed when the chelators were co-administered. It was concluded that at least an additive or possibly supraadditive effect may be obtained by combining a dithiocarbamate chelator with one of the aminocarboxylate class in total body Cd decorporation.

  14. Does the Addition of a Second Antipsychotic Drug Improve Clozapine Treatment?

    PubMed Central

    Barbui, Corrado; Signoretti, Alessandra; Mulè, Serena; Boso, Marianna; Cipriani, Andrea

    2009-01-01

    In patients with schizophrenia who do not have an optimal response to clozapine, it remains unclear if there is an evidence base to support a second antipsychotic in combination with clozapine. The present systematic review was therefore carried out to determine the efficacy of various clozapine combination strategies with antipsychotics. Relevant studies were located by searching the Cochrane Schizophrenia Group Trials Register, Medline, and Embase (up to November 2007). Only studies randomly allocating patients to clozapine plus another antipsychotic vs clozapine monotherapy were included. The search yielded 21 studies suitable for reanalysis. In 3 trials, clozapine was combined with a phenothiazine, in 8 trials with a benzamide, and in the remaining trials with risperidone. While the majority of randomized trials were not double blind, 6 studies were double-blind placebo-controlled trials. A total of 14 randomized open studies significantly favored clozapine combination strategy in terms of mean difference (random effect standardized mean difference [SMD] = −0.80, 95% confidence interval [CI] = −1.14 to −0.46); however, data extracted from 6 randomized double-blind studies did not show a statistically significant positive effect of this combination strategy in terms of mean difference (SMD = −0.12, 95% CI = −0.57 to 0.32). In terms of percentage of patients failing to show an improvement, a total of 10 randomized open studies significantly favored clozapine combination strategy (random effect relative risk [RR] = 0.64, 95% CI = 0.42 to 0.97), but data extracted from 6 randomized double-blind studies did not show a statistically significant positive effect of this combination strategy (RR = 0.91, 95% CI = 0.75 to 1.11). We conclude that the evidence base supporting a second antipsychotic in addition to clozapine in partially responsive patients with schizophrenia is weak. This weak evidence indicates modest to absent benefit. PMID:18436527

  15. Combined Treatment of Herbal Mixture Extract H9 with Trastuzumab Enhances Anti-tumor Growth Effect.

    PubMed

    Lee, Sunyi; Han, Sora; Jeong, Ae Lee; Park, Jeong Su; Jung, Seung Hyun; Choi, Kang-Duk; Yang, Young

    2015-07-01

    Extracts from Asian medicinal herbs are known to be successful therapeutic agents against cancer. In this study, the effects of three types of herbal extracts on anti-tumor growth were examined. Among the three types of herbal extracts, H9 showed stronger anti-tumor growth effects than H5 and H11 in vivo. To find the molecular mechanism by which H9 inhibited the proliferation of breast cancer cell lines, the levels of apoptotic markers were examined. Proapoptotic markers, including cleaved PARP and cleaved caspases 3 and 9, were increased, whereas the anti-apoptotic marker Bcl-2 was decreased by H9 treatment. Next, the combined effect of H9 with the chemotherapeutic drugs doxorubicin/cyclophosphamide (AC) on tumor growth was examined using 4T1-tumor-bearing mice. The combined treatment of H9 with AC did not show additive or synergetic anti-tumor growth effects. However, when tumor-bearing mice were co-treated with H9 and the targeted anti-tumor drug trastuzumab, a delay in tumor growth was observed. The combined treatment of H9 and trastuzumab caused an increase of natural killer (NK) cells and a decrease of myeloid-derived suppressor cells (MDSC). Taken together, H9 induces the apoptotic death of tumor cells while increasing anti-tumor immune activity through the enhancement of NK activity and diminishment of MDSC. PMID:25791851

  16. Combined treatment of olive mill wastewater by Fenton's reagent and anaerobic biological process.

    PubMed

    Amor, Carlos; Lucas, Marco S; García, Juan; Dominguez, Joaquín R; De Heredia, J Beltrán; Peres, José A

    2015-01-01

    This work presents the application of Fenton's reagent process combined with anaerobic digestion to treat an olive mill wastewater (OMW). Firstly, OMW was pre-treated by chemical oxidation in a batch reactor with Fenton's reagent, using a fixed H2O2/COD ratio of 0.20, pH = 3.5 and a H2O2/Fe(2+) molar ratio of 15:1. This advanced oxidation treatment allowed reaching reductions of 17.6 and 82.5% of chemical oxygen demand (COD) and total polyphenols (TP), respectively. Secondly, OMW treatment by anaerobic digestion was performed using previously adapted microorganisms immobilized in Sepiolite. These biological tests were carried out varying the substrate concentration supplied to the reactor and COD conversions from 52 to 74% were obtained. Afterwards, Fenton's reagent followed by anaerobic digestion was applied to OMW treatment. This combined process presented a significant improvement on organic load removal, reaching COD degradations from 64 to 88%. Beyond the pollutant load removal, it was also monitored the yield of methane generated throughout anaerobic experiments. The methane produced ranged from 281 cm(3) to 322 cm(3) of CH4/g COD removed. Additionally, a methane generation kinetic study was performed using the Monod Model. The application of this model allowed observing a kinetic constant increase of the combined process (kFN = 0.036 h(-1)) when compared to the single anaerobic process (kF = 0.017 h(-1)). PMID:25560262

  17. Improved superconducting properties of melt-textured Nd123 by additional heat treatment

    NASA Astrophysics Data System (ADS)

    Chikumoto, N.; Yoshioka, J.; Murakami, M.

    1997-02-01

    We have investigated the effect of additional heat-treatment on the superconducting transition and the flux pinning properties of NdBaCuO melt-textured in air. After the heat-treatment at high temperatures, >900°C, under low oxygen partial pressure, P(O 2) = 0.001 atm, the superconducting transition became sharper accompanied by an increase of Jc. However, the increase of Jc was very small and the secondary peak effect commonly observed in NdBaCuO melt textured in low P(O 2) could not be observed. Transmission electron microscopic observations and energy dispersive X-ray analyses show that the spatial variation of the Nd/Ba ratio is reduced after high-temperature heat-treatment, which indicates that an improvement in Tc and Jc is attributed to a suppression of Nd substitution on the Ba site.

  18. Emerging treatments and combinations in the management of NSCLC: clinical potential of nintedanib

    PubMed Central

    Reck, Martin; Mellemgaard, Anders

    2015-01-01

    There remains an unmet need for effective, well-tolerated treatment options in advanced non-small cell lung cancer (NSCLC) to alleviate the disease burden for a broad selection of patients. Nintedanib is a potent, oral, triple angiokinase inhibitor of vascular endothelial growth factor, fibroblast growth factor, and platelet-derived growth factor, and was recently approved in Europe for use in combination with docetaxel for the treatment of adults with locally advanced, metastatic, or locally recurrent NSCLC of adenocarcinoma tumor histology, following first-line chemotherapy. Nintedanib has been investigated extensively in preclinical research and in a number of clinical studies, the most important of which was the Phase III LUME-Lung 1 study, which investigated nintedanib in combination with docetaxel in patients with advanced NSCLC after failure of first-line chemotherapy. In this study, which led to the approval of nintedanib, addition of nintedanib to docetaxel significantly improved overall survival in patients with adenocarcinoma histology. Nintedanib demonstrated a manageable safety profile in combination with docetaxel. This review focuses on the clinical experience with nintedanib in NSCLC and discusses the clinical potential of this agent for use in combination with chemotherapy. PMID:26170616

  19. A comparison of haloperidol, lithium carbonate and their combination in the treatment of mania.

    PubMed

    Garfinkel, P E; Stancer, H C; Persad, E

    1980-12-01

    Previous investigations of the treatment of mania have resulted in uncertainty about the efficacy of lithium versus a neuroleptic. In addition there have been reports of toxicity with a haloperidol--lithium combination. In order to determine the comparative efficacy of lithium vs haloperidol vs a combination of haloperidol--lithium, we studied 21 severely ill manic patients who all met rigorous criteria for bipolar illness and who required in hospital treatment. Subjects were randomly assigned to 3 groups: (A) Lithium plus placebo (B) Placebo plus haloperidol and (C) Lithium plus haloperidol. The study was conducted in double blind fashion for 3 weeks with the dosages of the medications varied according to clinical response or untoward effects. Subjects on haloperidol and placebo or the haloperidol--lithium combination were significantly improved after 7 days in comparison to the lithium-treated group. Groups B and C did not differ from each other, either in degree of improvement or in side effects. Inspite of the relatively small sample size the results suggest (1) that haloperidol is superior to lithium for treating severely ill acute mania and (2) that while a haloperidol--lithium combination does not result in a significant increase in side effects, it is not superior to haloperidol alone. PMID:6450787

  20. Patient considerations in the treatment of COPD: focus on the new combination inhaler umeclidinium/vilanterol

    PubMed Central

    Albertson, Timothy E; Harper, Richart; Murin, Susan; Sandrock, Christian

    2015-01-01

    Medication adherence among patients with chronic diseases, such as COPD, may be suboptimal, and many factors contribute to this poor adherence. One major factor is the frequency of medication dosing. Once-daily dosing has been shown to be an important variable in medication adherence in chronic diseases, such as COPD. New inhalers that only require once-daily dosing are becoming more widely available. Combination once-daily inhalers that combine any two of the following three agents are now available: 1) a long-acting muscarinic antagonist; 2) a long acting beta2 agonist; and 3) an inhaled corticosteroid. A new once-daily inhaler with both a long-acting muscarinic antagonist, umeclidinium bromide, and a long acting beta2 agonist, vilanterol trifenatate, is now available worldwide for COPD treatment. It provides COPD patients convenience, efficacy, and a very favorable adverse-effects profile. Additional once-daily combination inhalers are available or will soon be available for COPD patients worldwide. The use of once-daily combination inhalers will likely become the standard maintenance management approach in the treatment of COPD because they improve medication adherence. PMID:25673975

  1. Winery wastewater treatment by combination of Cryptococcus laurentii and Fenton's reagent.

    PubMed

    Santos, Cátia; Lucas, Marco S; Dias, Albino A; Bezerra, Rui M F; Peres, José A; Sampaio, Ana

    2014-12-01

    Winery wastewaters (WW) have high levels of organic matter, resulting in high COD and BOD and suspended solids. This paper studies the combination of biological and chemical processes in WW treatment. Among 10 yeast isolates, Filobasidium sp. (AGG 577) and Cryptococcus laurentii (AGG 726) were selected due to their superior performance in COD removal. During WW degradation, COD and total polyphenols (TPP) content removal of 89-90% for Filobasidium sp. and 90-93% for C. laurentii were obtained. However, despite similar degradation efficiency for both yeasts, COD kinetics and pH evolution during treatment reveals that C. laurentii presents a faster response than Filobasidium sp. The toxicity (inhibition of Vibrio fischeri luminescence) of C. laurentii treated WW decreases to an inhibition value below 2.5%. However, treated WW exceeds the legal limits, making necessary an additional treatment. In this case, the selection of Fenton's reagent as a chemical final polish step process is a good compromise between efficiency and lower practical complexity. The best results for both COD and TPP removal were obtained with H2O2 initial concentration of 39.2mM and a H2O2:Fe(2+) molar ratio of 15:1. The combined C. laurentii - Fenton's reagent treatment of WW achieved a total reduction of 98% and 96%, for COD and TPP, respectively. PMID:24968162

  2. The Effects of Combined Treatment with Naringin and Treadmill Exercise on Osteoporosis in Ovariectomized Rats

    PubMed Central

    SUN, Xiaolei; Fengbo, LI; Xinlong, MA; Jianxiong, MA; ZHAO, Bin; ZHANG, Yang; Yanjun, LI; Jianwei, LV; MENG, Xinmin

    2015-01-01

    Osteoporosis is a disease characterized by low bone mass and progressive destruction of bone microstructure, resulting in increased the risk of fracture. Previous studies have demonstrated the effect of naringin (NG) or treadmill exercise (EX) on osteoporosis, however, reports about effects of NG plus EX on osteoporosis are limited. This study was designed to investigate the impact of combined treatment with naringin and treadmill exercise on osteoporosis in ovariectomized (OVX) rats. Three months after bilateral ovariectomy, Seventy-five rats were randomly assigned to the following treatment groups: OVX, sham-operated (SHAM), NG, EX, or NG plus EX treatment. Treatments were administered for 60 days. Bone metabolism, bone mineral density, trabecular bone parameters, immunohistochemistry, and the bone strength were evaluated. Compared to the OVX groups, all treatments increased bone volume (BV/TV), trabecula number (Tb.N), trabecula thickness (Tb.Th), bone mineral density (BMD), and mechanical strength. NG + EX showed the strongest effects on BV/TV, Tb.Th, and biomechanical strength. Additionally, decreased C-terminal telopeptides of type I collagen (CTX-1) and enhanced osteocalcin (OCN) expression were observed in the NG + EX group. The present study demonstrates that the NG + EX may have a therapeutic advantage over each monotherapy for the treatment of osteoporosis. PMID:26260240

  3. The Effects of Combined Treatment with Naringin and Treadmill Exercise on Osteoporosis in Ovariectomized Rats.

    PubMed

    Sun, Xiaolei; Li, Fengbo; Ma, Xinlong; Ma, Jianxiong; Zhao, Bin; Zhang, Yang; Li, Yanjun; Lv, Jianwei; Meng, Xinmin

    2015-01-01

    Osteoporosis is a disease characterized by low bone mass and progressive destruction of bone microstructure, resulting in increased the risk of fracture. Previous studies have demonstrated the effect of naringin (NG) or treadmill exercise (EX) on osteoporosis, however, reports about effects of NG plus EX on osteoporosis are limited. This study was designed to investigate the impact of combined treatment with naringin and treadmill exercise on osteoporosis in ovariectomized (OVX) rats. Three months after bilateral ovariectomy, Seventy-five rats were randomly assigned to the following treatment groups: OVX, sham-operated (SHAM), NG, EX, or NG plus EX treatment. Treatments were administered for 60 days. Bone metabolism, bone mineral density, trabecular bone parameters, immunohistochemistry, and the bone strength were evaluated. Compared to the OVX groups, all treatments increased bone volume (BV/TV), trabecula number (Tb.N), trabecula thickness (Tb.Th), bone mineral density (BMD), and mechanical strength. NG + EX showed the strongest effects on BV/TV, Tb.Th, and biomechanical strength. Additionally, decreased C-terminal telopeptides of type I collagen (CTX-1) and enhanced osteocalcin (OCN) expression were observed in the NG + EX group. The present study demonstrates that the NG + EX may have a therapeutic advantage over each monotherapy for the treatment of osteoporosis. PMID:26260240

  4. The combination of compost addition and arbuscular mycorrhizal inoculation produced positive and synergistic effects on the phytomanagement of a semiarid mine tailing.

    PubMed

    Kohler, J; Caravaca, F; Azcón, R; Díaz, G; Roldán, A

    2015-05-01

    A field experiment was carried out to assess the effectiveness of combining mycorrhizal inoculation with a native AM fungus (Glomus sp.) and the addition of an urban organic waste compost (OWC) applied at two rates (0.5 and 2.0% (w:w)), with regard to promoting the establishment of Anthyllis cytisoides L. seedlings in a heavy metal polluted mine tailing, as well as stimulating soil microbial functions. The results showed that the combined use of the highest dose of OWC and AM inoculation significantly increased shoot biomass - by 64% - compared to the control value. However, the separate use of each treatment had no effect on the shoot biomass of this shrub species. At the 2% rate, OWC enhanced root colonisation by the introduced fungus as well as soil nutrient content and soil dehydrogenase and ß-glucosidase activities. The combined treatment increased the uptake of Zn and Mn in shoots, although only Zn reached excessive or potentially toxic levels. This study demonstrates that the combination of organic amendment and an AM fungus is a suitable tool for the phytomanagement of degraded mine tailings, although its effectiveness is dependent on the dose of the amendment. PMID:25659304

  5. Combining biological control with physical and chemical treatments to control fruit decays after harvest

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This article reviews research on combining alternatives to conventional fungicide treatment with biological control to reduce postharvest decays on fruits. The basis for selection of the alternative treatments, the effectiveness of the combined treatments, and feasibility and readiness of their imp...

  6. Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit?

    PubMed Central

    Hetrick, Sarah E; Cox, Georgina R; Merry, Sally N

    2011-01-01

    Background Many young people with major depression fail first-line treatments. Treatment-resistant depression has various definitions in the literature but typically assumes nonresponse to medication. In young people, cognitive behavioral therapy (CBT) is the recommended first-line intervention, thus the definition of treatment resistance should be expanded. Therefore, our aim was to synthesize the existing evidence of any interventions for treatment-resistant depression, broadly defined, in children and adolescents and to investigate the effectiveness of CBT in this context. Methods We used Cochrane Collaboration methodology, with electronic searches of Medline, PsycINFO, Embase, and the Cochrane Depression Anxiety and Neurosis Group trials registers. Only randomized controlled trials were included, and were assessed for risk of bias. Meta- analysis was undertaken where possible and appropriate. Results Of 953 articles retrieved, four trials were eligible for inclusion. For one study, only the trial registration document was available, because the study was never completed. All other studies were well conducted with a low risk of bias, although one study had a high dropout rate. Two studies assessed the effect of adding CBT to medication. While an assertive trial of antidepressants does appear to lead to benefit, when compared with placebo, there was no significant advantage, in either study, or in a meta-analysis of data from these trials, that clearly demonstrated an additional benefit of CBT. The third trial showed little advantage of a tricyclic antidepressant over placebo in the context of an inpatient admission. Conclusion Few randomized controlled trials have investigated interventions for treatment-resistant depression in young people, and results from these show modest benefit from antidepressants with no additional benefit over medication from CBT. Overall, there is a lack of evidence about effective interventions to treat young people who have failed to

  7. Simultaneous control of acid gases and PAHs using a spray dryer combined with a fabric filter using different additives.

    PubMed

    Liu, Zhen Shu; Wey, Ming Yen; Lin, Chiou Liang

    2002-04-26

    The purpose of this research was to simultaneously evaluate the removal efficiency of acid gases and PAHs from the flue gas emitted by a laboratory incinerator. This flue gas contained dust, acid gases, organics and heavy metals. A spray dryer combined with a fabric filter was used as the air pollution control device (APCD) in this study. The operating conditions investigated included different feedstock additives (polyvinyl chloride (PVC) and NaCl) and spray dryer additives (SiO2, CaCl2 and NaHCO3). The removal efficiency for SO2 could be enhanced by adding inorganic additives, such as SiO2, CaCl2 and NaHCO3. The presence of PVC in the incinerator feedstock also increased the removal efficiency of SO2in the spray dryer. The improved removal of PAHs could be attributed to the addition of feedstock additives (PVC and NaCl) and spray dryer additives (SiO2, CaCl2 and NaHCO3). PMID:11900910

  8. Polycyclic aromatic hydrocarbon removal from petroleum sludge cake using thermal treatment with additives.

    PubMed

    Pakpahan, Edward Nixon; Isa, Mohamed Hasnain; Kutty, Shamsul Rahman Mohamed; Chantara, Somporn; Wiriya, Wan

    2013-01-01

    Petroleum sludge is a hazardous waste that contains various organic compounds including polycyclic aromatic hydrocarbons (PAHs) which have carcinogenic-mutagenic and toxic characteristics. This study focuses on the thermal treatment (indirect heating) of petroleum sludge cake for PAH degradation at 250, 450, and 650 degrees C using Ca(OH)2 + NaHCO3 as an additive. The treatment was conducted in a rotary drum electric heater. All experiments were carried out in triplicate. Concentrations of the 16 priority PAHs in gas (absorbed on Amberlite XAD-4 adsorbent), particulate (on quartz filter) and residue phases were determined using gas chromatography-mass spectrometry (GC-MS). The samples were extracted with acetonitrile by ultra-sonication prior to GC-MS analysis. The use of additive was beneficial and a temperature of 450 degrees C was suitable for PAH degradation. Low levels of PAH emissions, particularly carcinogenic PAH and toxic equivalent concentration (sigma TEC), were observed in gas, particulate and residue phases after treatment. PMID:23530354

  9. FLOCCULATION-FLOTATION AIDS FOR TREATMENT OF COMBINED SEWER OVERFLOWS

    EPA Science Inventory

    The objectives of this study were to investigate the flocculation/flotation characteristics of combined sewer overflow through laboratory and field testing. The concept involves the introduction of chemicals and buoyant flotation aids into the overflow and the subsequent cofloccu...

  10. Long term combination treatment for severe idiopathic pulmonary arterial hypertension

    PubMed Central

    Affuso, Flora; Cirillo, Plinio; Ruvolo, Antonio; Carlomagno, Guido; Fazio, Serafino

    2010-01-01

    We report the long-term follow-up of 3 cases of severe idiopathic pulmonary arterial hypertension, in whom tadalafil plus sitaxentan combination therapy improved the clinical condition and exercise performance without any relevant adverse event. PMID:21160759

  11. [Treatment of autonomic vascular dystonia by combined physiotherapy methods].

    PubMed

    Lobzin, V S; Poliakova, L A; Shiman, A G; Zavodnik, A I

    1989-03-01

    The use of combined physiotherapy methods in 65 patients suffering of vegetative-vascular dystonias resulted in an improvement of the clinical data, normalization or improvement of electroencephalographic, rheovasographic and thermovision indices. PMID:2750110

  12. The Facial Aesthetic index: An additional tool for assessing treatment need

    PubMed Central

    Sundareswaran, Shobha; Ramakrishnan, Ranjith

    2016-01-01

    Objectives: Facial Aesthetics, a major consideration in orthodontic diagnosis and treatment planning, may not be judged correctly and completely by simply analyzing dental occlusion or osseous structures. Despite this importance, there is no index to guarantee availability of treatment or prioritize patients based on their soft tissue treatment needs. Individuals having well-aligned teeth but unaesthetic convex profiles do not get included for treatment as per current malocclusion indices. The aim of this investigation is to develop an aesthetic index based on facial profiles which could be used as an additional tool with malocclusion indices. Materials and Methods: A chart showing typical facial profile changes due to underlying malocclusions was generated by soft tissue manipulations of standardized profile photographs of a well-balanced male and female face. A panel of 62 orthodontists judged the profile photographs of 100 patients with different soft tissue patterns for assessing profile variations and treatment need. The index was later tested in a cross-section of school population. Statistical analysis was done using “irr” package of R environment version 2.15.1. Results: The index exhibited very good reliability in determining profile variations (Fleiss kappa 0.866, P < 0.001), excellent reproducibility (kappa 0.9078), high sensitivity, and specificity (95.7%). Testing in population yielded excellent agreement among orthodontists (kappa 0.9286). Conclusions: A new Facial Aesthetic index, based on patient's soft tissue profile requirements is proposed, which can complement existing indices to ensure treatment to those in need. PMID:27127752

  13. Markedly additive antitumor activity with the combination of a selective survivin suppressant YM155 and alemtuzumab in adult T-cell leukemia.

    PubMed

    Chen, Jing; Pise-Masison, Cynthia A; Shih, Joanna H; Morris, John C; Janik, John E; Conlon, Kevin C; Keating, Anne; Waldmann, Thomas A

    2013-03-14

    Adult T-cell leukemia (ATL) is an aggressive malignancy of CD4(+)CD25(+) lymphocytes caused by human T-cell lymphotropic virus type 1. Currently, there is no accepted curative therapy for ATL. In gene expression profiling, the antiapoptotic protein survivin (BIRC5) demonstrated a striking increase in ATL, and its expression was increased in patient ATL cells resistant to the anti-CD52 monoclonal antibody alemtuzumab (Campath-1H). In this study, we investigated the antitumor activity of a small-molecule survivin suppressant YM155 alone and in combination with alemtuzumab in a murine model of human ATL (MET-1). Both YM155 alone and its combination with alemtuzumab demonstrated therapeutic efficacy by lowering serum soluble IL-2Rα (sIL-2Rα) levels (P < .001) and prolonged the survival of tumor-bearing mice (P < .0001). Moreover, the combination of YM155 with alemtuzumab demonstrated markedly additive antitumor activity by significantly lowering serum sIL-2Rα levels and improving the survival of leukemia-bearing mice compared with monotherapy with either YM155 (P < .001) or alemtuzumab (P < .05). More significantly, all mice that received the combination therapy survived and were tumor free >6 months after treatment. Our data support a clinical trial of the combination of YM155 with alemtuzumab in ATL. This trial was registered at www.clinicaltrials.gov as #NCT00061048. PMID:23321252

  14. Markedly additive antitumor activity with the combination of a selective survivin suppressant YM155 and alemtuzumab in adult T-cell leukemia

    PubMed Central

    Chen, Jing; Pise-Masison, Cynthia A.; Shih, Joanna H.; Morris, John C.; Janik, John E.; Conlon, Kevin C.; Keating, Anne

    2013-01-01

    Adult T-cell leukemia (ATL) is an aggressive malignancy of CD4+CD25+ lymphocytes caused by human T-cell lymphotropic virus type 1. Currently, there is no accepted curative therapy for ATL. In gene expression profiling, the antiapoptotic protein survivin (BIRC5) demonstrated a striking increase in ATL, and its expression was increased in patient ATL cells resistant to the anti-CD52 monoclonal antibody alemtuzumab (Campath-1H). In this study, we investigated the antitumor activity of a small-molecule survivin suppressant YM155 alone and in combination with alemtuzumab in a murine model of human ATL (MET-1). Both YM155 alone and its combination with alemtuzumab demonstrated therapeutic efficacy by lowering serum soluble IL-2Rα (sIL-2Rα) levels (P < .001) and prolonged the survival of tumor-bearing mice (P < .0001). Moreover, the combination of YM155 with alemtuzumab demonstrated markedly additive antitumor activity by significantly lowering serum sIL-2Rα levels and improving the survival of leukemia-bearing mice compared with monotherapy with either YM155 (P < .001) or alemtuzumab (P < .05). More significantly, all mice that received the combination therapy survived and were tumor free >6 months after treatment. Our data support a clinical trial of the combination of YM155 with alemtuzumab in ATL. This trial was registered at www.clinicaltrials.gov as #NCT00061048. PMID:23321252

  15. Lung cancer in HIV-infected patients in the combination antiretroviral treatment era

    PubMed Central

    Moltó, José; Sirera, Guillem; Clotet, Bonaventura

    2015-01-01

    The advent of combination antiretroviral treatment (cART) has been followed by a decrease in HIV-associated morbidity and mortality, but also by an apparent increase in the incidence of non-AIDS-defining cancers (NADCs). The risk of lung cancer is substantially higher in HIV-infected patients than in the general population, in part due to aging and tobacco use, and it is the most frequent NADC. The management of lung cancer in HIV-infected patients has some peculiarities that need to be taken into account. This review focuses on the epidemiology, risk factors, and clinical management of lung cancer in HIV-infected patients. In addition, screening tools and future perspectives are also discussed. Keywords Lung cancer; non-AIDS-defining cancers (NADCs); HIV infection; antiretroviral treatment PMID:26798577

  16. Longitudinal study of combined orthodontic and surgical treatment of Class II malocclusion with deep overbite.

    PubMed

    Jäger, A; Kubein-Meesenburg, D; Luhr, H G

    1991-01-01

    Twenty-one patients who had undergone orthodontic treatment in combination with mandibular advancement surgery to treat Class II malocclusion and deep overbite were followed up. Median vertical relapse at the bony chin (after a mean followup of 16 months) was found to be 2.9 mm (44%). Sagittal advancement was found to have good stability; most of the patients exhibited some additional anterior movement of the chin during the follow-up period. At the same time, the entire mandible rotated counterclockwise and the gonial angle increased. Individual response to treatment varied greatly; two patients exhibited major horizontal relapse. Controlling the position of the mandibular proximal segment seemed to be the most important factor in posttreatment stability of this sample. PMID:1940537

  17. ANAEROBIC AND AEROBIC TREATMENT OF COMBINED POTATO PROCESSING AND MUNICIPAL WASTES

    EPA Science Inventory

    Demonstration and evaluation of the treatment of combined potato processing waste-water and domestic wastes using various combinations of anaerobic and aerated lagoons. Measured parameters included: BOD, COD, TSS, VSS, nitrogen, phosphorus, volatile acids, total coliform, fecal c...

  18. Current concepts in combination therapy for the treatment of hypertension: combined calcium channel blockers and RAAS inhibitors

    PubMed Central

    Rubio-Guerra, Alberto F; Castro-Serna, David; Barrera, Cesar I Elizalde; Ramos-Brizuela, Luz M

    2009-01-01

    Recent guidelines for the management of hypertension recommend target blood pressures <140/90 mmHg in hypertensive patients, or <130/80 mmHg in subjects with diabetes, chronic kidney disease, or coronary artery disease. Despite the availability and efficacy of antihypertensive drugs, most hypertensive patients do not reach the recommended treatment targets with monotherapy, making combination therapy necessary to achieve the therapeutic goal. Combination therapy with 2 or more agents is the most effective method for achieving strict blood pressure goals. Fixed-dose combination simplifies treatment, reduces costs, and improves adherence. There are many drug choices for combination therapy, but few data are available about the efficacy and safety of some specific combinations. Combination therapy of calcium antagonists and inhibitors of the renin-angiotensin-aldosterone system (RAAS) are efficacious and safe, and have been considered rational by both the JNC 7 and the 2007 European Society of Hypertension – European Society of Cardiology guidelines for the management of arterial hypertension. The aim of this review is to discuss some relevant issues about the use of combinations with calcium channel blockers and RAAS inhibitors in the treatment of hypertension. PMID:21949615

  19. Urban runoff and combined sewer overflow. [Wastewater treatment

    SciTech Connect

    Moffa, P.E.; Freedman, S.D.; Owens, E.M.; Field, R.; Cibik, C.

    1982-06-01

    The control, treatment and management of urban runoff and sewer overflow are reviewed. Simplified modeling and monitoring techniques are used to characterize urban runoff and to assess control alternatives. (KRM)

  20. The role of temperature increase rate in combinational hyperthermia chemotherapy treatment

    NASA Astrophysics Data System (ADS)

    Tang, Yuan; McGoron, Anthony J.

    2010-02-01

    Hyperthermia in combination with chemotherapy has been widely used in cancer treatment. Our previous study has shown that rapid rate hyperthermia in combination with chemotherapy can synergistically kill cancer cells whereas a sub-additive effect was found when a slow rate hyperthermia was applied. In this study, we explored the basis of this difference. For this purpose, in vitro cell culture experiments with a uterine cancer cell line (MES-SA) and its multidrug resistant (MDR) variant MES-SA/Dx5 were conducted. P-glycoprotein (P-gp) expression, Caspase 3 activity, and heat shock protein 70 (HSP 70) expression following the two different modes of heating were measured. Doxorubicin (DOX) was used as the chemotherapy drug. Indocyanine green (ICG), which absorbs near infrared light at 808nm (ideal for tissue penetration), was chosen for achieving rapid rate hyperthermia. Slow rate hyperthermia was provided by a cell culture incubator. Two sets of thermal doses were delivered by either slow rate or rapid rate hyperthermia. HSP70 expression was highly elevated under low dose slow rate incubator hyperthermia while maintained at the baseline level under the other three treatments. Caspase3 level slightly increased after low dose slow rate incubator hyperthermia while necrotic cell death was found in the other three types of heat treatment. In conclusion, when given at the same thermal dose, slow rate hyperthermia is more likely to induce thermotolerance. Meanwhile, hyperthermia showed a dose dependent capability in reversing P-gp mediated MDR; when MDR is reversed, the combinational treatment induced extensive necrotic cell death. During this process, the rate of heating also played a very important role; necrosis was more dramatic in rapid rate hyperthermia than in slow rate hyperthermia even though they were given at the same dose.

  1. [New methods of complex treatment of upper micrognation combined with stenosis of the dental rows].

    PubMed

    Malanchuk, V O; Astapenko, O O; Chepurnyĭ, Iu V

    2013-06-01

    This paper presents the new methods of surgical treatment of upper micrognation, combined with stenosis of dental rows, described advantages of using of bioresorbable devises for osteosintesis for treatment of patients with deformations of middle facial zone. PMID:25095695

  2. Effect of different treatments on the preference of apple cubes dehydrated by a combined process.

    PubMed

    Ochoa-Martínez, Luz A; Márquez-Burciaga, Angelica; González-Herrera, Silvia M; Morales-Castro, Juliana; Gallegos-Infante, Jose A; Delgado, Efren

    2009-11-01

    The aim of this work was to determine the effect on consumer preference of dehydrated apple cubes caused by different modifications of a combined drying method. The combined process of convective-osmotic drying with pretreatment in solutions of CaCl(2) and citric acid was taken as the basic process, and was then modified to obtain six different treatments. The factors varied were the osmotic agent, the order of drying processes, and the addition of CaCl(2) to the osmotic solution. The drying kinetics of convective-osmotic treatment and the osmotic-convective process were studied. A sensory evaluation was conducted to determine the effect of these alterations in the drying process on the consumer preference for the product. The convective-osmotic treatment significantly reduced the time of processing. Water loss and solids gain were higher when fructose was used as the osmotic agent in the convective-osmotic process. According to the results of the preference test, only one of the modified processes showed significant preference compared with the basic process. PMID:19817634

  3. Allergic rhinitis: meaningful and less meaningful combination treatments including reminiscences.

    PubMed

    Szelenyi, I

    2014-06-01

    Allergic rhinitis (AR) results from a complex allergen-driven mucosal inflammation in the nasal cavity. Current guideline-based therapy for allergic rhinitis include oral and nasal antihistamines, topical and systemic glucocorticoids, decongestants, antimuscarinic agents, mast cell stabilizing drugs, leukotriene-receptor antagonists, and others. In spite of guideline recommendations, most patients are using multiple therapies in an attempt to achieve symptom control. Therefore, more effective therapies for the management of AR are clearly required. Recently, a novel fixed dose combination containing azelastine and fluticasone propionate has successfully been introduced. At present, it represents the only meaningful topical drug combination. Perhaps, it will be followed by others. PMID:24974572

  4. Treatment for Advanced and Recurrent Endometrial Carcinoma: Combined Modalities

    PubMed Central

    Rauh-Hain, J. Alejandro

    2010-01-01

    Women with recurrent or advanced endometrial cancer constitute a heterogeneous group of patients. Depending on previous treatment, women with recurrent endometrial cancer may be appropriate candidates for surgery, radiation therapy, hormonal therapy, or chemotherapy. Women with advanced stage disease at presentation may also be appropriate candidates for systemic and local therapies. We review the treatment options available to treat recurrent and locally advanced endometrial cancer. Treatment choice depends largely on the localization of disease, the patient’s performance status and previous treatment history, as well the tumor’s hormonal receptor status. Radiation therapy is appropriate for isolated vaginal recurrences in patients with no previous history of radiation therapy. Patients with recurrent low-grade tumors overexpressing estrogen and progesterone receptors may be treated with progestin therapy. Systemic therapy is appropriate for patients with disseminate recurrences or advanced stage disease at presentation, or for those with receptor-negative tumors. We review all these different treatment strategies available to patients with advanced or recurrent endometrial cancer. PMID:20660059

  5. Effects of thermal treatments on the characterisation and utilisation of red mud with sawdust additive.

    PubMed

    Liu, Yanju; Naidu, Ravi; Ming, Hui; Dharmarajan, Rajarathnam; Du, Jianhua

    2016-06-01

    Extremely large amounts of red mud (bauxite residue) are generated globally every year from alumina refining industries, which are being disposed of on engineered landfills. The objective of this study is to investigate the effects of thermal treatments on red mud for development of utilisation strategies. Thermal treatments of red mud samples and their characterisations were investigated under inert (N2) and oxidative (air) conditions with and without sawdust addition at 200-600°C. After calcination, the resulting samples were analysed using thermogravimetric-infrared spectroscopy (TG-IR) for functional group transformations, thermogravimetric analysis (TGA) for thermal loss profiles and X-ray diffraction (XRD) for mineral transformations. The characterisation results showed that in N2 environment, boehmite in red mud was transferred to transition alumina at around 400°C while losing water from structural components. The addition of sawdust for incubation and calcination of red mud in air increased the surface area, whereas that in nitrogen atmosphere lead to reduction of hematite to magnetite at around 500°C. The incorporated carbon materials played a major role in increasing the surface area especially for pore size less than 2.5 nm. This treated red mud with altered mineral composition and improved properties for binding contaminants can be used for environmental remediation and in the process of metal recovery such as iron. PMID:26951343

  6. Sonochemical degradation of the pharmaceutical fluoxetine: Effect of parameters, organic and inorganic additives and combination with a biological system.

    PubMed

    Serna-Galvis, Efraím A; Silva-Agredo, Javier; Giraldo-Aguirre, Ana L; Torres-Palma, Ricardo A

    2015-08-15

    Fluoxetine (FLX), one of the most widely used antidepressants in the world, is an emergent pollutant found in natural waters that causes disrupting effects on the endocrine systems of some aquatic species. This work explores the total elimination of FLX by sonochemical treatment coupled to a biological system. The biological process acting alone was shown to be unable to remove the pollutant, even under favourable conditions of pH and temperature. However, sonochemical treatment (600 kHz) was shown to be able to remove the pharmaceutical. Several parameters were evaluated for the ultrasound application: the applied power (20-60 W), dissolved gas (air, Ar and He), pH (3-11) and initial concentration of fluoxetine (2.9-162.0 μmol L(-1)). Additionally, the presence of organic (1-hexanol and 2-propanol) and inorganic (Fe(2+)) compounds in the water matrix and the degradation of FLX in a natural mineral water were evaluated. The sonochemical treatment readily eliminates FLX following a kinetic Langmuir. After 360 min of ultrasonic irradiation, 15% mineralization was achieved. Analysis of the biodegradability provided evidence that the sonochemical process transforms the pollutant into biodegradable substances, which can then be mineralized in a subsequent biological treatment. PMID:25912531

  7. Umeclidinium bromide/vilanterol combination in the treatment of chronic obstructive pulmonary disease: a review

    PubMed Central

    Spyratos, Dionisios; Sichletidis, Lazaros

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a common disease among the elderly that could be prevented by smoking cessation. As it is characterized by airflow limitation that is not fully reversible, bronchodilator therapy is the first choice of treatment. Symptomatic COPD patients with or without risk for future exacerbations have a strong indication for the permanent use of long- and ultralong-acting β2-agonists and/or long-acting muscarinic antagonists. Combining bronchodilators is an effective approach, as they demonstrate synergic action at a cellular level and have additive clinical benefits and fewer adverse events compared with increased doses of the monocomponents. Novel fixed-dose combinations of long-acting β2-agonists/long-acting muscarinic antagonists in one inhaler have been approved for clinical use by the US Food and Drug Administration and the European Medicines Agency. This review focuses on published clinical trials about the fixed-dose combination of umeclidinium/vilanterol trifenatate in patients with COPD. Results from six studies (five of them of 12 weeks’ duration and one that lasted 1 year, including more than 6,000 patients in total) showed that umeclidinium/vilanterol trifenatate improved lung function, dyspnea, and health-related quality of life and decreased the exacerbation rate with no serious adverse events. More longstanding trials are needed to evaluate the effect of the drug on disease progression and compare it directly with other fixed-dose combinations. PMID:25848294

  8. Umeclidinium bromide/vilanterol combination in the treatment of chronic obstructive pulmonary disease: a review.

    PubMed

    Spyratos, Dionisios; Sichletidis, Lazaros

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a common disease among the elderly that could be prevented by smoking cessation. As it is characterized by airflow limitation that is not fully reversible, bronchodilator therapy is the first choice of treatment. Symptomatic COPD patients with or without risk for future exacerbations have a strong indication for the permanent use of long- and ultralong-acting β2-agonists and/or long-acting muscarinic antagonists. Combining bronchodilators is an effective approach, as they demonstrate synergic action at a cellular level and have additive clinical benefits and fewer adverse events compared with increased doses of the monocomponents. Novel fixed-dose combinations of long-acting β2-agonists/long-acting muscarinic antagonists in one inhaler have been approved for clinical use by the US Food and Drug Administration and the European Medicines Agency. This review focuses on published clinical trials about the fixed-dose combination of umeclidinium/vilanterol trifenatate in patients with COPD. Results from six studies (five of them of 12 weeks' duration and one that lasted 1 year, including more than 6,000 patients in total) showed that umeclidinium/vilanterol trifenatate improved lung function, dyspnea, and health-related quality of life and decreased the exacerbation rate with no serious adverse events. More longstanding trials are needed to evaluate the effect of the drug on disease progression and compare it directly with other fixed-dose combinations. PMID:25848294

  9. Combined Periodontal, Orthodontic, and Prosthetic Treatment in an Adult Patient

    PubMed Central

    Sabatoski, Claudio Vinicius; Bueno, Regis Claret; Reyes Pacheco, Ariel Adriano; Pithon, Matheus Melo; Tanaka, Orlando Motohiro

    2015-01-01

    A 41-year-old man had a significant loss of bone and supporting tissues with pathologic migration of several teeth and several missing teeth. He was treated with an interdisciplinary therapeutic protocol that included nonsurgical periodontal therapy based on strict control of supragingival plaque, subgingival periodontal therapy, orthodontic and endodontic treatment, and replacement of restorations. The orthodontic therapy was performed in a severely reduced bone support and the presence of pathological tooth migration after periodontal disease control. The interdisciplinary treatment protocol was the key to achieve a significant improvement in his facial and dental esthetics, masticatory function, and quality of life. PMID:26587295

  10. Nitrification in lake sediment with addition of drinking water treatment residuals.

    PubMed

    Wang, Changhui; Liu, Juanfeng; Wang, Zhixin; Pei, Yuansheng

    2014-06-01

    Drinking water treatment residuals (WTRs), non-hazardous by-products generated during potable water production, can effectively reduce the lake internal phosphorus (P) loading and improve water quality in lakes. It stands to reason that special attention regarding the beneficial reuse of WTRs should be given not only to the effectiveness of P pollution control, but also to the effects on the migration and transformation of other nutrients (e.g., nitrogen (N)). In this work, based on laboratory enrichment tests, the effects of WTRs addition on nitrification in lake sediment were investigated using batch tests, fluorescence in situ hybridization, quantitative polymerase chain reaction and phylogenetic analysis techniques. The results indicated that WTRs addition had minor effects on the morphologies of AOB and NOB; however, the addition slightly enhanced the sediment nitrification potential from 12.8 to 13.2 μg-N g(-1)-dry sample h(-1) and also increased the ammonia oxidation bacteria (AOB) and nitrite oxidizing bacteria (NOB) abundances, particularly the AOB abundances (P < 0.05), which increased from 1.11 × 10(8) to 1.31 × 10(8) copies g(-1)-dry sample. Moreover, WTRs addition was beneficial to the enrichment of Nitrosomonas and Nitrosospira multiformis and promoted the emergence of a new Nitrospira cluster, causing the increase in AOB and NOB diversities. Further analysis showed that the variations of nitrification in lake sediment after WTRs addition were primarily due to the decrease of bioavailable P, the introduction of new nitrifiers and the increase of favorable carriers for microorganism attachment in sediments. Overall, these results suggested that WTRs reuse for the control of lake internal P loading would also lead to conditions that are beneficial to nitrification. PMID:24681379

  11. Addition of meloxicam to the treatment of clinical mastitis improves subsequent reproductive performance.

    PubMed

    McDougall, S; Abbeloos, E; Piepers, S; Rao, A S; Astiz, S; van Werven, T; Statham, J; Pérez-Villalobos, N

    2016-03-01

    A blinded, negative controlled, randomized intervention study was undertaken to test the hypothesis that addition of meloxicam, a nonsteroidal anti-inflammatory drug, to antimicrobial treatment of mild to moderate clinical mastitis would improve fertility and reduce the risk of removal from the herd. Cows (n=509) from 61 herds in 8 regions (sites) in 6 European countries were enrolled. Following herd-owner diagnosis of mild to moderate clinical mastitis within the first 120 d of lactation in a single gland, the rectal temperature, milk appearance, and California Mastitis Test score were assessed. Cows were randomly assigned within each site to be treated either with meloxicam or a placebo (control). All cows were additionally treated with 1 to 4 intramammary infusions of cephalexin and kanamycin at 24-h intervals. Prior to treatment and at 14 and 21 d posttreatment, milk samples were collected for bacteriology and somatic cell count. Cows were bred by artificial insemination and pregnancy status was subsequently defined. General estimating equations were used to determine the effect of treatment (meloxicam versus control) on bacteriological cure, somatic cell count, the probability of being inseminated by 21 d after the voluntary waiting period, the probability of conception to first artificial insemination, the number of artificial insemination/conception, the probability of pregnancy by 120 or 200 d postcalving, and the risk of removal by 300 d after treatment. Cox's proportional hazards models were used to test the effect of treatment on the calving to first insemination and calving to conception intervals. Groups did not differ in terms of age, clot score, California Mastitis Test score, rectal temperature, number of antimicrobial treatments given or bacteria present at the time of enrollment, but cows treated with meloxicam had greater days in milk at enrollment. Cows treated with meloxicam had a higher bacteriological cure proportion than those treated with

  12. Refinement of Eutectic Si in High Purity Al-5Si Alloys with Combined Ca and P Additions

    NASA Astrophysics Data System (ADS)

    Ludwig, Thomas Hartmut; Li, Jiehua; Schaffer, Paul Louis; Schumacher, Peter; Arnberg, Lars

    2015-01-01

    The effects of combined additions of Ca and P on the eutectic Si in a series of high purity Al-5 wt pct Si alloys have been investigated with the entrained droplet technique and complementary sets of conventional castings. Differential scanning calorimetry (DSC) and thermal analysis were used to investigate the eutectic droplet undercooling and the recalescence undercooling, respectively. Optical microscopy, SEM, EPMA, and TEM were employed to characterize the resultant microstructures. It was found that 250 ppm Ca addition to Al-5Si wt pct alloys with higher P contents leads to a significant increase of the eutectic droplet undercooling. For low or moderate cooling rates, the TEM results underline that Ca additions do not promote Si twinning. Thus, a higher twin density cannot be expected in Ca containing Al-Si alloys after, e.g., sand casting. Consequently, a refinement of the eutectic Si from coarse flake-like to fine plate-like structure, rather than a modification of the eutectic Si to a fibrous morphology, was achieved. This strongly indicates that the main purpose of Ca additions is to counteract the coarsening effect of the eutectic Si imposed by higher P concentrations. Significant multiple Si twinning was observed in melt-spun condition; however, this can be attributed to the higher cooling rate. After DSC heating (slow cooling), most of Si twins disappeared. Thus, the well-accepted impurity-induced twinning mechanism may be not valid in the case of Ca addition. The possible refinement mechanisms were discussed in terms of nucleation and growth of eutectic Si. We propose that the pre-eutectic Al2Si2Ca phase and preferential formation of Ca3P2 deactivate impurity particles, most likely AlP, poisoning the nucleation sites for eutectic Si.

  13. [OPTIMAL APPROACH TO COMBINED TREATMENT OF PATIENTS WITH UROGENITAL PAPILLOMATOSIS].

    PubMed

    Breusov, A A; Kulchavenya, E V; Brizhatyukl, E V; Filimonov, P N

    2015-01-01

    The review analyzed 59 sources of domestic and foreign literature on the use of immunomodulator izoprinozin in treating patients infected with human papilloma virus, and the results of their own experience. The high prevalence of HPV and its role in the development of cervical cancer are shown, the mechanisms of HPV development and the host protection from this infection are described. The authors present approaches to the treatment of HPV-infected patients with particular attention to izoprinozin. Isoprinosine belongs to immunomodulators with antiviral activity. It inhibits the replication of viral DNA and RNA by binding to cell ribosomes and changing their stereochemical structure. HPV infection, especially in the early stages, may be successfully cured till the complete elimination of the virus. Inosine Pranobex (izoprinozin) having dual action and the most abundant evidence base, may be recognized as the optimal treatment option. PMID:26859953

  14. [Nondrug methods in the combined treatment of peptic ulcer patients].

    PubMed

    Degtiareva, I I; Kharchenko, N V

    1992-09-01

    Use of treatment complexes including non-drug methods (auricular acupuncture, pathogenetic dietotherapy, ILBR) or reduced doses of modern pharmacopreparations allowed to achieve rapid clinical and endoscopic remission in patients with ulcer disease. Simultaneously occurs normalization of the aggressive and defensive properties of the gastric juice, immunological, microcirculatory changes in the body and gastroduodenal mucosa. The vascular laser blood radiation reduced antacid dose and pathogenetic dietotherapy. PMID:1481513

  15. Hot-Pack and 1-MHz Ultrasound Treatments Have an Additive Effect on Muscle Temperature Increase

    PubMed Central

    Draper, David O.; Harris, Shane T.; Schulthies, Shane; Durrant, Earlene; Knight, Kenneth L.; Ricard, Mark

    1998-01-01

    Objective: Therapeutic ultrasound is an effective deep heating modality commonly applied alone or after cooling or heating of the treatment area. The purpose of this study was to examine the tissue temperature rise in the human triceps surae muscle group after ultrasound with prior heating via a silicate gel hot pack. Design and Setting: This study was designed as a 2 × 2 × 3 factorial with repeated measures on two factors (depth and time). Independent variables were temperature of pack (hot and room temperature), depth of measurement (1 cm and 3 cm), and time (beginning, after pack application, and after ultrasound). The dependent variable was tissue temperature. Subjects were assigned to one of two treatment groups: ultrasound preceded by a 15-minute hot pack treatment or ultrasound preceded by a 15-minute application with a silicate gel pack at room temperature. Measurements were taken while subjects were treated in a university training room. Subjects: Twenty-one uninjured male and female college student volunteers were randomly assigned to one of the two pack groups. Measurements: The hot packs were stored in 75°C water. A 1-MHz ultrasound treatment was administered for 10 minutes at an intensity of 1.5 W/cm². Tissue temperature was measured every 30 seconds using 23-gauge hypodermic microprobes interfaced with a telethermometer and inserted 1 and 3 cm below the surface of anesthetized triceps surae muscle. Results: At both tissue depths, there was a 0.8°C greater increase in tissue temperature with hot packs and ultrasound. At 1 cm, ultrasound increased temperature 3.5°C after a 0.5°C rise during the room temperature-pack application, but only 0.6°C after a 3.8°C increase during hot-pack application. At 3 cm, ultrasound increased temperature 3.85°C following a slight (-0.26°C) decrease during the room temperature-pack application and 3.68°C after a 0.74°C increase during hot-pack application. Conclusions: Vigorous increases in deep muscle

  16. Treatment strategy in schizophrenia combined with eating disorder.

    PubMed

    Dadić-Hero, Elizabeta; Ružić, Klementina; Grahovac, Tanja; Valković, Toni; Petranović, Duška

    2011-03-01

    Like any other patient, a schizophrenic patient can get a physical illness, too. As such patients tend to ignore reality and neglect themselves and are stigmatized by society, due to which their physical symptomatology is often ignored, physical illness can remain undetected. If the schizophrenic patient is observed and adequate care is provided by the family, family doctor and a psychiatrist, it is possible to recognize the physical illness and intervene promptly. We are presenting a case of a female patient who has been treated for schizophrenia for a number of years. The treatment was mostly ambulatory (i.e. the patient was hospitalized twice) and consisted of first-generation antipsychotics. During the past two years, for reasons unknown, the patient stopped taking regular meals and as a result lost significant body weight, became apathetic and withdrawn, started avoiding social contacts and neglected personal hygiene. She reportedly took the psychopharmaca regularly, but rarely attended psychiatric follow-up consultations. Due to substantial weight loss and hypotonia, correction of antipsychotic was made and internist treatment administered. The choice of olanzapine was not an accidental one. We decided to take advantage of its side effect for the treatment of an anorectic syndrome. Interdisciplinary cooperation proved to be a justified decision. PMID:21448107

  17. Effects of combined exercise and progesterone treatments on cocaine seeking in male and female rats

    PubMed Central

    Zlebnik, Natalie E.; Saykao, Amy T.; Carroll, Marilyn E.

    2014-01-01

    BACKGROUND Individually, both treatment with progesterone and concurrent access to an exercise wheel reduce cocaine self-administration under long-access conditions and suppress cocaine-primed reinstatement in female rats. In the present study, wheel running and progesterone (alone and combined) were assessed for their effects on reinstatement of cocaine-seeking primed by yohimbine, cocaine, and cocaine-paired cues. METHODS Male and female rats were implanted with an intravenous catheter and allowed to self-administer cocaine (0.4 mg/kg/inf, iv) during 6-h sessions for 10 days. Subsequently, the groups of male and female rats were each divided into 2 groups that were given concurrent access to either a locked or unlocked running wheel under extinction conditions for 14 days. Next, all 4 groups were tested in a within-subjects design for reinstatement of cocaine-seeking precipitated by separate administration of cocaine-paired stimuli, yohimbine, or cocaine; or the combination of yohimbine + cocaine-paired stimuli or cocaine + cocaine-paired stimuli. These priming conditions were tested in the presence of concurrent wheel access (W), pretreatment with progesterone (P), or both (W+P). RESULTS In agreement with previous results, females responded more for cocaine than males during maintenance. Additionally, concurrent wheel running attenuated extinction responding and cocaine-primed reinstatement in females but not males. Across all priming conditions, W+P reduced reinstatement compared to control conditions, and for cocaine-primed reinstatement in male rats, the combined W+P treatment was more effective than W or P alone. CONCLUSION Under certain conditions, combined behavioral (exercise) and pharmacological (progesterone) interventions were more successful at reducing cocaine-seeking behavior than either intervention alone. PMID:24595506

  18. Efficacy of combined pharmacotherapy and psychotherapy versus monotherapy in the treatment of anxiety disorders.

    PubMed

    Black, Donald W

    2006-10-01

    Anxiety disorders in the United States are prevalent, widespread, and disabling. These illnesses may account for almost one third of the $148 billion total mental health bill each year. Pharmacologic options include tricyclic antidepressants, monoamine oxidase inhibitors, serotonin norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, and anxiolytics. Psychological treatments include cognitive-behavioral therapy (CBT), cognitive therapy, exposure, and ritual prevention therapies. Despite insufficient evidence, many experts recommend combined treatment, generally medication with CBT. A literature review was conducted to examine studies with random assignment, adequate methods and sample sizes, blind assessments, sufficient dosages and durations of treatment, and satisfactory reporting of data, to determine whether combined treatment was superior to monotherapy. Twenty-six randomized clinical trials were identified; nine met review criteria. A review of relevant studies could not confirm the superiority of combined treatment over monotherapy. In one of four studies of obsessive-compulsive disorder, combined treatment produced better results than monotherapy. There was no evidence of superiority for combined therapy over monotherapy for the treatment of social phobia or generalized anxiety disorder. There were no studies that met review criteria for either specific phobia or posttraumatic stress disorder (PTSD). With panic disorder, there was evidence that combined treatment might actually lead to worse outcome. Combined treatment is commonly recommended, but empirical support is limited. More research is needed. There are few well-designed studies, and little data regarding PTSD and specific phobias. PMID:17008828

  19. Additional Value of CH₄ Measurement in a Combined (13)C/H₂ Lactose Malabsorption Breath Test: A Retrospective Analysis.

    PubMed

    Houben, Els; De Preter, Vicky; Billen, Jaak; Van Ranst, Marc; Verbeke, Kristin

    2015-09-01

    The lactose hydrogen breath test is a commonly used, non-invasive method for the detection of lactose malabsorption and is based on an abnormal increase in breath hydrogen (H₂) excretion after an oral dose of lactose. We use a combined (13)C/H₂ lactose breath test that measures breath (13)CO₂ as a measure of lactose digestion in addition to H₂ and that has a better sensitivity and specificity than the standard test. The present retrospective study evaluated the results of 1051 (13)C/H₂ lactose breath tests to assess the impact on the diagnostic accuracy of measuring breath CH₄ in addition to H₂ and (13)CO₂. Based on the (13)C/H₂ breath test, 314 patients were diagnosed with lactase deficiency, 138 with lactose malabsorption or small bowel bacterial overgrowth (SIBO), and 599 with normal lactose digestion. Additional measurement of CH₄ further improved the accuracy of the test as 16% subjects with normal lactose digestion and no H₂-excretion were found to excrete CH₄. These subjects should have been classified as subjects with lactose malabsorption or SIBO. In conclusion, measuring CH₄-concentrations has an added value to the (13)C/H₂ breath test to identify methanogenic subjects with lactose malabsorption or SIBO. PMID:26371034

  20. Effects of a combination of feed additives on methane production, diet digestibility, and animal performance in lactating dairy cows.

    PubMed

    van Zijderveld, S M; Fonken, B; Dijkstra, J; Gerrits, W J J; Perdok, H B; Fokkink, W; Newbold, J R

    2011-03-01

    Two experiments were conducted to assess the effects of a mixture of dietary additives on enteric methane production, rumen fermentation, diet digestibility, energy balance, and animal performance in lactating dairy cows. Identical diets were fed in both experiments. The mixture of feed additives investigated contained lauric acid, myristic acid, linseed oil, and calcium fumarate. These additives were included at 0.4, 1.2, 1.5, and 0.7% of dietary dry matter, respectively (treatment ADD). Experimental fat sources were exchanged for a rumen inert source of fat in the control diet (treatment CON) to maintain isolipidic rations. Cows (experiment 1, n=20; experiment 2, n=12) were fed restricted amounts of feed to avoid confounding effects of dry matter intake on methane production. In experiment 1, methane production and energy balance were studied using open-circuit indirect calorimetry. In experiment 2, 10 rumen-fistulated animals were used to measure rumen fermentation characteristics. In both experiments animal performance was monitored. The inclusion of dietary additives decreased methane emissions (g/d) by 10%. Milk yield and milk fat content tended to be lower for ADD in experiment 1. In experiment 2, milk production was not affected by ADD, but milk fat content was lower. Fat- and protein-corrected milk was lower for ADD in both experiments. Milk urea nitrogen content was lowered by ADD in experiment 1 and tended to be lower in experiment 2. Apparent total tract digestibility of fat, but not that of starch or neutral detergent fiber, was higher for ADD. Energy retention did not differ between treatments. The decrease in methane production (g/d) was not evident when methane emission was expressed per kilogram of milk produced. Feeding ADD resulted in increases of C12:0 and C14:0 and the intermediates of linseed oil biohydrogenation in milk in both experiments. In experiment 2, ADD-fed cows tended to have a decreased number of protozoa in rumen fluid when

  1. [LAMA/LABA fixed dose combination for treatment of COPD].

    PubMed

    Kuwahira, Ichiro

    2016-05-01

    Several new fixed-dose combination bronchodilators have been launched in the world, and 3 different types are now available in Japan. Assessing their efficacy relative to each other has not been performed yet. In the present manuscript, characteristics of glycopyrronium/indacaterol, umeclidinium/vilanterol and tiotropium/olodaterol were reviewed. In particular, changes in trough and peak forced expiratory volume in 1 second (FEV1), St George's Respiratory Questionnaire (SGRQ) total scores, and transitional dyspnea index (TDI) focal scores were reviewed in these bronchodilators. PMID:27254953

  2. Treatment of enterococcus faecalis bacteria by a helium atmospheric cold plasma brush with oxygen addition

    SciTech Connect

    Chen Wei; Huang Jun; Wang Xingquan; Lv Guohua; Zhang Guoping; Du Ning; Liu Xiaodi; Guo Lihong; Yang Size

    2012-07-01

    An atmospheric cold plasma brush suitable for large area and low-temperature plasma-based sterilization is designed. Results demonstrate that the He/O{sub 2} plasma more effectively kills Enterococcus faecalis than the pure He plasma. In addition, the sterilization efficiency values of the He/O{sub 2} plasma depend on the oxygen fraction in Helium gas. The atmospheric cold plasma brush using a proper ratio of He/O{sub 2} (2.5%) reaches the optimum sterilization efficiency. After plasma treatment, the cell structure and morphology changes can be observed by the scanning electron microscopy. Optical emission measurements indicate that reactive species such as O and OH play a significant role in the sterilization process.

  3. Treatment of enterococcus faecalis bacteria by a helium atmospheric cold plasma brush with oxygen addition

    NASA Astrophysics Data System (ADS)

    Chen, Wei; Huang, Jun; Du, Ning; Liu, Xiao-Di; Wang, Xing-Quan; Lv, Guo-Hua; Zhang, Guo-Ping; Guo, Li-Hong; Yang, Si-Ze

    2012-07-01

    An atmospheric cold plasma brush suitable for large area and low-temperature plasma-based sterilization is designed. Results demonstrate that the He/O2 plasma more effectively kills Enterococcus faecalis than the pure He plasma. In addition, the sterilization efficiency values of the He/O2 plasma depend on the oxygen fraction in Helium gas. The atmospheric cold plasma brush using a proper ratio of He/O2 (2.5%) reaches the optimum sterilization efficiency. After plasma treatment, the cell structure and morphology changes can be observed by the scanning electron microscopy. Optical emission measurements indicate that reactive species such as O and OH play a significant role in the sterilization process.

  4. Exhaust after-treatment system with in-cylinder addition of unburnt hydrocarbons

    DOEpatents

    Coleman, Gerald N.; Kesse, Mary L.

    2007-10-30

    Certain exhaust after-treatment devices, at least periodically, require the addition of unburnt hydrocarbons in order to create reductant-rich exhaust conditions. The present disclosure adds unburnt hydrocarbons to exhaust from at least one combustion chamber by positioning, at least partially within a combustion chamber, a mixed-mode fuel injector operable to inject fuel into the combustion chamber in a first spray pattern with a small average angle relative to a centerline of the combustion chamber and a second spray pattern with a large average angle relative to the centerline of the combustion chamber. An amount of fuel is injected in the first spray pattern into a non-combustible environment within the at least one combustion chamber during at least one of an expansion stroke and exhaust stroke. The exhaust with the unburnt amount of fuel is moved into an exhaust passage via an exhaust valve.

  5. Combination treatments in Alzheimer's disease: risks and benefits.

    PubMed

    Sobow, Tomasz

    2010-05-01

    Currently approved medications to treat cognitive deficits in Alzheimer's disease are targeting relatively late neurotransmission alterations and, thus, new approaches are needed to improve the observed modest efficacy. Employing various combinations of existing drugs is one way to achieve this aim. We can attempt to boost the clinical effects by adding drugs with different modes of action, or by adding a compound that is not neurotransmitter-based and not directly symptomatic, which may result in achieving disease progression modification. Recent studies with add-on therapies in Alzheimer's disease, apart from expanding our clinical knowledge, have also provided some new insights to guide future studies and therapeutic approaches. One such lesson is the critical necessity for precise characterization of subjects recruited to the studies, preferably with the use of biomarkers. Currently, even the best studied combination (memantine with a cholinesterase inhibitor) still requires further detailed trials to elucidate its usefulness at different disease stages, in patients with comorbidities, with or without the use of other concomitant medications. PMID:20420490

  6. Treatment of porcine Pseudomonas ARDS with combination drug therapy.

    PubMed

    Sielaff, T D; Sugerman, H J; Tatum, J L; Kellum, J M; Blocher, C R

    1987-12-01

    A combination drug therapy (Poly-5: ibuprofen 12.5 mg/kg, methylprednisolone 30 mg/kg, cimetidine 150 mg, diphenhydramine 10 mg/kg, and ketanserin 0.2 mg/kg) given at 20 and 120 minutes after starting continuous intravenous Pseudomonas (Ps, 5 X 10(8) CFU/20 kg/min) was studied in three groups of swine: saline control (C, n = 9), Ps alone (Ps, n = 8), and Ps plus Poly-5 (n = 5). PaO2, systemic (SAP) and pulmonary arterial (PAP) pressures, cardiac index (CI), thermal-cardiogreen extravascular lung water (EVLW), pulmonary albumin flux (slope index, SI), and arterial blood serotonin levels (5-HT) were measured. Ps produced significant (p less than 0.05) increases in PAP, EVLW, and SI with decreases in PaO2, CI, and SAP. 5-HT fell significantly compared to baseline. Poly-5 prevented (p less than 0.05) the rise in EVLW and SI and the fall in PaO2 and CI compared to Ps. PAP and SI were maintained at C until 90 and 150 minutes, respectively. SAP fell significantly from C at 30, 60, and 180 minutes. 5-HT was significantly lower than Ps throughout, and significantly lower than baseline at 180 minutes. Combined blockade of arachidonic acid metabolites, histamine, and serotonin receptors prevented hypoxemia, increased pulmonary capillary permeability, and cardiovascular deterioration in this porcine septic ARDS model. PMID:3694722

  7. Pharmacology of novel treatments for COPD: are fixed dose combination LABA/LAMA synergistic?

    PubMed

    Spina, Domenico

    2015-01-01

    Bronchodilators are mainstay for the symptomatic treatment of chronic obstructive pulmonary disease (COPD) and the introduction of long-acting bronchodilators has led to an improvement in the maintenance treatment of this disease. Various clinical trials have evaluated the effects of fixed dose long-acting β2-agonists (LABA)/long-acting anti-muscarinics (LAMA) combinations and documented greater improvements in spirometry but such improvements do not always translate to greater improvements in symptom scores or reduction in the rates of exacerbation compared with a single component drug. An analysis of whether this significantly greater change in spirometry with combination therapy is additive or synergistic was undertaken and is the subject of this review. Bronchodilators are not disease modifiers and whilst glucocorticosteroids have been shown to reduce rates of exacerbation in moderate to severe COPD, the increase risk of pneumonia and bone fractures is a motivation enough to warrant developing novel anti-inflammatory and disease-modifying drugs and with the expectation of positive outcomes. PMID:26557255

  8. Influence of dimethyl dicarbonate on the resistance of Escherichia coli to a combined UV-Heat treatment in apple juice

    PubMed Central

    Gouma, Maria; Gayán, Elisa; Raso, Javier; Condón, Santiago; Álvarez, Ignacio

    2015-01-01

    Commercial apple juice inoculated with Escherichia coli was treated with UV-C, heat (55°C) and dimethyl dicarbonate – DMDC (25, 50, and 75 mg/L)-, applied separately and in combination, in order to investigate the possibility of synergistic lethal effects. The inactivation levels resulting from each treatment applied individually for a maximum treatment time of 3.58 min were limited, reaching 1.2, 2.9, and 0.06 log10 reductions for UV, heat, and DMDC (75 mg/L), respectively. However, all the investigated combinations resulted in a synergistic lethal effect, reducing the total treatment time and UV dose, with the synergistic lethal effect being higher when larger concentrations of DMDC were added to the apple juice. The addition of 75 mg/L of DMDC prior to the combined UV-C light treatment at 55°C resulted in 5 log10 reductions after only 1.8 min, reducing the treatment time and UV dose of the combined UV-Heat treatment by 44%. PMID:26042117

  9. Influence of dimethyl dicarbonate on the resistance of Escherichia coli to a combined UV-Heat treatment in apple juice.

    PubMed

    Gouma, Maria; Gayán, Elisa; Raso, Javier; Condón, Santiago; Álvarez, Ignacio

    2015-01-01

    Commercial apple juice inoculated with Escherichia coli was treated with UV-C, heat (55°C) and dimethyl dicarbonate - DMDC (25, 50, and 75 mg/L)-, applied separately and in combination, in order to investigate the possibility of synergistic lethal effects. The inactivation levels resulting from each treatment applied individually for a maximum treatment time of 3.58 min were limited, reaching 1.2, 2.9, and 0.06 log10 reductions for UV, heat, and DMDC (75 mg/L), respectively. However, all the investigated combinations resulted in a synergistic lethal effect, reducing the total treatment time and UV dose, with the synergistic lethal effect being higher when larger concentrations of DMDC were added to the apple juice. The addition of 75 mg/L of DMDC prior to the combined UV-C light treatment at 55°C resulted in 5 log10 reductions after only 1.8 min, reducing the treatment time and UV dose of the combined UV-Heat treatment by 44%. PMID:26042117

  10. A novel combination treatment for breast cancer cells involving BAPTA-AM and proteasome inhibitor bortezomib

    PubMed Central

    YERLIKAYA, AZMI; ERDOĞAN, ELIF; OKUR, EMRAH; YERLIKAYA, ŞERIFE; SAVRAN, BIRCAN

    2016-01-01

    Glucose-regulated protein 78 kDa/binding immunoglobulin protein (GRP78/BIP) is a well-known endoplasmic reticulum (ER) chaperone protein regulating ER stress by facilitating protein folding, assembly and Ca2+ binding. GRP78 is also a member of the heat shock protein 70 gene family and induces tumor cell survival and resistance to chemotherapeutics. Bortezomib is a highly specific 26S proteasome inhibitor that has been approved as treatment for patients with multiple myeloma. The present study first examined the dose- and time-dependent effects of bortezomib on GRP78 expression levels in the highly metastatic mouse breast cancer 4T1 cell line using western blot analysis. The analysis results revealed that GRP78 levels were significantly increased by bortezomib at a dose as low as 10 nM. Time-dependent experiments indicated that the accumulation of GRP78 was initiated after a 24 h incubation period following the addition of 10 nM bortezomib. Subsequently, the present study determined the half maximal inhibitory concentration of intracellular calcium chelator BAPTA-AM (13.6 µM) on 4T1 cells. The combination effect of BAPTA-AM and bortezomib on the 4T1 cells was investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and WST-1 assays and an iCELLigence system. The results revealed that the combination of 10 nM bortezomib + 5 µM BAPTA-AM is more cytotoxic compared with monotherapies, including 10 nM bortezomib, 1 µM BAPTA-AM and 5 µM BAPTA-AM. In addition, the present results revealed that bortezomib + BAPTA-AM combination causes cell death through the induction of apoptosis. The present results also revealed that bortezomib + BAPTA-AM combination-induced apoptosis is associated with a clear increase in the phosphorylation of stress-activated protein kinase/Jun amino-terminal kinase SAPK/JNK. Overall, the present results suggest that bortezomib and BAPTA-AM combination therapy may be a novel therapeutic strategy for breast cancer treatment

  11. Effect of PAC addition on immersed ultrafiltration for the treatment of algal-rich water.

    PubMed

    Zhang, Yan; Tian, Jiayu; Nan, Jun; Gao, ShanShan; Liang, Heng; Wang, Meilian; Li, Guibai

    2011-02-28

    The aim of this study was to evaluate the effect of powdered activated carbon (PAC) addition on the treatment of algal-rich water by immersed ultrafiltration (UF), in terms of permeate quality and membrane fouling. Experiments were performed with a hollow-fiber polyvinyl chloride ultrafiltration membrane at a laboratory scale, 20-25°C and 10 L/(m(2) h) constant permeate flux. UF could achieve an absolute removal of Microcystis aeruginosa cells, but a poor removal of algogenic organic matter (AOM) released into water, contaminants responsible for severe membrane fouling. The addition of 4 g/L PAC to the immersed UF reactor significantly alleviated the development of trans-membrane pressure and enhanced the removal of dissovled organic carbon (by 10.9±1.7%), UV(254) (by 27.1±1.7%), and microcystins (expressed as MC-LR(eq), by 40.8±4.2%). However, PAC had little effect on the rejection of hydrophilic high molecular weight AOM such as carbohydrates and proteins. It was also identified that PAC reduced the concentrations of carbohydrates and proteins in the reactor due to decreased light intensity, as well as the MC-LR(eq) concentration by PAC adsorption. PMID:21216530

  12. Biochar Addition to Stormwater Treatment Media for Enhanced Removal of Nitrogen

    NASA Astrophysics Data System (ADS)

    Imhoff, P. T.; Jin, J.; Tian, J.; Chiu, P.; Guo, M.

    2015-12-01

    Urban stormwater management systems, such as bioretention facilities, require substantial land area and are often ineffective in removing nitrogen. This project seeks to improve nitrogen removal in bioretention media by modifying the hydraulic and treatment characteristics of the infiltration medium with biochar addition. A commercial wood biochar pyrolyzed from Southern Yellow Pine at 500°C was used. Laboratory experiments demonstrated that biochar addition to a typical bioretention medium (soil-mix: 4% saw dust, 88% sand, 8% clay) increased ammonium sorption at typical stormwater concentrations (2 mg/L) by a factor of 6, total porosity by 16.6%, and water retention at most matric potentials. The effect of the biochar-amended medium on nitrate removal was evaluated in pilot-scale experiments. Side-by-side experimental cells (91 cm dia., 1.2 m deep) were constructed to treat stormwater runoff from a parking lot. The control cell contained 100% soil mix while the biochar cell contained 4% biochar and 96% soil-mix by mass. Treatment media were 76.2 cm in depth and overlain by 5.1 cm of wood mulch in both cells, with a water table maintained at the bottom of the treatment zones. Cells were instrumented with TDR moisture sensors, pressure transducers, and redox and temperature sensors. Two pilot-scale experiments were conducted that included a bromide tracer and nitrate with a hydraulic loading of 5.5cm/h for 24 h in early spring and 36 h in summer. Effluent was continuously sampled for nitrogen compounds during these tests. Tracer tests and TDR measurements showed that biochar increased the average volumetric water content of the vadose zone by 14.7% and the mean residence time by 12.6%. For the spring field test at 14°C, nitrate in the control cell effluent increased by 6.1% but decreased by 43.5% for the biochar cell. For the summer field test at 22°C, 30.6% and 84.7% of influent nitrate was removed in the control and biochar cells, respectively. In the summer

  13. Combination of probenecid-sulphadoxine-pyrimethamine for intermittent preventive treatment in pregnancy

    PubMed Central

    2012-01-01

    The antifolate sulphadoxine-pyrimethamine (SP) has been used in the intermittent prevention of malaria in pregnancy (IPTp). SP is an ideal choice for IPTp, however, as resistance of Plasmodium falciparum to SP increases, data are accumulating that SP may no longer provide benefit in areas of high-level resistance. Probenecid was initially used as an adjunctive therapy to increase the blood concentration of penicillin; it has since been used to augment concentrations of other drugs, including antifolates. The addition of probenecid has been shown to increase the treatment efficacy of SP against malaria, suggesting that the combination of probenecid plus SP may prolong the useful lifespan of SP as an effective agent for IPTp. Here, the literature on the pharmacokinetics, adverse reactions, interactions and available data on the use of these drugs in pregnancy is reviewed, and the possible utility of an SP-probenecid combination is discussed. This article concludes by calling for further research into this potentially useful combination. PMID:22321288

  14. Plant tolerance to mercury in a contaminated soil is enhanced by the combined effects of humic matter addition and inoculation with arbuscular mycorrhizal fungi.

    PubMed

    Cozzolino, V; De Martino, A; Nebbioso, A; Di Meo, V; Salluzzo, A; Piccolo, A

    2016-06-01

    In a greenhouse pot experiment, lettuce plants (Lactuca sativa L.) were grown in a Hg-contaminated sandy soil with and without inoculation with arbuscular mycorrhizal fungi (AMF) (a commercial inoculum containing infective propagules of Rhizophagus irregularis and Funneliformis mosseae) amended with different rates of a humic acid (0, 1, and 2 g kg(-1) of soil), with the objective of verifying the synergistic effects of the two soil treatments on the Hg tolerance of lettuce plants. Our results indicated that the plant biomass was significantly increased by the combined effect of AMF and humic acid treatments. Addition of humic matter to soil boosted the AMF effect on improving the nutritional plant status, enhancing the pigment content in plant leaves, and inhibiting both Hg uptake and Hg translocation from the roots to the shoots. This was attributed not only to the Hg immobilization by stable complexes with HA and with extraradical mycorrhizal mycelium in soil and root surfaces but also to an improved mineral nutrition promoted by AMF. This work indicates that the combined use of AMF and humic acids may become a useful practice in Hg-contaminated soils to reduce Hg toxicity to crops. PMID:26931658

  15. 40 CFR 141.711 - Filtered system additional Cryptosporidium treatment requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Cryptosporidium treatment requirements. 141.711 Section 141.711 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Treatment for Cryptosporidium Treatment Technique Requirements § 141.711 Filtered system...

  16. 40 CFR 141.711 - Filtered system additional Cryptosporidium treatment requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Cryptosporidium treatment requirements. 141.711 Section 141.711 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Treatment for Cryptosporidium Treatment Technique Requirements § 141.711 Filtered system...

  17. 40 CFR 141.711 - Filtered system additional Cryptosporidium treatment requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Cryptosporidium treatment requirements. 141.711 Section 141.711 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Treatment for Cryptosporidium Treatment Technique Requirements § 141.711 Filtered system...

  18. Additive Manufacturing of 17-4 PH Stainless Steel: Post-processing Heat Treatment to Achieve Uniform Reproducible Microstructure

    NASA Astrophysics Data System (ADS)

    Cheruvathur, Sudha; Lass, Eric A.; Campbell, Carelyn E.

    2016-03-01

    17-4 precipitation hardenable (PH) stainless steel is a useful material when a combination of high strength and good corrosion resistance up to about 315°C is required. In the wrought form, this steel has a fully martensitic structure that can be strengthened by precipitation of fine Cu-rich face-centered cubic phase upon aging. When fabricated via additive manufacturing (AM), specifically laser powder-bed fusion, 17-4 PH steel exhibits a dendritic structure containing a substantial fraction of nearly 50% of retained austenite along with body centered cubic/martensite and fine niobium carbides preferentially aligned along interdendritic boundaries. The effect of post-build thermal processing on the material microstructure is studied in comparison to that of conventionally produced wrought 17-4 PH with the intention of creating a more uniform, fully martensitic microstructure. The recommended stress relief heat treatment currently employed in industry for post-processing of AM 17-4 PH steel is found to have little effect on the as-built dendritic microstructure. It is found that, by implementing the recommended homogenization heat treatment regimen of Aerospace Materials Specification 5355 for CB7Cu-1, a casting alloy analog to 17-4 PH, the dendritic solidification structure is eliminated, resulting in a microstructure containing about 90% martensite with 10% retained austenite.

  19. Operative Treatment of Combined Aortic Stenosis and Coronary Artery Disease

    PubMed Central

    Kadric, Nedzad; Kabil, Emir; Mujanovic, Emir; Hadziselimovic, Mehdin; Jahic, Mirza; Rajkovic, Stojan; Osmanovic, Enes; Avdic, Sevleta; Keranovic, Suad; Behrem, Adnan

    2015-01-01

    Introduction: The aortic valve replacement is a standard operating procedure in patients with severe aortic stenosis. Structure of patients undergoing surgery ranges from young population with isolated mitral valvular disease to the elderly population, which is in addition to the underlying disease additionally burdened with comorbidity. One of the most commonly present factors that further complicate the surgery is coronary heart disease that occurs in, almost, one third of patients with aortic stenosis. The aim is to compare the results of surgery for aortic valve replacement with or without coronary artery bypass graft (CABG). Patients and Methods: From August 2008 to January 2013 in our center operated on 120 patients for aortic stenosis. Of this number, 75 were men and 45 women. The average age was 63.37 years (16-78). Isolated aortic valve replacement was performed in 89 patients and in 31 patients underwent aortic valve replacement and coronary bypass surgery. Implanted 89 biological and 31 mechanical valves. Results: Patients with associated aortic stenosis and coronary artery disease were more expressed symptomatic symptoms preoperatively to patients with isolated aortic stenosis who were on average younger age. Intra-hospital morbidity and mortality was more pronounced in the group of patients with concomitant aortic valve replacement and coronary bypass surgery. Morbidity was recorded in 17 patients (14.3%) in both groups, while the mortality rate in both groups was 12 patients (10.1%). Conclusion: Evaluation of preoperative risk factors and comorbidity in patients with aortic stenosis and coronary artery disease contributes to a significant reduction in intraoperative and postoperative complications. Also, early diagnosis of associated coronary artery disease and aortic stenosis contributes to timely decision for surgery thus avoiding subsequent ischaemic changes and myocardial damage. PMID:25870480

  20. Aclidinium/formoterol fixed-dose combination for the treatment of chronic obstructive pulmonary disease.

    PubMed

    Cazzola, M; Calzetta, L; Matera, M G

    2015-02-01

    This review will be focused on the development of aclidinium bromide/formoterol fumarate (ACLI/FORM) fixed-dose combinations (FDC) that have been granted marketing authorization by the European Commission to be used as a maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD). ACLI/FORM FDC has been studied in 2 pivotal trials involving over 3,400 patients with COPD, in which it was compared with ACLI alone, FORM alone and placebo. The addition of FORM to ACLI resulted in greater bronchodilation than FORM or ACLI alone. ACLI/FORM FDC was also shown to increase the percentage of patients who had an improvement in symptoms and health-related quality of life compared with monotherapies. The frequency of side effects reported with ACLI/FORM FDC was low and their nature did not raise any major safety concern. PMID:25756065

  1. [Treatment outcomes of colon cancer surgery combined with radical lymphadenectomy].

    PubMed

    Lipská, L; Visokai, V; Mrácek, M; Levý, M

    2008-05-01

    The authors analyzed a group of 1281 subjects with colorectal cancer operated and followed up in a single institution from I/1992 to VIII/2007. Colon carcinoma patients were assessed separately (C18). Patients with rectal and rectosigmoid tumors are not included in the presentation. A total of 846 patients were operated for colon carcinomas. In 546 subjects, radical R0 resections were achieved. In the R0 group, the male/female ratio is 315/231, age 29-94 years, the mean age of 69 years. The R0 group stratification by TNM classification was: I 17.8%, II 49.6%, III 24.0%, IV 8.1%, TNMx 0.5%. Irrespective of the TNM staging, three-year, five-year and ten-year survival rates were 80%, 71%, and 51%, resp. The median survival time was 9.85 years. Postoperative morality was 5.5%, morbidity 29.8%, anastomic leak occured in 5.7%. Systematic lymph node dissection up to the apical level, had been gradually introduced as an integral part of the R0 surgery. The aim of the study is to analyze outcomes of the colon carcinoma surgical management, combined with radical lymphadenectomy. Furthermore, effects of the extensive procedure on the postoperative morbidity and moratility rates are analyzed as well. PMID:18595540

  2. Composite scaffolds for osteochondral repair obtained by combination of additive manufacturing, leaching processes and hMSC-CM functionalization.

    PubMed

    Díaz Lantada, Andrés; Alarcón Iniesta, Hernán; García-Ruíz, Josefa Predestinación

    2016-02-01

    Articular repair is a relevant and challenging area for the emerging fields of tissue engineering and biofabrication. The need of significant gradients of properties, for the promotion of osteochondral repair, has led to the development of several families of composite biomaterials and scaffolds, using different effective approaches, although a perfect solution has not yet been found. In this study we present the design, modeling, rapid manufacturing and in vitro testing of a composite scaffold aimed at osteochondral repair. The presented composite scaffold stands out for having a functional gradient of density and stiffness in the bony phase, obtained in titanium by means of computer-aided design combined with additive manufacture using selective laser sintering. The chondral phase is obtained by sugar leaching, using a PDMS matrix and sugar as porogen, and is joined to the bony phase during the polymerization of PDMS, therefore avoiding the use of supporting adhesives or additional intermediate layers. The mechanical performance of the construct is biomimetic and the stiffness values of the bony and chondral phases can be tuned to the desired applications, by means of controlled modifications of different parameters. A human mesenchymal stem cell (h-MSC) conditioned medium (CM) is used for improving scaffold response. Cell culture results provide relevant information regarding the viability of the composite scaffolds used. PMID:26652367

  3. Canine gastrointestinal pythiosis treatment by combined antifungal and immunotherapy and review of published studies.

    PubMed

    Pereira, Daniela I B; Botton, Sônia A; Azevedo, Maria I; Motta, Marco A A; Lobo, Raulene R; Soares, Mauro P; Fonseca, Anelise O S; Jesus, Francielli P K; Alves, Sydney H; Santurio, Janio M

    2013-10-01

    Pythium insidiosum is an oomycete, a fungal like microorganism, which infects mammals, causing pythiosis in animals and humans, especially in tropical and subtropical regions around the world. The treatment for this infection is very difficult, and therapeutic options commonly comprise surgery, immunotherapy and antimicrobial drugs. The present report describes the clinical healing of a dog with gastrointestinal pythiosis by treatment with a combination of antifungals and immunotherapy, as well as reviews the cases reported in the literature that used some type of therapy for canine pythiosis. A 2.5-year-old male beagle initially showed sporadic vomiting episodes, and this symptom became more frequent 5 months after the onset of clinical signs. Celiotomy procedure found thickness of the stomach wall extending to the pylorus and duodenum. A biopsy was performed, and the diagnosis of pythiosis was made by mycological, histopathological analyses and molecular identification. Therapy was based on an association of terbinafine plus itraconazole during 12 months and immunotherapy for 2.5 months. The healing of the dog reported here allows us to propose the use of immunotherapy associated with antifungal therapy to treat canine gastrointestinal pythiosis. However, additional studies should be performed on a larger number of patients to establish a standard treatment protocol for canine pythiosis. PMID:23918089

  4. Development of a multi-modal Monte-Carlo radiation treatment planning system combined with PHITS

    NASA Astrophysics Data System (ADS)

    Kumada, Hiroaki; Nakamura, Takemi; Komeda, Masao; Matsumura, Akira

    2009-07-01

    A new multi-modal Monte-Carlo radiation treatment planning system is under development at Japan Atomic Energy Agency. This system (developing code: JCDS-FX) builds on fundamental technologies of JCDS. JCDS was developed by JAEA to perform treatment planning of boron neutron capture therapy (BNCT) which is being conducted at JRR-4 in JAEA. JCDS has many advantages based on practical accomplishments for actual clinical trials of BNCT at JRR-4, the advantages have been taken over to JCDS-FX. One of the features of JCDS-FX is that PHITS has been applied to particle transport calculation. PHITS is a multipurpose particle Monte-Carlo transport code, thus application of PHITS enables to evaluate doses for not only BNCT but also several radiotherapies like proton therapy. To verify calculation accuracy of JCDS-FX with PHITS for BNCT, treatment planning of an actual BNCT conducted at JRR-4 was performed retrospectively. The verification results demonstrated the new system was applicable to BNCT clinical trials in practical use. In framework of R&D for laser-driven proton therapy, we begin study for application of JCDS-FX combined with PHITS to proton therapy in addition to BNCT. Several features and performances of the new multimodal Monte-Carlo radiotherapy planning system are presented.

  5. Development of a multi-modal Monte-Carlo radiation treatment planning system combined with PHITS

    SciTech Connect

    Kumada, Hiroaki; Nakamura, Takemi; Komeda, Masao; Matsumura, Akira

    2009-07-25

    A new multi-modal Monte-Carlo radiation treatment planning system is under development at Japan Atomic Energy Agency. This system (developing code: JCDS-FX) builds on fundamental technologies of JCDS. JCDS was developed by JAEA to perform treatment planning of boron neutron capture therapy (BNCT) which is being conducted at JRR-4 in JAEA. JCDS has many advantages based on practical accomplishments for actual clinical trials of BNCT at JRR-4, the advantages have been taken over to JCDS-FX. One of the features of JCDS-FX is that PHITS has been applied to particle transport calculation. PHITS is a multipurpose particle Monte-Carlo transport code, thus application of PHITS enables to evaluate doses for not only BNCT but also several radiotherapies like proton therapy. To verify calculation accuracy of JCDS-FX with PHITS for BNCT, treatment planning of an actual BNCT conducted at JRR-4 was performed retrospectively. The verification results demonstrated the new system was applicable to BNCT clinical trials in practical use. In framework of R and D for laser-driven proton therapy, we begin study for application of JCDS-FX combined with PHITS to proton therapy in addition to BNCT. Several features and performances of the new multimodal Monte-Carlo radiotherapy planning system are presented.

  6. Reduction of immunoreactivity of bovine beta-lactoglobulin upon combined physical and proteolytic treatment.

    PubMed

    Bonomi, Francesco; Fiocchi, Alessandro; Frøkiaer, Hanne; Gaiaschi, Antonella; Iametti, Stefania; Poiesi, Claudio; Rasmussen, Patrizia; Restani, Patrizia; Rovere, Pierpaolo

    2003-02-01

    Bovine beta-lactoglobulin was hydrolyzed with trypsin or chymotrypsin before, during and after treatment at 600 MPa and pH 6.8 for 10 min at 30, 37 and 44 degrees C. The extent of beta-lactoglobulin hydrolysis under pressure was noticeably higher than at atmospheric pressure, particularly when chymotrypsin was used. Addition of proteases at ambient pressure to previously pressure-treated beta-lactoglobulin gave only a modest increase in proteolysis with respect to the untreated protein. Products of enzyme hydrolysis under pressure were separated by reverse-phase HPLC, and were found to be different from those obtained at atmospheric pressure when chymotrypsin was used. The residual immunochemical reactivity of the products of combined pressure-enzyme treatment was assessed on the unresolved hydrolysates by ELISA tests using polyclonal and monoclonal antibodies, and on individual hydrolytic fractions by Western Blotting using sera of paediatric patients allergic to whey proteins in cow milk. The immunoreactivity of the whole hydrolysates was related to their content of residual intact beta-lactoglobulin, and no immunochemical reactivity was found for all the products of chymotrypsin hydrolysis under pressure. The results indicate that chymotrypsin effectively hydrolysed hydrophobic regions of beta-lactoglobulin that were transiently exposed during the pressure treatments and that were not accessible in the native protein or in the protein that had been previously pressure treated. PMID:12617393

  7. Vacuum Sealing Drainage Treatment Combined with Antibiotic-Impregnated Bone Cement for Treatment of Soft Tissue Defects and Infection

    PubMed Central

    Liu, Xin; Liang, Jiulong; Zhao, Jun; Quan, Liangliang; Jia, Xunyuan; Li, Mingchao; Tao, Kai

    2016-01-01

    Background This study aimed to evaluate the combined effect of vacuum sealing drainage (VSD) and antibiotic-loaded bone cement on soft tissue defects and infection. Material/Methods This prospective non-blinded study recruited 46 patients with soft tissue defects and infection from January 2010 to May 2014 and randomly divided them into experimental and control groups (n=23). Patients in the experimental group were treated with VSD and antibiotic-loaded bone cement, while the patients in the control group were treated with VSD only. Results In the experimental group, the wound was healed in 23 cases at 4 weeks postoperatively, of which direct suture was performed in 12 cases, and additional free flap transplantation or skin grafting was performed in 6 cases and 5 cases, respectively. No infection reoccurred in 1-year follow-up. In the control group, the wound was healed in 15 cases at 6 weeks postoperatively, of which direct suture was performed in 8 cases, and additional free flap transplantation or skin grafting was performed in 3 cases and 4 cases, respectively. In the other 8 cases the wound was healed at 8 weeks postoperatively. Infection reoccurred in 3 cases during the follow-up. The experimental group had significantly fewer VSD dressing renewals, shorter time needed until the wound was ready for surgery, shorter duration of antibiotic administration, faster wound healing, and shorter hospital stay than the control group (p<0.01). Conclusions The combination of VSD and antibiotic bone cement might be a better method for treatment of soft tissue defects and infection. PMID:27281233

  8. Vacuum Sealing Drainage Treatment Combined with Antibiotic-Impregnated Bone Cement for Treatment of Soft Tissue Defects and Infection.

    PubMed

    Liu, Xin; Liang, Jiulong; Zao, Jun; Quan, Liangliang; Jia, Xunyuan; Li, Mingchao; Tao, Kai

    2016-01-01

    BACKGROUND This study aimed to evaluate the combined effect of vacuum sealing drainage (VSD) and antibiotic-loaded bone cement on soft tissue defects and infection. MATERIAL AND METHODS This prospective non-blinded study recruited 46 patients with soft tissue defects and infection from January 2010 to May 2014 and randomly divided them into experimental and control groups (n=23). Patients in the experimental group were treated with VSD and antibiotic-loaded bone cement, while the patients in the control group were treated with VSD only. RESULTS In the experimental group, the wound was healed in 23 cases at 4 weeks postoperatively, of which direct suture was performed in 12 cases, and additional free flap transplantation or skin grafting was performed in 6 cases and 5 cases, respectively. No infection reoccurred in 1-year follow-up. In the control group, the wound was healed in 15 cases at 6 weeks postoperatively, of which direct suture was performed in 8 cases, and additional free flap transplantation or skin grafting was performed in 3 cases and 4 cases, respectively. In the other 8 cases the wound was healed at 8 weeks postoperatively. Infection reoccurred in 3 cases during the follow-up. The experimental group had significantly fewer VSD dressing renewals, shorter time needed until the wound was ready for surgery, shorter duration of antibiotic administration, faster wound healing, and shorter hospital stay than the control group (p<0.01). CONCLUSIONS The combination of VSD and antibiotic bone cement might be a better method for treatment of soft tissue defects and infection. PMID:27281233

  9. Early Treatment with Addition of Low Dose Prednisolone to Methotrexate Improves Therapeutic Outcome in Severe Psoriatic Arthritis

    PubMed Central

    Mahajan, Vikram K; Sharma, Anju Lath; Chauhan, Pushpinder S; Mehta, Karaninder S; Sharma, Nand Lal

    2013-01-01

    Psoriatic arthritis (PsA) is increasingly being recognized to cause progressive joint damage and disability. PsA unresponsive to non-steroidal anti-inflammatory drugs (NSAIDs), the conventional first-line choice of treatment, is usually managed with disease-modifying antirheumatic drugs (DMARDs) especially methotrexate. An 18-year-old HIV-negative male had progressively severe PsA of 4-month duration that was nearly confining him to a wheel chair. He did not respond to multiple NSAIDs, alone or in combination with methotrexate (15 mg/week), given for 4 weeks. Addition of prednisolone (10 mg on alternate days) controlled his symptoms within a week. The NSAIDs could be withdrawn after 4 weeks as the treatment progressed. The doses were tapered for methotrexate (5 mg/week) and prednisolone (2.5 mg on alternate days) every 8 weekly subsequently during 15 months of follow-up without recurrence/deformities or drug toxicity. For years, the use of corticosteroids in psoriasis has been criticized for their propensity to exacerbate the skin disease on withdrawal. However, monitored use of corticosteroids, even in low doses, combined with DMARDs may be a good therapeutic option in early stage of the PsA rather than ‘steroid rescue’ later. This will help in early control of joint inflammation, prevent joint damage and maintain long-term good functional capacity and quality of life. This may be useful when the cost or availability of biologics precludes their use. However, we discourage the use of corticosteroids as monotherapy. PMID:23723489

  10. A new sensitizer DVDMS combined with multiple focused ultrasound treatments: an effective antitumor strategy

    NASA Astrophysics Data System (ADS)

    Xiong, Wenli; Wang, Pan; Hu, Jianmin; Jia, Yali; Wu, Lijie; Chen, Xiyang; Liu, Quanhong; Wang, Xiaobing

    2015-12-01

    Sonodynamic therapy (SDT) was developed as a promising noninvasive approach. The present study investigated the antitumor effect of a new sensitizer (sinoporphyrin sodium, referred to as DVDMS) combined with multiple ultrasound treatments on sarcoma 180 both in vitro and in vivo. The combined treatment significantly suppressed cell viability, potentiated apoptosis, and markedly inhibited angiogenesis in vivo. In vivo, the tumor weight inhibition ratio reached 89.82% fifteen days after three sonication treatments plus DVDMS. This effect was stronger than one ultrasound alone (32.56%) and than one round of sonication plus DVDMS (59.33%). DVDMS combined with multiple focused ultrasound treatments initiated tumor tissue destruction, induced cancer cell apoptosis, inhibited tumor angiogenesis, suppressed cancer cell proliferation, and decreased VEGF and PCNA expression levels. Moreover, the treatment did not show obvious signs of side effects or induce a drop in body weight. These results indicated that DVDMS combined with multiple focused ultrasounds may be a promising strategy against solid tumor.

  11. Application of combined treatment for control of Botrytis cinerea in phytosanitary irradiation processing

    NASA Astrophysics Data System (ADS)

    Jung, Koo; Yoon, Minchul; Park, Hae-Jun; Youll Lee, Kwang; Jeong, Rae-Dong; Song, Beom-Seok; Lee, Ju-Woon

    2014-06-01

    Phytosanitary treatments are required to disinfest quarantine pests and pathogens in agricultural commodities. Gray mold in fruit is caused by Botrytis cinerea, which is one of the major postharvest pathogen of apple and pear. Irradiation treatment is a viable alternative for phytosanitary purposes and a useful nonchemical method for controlling pests and postharvest pathogens. An irradiation dose of over 0.4 kGy is used for the control of insects and fungal disease in fresh fruit, but a loss of firmness occurs. Combined treatments are needed to reduce the irradiation dose in phytosanitary irradiation processing. This study focuses on the application of combined treatments to reduce the loss of fruit quality when fresh fruit is irradiated for phytosanitary purposes. Comparing the antifungal activity against B. cinerea, while gamma irradiation showed no antifungal activity at a dose of 1.0 kGy, combined treatments (nano Ag particle, nano-sized silica silver) at a dose of 1.0 kGy showed the strongest antifungal activity. This study demonstrates the synergistic impacts of combined treatments in phytosanitary irradiation processing. Taken together, the combined treatments may affect reduction of fruit injury that occurred with irradiation only, meaning that the use of combined treatments with gamma irradiation is significantly effective for the preservation of fruit quality.

  12. [Correlation analysis on combined medication with of Xiyanping injection in treatment of lung infection in real world].

    PubMed

    Yin, Xiu-ping; Xie, Yan-ming; Zhi, Ying-jie; Yang, Wei; Wang, Zhi-fei; Huo, Jian

    2015-06-01

    To analyze the regularity in combined medication with Xiyanping injection (Xiyanping for short) in the real world by as- sociation rules. Totally 5 822 patients using Xiyanping injection was collected from the 18 Class III Grade I hospitals nationwide to study the combined medication information of the patient with lung infection and make the analysis by using association rules and Apriori. According to the results, major drugs combined with Xiyanping in treatment of lung infection included compound amino acid, inosine, coenzyme A, cytidine triphosphate, vitamin C. Common drugs combined with Xiyanping can be divided into 5 categories: nutrition support therapy (vitamin C, compound amino acid) , coenzymes (coenzyme A, cytidine triphosphate, inosine), expectorants and antiasthmatics (ambroxol, salbutamol, doxofylline), hormones (dexamethasone, budesonide), antibiotics (mainly cefminox). The main combined medicines mostly conformed to the regularity for drugs treating lung infection. In addition, there were two most common medical combination models: the model for Xiyanping combined a single medicine is Xiyanping + nutrition support therapy, while the model for Xiyanping combined two or more than two medicines is Xiyanping + nutrition support therapy + coenzyme. Pharmacologically, Xiyanping is mostly combined with western medicines with similar pharmacological effects to substitute or supplement the antibiotic effect in treating lung infection. However, further studies shall be conducted for the safety and rationality of the combined medication based on clinical practices, in order to provide reference for clinical medication. PMID:26591539

  13. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

    PubMed Central

    Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

    2015-01-01

    Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; p<0.0001) with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

  14. Efficient reduction of pathogenic and spoilage microorganisms from apple cider by combining microfiltration with UV treatment.

    PubMed

    Zhao, Dongjun; Barrientos, Jessie Usaga; Wang, Qing; Markland, Sarah M; Churey, John J; Padilla-Zakour, Olga I; Worobo, Randy W; Kniel, Kalmia E; Moraru, Carmen I

    2015-04-01

    Thermal pasteurization can achieve the U. S. Food and Drug Administration-required 5-log reduction of pathogenic Escherichia coli O157:H7 and Cryptosporidium parvum in apple juice and cider, but it can also negatively affect the nutritional and organoleptic properties of the treated products. In addition, thermal pasteurization is only marginally effective against the acidophilic, thermophilic, and spore-forming bacteria Alicyclobacillus spp., which is known to cause off-flavors in juice products. In this study, the efficiency of a combined microfiltration (MF) and UV process as a nonthermal treatment for the reduction of pathogenic and nonpathogenic E. coli, C. parvum, and Alicyclobacillus acidoterrestris from apple cider was investigated. MF was used to physically remove suspended solids and microorganisms from apple cider, thus enhancing the effectiveness of UV and allowing a lower UV dose to be used. MF, with ceramic membranes (pore sizes, 0.8 and 1.4 μm), was performed at a temperature of 10 °C and a transmembrane pressure of 155 kPa. The subsequent UV treatment was conducted using at a low UV dose of 1.75 mJ/cm(2). The combined MF and UV achieved more than a 5-log reduction of E. coli, C. parvum, and A. acidoterrestris. MF with the 0.8-μm pore size performed better than the 1.4-μm pore size on removal of E. coli and A. acidoterrestris. The developed nonthermal hurdle treatment has the potential to significantly reduce pathogens, as well as spores, yeasts, molds, and protozoa in apple cider, and thus help juice processors improve the safety and quality of their products. PMID:25836396

  15. An additional simple denitrification bioreactor using packed gel envelopes applicable to industrial wastewater treatment.

    PubMed

    Morita, Masahiko; Uemoto, Hiroaki; Watanabe, Atsushi

    2007-08-15

    A simple denitrification bioreactor for nitrate-containing wastewater without organic compounds was developed. This bioreactor consisted of packed gel envelopes in a single tank. Each envelope comprised two plates of gels containing Paracoccus denitrificans cells with an internal space between the plates. As an electron donor for denitrification, ethanol was injected into the internal space and not directly into the wastewater. P. denitrificans cells in the gel reduced nitrate to nitrogen gas by using the injected ethanol. Nitrate-containing desulfurization wastewater derived from a coal-fired thermal power plant was continuously treated with 20 packed gel envelopes (size, 1,000 x 900 x 12 mm; surface area, 1.44 m(2)) in a reactor tank (volume 1.5 m(3)). When the total nitrogen concentration in the inflow was around 150 mg-N x L(-1), the envelopes removed approximately 60-80% of the total nitrogen, and the maximum nitrogen removal rate was 5.0 g-N x day(-1) per square meter of the gel surface. This value corresponded to the volumetric nitrogen removal performance of 0.109 kg-N x m(-3) x day(-1). In each envelope, a high utilization efficiency of the electron donor was attained, although more than the double amount of the electron donor was empirically injected in the present activated sludge system to achieve denitrification when compared with the theoretical value. The bioreactor using the envelopes would be extremely effective as an additional denitrification system because these envelopes can be easily installed in the vacant spaces of preinstalled water treatment systems, without requiring additional facilities for removing surplus ethanol and sludge. PMID:17252606

  16. Recent Advances in Delivery of Drug-Nucleic Acid Combinations for Cancer Treatment

    PubMed Central

    Li, Jing; Wang, Yan; Zhu, Yu; Oupický, David

    2013-01-01

    Cancer treatment that uses a combination of approaches with the ability to affect multiple disease pathways has been proven highly effective in the treatment of many cancers. Combination therapy can include multiple chemotherapeutics or combinations of chemotherapeutics with other treatment modalities like surgery or radiation. However, despite the widespread clinical use of combination therapies, relatively little attention has been given to the potential of modern nanocarrier delivery methods, like liposomes, micelles, and nanoparticles, to enhance the efficacy of combination treatments. This lack of knowledge is particularly notable in the limited success of vectors for the delivery of combinations of nucleic acids with traditional small molecule drugs. The delivery of drug-nucleic acid combinations is particularly challenging due to differences in the physicochemical properties of the two types of agents. This review discusses recent advances in the development of delivery methods using combinations of small molecule drugs and nucleic acid therapeutics to treat cancer. This review primarily focuses on the rationale used for selecting appropriate drug-nucleic acid combinations as well as progress in the development of nanocarriers suitable for simultaneous delivery of drug-nucleic acid combinations. PMID:23624358

  17. Combined effect of fluconazole and thymosin alpha 1 on systemic candidiasis in mice immunosuppressed by morphine treatments.

    PubMed Central

    di Francesco, P; Gaziano, R; Casalinuovo, I A; Belogi, L; Palamara, A T; Favalli, C; Garaci, E

    1994-01-01

    Treatment of systemic infection with Candida albicans with a combination of an antifungal agent (i.e. fluconazole) and a thymus-derived immunostimulant (i.e. thymosin alpha 1 (T alpha 1)) in mice immunosuppressed by morphine treatments was investigated. In normal mice, fluconazole given after infection with 10(6) C. albicans cells was more effective than in mice treated with morphine. Combination treatment with fluconazole and T alpha 1 prolonged survival and reduced the fungal burden in the kidneys of immunosuppressed mice. We also investigated the influence of this combined treatment on killing properties of polymorphonuclear leucocytes (PMN) and natural killer (NK) cell activity, inhibited by morphine administrations. Treatment with T alpha 1 or fluconazole as single agents promoted a recovery of normal NK cell activity and intracellular killing of C. albicans by PMN, while the combination significantly increased both of these responses, probably through the modulation of lymphokine production. Our data suggest that the additive effect of T alpha 1 and fluconazole is due to a direct antifungal action and activation of the immunocompetence. PMID:8082290

  18. Cheap and Cheerful Stream Restoration - An Example of System Wide Woody Addition Treatment

    NASA Astrophysics Data System (ADS)

    Wheaton, J. M.; Bennett, S. N.; Bouwes, N.; Camp, R.

    2012-12-01

    Stream restoration has been plagued with high price tags, limited spatial extents, and questionable effectiveness in light of largely absent monitoring efforts. One prominent example is the placement of large woody debris (LWD) structures and engineered log jams that are frequently employed to promote heterogeneity of instream habitat. Ironically, many of these treatments attempt to lock in place and over-engineer the woody structures as opposed to allowing them to adjust and rearrange themselves as natural LWD would have. We are in the midst of a large scale restoration experiment using LWD to recover ESA-listed steelhead trout (Oncorhynchus mykiss) populations in the Asotin Creek Watershed of Southeast Washington. The project is an Intensively Monitored Watershed (IMW) where the restoration treatment and monitoring use a hierarchal staircase design maximizing the power to detect a population level response in steelhead. We are treating over 12 km of stream with enough LWD input (> 200 pieces per km) to mimic the historic background wood loading and encourage the stream to reshape and regularly rework itself leaving. We are using hundreds of structures we call DWS (dynamic woody structures), which generally consist of a series of wooden fence posts driven into the stream bed and complex LWD anchored between them to invoke a specific hydrogeomorphic response. The real advantage of these DWS are their cost. They can be installed quickly (15-30 minutes each) and cheaply (< $100/DWS); even in remote settings with a 2-3 person crew, hydraulic post pounder, very cheap materials, and avoiding impacts associated with operating heavy equipment. This allows us to install lots of the structures at high density (every 5-15 channel widths) over an entire stream system. We call this overall approach System Wide Woody Addition Treatment (SWWAT). In the long term, we hypothesize that the SWWAT will provide an intial input LWD that will become a part of study creeks which are more

  19. Mind over PMDD: A Glimpse into the Process of Pharmacotherapy-Psychotherapy Combination Treatment

    PubMed Central

    Adler Nevo, Gili W.; Nefsky, Colman

    2014-01-01

    The practice of combining pharmacotherapy with psychotherapy is advocated for as treatment of choice for many psychiatric disorders. Despite an abundance of outcome studies addressing this subject, little has been written about the process of combined treatment, leaving clinicians with insufficient guidance as to the “how” of the medication-psychotherapy merger. This case report follows the treatment course of a fourteen-year-old young woman initially diagnosed with Premenstrual Dysphoric Disorder (PMDD) and provisional Generalized Anxiety Disorder (GAD). It demonstrates the benefits, drawbacks, possible pitfalls and successful outcome of combined therapy, an outcome which may not have been achieved had only one of the modalities been used. PMID:24872831

  20. Enhancing the efficiency of wastewater treatment by addition of Fe-based amorphous alloy powders with H2O2 in ferrofluid

    NASA Astrophysics Data System (ADS)

    Yang, Chun-Cheng; Bian, Xiu-Fang; Yang, Jian-Fei

    2014-03-01

    Using combination of ferrofluid (FF) and Fe-based amorphous alloy in the advanced treatment of high concentration, organic wastewater was investigated. The addition of Fe73.5Nb3Cu1Si13.5B9 amorphous alloy powders into a FF give rise to a dramatic enhancement in decreasing chemical oxygen demand (COD) and decolorization. The removal rate of COD by using FF that combined Fe73.5Nb3Cu1Si13.5B9 metallic glass (MG) particles reached 92% in the presence of H2O2, nearly more than 50% higher than that by using only FF. Furthermore, compared with the FF, the decolorizing effect of the combination was 20% higher. It has been found that MG powders with the amorphous structures have high efficiency of waste water treatment and lead to high catalytic ability.

  1. Combined orthodontic and periodontic treatment in a child with Papillon Lefèvre syndrome

    PubMed Central

    AlSarheed, Maha A.; Al-Sehaibany, Fares S.

    2015-01-01

    A 9-year-old girl with Papillon-Lefèvre syndrome (PLS) was treated orthodontically 24 months after the start of mechanical and antibiotic therapy in adjunct with periodontal treatment every 6 weeks. After achieving stable periodontal conditions, orthodontic treatment was commenced to correct the teeth position, facial profile, and maxillary protraction. Following the combination therapy and a failure to detect Actinobacillus actinomycetemcomitans from any site in the oral cavity, orthodontic treatment with a fixed appliance was performed aside from creating space for eruption of permanent teeth. We found that combined periodontal and orthodontic treatment of PLS may be successful with a complex interdisciplinary regimen and close follow up. This is a 2-year follow-up case report of a girl with PLS. Orthodontic and periodontic therapy were offered using combined treatments of orthodontic and periodontal with the benefit of prosthodontic consultation, resulting in a treatment plan. PMID:26219452

  2. Application and Progress of Combined Mesenchymal Stem Cell Transplantation in the Treatment of Ischemic Cardiomyopathy

    PubMed Central

    Hua, Ping; Liu, Jian-Yang; Tao, Jun; Yang, Song-Ran

    2015-01-01

    Treatment of ischemic cardiomyopathy caused by myocardial infarction (MI) using mesenchymal stem cell (MSC) transplantation is a widely researched field, with promising clinical application. However, the low survival rate of transplanted cells has a severe impact on treatment outcome. Currently, research is focused on investigating the strategy of combining genetic engineering, tissue engineering materials, and drug/hypoxia preconditioning to improve ischemic cardiomyopathy treatment outcome using MSC transplantation treatment (MSCTT). This review discusses the application and progress of these techniques. PMID:26295041

  3. Combined effects of high pressure and sodium hydrogen carbonate treatment on pork ham: improvement of texture and palatability

    NASA Astrophysics Data System (ADS)

    Kim, Yun-Jung; Nishiumi, Tadayuki; Fujimura, Shinobu; Ogoshi, Hiro; Suzuki, Atsushi

    2013-06-01

    In this study, the combined effects of high pressure and sodium hydrogen carbonate (NaHCO3) treatment on the physical and chemical properties, and palatability of pork ham, a tough and under-utilized meat, were investigated. Assessment of meat properties with heat treatment, after exposure to NaHCO3 and high pressure treatment, revealed an increase in water content, and decreased weight reduction and rupture stress. The free amino acid content of meat samples increased with NaHCO3 and high pressure treatment. The effect of high pressure processing was especially notable at a pressure of 300 MPa. Sensory evaluation showed that meat subjected to high pressure processing after NaHCO3 treatment was tender and juicy. In addition, the sample produced minimal residue in the mouth and was characterized by a good taste.

  4. Combined Use of Etomidate and Dexmedetomidine Produces an Additive Effect in Inhibiting the Secretion of Human Adrenocortical Hormones.

    PubMed

    Gu, Hongbin; Zhang, Mazhong; Cai, Meihua; Liu, Jinfen

    2015-01-01

    BACKGROUND The direct effects of etomidate were investigated on the secretion of cortisol and its precursors by dispersed cells from the adrenal cortex of human of animals. Dexmedetomidine (DEX) is an anesthetic agent that may interfere with cortisol secretion via an unknown mechanism, such as involving inhibition of 11b-hydroxylase and the cholesterol side-chain cleavage enzyme system. The aim of this study was to determine whether dexmedetomidine (DEX) has a similar inhibitory effect on adrenocortical function, and whether combined use of etomidate (ETO) and DEX could produce a synergistic action in inhibiting the secretion of human adrenocortical hormones. MATERIAL AND METHODS Human adrenocortical cells were exposed to different concentrations of ETO and DEX. The dose-effect model between the ETO concentration and the mean secretion of cortisone (CORT) and aldosterone (ALDO) per hour was estimated. RESULTS Hill's equation well-described the dose-effect correlation between the ETO concentration and the amount of ALDO and CORT secretion. When the DEX concentration was introduced into the model by using E0 (basal secretion) as the covariate, the goodness of fit of the ETO-CORT dose-effect model was improved significantly and the objective function value was reduced by 4.55 points (P<0.05). The parameters of the final ETO-ALDO pharmacodynamics model were EC50=9.74, Emax=1.20, E0=1.33, and γ=18.5; the parameters of the final ETO-CORT pharmacodynamics model were EC50=9.49, Emax=8.16, E0=8.57, and γ=37.0. In the presence of DEX, E0 was 8.57-0.0247×(CDEX-4.6), and the other parameters remained unchanged. All parameters but γ were natural logarithm conversion values. CONCLUSIONS Combined use of DEX and ETO reduced ETO's inhibitory E0 (basal secretion) of CORT from human adrenocortical cells in a dose-dependent manner, suggesting that combined use of ETO and DEX produced an additive effect in inhibiting the secretion of human adrenocortical hormones. PMID:26568275

  5. Combined Use of Etomidate and Dexmedetomidine Produces an Additive Effect in Inhibiting the Secretion of Human Adrenocortical Hormones

    PubMed Central

    Gu, Hongbin; Zhang, Mazhong; Cai, Meihua; Liu, Jinfen

    2015-01-01

    Background The direct effects of etomidate were investigated on the secretion of cortisol and its precursors by dispersed cells from the adrenal cortex of human of animals. Dexmedetomidine (DEX) is an anesthetic agent that may interfere with cortisol secretion via an unknown mechanism, such as involving inhibition of 11β-hydroxylase and the cholesterol side-chain cleavage enzyme system. The aim of this study was to determine whether dexmedetomidine (DEX) has a similar inhibitory effect on adrenocortical function, and whether combined use of etomidate (ETO) and DEX could produce a synergistic action in inhibiting the secretion of human adrenocortical hormones. Material/Methods Human adrenocortical cells were exposed to different concentrations of ETO and DEX. The dose-effect model between the ETO concentration and the mean secretion of cortisone (CORT) and aldosterone (ALDO) per hour was estimated. Results Hill’s equation well-described the dose-effect correlation between the ETO concentration and the amount of ALDO and CORT secretion. When the DEX concentration was introduced into the model by using E0 (basal secretion) as the covariate, the goodness of fit of the ETO-CORT dose-effect model was improved significantly and the objective function value was reduced by 4.55 points (P<0.05). The parameters of the final ETO-ALDO pharmacodynamics model were EC50=9.74, Emax=1.20, E0=1.33, and γ=18.5; the parameters of the final ETO-CORT pharmacodynamics model were EC50=9.49, Emax=8.16, E0=8.57, and γ=37.0. In the presence of DEX, E0 was 8.57–0.0247×(CDEX–4.6), and the other parameters remained unchanged. All parameters but γ were natural logarithm conversion values. Conclusions Combined use of DEX and ETO reduced ETO’s inhibitory E0 (basal secretion) of CORT from human adrenocortical cells in a dose-dependent manner, suggesting that combined use of ETO and DEX produced an additive effect in inhibiting the secretion of human adrenocortical hormones. PMID

  6. A combined group treatment for nightmares and insomnia in combat veterans: a pilot study.

    PubMed

    Swanson, Leslie M; Favorite, Todd K; Horin, Elizabeth; Arnedt, J Todd

    2009-12-01

    Insomnia and nightmares are hallmarks of posttraumatic stress disorder (PTSD). Sleep disturbances in PTSD negatively impact clinical course and functioning. In this open clinical trial, the preliminary effects of a combined treatment for insomnia and nightmares in combat veterans with PTSD were assessed. Ten combat veterans participated in a 10-session group treatment combining cognitive-behavioral therapy for insomnia with exposure, rescripting, and relaxation therapy. Participants maintained daily sleep and dream diaries and completed self-report measures of sleep quality and PTSD symptoms pre- and posttreatment. Participants reported improvements in sleep and nightmares following treatment. Future research using controlled designs to evaluate this treatment is warranted. PMID:19908322

  7. Combining normobaric hypoxia with short-term resistance training has no additive beneficial effect on muscular performance and body composition.

    PubMed

    Ho, Jen-Yu; Kuo, Tai-Yu; Liu, Kuan-Lin; Dong, Xiang-Yi; Tung, Kang

    2014-04-01

    The aim of this study was to determine the effects of short-term resistance training combined with systemic hypoxia on muscular performance and body composition. Eighteen resistance-untrained men (21.3 ± 2.0 years, 172.7 ± 5.5 cm, 67.3 ± 9.7 kg) were matched and assigned to 2 experimental groups: performing 6 weeks of squat exercise training under normobaric hypoxia (H, FiO2 = 15%) or normoxia (N). In both groups, subjects performed 3 weekly sessions (a total of 18 sessions) of 3 sets of back squat at 10-repetition maximum with 2 minutes of rest between sets. Dynamic, isometric, and isokinetic leg strength and body composition were measured under normoxia before and after resistance training. Squat 1 repetition maximum (1RM) improved significantly (p ≤ 0.05) after resistance training in both H and N groups (88.9 ± 16.9 to 109.4 ± 17.0 kg and 90.0 ± 12.2 to 105.6 ± 13.3 kg, respectively). However, there were no changes in maximal isometric and isokinetic leg strength, lean body mass, and fat mass after the resistance training in both groups. In addition, no significant differences were observed between H and N groups in squat 1RM, maximal isometric and isokinetic leg strength, and body composition. The major findings of this study suggest that short-term resistance training performed under normobaric hypoxia has no additive beneficial effect on muscular performance and body composition. In practical terms, our data suggest that the use of systemic hypoxia during short-term resistance training is not a viable method to further enhance muscular performance and body composition in previously resistance-untrained men. PMID:24149753

  8. [Rasagiline in daily clinical use. Results of a treatment study of Parkinson patients with a combination treatment].

    PubMed

    Jost, W H; Klasser, M; Reichmann, H

    2008-10-01

    Rasagiline (Azilect) is a potent, highly selective and irreversible inhibitor of monoamine oxidase type B of the second generation. Rasagiline is indicated for the treatment of Parkinson's disease (PD) as monotherapy (without levodopa) or as adjunct therapy (with levodopa) in patients with end of dose fluctuations. The efficacy and tolerability of rasagiline has been demonstrated in large-scale, controlled clinical studies in patients with early PD as well as with more advanced PD. This multicentred post-marketing observational study included an investigation of the efficacy and tolerability of rasagiline in a large patient population under conditions of the daily routine in neurologic practice with a special attention on the collection of data regarding a patients' subjective evaluation of quality of life. A total of 754 patients with Parkinson's disease were enrolled, 545 of the patients (63% male patients, mean age 68 years, mean duration of PD 6 years, Hoehn & Yahr stage II to III in 69% of the patients) started rasagiline 1 mg/day as adjunct therapy for up to 4 months. The PD symptoms were rated by the physicians using the Columbia University Rating Scale (CURS) and the clinical fluctuations subscale of the Unified Parkinson's Disease Rating Scale (UPDRS, part IV B). Different aspects of quality of life were rated by the patients using the self-rating Parkinson's Disease Questionaire (PDQ-39). In addition, patients documented the number of hours spend in the OFF-state in "24-hour" home diaries prior to each of the assessment visits. During the treatment period rasagiline was most frequently co-administered with levodopa/DCI (81.7%) and/or dopamine agonists (65.8%). The mean treatment duration was 117.4 (+/-36.4) days, during which PD medication remained unchanged in 86.6% of the cases. The improvement rates in each of the CURS items ranged between 31.1% to 48.4% and the total score was reduced by 22% under the therapy of rasagiline. In the motor part (tremor

  9. Efficient Suppression of Hepatitis C Virus Replication by Combination Treatment with miR-122 Antagonism and Direct-acting Antivirals in Cell Culture Systems

    PubMed Central

    Liu, Fanwei; Shimakami, Tetsuro; Murai, Kazuhisa; Shirasaki, Takayoshi; Funaki, Masaya; Honda, Masao; Murakami, Seishi; Yi, Minkyung; Tang, Hong; Kaneko, Shuichi

    2016-01-01

    Direct-acting antivirals (DAAs) against Hepatitis C virus (HCV) show effective antiviral activity with few side effects. However, the selection of DAA-resistance mutants is a growing problem that needs to be resolved. In contrast, miR-122 antagonism shows extensive antiviral effects among all HCV genotypes and a high barrier to drug resistance. In the present study, we evaluated three DAAs (simeprevir, daclatasvir, and sofosbuvir) in combination with anti-miR-122 treatment against HCV genotype 1a in cell cultures. We found that combination treatments with anti-miR-122 and a DAA had additive or synergistic antiviral effects. The EC50 values of simeprevir in simeprevir-resistant mutants were significantly decreased by combining simeprevir with anti-miR-122. A similar reduction in EC50 in daclatasvir-resistant mutants was achieved by combining daclatasvir with anti-miR-122. Combination treatment in HCV-replicating cells with DAA and anti-miR-122 sharply reduced HCV RNA amounts. Conversely, DAA single treatment with simeprevir or daclatasvir reduced HCV RNA levels initially, but the levels later rebounded. DAA-resistant mutants were less frequently observed in combination treatments than in DAA single treatments. In summary, the addition of miR-122 antagonism to DAA single treatments had additive or synergistic antiviral effects and helped to efficiently suppress HCV replication and the emergence of DAA-resistant mutants. PMID:27484655

  10. Hardening of the surface layers of commercial pure titanium VT1-0 under combined treatment

    NASA Astrophysics Data System (ADS)

    Bashchenko, Lyudmila P.; Gromov, Viktor E.; Budovskikh, Evgenii A.; Ivanov, Yurii F.; Soskova, Nina A.

    2015-10-01

    The treatment of VT1-0 titanium samples was carried out by concentrated energy fluxes. The combined treatment included surface carburizing with the joint use of powder samples of compounds with high physical and mechanical properties (namely, titanium diboride TiB2, silicon carbide SiC and zirconium oxide ZrO2) and subsequent electron beam treatment of surface layers formed in electroexplosive treatment. The combined treatment of surface layers resulted in the multifold increase in microhardness, which reduces depending on the depth of hardening zone. After electron-beam treatment, the depth of hardening zone is increased. During electron-beam treatment, the two-layer hardening zone forms.

  11. Hardening of the surface layers of commercial pure titanium VT1-0 under combined treatment

    SciTech Connect

    Bashchenko, Lyudmila P. Gromov, Viktor E. Budovskikh, Evgenii A. Soskova, Nina A.; Ivanov, Yurii F.

    2015-10-27

    The treatment of VT1-0 titanium samples was carried out by concentrated energy fluxes. The combined treatment included surface carburizing with the joint use of powder samples of compounds with high physical and mechanical properties (namely, titanium diboride TiB{sub 2}, silicon carbide SiC and zirconium oxide ZrO{sub 2}) and subsequent electron beam treatment of surface layers formed in electroexplosive treatment. The combined treatment of surface layers resulted in the multifold increase in microhardness, which reduces depending on the depth of hardening zone. After electron-beam treatment, the depth of hardening zone is increased. During electron-beam treatment, the two-layer hardening zone forms.

  12. Combination treatment with risperidone long-acting injection and psychoeducational approaches for preventing relapse in schizophrenia

    PubMed Central

    Zhao, Yueren; Kishi, Taro; Iwata, Nakao; Ikeda, Manabu

    2013-01-01

    A recent meta-analysis showed that long-acting injectable (LAI) antipsychotics were not superior to oral antipsychotics for preventing relapse in patients with schizophrenia. We therefore designed a treatment strategy combining risperidone LAI and COMPASS (COMprehensive Psycho-educational Approach and Scheme Set), an original psychoeducational program supporting treatment with risperidone LAI and evaluating subjective treatment satisfaction, transition of symptoms, and effectiveness in preventing symptomatic relapse. The aim of this study was to examine whether addition of COMPASS to risperidone LAI was more effective in preventing relapse in schizophrenia patients than risperidone LAI alone, with the latter group consisting of patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients were followed up for 6 months, with COMPASS continuously implemented from the transition to the observation phase. The primary efficacy measurements were relapse rate (rates of rehospitalization and discontinuation due to inefficacy). Secondary efficacy measurements were the Brief Psychiatric Rating Scale (BPRS) and Global Assessment of Functioning (GAF) scores. Of the 96 patients originally enrolled, 19 (19.8%) were discontinued from all causes. During the 6-month study period, ten of the 96 patients (10.4%) relapsed, compared with a 12.2% relapse rate in patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients showed significant improvements in BPRS total scores (P = 0.0031), BPRS positive (P = 0.0451), BRPS negative (P < 0.0001), and general subscale scores (P = 0.0031), and GAF (P < 0.0001) from baseline to 6 months. In conclusion, the lower relapse rate observed in patients treated with COMPASS plus risperidone LAI than in patients treated with risperidone LAI alone suggests that COMPASS may have benefits in the treatment of schizophrenia, indicating a need for randomized, controlled trials in larger numbers of patients. PMID:24194642

  13. SYSTEMATIC SCANNING ELECTRON MICROSCOPY TECHNIQUE FOR EVALUATING COMBINED BIOLOIGCAL/GRANULAR ACTIVATED CARBON TREATMENT PROCESSES

    EPA Science Inventory

    A systematic scanning election microscope analytical technique has been developed to examine granular activated carbon used a a medium for biomass attachment in liquid waste treatment. The procedure allows for the objective monitoring, comparing, and trouble shooting of combined ...

  14. SYSTEMATIC SCANNING ELECTRON MICROSCOPY FOR EVALUATING COMBINED BIOLOGICAL/GRANULAR ACTIVATED CARBON TREATMENT PROCESSES

    EPA Science Inventory

    A semi-quantitative scanning electron microscope (SEK) analytical technique has been developed to examine granular activated carbon (GAC) utilized as media for biomass attachment in liquid waste treatment (combined processes). he procedure allows for the objective monitoring, com...

  15. A combined electrochemical-irradiation treatment of highly colored and polluted industrial wastewater

    NASA Astrophysics Data System (ADS)

    Barrera-Díaz, C.; Ureña-Nuñez, F.; Campos, E.; Palomar-Pardavé, M.; Romero-Romo, M.

    2003-07-01

    This study reports on the attainment of optimal conditions for two electrolytic methods to treat wastewater: namely, electrocoagulation and particle destabilization of a highly polluted industrial wastewater, and electrochemically induced oxidation induced by in situ generation of Fenton's reactive. Additionally, a combined method that consisted of electrochemical treatment plus γ-irradiation was carried out. A typical composition of the industrial effluent treated was COD 3400 mg/l, color 3750 Pt/Co units, and fecal coliforms 21000 MPN/ml. The best removal efficiency was obtained with electrochemical oxidation induced in situ , that resulted in the reduction of 78% for the COD, 86% color and 99.9% fecal coliforms removal. A treatment sequence was designed and carried out, such that after both electrochemical processes, a γ-irradiation technique was used to complete the procedure. The samples were irradiated with various doses in an ALC γ-cell unit provided with a Co-60 source. The removal efficiency obtained was 95% for the COD values, 90% color and 99.9% for fecal coliforms.

  16. Electron beam combined with hydrothermal treatment for enhancing the enzymatic convertibility of sugarcane bagasse

    NASA Astrophysics Data System (ADS)

    Duarte, C. L.; Ribeiro, M. A.; Oikawa, H.; Mori, M. N.; Napolitano, C. M.; Galvão, C. A.

    2012-08-01

    The use of microbial cellulolytic enzymes is the most efficient process to liberate glucose from cellulose in biomass without the formation of fermentation inhibitors. A combination of pretreatment technologies is an alternative way to increase the access of enzymes to cellulose, and consequently, the conversion yield. In this way, the present study reports on the enzymatic hydrolysis of SCB submitted to three kinds of pretreatment: electron beam processing (EBP), and EBP followed by hydrothermal (TH) and diluted acid (AH) treatment. SCB samples were irradiated using a radiation dynamics electron beam accelerator, and then submitted to thermal and acid (0.1% sulfuric acid) hydrolysis for 40 and 60 min at 180 °C. These samples were submitted to enzymatic hydrolysis (EH) using commercial preparations, including Celluclast 1.5 L and beta-glycosidase. The addition of diluted acid improved TH treatment allowing for a shorter application time. EBP with 50 kGy increased the enzymatic hydrolysis yield of cellulose by 20% after TH and 30% after AH.

  17. Cancer treatment using an optically inert Rose Bengal derivative combined with pulsed focused ultrasound

    NASA Astrophysics Data System (ADS)

    Kim, Yoo-Shin; Rubio, Valentina; Qi, Jianjun; Xia, Rongmin; Shi, Zheng-Zheng; Peterson, Leif; Tung, Ching-Hsuan; O'Neill, Brian E.

    2012-10-01

    Pulsed high intensity focused ultrasound (HIFU) produced has been combined with a photo-insensitive Rose Bengal derivative (RB2) to provide a synergistic cytotoxicity requiring the presence of both ultrasonic cavitation and drug. In vitro tests have shown that a short treatment (less than 30 s) of pulsed HIFU with peak negative pressure >7 MPa (˜27 W acoustic power at 1.4 MHz) destroys >95 % of breast cancer cells MDA-MB-231 in suspension with >10 μM of the compound. Neither the pulsed HIFU nor the RB2 compound was found to have any significant impact on the viability of the cells when used alone. Introducing an antioxidant (Nacetylcysteine) reduced the effectiveness of the treatment. In vivo tests using these same cells growing as a xenograft in nu/nu mice were also done. An ultrasound contrast agent (Optison) and lower frequency (1.0 MHz) was used to help initiate cavitation at the tumor site. We were able to demonstrate tumor regression with cavitation alone, however, addition of RB2 compound injected i.v. yielded a substantial synergistic improvement over either cavitation or RB2 injection alone.

  18. Combination therapy with monoamine oxidase inhibitors and other antidepressants or stimulants: strategies for the management of treatment-resistant depression.

    PubMed

    Thomas, Samantha J; Shin, Mirae; McInnis, Melvin G; Bostwick, Jolene R

    2015-04-01

    Treatment-resistant depression (TRD) is a major health concern. More than 40% of patients treated for major depressive disorder with an appropriate antidepressant dose for an adequate duration fail to respond. Further, approximately half of adults with major depressive disorder fail to achieve sustained remission despite various medication trials. The utilization of monoamine oxidase inhibitors (MAOIs) for the treatment of depression in clinical practice today is low due to their widely known adverse effects, some of which may be life threatening, and the risk for dietary and drug interactions. For these reasons, MAOIs are not recommended to be prescribed along with other antidepressants or certain prescription or nonprescription drugs. Pharmacologic options are limited for individuals with TRD, however, and there is a paucity of data on the efficacy of MAOIs in combination with other antidepressants for the management of TRD. We performed a search of the PubMed database (inception through January 25, 2015) to identify cases that illustrate the potential utility, as well as risks, of combination treatment with MAOIs and other antidepressants for the management of TRD; 18 articles met the criteria for our search. In addition, we performed a retrospective case series by reviewing the medical records of 29 adults treated for depression with an MAOI plus another psychotropic agent (an antidepressant or stimulant medication) between 2003 and 2012 at a large Midwestern teaching hospital. We compared the findings of the published experience with our local experience to allow for more informed decisions regarding pharmacotherapy in patients with TRD. We separated the local experience into two groups: 15 cases with the selective MAO type B inhibitor selegiline combined with medications presumed to increase the risk of serotonin syndrome and 14 cases with nonselective MAOIs (phenelzine and tranylcypromine) combined with other contraindicated medications. Although risks of

  19. Combination treatment of chlorine dioxide gas and aerosolized sanitizer for inactivating foodborne pathogens on spinach leaves and tomatoes.

    PubMed

    Park, Sang-Hyun; Kang, Dong-Hyun

    2015-08-17

    The objective of this study was to evaluate the antimicrobial effect of chlorine dioxide (ClO2) gas and aerosolized sanitizer, when applied alone or in combination, on the survival of Escherichia coli O157:H7, Salmonella Typhimurium, and Listeria monocytogenes inoculated onto spinach leaves and tomato surfaces. Spinach leaves and tomatoes were inoculated with a cocktail of three strains each of the three foodborne pathogens. ClO2 gas (5 or 10 ppmv) and aerosolized peracetic acid (PAA) (80 ppm) were applied alone or in combination for 20 min. Exposure to 10 ppmv of ClO2 gas for 20 min resulted in 3.4, 3.3, and 3.4 log reductions of E. coli O157:H7, S. Typhimurium, and L. monocytogenes on spinach leaves, respectively. Treatment with 80 ppm of aerosolized PAA for 20 min caused 2.3, 1.9, and 0.8 log reductions of E. coli O157:H7, S. Typhimurium, and L. monocytogenes, respectively. Combined treatment of ClO2 gas (10 ppmv) and aerosolized PAA (80 ppm) for 20 min caused 5.4, 5.1, and 4.1 log reductions of E. coli O157:H7, S. Typhimurium, and L. monocytogenes, respectively. E. coli O157:H7, S. Typhimurium, and L. monocytogenes on tomatoes experienced similar reduction patterns to those on spinach leaves. As treatment time increased, most combinations of ClO2 gas and aerosolized PAA showed additive effects in the inactivation of the three pathogens. Combined treatment of ClO2 gas and aerosolized PAA produced injured cells of three pathogens on spinach leaves while generally did not produce injured cells of these pathogens on tomatoes. Combined treatment of ClO2 gas (10 ppmv) and aerosolized PAA (80 ppm) did not significantly (p>0.05) affect the color and texture of samples during 7 days of storage. PMID:26001524

  20. Combined effects of tumor necrosis factor alpha and radiation in the treatment of renal cell carcinoma grown as radia spheroids.

    PubMed

    Van Moorselaar, R J; Schwachöfer, J H; Crooijmans, R P; Van Stratum, P; Debruyne, F M; Schalken, J A

    1990-01-01

    We have investigated the antiproliferative effects of Tumor Necrosis Factor Alpha (TNF) and radiation on a recently described rat renal cell tumor line grown as multicellular tumor spheroids (MTS). Treatment commenced when the spheroids had reached a diameter of 250 microns. TNF was diluted in the tissue culture medium in different concentrations, ranging from 250-1000 ng/ml. TNF monotherapy had a dose-dependent inhibiting effect on spheroid growth. Single-dose irradiation with 2, 4 or 6 Gy also retarded spheroids significantly in their growth. In the combination treatment the highest dose of TNF (1000 ng/ml) was added 4 hours prior to radiation. TNF could not induce a potentiation of the radiation injury at 2 Gy. The combination with 4 Gy, however, had additive and the combination with 6 Gy synergistic antiproliferative effects; in these treatment regimens respectively 2 and 5 out of 24 spheroids were controlled, i.e. cured. These experiments suggest that TNF in combination with radiotherapy may be beneficial for the treatment of renal cell carcinoma or cancer in general. PMID:2285257

  1. Survival mechanism of Escherichia coli O157:H7 against combined treatment with acetic acid and sodium chloride.

    PubMed

    Lee, Sun-Young; Kang, Dong-Hyun

    2016-05-01

    The combination of salt and acid is commonly used in the production of many foods, including pickles and fermented foods. However, in our previous studies, the addition of salt significantly reduced the inhibitory effect of acetic acid on Escherichia coli O157:H7 in laboratory media and pickled cucumbers. Therefore, this study was conducted to determine the mechanism by which salt confers resistance against acetic acid in E. coli O157:H7. The addition of high concentrations (up to 9% or 15% [w/v]) of salt increased the resistance of E. coli O157:H7 to acetic acid treatment. Combined treatment with acetic acid and salt showed varying results among different bacterial strains (an antagonistic effect for E. coli O157:H7 and Shigella and a synergistic effect for Listeria monocytogenes and Staphylococcus aureus). The addition of salt increased the cytoplasmic pH of E. coli O157:H7, but decreased the cytoplasmic pH of L. monocytogenes and S. aureus on treatment with acetic acid. Therefore, the addition of salt increases the acid resistance of E. coli O157:H7 possibly by increasing its acid resistance response and consequently preventing the acidification of its cytoplasm by organic acids. PMID:26742620

  2. Combined dynamic and static optical tomography for prediction of treatment outcome in breast cancer patients

    NASA Astrophysics Data System (ADS)

    Gunther, Jacqueline; Lim, Emerson; Kim, Hyun Keol; Flexman, Molly; Zweck, Lukas; Arora, Sindhiya; Refice, Susan; Brown, Mindy; Kalinsky, Kevin; Hershman, Dawn; Hielscher, Andreas H.

    2015-07-01

    We explored evidence that a combination of dynamic and static diffuse optical tomography can be used to predict treatment response in patients undergoing neo adjuvant chemotherapy. Both blood chromophore concentrations and hemodynamic signatures were measured over the 5-month course of treatment.

  3. External beam re-irradiation, combination chemoradiotherapy, and particle therapy for the treatment of recurrent glioblastoma

    PubMed Central

    Taunk, Neil K.; Moraes, Fabio Y.; Escorcia, Freddy E.; Mendez, Lucas Castro; Beal, Kathryn; Marta, Gustavo N.

    2016-01-01

    SUMMARY Glioblastoma is a common aggressive primary malignant brain tumor, and is nearly universal in progression and mortality after initial treatment. Re-irradiation presents a promising treatment option for progressive disease, both palliating symptoms and potentially extending survival. Highly conformal radiation techniques such as stereotactic radiosurgery and hypofractionated radiosurgery are effective short courses of treatment that allow delivery of high doses of therapeutic radiation with steep dose gradients to protect normal tissue. Patients with higher performance status, younger age, and longer interval between primary treatment and progression represent the best candidates for re-irradiation. Multiple studies are also underway involving combinations of radiation and systemic therapy to bend the survival curve and improve the therapeutic index. In the multimodal treatment of recurrent high-grade glioma, the use of surgery, radiation, and systemic therapy should be highly individualized. Here we comprehensively review radiation therapy and techniques, along with discussion of combination treatment and novel strategies. PMID:26781426

  4. Combined varenicline and naltrexone treatment reduces smoking topography intensity in heavy-drinking smokers.

    PubMed

    Roche, Daniel J O; Bujarski, Spencer; Hartwell, Emily; Green, ReJoyce; Ray, Lara A

    2015-07-01

    Heavy drinking smokers constitute a distinct sub-population of smokers for whom traditional smoking cessation therapies may not be effective. Recent evidence suggested that combined varenicline (VAR) and naltrexone (NTX) therapy may be more efficacious than either monotherapy alone in reducing smoking and drinking-related behavior in this population. The manner in which individuals smoke a cigarette (i.e., smoking topography) may be predictive of smoking cessation outcomes, yet the effects of smoking pharmacotherapies on puffing behavior have not been thoroughly examined. Therefore, the current double-blind medication study examined the effects of VAR alone (1mg BID), low dose NTX alone (25mg QD), the combination of VAR+NTX, and placebo on smoking topography measures in heavy drinking, non-treatment seeking daily smokers (n=120). After a 9-day titration period, participants completed a laboratory session in which they smoked their first cigarette of the day using a smoking topography device following 12h of nicotine abstinence and consumption of an alcoholic beverage (BrAC=0.06g/dl). The primary measures were puff count, volume, duration, and velocity and inter-puff interval (IPI). Independent of medication group, puff velocity and IPI increased, while puff volume and duration decreased, over the course of the cigarette. The active medication groups, vs. the placebo group, had significantly blunted puff duration and velocity slopes over the course of the cigarette, and this effect was particularly evident in the VAR+NTX group. Additionally, the VAR+NTX group demonstrated lower average IPI than the monotherapy groups and lower average puff volume than all other groups. These results suggest that smoking pharmacotherapies, particularly the combination of VAR+NTX, alter smoking topography in heavy drinking smokers, producing a pattern of less intense puffing behavior. As smoking topography has been predictive of the ability to quit smoking, future studies should

  5. A combination of exercise and capsinoid supplementation additively suppresses diet-induced obesity by increasing energy expenditure in mice.

    PubMed

    Ohyama, Kana; Nogusa, Yoshihito; Suzuki, Katsuya; Shinoda, Kosaku; Kajimura, Shingo; Bannai, Makoto

    2015-02-15

    Exercise effectively prevents the development of obesity and obesity-related diseases such as type 2 diabetes. Capsinoids (CSNs) are capsaicin analogs found in a nonpungent pepper that increase whole body energy expenditure. Although both exercise and CSNs have antiobesity functions, the effectiveness of exercise with CSN supplementation has not yet been investigated. Here, we examined whether the beneficial effects of exercise could be further enhanced by CSN supplementation in mice. Mice were randomly assigned to four groups: 1) high-fat diet (HFD, Control), 2) HFD containing 0.3% CSNs, 3) HFD with voluntary running wheel exercise (Exercise), and 4) HFD containing 0.3% CSNs with voluntary running wheel exercise (Exercise + CSN). After 8 wk of ingestion, blood and tissues were collected and analyzed. Although CSNs significantly suppressed body weight gain under the HFD, CSN supplementation with exercise additively decreased body weight gain and fat accumulation and increased whole body energy expenditure compared with exercise alone. Exercise together with CSN supplementation robustly improved metabolic profiles, including the plasma cholesterol level. Furthermore, this combination significantly prevented diet-induced liver steatosis and decreased the size of adipocyte cells in white adipose tissue. Exercise and CSNs significantly increased cAMP levels and PKA activity in brown adipose tissue (BAT), indicating an increase of lipolysis. Moreover, they significantly activated both the oxidative phosphorylation gene program and fatty acid oxidation in skeletal muscle. These results indicate that CSNs efficiently promote the antiobesity effect of exercise, in part by increasing energy expenditure via the activation of fat oxidation in skeletal muscle and lipolysis in BAT. PMID:25516550

  6. Combined dermal exposure to permethrin and cis-urocanic acid suppresses the contact hypersensitivity response in C57BL/6N mice in an additive manner.

    PubMed

    Prater, M R; Blaylock, B L; Holladay, S D

    2005-01-14

    Cutaneous exposure to the pyrethroid insecticide permethrin significantly suppresses contact hypersensitivity (CH) response to oxazolone in C57BL/6N mice. Additionally, cis-urocanic acid (cUCA), an endogenous cutaneous chromophore isomerized to its active form following exposure to ultraviolet radiation, modulates cell-mediated cutaneous immune responses. This study describes cutaneous immune alterations following combined topical permethrin and intradermal cUCA exposure. Female C57BL/6N mice were administered 5, 50 or 100 microg cUCA daily for 5 consecutive days. CH was then evaluated by the mouse ear swelling test (MEST) response to oxazolone. Decreased responses of 52.3%, 76.3% and 76.3%, respectively, as compared to controls were observed. Then, mice were co-exposed to 5 microg cUCA daily for 5 days and 1.5, 5, 15, or 25 microL permethrin, on either day 1, 3 or 5 of the cUCA treatment to evaluate combined immunomodulatory effects of the two chemicals, or cUCA daily for 5 days followed by permethrin on day 3, 5, or 7 after the last cUCA injection to demonstrate prolonged immunosuppressive effects. Two days after final treatment, mice were sensitized with oxazolone and MEST was performed. Mice receiving five cUCA injections and permethrin topically on cUCA injection day 1 showed up to 93.3% suppression of MEST compared to vehicle control. CH was suppressed by 87.5%, 86.6% and 74.2% in mice treated with 25 muL permethrin on days 3, 5 and 7 after cUCA, respectively, compared to vehicle control. Taken together, these data indicate co-exposure to cUCA and permethrin profoundly suppresses cell-mediated cutaneous immunity. PMID:15629246

  7. Combination of intravitreal bevacizumab and peripheral photocoagulation: an alternative treatment in eales disease.

    PubMed

    Cp, Juarez; Al, Gramajo; Jd, Luna

    2013-01-01

    To report the efficacy of combination therapy (bevacizumab and photocoagulation) in a case of Eales Disease this study has been performed. Bevacizumab (Avastin, 1.25 mg/0.05 ml) was injected intravitreously for the treatment of iris and retinal neovascularization in a 56-year old Hispanic female with photocoagulation treatment to control the recurrence of vitreous haemorrhage. Our results revealed that stabilization of the disease and improvement in visual acuity were achieved without any signs of recurrence. Intravitreal bevacizumab in combination with photocoagulation treatment of ischemic retinal areas may be a good alternative for patients with recurrent vitreous haemorrhage due to Eales disease. PMID:24600639

  8. Combination of Intravitreal Bevacizumab and Peripheral Photocoagulation: An Alternative Treatment in Eales Disease

    PubMed Central

    CP, Juarez; AL, Gramajo; JD, Luna

    2013-01-01

    To report the efficacy of combination therapy (bevacizumab and photocoagulation) in a case of Eales Disease this study has been performed. Bevacizumab (Avastin, 1.25 mg/0.05 ml) was injected intravitreously for the treatment of iris and retinal neovascularization in a 56-year old Hispanic female with photocoagulation treatment to control the recurrence of vitreous haemorrhage. Our results revealed that stabilization of the disease and improvement in visual acuity were achieved without any signs of recurrence. Intravitreal bevacizumab in combination with photocoagulation treatment of ischemic retinal areas may be a good alternative for patients with recurrent vitreous haemorrhage due to Eales disease. PMID:24600639

  9. Combination of Advanced Oxidation Processes and biological treatments for wastewater decontamination--a review.

    PubMed

    Oller, I; Malato, S; Sánchez-Pérez, J A

    2011-09-15

    Nowadays there is a continuously increasing worldwide concern for development of alternative water reuse technologies, mainly focused on agriculture and industry. In this context, Advanced Oxidation Processes (AOPs) are considered a highly competitive water treatment technology for the removal of those organic pollutants not treatable by conventional techniques due to their high chemical stability and/or low biodegradability. Although chemical oxidation for complete mineralization is usually expensive, its combination with a biological treatment is widely reported to reduce operating costs. This paper reviews recent research combining AOPs (as a pre-treatment or post-treatment stage) and bioremediation technologies for the decontamination of a wide range of synthetic and real industrial wastewater. Special emphasis is also placed on recent studies and large-scale combination schemes developed in Mediterranean countries for non-biodegradable wastewater treatment and reuse. The main conclusions arrived at from the overall assessment of the literature are that more work needs to be done on degradation kinetics and reactor modeling of the combined process, and also dynamics of the initial attack on primary contaminants and intermediate species generation. Furthermore, better economic models must be developed to estimate how the cost of this combined process varies with specific industrial wastewater characteristics, the overall decontamination efficiency and the relative cost of the AOP versus biological treatment. PMID:20956012

  10. The rationale for recommending fixed-dose combination tablets for treatment of tuberculosis.

    PubMed Central

    Blomberg, B.; Spinaci, S.; Fourie, B.; Laing, R.

    2001-01-01

    There is considerable exigency to take all necessary steps to cure tuberculosis cases and prevent further emergence of drug-resistant tuberculosis. The most important of these steps is to ensure that the treatment, particularly of sputum smear-positive cases, is adequate and that patients adhere to their treatment by supervised, direct observation of drug-taking according to the standardized regimens. Use of fixed-dose combinations (FDCs) of tablets against tuberculosis is now being recommended by WHO and the International Union Against Tuberculosis and Lung Disease (IUATLD) as an additional step to ensuring proper treatment. FDCs simplify the prescription of drugs and the management of drug supply, and may also limit the risk of drug-resistant tuberculosis arising as a result of inappropriate drug selection and monotherapy. Only FDCs of proven quality and proven rifampicin bioavailability should be purchased and used. In most situations, blood levels of the drugs are inadequate because of poor drug quality rather than poor absorption. This is true irrespective of the human immunodeficiency virus (HIV) infection status of the tuberculosis patients (other than those with overt acquired immunodeficiency syndrome, with CD4 counts < 200 cells/mm3). Currently, WHO, IUATLD and their partners are developing strategies for ensuring that only quality FDCs are used in tuberculosis programmes. A simplified and effective protocol for assessment of rifampicin bioavailability has been developed, and laboratories are being recruited to form a supranational network for quality assurance of FDCs. Standardization of FDC drug formulations has been proposed, which limits rifampicin-containing preparations to nine (including a four-drug FDC and three paediatric FDCs). PMID:11217670

  11. Aescin and troxerutin as a successful combination for the treatment of inner ear perfusion disturbances.

    PubMed

    Siegers, C P; Syed Ali, S; Tegtmeier, M

    2008-03-01

    A fixed combination of aescin and troxerutin has been developed for treating inner ear perfusion problems of different aetiology. The efficacy of this combination is tested versus pentoxyfyllin in a randomized clinical study as group comparison with 34 patients for each group. The improvement of hearing after 40-44 days of treatment is determined as end point of treatment. Hearing was measured by threshold, whereby a difference of more than 10dB is judged as a significant improvement. After the treatment with the combination of aescin and troxerutin hearing is significantly improved, in 23 of 34 patients the threshold is changed more than 10dB, which is checked by sign-test with p<0.05. With pentoxyfyllin hearing is also improved, although to a lesser degree. Both drugs are well tolerated, major adverse drug effects are not observed with either treatment. PMID:18222671

  12. Safety of the Combined Use of Praziquantel and Albendazole in the Treatment of Human Hydatid Disease

    PubMed Central

    Alvela-Suárez, Lucía; Velasco-Tirado, Virginia; Belhassen-Garcia, Moncef; Novo-Veleiro, Ignacio; Pardo-Lledías, Javier; Romero-Alegría, Angela; Pérez del Villar, Luis; Valverde-Merino, María Paz; Cordero-Sánchez, Miguel

    2014-01-01

    There is still no well-established consensus about the clinical management of hydatidosis. Currently, surgery continues to be the first therapeutic option, although treatment with anti-parasitic drugs is indicated as an adjuvant to surgery to decrease the number of relapses and hydatid cyst size. When surgery is not possible, medical treatment is indicated. Traditionally, albendazole was used in monotherapy as the standard treatment. However, combined therapy with albendazole plus praziquantel appears to improve anti-parasitic effectiveness. To date, no safety studies focusing on such combined therapy have been published for the treatment of hydatidosis. In this work, we analyze the adverse effects seen in 57 patients diagnosed with hydatidosis who were treated with praziquantel plus albendazole combined therapy between 2006 and 2010. PMID:24615131

  13. Dynamics of Plasmodium falciparum Parasitemia Regarding Combined Treatment Regimens for Acute Uncomplicated Malaria, Antioquia, Colombia

    PubMed Central

    Álvarez, Gonzalo; Tobón, Alberto; Piñeros, Juan-Gabriel; Ríos, Alexandra; Blair, Silvia

    2010-01-01

    Selecting suitable anti-malarial treatment represents one of the best tools for reducing morbidity and mortality caused by this disease. Sexual and asexual parasite dynamics were thus evaluated in patients involved in antimalarial drug efficacy studies by using combined treatment with and without artemisinin derivatives for treating uncomplicated acute Plasmodium falciparum malaria in Antioquia, Colombia. All treatment doses were supervised and administered according to patients' weight; sexual and asexual parasitemia were evaluated during 28- or 42-days follow-up in 468 patients. Artemisinin-based combination therapy showed greater parasiticidal ability, showing a mean asexual parasitemia survival rate of one day and mean gametocyte survival rate of 1–2 days. Sexual and asexual parasitemias were eliminated more quickly and effectively in the group receiving artemisinin-based combination therapy. Adding 45 mg of primaquine to treatment with artesunate and mefloquine reduced gametocyte and asexual parasite survival by one day. PMID:20595483

  14. [Ozonotherapy as an efficient component of the combined treatment of the patients presenting with bacterial vaginosis].

    PubMed

    Yarustovskaya, O V; Kulikov, A G; Shtro, L P

    2015-01-01

    The objective of the present study was to evaluate the effectiveness of the combined treatment of the patients suffering from bacterial vaginosis using various methods of ozone therapy. The comprehensive clinical and laboratory examination and treatment involved 102 patients of the child-bearing age divided into 3 groups, matched for the age and the main clinical manifestations of the disease. All the patients comprising group IlIl received basic therapy alone while the treatment of the patients of group I consisted of local ozone therapy and that of the patients of group 11 of the combination of local and general ozone therapy. The study has demonstrated the enhanced effectiveness of the combined local and general ozone therapy compared with the two other modalities and the feasibility of its application for the treatment of the patients presenting with bacterial vaginosis. PMID:26852502

  15. Field-scale investigation of enhanced petroleum hydrocarbon biodegradation in the vadose zone combining soil venting as an oxygen source with moisture and nutrient addition. Appendices. Doctoral thesis

    SciTech Connect

    Miller, R.N.

    1990-01-01

    This document contains appendices regarding a reprint on a field scale investigation of enhanced petroleum hydrocarbon biodegradation in the vadose zone combining soil venting as a oxygen source with moisture and nutrient addition.

  16. Combination treatments for killing Escherichia coli O157:H7 on alfalfa, radish, broccoli, and mung bean seeds.

    PubMed

    Bari, M L; Nei, D; Enomoto, K; Todoriki, S; Kawamoto, S

    2009-03-01

    In this study, the effectiveness of prolonged dry-heat treatment (50 degrees C) alone or in combination with chemical treatments (1% oxalic acid, 0.03% phytic acid, 50% ethanol, electrolyzed acidic water, and electrolyzed alkaline water) in eliminating Escherichia coli O157:H7 on laboratory-inoculated alfalfa, radish, broccoli, and mung bean seeds was compared with that of dry-heat treatment in combination with irradiation treatment. Dry-heat treatment for 17 or 24 h alone could reduce E. coli O157:H7 numbers to below detectable levels in radish, broccoli, and alfalfa seeds, but was unable to reduce the pathogen numbers to below the detectable level in mung bean seeds. In addition, dry-heat treatment for 17 h plus sanitizer treatments were effective in greatly reducing pathogen populations on radish, broccoli, and alfalfa seeds, without compromising the quality of the sprouts, but these treatments did not eliminate the pathogen from radish and alfalfa seeds. Seventeen hours of dry heat followed by a 1.0-kGy dose of irradiation completely eliminated E. coli O157:H7 from radish and mung bean seeds, whereas only a minimum radiation dose of 0.25 kGy was required to completely eliminate the pathogen from broccoli and alfalfa seeds. Dry heat in combination with radiation doses of up to 1.0 kGy did not negatively impact the seed germination rate or length of alfalfa, broccoli, and radish seeds or the length of alfalfa, broccoli, and radish sprouts, but did decrease the length of mung bean sprouts. PMID:19343955

  17. Assessing the application of advanced oxidation processes, and their combination with biological treatment, to effluents from pulp and paper industry.

    PubMed

    Merayo, Noemí; Hermosilla, Daphne; Blanco, Laura; Cortijo, Luis; Blanco, Angeles

    2013-11-15

    The closure of water circuits within pulp and paper mills has resulted in a higher contamination load of the final mill effluent, which must consequently be further treated in many cases to meet the standards imposed by the legislation in force. Different treatment strategies based on advanced oxidation processes (ozonation and TiO2-photocatalysis), and their combination with biological treatment (MBR), are herein assessed for effluents of a recycled paper mill and a kraft pulp mill. Ozone treatment achieved the highest efficiency of all. The consumption of 2.4 g O3 L(-1) resulted in about a 60% COD reduction treating the effluent from the kraft pulp mill at an initial pH=7; although it only reached about a 35% COD removal for the effluent of the recycled paper mill. Otherwise, photocatalysis achieved about a 20-30% reduction of the COD for both type of effluents. In addition, the effluent from the recycled paper mill showed a higher biodegradability, so combinations of these AOPs with biological treatment were tested. As a result, photocatalysis did not report any significant COD reduction improvement whether being performed as pre- or post-treatment of the biological process; whereas the use of ozonation as post-biological treatment enhanced COD removal a further 10%, summing up a total 90% reduction of the COD for the combined treatment, as well as it also supposed an increase of the presence of volatile fatty acids, which might ultimately enable the resultant wastewater to be recirculated back to further biological treatment. PMID:24076569

  18. Additional treatment of wastewater reduces endocrine disruption in wild fish--a comparative study of tertiary and advanced treatments.

    PubMed

    Baynes, Alice; Green, Christopher; Nicol, Elizabeth; Beresford, Nicola; Kanda, Rakesh; Henshaw, Alan; Churchley, John; Jobling, Susan

    2012-05-15

    Steroid estrogens are thought to be the major cause of feminization (intersex) in wild fish. Widely used wastewater treatment technologies are not effective at removing these contaminants to concentrations thought to be required to protect aquatic wildlife. A number of advanced treatment processes have been proposed to reduce the concentrations of estrogens entering the environment. Before investment is made in such processes, it is imperative that we compare their efficacy in terms of removal of steroid estrogens and their feminizing effects with other treatment options. This study assessed both steroid removal and intersex induction in adult and early life stage fish (roach, Rutilus rutilus). Roach were exposed directly to either secondary (activated sludge process (ASP)), tertiary (sand filtrated (SF)), or advanced (chlorine dioxide (ClO(2)), granular activated charcoal (GAC)) treated effluents for six months. Surprisingly, both the advanced GAC and tertiary SF treatments (but not the ClO(2) treatment) significantly removed the intersex induction associated with the ASP effluent; this was not predicted by the steroid estrogen measurements, which were higher in the tertiary SF than either the GAC or the ClO(2). Therefore our study highlights the importance of using both biological and chemical analysis when assessing new treatment technologies. PMID:22500691

  19. MONITORING SEPTAGE ADDITION TO WASTEWATER TREATMENT PLANTS. VOLUME II. VACUUM FILTRATION OF SEPTAGE

    EPA Science Inventory

    The study examined the feasibility of using conventional vacuum filtration to dewater conditioned septage sludge, alone and in combination with thickened waste activated sludge. The septage was conditioned with aluminum sulfate, ferric chloride, and sulfuric acid, each used indep...

  20. Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

    PubMed Central

    Cosgrove, Sara E.; Maragakis, Lisa L.

    2012-01-01

    Summary: Combination antibiotic therapy for invasive infections with Gram-negative bacteria is employed in many health care facilities, especially for certain subgroups of patients, including those with neutropenia, those with infections caused by Pseudomonas aeruginosa, those with ventilator-associated pneumonia, and the severely ill. An argument can be made for empiric combination therapy, as we are witnessing a rise in infections caused by multidrug-resistant Gram-negative organisms. The wisdom of continued combination therapy after an organism is isolated and antimicrobial susceptibility data are known, however, is more controversial. The available evidence suggests that the greatest benefit of combination antibiotic therapy stems from the increased likelihood of choosing an effective agent during empiric therapy, rather than exploitation of in vitro synergy or the prevention of resistance during definitive treatment. In this review, we summarize the available data comparing monotherapy versus combination antimicrobial therapy for the treatment of infections with Gram-negative bacteria. PMID:22763634

  1. Combined Ethanol Injection Therapy and Radiofrequency Ablation Therapy in Percutaneous Treatment of Hepatocellular Carcinoma Larger than 4 cm

    SciTech Connect

    Vallone, Paolo; Catalano, Orlando Izzo, Francesco; Siani, Alfredo

    2006-08-15

    Background. Optimal treatment of large-sized hepatocellular carcinoma (HCC) is still debated, because percutaneous ablation therapies alone do not always achieve complete necrosis. Objective. To report our experience in the treatment of patients with HCC larger than 4 cm in diameter by combined percutaneous ethanol injection and radiofrequency thermal ablation. Methods. In a 5-year period there were 40 consecutive patients meeting the inclusion criteria (24 men and 16 women; age range 41-72 years, mean 58 years). These subjects had a single HCC larger than 4 cm. Twelve subjects also had one or two additional nodules smaller than 4 cm (mean 1.2 nodules per patient). Patients were submitted to one to three sessions consisting of ethanol injection at two opposite tumor poles (mean 12 ml) and then of radiofrequency application through one or two electrodes placed at the tumor center (mean treatment duration 30 min). Results. Complete necrosis was obtained in all cases with one to three sessions (mean 1.3 sessions per patient). All patients experienced pain and fever but one only subject had a major complication requiring treatment (abscess development and fistulization). Overall follow-up was 7-69 months. Two patients showed local recurrence and 9 developed new etherotopic HCC nodules. Seven subjects died during follow-up while 33 were free from recurrence 8-69 months after treatment. Conclusion. A combination of ethanol injection and radiofrequency ablation is effective in the treatment of large HCC.

  2. Pivmecillinam and amoxycillin as combined treatment in purulent exacerbations of chronic bronchitis.

    PubMed

    Pines, A; Nandi, A R; Raafat, H; Rahman, M

    1977-07-01

    One hundred and thirty-two patients with purulent exacerbations of chronic bronchitis were randomly allotted to treatment in three groups. They received (a) amoxycillin 250 mg and pivmecillinam 200 mg; or (b) amoxycillin 500 mg; or (c) amoxycillin 500 mg and pivmecillinam 400 mg: three times daily for 10 days. By the 7th day of treatment there was significant improvement over amoxycillin alone for both groups given combined chemotherapy in conversion of sputum to mucoid and in general improvement; at the end of treatment results in patients given the higher doses of both antibiotics were still superior to amoxycillin alone. Patients were observed 2 to 4 weeks later, when those given amoxycillin alone relapsed much more frequently. The three treatments were well tolerated and succeeded equally in clearing potential pathogens from the sputum. Combined treatment may be superior due to synergy against Haemophilus influenzae or to the elimination of beta-lactamase producing organisms and should be investigated further. PMID:330483

  3. Combine or Separate Future Pain? The Impact of Current Pain on Decisions about Future Dental Treatments

    PubMed Central

    Andrade, Eduardo B.; Bianchini, Marco Aurélio; Lucchiari, Newton

    2013-01-01

    Patients are often given the option of undergoing future painful treatments in one or multiple sessions (e.g., extracting two wisdom teeth on one or two different days). In a randomized controlled field experiment, we investigated the impact of transient pain on patients’ decision to combine or separate future periodontal treatments. The main results show that most patients preferred to have the future treatments take place in one session when they made their choice after a painless examination (i.e., general clinical exam). However, the patients’ preference for combining the future treatments did not differ from chance when the choice was made immediately following a painful examination (i.e., pocketing and bleeding on probing exam). The impact of pain on decision making is observed within and between participants. Current pain seems to lead patients to question their ability to endure future painful treatments in one session. PMID:23704972

  4. Combined pulsed dye and CO2 lasers in the treatment of angiolymphoid hyperplasia with eosinophilia.

    PubMed

    Sagi, Lior; Halachmi, Shlomit; Levi, Assi; Amitai, Dan Ben; Enk, Claes D; Lapidoth, Moshe

    2016-08-01

    Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon dermatosis of unknown etiology that manifests as characteristic red nodules and papules with a predilection for the scalp and periauricular region. Treatment is required for both esthetic and functional reasons, as lesions may ulcerate and bleed. Many treatment approaches have been reported, including excision, systemic medical approaches, topical or intralesional therapies, and non-invasive modalities including cryotherapy, electrosurgery, and laser. Treatments have exhibited variable efficacy, and the recurrence rate is 100 %. We report the combination of pulsed dye laser and CO2 laser in the treatment of ALHE in 14 patients. All patients exhibited clinical response after a mean of 2.4 ± 0.4 treatment sessions. The clinical efficacy of the combined treatment, together with its well-tolerated nature, render the use of pulsed dye laser in combination with CO2 laser, a viable treatment for debulking ALHE lesions. Ongoing maintenance treatments are needed to due to the high degree of relapse. PMID:27184154

  5. Treatment of angina pectoris with nifedipine: a double blind comparison of nifedipine and slow-release nifedipine alone and in combination with atenolol.

    PubMed

    Crake, T; Quyyumi, A A; Wright, C; Mockus, L; Fox, K M

    1987-12-01

    The relative efficacy of nifedipine and slow-release nifedipine (Adalat Retard) in the treatment of stable exertional angina pectoris was evaluated in a double blind randomised crossover study in eight patients on no concomitant antianginal treatment and in 10 patients who were additionally on atenolol. Patients were assessed by angina diaries and exercise testing. Slow-release nifedipine was as effective as nifedipine in the treatment of these patients, both alone and in combination with atenolol. PMID:3322352

  6. Treatment of angina pectoris with nifedipine: a double blind comparison of nifedipine and slow-release nifedipine alone and in combination with atenolol.

    PubMed Central

    Crake, T; Quyyumi, A A; Wright, C; Mockus, L; Fox, K M

    1987-01-01

    The relative efficacy of nifedipine and slow-release nifedipine (Adalat Retard) in the treatment of stable exertional angina pectoris was evaluated in a double blind randomised crossover study in eight patients on no concomitant antianginal treatment and in 10 patients who were additionally on atenolol. Patients were assessed by angina diaries and exercise testing. Slow-release nifedipine was as effective as nifedipine in the treatment of these patients, both alone and in combination with atenolol. PMID:3322352

  7. Prediction of post-treatment outcome after combined treatment with maxillary protraction and chincap appliances.

    PubMed

    Yoshida, Ikue; Yamaguchi, Nobuhito; Mizoguchi, Itaru

    2006-02-01

    The aims of this study were to identify differences in the initial skeletal morphology between successful and unsuccessful groups and to establish a novel method for predicting the final outcome of treatment with a maxillary protraction appliance (MPA) and chincap. The cephalograms used in this study were taken from 32 Japanese girls (mean age 10.2 years) with a Class III malocclusion at the beginning of treatment with an MPA and chincap (T1), at removal of the appliance (T2), and during the final post-treatment period (T3). The subjects were divided into two groups according to the treatment outcome at T3. Lower face height (ANS-Me), total face height (N-Me), ratio of face height (ANS-Me/N-ANS), maxillary position, mandibular plane and gonial angle at T1 were all significantly larger in the unsuccessful group, compared with the successful group. Discriminant analysis indicated that lower face height and gonial angle were significant determinants for distinguishing between the two groups at T1. From T1 to T2, while the anterior displacement of the maxilla was almost the same in the two groups, SNB decreased by 1.6 degrees in the successful group and 0.4 degrees in the unsuccessful group. After orthopaedic treatment, a second phase of treatment with a multibracket system was performed (T2 to T3). From T2 to T3, SNA increased by 0.4 degrees in the successful group and decreased by 0.7 degrees in the unsuccessful group. These results indicate that the vertical dimensions of the craniofacial skeleton are important for predicting the prognosis of skeletal Class III patients treated with a MPA and chincap and that the discriminant formula established in this study is effective in predicting the final treatment outcome. PMID:16113036

  8. Validation of the AQT Color-Form Additive Model for Screening and Monitoring Pharmacological Treatment of ADHD

    ERIC Educational Resources Information Center

    Nielsen, Niels Peter; Wiig, Elisabeth Hemmersam

    2013-01-01

    Objective:This retrospective study used A Quick Test of Cognitive Speed (AQT) processing-speed and efficiency measures for evaluating sensitivity and monitoring effects during pharmacological treatment of adults with ADHD. Method: Color (C), form (F), and color-form (CF) combination naming were administered to 69 adults during outpatient…

  9. Mathematical modeling of COD removal via the combined treatment of domestic wastewater and landfill leachate based on the PACT process.

    PubMed

    Fernández Bou, Ángel S; Nascentes, Alexandre Lioi; Costa Pereira, Barbara; Da Silva, Leonardo Duarte Batista; Alberto Ferreira, João; Campos, Juacyara Carbonelli

    2015-01-01

    The experiments performed in this study consisted of 16 batch reactors fed different mixtures of landfill leachate combined with synthetic wastewater treated using the Powdered Activated Carbon Treatment (PACT) process. The objective was to measure the COD mass removal per liter each day for each reactor using two models: the first model combined the variables PAC concentration (0 g·L(-1), 2 g·L(-1), 4 g·L(-1), and 6 g·L(-1)) and leachate rate in the wastewater (0%, 2%, 5%, and 10%), and the second model combined the PAC concentration and the influent COD. The Response Surface Methodology with Central Composite Design was used to describe the response surface of both models considered in this study. Domestic wastewater was produced under controlled conditions in the laboratory where the experiments were performed. The results indicated that the PAC effect was null when the influent did not contain leachate; however, as the concentration of leachate applied to the mixture was increased, the addition of a higher PAC concentration resulted in a better COD mass removal in the reactors. The adjusted R(2) values of the two models were greater than 0.95, and the predicted R(2) values were greater than 0.93. The models may be useful for wastewater treatment companies to calculate PAC requirements in order to meet COD mass removal objectives in combined treatment. PMID:25723064

  10. A combination of tyrosine kinase inhibitors, crizotinib and dasatinib for the treatment of glioblastoma multiforme

    PubMed Central

    Nehoff, Hayley; Parayath, Neha N.; McConnell, Melanie J.; Taurin, Sebastien; Greish, Khaled

    2015-01-01

    Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor. Despite the advances in surgery, radiotherapy and chemotherapy, patient survival averages only 14.6 months. In most GBM tumors, tyrosine kinases show increased activity and/or expression and actively contribute to the development, recurrence and onset of treatment resistance; making their inhibition an appealing therapeutic strategy. We compared the cytotoxicity of 12 tyrosine kinase inhibitors in vitro. A combination of crizotinib and dasatinib emerged as the most cytotoxic across established and primary human GBM cell lines. The combination treatment induced apoptotic cell death and polyploidy. Furthermore, the combination treatment led to the altered expression and localization of several tyrosine kinase receptors such as Met and EGFR and downstream effectors as such as SRC. Furthermore, the combination treatment reduced the migration and invasion of GBM cells and prevented endothelial cell tube formation in vitro. Overall, our study demonstrated the broad specificity of a combination of crizotinib and dasatinib across multiple GBM cell lines. These findings provide insight into the development of alternative therapy for the treatment of GBM. PMID:26517812

  11. Gluteal re-contouring with combination treatments: implants, liposuction, and fat transfer.

    PubMed

    Aiache, Adrien E

    2006-07-01

    Patients seeking augmentation or re-contouring of the gluteal region have three basic options: gluteal implants, liposuction, and augmentation with fat injections. In many cases, all three treatments are used together to achieve attractively shaped buttocks with proper proportions and good projection. The treatment or combination of approaches that is appropriate for each individual patient is discovered through consultation that focuses on understanding a patient's goals. To determine the treatment(s) required by a patient, his or her unique anatomy must be analyzed to identify gluteal areas that have excesses or deficiencies that can be successfully addressed in gluteal re-contouring. PMID:16818096

  12. The combined effect of genetic polymorphisms and clinical parameters on treatment outcome in treatment-resistant depression.

    PubMed

    Kautzky, Alexander; Baldinger, Pia; Souery, Daniel; Montgomery, Stuart; Mendlewicz, Julien; Zohar, Joseph; Serretti, Alessandro; Lanzenberger, Rupert; Kasper, Siegfried

    2015-04-01

    For over a decade, the European Group for the Study of Resistant Depression (GSRD) has examined single nucleotide polymorphisms (SNP) and clinical parameters in regard to treatment outcome. However, an interaction based model combining these factors has not been established yet. Regarding the low effect of individual SNPs, a model investigating the interactive role of SNPs and clinical variables in treatment-resistant depression (TRD) seems auspicious. Thus 225 patients featured in previous work of the GSRD were enrolled in this investigation. According to data availability and previous positive results, 12 SNPs in HTR2A, COMT, ST8SIA2, PPP3CC and BDNF as well as 8 clinical variables featured in other GSRD studies were chosen for this investigation. Random forests algorithm were used for variable shrinkage and k-means clustering for surfacing variable characteristics determining treatment outcome. Using these machine learning and clustering algorithms, we detected a set of 3 SNPs and a clinical variable that was significantly associated with treatment response. About 62% of patients exhibiting the allelic combination of GG-GG-TT for rs6265, rs7430 and rs6313 of the BDNF, PPP3CC and HTR2A genes, respectively, and without melancholia showed a HAM-D decline under 17 compared to about 34% of the whole study sample. Our random forests prediction model for treatment outcome showed that combining clinical and genetic variables gradually increased the prediction performance recognizing correctly 25% of responders using all 4 factors. Thus, we could confirm our previous findings and furthermore show the strength of an interaction-based model combining statistical algorithms in identifying and operating treatment predictors. PMID:25769916

  13. Deviation from additivity in mixture toxicity: relevance of nonlinear dose-response relationships and cell line differences in genotoxicity assays with combinations of chemical mutagens and gamma-radiation.

    PubMed Central

    Lutz, Werner K; Vamvakas, Spyros; Kopp-Schneider, Annette; Schlatter, Josef; Stopper, Helga

    2002-01-01

    Sublinear dose-response relationships are often seen in toxicity testing, particularly with bioassays for carcinogenicity. This is the result of a superimposition of various effects that modulate and contribute to the process of cancer formation. Examples are saturation of detoxification pathways or DNA repair with increasing dose, or regenerative hyperplasia and indirect DNA damage as a consequence of high-dose cytotoxicity and cell death. The response to a combination treatment can appear to be supra-additive, although it is in fact dose-additive along a sublinear dose-response curve for the single agents. Because environmental exposure of humans is usually in a low-dose range and deviation from linearity is less likely at the low-dose end, combination effects should be tested at the lowest observable effect levels (LOEL) of the components. This principle has been applied to combinations of genotoxic agents in various cellular models. For statistical analysis, all experiments were analyzed for deviation from additivity with an n-factor analysis of variance with an interaction term, n being the number of components tested in combination. Benzo[a]pyrene, benz[a]anthracene, and dibenz[a,c]anthracene were tested at the LOEL, separately and in combination, for the induction of revertants in the Ames test, using Salmonella typhimurium TA100 and rat liver S9 fraction. Combined treatment produced no deviation from additivity. The induction of micronuclei in vitro was investigated with ionizing radiation from a 137Cs source and ethyl methanesulfonate. Mouse lymphoma L5178Y cells revealed a significant 40% supra-additive combination effect in an experiment based on three independent replicates for controls and single and combination treatments. On the other hand, two human lymphoblastoid cell lines (TK6 and WTK1) as well as a pilot study with human primary fibroblasts from fetal lung did not show deviation from additivity. Data derived from one cell line should therefore

  14. Benznidazole/Itraconazole Combination Treatment Enhances Anti-Trypanosoma cruzi Activity in Experimental Chagas Disease.

    PubMed

    Assíria Fontes Martins, Tassiane; de Figueiredo Diniz, Lívia; Mazzeti, Ana Lia; da Silva do Nascimento, Álvaro Fernando; Caldas, Sérgio; Caldas, Ivo Santana; de Andrade, Isabel Mayer; Ribeiro, Isabela; Bahia, Maria Terezinha

    2015-01-01

    The nitroheterocyclic drugs nifurtimox and benznidazole are first-line drugs available to treat Chagas disease; however, they have limitations, including long treatment courses and toxicity. Strategies to overcome these limitations include the identification of new drugs with specific target profiles, re-dosing regimens for the current drugs, drug repositioning and combination therapy. In this work, we evaluated combination therapy as an approach for optimization of the current therapeutic regimen for Chagas disease. The curative action of benznidazole/itraconazole combinations was explored in an established infection of the mice model with the T. cruzi Y strain. The activities of the benznidazole/itraconazole combinations were compared with the results from those receiving the same dosage of each individual drug. The administration of benznidazole/itraconazole in combination eliminated parasites from the blood more efficiently than each drug alone. Here, there was a significant reduction of the number of treatment days (number of doses) necessary to induce parasitemia suppression with the benznidazole/itraconazole combination, as compared to each compound administered alone. These results clearly indicate the enhanced effects of these drugs in combination, particularly at the dose of 75 mg/kg, as the effects observed with the drug combinations were four times more effective than those of each drug used alone. Moreover, benznidazole/itraconazole treatment was shown to prevent or decrease the typical lesions associated with chronic experimental Chagas disease, as illustrated by similar levels of inflammatory cells and fibrosis in the cardiac muscle tissue of healthy and treated mice. These results emphasize the importance of exploring the potential of combination treatments with currently available compounds to specifically treat Chagas disease. PMID:26076455

  15. Supraadditive formation of micronuclei in preimplantation mouse embryos in vitro after combined treatment with X-rays and caffeine

    SciTech Connect

    Mueller, W.U.S.; Streffer, C.; Wurm, R.

    1985-01-01

    The influence of caffeine (0.1 or 2 mM), X-rays (0.24 Gy or 0.94 Gy, or of a combination of both on the formation of micronuclei in early stages of preimplantation mouse embryos in vitro was studied. X-rays as well as caffeine induced micronuclei. The dose-effect curve after irradiation was linear for the dose range measured. Caffeine did not induce micronuclei if the concentration was 1 mM or less; between 1 mM and 7 mM, however, there was a linear increase in the number of micronuclei. A considerable enhancement of the number of radiation-induced micronuclei was observed when irradiation of the embryos was followed by a treatment with caffeine. Not only was the sum of the single effects exceeded by the combination effects, but the combination results even lay in the range of supraadditivity of the envelope of additivity.

  16. Decrease in the acrylamide content in canned coffee by heat treatment with the addition of cysteine.

    PubMed

    Narita, Yusaku; Inouye, Kuniyo

    2014-12-17

    Acrylamide (AA) is classified as a Group 2A carcinogen according to the International Agency for Research on Cancer. Although coffee contains a small amount of AA, it is a popular beverage worldwide. Approximately 10 billion canned coffees are consumed each year in Japan. In this study, we investigated how to decrease AA contained in canned coffee by modifying the heat treatment used for sterilization during the manufacturing process. The AA content of both types of canned coffee (black and milk) was decreased by approximately 95% by heat treatment with adding cysteine at 121 °C for 6 min. The content was also decreased by heat treatment with dithiothreitol, although that with cystine had no effect. Therefore, it is shown that thiol groups in cysteine and dithiothreitol might play an important role in decreasing the AA content. PMID:25420187

  17. Hyperbaric oxygen therapy in tinnitus with normal hearing in association with combined treatment.

    PubMed

    Holy, Richard; Prazenica, Pavol; Stolarikova, Eva; Dosel, Petr; Fundova, Petra; Kovar, Daniel; Astl, Jaromir

    2016-01-01

    Tinnitus is a phantom perception of sound in the absence of overt acoustic stimulation. The focus of our attention is a combined therapy of tinnitus. In this prospective study (2013-2014) we evaluated the data of normal-hearing patients with tinnitus treated with various treatment modalities. In Group 1 we evaluated the data of 84 patients/124 ears after six weeks of treatment with betahistine dihydrochloride (72 mg). In Group 2, we evaluated the data of 36 patients/ 55 ears unimproved from Group 1 who were then treated for six weeks with hyperbaric oxygen (HBO₂) therapy combined with gingko biloba extract (120 mg). In Group 1, tinnitus disappeared in 9.7%, alleviated in 18.5% and improved overall in 28.2%. Average intensity of tinnitus before/after treatment was 37 decibels (dB)/33 dB. Tinnitus intensities after treatment are statistically significantly lower (p = 0.001) than the values before treatment. In Group 2 tinnitus disappeared in 5.4%, 36.4% achieved alleviation, and 41.8% showed overall improvement. The average intensity of tinnitus before/after treatment was 41dB/ 38dB. The values of tinnitus intensity after combined therapy are statistically significantly lower (p = 0.046). We have shown that both methods treatment of tinnitus are statistically significant. HBO₂therapy was recommended for the general public. PMID:27416687

  18. New Combinational Method for Noninvasive Treatments of Superficial Tissues for Body Aesthetics Applications

    NASA Astrophysics Data System (ADS)

    Rybyanets, A. N.; Naumenko, A. A.

    The paper introduces an innovative combinational treatment method based on ultrasonic standing waves (USW) technology for noninvasive surgical, therapeutic, lypolitic or cosmetic treatment of tissues including subcutaneous adipose tissue, cellulite or skin on arbitrary body part of patient. The method is based on simultaneous or successive applying of constructively interfering physically and biologically sensed influences: USW, ultrasonic shear waves, radio-frequency (RF) heating, and vacuum massage. The paper provides basic physical principles of USW as well as critical comparison of USW and HIFU methods. The results of finite-elements and finite- difference modeling of USW transducer design and nodal pattern structure in tissue are presented. Biological effects of USW-tissue interaction and synergetic aspects of USW and RF combination are explored. Combinational treatment transducer designs and original in-vitro experiments on tissues are described.

  19. Treatment of symptomatic lumbar spinal degenerative pathologies by means of combined conservative biochemical treatments.

    PubMed

    Alexandre, A; Corò, L; Paradiso, R; Dall'aglio, R; Alexandre, A M; Fraschini, F; Spaggiari, P G

    2011-01-01

    Research in spine surgery has proposed new soft and less invasive techniques. These are the results of our experience with oxygen-ozone therapy, which we could experiment within the Italian National Health System over 3 years. A total of 1,920 patients were admitted on the basis of unselected enrolment because of lumbosciatic pain. Patients were divided into three groups: (A) Patients with degenerative disc disease and arthropathy: 509 (26.5%), (B) Patients with failed back surgery syndrome (FBSS): 1,027 (53.489%), and (C) Patients with pure herniated lumbar disc: 384 (20%). The rationale of the treatment for all these different pathologies we have taken into consideration is the biochemical mechanism by which they can engender pain and dysfunction. Treatment for group A: paravertebral injection and phleboclysis (two cycles of 6 sessions, one each 3 days) +endoscopic neurolysis. Treatment for group B: paravertebral injection and phleboclysis (two cycles of 6 sessions, one each 3 days) + endoscopic neurolysis with intradiscal procedure (named percutaneous peridurodiscolysis). Treatment for group C: paravertebral injection (two cycles of 6 sessions, one each 3 days) + percutaneous discolysis.The perceived quality of result for this minimally invasive procedure makes oxygen-ozone therapy an interesting weapon in the hands of doctors. Furthermore, if the technique loses its clinical effectiveness, it can be repeated without harm for the patient, and costs for the health organization are notably very low, above all if compared to surgical procedures.We underline the need that this treatment should be performed in protected structures, in operative rooms, under anesthesiologic control, and in the hands of specialists. PMID:21107949

  20. Memantine and donepezil: a fixed drug combination for the treatment of moderate to severe Alzheimer's dementia.

    PubMed

    Owen, R T

    2016-04-01

    Donepezil (and other cholinesterase inhibitors [ChEIs]) and memantine are the mainstays of treatment in Alzheimer's dementia, addressing respectively, the cholinergic and glutamatergic dysregulation which underlies or results from its pathophysiology. To alleviate the pill burden and swallowing difficulties associated with the condition, a fixed drug combination of extended-release memantine and donepezil was developed. This combination was shown to be both bioequivalent to the components administered separately and could be administered sprinkled over soft food. The mode of action, pharmacokinetics, clinical efficacy and safety and tolerability of the combination are discussed together with the wider, often conflicting trial literature of combination versus monotherapy with memantine and ChEIs, their meta-analyses and treatment guidelines. PMID:27252988

  1. Ipilimumab Combined with Nivolumab: A Standard of Care for the Treatment of Advanced Melanoma?

    PubMed

    Carlino, Matteo S; Long, Georgina V

    2016-08-15

    Ipilimumab, an inhibitor of CTLA-4 on T cells, was the first drug to improve overall survival in patients with advanced melanoma. Subsequently, inhibitors of PD-1, including nivolumab and pembrolizumab, were shown to be superior to ipilimumab with a more favorable safety profile. The combination of ipilimumab and nivolumab is associated with a further improvement in response rate and progression-free survival; however, the combination is associated with an increased rate of immune-related toxicities. In 2015, the FDA approved the combination for the treatment of BRAF wild-type advanced melanoma. This review examines the preclinical rationale for the combination of ipilimumab and nivolumab as well as the efficacy and toxicity data from clinical trials in patients with advanced melanoma. Finally, alternative treatment options are discussed with a focus on patient selection. Clin Cancer Res; 22(16); 3992-8. ©2016 AACR. PMID:27340279

  2. Elimination of Listeria monocytogenes in sausage meat by combination treatment: Radiation and radiation-resistant bacteriocins

    NASA Astrophysics Data System (ADS)

    Turgis, Mélanie; Stotz, Viviane; Dupont, Claude; Salmieri, Stéphane; Khan, Ruhul A.; Lacroix, Monique

    2012-08-01

    Two new bacteria were isolated from human feces and were designated MT 104 and MT 162. They were able to produce bacteriocins that are active against five strains of Listeria monocytogenes. Bacteriocins produced by these isolated strains had 100% and 82.35% residual activity when they were treated by gamma radiation at doses of 4 and 40 kGy, respectively. A reduction of 1.0, 1.5 and 3 log CFU/g of L. monocytogenes was observed in sausage meat when treated with bacteriocins from MT 104, MT 162, and nisin, respectively. For synergic effect, the D10 value in presence of the bacteriocins produced by MT 104 showed a 1.08 fold increased relative sensitivity of L. monocytogenes as compared to control after 5 days. The highest synergic effect was observed in presence of nisin which led to 1.61 fold increased relative sensitivity. Combined treatments with nisin and γ-irradiation showed a synergic antimicrobial effect in meat after 24 h and 5 days of storage. A synergic effect was observed only after 5 days at 4 °C for the bacteriocin from MT 104, as compared to the bacteriocin produced by MT 162 that had only an additive antimicrobial effect in all conditions.

  3. The advantages of topical combination therapy in the treatment of inflammatory dermatomycoses.

    PubMed

    Havlickova, Blanka; Friedrich, Markus

    2008-09-01

    Dermatomycoses are contagious superficial fungal infections, which are highly prevalent in developed and developing countries. Caused by a range of Epidermophyton, Microsporum and Trichophyton species, dermatomycoses manifest on glabrous skin as 'ringworm', an annular scaly lesion with a variable inflammatory component. Itch is the chief subjective symptom, particularly in tinea cruris. Unless lesions are extensive or resistant to local therapy, dermatomycoses of glabrous skin are treated with topical antifungal agents, such as imidazoles and allylamines. Studies show, however, that the addition of a topical corticosteroid to imidazole therapy increases the bioavailability and prolongs the activity of the antimycotic, while rapidly reducing inflammatory symptoms. Travocort is a combination of 1% isoconazole nitrate (ISN), a broad-spectrum imidazole with established antimicrobial activity and antimycotic efficacy, and 0.1% diflucortolone valerate (DFV), a potent topical corticosteroid with low systemic absorption and therefore a low risk of systemic glucocorticoid side-effects. In randomised, double-blind controlled clinical trials, Travocort therapy showed a more rapid onset of action, faster relief of itch and other inflammatory symptoms, improved overall therapeutic benefits and better mycological cure rate during the first 2 weeks of treatment compared with ISN monotherapy. Travocort is well tolerated and, because of prolonged ISN retention in the skin, provides antifungal protection against reinfection for some weeks after therapy. PMID:18783560

  4. Combined anticalcification treatment of bovine pericardium with decellularization and hyaluronic acid derivative.

    PubMed

    Zhu, Deyi; Jin, Liqiang; Wang, Xuemei; Xu, Li; Liu, Tianqi

    2014-01-01

    The objective of this work was to evaluate the effect of decellularization and hyaluronic acid derivative on the improvement of anticalcification of glutaraldehyde fixed bovine pericardium (GFBP) using a rat subcutaneous implantation model A cell extraction process was employed to remove the cells and cellular components from bovine pericardium (BP), leaving a framework of largely insoluble collagen. Then acellular BP was cross-linked by glutaraldehyde solution and treated with hyaluronic acid derivative (HA-ADH) which was obtained by coupling adipic dihydrazide (ADH) on-COOH of hyaluronic acid (HA). The results of in vivo calcification tests showed that the calcium content was decreased dramatically by decellularization alone (from 28.07 ± 18.87 to 2.44 ± 0.55 μg Ca/mg dry tissue after 8 weeks' implantation), and even less concentration was shown by the combination of HA derivative treatment and decellularization (GFaBP-HA group) (0.25 ± 0.08 μg Ca/mg dry tissue after 8 weeks' implantation). In addition, GFaBP-HA group not only presented a lower degree of calcification, but also showed lower ratios of Ca/P molar, which corresponded to amorphous calcium phosphates. The obtained results indicated that GFaBP-HA was a potential candidate for the manufacture of anticalcification bioprostheses. PMID:24211959

  5. Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

    ERIC Educational Resources Information Center

    Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.

    2010-01-01

    This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…

  6. Treatment of sugarcane vinasse by combination of coagulation/flocculation and Fenton's oxidation.

    PubMed

    Guerreiro, Lígia F; Rodrigues, Carmen S D; Duda, Rose M; de Oliveira, Roberto A; Boaventura, Rui A R; Madeira, Luis M

    2016-10-01

    The efficiency of individual and integrated processes applied to organic matter reduction and biodegradability improvement of a biodigested sugarcane vinasse wastewater was assessed. Strategies considered were Fenton's oxidation (Strategy 1), coagulation/flocculation (Strategy 2) and the combination of both processes (coagulation/flocculation followed by Fenton's reaction) - Strategy 3. It was found that Fenton's oxidation per se allowed reducing the organic matter, increasing the wastewater biodegradability and a non-toxic effluent was generated; however the cost of treatment was very high (86.6 R$/m(3) - 21.2 €/m(3)). Under optimized conditions, coagulation/flocculation provided a slight increase in effluent's biodegradability, toxicity towards Vibrio fischeri was also eliminated and moderate removals of total organic carbon - TOC - (30.5%), biological oxygen demand - BOD5 - (27.9%) and chemical oxygen demand - COD - (43.6%) were achieved; however, the operating costs are much smaller. The use of dissolved iron resulting from coagulation/flocculation (270 mg/L) as catalyst in the second stage - Fenton's oxidation - was shown to be an innovative and economically attractive strategy. Under optimal conditions overall removals of 51.6% for TOC, 45.7% for BOD5 and 69.2% for COD were achieved, and a biodegradable (BOD5:COD ratio = 0.54) and non-toxic effluent was obtained. In order to increase the efficiency of the process but using less hydrogen peroxide, the Fenton's oxidation was performed by gradually adding the oxidant. This procedure allowed to obtain the highest organic matter removal efficiency (as compared with the addition of all hydrogen peroxide at the beginning of the reaction). This way it was possible to minimize the reagent consumption and, consequently, reduce the treatment cost. PMID:27353374

  7. Disinfection of herbal spa pool using combined chlorine dioxide and sodium hypochlorite treatment.

    PubMed

    Hsu, Ching-Shan; Huang, Da-Ji

    2015-02-01

    The presence of pathogenic microorganisms in public spa pools poses a serious threat to human health. The problem is particularly acute in herbal spas, in which the herbs and microorganisms may interact and produce undesirable consequences. Accordingly, the present study investigated the effectiveness of a combined disinfectant containing chlorine dioxide and sodium hypochlorite in improving the water quality of a public herbal spa in Taiwan. Water samples were collected from the spa pool and laboratory tests were then performed to measure the variation over time of the microorganism content (total CFU and total coliforms) and residual disinfectant content given a single disinfection mode (SDM) with disinfectant concentrations of 5.2 × 10, 6.29 × 10, 7.4 × 10, and 11.4 × 10(-5) N, respectively. Utilizing the experience gained from the laboratory tests, a further series of on-site investigations was performed using three different disinfection modes, namely SDM, 3DM (once every 3 h disinfection mode), and 2DM (once every 2 h disinfection mode). The laboratory results showed that for all four disinfectant concentrations, the CFU concentration reduced for the first 6 h following SDM treatment, but then increased. Moreover, the ANOVA results showed that the sample treated with the highest disinfectant concentration (11.4 × 10(-5) N) exhibited the lowest rate of increase in the CFU concentration. In addition, the on-site test results showed that 3DM and 2DM treatments with disinfectant concentrations in excess of 9.3 × 10 and 5.5 × 10(-5) N, respectively, provided an effective reduction in the total CFU concentration. In conclusion, the experimental results presented in this study provide a useful source of reference for spa businesses seeking to improve the water quality of their spa pools. PMID:25632897

  8. Combined treatment by octreotide and everolimus: Octreotide enhances inhibitory effect of everolimus in aggressive meningiomas.

    PubMed

    Graillon, Thomas; Defilles, Céline; Mohamed, Amira; Lisbonis, Christophe; Germanetti, Anne-Laure; Chinot, Olivier; Figarella-Branger, Dominique; Roche, Pierre-Hugues; Adetchessi, Tarek; Fuentes, Stéphane; Metellus, Philippe; Dufour, Henry; Enjalbert, Alain; Barlier, Anne

    2015-08-01

    Treatment for recurrent and aggressive meningiomas remains an unmet medical need in neuro-oncology, and chemotherapy exhibits limited clinical activity, if any. Merlin expression, encoded by the NF2 gene, is lost in a majority of meningiomas, and merlin is a negative regulator of mTORC1. The sst2 somatostatin receptor, targeted by octreotide, is highly expressed in meningiomas. To investigate new therapeutic strategies, we evaluated the activity of everolimus (mTOR inhibitor), BKM-120 and BEZ-235 (new Pi3K/Akt/mTOR inhibitors), octreotide and a combined treatment (octreotide plus everolimus), on cell proliferation, signaling pathways, and cell cycle proteins, respectively. The in vitro study was conducted on human meningioma primary cells extracted from fresh tumors, allowing the assessment of somatostatin analogs at the concentration levels used in patients. The results were correlated to WHO grades. Further, everolimus decreased cell viability of human meningiomas, but concomitantly, induced Akt activation, reducing the antiproliferative effect of the drug. The new Pi3K inhibitors were not more active than everolimus alone, limiting their clinical relevance. In contrast, a clear cooperative inhibitory effect of octreotide and everolimus was observed on cell proliferation in all tested meningiomas, including WHO grades II-III. Octreotide not only reversed everolimus-induced Akt phosphorylation but also displayed additive and complementary effects with everolimus on downstream proteins involved in translation (4EB-P1), and controlling cell cycle (p27Kip1 and cyclin D1). We have demonstrated a co-operative action between everolimus and octreotide on cell proliferation in human meningiomas, including aggressive ones, establishing the basis for a clinical trial. PMID:26015296

  9. Intensification of degradation of methomyl (carbamate group pesticide) by using the combination of ultrasonic cavitation and process intensifying additives.

    PubMed

    Raut-Jadhav, Sunita; Pinjari, Dipak V; Saini, Daulat R; Sonawane, Shirish H; Pandit, Aniruddha B

    2016-07-01

    In the present work, the degradation of methomyl has been carried out by using the ultrasound cavitation (US) and its combination with H2O2, Fenton and photo-Fenton process. The study of effect of operating pH and ultrasound power density has indicated that maximum extent of degradation of 28.57% could be obtained at the optimal pH of 2.5 and power density of 0.155 W/mL. Application of US in combination with H2O2, Fenton and photo-Fenton process has further accelerated the rate of degradation of methomyl with complete degradation of methomyl in 27 min, 18 min and 9 min respectively. Mineralization study has proved that a combination of US and photo-Fenton process is the most effective process with maximum extent of mineralization of 78.8%. Comparison of energy efficiency and cost effectiveness of various processes has indicated that the electrical cost of 79892.34Rs./m(3) for ultrasonic degradation of methomyl has drastically reduced to 2277.00Rs./m(3), 1518.00Rs./m(3) and 807.58Rs./m(3) by using US in combination with H2O2, Fenton and photo-Fenton process respectively. The cost analysis has also indicated that the combination of US and photo-Fenton process is the most energy efficient and cost effective process. PMID:26964933

  10. [Combination chemotherapy with VP-16 in the treatment of lung cancer and malignant lymphoma].

    PubMed

    Hosomi, Y; Shibuya, M

    2001-10-01

    Many investigators have reported the dose and schedule of VP-16 administration, but as yet they remain undetermined. VP-16 is one of the most active agents for several carcinomas and usually administered intravenously over 3 to 5 consecutive days in combination with other agents. Although, the development of new drugs recently reduces the use of VP-16 administration, VP-16 is still an important drug for the treatment of lung cancer and malignant lymphoma. In this paper, the combination therapy with VP-16, especially in the treatment of lung cancer and malignant lymphoma, are reviewed. PMID:11681241

  11. Combined approach to hepatocellular carcinoma: a new treatment concept for nonresectable disease.

    PubMed

    Strebel, Bruno M; Dufour, Jean-François

    2008-11-01

    Depending on tumor burden, hepatic function and patients' performance status, hepatocellular carcinoma is treated by surgery, local procedures, systemic therapy or palliation. The majority of patients are diagnosed at a stage where local therapy is the treatment of choice. Recently, the multikinase inhibitor sorafenib was found to improve the survival of patients with advanced hepatocellular carcinoma and conserved liver function. In this manuscript, we summarize the experimental evidence supporting the combination of a systemic targeted therapy with a local therapy. We also discuss the pros and cons of different schedules of combining such treatments. We conclude that there is enough of a theoretical argument to design clinical trials testing this strategy. PMID:18983234

  12. Gender Differences in Alcohol Treatment: An Analysis of Outcome from the COMBINE Study

    PubMed Central

    Greenfield, Shelly F.; Pettinati, Helen M.; O’Malley, Stephanie; Randall, Patrick K.; Randall, Carrie L.

    2010-01-01

    Background Relatively few studies have examined gender differences in the effectiveness of specific behavioral or pharmacologic treatment of alcohol dependence. The aim of this study is to assess whether there were gender differences in treatment outcomes for specific behavioral and medication treatments singly or in combination by conducting a secondary analysis of public access data from the national, multi-site NIAAA-sponsored COMBINE study. Methods The COMBINE study investigated alcohol treatment among eight groups of patients (378 women, 848 men) who received Medical Management with 16 weeks of placebo, naltrexone (100mg/day), acamprosate (3 grams/day), or their combination with or without a specialist-delivered Combined Behavioral Intervention. We examined efficacy measures separately for men and women, followed by an overall analysis that included gender and its interaction with treatment condition in the analyses. These analyses were done to confirm whether the findings reported in the parent trial were also relevant to women, and to more closely examine secondary outcome variables that were not analyzed previously for gender effects. Results Compared to men, women reported a later age of onset of alcohol dependence by approximately 3 years, were significantly less likely to have had previous alcohol treatment; and drank fewer drinks per drinking day. Otherwise, there were no baseline gender differences in drinking measures. Outcome analyses of two primary (percent days abstinent and time to first heavy drinking day) and two secondary (good clinical response and percent heavy drinking days) drinking measures yielded the same overall pattern in each gender as that observed in the parent COMBINE study report. That is, only the naltrexone by behavioral intervention interaction reached or approached significance in women as well as in men. There was a naltrexone main effect that was significant in both men and women in reduction in alcohol craving scores with

  13. Rational therapeutic combinations with histone deacetylase inhibitors for the treatment of cancer

    PubMed Central

    Thurn, K Ted; Thomas, Scott; Moore, Amy; Munster, Pamela N

    2011-01-01

    Histone deacetylases (HDACs) regulate the acetylation of a variety of histone and nonhistone proteins, controlling the transcription and regulation of genes involved in cell cycle control, proliferation, survival, DNA repair and differentiation. Unsurprisingly, HDAC expression is frequently altered in hematologic and solid tumor malignancies. Two HDAC inhibitors (vorinostat and romidepsin) have been approved by the US FDA for the treatment of cutaneous T-cell lymphoma. As single agents, treatment with HDAC inhibitors has demonstrated limited clinical benefit for patients with solid tumors, prompting the investigation of novel treatment combinations with other cancer therapeutics. In this article, the rationales and clinical progress of several combinations with HDAC inhibitors are presented, including DNA-damaging chemotherapeutic agents, radiotherapy, hormonal therapies, DNA methyltransferase inhibitors and various small-molecule inhibitors. The future application of HDAC inhibitors as a treatment for cancer is discussed, examining current hurdles to overcome before realizing the potential of this new approach. PMID:21345145

  14. Behavioral Weight Control Treatment Combined with Supervised Exercise or Peer Enhanced Adventure for Overweight Adolescents

    PubMed Central

    Jelalian, Elissa; Lloyd-Richardson, Elizabeth E.; Mehlenbeck, Robyn S.; Hart, Chantelle N.; Flynn-O’Brien, Katherine; Kaplan, Jamie; Neill, Meghan; Wing, Rena R.

    2010-01-01

    Objectives To evaluate the efficacy of behavioral weight control intervention combined with a peer-enhanced activity intervention versus structured aerobic exercise in decreasing BMI and z-BMI in overweight adolescents. Study design Participants were randomized to one of two group-based treatment conditions: 1) cognitive behavioral treatment combined with peer enhanced adventure therapy (CBT+PEAT) or 2) cognitive behavioral weight control treatment combined with supervised aerobic exercise (CBT+EXER). Participants included 118 overweight adolescents, ages 13 – 16 years, and a primary caregiver. Changes in body mass index (BMI), standardized BMI, percent over BMI, and waist circumference were examined. Results Analysis of variance based on intent to treat (ITT) indicated significant decreases in all weight change outcomes at end of treatment, with significant decreases maintained at 12-month follow-up. No differences between treatment conditions were observed. Secondary analyses indicated that adherence with attendance and completion of weekly diet records contributed significantly to reductions in BMI. Conclusions A cognitive behavioral weight control intervention combined with supervised aerobic exercise or peer-enhanced adventure therapy is equally effective in short-term reduction of BMI and z-BMI among overweight adolescents. Adherence, as measured by session attendance and self-monitoring, is a key dimension of weight change. PMID:20655544

  15. Combined soil treatments and sequence of application in improving the control of soilborne pathogens.

    PubMed

    Eshel, D; Gamliel, A; Grinstein, A; Di Primo, P; Katan, J

    2000-07-01

    ABSTRACT The effects of reduced doses of methyl bromide (MB) or metham sodium, heating, short solarization, and soil microbial activity, alone or in combination, on survival of soilborne fungal pathogens were tested in a controlled-environment system and field plots. Sublethal doses of heating or MB delayed germination of Sclerotium rolfsii sclerotia. Combining MB and heating treatments was more effective than either treatment alone in controlling S. rolfsii and Fusarium oxysporum f. sp. basilici. The application heating followed by fumigation with MB, was significantly more effective in delaying and reducing germination of S. rolfsii sclerotia and in controlling F. oxysporum f. sp. basilici than the opposite sequence. Further, incubation in soil and exposure to microbial activity of previously heated or MB-treated sclerotia increased the mortality rate, indicating a weakening effect. Similarly, incubation of chlamydospores of F. oxysporum f. sp. melonis and F. oxysporum f. sp. radicis-lycopersici in soil in the field after fumigation further reduced their survival, confirming the laboratory results. In field tests, combining MB or metham sodium at reduced doses with short solarization was more effective in controlling fungal pathogens than either treatment alone. Treatment sequence significantly affected pathogen control in the field, similar to its effect under controlled conditions. This study demonstrates a frequent synergistic effect of combining soil treatments and its potential for improving pathogen control and reducing pesticide dose, especially when an appropriate sequence was followed. PMID:18944494

  16. A new sensitizer DVDMS combined with multiple focused ultrasound treatments: an effective antitumor strategy

    PubMed Central

    Xiong, Wenli; Wang, Pan; Hu, Jianmin; Jia, Yali; Wu, Lijie; Chen, Xiyang; Liu, Quanhong; Wang, Xiaobing

    2015-01-01

    Sonodynamic therapy (SDT) was developed as a promising noninvasive approach. The present study investigated the antitumor effect of a new sensitizer (sinoporphyrin sodium, referred to as DVDMS) combined with multiple ultrasound treatments on sarcoma 180 both in vitro and in vivo. The combined treatment significantly suppressed cell viability, potentiated apoptosis, and markedly inhibited angiogenesis in vivo. In vivo, the tumor weight inhibition ratio reached 89.82% fifteen days after three sonication treatments plus DVDMS. This effect was stronger than one ultrasound alone (32.56%) and than one round of sonication plus DVDMS (59.33%). DVDMS combined with multiple focused ultrasound treatments initiated tumor tissue destruction, induced cancer cell apoptosis, inhibited tumor angiogenesis, suppressed cancer cell proliferation, and decreased VEGF and PCNA expression levels. Moreover, the treatment did not show obvious signs of side effects or induce a drop in body weight. These results indicated that DVDMS combined with multiple focused ultrasounds may be a promising strategy against solid tumor. PMID:26631871

  17. Effects of melatonin and dexpanthenol on antioxidant parameters when combined with estrogen treatment in ovariectomized rats.

    PubMed

    Turgut, Ozan; Ay, Aybala Agac; Turgut, Hulya; Ay, Ahmet; Kafkas, Samet; Dost, Turhan

    2013-12-01

    The purpose of the study was to assess whether it is possible to reduce the oxidative damage using antioxidant agents combined with hormone replacement therapy after menopause. In this prospective experimental study, 50 mature female Wistar albino rats weighing 270-310 g were used. Rats were divided into the following six groups: (1) Ovx group (n = 7): the animals underwent bilateral ovariectomy. No drug was administered following bilateral ovariectomy. (2) Ovx + E 2 group (n = 7): bilateral ovariectomy + 17β-estradiol (100 μg/kg/day); (3) Ovx + E 2 + MT5 group (n = 7): bilateral ovariectomy + 17β-estradiol (100 μg/kg/day) + melatonin (5 mg/kg/day); (4) Ovx + E 2 + MT20 group (n = 7): bilateral ovariectomy + 17β-estradiol (100 μg/kg/day) + melatonin (20 mg/kg/day); (5) Ovx + E 2 + Dxp250 group (n = 7): bilateral ovariectomy + 17β-estradiol (100 μg/kg/day) + dexpanthenol (250 mg/kg/day); (6) Ovx + E 2 + Dxp500 group (n = 7): bilateral ovariectomy + 17β-estradiol (100 μg/kg/day) + dexpanthenol (500 mg/kg/day), and the activity of these antioxidative enzymes and oxidative stress products were measured. Enzymatic activity levels of catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase(GSH-Px), and glutathione reductase and levels of free radicals (malondialdehyde (MDA) and nitric oxide) were both analyzed. We observed an increase in the level of GSH activity, but no significant differences in levels of CAT, SOD, and GSH-Px enzymatic activity and in levels of free radical MDA following 17β-estradiol or additional antioxidant treatment (melatonin or dexpanthenol). Despite the present study indicating that the addition of melatonin and dexpanthenol into the hormone replacement therapy regimen may contribute to the antioxidant effect of estrogen, the existence of limited data in this field indicates that further studies are warranted. PMID:23471492

  18. Work productivity among treatment-naïve patients with genotype 1 chronic hepatitis C infection receiving telaprevir combination treatment.

    PubMed

    Aggarwal, J; Vera-Llonch, M; Donepudi, M; Suthoff, E; Younossi, Z; Goss, T F

    2015-01-01

    Work productivity is impacted in hepatitis C virus (HCV)-infected patients and has been linked to treatment. In two Phase 3 trials, ADVANCE and ILLUMINATE, treatment-naïve genotype 1 chronic HCV-infected patients received 12-week telaprevir (T) with 24 (T12PR24)- or 48 (T12PR48)-week peginterferon alfa-2a/ribavirin. The objective of this analysis was to examine the impact of chronic HCV infection and its treatment with combination therapy on work productivity. The 5-item, self-reported work productivity questionnaire (WPQ) was administered in Phase 3 trials to assess unemployment status, days unable to work due to HCV/treatment, reduced hours worked and impact on productivity in prior 4 weeks. Descriptive statistics and multivariate regression analyses were employed in analyses of pooled trial data. About 1147 patients were included; 22% (n = 255) were unemployed at baseline, with 8% being unemployed due to health reasons. At week 12, there were no differences by treatment regimen in the number of days unable to work. At week 48, improvements were observed earlier among patients receiving the shorter duration of T combination treatment. Mean (95% CI) change from baseline in days unable to work was -0.48 (-0.85, -0.11) days for T12PR24, 1.43 (0.63, 2.24) days for T12PR48 and 1.24 (0.18, 2.30) days for PR48 with placebo. Predictors of days unable to work were identified and include demographic characteristics, pretreatment and on-treatment levels of fatigue, as well regional variation. In post hoc analyses of the ADVANCE and ILLUMINATE trials, work productivity decreased during the initial 12 weeks regardless of treatment group. PMID:24528927

  19. New combined antifriction treatment of the guides of machines and mechanisms

    NASA Astrophysics Data System (ADS)

    Bishutin, S. G.

    2016-04-01

    The technology description of the combined antifriction treatment, including three stages, is presented. These stages are the following: abrasive rough-down for surface preparation to coating with antifriction material; surface rubbing with antifriction material; surface plastic deformation of the processed surface area. These stages are executed with one instrument. The article presents the technological modes of this treatment allowing the formation of wear resistant surface layers of guides of machines and mechanisms.

  20. UASB Treatment of Methanolic Pulp Wastewater with Addition of Waste Starch and Incinerated Ash

    NASA Astrophysics Data System (ADS)

    Takahashi, Shintaro; Kobaysashi, Takuro; Li, Yu-You; Harada, Hideki

    The pulp wastewater consists mainly of methanol. It is expected to treat using upflow anaerobic sludge blanket (UASB) process. Paper manufactories also produce waste starch and incinerated ash. The integrated treating for these wastes is desirable. In this study, two UASB reactors were operated to treat pulp wastewater with addition of waste starch and with addition of incinerated ash, receptively. Continuous operations of a UASB reactor treating pulp wastewater with addition of waste starch (PS reactor) and a UASB reactor treating pulp wastewater with addition of incinerated ash (PA reactor) , were investigated at mesophilic conditions. The PS reactor performed well with an average 93.7% total CODCr and 97.3% soluble CODCr removal efficiency in average at a maximum volumetric loading rate (VLR) of 16.0 kgCOD/m3/d. The PA reactor was also successfully operated with an average 95.3% total CODCr and 97.5% soluble CODCr removal efficiency in average at a maximum VLR of 14.6 kgCOD/m3/d. Successfully developed granules were obtained after over 140 days of operation in both reactors, and the granules were 1 to 2 mm in mean diameter. Microbial analysis revealed the genus Methanomethylovorans was predominant in the granules of both reactors.

  1. Hydrothermal treatment of incineration fly ash for PCDD/Fs decomposition: the effect of iron addition.

    PubMed

    Chen, De-Zhen; Hu, Yu-Yan; Zhang, Peng-Fei

    2012-12-01

    The catalytic effect of Fe addition on the decomposition of polychlorinated dibenzo-dioxins and polychlorinated dibenzofurans (PCDD/Fs) contained in municipal solid waste incineration (MSWI) fly ash during the hydrothermal process was investigated. Influencing factors, such as Fe addition mode, reaction time and cooling procedure after reaction, were tested to evaluate their effects. Experimental results indicated that Fe addition in the form of a mixture of ferrous sulphate and ferric sulphate enhanced decomposition of PCDD/Fs contained in the MSWI fly ash, particularly for the decomposition of 2,3,7,8-tetrachlorodibenzo-dioxin and 2,3,7,8-tetrachlorodibenzo-furan under the reaction temperature of 563 K. The decomposition rate of PCDD/Fs reached 90.33% by international toxicity equivalent (I-TEQ) when Fe was added as a mixture of ferrous and ferric sulphates by 5% (wt/wt) with the Fe (III)/Fe (II) ratio being 2; without Fe addition, the decomposition rate of PCDD/Fs was only 46.17% by I-TEQ in the same process. Fe addition in the form of ferrous sulphate alone also showed an enhancing effect on PCDD/Fs decomposition, but the associated decomposition rates were relatively lower, suggesting iron oxides formed from the mixture of ferric and ferrous sulphates are more favourable catalysts. At the same time, the cooling procedure after the hydrothermal reaction became more flexible if Fe was added in the form of a mixture of ferric and ferrous sulphates. Although a longer reaction time was helpful to increase decomposition rates of PCDD/Fs, 1 h was proved to be a reasonable time under this condition. PMID:23437649

  2. Is There an Additional Value of Inpatient Treatment for Patients with Atopic Dermatitis?

    PubMed

    van der Schaft, Jorien; Keijzer, Welmoed W; Sanders, Koos J G; de Groot, Jette J C; van den Bersselaar, Donna L C M; van Os-Medendorp, Harmieke; van Doorn-Op den Akker, Margreet M; Bruijnzeel-Koomen, Carla A F M; de Bruin-Weller, Marjolein S

    2016-08-23

    An inpatient treatment and education programme has been developed for patients with difficult to control atopic dermatitis (AD), with the aim of achieving adequate self-management and long-term disease control. This observational study included adult patients diagnosed with difficult to control AD, admitted for a structured inpatient treatment and education programme. The primary outcome was the Six Area, Six Sign Atopic Dermatitis (SASSAD) score. In total, 79 patients (mean ± SD age 38.8 ± 17.1 years) were included. The median duration of hospitalization was 11 days (interquartile range 8-14). The mean percentage decrease in SASSAD score between admission and discharge was 60.7%, of which 64 (81.0%) patients achieved SASSAD50. The mean percentage decrease in SASSAD score was 69.0% during follow-up, of which 63 (79.7%) patients still had a SASSAD50. In the majority of these patients with difficult to control AD the admission resulted in sustained disease control. This could be achieved by optimization of treatment with topical corticosteroids. PMID:26983375

  3. Combined psychoeducation and treatment with selective serotonin reuptake inhibitors for youth with generalized social anxiety disorder.

    PubMed

    Chavira, Denise A; Stein, Murray B

    2002-01-01

    Treatment outcome data for childhood social anxiety are scant. Studies that do exist support the efficacy of both pharmacological and psychotherapeutic interventions. Aside from case reports, studies assessing the efficacy of combined treatment approaches are even more limited. In the current study, we present preliminary findings from a combined psychoeducational and pharmacological treatment program for children and adolescents (ages 8-17 years) with generalized social anxiety disorder. Twelve participants received 12 weeks of citalopram treatment (maximum dose 40 mg/day) and eight brief counseling sessions (15 minutes each). Counseling sessions included education about social anxiety, skills coaching, and behavioral exercises; parents were included in these sessions. Based on clinician global ratings of change, 10 of 12 (83.3%) youths reported improvement: 41.7% (n = 5) of the participants were very much improved, and 41.7% (n = 5) were much improved. Significant changes were also found on self-report ratings of social anxiety, depression, and parents' perceptions of children's social skills during the course of treatment. Findings support the need for double-blind, placebo-controlled studies of combined treatments for youth with generalized social anxiety disorder. PMID:12014595

  4. Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety

    PubMed Central

    YANG, LI-JUAN; ZHU, DONG-NING; DANG, YAN-LING; ZHAO, XIONG

    2016-01-01

    Patients with condyloma acuminata (CA) during pregnancy represent a special risk group. The outcomes of many treatment methods for such cases are not satisfactory. The purpose of the present study was to evaluate the treatment outcome and safety of cryotherapy combined with proanthocyanidins (PCs) for CA in pregnant women. In this study, 46 pregnant women with CA were treated with cryotherapy combined with PCs. The lesions were sprayed with liquid nitrogen until the color of the wart changed from flesh colored to purple. A PC-containing formulation was then sprayed onto a non-woven fabric or single-layer gauze and applied to the affected area. The PC treatment was applied for 20 min, 2 or 3 times per day. All patients were followed up at 1 and 3 months. No visible warts remained after the cryotherapy and PC treatment. At the 1-month follow-up, only 1 case of recurrence was identified. At 3 months, 5 cases of recurrence were identified, and the recurrence rate was 10.9%. The satisfaction rate of the patients was 94% at 1 month and 87% at 3 months after treatment. All pregnancies resulted in healthy live births without delivery complications. Cryotherapy combined with PCs is indicated to be a safe and effective procedure and may serve as a treatment option for pregnant women with CA. PMID:27284325

  5. Fostering First Graders' Fluency with Basic Subtraction and Larger Addition Combinations via Computer-Assisted Instruction

    ERIC Educational Resources Information Center

    Baroody, Arthur J.; Purpura, David J.; Eiland, Michael D.; Reid, Erin E.

    2014-01-01

    Achieving fluency with basic subtraction and add-with-8 or -9 combinations is difficult for primary grade children. A 9-month training experiment entailed evaluating the efficacy of software designed to promote such fluency via guided learning of reasoning strategies. Seventy-five eligible first graders were randomly assigned to one of three…

  6. Combined Treatment with Morphine and Δ9-Tetrahydrocannabinol in Rhesus Monkeys: Antinociceptive Tolerance and Withdrawal.

    PubMed

    Gerak, L R; France, C P

    2016-05-01

    Opioid receptor agonists are effective for treating pain; however, tolerance and dependence can develop with repeated use. Combining opioids with cannabinoids can enhance their analgesic potency, although it is less clear whether combined treatment alters opioid tolerance and dependence. In this study, four monkeys received 3.2 mg/kg morphine alone or in combination with 1 mg/kg Δ(9)-tetrahydrocannabinol (THC) twice daily; the antinociceptive effects (warm water tail withdrawal) of morphine, the cannabinoid receptor agonists WIN 55,212 [(R)-(1)-[2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]-1,4-benzoxazin-6-yl]-1-naphthalenylmethanone mesylate] and CP 55,940 (2-[(1R,2R,5R)-5-hydroxy-2-(3-hydroxypropyl) cyclohexyl]-5-(2-methyloctan-2-yl)phenol), and the κ opioid receptor agonist U-50,488 (trans-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)-cyclohexyl]benzenacetamide methanesulfonate) were examined before, during, and after treatment. To determine whether concurrent THC treatment altered morphine dependence, behavioral signs indicative of withdrawal were monitored when treatment was discontinued. Before treatment, each drug increased tail withdrawal latency to 20 seconds (maximum possible effect). During treatment, latencies did not reach 20 seconds for morphine or the cannabinoids up to doses 3- to 10-fold larger than those that were fully effective before treatment. Rightward and downward shifts in antinociceptive dose-effect curves were greater for monkeys receiving the morphine/THC combination than monkeys receiving morphine alone. When treatment was discontinued, heart rate and directly observable withdrawal signs increased, although they were generally similar in monkeys that received morphine alone or with THC. These results demonstrated that antinociceptive tolerance was greater during treatment with the combination, and although treatment conditions were sufficient to result in the development of dependence on morphine, withdrawal was not

  7. Rapid optimization of drug combinations for the optimal angiostatic treatment of cancer.

    PubMed

    Weiss, Andrea; Ding, Xianting; van Beijnum, Judy R; Wong, Ieong; Wong, Tse J; Berndsen, Robert H; Dormond, Olivier; Dallinga, Marchien; Shen, Li; Schlingemann, Reinier O; Pili, Roberto; Ho, Chih-Ming; Dyson, Paul J; van den Bergh, Hubert; Griffioen, Arjan W; Nowak-Sliwinska, Patrycja

    2015-07-01

    Drug combinations can improve angiostatic cancer treatment efficacy and enable the reduction of side effects and drug resistance. Combining drugs is non-trivial due to the high number of possibilities. We applied a feedback system control (FSC) technique with a population-based stochastic search algorithm to navigate through the large parametric space of nine angiostatic drugs at four concentrations to identify optimal low-dose drug combinations. This implied an iterative approach of in vitro testing of endothelial cell viability and algorithm-based analysis. The optimal synergistic drug combination, containing erlotinib, BEZ-235 and RAPTA-C, was reached in a small number of iterations. Final drug combinations showed enhanced endothelial cell specificity and synergistically inhibited proliferation (p < 0.001), but not migration of endothelial cells, and forced enhanced numbers of endothelial cells to undergo apoptosis (p < 0.01). Successful translation of this drug combination was achieved in two preclinical in vivo tumor models. Tumor growth was inhibited synergistically and significantly (p < 0.05 and p < 0.01, respectively) using reduced drug doses as compared to optimal single-drug concentrations. At the applied conditions, single-drug monotherapies had no or negligible activity in these models. We suggest that FSC can be used for rapid identification of effective, reduced dose, multi-drug combinations for the treatment of cancer and other diseases. PMID:25824484

  8. Radiobiological Optimization of Combination Radiopharmaceutical Therapy Applied to Myeloablative Treatment of Non-Hodgkin’s Lymphoma

    PubMed Central

    Hobbs, Robert F; Wahl, Richard L; Frey, Eric C; Kasamon, Yvette; Song, Hong; Huang, Peng; Jones, Richard J; Sgouros, George

    2014-01-01

    Combination treatment is a hallmark of cancer therapy. Although the rationale for combination radiopharmaceutical therapy was described in the mid ‘90s, such treatment strategies have only been implemented clinically recently, and without a rigorous methodology for treatment optimization. Radiobiological and quantitative imaging-based dosimetry tools are now available that enable rational implementation of combined targeted radiopharmaceutical therapy. Optimal implementation should simultaneously account for radiobiological normal organ tolerance while optimizing the ratio of two different radiopharmaceuticals required to maximize tumor control. We have developed such a methodology and applied it to hypothetical myeloablative treatment of non-hodgkin’s lymphoma (NHL) patients using 131I-tositumomab and 90Y-ibritumomab tiuxetan. Methods The range of potential administered activities (AA) is limited by the normal organ maximum tolerated biologic effective doses (MTBEDs) arising from the combined radiopharmaceuticals. Dose limiting normal organs are expected to be the lungs for 131I-tositumomab and the liver for 90Y-ibritumomab tiuxetan in myeloablative NHL treatment regimens. By plotting the limiting normal organ constraints as a function of the AAs and calculating tumor biological effective dose (BED) along the normal organ MTBED limits, the optimal combination of activities is obtained. The model was tested using previously acquired patient normal organ and tumor kinetic data and MTBED values taken from the literature. Results The average AA values based solely on normal organ constraints was (19.0 ± 8.2) GBq with a range of 3.9 – 36.9 GBq for 131I-tositumomab, and (2.77 ± 1.64) GBq with a range of 0.42 – 7.54 GBq for 90Y-ibritumomab tiuxetan. Tumor BED optimization results were calculated and plotted as a function of AA for 5 different cases, established using patient normal organ kinetics for the two radiopharmaceuticals. Results included AA ranges

  9. Efficacy of combined antiangiogenic and vascular disrupting agents in treatment of solid tumors

    SciTech Connect

    Siemann, Dietmar W. . E-mail: siemadw@ufl.edu; Shi Wenyin

    2004-11-15

    Purpose: To evaluate the antitumor efficacy of a vascular targeting strategy that combines an agent that disrupts established tumor blood vessels (ZD6126) with one that interferes with new vessel formation (ZD6474) in models of human renal cell carcinoma (Caki-1) and Kaposi's sarcoma (KSY-1). Methods and materials: Caki-1 and KSY-1 xenograft-bearing nude mice were treated with ZD6126 and ZD6474 either as single agents or in combination when the tumors reached a size of {approx}200 mm{sup 3}. ZD6126 therapy consisted of three doses of 100 mg/kg administered 1, 3, and 5 days after the tumor reached the starting size. ZD6474 was administered daily (25 mg/kg) on Days 1-5. In the combination studies, ZD6474 treatment began immediately after the first dose of ZD6126. The tumor response to treatment was evaluated using a regrowth delay endpoint. Results: Significant tumor growth delays were observed in both tumor models with either agent with the treatment regimen used. In the Caki-1 and KSY-1 models, respectively, ZD6126 treatment resulted in a tumor growth delay of 23 and 26 days and ZD6474 produced a tumor growth delay of 24.5 and 14.5 days. When ZD6126 and ZD6474 were combined, the tumor growth delays increased to 55 (Caki-1) and 86 (KSY-1) days. In the KSY-1 model, the combination therapy also resulted in 3 of 8 long-term tumor-free survivors. Conclusion: These results indicate that statistically significant antitumor efficacy can be achieved using a treatment strategy that combines a therapy that targets the established tumor blood vessels with one that interferes with the process of angiogenesis.

  10. Combined local and systemic bleomycin administration in electrochemotherapy to reduce the number of treatment sessions

    PubMed Central

    Tellado, Matias; Olaiz, Nahuel; Michinski, Sebastian; Marshall, Guillermo

    2016-01-01

    Background Electrochemotherapy (ECT), a medical treatment widely used in human patients for tumor treatment, increases bleomycin toxicity by 1000 fold in the treated area with an objective response rate of around 80%. Despite its high response rate, there are still 20% of cases in which the patients are not responding. This could be ascribed to the fact that bleomycin, when administered systemically, is not reaching the whole tumor mass properly because of the characteristics of tumor vascularization, in which case local administration could cover areas that are unreachable by systemic administration. Patients and methods We propose combined bleomycin administration, both systemic and local, using companion animals as models. We selected 22 canine patients which failed to achieve a complete response after an ECT treatment session. Eleven underwent another standard ECT session (control group), while 11 received a combined local and systemic administration of bleomycin in the second treatment session. Results According to the WHO criteria, the response rates in the combined administration group were: complete response (CR) 54% (6), partial response (PR) 36% (4), stable disease (SD) 10% (1). In the control group, these were: CR 0% (0), PR 19% (2), SD 63% (7), progressive disease (PD) 18% (2). In the combined group 91% objective responses (CR+PR) were obtained. In the control group 19% objective responses were obtained. The difference in the response rate between the treatment groups was significant (p < 0.01). Conclusions Combined local and systemic bleomycin administration was effective in previously to ECT non responding canine patients. The results indicate that this approach could be useful and effective in specific population of patients and reduce the number of treatment sessions needed to obtain an objective response. PMID:27069450

  11. Sex differences in reinstatement of cocaine-seeking with combination treatments of progesterone and atomoxetine.

    PubMed

    Swalve, Natashia; Smethells, John R; Zlebnik, Natalie E; Carroll, Marilyn E

    2016-06-01

    Two repurposed medications have been proposed to treat cocaine abuse. Progesterone, a gonadal hormone, and atomoxetine, a medication commonly used to treat attention deficit/hyperactivity disorder, have both been separately shown to reduce cocaine self-administration and reinstatement (i.e., relapse). The goal of the present study was to examine sex differences in the individual effects of PRO and ATO as well as the combination PRO+ATO treatment on cocaine (COC), caffeine (CAF), and/or cue-primed reinstatement of cocaine-seeking. Adult male and female Wistar rats lever-pressed under a FR 1 schedule for cocaine infusions (0.4mg/kg/inf). After 14 sessions of stable responding in daily 2-h sessions, rats underwent a 21-day extinction period when no drug or drug-related stimuli were present. Rats were then separated into four groups that received PRO (0.5mg/kg) alone (PRO+SAL), ATO (1.5mg/kg) alone (VEH+ATO), control (VEH+SAL) or combination (PRO+ATO) treatments prior to the reinstatement condition. Reinstatement of cocaine-seeking to cues and/or drug injections of cocaine or caffeine was tested after extinction. During maintenance, females self-administered more cocaine than males, but no sex differences were seen during extinction. Females showed greater cocaine-seeking than males after a CAF priming injection. Individual treatment with ATO did not decrease reinstatement under any priming condition; however, the combination treatment decreased cocaine-seeking under the COC+CUES priming condition in males, and both PRO alone and the combination treatment decreased cocaine-seeking in the CAF+CUES condition in females. Overall, PRO alone was only effective in reducing reinstatement in females, while the combination treatment was consistently effective in reducing reinstatement in both sexes. PMID:27003832

  12. Duloxetine-bupropion combination for treatment-resistant atypical depression: a double-blind, randomized, placebo-controlled trial.

    PubMed

    Fornaro, Michele; Martino, Matteo; Mattei, Chiara; Prestia, Davide; Vinciguerra, Valentina; De Berardis, Domenico; De Pasquale, Concetta; Iasevoli, Felice; Mungo, Sergio; Fornaro, Pantaleo

    2014-08-01

    The efficacy, safety, and tolerability of combined bupropion versus placebo using duloxetine as active reference drug, in patients with a DSM-IV diagnosis of major depression with atypical features and a history of treatment resistance, were evaluated in this preliminary six-week study. Patients (n=46) had a baseline Hamilton Depression Scale (HAM-D) ≥14 and were randomly assigned to 150/300 mg/day bupropion vs. placebo, which was added to 60 to 120 mg/day duloxetine depending on baseline depression severity. Atypical features of depression were assessed using the additional eight-item module of the Structured Interview Guide for the HAM-D with the Atypical Depression Supplement. By week 6, only five (21.7%) patients receiving duloxetine+placebo vs. six (26.1%) patients on the bupropion combination achieved response. No significant difference in final HAM-D scores between the two groups was observed between those patients achieving response. The presence of a higher number of atypical features significantly predicted non-response, with the relevant binary logistic regression model correctly classifying 17 out 22 (77.3%) of non-responders [Exp(B)=0.294; p=0.016] vs. 17 out 23 (73.9%) [Exp(B)=0.353; p=0.028] non-responder cases in the "+placebo" and "+bupropion" groups, respectively. In those patients receiving bupropion, treatment-emergent adverse events leading to withdrawal were more common among those receiving lower doses of the combination drug, and no life-threating dangers were noted. Additional studies, including an adequate course of duloxetine trial, are nonetheless aimed to allow a firm conclusion about the usefulness of the combination of duloxetine and bupropion for treatment-resistant cases of major depression with atypical features. PMID:24842649

  13. Clinical efficacy of combined sodium dimercaptopropanesulfonate and zinc treatment in neurological Wilson’s disease with D-penicillamine treatment failure

    PubMed Central

    Chen, Dingbang; Zhou, Xiangxue; Hou, Haiman; Feng, Li; Liu, JunXiu; Liang, Yinyin; Lin, Xiaopu; Zhang, Jiwei; Wu, Chao; Liang, Xiuling; Pei, Zhong; Li, Xunhua

    2016-01-01

    Objectives: There are limited pharmacological treatments for patients with neurological Wilson’s disease (WD) and a history of copper-chelating treatment failure. Methods: We retrospectively evaluated the clinical records of 38 patients with WD who were treated with sodium dimercaptopropanesulfonate (DMPS) and zinc (group 1) or zinc alone (group 2). All patients had a history of neurological deterioration during their previous treatment with D-penicillamine (DPA). Results: Twenty-one patients were treated with intravenous DMPS for 4 weeks, followed by zinc gluconate for 6 months, and the treatment protocol was repeated twice. Relative to the baseline, repeated DMPS therapy and zinc maintenance therapy decreased neurological scores continuously (p < 0.01). Sixteen patients (76.2%) demonstrated neurological improvements after 1 year of therapy and four patients (19.0%) exhibited neurological deterioration at the follow-up session. In addition, 17 patients were treated with zinc monotherapy for 12 months. Two patients (11.8%) demonstrated neurological improvements and five patients (29.4%) exhibited neurological deterioration. Compared with the patients in group 2, a greater improvement ratio (p < 0.01) and lower deterioration ratio (p < 0.01) were observed in the patients in group 1 after 1 year of therapy. Conclusions: Our findings indicate that the safety and efficacy of combined treatment of DMPS and zinc is superior to those of zinc monotherapy in patients with neurological WD with a history of DPA treatment failure. PMID:27366238

  14. Improved control of anthracnose rot in loquat fruit by a combination treatment of Pichia membranifaciens with CaCl(2).

    PubMed

    Cao, Shifeng; Zheng, Yonghua; Tang, Shuangshuang; Wang, Kaituo

    2008-08-15

    The beneficial effect of 2% CaCl(2) (w/v) on the antagonistic yeast Pichia membranifaciens for control of anthracnose rot caused by Colletotrichum acutatum in postharvest loquat fruit (Eriobotrya japonica L.) and the possible mechanisms involved were investigated. The results showed that treatment with P. membranifaciens at 1x10(8) CFU ml(-1) or 2% CaCl(2) alone both resulted in significantly smaller lesion diameter and lower disease incidence of anthracnose rot on loquat fruit wounds compared with the controls. The biocontrol activity of P. membranifaciens on the disease was enhanced by the addition of 2% CaCl(2), the combined treatment of P. membranifaciens with CaCl(2) resulted in a remarkably improved control of the disease in comparison with the treatment of P. membranifaciens or CaCl(2) alone. P. membranifaciens in combination with CaCl(2) induced higher activities of two defense-related enzymes chitinase and beta-1,3-glucanase in loquat fruit than applying the yeast or CaCl(2) alone. The in vitro experiment showed that the addition of 2% CaCl(2) in the suspensions of P. membranifaciens significantly inhibited spore germination and germ tube elongation of C. acutatum than the yeast or CaCl(2) alone. However, adding CaCl(2) did not significantly influence the population of P. membranifaciens in NYDB medium or fruit wounds. These results suggest that CaCl(2) could improve the biocontrol activity of P. membranifaciens on anthracnose rot in loquat fruit. It is postulated that the improved control of the disease is directly because of the higher inhibitory effect on pathogen growth and indirectly because of the enhanced disease resistance in loquat fruit by the combination treatment. PMID:18590937

  15. [Treatment of acute respiratory tract diseases in cattle with Bisolvon in combination with either enrofloxacin, cefquinome, ceftiofur or florfenicol].

    PubMed

    Schmidt, H; Philipp, H; Hamel, U; Quirke, J F

    1998-05-01

    The purpose of the present clinical studies was to determine the clinical efficacy of a combined parenteral and oral treatment with Bisolvon in combination with antibiotics in bovines suffering from acute respiratory disease. To this end four trials were conducted in respiratory diseased bovines; a total of 619 animals were evaluated. The animals were randomly assigned to one of two treatment groups within each study and were treated either with enrofloxacin, cefquinome, ceftiofur or florfenicol. The Bisolvon group was additionally treated with Bisolvon over 5 consecutive days. Daily clinical examinations were carried out over a period of 6 days. The clinical respiratory score, the primary parameter, representing a summation of the scoring points for the parameters respiratory rate, nasal discharge, spontaneous coughing, lung sounds and grade of dyspnoea and the clinical index score, which additionally included the general parameters fever, demeanour and feed intake, were significantly lower in the Bisolvon groups compared to the controls at all examinations after initiation of therapy in all trials with the exception of day 2 in one study. Lower values correspond to a less severe clinical condition. This consistent result as well as the evaluation of the single parameters are indicative of an acceleration of the recovery of the animals additionally treated with Bisolvon. PMID:9646401

  16. Local Tumor Treatment in Combination with Systemic Ipilimumab Immunotherapy Prolongs Overall Survival in Patients with Advanced Malignant Melanoma.

    PubMed

    Theurich, Sebastian; Rothschild, Sacha I; Hoffmann, Michael; Fabri, Mario; Sommer, Andrea; Garcia-Marquez, Maria; Thelen, Martin; Schill, Catherine; Merki, Ramona; Schmid, Thomas; Koeberle, Dieter; Zippelius, Alfred; Baues, Christian; Mauch, Cornelia; Tigges, Christian; Kreuter, Alexander; Borggrefe, Jan; von Bergwelt-Baildon, Michael; Schlaak, Max

    2016-09-01

    Immune checkpoint inhibition with ipilimumab has revolutionized cancer immunotherapy and significantly improved outcomes of patients with advanced malignant melanoma. Local peripheral treatments (LPT), such as radiotherapy or electrochemotherapy, have been shown to modulate systemic immune responses, and preliminary data have raised the hypothesis that the combination of LPT with systemic immune checkpoint blockade might be beneficial. Clinical data from 127 consecutively treated melanoma patients at four cancer centers in Germany and Switzerland were analyzed. Patients received either ipilimumab (n = 82) or ipilimumab and additional LPT (n = 45) if indicated for local tumor control. The addition of LPT to ipilimumab significantly prolonged overall survival (OS; median OS 93 vs. 42 weeks, unadjusted HR, 0.46; P = 0.0028). Adverse immune-related events were not increased by the combination treatment, and LPT-induced local toxicities were in most cases mild. In a multivariable Cox regression analysis, we show that the effect of added LPT on OS remained statistically significant after adjusting for BRAF status, tumor stage, tumor burden, and central nervous system metastases (adjusted HR, 0.56; 95% confidence interval, 0.31-1.01, P = 0.05). Our data suggest that the addition of LPT to ipilimumab is safe and effective in patients with metastatic melanoma irrespective of clinical disease characteristics and known risk factors. Induction of antitumor immune responses is most likely the underlying mechanism and warrants prospective validation. Cancer Immunol Res; 4(9); 744-54. ©2016 AACR. PMID:27466265

  17. Combined oral contraceptives for the treatment of acne: a practical guide.

    PubMed

    Arrington, Elizabeth A; Patel, Nishit S; Gerancher, Karen; Feldman, Steven R

    2012-08-01

    Many therapies exist in the arsenal of drugs available to dermatologists for the treatment of acne vulgaris. Among them, hormonal therapy stands out as a unique and highly efficacious treatment modality. Although some dermatologists may be hesitant to prescribe hormonal therapies, they can be safely and appropriately used in eligible female patients to treat acne vulgaris. Herein, current issues regarding the hormonal treatment of acne in the form of combined oral contraceptives (COCs) are presented, and a practical method for implementing this therapy is proposed. Specifically, drug selection, associated risks, benefits, monitoring, and counseling are discussed, with emphasis on the practicality of use in the clinical setting. PMID:22988652

  18. Biodegradable multiblock poly(N-2-hydroxypropyl)methacrylamide gemcitabine and paclitaxel conjugates for ovarian cancer cell combination treatment

    PubMed Central

    Larson, Nate; Yang, Jiyuan; Ray, Abhijit; Cheney, Darwin L.; Ghandehari, Hamidreza; Kopeček, Jindřich

    2013-01-01

    The synthesis, characterization, and in vitro evaluation of a combination delivery of multiblock poly(N-2-hydroxypropyl)methacrylamide (HPMA), gemcitabine (GEM) and paclitaxel (PTX) conjugates is described in this study. Multiblock copolymer conjugates of a large molecular weight (Mw > 200 kDa) were studied and compared to traditional, small molecular weight (Mw < 45 kDa) conjugates. Stability of the conjugates in different pH was assessed, and their cytotoxicity in combination toward A2780 human ovarian cancer cells was evaluated by combination index analysis. Treatment duration (4 and 72 h) and sequence of addition were explored. In addition, an HPMA copolymer conjugate with both GEM and PTX in the side chains was evaluated in a similar manner and compared to a physical mixture of individual conjugates. Conjugates with narrow molecular weight distribution (Mw/Mn < 1.1) were obtained via RAFT polymerization, and drug loadings of between 5.5 and 9.2 wt% were achieved. Conjugates demonstrated moderate stability with less than 65% release over 24 h at pH 7.4, and near complete drug release in the presence of the lysosomal enzyme cathepsin B in 3 h. In combination, the cytotoxic effects of a mixture of the conjugates were primarily additive. Synergistic effects were observed when A2780 human ovarian cancer cells were treated simultaneously for 4 h with multiblock conjugates (CI < 0.7). When both GEM and PTX were conjugated to the same copolymer backbone, moderate antagonism (CI 1.3–1.6) was observed. These results demonstrate that multiblock HPMA copolymer–GEM and –PTX conjugates, when delivered as a mixture of individual agents, are promising for the treatment of ovarian cancer. PMID:23827653

  19. Immunoadsorption versus plasma exchange versus combination for treatment of myasthenic deterioration

    PubMed Central

    Schneider-Gold, Christiane; Krenzer, Marco; Klinker, Erdmute; Mansouri-Thalegani, Behrouz; Müllges, Wolfgang; Toyka, Klaus V.; Gold, Ralf

    2016-01-01

    Objectives: The goal of this study was to analyze safety and assess the efficacy of standard plasma exchange (PE) compared with immunoadsorption (IA) alone, or an alternating combination of both in deteriorating myasthenia gravis (MG). Methods: A total of 72 patients with MG who had received PE procedures for treatment of severe deterioration were retrospectively analyzed. They received either five cycles of PE (1–1.5 plasma volumes), or five cycles of IA in line with plasma separation, or a sequential alternating procedure of one cycle of PE followed by two cycles of IA, which was repeated once or more if needed. Results: A total of 19 patients received PE, 24 patients IA, and 29 the alternating combination therapy. All groups were equally distributed by sex and mean MG score before treatment. The number of treatment cycles and days on therapy did not differ between the groups. Mean MG scores at discharge were 3.0 (PE), 1.8 (IA) and 1.6 (combination) (p = 0.028 for combination versus PE). Inpatient time was 30.7 days (PE), 22.3 days (IA) and 20.0 days in combination therapy (p < 0.05 for combination versus PE). Side effects such as allergic reactions or hypocoagulability were significantly more frequent in the PE group (37% in PE versus 4% in IA and 3.6% in the alternating combination, p < 0.05). Conclusion: Semiselective IA in combination with PE, and to a lesser extent IA alone, was associated with a shorter hospital stay and more pronounced reduction of the MG score than PE. PMID:27366236

  20. Efficacy and adverse events of transcatheter arterial chemoembolization in combination with sorafenib in the treatment of unresectable hepatocellular carcinoma

    PubMed Central

    YAO, XUESONG; YAN, DONG; LIU, DEZHONG; ZENG, HUIYING; LI, HUAI

    2015-01-01

    The aim of the present study was to assess the association between the efficacy and adverse events (AEs) of transcatheter arterial chemoembolization (TACE) combined with sorafenib in patients with unresectable hepatocellular carcinoma (HCC). Between July 2008 and May 2011, 50 patients with unresectable HCC were enrolled and assigned to receive TACE combined with sorafenib in the present study. The primary outcomes were considered as time to disease progression (TTP) and sorafenib-related AEs. In the present study, 34 of 50 patients had disease progression with a median TTP (mTTP) of 210 days. The most common AEs included hand-foot skin reaction (HFSR), fatigue, diarrhea and hypertension. The mTTP of patients with HFSR extended 140 days compared to that of the patients without HFSR. Kaplan-Meier analysis was used for mTTP between the two groups of patients. This difference was statistically significant when analyzed by the univariate COX proportional hazards regression model. In conclusion, TACE in combination with sorafenib had an acceptable safety profile in the treatment of unresectable HCC. Additionally, it also revealed that HFSR served as a good prognostic predictor in using combination therapy. Therefore, discontinuation of sorafenib treatment should be prevented to avoid disease progression. PMID:26171209

  1. Combination treatment with a calcium channel blocker and an angiotensin blocker in a rat systolic heart failure model with hypertension.

    PubMed

    Namba, Masashi; Kim, Shokei; Zhan, Yumei; Nakao, Takafumi; Iwao, Hiroshi

    2002-05-01

    The mechanism and treatment of hypertensive systolic heart failure are not well defined. We compared the effect of an angiotensin-converting enzyme inhibitor (cilazapril, 10 mg/kg), an angiotensin receptor blocker (candesartan, 3 mg/kg), a calcium channel blocker (benidipine, 1, 3 or 6 mg/kg), and the same calcium channel blocker combined with renin-angiotensin blockers on systolic heart failure in Dahl salt-sensitive (DS) rats. DS rats were fed an 8% Na diet from 6 weeks of age and then subjected to the above drug treatments. Benidipine (1 mg/kg), cilazapril, and candesartan had compatible hypotensive effects and similar beneficial effects on cardiac hypertrophy, gene expression, and survival rate. The combination of benidipine with cilazapril or candesartan was found to have no additional beneficial effects on the above parameters, with the exception of a reduction in atrial natriuretic polypeptide gene expression. On the other hand, candesartan normalized serum creatinine, but serum creatinine was unaffected by either benidipine at 1 or 3 mg/kg or cilazapril. Further, the combined use of benidipine and either candesartan or cilazapril resulted in an additional reduction of urinary albumin excretion in DS rats. Thus systolic heart failure in DS rats is mainly mediated by hypertension, while renal dysfunction of DS rats is due to both hypertension and the AT1 receptor itself. These findings suggest that the combination of a calcium channel blocker with an AT1 receptor blocker or ACE inhibitor may be more effective in treating the renal dysfunction associated with systolic heart failure than monotherapy with either agent alone. However, further studies will be needed before reaching any definitive conclusion on the efficacy of this combination therapy in patients with heart failure. PMID:12135327

  2. Uterine Artery Embolization Combined with Local Methotrexate and Systemic Methotrexate for Treatment of Cesarean Scar Pregnancy with Different Ultrasonographic Pattern

    SciTech Connect

    Lian Fan; Wang Yu Chen Wei; Li Jiaping; Zhan Zhongping; Ye Yujin; Zhu, Yunxiao; Huang Jia; Xu Hanshi; Yang Xiuyan; Liang Liuqin; Yang Jianyong

    2012-04-15

    Purpose: This study was designed to compare the effectiveness of systemic methotrexate (MTX) with uterine artery embolization (UAE) combined with local MTX for the treatment of cesarean scar pregnancy (CSP) with different ultrasonographic pattern, and to indicate the preferable therapy in CSP patients. Methods: The results of 21 CSP cases were reviewed. All subjects were initially administrated with systemic MTX (50 mg/m{sup 2} body surface area). UAE combined with local MTX was added to the patients who had failed systemic MTX. The transvaginal ultrasonography data were retrospectively assessed, and two different ultrasonographic patterns were found: surface implantation and deep implantation of amniotic sac. The management and its effectiveness for patients with the two ultrasonographic patterns were studied retrospectively. Ultrasound scan and serum {beta}-hCG were monitored during follow-up. Data were analyzed with the Student's t test. Results: Nine patients were successfully treated with systemic MTX. The remaining 12 cases were successfully treated with additional UAE combined with local MTX. According to the classification by Vial et al. of CSP on ultrasonography, most surface implanted CSPs (8/11, 72.7%) could be successfully treated with systemic MTX, whereas most deeply implanted CSPs (9/10, 90%) had failed systemic MTX but still could be successfully treated with additional UAE combined with local MTX. All patients recovered without severe side effects. Most patients with a future desire for reproduction achieved subsequent pregnancy. Conclusions: For CSP patients suitable for nonsurgical treatment, UAE combined with local MTX would be the superior option compared with systemic MTX in the cases with deep implantation of amniotic sac.

  3. Novel diode-based laser system for combined transcutaneous monitoring and computer-controlled intermittent treatment of jaundiced neonates

    NASA Astrophysics Data System (ADS)

    Hamza, Mostafa; El-Ahl, Mohammad H. S.; Hamza, Ahmad M.

    2001-06-01

    The high efficacy of laser phototherapy combined with transcutaneous monitoring of serum bilirubin provides optimum safety for jaundiced infants from the risk of bilirubin encephalopathy. In this paper the authors introduce the design and operating principles of a new laser system that can provide simultaneous monitoring and treatment of several jaundiced babies at one time. The new system incorporates diode-based laser sources oscillating at selected wavelengths to achieve both transcutaneous differential absorption measurements of bilirubin concentration in addition to the computer controlled intermittent laser therapy through a network of optical fibers. The detailed description and operating characteristics of this system are presented.

  4. Hydrolysis of Miscanthus for bioethanol production using dilute acid presoaking combined with wet explosion pre-treatment and enzymatic treatment.

    PubMed

    Sørensen, Annette; Teller, Philip J; Hilstrøm, Troels; Ahring, Birgitte K

    2008-09-01

    Miscanthus is a high yielding bioenergy crop. In this study we used acid presoaking, wet explosion, and enzymatic hydrolysis to evaluate the combination of the different pre-treatment methods for bioethanol production with Miscanthus. Acid presoaking is primarily carried out in order to remove xylose prior to wet explosion. The acid presoaking extracted 63.2% xylose and 5.2% glucose. Direct enzymatic hydrolysis of the presoaked biomass was found to give only low sugar yields of 24-26% glucose. Wet explosion is a pre-treatment method that combines wet-oxidation and steam explosion. The effect of wet explosion on non-presoaked and presoaked Miscanthus was investigated using both atmospheric air and hydrogen peroxide as the oxidizing agent. All wet explosion pre-treatments showed to have a disrupting effect on the lignocellulosic biomass, making the sugars accessible for enzymatic hydrolysis. The combination of presoaking, wet explosion, and enzymatic hydrolysis was found to give the highest sugar yields. The use of atmospheric air gave the highest xylose yield (94.9% xylose, 61.3% glucose), while hydrogen peroxide gave the highest glucose yield (82.4% xylose, 63.7% glucose). PMID:18164954

  5. Effect of alkaline addition on anaerobic sludge digestion with combined pretreatment of alkaline and high pressure homogenization.

    PubMed

    Fang, Wei; Zhang, Panyue; Zhang, Guangming; Jin, Shuguang; Li, Dongyi; Zhang, Meixia; Xu, Xiangzhe

    2014-09-01

    To improve anaerobic digestion efficiency, combination pretreatment of alkaline and high pressure homogenization was applied to pretreat sewage sludge. Effect of alkaline dosage on anaerobic sludge digestion was investigated in detail. SCOD of sludge supernatant significantly increased with the alkaline dosage increase after the combined pretreatment because of sludge disintegration. Organics were significantly degraded after the anaerobic digestion, and the maximal SCOD, TCOD and VS removal was 73.5%, 61.3% and 43.5%, respectively. Cumulative biogas production, methane content in biogas and biogas production rate obviously increased with the alkaline dosage increase. Considering both the biogas production and alkaline dosage, the optimal alkaline dosage was selected as 0.04 mol/L. Relationships between biogas production and sludge disintegration showed that the accumulative biogas was mainly enhanced by the sludge disintegration. The methane yield linearly increased with the DDCOD increase as Methane yield (ml/gVS)=4.66 DDCOD-9.69. PMID:24703958

  6. Processing time of addition or withdrawal of single or combined balance-stabilizing haptic and visual information.

    PubMed

    Honeine, Jean-Louis; Crisafulli, Oscar; Sozzi, Stefania; Schieppati, Marco

    2015-12-01

    We investigated the integration time of haptic and visual input and their interaction during stance stabilization. Eleven subjects performed four tandem-stance conditions (60 trials each). Vision, touch, and both vision and touch were added and withdrawn. Furthermore, vision was replaced with touch and vice versa. Body sway, tibialis anterior, and peroneus longus activity were measured. Following addition or withdrawal of vision or touch, an integration time period elapsed before the earliest changes in sway were observed. Thereafter, sway varied exponentially to a new steady-state while reweighting occurred. Latencies of sway changes on sensory addition ranged from 0.6 to 1.5 s across subjects, consistently longer for touch than vision, and were regularly preceded by changes in muscle activity. Addition of vision and touch simultaneously shortened the latencies with respect to vision or touch separately, suggesting cooperation between sensory modalities. Latencies following withdrawal of vision or touch or both simultaneously were shorter than following addition. When vision was replaced with touch or vice versa, adding one modality did not interfere with the effect of withdrawal of the other, suggesting that integration of withdrawal and addition were performed in parallel. The time course of the reweighting process to reach the new steady-state was also shorter on withdrawal than addition. The effects of different sensory inputs on posture stabilization illustrate the operation of a time-consuming, possibly supraspinal process that integrates and fuses modalities for accurate balance control. This study also shows the facilitatory interaction of visual and haptic inputs in integration and reweighting of stance-stabilizing inputs. PMID:26334013

  7. HANDLING AND DISPOSAL OF SLUDGES FROM COMBINED SEWER OVERFLOW TREATMENT. PHASE II - IMPACT ASSESSMENT

    EPA Science Inventory

    This report documents the results of an assessment of the effort that the United States will have to exert in the area of sludge handling and disposal if, in fact, full-scale treatment of combined sewer overflows is to become a reality. The results indicate that nationwide an ave...

  8. [CLINICAL FEATURES AND OPTIMIZATION OF THE TREATMENT OF CHILDREN WITH COMBINATION GASTRODUODENAL PATHOLOGY AND PRIMARY HYPERTENSION].

    PubMed

    Marushco, Y V; Zlobynets, A S

    2015-01-01

    The paper present dynamic of clinical picture, daily blood pressure monitoring results and subjective assessment of functional status in children with combination of chronic gastroduodenal pathology and primary hypertension when L-carnitine used with the standard treatment regimen. PMID:26118045

  9. Combination medical treatment for primary open angle glaucoma and ocular hypertension: a network meta-analysis

    PubMed Central

    Michelessi, Manuele; Lindsley, Kristina; Yu, Tsung; Li, Tianjing

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: The objectives of this review are to examine the comparative effectiveness and safety of different glaucoma fixed combination therapies and monotherapies in eyes with primary open angle glaucoma or ocular hypertension and to provide relative rankings of these treatments. PMID:25774087

  10. Combining treatments to improve the fermentation of sugarcane bagasse hydrolysates by ethanologenic Escherichia coli LY180.

    PubMed

    Geddes, Ryan; Shanmugam, Keelnatham T; Ingram, Lonnie O

    2015-01-01

    Inhibitory side products from dilute acid pretreatment is a major challenge for conversion of lignocellulose into ethanol. Six strategies to detoxify sugarcane hydrolysates were investigated alone, and in combinations (vacuum evaporation of volatiles, high pH treatment with ammonia, laccase, bisulfite, microaeration, and inoculum size). High pH was the most beneficial single treatment, increasing the minimum inhibitory concentration (measured by ethanol production) from 15% (control) to 70% hydrolysate. Combining treatments provided incremental improvements, consistent with different modes of action and multiple inhibitory compounds. Screening toxicity using tube cultures proved to be an excellent predictor of relative performance in pH-controlled fermenters. A combination of treatments (vacuum evaporation, laccase, high pH, bisulfite, microaeration) completely eliminated all inhibitory activity present in hydrolysate. With this combination, fermentation of hemicellulose sugars (90% hydrolysate) to ethanol was complete within 48 h, identical to the fermentation of laboratory xylose (50 g/L) in AM1 mineral salts medium (without hydrolysate). PMID:25864026

  11. Effect of Combined Treatment Using Wilfortrine and Paclitaxel in Liver Cancer and Related Mechanism

    PubMed Central

    Li, Shuzhen; Zheng, Lei

    2016-01-01

    Background Liver cancer is a common malignant tumor with high mortality. Currently, effective medicines against liver cancer are still lacking. Paclitaxel is a wide-spectrum anti-tumor agent, while wilfortrine has been shown to have an inhibitory effect on the proliferation of liver cancer cells. This study thus investigated the potential effect of paclitaxel combined with wilfortrine on cultured liver cancer cells and related mechanisms, in order to provide evidence for pathogenesis and treatment of liver cancer. Material/Methods Liver cancer cell line HpeG2 was divided into control, paclitaxel, wilfortrine, and combined treatment groups. Cell proliferation was tested by MTT, while invasion was detected in Transwell chamber assay. Apoptotic protein Bcl-2 and Bax expression levels were further quantified using real-time PCR and Western blotting. Results Both of those 2 drugs can effectively inhibit cancer cell proliferation, depress invasion ability, increase Bcl-2 expression, and elevate Bax expression levels (p<0.05 in all cases). The combined therapy had better treatment efficacy compared to either of those drugs alone (p<0.05). Conclusions The combined treatment using wilfortrine and paclitaxel can inhibit proliferation and invasion of liver cancer cells via down-regulating Bcl-2 and up-regulating Bax, with better efficacy than single use of either drug. PMID:27043783

  12. Synergistic activity of combination therapy with PEGylated pemetrexed and gemcitabine for an effective cancer treatment.

    PubMed

    Vandana, Mallaredy; Sahoo, Sanjeeb K

    2015-08-01

    Combination therapy in cancer is now opted as a potential therapeutic strategy for cancer treatment. However, effective delivery of drugs in combination at the tumor site is marred by low bioavailability and systemic toxicity of individual drugs. Polymer therapeutics is indeed an upcoming approach for the combinational drug delivery in favor of better cancer management. Hence, the objective of our investigation was to develop a dual drug PEGylated system that carries two chemotherapeutic drugs simultaneously for effective treatment of cancer. In this regard, we have synthesized Pem-PEG-Gem, wherein pemetrexed (Pem) and gemcitabine (Gem) are conjugated to a heterobifunctional polyethylene glycol (PEG) polymer for the effective treatment of Non-Small Cell Lung Cancer (NSCLC). Our results demonstrate enhanced bioavailability of the individual drugs in Pem-PEG-Gem in comparison with the drugs in their native form. The developed Pem-PEG-Gem showed enhanced cell death with respect to their native counterparts when treated singly or in combination against NSCLC cells. This might be attributed to better cellular internalization through the process of macropinocytosis and synergistic cytotoxic action of Pem-PEG-Gem in NSCLC cells. Hence, we propose the above dual drug based polymer therapeutic approach suitable for better clinical application in the treatment of NSCLC. PMID:25968494

  13. Psychotherapeutic Treatment in Combination with Relaxation in a Flotation Tank: Effects on "Burn-Out Syndrome"

    ERIC Educational Resources Information Center

    Kjellgren, Anette; Buhrkall, Hanne; Norlander, Torsten

    2010-01-01

    The focus of this study was to investigate experiences gained from treatment combining relaxation in flotation tank with psychotherapy for sufferers from "burn-out syndrome". Six people participated in a ten week program. They were all interviewed; the data were analyzed using the Empirical Phenomenological Psychological method. Five themes…

  14. Addition of a Magnetite Layer onto a Polysulfone Water Treatment Membrane to Enhance Virus Removal

    NASA Astrophysics Data System (ADS)

    Raciny, Isabel

    The applicability of low-pressure membranes systems in distributed (point of use) water treatment is hindered by, among other things, their inability to remove potentially harmful viruses and ions via size exclusion. According to the USEPA and the Safe Drinking Water Act, drinking water treatment processes must be designed for 4-log virus removal. Batch experiments using magnetite nanoparticle (nano-Fe3O4) suspensions and water filtration experiments with Polysulfone (PSf) membranes coated with nano-Fe3O 4 were conducted to assess the removal of a model virus (bacteriophage MS2). The membranes were coated via a simple filtration protocol. Unmodified membranes were a poor adsorbent for MS2 bacteriophage with less than 0.5-log removal, whereas membranes coated with magnetite nanoparticles exhibited a removal efficiency exceeding 99.99% (4-log). Thus, a cartridge of PSf membranes coated with nano-Fe3O4 particles could be used to remove viruses from water. Such membranes showed negligible iron leaching into the filtrate, thus obviating concern about colored water. Further research is needed to reduce the loss of water flux caused by coating.

  15. VOLUNTARY EXERCISE OR AMPHETAMINE TREATMENT, BUT NOT THE COMBINATION, INCREASES HIPPOCAMPAL BRAIN-DERIVED NEUROTROPHIC FACTOR AND SYNAPSIN I FOLLOWING CORTICAL CONTUSION INJURY IN RATS

    PubMed Central

    GRIESBACH, G. S.; HOVDA, D. A.; GOMEZ-PINILLA, F.; SUTTON, R. L.

    2008-01-01

    Prior work has shown that d-amphetamine (AMPH) treatment or voluntary exercise improves cognitive functions after traumatic brain injury (TBI). In addition, voluntary exercise increases levels of brain-derived neurotrophic factor (BDNF). The current study was conducted to determine how AMPH and exercise treatments, either alone or in combination, affect molecular events that may underlie recovery following controlled cortical impact (CCI) injury in rats. We also determined if these treatments reduced injury-induced oxidative stress. Following a CCI or sham injury, rats received AMPH (1 mg/kg/day) or saline treatment via an ALZET® pump and were housed with or without access to a running wheel for 7 days. CCI rats ran significantly less than sham controls, but exercise level was not altered by drug treatment. On day 7 the hippocampus ipsilateral to injury was harvested and BDNF, synapsin I and phosphorylated (P) -synapsin I proteins were quantified. Exercise or AMPH alone significantly increased BDNF protein in sham and CCI rats, but this effect was lost with the combined treatment. In sham-injured rats synapsin I increased significantly after AMPH or exercise, but did not increase after combined treatment. Synapsin levels, including the P-synapsin/total synapsin ratio, were reduced from sham controls in the saline-treated CCI groups, with or without exercise. AMPH treatment significantly increased the P-synapsin/total synapsin ratio after CCI, an effect that was attenuated by combining AMPH with exercise. Exercise or AMPH treatment alone significantly decreased hippocampal carbonyl groups on oxidized proteins in the CCI rats, compared with saline-treated sedentary counterparts, but this reduction in a marker of oxidative stress was not found with the combination of exercise and AMPH treatment. These results indicate that, whereas exercise or AMPH treatment alone may induce plasticity and reduce oxidative stress after TBI, combining these treatments may cancel each

  16. Nanotechnology-based combination therapy improves treatment response in cancer models

    NASA Astrophysics Data System (ADS)

    Rai, Prakash; Chang, Sung K.; Mai, Zhiming; Neuman, Daniel; Hasan, Tayyaba

    2009-06-01

    Pancreatic cancer (PanCa) has a poor prognosis with a 5-year survival rate of only 5%. Photodynamic therapy (PDT) has shown promising results in treating PanCa. Mechanism-based combinations with PDT have enhanced treatment outcome. Agents tested with PDT include Avastin, an antibody against vascular endothelial growth factor (VEGF) which is approved for treating various cancers. Simultaneous delivery of drugs in nano-constructs could improve the treatment response of mechanism based combination therapies. Here, we investigate the effect of neutralizing VEGF using nanotechnology for the delivery of Avastin in combination with PDT. For this we used a construct called "nanocells" in which the photosensitizer was trapped inside polymer nanoparticles and these, with Avastin, were then encapsulated inside liposomes. In vitro, nanocells containing Avastin (NCA) significantly enhanced cytotoxicity in PanCa cells. NCA based PDT also significantly improved treatment response in mice that were orthotopically implanted with PanCa. Avastin delivered extracellularly in combination with PDT did not show any improvement. Here we propose a new paradigm for Avastin-based therapy by combining intracellular delivery of the antibody and PDT using nanotechnology for treating PanCa.

  17. Effects of combined UV and chlorine treatment on chloroform formation from triclosan.

    PubMed

    Ben, Weiwei; Sun, Peizhe; Huang, Ching-Hua

    2016-05-01

    The co-exposure to UV irradiation and free chlorine may occur in certain drinking water and wastewater treatment systems. This study investigated the effects of simultaneous low pressure ultraviolet (LPUV) irradiation and free chlorination on the formation of chloroform from triclosan which is a commonly used antibacterial agent. Different treatment systems (i.e., combined UV/chlorine, UV alone, and chlorine alone) were applied to examine the degradation of triclosan and formation of chloroform. The fate of representative intermediates, including chlorinated triclosan, dechlorinated triclosan intermediates and 2,4-dichlorophenol, were tracked to deduce the effect of combined UV/chlorine on the transformation of chloroform formation precursors. The relation between intermediates degradation and chloroform formation was investigated in depth by conducting stepwise experiments with UV and chlorine in different sequences. Results indicate that the combined UV/chlorine notably enhanced the chloroform formation from triclosan. From the reaction mechanism perspective the combined UV/chlorine, where the direct photolysis may play an important role, could accelerate the decay of intermediates and facilitate the generation of productive chloroform precursors. The radicals had modest influence on the degradation of triclosan and intermediates and partly hindered the formation of chloroform. These results emphasize the necessity of considering disinfection by-products formation in the application of combined UV/chlorine technology during water treatment. PMID:26746417

  18. Combined Use of Metformin and Everolimus Is Synergistic in the Treatment of Breast Cancer Cells.

    PubMed

    Wang, Yunshan; Wei, Junmin; Li, Li; Fan, Cong; Sun, Ying

    2014-01-01

    Everolimus inhibits mammalian target of rapamycin (mTOR) and leads to decreased protein synthesis and decreased cancer cell proliferation in many experimental systems. Adenosine 5'-monophosphate-activated protein kinase (AMPK) activators such as metformin have similar actions in keeping with the TSC2/1 pathway linking activation of AMPK to inhibition of mTOR. Histopathological and biochemical studies of breast cancer show frequent dysregulation of the AMPK and the mTOR pathway. Therefore, we investigated the efficacy of the mTOR inhibitor everolimus and metformin in the treatment of breast cancer cells. This study evaluated the in vitro and in vivo effects of everolimus alone or in combination with metformin on breast cancer cells. MTT assay was used to quantify the inhibitory effect of the drugs on breast cancer cells in vitro. SCID mice injected with HCC1428 cells followed by different treatments were used to assess the in vivo efficacy of different agents. Data showed that the combination of everolimus and metformin exerted synergistic inhibitory effects on the growth of breast cancer cells both in culture and in a mouse xenograft model. Further, this combination abrogated S6 and 4EBP1phosphorylation. Collectively, we suggest that the combination of everolimus and metformin may be an effective regimen for treatment of breast cancer, hence warranting further evaluation of the combination in the clinic. PMID:26351208

  19. Immunological responses induced by the combination of phototherapy and immunotherapy in the treatment of metastatic tumors

    NASA Astrophysics Data System (ADS)

    Chen, Wei R.; Naylor, Mark F.; Nordquist, Robert E.; Teague, T. Kent; Liu, Hong

    2008-02-01

    Combination therapy using laser photothermal interaction and immunological stimulation has demonstrated its ability to induce immunological responses. Glycated chitosan (GC), an immunological stimulant, and imiquimod, a new type of immune response modifier (IRM), when used in conjunction with laser phototherapy, have shown to have a great immunological stimulation function. Specifically, imiquimod can help release cytokines from immunocompetent cells, stimulate TH1 lymphocyte responses (CD8+ T-cells), and recruit additional dendritic cells. To study the effects of immunoadjuvnats in combination of laser photo-irradiation, we treated animal tumors with laser-ICG-GC combination and late-stage melanoma patients with laser-ICG-imiquimod combination. At designated times, tumors, blood, and spleens in both treated and untreated animals were colleted for analysis. The major immunological indicators, such as IL-6, IL-12, IFN-gamma, CD4, and CD8 were analyzed. The same immunological analysis was also performed for melanoma patients treated by the laser-imiquimod combination.

  20. Simultaneous active intracellular delivery of doxorubicin and C6-ceramide shifts the additive/antagonistic drug interaction of non-encapsulated combination.

    PubMed

    Fonseca, Nuno A; Gomes-da-Silva, Lígia C; Moura, Vera; Simões, Sérgio; Moreira, João Nuno

    2014-12-28

    Drug resistance remains the Achilles tendon undermining the success of chemotherapy. It has been recognized that success requires the identification of compounds that, when combined, lead to synergistic tumor inhibition while simultaneously minimizing systemic toxicity. However, in vivo application of such protocols is dependent on the ability to deliver the appropriate drug ratio at the tumor level. In this respect, nanotechnology-based delivery platforms, like liposomes, offer an elegant solution for the in vivo translation of such strategy. In this work, we propose the active intracellular delivery of combinations of doxorubicin and the pro-apoptotic sphingolipid, C6-ceramide, using our previously described cytosolic triggered release-enabling liposomes, targeting nucleolin with the F3 peptide. Combination of doxorubicin (DXR):C6-ceramide (C6-Cer) at 1:2 molar ratio interacted synergistically against drug resistant/triple negative MDA-MB-231 breast cancer cells, as well as drug sensitive MDA-MB-435S melanoma cells. Cell viability studies indicated that F3-targeted liposomes encapsulating DXR:C6-Cer 1:2 molar ratio (p[F3]DC12) performed similarly as targeted liposomal DXR (p[F3]SL), encapsulating twice the amount of DXR, at the IC50, for an incubation time of 24 h. Importantly, F3-targeted liposomes encapsulating DXR:C6-Cer 1:2 molar ratio (p[F3]DC12) enabled a cell death above 90% at 24 h of treatment against both DXR-resistant and sensitive cells, unattainable by the F3-targeted liposomal doxorubicin. Furthermore, a F3-targeted formulation encapsulating a mildly additive/antagonistic DXR:C6-Cer 1:1 molar ratio (p[F3]DC11) enabled an effect above 90% for an incubation period as short as 4 h, suggesting that the delivery route at the cell level may shift the nature of drug interaction. Such activity, including the one for p[F3]DC12, induced a marked cell and nucleus swelling at similar extent, consistent with necrotic cell death. Overall, these results

  1. Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee.

    PubMed

    Zeng, Chao; Wei, Jie; Li, Hui; Wang, Yi-lun; Xie, Dong-xing; Yang, Tuo; Gao, Shu-guang; Li, Yu-sheng; Luo, Wei; Lei, Guang-hua

    2015-01-01

    This study aimed to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis (OA). PubMed, Embase and Cochrane Library were searched through from inception to February 2015. A total of 54 studies covering 16427 patients were included. Glucosamine plus chondroitin, glucosamine alone, and celecoxib were all more effective than placebo in pain relief and function improvement. Specifically, celecoxib is most likely to be the best treatment option, followed by the combination group. All treatment options showed clinically significant improvement from baseline pain, but only glucosamine plus chondroitin showed clinically significant improvement from baseline function. In terms of the structure-modifying effect, both glucosamine alone and chondroitin alone achieved a statistically significant reduction in joint space narrowing. Although no significant difference was observed among the five options with respect to the three major adverse effects (withdrawal due to adverse events, serious adverse events and the number of patients with adverse events), the additional classical meta-analysis showed that celecoxib exhibited a higher rate of gastrointestinal adverse effect comparing with the placebo group. The present study provided evidence for the symptomatic efficacy of glucosamine plus chondroitin in the treatment of knee OA. PMID:26576862

  2. Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee

    PubMed Central

    Zeng, Chao; Wei, Jie; Li, Hui; Wang, Yi-lun; Xie, Dong-xing; Yang, Tuo; Gao, Shu-guang; Li, Yu-sheng; Luo, Wei; Lei, Guang-hua

    2015-01-01

    This study aimed to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis (OA). PubMed, Embase and Cochrane Library were searched through from inception to February 2015. A total of 54 studies covering 16427 patients were included. Glucosamine plus chondroitin, glucosamine alone, and celecoxib were all more effective than placebo in pain relief and function improvement. Specifically, celecoxib is most likely to be the best treatment option, followed by the combination group. All treatment options showed clinically significant improvement from baseline pain, but only glucosamine plus chondroitin showed clinically significant improvement from baseline function. In terms of the structure-modifying effect, both glucosamine alone and chondroitin alone achieved a statistically significant reduction in joint space narrowing. Although no significant difference was observed among the five options with respect to the three major adverse effects (withdrawal due to adverse events, serious adverse events and the number of patients with adverse events), the additional classical meta-analysis showed that celecoxib exhibited a higher rate of gastrointestinal adverse effect comparing with the placebo group. The present study provided evidence for the symptomatic efficacy of glucosamine plus chondroitin in the treatment of knee OA. PMID:26576862

  3. Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma

    PubMed Central

    Omar, Ayman I.

    2014-01-01

    A novel device that employs TTF therapy has recently been developed and is currently in use for the treatment of recurrent glioblastoma (rGBM). It was FDA approved in April 2011 for the treatment of patients 22 years or older with rGBM. The device delivers alternating electric fields and is programmed to ensure maximal tumor cell kill1. Glioblastoma is the most common type of glioma and has an estimated incidence of approximately 10,000 new cases per year in the United States alone2. This tumor is particularly resistant to treatment and is uniformly fatal especially in the recurrent setting3-5. Prior to the approval of the TTF System, the only FDA approved treatment for rGBM was bevacizumab6. Bevacizumab is a humanized monoclonal antibody targeted against the vascular endothelial growth factor (VEGF) protein that drives tumor angiogenesis7. By blocking the VEGF pathway, bevacizumab can result in a significant radiographic response (pseudoresponse), improve progression free survival and reduce corticosteroid requirements in rGBM patients8,9. Bevacizumab however failed to prolong overall survival in a recent phase III trial26. A pivotal phase III trial (EF-11) demonstrated comparable overall survival between physicians’ choice chemotherapy and TTF Therapy but better quality of life were observed in the TTF arm10. There is currently an unmet need to develop novel approaches designed to prolong overall survival and/or improve quality of life in this unfortunate patient population. One appealing approach would be to combine the two currently approved treatment modalities namely bevacizumab and TTF Therapy. These two treatments are currently approved as monotherapy11,12, but their combination has never been evaluated in a clinical trial. We have developed an approach for combining those two treatment modalities and treated 2 rGBM patients. Here we describe a detailed methodology outlining this novel treatment protocol and present representative data from one of the

  4. Combination drug treatment in patients with non-alcoholic fatty liver disease

    PubMed Central

    Filippatos, Theodosios D; Elisaf, Moses S

    2010-01-01

    Non-alcoholic fatty liver disease (NAFLD) includes simple steatosis, a benign condition, and non-alcoholic steatohepatitis, a condition that beyond TG accumulation also includes necroinflammation and fibrosis. An association between NAFLD and cardiovascular disease (CVD) has been recently suggested. NAFLD patients usually have an increased CVD risk profile. NAFLD is also associated with metabolic syndrome (MetS) and is considered as the hepatic component of MetS by some authors. Currently, the only established treatment of NAFLD is gradual weight loss. However, multifactorial treatment of NAFLD risk factors may be needed to reduce the increased CVD risk of NALFD patients. Drug combinations that include antiobesity drugs (such as orlistat and sibutramine) and target CVD risk factors may be a good approach to NAFLD patients. Our group has investigated the orlistat-fenofibrate combination treatment in obese patients with MetS and the orlistat-ezetimibe and sibutramine-antihypertensive combination treatment in obese patients with hyperlipidaemia with promising results in CVD risk factor reduction and improvement of liver function tests. Small studies give promising results but double-blind, randomized trials examining the effects of such multifactorial treatment in hard CVD endpoints in NAFLD patients are missing. PMID:21160985

  5. The combined use of cracking residues and a caking additive in the briquetting and coking of poorly caking coals

    SciTech Connect

    Balabanov, V.A.; Barsky, V.D.

    1994-12-31

    The waste product utilization of the by-products of petroleum refining, i.e. cracking residues, as the binder in briquetting coals of is described. A refractory petroleum caking additive with a high cokeability together with a liquid cracking residue is proposed to increase the strength of the coal briquettes and the quality of the coke. 6 refs., 3 figs., 2 tabs.

  6. The synergistic effect of combination temozolomide and chloroquine treatment is dependent on autophagy formation and p53 status in glioma cells.

    PubMed

    Lee, Seung Woo; Kim, Hyun-Kyung; Lee, Na-Hyeon; Yi, Hee-Yeon; Kim, Hong-Sug; Hong, Sung Hee; Hong, Yong-Kil; Joe, Young Ae

    2015-05-01

    Temozolomide (TMZ) is an alkylating agent used for the treatment of glioblastoma. The late autophagy inhibitor chloroquine (CQ) inhibits glioblastoma tumors in a p53-independent and p53-dependent manner. We addressed a possible beneficial effect of combination treatment with TMZ and CQ by examining the molecular and cellular mechanism of co-treatment. Combination treatment of U87 cell (wild type p53) with TMZ and CQ synergistically reduced cell proliferation and enhanced apoptosis, with increased sub-G1 hypodiploid cells and caspase activation. This effect was abolished by a pan-caspase inhibitor, Z-VAD-FMK. TMZ induced autophagy, and the addition of CQ further increased autophagic vacuoles. Inhibition of early stages of autophagy by Beclin 1 knockdown and 3-methyladenine pretreatment prevented the enhanced effect of the combination treatment. The combination treatment also upregulated p53 and phospho-p53 levels, whereas p53 knockdown or overexpression of mutant p53 abolished the combination effect. In contrast, combination therapy had no enhanced effect on U373 cell (mutant p53) proliferation and apoptosis within 3 d, although TMZ induced autophagy and co-treatment with CQ increased autophagic vacuole accumulation. However, long term combination treatment for 9-10 d effectively decreased clonal and cellular growth with increased G2-M arrest. This effect was also abolished by Beclin 1 knockdown. Our data support the beneficial effect of combination treatment with TMZ and CQ in glioma via differential autophagy-associated mechanisms, depending on p53 status. PMID:25681668

  7. Dasatinib suppression of medulloblastoma survival and migration is markedly enhanced by combining treatment with the aurora kinase inhibitor AT9283

    PubMed Central

    Petersen, William; Liu, Jingbo; Yuan, Liangping; Zhang, Hongying; Schneiderjan, Matthew; Cho, Yoon-Jae; MacDonald, Tobey J.

    2014-01-01

    Medulloblastoma (MB) expresses Src kinase, while aurora kinase A overexpression correlates with poor survival. We thus investigated novel combination treatment with dasatinib and AT9283, inhibitors of Src and aurora kinase, respectively, on MB growth in vitro and in vivo. Treatment with each drug significantly reduced cell viability and combined treatment markedly potentiated this response. AT9283 induced p53 expression, autophagy, and G2/M cell-cycle arrest, while combined treatment induced S phase arrest. Dasatinib treatment caused tumor regression in vivo. Activated Src was detected in 44% MB analyzed. We conclude that further evaluation of this combination therapy for MB is highly warranted. PMID:25107642

  8. Efficacy of neurodevelopmental treatment combined with the Nintendo® Wii in patients with cerebral palsy

    PubMed Central

    Acar, Gönül; Altun, Gamze Polen; Yurdalan, SaadetUfuk; Polat, Mine Gülden

    2016-01-01

    [Purpose] The aim of this study was to investigate the efficiency of Nintendo® Wii games in addition to neurodevelopmental treatment in patients with cerebral palsy. [Subjects and Methods] Thirty hemiparetic cerebral palsy patients (16 females, 14 males; mean age, 6–15 years) were included in the study and divided into two groups: a neurodevelopmental treatment+Nintendo Wii group (group 1, n=15) and a neurodevelopmental treatment group (group 2, n=15). Both groups received treatment in 45-minute sessions 2 days/week for six weeks. Use of the upper extremities, speed, disability and functional independence were evaluated using the Quality of Upper Extremity Skills Test, Jebsen Taylor Hand Function Test, ABILHAND-Kids test, and Pediatric Functional Independence Measure (self-care) before and after treatment. [Results] There were statistically significant improvements in all parameters for group 1 and group 2 (except quality of function) after six weeks of treatment. Intergroup analysis showed that group 1 was superior to group 2 in mean change differences in the Jebsen Taylor Hand Function Test. [Conclusion] Our results showed that neurodevelopmental treatment is effective for improving hand functions in hemiplegic cerebral palsy. To provide a enjoyable, motivational, safe, and effective rehabilitation program, the Nintendo® Wii may be used in addition to neurodevelopmental treatment. PMID:27134357

  9. Efficacy of neurodevelopmental treatment combined with the Nintendo(®) Wii in patients with cerebral palsy.

    PubMed

    Acar, Gönül; Altun, Gamze Polen; Yurdalan, SaadetUfuk; Polat, Mine Gülden

    2016-03-01

    [Purpose] The aim of this study was to investigate the efficiency of Nintendo(®) Wii games in addition to neurodevelopmental treatment in patients with cerebral palsy. [Subjects and Methods] Thirty hemiparetic cerebral palsy patients (16 females, 14 males; mean age, 6-15 years) were included in the study and divided into two groups: a neurodevelopmental treatment+Nintendo Wii group (group 1, n=15) and a neurodevelopmental treatment group (group 2, n=15). Both groups received treatment in 45-minute sessions 2 days/week for six weeks. Use of the upper extremities, speed, disability and functional independence were evaluated using the Quality of Upper Extremity Skills Test, Jebsen Taylor Hand Function Test, ABILHAND-Kids test, and Pediatric Functional Independence Measure (self-care) before and after treatment. [Results] There were statistically significant improvements in all parameters for group 1 and group 2 (except quality of function) after six weeks of treatment. Intergroup analysis showed that group 1 was superior to group 2 in mean change differences in the Jebsen Taylor Hand Function Test. [Conclusion] Our results showed that neurodevelopmental treatment is effective for improving hand functions in hemiplegic cerebral palsy. To provide a enjoyable, motivational, safe, and effective rehabilitation program, the Nintendo(®) Wii may be used in addition to neurodevelopmental treatment. PMID:27134357

  10. Combined System of Activated Sludge and Ozonation for the Treatment of Kraft E1 Effluent

    PubMed Central

    Assalin, Marcia Regina; dos Santos Almeida, Edna; Durán, Nelson

    2009-01-01

    The treatment of paper mill effluent for COD, TOC, total phenols and color removal was investigated using combined activated sludge-ozonation processes and single processes. The combined activated sludge-O3/pH 10 treatment was able to remove around 80% of COD, TOC and color from Kraft E1 effluent. For the total phenols, the efficiency removal was around 70%. The ozonation post treatment carried out at pH 8.3 also showed better results than the single process. The COD, TOC, color and total phenols removal efficiency obtained were 75.5, 59.1, 77 and 52.3%, respectively. The difference in the concentrations of free radical produced by activated sludge-O3/pH 10 and activated sludge-O3/pH 8.3 affected mainly the TOC and total phenol removal values. PMID:19440438

  11. Sorafenib-based combined molecule targeting in treatment of hepatocellular carcinoma

    PubMed Central

    Gao, Jian-Jun; Shi, Zhen-Yan; Xia, Ju-Feng; Inagaki, Yoshinori; Tang, Wei

    2015-01-01

    Sorafenib is the only and standard systematic chemotherapy drug for treatment of advanced hepatocellular carcinoma (HCC) at the current stage. Although sorafenib showed survival benefits in large randomized phase III studies, its clinical benefits remain modest and most often consist of temporary tumor stabilization, indicating that more effective first-line treatment regimens or second-line salvage therapies are required. The molecular pathogenesis of HCC is very complex, involving hyperactivated signal transduction pathways such as RAS/RAF/MEK/ERK and PI3K/AKT/mTOR and aberrant expression of molecules such as receptor tyrosine kinases and histone deacetylases. Simultaneous or sequential abrogation of these critical pathways or the functions of these key molecules involved in angiogenesis, proliferation, and apoptosis may yield major improvements in the management of HCC. In this review, we summarize the emerging sorafenib-based combined molecule targeting for HCC treatment and analyze the rationales of these combinations. PMID:26576091

  12. Treatment of Combined Spinal Deformity in Patient with Ollier Disease and Abnormal Vertebrae

    PubMed Central

    Ryabykh, S. О.; Gubin, A. V.; Prudnikova, О. G.; Kobyzev, А. Е.

    2012-01-01

    We report staged treatment of severe combined spinal deformity in an 11-year-old patient with Ollier disease and abnormal cervical vertebra. Combined scoliosis with systemic pathology and abnormal vertebrae is a rare condition and features atypical deformity location and rapid progression rate and frequently involves the rib cage and pelvis, disturbing the function of chest organs and skeleton. Progressive deformity resulted in cachexia and acute respiratory failure. A halo-pelvic distraction device assembled of Ilizarov components was employed for a staged surgical treatment performed for lifesaving indications. After vital functions stabilized, the scoliosis curve of the cervical spine was corrected and fixed with a hybrid system of transpedicular supporting points, connecting rods, and connectors that provided staged distraction during growth. The treatment showed good functional and cosmetic result. PMID:24436859

  13. Treatment of combined spinal deformity in patient with ollier disease and abnormal vertebrae.

    PubMed

    Ryabykh, S О; Gubin, A V; Prudnikova, Capital O Cyrillic G; Kobyzev, Capital A Cyrillic Е

    2013-06-01

    We report staged treatment of severe combined spinal deformity in an 11-year-old patient with Ollier disease and abnormal cervical vertebra. Combined scoliosis with systemic pathology and abnormal vertebrae is a rare condition and features atypical deformity location and rapid progression rate and frequently involves the rib cage and pelvis, disturbing the function of chest organs and skeleton. Progressive deformity resulted in cachexia and acute respiratory failure. A halo-pelvic distraction device assembled of Ilizarov components was employed for a staged surgical treatment performed for lifesaving indications. After vital functions stabilized, the scoliosis curve of the cervical spine was corrected and fixed with a hybrid system of transpedicular supporting points, connecting rods, and connectors that provided staged distraction during growth. The treatment showed good functional and cosmetic result. PMID:24436859

  14. Controlled Trial of Very Low Calorie Diet, Behavior Therapy, and Their Combination in the Treatment of Obesity.

    ERIC Educational Resources Information Center

    Wadden, Thomas A; Stunkard, Albert J.

    1986-01-01

    Assessed the effectiveness of a combined program of very low calorie diet and behavior therapy in treating obesity. Combined treatment and behavior therapy alone subjects maintained weight losses; none of the diet alone subjects met the criterion used to define maintenance. Only those receiving behavior therapy alone and combined treatment showed…

  15. Outcome following addition of peroneus brevis tendon transfer to treatment of acquired posterior tibial tendon insufficiency.

    PubMed

    Song, S J; Deland, J T

    2001-04-01

    The flexor digitorum longus, the tendon most often used for transfer in posterior tibial tendon insufficiency, is one-half to one-third the size of the posterior tibial tendon. Occasionally it may be particularly small or may have been previously used for transfer. In these cases, the senior author has felt that the addition of a transfer of the Peroneus Brevis (PBr) tendon may be helpful in maintaining sufficient tendon and muscle mass to rebalance the foot. Thirteen patients who underwent this procedure were retrospectively identified and matched by age and length of follow-up to patients who underwent a more standard tendon transfer operation minus the addition of the PBr transfer. Pain and functional status were then assessed by the American Orthopaedic Foot and Ankle Society's ankle/hindfoot rating scale. Each patient was tested by an independent physical therapist to evaluate inversion and eversion strength. The mean duration of follow-up was 20.6 months (12 to 34 months). The average AOFAS score of the PBr group was 75.8 compared to 71.5 for the standard control group. There was no significant difference between the groups when inversion or eversion strengths were compared. Inversion strength and eversion strength was rated good or excellent (4 or 5) in 12 out of 13 of the PBr transfer group patients. No major complications were encountered in either group. Although it does not increase inversion strength, a PBr transfer can be used to augment a small FDL without causing significant eversion weakness. This can be useful when the FDL is particularly small or in revision surgery. PMID:11354442

  16. Combining silver catalysis and organocatalysis: a sequential Michael addition/hydroalkoxylation one-pot approach to annulated coumarins.

    PubMed

    Hack, Daniel; Chauhan, Pankaj; Deckers, Kristina; Hermann, Gary N; Mertens, Lucas; Raabe, Gerhard; Enders, Dieter

    2014-10-01

    A highly stereoselective one-pot procedure for the synthesis of five-membered annulated hydroxycoumarins has been developed. By merging primary amine catalysis with silver catalysis, a series of functionalized coumarin derivatives were obtained in good yields (up to 91%) and good to excellent enantioselectivities (up to 99% ee) via a Michael addition/hydroalkoxylation reaction. Depending on the substituents on the enynone, the synthesis of annulated six-membered rings is also feasible. PMID:25250728

  17. The impact of transient combination antiretroviral treatment in early HIV infection on viral suppression and immunologic response in later treatment

    PubMed Central

    Pantazis, Nikos; Touloumi, Giota; Meyer, Laurence; Olson, Ashley; Costagliola, Dominique; Kelleher, Anthony D.; Lutsar, Irja; Chaix, Marie-Laure; Fisher, Martin; Moreno, Santiago; Porter, Kholoud

    2016-01-01

    Objective: Effects of transient combination antiretroviral treatment (cART) initiated during early HIV infection (EHI) remain unclear. We investigate whether this intervention affects viral suppression and CD4+ cell count increase following its reinitiation in chronic infection (CHI). Design: Longitudinal observational study. Methods: We identified adult patients from Concerted Action of Seroconversion to AIDS and Death in Europe who seroconverted after 1/1/2000, had a 12 months or less HIV test interval and initiated cART from naive. We classified individuals as ‘pretreated in EHI’ if treated within 6 months of seroconversion, interrupted for at least 12 weeks, and reinitiated during CHI. Statistical analysis was performed using survival analysis methods and mixed models. Results: Pretreated and initiated in CHI groups comprised 202 and 4263 individuals, with median follow-up after CHI treatment 4.5 and 3 years, respectively. Both groups had similar virologic response and relapse rates (P = 0.585 and P = 0.206) but pretreated individuals restarted treatment with higher baseline CD4+ cell count (∼80 cells/μl; P < 0.001) and retained significantly higher CD4+ cell count for more than 3 years after treatment (re)initiation. Assuming common baseline CD4+ cell count, differences in CD4+ cell count slopes were nonsignificant. Immunovirologic response to CHI treatment was not associated with timing or duration of the transient treatment. Conclusion: Although treatment interruptions are not recommended, stopping cART initiated in EHI does not seem to reduce the chance of a successful outcome of treatment in CHI. PMID:26636925

  18. Two novel combined drug treatments for women with hypoactive sexual desire disorder.

    PubMed

    Poels, Saskia; Bloemers, Jos; van Rooij, Kim; Koppeschaar, Hans; Olivier, Berend; Tuiten, Adriaan

    2014-06-01

    Low sexual desire is the most common sexual complaint in women. As a result, many women suffer from sexual dissatisfaction which often negatively interferes with their quality of life. These complaints have been classified as the condition Hypoactive Sexual Desire Disorder (HSDD), and have recently been merged with the condition Female Sexual Arousal Disorder (FSAD) into the diagnosis Female Sexual Interest/Arousal Disorder (FSIAD) in the DSM-5. To date, no drug treatment approved by the U.S. Food & Drug Administration (FDA)/European Medicines Agency (EMA) is available to treat women with HSDD/FSIAD. As a result, there is an unmet need for a drug treatment for HSDD/FSIAD. In our search for an adequate treatment we followed a different approach compared to other pharmaceutical companies. Based on a personalized sexual medicine approach we proposed that different mechanisms cause low sexual desire in women, namely an insensitive system for sexual cues or dysfunctional activation of sexual inhibitory mechanisms. Subsequently we developed two new on-demand drug treatments for women with HSDD/FSIAD based on these different causal mechanisms. One treatment (testosterone combined with a phosphodiesterase type 5 inhibitor) has been developed for women with HSDD/FSIAD due to a relatively insensitive system for sexual cues, while the second treatment (testosterone combined with a 5-HT₁A receptor agonist) has been developed for women with HSDD/FSIAD due to dysfunctional activation of sexual inhibitory mechanisms. PMID:24534417

  19. Treatment considerations for inflammatory acne: clinical evidence for adapalene 0.1% in combination therapies.

    PubMed

    Thiboutot, Diane M; Gollnick, Harald P

    2006-09-01

    Acne vulgaris is an exceptionally common, chronic, and recurring disease. It involves multiple etiological factors including follicular hyperkeratinization, increased sebum production, Propionibacterium acnes proliferation, and inflammation. Presently, oral isotretinoin is the only single agent that is effective against all 4 major pathophysiologic features. However, this drug is also responsible for several serious side effects, including teratogenicity. Therefore, it should be used in only the most severe cases and alternative treatment approaches for inflammatory acne, such as initial combination therapy, should be considered first. Combination therapy in inflammatory acne simultaneously targets multiple pathogenic factors. Current guidelines recommend early initiation of combination therapy with a topical retinoid and antimicrobials for mild to moderate inflammatory acne and topical retinoids with oral antibiotics (with or without the use of benzoyl peroxide) for moderate to severe cases of acne, followed by maintenance therapy with topical retinoids. This review evaluates the rationale and clinical evidence for the use of adapalene in combination therapy for inflammatory acne. PMID:16989194

  20. Future treatment options for HCV: double, triple, what is the optimal combination?

    PubMed

    Kronenberger, Bernd; Zeuzem, Stefan

    2008-01-01

    Specifically Targeted Antiviral Therapy against hepatitis C virus (STAT-C) stands for a new era in the treatment of patients with chronic hepatitis C. Results from recent trials with protease and polymerase inhibitors indicate that therapy with a single HCV specific compound will not be sufficient to eradicate hepatitis C virus infection and that combination therapy will be necessary to improve sustained virologic response rates. The search for the optimal combination of STAT-C compounds with peginterferon alfa with or without ribavirin is currently under investigation in several clinical trials. Overall the current studies indicate that peginterferon alfa and ribavirin remain the backbone of antiviral therapy of chronic hepatitis C even in the era of STAT-C. Nevertheless, it can be anticipated that combination of STAT-C compounds with non-overlapping resistance profiles could improve response to antiviral therapy. Promising combinations are protease inhibitors plus nucleoside analogue and non-nucleoside analogue polymerase inhibitors. PMID:19187871

  1. The additive and interactive effects of parenting style and temperament in obese youth seeking treatment

    PubMed Central

    Zeller, MH; Boles, RE; Reiter-Purtill, J

    2009-01-01

    Objective To examine maternal parenting behaviors, child temperament and their potential interactions in families of obese children and demographically similar families of nonoverweight children. Design A total of 77 obese youth (M body mass index (BMI) z-score values, zBMI = 2.4; ages 8–16, 59% female, 50% African American) and their parents were recruited from a pediatric weight management clinic and compared to 69 families of nonoverweight youth (M zBMI = − 0.03). Comparison youth were classmates of each obese participant matched on gender, race and age. Measurements Maternal report of child temperament, parenting style and anthropometric assessments were obtained. Results Compared to nonoverweight youth, mothers of obese youth described their child as having a more difficult temperament and their parenting style as lower in behavioral control. A logistic regression model indicated that difficult temperament, lower behavioral control and the interaction of low maternal warmth and difficult child temperament were associated with increased odds of a child being classified as obese. Conclusions Treatment-seeking obese youth and their parents are characterized by different parent and child factors when compared to nonoverweight comparison families. These findings direct investigators to test more complex models of the relation between parent and child characteristics and their mutual role in the weight-related behavior change process. PMID:18698318

  2. Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure?

    PubMed Central

    Silverberg, Donald S.; Wexler, Dov; Schwartz, Doron

    2015-01-01

    Anemia is present in about 40% of heart failure (HF) patients. Iron deficiency (ID) is present in about 60% of the patients with anemia (about 24% of all HF patients) and in about 40% of patients without anemia (about 24% of all HF patients). Thus ID is present in about half the patients with HF. The ID in HF is associated with reduced iron stores in the bone marrow and the heart. ID is an independent risk factor for severity and worsening of the HF. Correction of ID with intravenous (IV) iron usually corrects both the anemia and the ID. Currently used IV iron preparations are very safe and effective in treating the ID in HF whereas little information is available on the effectiveness of oral iron. In HF IV iron correction of ID is associated with improvement in functional status, exercise capacity, quality of life and, in some studies, improvement in rate of hospitalization for HF, cardiac structure and function, and renal function. Large long-term adequately-controlled intervention studies are needed to clarify the effect of IV iron in HF. Several heart associations suggest that ID should be routinely sought for in all HF patients and corrected if present. In this paper we present our approach to diagnosis and treatment of iron deficiency in heart failure. PMID:26096008

  3. Effect of Ag nanoparticle addition and ultrasonic treatment on a stable TiO2 nanofluid.

    PubMed

    Chakraborty, Subhrakanti; Mukherjee, Jonaki; Manna, Manindra; Ghosh, Pampa; Das, Sumitesh; Denys, Mark B

    2012-09-01

    Nanoparticles, when homogeneously dispersed in a base fluid, e.g. water, ethylene glycol etc. are commonly known as nanofluids. Nanofluids have gained attention in the scientific community for their enhanced thermal properties. One of the major problems in using nanofluids as a heat transfer medium for commercial applications is that, in most of the closed circuit industrial cooling processes, the cooling fluid has to be replaced after several cycles of cooling operation because of an increased presence of contaminants. If nanofluids were used as a coolant, it would be very hard to separate the nanoparticles from the waste fluid. The present work is aimed at the separation and recycling of nanoparticles from fluid waste by means of quick settling of titanium dioxide nanoparticles using silver nanoparticles along with ultrasonic treatment. It is observed that with increasing silver concentration and time of ultrasonication, the stability of the dispersion decreases. There is a value for both the silver concentration and ultrasonication time above which the settling time decreases drastically. PMID:22421063

  4. Additional Electrochemical Treatment Effects on the Switching Characteristics of Anodic Porous Alumina Resistive Switching Memory

    NASA Astrophysics Data System (ADS)

    Otsuka, Shintaro; Takeda, Ryouta; Furuya, Saeko; Shimizu, Tomohiro; Shingubara, Shouso; Iwata, Nobuyuki; Watanabe, Tadataka; Takano, Yoshiki; Takase, Kouichi

    2012-06-01

    We have investigated the current-voltage characteristics of a resistive switching memory (ReRAM), especially the reproducibility of the switching voltage between an insulating state and a metallic state. The poor reproducibility hinders the practical use of this memory. According to a filament model, the variation of the switching voltage may be understood in terms of the random choice of filaments with different conductivities and lengths at each switching. A limitation of the number of conductive paths is expected to lead to the suppression of the variation of switching voltage. In this study, two strategies for the limitation have been proposed using an anodic porous alumina (APA). The first is the reduction of the number of conductive paths by restriction of the contact area between the top electrodes and the insulator. The second is the lowering of the resistivity of the insulator, which makes it possible to grow filaments with the same characteristics by electrochemical treatments using a pulse-electroplating technique.

  5. Winter depression recurrence one year after cognitive-behavioral therapy, light therapy, or combination treatment.

    PubMed

    Rohan, Kelly J; Roecklein, Kathryn A; Lacy, Timothy J; Vacek, Pamela M

    2009-09-01

    The central public health challenge in the management of seasonal affective disorder (SAD) is prevention of depression recurrence each fall/winter season. The need for time-limited treatments with enduring effects is underscored by questionable long-term compliance with clinical practice guidelines recommending daily light therapy during the symptomatic months each year. We previously developed a SAD-tailored group cognitive-behavioral therapy (CBT) and tested its acute efficacy in 2 pilot studies. Here, we report an intent-to-treat (ITT) analysis of outcomes during the subsequent winter season (i.e., approximately 1 year after acute treatment) using participants randomized to CBT, light therapy, and combination treatment across our pilot studies (N=69). We used multiple imputation to estimate next winter outcomes for the 17 individuals who dropped out during treatment, were withdrawn from protocol, or were lost to follow-up. The CBT (7.0%) and combination treatment (5.5%) groups had significantly smaller proportions of winter depression recurrences than the light therapy group (36.7%). CBT alone, but not combination treatment, was also associated with significantly lower interviewer- and patient-rated depression severity at 1 year as compared to light therapy alone. Among completers who provided 1-year data, all statistically significant differences between the CBT and light therapy groups persisted after adjustment for ongoing treatment with light therapy, antidepressants, and psychotherapy. If these findings are replicated, CBT could represent a more effective, practical, and palatable approach to long-term SAD management than light therapy. PMID:19647524

  6. Orally inhaled fixed-dose combination products for the treatment of asthma and chronic obstructive pulmonary disease: not simple math.

    PubMed

    Ehrick, Jason D; Wylie, Jennifer; Goodey, Adrian P; Li, Ying; Liu, Oscar; Donovan, Brent

    2014-03-01

    Over the past decade, orally inhaled fixed-dose combination products (FDCs) have emerged as an important therapeutic class for the treatment of asthma and chronic obstructive pulmonary disease. However, the conceptual simplicity of inhaled FDCs belies both the complexity of their development, and the profound advantages they offer patients. The benefits of combining agents are not merely additive, and range from increased compliance via simple convenience to complex receptor-level synergies. Similarly, though, the development challenges often exceed the sum of their parts. FDC formulation and analytical method development is generally more complex than for two monotherapy products. Likewise, FDC clinical programs can easily eclipse those of their monotherapy peers and their inherent complexity is often furthered by the diverse regulatory requirements for worldwide approval. As such, the proposition of developing an orally inhaled FDC for global registration often represents a significant increase in both the potential rewards and assumed risks of drug development. PMID:24592955

  7. New pyrometallurgical process of EAF dust treatment with CaO addition

    NASA Astrophysics Data System (ADS)

    Chairaksa-Fujimoto, Romchat; Inoue, Yosuke; Umeda, Naoyoshi; Itoh, Satoshi; Nagasaka, Tetsuya

    2015-08-01

    The non-carbothermic zinc pyrometallurgical processing of electric arc furnace (EAF) dust was investigated on a laboratory scale. The main objective of this process was to convert highly stable zinc ferrite (ZnFe2O4), which accounts for more than half of total zinc in the EAF dust, into ZnO and Ca2Fe2O5 by CaO addition. The EAF dust was mixed with CaO powder in various ratios, pressed into pellets, and heated in a muffle furnace in air at temperatures ranging from 700 to 1100°C for a predetermined holding time. All ZnFe2O4 was transformed into ZnO and Ca2Fe2O5 at a minimum temperature of 900°C within 1 h when sufficient CaO to achieve a Ca/Fe molar ratio of 1.1 was added. However, at higher temperatures, excess CaO beyond the stoichiometric ratio was required because it was consumed by reactions leading to the formation of compounds other than ZnFe2O4. The evaporation of halides and heavy metals in the EAF dust was also studied. These components could be preferentially volatilized into the gas phase at 1100°C when CaO was added.

  8. Oxidative addition of hydrogen to bis(phosphine)platinum(0) complexes: an ab initio theroretical treatment

    SciTech Connect

    Noell, J.O.; Hay, P.J.

    1982-08-25

    Ab initio molecular orbital methods utilizing relativistic core potentials and correlated wave functions are employed to examine the oxidative addition reactions H/sub 2/ + Pt(PH/sub 3/)/sub 2/..-->..cis-Pt(PH/sub 3/)/sub 2/H/sub 2/ and H/sub 2/ + Pt(P(CH/sub 3/)/sub 3/)/sub 2/..-->..cis-Pt(P(CH/sub 3/)/sub 3/)/sub 2/H/sub 2/. For this symmetry-allowed process, an activation barrier of 17 kcal/mol and an exothermicity of 7 kcal/mol are calculated at the SCF level for the PH/sub 3/ liquid; similar values are obtained for the P(CH/sub 3/)/sub 3/ ligand. This implies a barrier of 24 kcal/mol for the reverse reductive elimination reaction. These values were not significantly altered in MC-SCF or CI calculations. This barrier is consistent with available data in the analogous process in six-coordinate complexes but is puzzling in light of the paucity of known four-coordinate cis dihydrides. The reaction is analyzed in terms of three phases: initial repulsion, partial transfer of charge from the platinum to the hydrogen, and final metal-hydrogen bond formation. The relative energies of the cis and trans isomers are also discussed.

  9. Combined heat treatment and acid hydrolysis of cassava grate waste (CGW) biomass for ethanol production

    SciTech Connect

    Agu, R.C.; Amadife, A.E.; Ude, C.M.; Onyia, A.; Ogu, E.O.; Okafor, M.; Ezejiofor, E.

    1997-12-31

    The effect of combined heat treatment and acid hydrolysis (various concentrations) on cassava grate waste (CGW) biomass for ethanol production was investigated. At high concentrations of H{sub 2}SO{sub 4} (1--5 M), hydrolysis of the CGW biomass was achieved but with excessive charring or dehydration reaction. At lower acid concentrations, hydrolysis of CGW biomass was also achieved with 0.3--0.5 M H{sub 2}SO{sub 4}, while partial hydrolysis was obtained below 0.3 M H{sub 2}SO{sub 4} (the lowest acid concentration that hydrolyzed CGW biomass) at 120 C and 1 atm pressure for 30 min. A 60% process efficiency was achieved with 0.3 M H{sub 2}SO{sub 4} in hydrolyzing the cellulose and lignin materials present in the CGW biomass. High acid concentration is therefore not required for CGW biomass hydrolysis. The low acid concentration required for CGW biomass hydrolysis, as well as the minimal cost required for detoxification of CGW biomass because of low hydrogen cyanide content of CGW biomass would seem to make this process very economical. From three liters of the CGW biomass hydrolysate obtained from hydrolysis with 0.3M H{sub 2}SO{sub 4}, ethanol yield was 3.5 (v/v%) after yeast fermentation. However, although the process resulted in gainful utilization of CGW biomass, additional costs would be required to effectively dispose new by-products generated from CGW biomass processing.

  10. Clinical study on VATS combined mechanical ventilation treatment of ARDS secondary to severe chest trauma

    PubMed Central

    Qi, Yongjun

    2016-01-01

    The aim of the study was to investigate the clinical effects of microinvasive video-assisted thoracoscopic surgery (VATS) combined with mechanical ventilation in the treatment of acute respiratory distress syndrome (ARDS) secondary to severe chest trauma. A total of 62 patients with ARDS secondary to severe chest trauma were divided into the observation and control groups. The patients in the observation groups were treated with VATS combined with early mechanical ventilation while patients in the control group were treated using routine open thoracotomy combined with early mechanical ventilation. Compared to the controls, the survival rate of the observation group was significantly higher. The average operation time of the observation group was significantly shorter than that of the control group, and the incidence of complications in the perioperative period of the observation group was significantly lower than that of the control group (p<0.05). The average application time of the observation group was significantly shorter than that of the control group, and the incidence of ventilator-associated complications was significantly lower than that of the control group (p<0.05). In conclusion, a reasonable understanding of the indications and contraindications of VATS, combined with early mechanical treatment significantly improved the success rate of the treatment of ARDS patients secondary to severe chest trauma and reduced the complications. PMID:27446317

  11. Targeted near infrared hyperthermia combined with immune stimulation for optimized therapeutic efficacy in thyroid cancer treatment

    PubMed Central

    Zhou, Le; Zhang, Mengchao; Fu, Qingfeng; Li, Jingting; Sun, Hui

    2016-01-01

    Treatment of thyroid cancer has incurred much focus because of its high prevalency. As a new strategy treating thyroid cancer, hyperthermia takes several advantages compared with surgery or chemotherapy, including minimal invasion, low systematic toxicity and the ability to enhance the immunogenicity of cancer cells with the expression Hsp70 which serves as Toll-like receptors-4 (TLR-4 agonist). However, Hsp70 as a molecular chaperone can protect cells from heat induced apoptosis and therefore compromise the tumor killing effect of hyperthermia. In this study, to solve this problem, a combined hyperthermia therapy was employed to treat thyroid cancer. We prepared a probe with the tumor targeting agent AG to monitor thyroid tumor issue and generate heat to kill tumor cells in vivo. At the same time Quercetin (inhibitor of HSP70) and lipopolysaccharide (LPS) (agonist of TLR-4) were used for the combined hyperthermia therapy. The results showed that compared with free IR820, AG modification facilitated much enhanced cellular uptake and greatly pronounced tumor targeting ability. The combined therapy exhibited the most remarkable tumor inhibition compared with the single treatments both in vitro and in vivo. These findings verified that the new therapeutic combination could significantly improve the effect of hyperthermia and shed light on a novel clinical strategy in thyroid cancer treatment. PMID:26769848

  12. Combined modality treatment for stage I-II non-Hodgkin's lymphomas: CVP versus BACOP chemotherapy

    SciTech Connect

    Bajetta, E.; Valagussa, P.; Bonadonna, G.; Lattuada, A.; Buzzoni, R.; Rilke, F.; Banfi, A.

    1988-07-01

    This paper reports the 5-year results of a prospective randomized study beginning in 1976 on 177 evaluable patients with pathologic Stage I-IE and II-IIE non-Hodgkin's lymphomas with diffuse histology according to the Rappaport classification. Treatment consisted of either CVP or BACOP chemotherapy (3 cycles) followed by regional radiotherapy (40 to 50 Gy) and further cycles of either combination. In both arms, complete remission at the end of combined treatment was high (CVP 93%, BACOP 98%) regardless of age, stage or bulky disease. At 5 years, the comparative freedom from first progression was 62% for CVP vs 78% for BACOP (p = 0.02), respectively. Clinically relevant differences favoring BACOP chemotherapy were essentially documented in patients with large cell lymphomas (International Working Formulation), those with Stage II having more than three involved anatomical sites, bulky disease and age over 60 years. Recurrence within radiation fields was documented in only 5% of complete responders. Combined treatment was, in general, well tolerated particularly when BACOP was used. In only 2 patients given CVP post radiation cutaneous fibrosis was documented. Second solid tumors were detected in 4 patients. One patient started on CVP died because of brain stem necrosis after 45 Gy. We conclude that in Stage I-II patients with nodal and extranodal diffuse non-Hodgkin's lymphomas, particularly large cell lymphomas, combined modality approach with primary Adriamycin and bleomycin containing regimen, such as BACOP, followed by adjuvant radiotherapy offers high chances of cure with minimal toxicity.

  13. Overexpression of hepatocyte growth factor in SBMA model mice has an additive effect on combination therapy with castration.

    PubMed

    Ding, Ying; Adachi, Hiroaki; Katsuno, Masahisa; Huang, Zhe; Jiang, Yue-Mei; Kondo, Naohide; Iida, Madoka; Tohnai, Genki; Nakatsuji, Hideaki; Funakoshi, Hiroshi; Nakamura, Toshikazu; Sobue, Gen

    2015-12-25

    Spinal and bulbar muscular atrophy (SBMA) is an inherited motor neuron disease caused by the expansion of a polyglutamine (polyQ)-encoding tract within the androgen receptor (AR) gene. The pathologic features of SBMA are motor neuron loss in the spinal cord and brainstem and diffuse nuclear accumulation and nuclear inclusions of mutant AR in residual motor neurons and certain visceral organs. Hepatocyte growth factor (HGF) is a polypeptide growth factor which has neuroprotective properties. To investigate whether HGF overexpression can affect disease progression in a mouse model of SBMA, we crossed SBMA transgenic model mice expressing an AR gene with an expanded CAG repeat with mice overexpressing HGF. Here, we report that high expression of HGF induces Akt phosphorylation and modestly ameliorated motor symptoms in an SBMA transgenic mouse model treated with or without castration. These findings suggest that HGF overexpression can provide a potential therapeutic avenue as a combination therapy with disease-modifying therapies in SBMA. PMID:26551462

  14. Addition of Berberine to 5-Aminosalicylic Acid for Treatment of Dextran Sulfate Sodium-Induced Chronic Colitis in C57BL/6 Mice.

    PubMed

    Li, Yan-hong; Zhang, Man; Xiao, Hai-tao; Fu, Hai-bo; Ho, Alan; Lin, Cheng-yuan; Huang, Yu; Lin, Ge; Bian, Zhao-xiang

    2015-01-01

    Ulcerative colitis (UC) is a common chronic remitting disease but without satisfactory treatment. Alternative medicine berberine has received massive attention for its potential in UC treatment. Conventional therapies with the addition of berberine are becoming attractive as novel therapies in UC. In the present study, we investigated the preclinical activity of a conventional oral 5-aminosalicylic acid (5-ASA) therapy plus berberine in experimental colitis. A subclinical dose of 5-ASA (200 mg/kg/day) alone or 5-ASA plus berberine (20 mg/kg/day) was orally administered for 30 days to C57BL/6 mice with colitis induced by three cycles of 2% dextran sulfate sodium (DSS). The disease severity, inflammatory responses, drug accumulation and potential toxicity of colitis mice were examined. The results showed that comparing to 5-ASA alone, 5-ASA plus berberine more potently ameliorated DSS-induced disease severity, colon shortening, and colon histological injury. Further, the up-regulation in mRNA level of colonic TNF-α as well as NFκB and JAK2 phosphorylation caused by DSS were more pronouncedly reversed in animals treated with the combination therapy than those treated with 5-ASA alone. Moreover, the addition of berberine to 5-ASA more significantly inhibited lymphocyte TNF-α secretion of DSS mice than 5-ASA alone. In the meanwhile, no extra drug accumulation or potential toxicity to major organs of colitis mice was observed with this combination treatment. In summary, our studies provide preclinical rationale for the addition of berberine to 5-ASA as a promising therapeutic strategy in clinic by reducing dose of standard therapy. PMID:26642326

  15. Addition of Berberine to 5-Aminosalicylic Acid for Treatment of Dextran Sulfate Sodium-Induced Chronic Colitis in C57BL/6 Mice

    PubMed Central

    Li, Yan-hong; Zhang, Man; Xiao, Hai-tao; Fu, Hai-bo; Ho, Alan; Lin, Cheng-yuan; Huang, Yu; Lin, Ge; Bian, Zhao-xiang

    2015-01-01

    Ulcerative colitis (UC) is a common chronic remitting disease but without satisfactory treatment. Alternative medicine berberine has received massive attention for its potential in UC treatment. Conventional therapies with the addition of berberine are becoming attractive as novel therapies in UC. In the present study, we investigated the preclinical activity of a conventional oral 5-aminosalicylic acid (5-ASA) therapy plus berberine in experimental colitis. A subclinical dose of 5-ASA (200 mg/kg/day) alone or 5-ASA plus berberine (20 mg/kg/day) was orally administered for 30 days to C57BL/6 mice with colitis induced by three cycles of 2% dextran sulfate sodium (DSS). The disease severity, inflammatory responses, drug accumulation and potential toxicity of colitis mice were examined. The results showed that comparing to 5-ASA alone, 5-ASA plus berberine more potently ameliorated DSS-induced disease severity, colon shortening, and colon histological injury. Further, the up-regulation in mRNA level of colonic TNF-α as well as NFκB and JAK2 phosphorylation caused by DSS were more pronouncedly reversed in animals treated with the combination therapy than those treated with 5-ASA alone. Moreover, the addition of berberine to 5-ASA more significantly inhibited lymphocyte TNF-α secretion of DSS mice than 5-ASA alone. In the meanwhile, no extra drug accumulation or potential toxicity to major organs of colitis mice was observed with this combination treatment. In summary, our studies provide preclinical rationale for the addition of berberine to 5-ASA as a promising therapeutic strategy in clinic by reducing dose of standard therapy. PMID:26642326

  16. Combining Pharmacological and Psychological Treatments for Binge Eating Disorder: Current Status, Limitations, and Future Directions.

    PubMed

    Grilo, Carlos M; Reas, Deborah L; Mitchell, James E

    2016-06-01

    Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress about binge eating without the extreme compensatory behaviors for weight control that characterize other eating disorders. BED is prevalent, associated strongly with obesity, and is associated with heightened levels of psychological, psychiatric, and medical concerns. This article provides an overview of randomized controlled treatments for combined psychological and pharmacological treatment of BED to inform current clinical practice and future treatment research. In contrast to the prevalence and significance of BED, to date, limited research has been performed on combining psychological and pharmacological treatments for BED to enhance outcomes. Our review here found that combining certain medications with cognitive behavioral therapy (CBT) or behavioral weight loss (BWL) interventions produces superior outcomes to pharmacotherapy only but does not substantially improve outcomes achieved with CBT/BWL only. One medication (orlistat) has improved weight losses with CBT/BWL albeit minimally, and only one medication (topiramate) has enhanced reductions achieved with CBT in both binge eating and weight. Implications for future research are discussed. PMID:27086316

  17. Atazanavir/ritonavir-based combination antiretroviral therapy for treatment of HIV-1 infection in adults.

    PubMed

    Achenbach, Chad J; Darin, Kristin M; Murphy, Robert L; Katlama, Christine

    2011-02-01

    In the past 15 years, improvements in the management of HIV infection have dramatically reduced morbidity and mortality. Similarly, rapid advances in antiretroviral medications have resulted in the possibility of life-long therapy with simple and tolerable regimens. Protease inhibitors have been important medications in regimens of combination antiretroviral therapy for the treatment of HIV. One of the recommended and commonly used therapies in this class is once-daily-administered atazanavir, pharmacologically boosted with ritonavir (atazanavir/r). Clinical studies and practice have shown these drugs, in combination with other antiretroviral agents, to be potent, safe and easy to use in a variety of settings. Atazanavir/r has minimal short-term toxicity, including benign bilirubin elevation, and has less potential for long-term complications of hyperlipidemia and insulin resistance compared with other protease inhibitors. A high genetic barrier to resistance and a favorable resistance profile make it an excellent option for initial HIV treatment or as the first drug utilized in the protease inhibitors class. Atazanavir/r is also currently being studied in novel treatment strategies, including combinations with new classes of antiretrovirals to assess nucleoside reverse transcriptase inhibitor-sparing regimens. In this article we review atazanavir/r as a treatment for HIV infection and discuss the latest information on its pharmacology, efficacy and toxicity. PMID:21731578

  18. Summary of combined treatment under endoscope on 70 esophagus cancer inpatients

    NASA Astrophysics Data System (ADS)

    Wang, Cheng; Nong, Meilong; Li, Laisheng; Jia, Fang; Hao, Runchun

    1993-03-01

    We announce with satisfaction that combined treatment on 70 inpatients who suffered esophageal cancer in its middle or late course is perfectly successful. The combined methods include phototherapy, microwave therapy, and anticarcinogen local injection. The results are as follows: CR 3 cases, holds 4.3% of the total inpatients; PR 36 cases, 51.4%; MR 24 cases, 34.3%; NR 7 cases, 10%; the total effective rate 90%. Splendid results of treatment on enlarging the canal, improving dysphagia, and releasing obstruction have been obtained. The dysphagic grade increased from 66 to 148, the grade of esophagostenosis from 64 to 147, and the obstruction releasing rate is 69 out of 70 (that is 98.6%). The histological observation after treatment shows that 59/62 inpatients being reported as having cancer cells appear to have retrogression accompanied with a few or large quantities of necrotic cancer cells, and 3 inpatients were changed to negative reaction. No obvious poisoning or side effects arose. The combined treatment is more advantageous on those of old age or the physically weak and those who cannot stand for an operation, radiotherapy, or normal chemotherapy.

  19. Genetic polymorphisms, their allele combinations and IFN-β treatment response in Irish multiple sclerosis patients

    PubMed Central

    O’Doherty, Catherine; Favorov, Alexander; Heggarty, Shirley; Graham, Colin; Favorova, Olga; Ochs, Michael; Hawkins, Stanley; Hutchinson, Michael; O’Rourke, Killian; Vandenbroeck, Koen

    2009-01-01

    Introduction IFN-β is widely used as first-line immunomodulatory treatment for multiple sclerosis. Response to treatment is variable (30–50% of patients are nonresponders) and requires a long treatment duration for accurate assessment to be possible. Information about genetic variations that predict responsiveness would allow appropriate treatment selection early after diagnosis, improve patient care, with time saving consequences and more efficient use of resources. Materials & methods We analyzed 61 SNPs in 34 candidate genes as possible determinants of IFN-β response in Irish multiple sclerosis patients. Particular emphasis was placed on the exploration of combinations of allelic variants associated with response to therapy by means of a Markov chain Monte Carlo-based approach (APSampler). Results The most significant allelic combinations, which differed in frequency between responders and nonresponders, included JAK2–IL10RB–GBP1–PIAS1 (permutation p-value was pperm = 0.0008), followed by JAK2–IL10–CASP3 (pperm = 0.001). Discussion The genetic mechanism of response to IFN-β is complex and as yet poorly understood. Data mining algorithms may help in uncovering hidden allele combinations involved in drug response versus nonresponse. PMID:19604093

  20. Atazanavir/ritonavir-based combination antiretroviral therapy for treatment of HIV-1 infection in adults

    PubMed Central

    Achenbach, Chad J; Darin, Kristin M; Murphy, Robert L; Katlama, Christine

    2011-01-01

    In the past 15 years, improvements in the management of HIV infection have dramatically reduced morbidity and mortality. Similarly, rapid advances in antiretroviral medications have resulted in the possibility of life-long therapy with simple and tolerable regimens. Protease inhibitors have been important medications in regimens of combination antiretroviral therapy for the treatment of HIV. One of the recommended and commonly used therapies in this class is once-daily-administered atazanavir, pharmacologically boosted with ritonavir (atazanavir/r). Clinical studies and practice have shown these drugs, in combination with other antiretroviral agents, to be potent, safe and easy to use in a variety of settings. Atazanavir/r has minimal short-term toxicity, including benign bilirubin elevation, and has less potential for long-term complications of hyperlipidemia and insulin resistance compared with other protease inhibitors. A high genetic barrier to resistance and a favorable resistance profile make it an excellent option for initial HIV treatment or as the first drug utilized in the protease inhibitors class. Atazanavir/r is also currently being studied in novel treatment strategies, including combinations with new classes of antiretrovirals to assess nucleoside reverse transcriptase inhibitor-sparing regimens. In this article we review atazanavir/r as a treatment for HIV infection and discuss the latest information on its pharmacology, efficacy and toxicity. PMID:21731578

  1. In Situ Tumor Vaccination by Combining Local Radiation and Tumor-Specific Antibody or Immunocytokine Treatments.

    PubMed

    Morris, Zachary S; Guy, Emily I; Francis, David M; Gressett, Monica M; Werner, Lauryn R; Carmichael, Lakeesha L; Yang, Richard K; Armstrong, Eric A; Huang, Shyhmin; Navid, Fariba; Gillies, Stephen D; Korman, Alan; Hank, Jacquelyn A; Rakhmilevich, Alexander L; Harari, Paul M; Sondel, Paul M

    2016-07-01

    Interest in combining radiotherapy and immune checkpoint therapy is growing rapidly. In this study, we explored a novel combination of this type to augment antitumor immune responses in preclinical murine models of melanoma, neuroblastoma, and head and neck squamous cell carcinoma. Cooperative effects were observed with local radiotherapy and intratumoral injection of tumor-specific antibodies, arising in part from enhanced antibody-dependent cell-mediated cytotoxicity (ADCC). We could improve this response by combining radiation with intratumoral injection of an IL2-linked tumor-specific antibody (termed here an immunocytokine), resulting in complete regression of established tumors in most animals associated with a tumor-specific memory T-cell response. Given the T-cell response elicited by combined local radiation and intratumoral immunocytokine, we tested the potential benefit of adding this treatment to immune checkpoint blockade. In mice bearing large primary tumors or disseminated metastases, the triple-combination of intratumoral immunocytokine, radiation, and systemic anti-CTLA-4 improved primary tumor response and animal survival compared with combinations of any two of these three interventions. Taken together, our results show how combining radiation and intratumoral immunocytokine in murine tumor models can eradicate large tumors and metastases, eliciting an in situ vaccination effect that can be leveraged further by T-cell checkpoint blockade, with immediate implications for clinical evaluation. Cancer Res; 76(13); 3929-41. ©2016 AACR. PMID:27197149

  2. Speed and trajectory of changes of insomnia symptoms during acute treatment with cognitive–behavioral therapy, singly and combined with medication

    PubMed Central

    Morin, Charles M.; Beaulieu-Bonneau, Simon; Ivers, Hans; Vallières, Annie; Guay, Bernard; Savard, Josée; Mérette, Chantal

    2014-01-01

    Objectives To examine the speed and trajectory of changes in sleep/wake parameters during short-term treatment of insomnia with cognitive–behavioral therapy (CBT) alone versus CBT combined with medication; and to explore the relationship between early treatment response and post-treatment recovery status. Methods Participants were 160 adults with insomnia (mean age, 50.3 years; 97 women, 63 men) who underwent a six-week course of CBT, singly or combined with 10 mg zolpidem nightly. The main dependent variables were sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency, and sleep quality, derived from sleep diaries completed daily by patients throughout the course of treatment. Results Participants treated with CBT plus medication exhibited faster sleep improvements as evidenced during the first week of treatment compared to those receiving CBT alone. Optimal sleep improvement was reached on average after only one week for the combined treatment compared to two to three weeks for CBT alone. Early treatment response did not reliably predict post-treatment recovery status. Conclusions Adding medication to CBT produces faster sleep improvement than CBT alone. However, the magnitude of early treatment response is not predictive of final response after the six-week therapy. Additional research is needed to examine mechanisms involved in this early treatment augmentation effect and its impact on long-term outcome. PMID:24831251

  3. Indication of advanced orthokeratology as an additional treatment after refractive surgeries

    NASA Astrophysics Data System (ADS)

    Mitsui, Iwane; Yamada, Yoshida

    2005-04-01

    Ortho-K was indicated for twenty-three eyes of thirteen patients after refractive surgeries such as RK(1) ,PRK(2), and LASIK(3). The average of their Uncorrective Visual Acuity (UCVA) after surgeries was 20/30 or worse, and mean spherical equivalent (SE) was -2.42D. They were followed at least two years wearing of Advanced Ortho-K lenses during night. The following studies were examined on their auto-refraction, auto-keratometry, uncorrected and corrected visual acuity, intra-ocular pressure, corneal endothelium, corneal thickness, corneal curvature, and corneal shape for more than two years. 95% of the patients improved in UCVA up to 20/20 or better, 86% of them improved up to 20/15 or better, and 76% of them improved up to 20/10. The mean SEs improved to -1.20+/-1.02D during six months, - 1.03+/-0.83D during one year, and -0.73+/-0.64D during two years. Astigmatism also slightly decreased. Ophthalmologic examinations showed no abnormalities including flap formation, intra-ocular pressure, and endothelium. Among the refractive surgeries as well as RK and PRK, LASIK has been most popularly spread all over the world. However, patient's quality of vision is not always satisfied during and/or after refractive surgeries, because of several complications such as instability of flap formation, unexpected keratoectasia, diffuse lamellar keratitis, epithelial ingrowth, irregularity of corneal surface which caused myopia regression. In such cases, additional surgical procedures should not be indicated easily. However, Ortho-K is safe and effective enough to correct refractive errors still remained or re-appeared after refractive surgeries. It enables to restore the corneal irregularity to the ideal shape.

  4. Efficacy of the treatment of dogs with leishmaniosis with a combination of metronidazole and spiramycin.

    PubMed

    Pennisi, M G; De Majo, M; Masucci, M; Britti, D; Vitale, F; Del Maso, R

    2005-03-12

    Twenty-seven dogs infected naturally with Leishmania infantum were used in a randomised controlled trial to compare the clinical and parasitological efficacy of an oral treatment with a combination of metronidazole and spiramycin (13 dogs) with the efficacy of conventional treatment with meglumine antimonate and allopurinol (14 dogs) as controls. In the test group one dog had to be withdrawn from the treatment because it developed pemphigus foliaceus; 10 of the dogs were clinically responsive but none was cured parasitologically. In the control group four dogs were withdrawn from the treatment because of side effects; eight of the dogs were clinically responsive but none was cured parasitologically. The control group showed signs of improvement after an average of 30 days, whereas the test group did not show signs of improvement until after an average of 45 days. PMID:15789648

  5. Treatment of murine cryptococcal meningitis with an SCH 39304-amphotericin B combination.

    PubMed Central

    Albert, M M; Graybill, J R; Rinaldi, M G

    1991-01-01

    Cryptococcal meningitis was induced in BALB/c mice by intracerebral infection with Cryptococcus neoformans. Drug therapy was initiated 1 day later, with mice receiving amphotericin B (AMB), SCH 39304, combination therapy, or no drug therapy (controls). Most, but not all, combinations showed additive benefits, significantly prolonging survival and reducing organism counts in tissues compared with those in controls and groups which received the drugs independently. Optimum protection was obtained when a single dose of 10 mg of AMB per kg of body weight was combined with a fairly narrow SCH 39304 dose range. AMB antagonism did not occur with any regimen tested. AMB-azole combinations may be reasonable alternatives for patients who fail standard cryptococcosis therapeutic regimens. PMID:1952837

  6. Comparative Cost Analysis of Sequential, Adaptive, Behavioral, Pharmacological, and Combined Treatments for Childhood ADHD.

    PubMed

    Page, Timothy F; Pelham, William E; Fabiano, Gregory A; Greiner, Andrew R; Gnagy, Elizabeth M; Hart, Katie C; Coxe, Stefany; Waxmonsky, James G; Foster, E Michael; Pelham, William E

    2016-01-01

    We conducted a cost analysis of the behavioral, pharmacological, and combined interventions employed in a sequential, multiple assignment, randomized, and adaptive trial investigating the sequencing and enhancement of treatment for children with attention deficit hyperactivity disorder (ADHD; Pelham et al., 201X; N = 146, 76% male, 80% Caucasian). The quantity of resources expended on each child's treatment was determined from records that listed the type, date, location, persons present, and duration of all services provided. The inputs considered were the amount of physician time, clinician time, paraprofessional time, teacher time, parent time, medication, and gasoline. Quantities of these inputs were converted into costs in 2013 USD using national wage estimates from the Bureau of Labor Statistics, the prices of 30-day supplies of prescription drugs from the national Express Scripts service, and mean fuel prices from the Energy Information Administration. Beginning treatment with a low-dose/intensity regimen of behavior modification (large-group parent training) was less costly for a school year of treatment ($961) than beginning treatment with a low dose of stimulant medication ($1,669), regardless of whether the initial treatment was intensified with a higher "dose" or if the other modality was added. Outcome data from the parent study (Pelham et al., 201X) found equivalent or superior outcomes for treatments beginning with low-intensity behavior modification compared to intervention beginning with medication. Combined with the present analyses, these findings suggest that initiating treatment with behavior modification rather than medication is the more cost-effective option for children with ADHD. PMID:26808137

  7. [Monotherapy vs. combined therapy in the treatment of multi-drug resistance gramnegative bacteria].

    PubMed

    Martínez-Sagasti, F; González-Gallego, M A; Moneo-González, A

    2016-09-01

    The increasing number of multidrug resistant gram negative bacteria, particularly in patients with risk factors, but in those who suffer community infections as well, is doing more and more difficult to choose the appropriate treatment. The most challenging cases are due to the production of extended-spectrum-β-lactamases (ESBL) and carbapenemases. This mini-review will discuss the adequacy of administering carbapenems when suspecting infections due to ESBL that could be modified after knowing the MIC of the isolated bacteria and the combined therapy in cases of carbapenemases, being particularly important to include a carbapenem and/or colistine at high dosages in this combination. PMID:27608313

  8. Endoscopic Combination Therapy Of Nd:YAG Laser In Conjunction With Conventional Treatments

    NASA Astrophysics Data System (ADS)

    Suzuki, Sohtaro; Aoki, Jun; Shiina, Yasubimi; Miwa, Takeshi; Daikuzono, Norio; Joffe, Stephen N.

    1988-06-01

    In this paper, we discuss the possibilities of the clinical application of the contact method with various endoprobes, either alone or combination with other conventional treat ment such as endoscopic polypectomy, local injection therapy, intubation of prosthesis, radiation therapy and general chemotherapy. According to the type of lesions and the severity of the complicated diseases, endoscopic techniques were chosen and combined. It was generally recognized that all of the endoscopic treatments were not curative therapies but applied as local therapeutics. Therefore, during the management of high risk patients with GI cancer within the mucosa, contact endoscopic Nd:YAG laser therapy should be preferred to general surgery.

  9. Preclinical Evaluation of Laromustine for use in Combination with Radiation Therapy in the Treatment of Solid Tumors

    PubMed Central

    Rockwell, Sara; Liu, Yanfeng; Seow, Helen A.; Ishiguro, Kimiko; Baumann, Raymond P.; Penketh, Philip G.; Shyam, Krishnamurthy; Akintujoye, Oluwatoyin M.; Glazer, Peter M.; Sartorelli, Alan C.

    2013-01-01

    Purpose These studies explored questions related to the potential use of Laromustine in the treatment of solid tumors and in combination with radiotherapy. Materials and Methods These studies used mouse EMT6 cells [both parental and transfected with genes for O6-alkylguanine transferase (AGT)], repair-deficient human Fanconi Anemia C and Chinese hamster VC8 (BRCA2−/ −) cells and corresponding control cells, and EMT6 tumors in mice assayed using cell survival and tumor growth assays. Results Hypoxia during Laromustine treatment did not protect EMT6 cells or human fibroblasts from this agent. Rapidly proliferating EMT6 cells were more sensitive than quiescent cultures. EMT6 cells expressing mouse or human AGT, which removes O6 -alkyl groups from DNA guanine, thereby protecting against G-C crosslink formation, increased resistance to Laromustine. Crosslink-repair-deficient Fanconi Anemia C and VC8 cells were hypersensitive to Laromustine, confirming the importance of crosslinks as lethal lesions. In vitro, Laromustine and radiation produced additive toxicities to EMT6 cells. Studies using tumor cell survival and tumor growth assays showed effects of regimens combining Laromustine and radiation that were compatible with additive or subadditive interactions. Conclusions The effects of Laromustine on solid tumors and with radiation are complex and are influenced by microenvironmental and proliferative heterogeneity within these malignancies. PMID:22111842

  10. Mechanical competence of ovariectomy-induced compromised bone after single or combined treatment with high-frequency loading and bisphosphonates

    PubMed Central

    Camargos G. V.; Bhattacharya P.; van Lenthe G. H.; Del Bel Cury A. A.; Naert I.; Duyck J.; Vandamme K.

    2015-01-01

    Osteoporosis leads to increased bone fragility, thus effective approaches enhancing bone strength are needed. Hence, this study investigated the effect of single or combined application of high-frequency (HF) loading through whole body vibration (WBV) and alendronate (ALN) on the mechanical competence of ovariectomy-induced osteoporotic bone. Thirty-four female Wistar rats were ovariectomized (OVX) or sham-operated (shOVX) and divided into five groups: shOVX, OVX-shWBV, OVX-WBV, ALN-shWBV and ALN-WBV. (Sham)WBV loading was applied for 10 min/day (130 to 150 Hz at 0.3g) for 14 days and ALN at 2 mg/kg/dose was administered 3x/week. Finite element analysis based on micro-CT was employed to assess bone biomechanical properties, relative to bone micro-structural parameters. HF loading application to OVX resulted in an enlarged cortex, but it was not able to improve the biomechanical properties. ALN prevented trabecular bone deterioration and increased bone stiffness and bone strength of OVX bone. Finally, the combination of ALN with HF resulted in an increased cortical thickness in OVX rats when compared to single treatments. Compared to HF loading, ALN treatment is preferred for improving the compromised mechanical competence of OVX bone. In addition, the association of ALN with HF loading results in an additive effect on the cortical thickness. PMID:26027958

  11. Translational treatment of aphasia combining neuromodulation and behavioral intervention for lexical retrieval: implications from a single case study

    PubMed Central

    Galletta, Elizabeth E.; Vogel-Eyny, Amy

    2015-01-01

    Background: Transcranial direct current stimulation (tDCS), a non-invasive method of brain stimulation, is an adjunctive research-therapy for aphasia. The concept supporting translational application of tDCS is that brain plasticity, facilitated by language intervention, can be enhanced by non-invasive brain stimulation. This study combined tDCS with an ecologically focused behavioral approach that involved training nouns and verbs in sentences. Method: Participant: A 43-year-old, right-handed male with fluent-anomic aphasia who sustained a single-left-hemisphere-temporal-parietal stroke was recruited. Treatment: Instrumentation included the Soterix Medical 1 × 1 Device. Anodal tDCS was applied over Broca’s area. Behavioral materials included: sentence production, naming in the sentence context, and implementation of a social-conversational-discourse treatment. Design and Procedures: The independent variable of this crossover case-study was tDCS, and the dependent variables were language and quality-of-life measures. In each session the subject received language treatment with the first 20 minutes additionally including tDCS. Results: Performance in naming nouns and verbs in single words and sentences were obtained. Verb production in the sentence context increased after active anodal tDCS and speech-language treatment. Conclusion: Aphasia treatment that involves naming in the sentence context in conjunction with translational application of tDCS may be a promising approach for language-recovery post stroke. PMID:26347634

  12. Genetic Variations in the Serotonergic System Mediate a Combined, Weakened Response to SSRI Treatment: A Proposed Model1,2

    PubMed Central

    2015-01-01

    Abstract Individuals with the short (S) allele in the promoter region of the serotonin transporter gene (5-HTTLPR) show a less favorable response to selective serotonin reuptake inhibitor (SSRI) treatment than individuals with the long (L) allele. Similarly, individuals with the C(-1019)G allele for the mutation found in the promoter region of the serotonin 1A receptor gene (5-HTR1A) have shown blunted responses to SSRI treatment when compared with individuals lacking this polymorphism. While these findings have been replicated across multiple studies, only two studies to date have reported data for a gene–gene interaction associated with response to SSRI treatment. Both of these studies reported a combined effect for these genotypes, with individuals homozygous for the L allele and the C allele (5-HTTL/L−1AC/C) reporting the most favorable response to SSRI treatment, and individuals homozygous for the S allele and the G allele (5-HTTS/S–1AG/G) reporting the least favorable response to SSRI treatment. Additionally, no neural mechanisms have been proposed to explain why this gene–gene interaction has been observed. To that end, this article provides a review of the relevant literature associated with these polymorphisms and proposes a feasible model that describes a genotype-dependent modulation of postsynaptic serotonin signaling associated with the 5-HTT and 5-HTR1A genes. PMID:26464988

  13. Genetic Variations in the Serotonergic System Mediate a Combined, Weakened Response to SSRI Treatment: A Proposed Model(1,2).

    PubMed

    Pettitt, Adam

    2015-01-01

    Individuals with the short (S) allele in the promoter region of the serotonin transporter gene (5-HTTLPR) show a less favorable response to selective serotonin reuptake inhibitor (SSRI) treatment than individuals with the long (L) allele. Similarly, individuals with the C(-1019)G allele for the mutation found in the promoter region of the serotonin 1A receptor gene (5-HTR1A) have shown blunted responses to SSRI treatment when compared with individuals lacking this polymorphism. While these findings have been replicated across multiple studies, only two studies to date have reported data for a gene-gene interaction associated with response to SSRI treatment. Both of these studies reported a combined effect for these genotypes, with individuals homozygous for the L allele and the C allele (5-HTT(L/L)-1A(C/C)) reporting the most favorable response to SSRI treatment, and individuals homozygous for the S allele and the G allele (5-HTT(S/S)-1A(G/G)) reporting the least favorable response to SSRI treatment. Additionally, no neural mechanisms have been proposed to explain why this gene-gene interaction has been observed. To that end, this article provides a review of the relevant literature associated with these polymorphisms and proposes a feasible model that describes a genotype-dependent modulation of postsynaptic serotonin signaling associated with the 5-HTT and 5-HTR1A genes. PMID:26464988

  14. A new combination treatment for premature ejaculation: a sex therapist's perspective.

    PubMed

    Perelman, Michael A

    2006-11-01

    This article describes the diagnosis and treatment of premature ejaculation (PE) from a sex therapist's perspective and proposes that combination therapy integrating sex therapy and sexual pharmaceuticals is frequently the best treatment approach. Failure to appreciate the multimodal etiology and pathophysiology of PE makes the condition more difficult to diagnose and treat. Many physicians have tried pharmacologic approaches, but are limited to providing topical anesthetics or suggesting off-label uses of antidepressant and erectile dysfunction medications, because no medication is currently indicated specifically for PE. Furthermore, patients frequently relapse after discontinuation of the pharmaceutical. Sex therapists appreciate the multidimensional nature of PE for the patient and partner, but few patients seek out this approach, which is labor-intensive and often lacking long-term follow-up success. Most men with PE are not receiving treatment, secondary to their embarrassment about discussing their condition and a lack of clinician inquiry about sexual dysfunction. Even for those who do engage in discussion, diagnoses may be inconsistent, because a universally accepted definition of the condition and diagnostic criteria are nonexistent. Men with PE experience anxiety and lack sexual self-confidence; subsequently, their sexual and overall relationship frequently suffer. Because PE involves psychosocial and physiologic factors, treatment that addresses both should yield the best balance of function. There is interest in new agents designed specifically for PE to provide an improved pharmacotherapeutic opportunity. Yet, a combination treatment integrating pharmaceuticals and sex therapy would provide an optimized approach. Besides increasing coital latency directly, sexual pharmaceuticals could be used to provide greater opportunity for men to recognize their premonitory sensations to ejaculation more readily, facilitating a "choice point", which is key to

  15. Calcofluor White Combination Antifungal Treatments for Trichophyton rubrum and Candida albicans

    PubMed Central

    Kingsbury, Joanne M.; Heitman, Joseph; Pinnell, Sheldon R.

    2012-01-01

    Superficial mycoses caused by dermatophyte fungi are among the most common infections worldwide, yet treatment is restricted by limited effective drugs available, drug toxicity, and emergence of drug resistance. The stilbene fluorescent brightener calcofluor white (CFW) inhibits fungi by binding chitin in the cell wall, disrupting cell wall integrity, and thus entails a different mechanism of inhibition than currently available antifungal drugs. To identify novel therapeutic options for the treatment of skin infections, we compared the sensitivity of representative strains of the dermatophyte Trichophyton rubrum and Candida albicans to CFW and a panel of fluorescent brighteners and phytoalexin compounds. We identified the structurally related stilbene fluorescent brighteners 71, 85, 113 and 134 as fungicidal to both T. rubrum and C. albicans to a similar degree as CFW, and the stilbene phytoalexins pinosylvan monomethyl ether and pterostilbene inhibited to a lesser degree, allowing us to develop a structure-activity relationship for fungal inhibition. Given the abilities of CFW to absorb UV365 nm and bind specifically to fungal cell walls, we tested whether CFW combined with UV365 nm irradiation would be synergistic to fungi and provide a novel photodynamic treatment option. However, while both treatments individually were cytocidal, UV365 nm irradiation reduced sensitivity to CFW, which we attribute to CFW photoinactivation. We also tested combination treatments of CFW with other fungal inhibitors and identified synergistic interactions between CFW and some ergosterol biosynthesis inhibitors in C. albicans. Therefore, our studies identify novel fungal inhibitors and drug interactions, offering promise for combination topical treatment regimes for superficial mycoses. PMID:22792174

  16. Combined analysis of passive and active seismic measurements using additional geologic data for the determination of shallow subsurface structures

    NASA Astrophysics Data System (ADS)

    Horstmann, Tobias; Brüstle, Andrea; Spies, Thomas; Schlittenhardt, Jörg; Schmidt, Bernd

    2016-04-01

    A detailed knowledge of subsurface structure is essential for geotechnical projects and local seismic hazard analyses. Passive seismic methods like microtremor measurements are widely used in geotechnical practice, but limitations and developments are still in focus of scientific discussion. The presentation outlines microtremor measurements in the context of microzonation in the scale of districts or small communities. H/V measurements are used to identify zones with similar underground properties. Subsequently a shear wave velocity (Vs) depth profile for each zone is determined by array measurements at selected sites. To reduce possible uncertainties in dispersion curve analyses of passive array measurements and ambiguities within the inversion process, we conducted an additional active seismic experiment and included available geological information. The presented work is realized in the framework of the research project MAGS2 ("Microseismic Activity of Geothermal Systems") and deals with the determination of seismic hazard analysis at sites near deep geothermal power plants in Germany. The measurements were conducted in the Upper Rhine Graben (URG) and the Bavarian molasses, where geothermal power plants are in operation. The results of the H/V- and array-measurements in the region of Landau (URG) are presented and compared to known geological-tectonic structures. The H/V measurements show several zones with similar H/V-curves which indicate homogenous underground properties. Additionally to the passive seismic measurements an active refraction experiment was performed and evaluated using the MASW method („Multichannel Analysis of Surface Waves") to strengthen the determination of shear-wave-velocity depth profile. The dispersion curves for Rayleigh-waves of the active experiment support the Rayleigh-dispersion curves from passive measurements and therefore provide a valuable supplement. Furthermore, the Rayleigh-wave ellipticity was calculated to reduce

  17. [Photodynamic therapy in combined treatment of stage III non-small cell lung carcinoma].

    PubMed

    Akopov, A L; Rusanov, A A; Molodtsova, V P; Chistiakov, I V; Kazakov, N V; Urtenova, M A; Rait, Makhmud; Papaian, G V

    2013-01-01

    The aim of the study was to evaluate the effectiveness of combined treatment of locally advanced lung cancer with the use of neoadjuvant chemotherapy and surgery with the use of pre- and intraoperative photodynamic therapy. 20 patients with IIIa (n=7) and IIIb (n=13) stage of non-small cell lung carcinoma were included. At the time of diagnosis the surgical treatment was decided to abstain because of the trachea invasion in 9 patients, wide mediastinal invasion in 2 patients and contralateral mediastinal lymph nodes metastases in 2 patients; pneumonectomy was not possible due to the poor respiratory function in 7 patients. Neoadjuvant therapy included 3 courses of chemotherapy and endobronchial photodynamic therapy. During the operation, along with the lung resection (pneumonectomy - 15, lobectomy - 5), photodynamic therapy of the resection margins were carried out. No adjuvant treatment was done. Preoperative treatment led to partial regress of the disease in all cases; the goal of surgery was the complete tumor removal. No complications of the photodynamic therapy were observed. 18 surgical interventions were radical and two non-complete microscopically (R1). Postoperative morbidity was 20%, one patient died due to massive gastrointestinal bleeding. The average follow-up period was 18 months: 19 patients were alive, of them 18 with no signs of the disease recurrence. The first experience of the combined use of neoadjuvant chemotherapy and surgery with pre- and intraoperative photodynamic therapy demonstrates safety and efficacy of the suggested treatment tactics. PMID:23612332

  18. Interstitial laser and chemotherapy combined for treatment of human squamous cell carcinoma

    NASA Astrophysics Data System (ADS)

    Saxton, Romaine E.; Graeber, Ines P.; Suh, Michael J.; Paek, Woo H.; Paiva, Marcos B.; Castro, Dan J.

    1997-05-01

    We have tested a combined treatment for squamous cell carcinoma based on laser activation of anti-cancer drugs in human solid tumors. Cisplatinum and the new anthrapyrazole CI- 941 are reported to interact with photothermal energy. Combined intratumor drug and interstitial laser therapy were tested in nude mice bearing human squamous cell carcinomas grown as subcutaneous tumors. Cisplatinum injection (1.2 mg/500 mg tumor) 4 hours before KTP laser fiberoptic treatment (532 nm, 0.8 W, 10 sec/site, 300 J) resulted in complete tumor regression in 6/8 animals, while intratumor drug alone led to partial regression and tumor regrowth in 10/10 mice during 12 weeks followup. Laser treatment alone resulted in ablation followed by recurrence in 7/8 cases. Similar laser treatment 4 hours after injection of the light sensitive anthrapyrazole CI-941 led to complete tumor regression in 15/22 cases. CI-941 alone at drug levels up to 1.2 mg/gm tumor in 30 mice induced stasis followed by progression in all cases. Finally, tumor retention of 14C-CI-941 in mice 4 hrs after intralesional injection was 200-fold higher than via the systemic route and by 24 hrs remained 40-fold higher, but drug levels in normal tissues were reduced 10 - 100 fold. The data suggest laser chemotherapy may be a useful new treatment for human cancer.

  19. [CHRONOLOGICAL APPROACH TO COMPLEX TREATMENT OF PATIENTS WITH CHRONIC CHOLECYSTITIS IN COMBINATION WITH THE OPISTHORCHIASIS].

    PubMed

    Poddubnaya, O A

    2015-01-01

    The development of new technologies of medical rehabilitation of patients with chronic cholecystitis in combination with a chronic opisthorchiasis, remains an actual problem of clinical gastroenterology. The use of a group chronobiological approach to the complex treatment of these patients including EHF-therapy allows to increase efficiency of the conducted measures. The analysis of results testified to beneficial effect of such approach on indicators of a functional condition of hepatobiliarity system and an organism in general. The positive dynamics of all studied indicators provided high thera- peutic effect (to 84.8%), and the revealed contingency of these results to features of carrying out treatment, allowed to establish their interrelation (χ² = 104.13; p = 0.0001; Kramer's V-coefficient = 0.35). It guarantees (is a predictor) receiving of high therapeutic effect (Percent Concordant of = 86.4%; the standardized coefficient = 2.54; r = 0.001) of the complex treatment including EHF-therapy with use of chronobiological approach to treatment of patients with chronic cholecystitis in combination with a chronic opisthorchiasis. The established dependences have a great practical importance and can be used in a choice of tactics of treatment of this category of patients. PMID:27214989

  20. Electrochemical advanced oxidation and biological processes for wastewater treatment: a review of the combined approaches.

    PubMed

    Ganzenko, Oleksandra; Huguenot, David; van Hullebusch, Eric D; Esposito, Giovanni; Oturan, Mehmet A

    2014-01-01

    As pollution becomes one of the biggest environmental challenges of the twenty-first century, pollution of water threatens the very existence of humanity, making immediate action a priority. The most persistent and hazardous pollutants come from industrial and agricultural activities; therefore, effective treatment of this wastewater prior to discharge into the natural environment is the solution. Advanced oxidation processes (AOPs) have caused increased interest due to their ability to degrade hazardous substances in contrast to other methods, which mainly only transfer pollution from wastewater to sludge, a membrane filter, or an adsorbent. Among a great variety of different AOPs, a group of electrochemical advanced oxidation processes (EAOPs), including electro-Fenton, is emerging as an environmental-friendly and effective treatment process for the destruction of persistent hazardous contaminants. The only concern that slows down a large-scale implementation is energy consumption and related investment and operational costs. A combination of EAOPs with biological treatment is an interesting solution. In such a synergetic way, removal efficiency is maximized, while minimizing operational costs. The goal of this review is to present cutting-edge research for treatment of three common and problematic pollutants and effluents: dyes and textile wastewater, olive processing wastewater, and pharmaceuticals and hospital wastewater. Each of these types is regarded in terms of recent scientific research on individual electrochemical, individual biological and a combined synergetic treatment. PMID:24965093

  1. Combined effects of high pressure processing and addition of soy sauce and olive oil on safety and quality characteristics of chicken breast meat.

    PubMed

    Kruk, Zbigniew A; Kim, Hyun Joo; Kim, Yun Ji; Rutley, David L; Jung, Samooel; Lee, Soo Kee; Jo, Cheorun

    2014-02-01

    This study was conducted to evaluate the combined effect of high pressure (HP) with the addition of soy sauce and/or olive oil on the quality and safety of chicken breast meats. Samples were cut into 100 g pieces and 10% (w/w) of soy sauce (SS), 10% (w/w) of olive oil (OO), and a mixture of both 5% of soy sauce and 5% olive oil (w/w) (SO) were pressurized into meat with high pressure at 300 or 600 MPa. Cooking loss was lower in OO samples than SS samples. With increased pressure to 600 MPa, the oleic acid content of OO samples increased. The total unsaturated fatty acids were the highest in SO and OO 600 MPa samples. Lipid oxidation was retarded by addition of olive oil combined with HP. The addition of olive oil and soy sauce followed by HP decreased the amount of volatile basic nitrogen during storage and reduced the population of pathogens. Sensory evaluation indicated that the addition of olive oil enhanced the overall acceptance and willingness to buy. In conclusion, the combination of HP with the addition of soy sauce and/or olive oil is an effective technology that can improve chemical, health, sensory qualities and safety of chicken breast. PMID:25049950

  2. Combined Effects of High Pressure Processing and Addition of Soy Sauce and Olive Oil on Safety and Quality Characteristics of Chicken Breast Meat

    PubMed Central

    Kruk, Zbigniew A.; Kim, Hyun Joo; Kim, Yun Ji; Rutley, David L.; Jung, Samooel; Lee, Soo Kee; Jo, Cheorun

    2014-01-01

    This study was conducted to evaluate the combined effect of high pressure (HP) with the addition of soy sauce and/or olive oil on the quality and safety of chicken breast meats. Samples were cut into 100 g pieces and 10% (w/w) of soy sauce (SS), 10% (w/w) of olive oil (OO), and a mixture of both 5% of soy sauce and 5% olive oil (w/w) (SO) were pressurized into meat with high pressure at 300 or 600 MPa. Cooking loss was lower in OO samples than SS samples. With increased pressure to 600 MPa, the oleic acid content of OO samples increased. The total unsaturated fatty acids were the highest in SO and OO 600 MPa samples. Lipid oxidation was retarded by addition of olive oil combined with HP. The addition of olive oil and soy sauce followed by HP decreased the amount of volatile basic nitrogen during storage and reduced the population of pathogens. Sensory evaluation indicated that the addition of olive oil enhanced the overall acceptance and willingness to buy. In conclusion, the combination of HP with the addition of soy sauce and/or olive oil is an effective technology that can improve chemical, health, sensory qualities and safety of chicken breast. PMID:25049950

  3. Degradation of aromatic amines in textile-dyeing sludge by combining the ultrasound technique with potassium permanganate treatment.

    PubMed

    Liang, Jieying; Ning, Xun-An; An, Taicheng; Sun, Jian; Zhang, Yaping; Wang, Yujie

    2016-08-15

    This paper reports, for the first time, a combined technique of ultrasound (US) with KMnO4 degradation of aromatic amines in a textile-dyeing sludge. The reaction mechanisms and the degradation kinetics of aromatic amines at various operating parameters (KMnO4 dosage, US power density and pH) were systematically examined by the combined system of US-KMnO4. The results indicated that there was a synergistic effect between US and KMnO4, as US greatly enhanced KMnO4 in the degradation of aromatic amines and exhibited apparent sludge disintegration and separated pollutants from the sludge. In addition to accelerating the Mn(VII) reaction with pollutants in the filtrate, US also caused Mn(VII) to enter the porous sludge and sufficiently facilitated the reaction of the strongly absorbed aromatic amines. The combined treatment of US-KMnO4 was effective in the degradation of aromatic amines in textile-dyeing sludge. On average, 58.7% of monocyclic anilines, 88.3% of other forms of aromatic amines, and 24.0% of TOC were removed under the optimal operating conditions of a KMnO4 dosage of 12mM, an US power density of 1.80W/cm(3) and pH 5. The present study proposed US-KMnO4 treatment as a practical method for the disposal of aromatic amines in textile-dyeing sludge. PMID:27107230

  4. The Effectiveness of Additional Treatment Modalities after the Failure of Recanalization by Thrombectomy Alone in Acute Vertebrobasilar Arterial Occlusion

    PubMed Central

    Kim, Seong Mook; Sohn, Sung-Il; Hong, Jeong-Ho; Chang, Hyuk-Won; Lee, Chang-Young

    2015-01-01

    Objective Acute vertebrobasilar artery occlusion (AVBAO) is a devastating disease with a high mortality rate. One of the most important factors affecting favorable clinical outcome is early recanalization. Mechanical thrombectomy is an emerging treatment strategy for achieving a high recanalization rates. However, thrombectomy alone can be insufficient to complete recanalization, especially for acute stroke involving large artery atheromatous disease. The purpose of this study is to investigate the safety and efficacy of mechanical thrombectomy in AVBAO. Methods Fourteen consecutive patients with AVBAO were treated with mechanical thrombectomy. Additional multimodal treatments were intra-arterial (IA) thrombolysis, balloon angioplasty, or permanent stent placement. Recanalization by thrombectomy alone and multimodal treatments were assessed by the Thrombolysis in Cerebral Infarction (TICI) score. Clinical outcome was determined using the National Institutes of Health Stroke Scale (NIHSS) at 7 days and the modified Rankin Scale (mRS) at 3 months. Results Thrombectomy alone and multimodal treatments were performed in 10 patients (71.4%) and 4 patients (28.6%), respectively. Successful recanalization (TICI 2b-3) was achieved in 11 (78.6%). Among these 11 patients, 3 (27.3%) underwent multimodal treatment due to underlying atherosclerotic stenosis. Ten (71.4%) of the 14 showed NIHSS score improvement of >10. Overall mortality was 3 (21.4%) of 14. Conclusion We suggest that mechanical thrombectomy is safe and effective for improving recanalization rates in AVBAO, with low complication rates. Also, in carefully selected patients after the failure of recanalization by thrombectomy alone, additional multimodal treatment such as IA thrombolysis, balloons, or stents can be needed to achieve successful recanalization. PMID:26713141

  5. Optimal Combinations of Broadly Neutralizing Antibodies for Prevention and Treatment of HIV-1 Clade C Infection

    PubMed Central

    Wagh, Kshitij; Bhattacharya, Tanmoy; Williamson, Carolyn; Robles, Alex; Bayne, Madeleine; Garrity, Jetta; Rist, Michael; Rademeyer, Cecilia; Yoon, Hyejin; Lapedes, Alan; Gao, Hongmei; Greene, Kelli; Louder, Mark K.; Kong, Rui; Karim, Salim Abdool; Burton, Dennis R.; Barouch, Dan H.; Nussenzweig, Michel C.; Mascola, John R.; Morris, Lynn; Montefiori, David C.; Korber, Bette; Seaman, Michael S.

    2016-01-01

    The identification of a new generation of potent broadly neutralizing HIV-1 antibodies (bnAbs) has generated substantial interest in their potential use for the prevention and/or treatment of HIV-1 infection. While combinations of bnAbs targeting distinct epitopes on the viral envelope (Env) will likely be required to overcome the extraordinary diversity of HIV-1, a key outstanding question is which bnAbs, and how many, will be needed to achieve optimal clinical benefit. We assessed the neutralizing activity of 15 bnAbs targeting four distinct epitopes of Env, including the CD4-binding site (CD4bs), the V1/V2-glycan region, the V3-glycan region, and the gp41 membrane proximal external region (MPER), against a panel of 200 acute/early clade C HIV-1 Env pseudoviruses. A mathematical model was developed that predicted neutralization by a subset of experimentally evaluated bnAb combinations with high accuracy. Using this model, we performed a comprehensive and systematic comparison of the predicted neutralizing activity of over 1,600 possible double, triple, and quadruple bnAb combinations. The most promising bnAb combinations were identified based not only on breadth and potency of neutralization, but also other relevant measures, such as the extent of complete neutralization and instantaneous inhibitory potential (IIP). By this set of criteria, triple and quadruple combinations of bnAbs were identified that were significantly more effective than the best double combinations, and further improved the probability of having multiple bnAbs simultaneously active against a given virus, a requirement that may be critical for countering escape in vivo. These results provide a rationale for advancing bnAb combinations with the best in vitro predictors of success into clinical trials for both the prevention and treatment of HIV-1 infection. PMID:27028935

  6. Optimal combinations of broadly neutralizing antibodies for prevention and treatments of HIV-1 clade C infection

    DOE PAGESBeta

    Wagh, Kshitij; Bhattacharya, Tanmoy; Williamson, Carolyn; Robles, Alex; Bayne, Madeleine; Garrity, Jetta; Rist, Michael; Rademeyer, Cecilia; Yoon, Hyejin; Lapedes, Alan Scott; et al

    2016-03-30

    In this study, the identification of a new generation of potent broadly neutralizing HIV-1 antibodies (bnAbs) has generated substantial interest in their potential use for the prevention and/or treatment of HIV-1 infection. While combinations of bnAbs targeting distinct epitopes on the viral envelope (Env) will likely be required to overcome the extraordinary diversity of HIV-1, a key outstanding question is which bnAbs, and how many, will be needed to achieve optimal clinical benefit. We assessed the neutralizing activity of 15 bnAbs targeting four distinct epitopes of Env, including the CD4-binding site (CD4bs), the V1/V2-glycan region, the V3-glycan region, and themore » gp41 membrane proximal external region (MPER), against a panel of 200 acute/early clade C HIV-1 Env pseudoviruses. A mathematical model was developed that predicted neutralization by a subset of experimentally evaluated bnAb combinations with high accuracy. Using this model, we performed a comprehensive and systematic comparison of the predicted neutralizing activity of over 1,600 possible double, triple, and quadruple bnAb combinations. The most promising bnAb combinations were identified based not only on breadth and potency of neutralization, but also other relevant measures, such as the extent of complete neutralization and instantaneous inhibitory potential (IIP). By this set of criteria, triple and quadruple combinations of bnAbs were identified that were significantly more effective than the best double combinations, and further improved the probability of having multiple bnAbs simultaneously active against a given virus, a requirement that may be critical for countering escape in vivo. These results provide a rationale for advancing bnAb combinations with the best in vitro predictors of success into clinical trials for both the prevention and treatment of HIV-1 infection.« less

  7. Photocatalytic water treatment over WO 3 under visible light irradiation combined with ozonation

    NASA Astrophysics Data System (ADS)

    Nishimoto, Shunsuke; Mano, Takayuki; Kameshima, Yoshikazu; Miyake, Michihiro

    2010-11-01

    Photocatalytic water treatment over bare WO 3 under visible light irradiation combined with ozonation (O 3/vis/WO 3) was investigated using an aqueous phenol solution as model wastewater. The O 3/vis/WO 3 treatment exhibited a much higher total organic carbon removal than ozonation alone. Bare WO 3 was found to function as an active visible-light-responsive photocatalyst for decomposition of organic compounds in the presence of ozone, which readily reacts with photoexcited electrons in the conduction band of WO 3.

  8. [Use of magnetic therapy combined with galvanization and tissue electrophoresis in the treatment of trophic ulcers].

    PubMed

    Alekseenko, A V; Gusak, V V; Stoliar, V F; Iftodiĭ, A G; Tarabanchuk, V V; Shcherban, N G; Naumets, A A

    1993-01-01

    The results of treatment of 86 patients with the use of magnetotherapy in combination with galvanization and intratissue electrophoresis are presented. To create an electric field, the "Potok-1" apparatus with a density of current equal to 0.05-0.1 mA/cm2 was employed. Simultaneously, the "MAG-30" apparatus for low-frequency magnetotherapy with induction of 30 mT and area of exposure of 20 cm2 was applied to a trophic ulcer site. The use of magnetogalvanotherapy in the complex of treatment of trophic ulcers of the lower extremities is recommended. PMID:8139189

  9. Tunable wetting behavior of nanostructured poly(dimethylsiloxane) by plasma combination treatments

    NASA Astrophysics Data System (ADS)

    Peter, Nicolas J.; Zhang, Xiao-Sheng; Chu, Shi-Gan; Zhu, Fu-Yun; Seidel, Helmut; Zhang, Hai-Xia

    2012-11-01

    This letter reports on the tunable wetting behavior of poly(dimethylsiloxane) (PDMS) via the combination of nanostructuring and plasma treatment. The PDMS is first micro/nanostructured by an integrated casting process. Subsequently, an inductively coupled plasma is used to modify the siloxanes' surface chemistry. Sulfur hexafluoride, fluoroform, as well as octafluorocyclobutane plasma were applied to treat PDMS samples successively. By optimizing the treatment parameters, tunable wettability of the siloxane was observed, i.e., superhydrophilicity and superhydrophobicity. The stability of its wetting behavior has been demonstrated after 24 h. This stable and tunable wettability extends the applications of PDMS in microfluidic systems.

  10. Treatment of Murine Cerebral Malaria by Artemisone in Combination with Conventional Antimalarial Drugs: Antiplasmodial Effects and Immune Responses

    PubMed Central

    Guiguemde, W. Armand; Hunt, Nicholas H.; Guo, Jintao; Marciano, Annael; Haynes, Richard K.; Clark, Julie; Guy, R. Kiplin

    2014-01-01

    The decreasing effectiveness of antimalarial therapy due to drug resistance necessitates constant efforts to develop new drugs. Artemisinin derivatives are the most recent drugs that have been introduced and are considered the first line of treatment, but there are already indications of Plasmodium falciparum resistance to artemisinins. Consequently, drug combinations are recommended for prevention of the induction of resistance. The research here demonstrates the effects of novel combinations of the new artemisinin derivative, artemisone, a recently described 10-alkylamino artemisinin derivative with improved antimalarial activity and reduced neurotoxicity. We here investigate its ability to kill P. falciparum in a high-throughput in vitro assay and to protect mice against lethal cerebral malaria caused by Plasmodium berghei ANKA when used alone or in combination with established antimalarial drugs. Artemisone effects against P. falciparum in vitro were synergistic with halofantrine and mefloquine, and additive with 25 other drugs, including chloroquine and doxycycline. The concentrations of artemisone combinations that were toxic against THP-1 cells in vitro were much higher than their effective antimalarial concentration. Artemisone, mefloquine, chloroquine, or piperaquine given individually mostly protected mice against cerebral malaria caused by P. berghei ANKA but did not prevent parasite recrudescence. Combinations of artemisone with any of the other three drugs did completely cure most mice of malaria. The combination of artemisone and chloroquine decreased the ratio of proinflammatory (gamma interferon, tumor necrosis factor) to anti-inflammatory (interleukin 10 [IL-10], IL-4) cytokines in the plasma of P. berghei-infected mice. Thus, artemisone in combinations with other antimalarial drugs might have a dual action, both killing parasites and limiting the potentially deleterious host inflammatory response. PMID:24913162

  11. Invasive leg vein treatment with 1064/1319 Nd:YAG laser: combination with dye laser treatment

    NASA Astrophysics Data System (ADS)

    Smucler, Roman; Horak, Ladislav; Mazanek, Jiri

    1999-06-01

    More than 2 500 leg veins patients were treated with dye laser / ScleroPlus, Candela, USA / successfully in our clinic and we use this therapy as the basic cosmetics treatment. But especially diameter of leg vein is limiting factor. Very often we have to treat some cases that are not ideal for classical surgical or for dye laser method. We decided to make invasive perivenous laser coagulation. We adapted original Czech 1064/1319 nm Nd:YAG laser / US patent pending /, which is new combine tool, for invasive application. Principe: After we have penetrated the cutis with laser fiber we coagulate leg veins during slowly perivenous motion. Perfect preoperative examination is a condition of success. After 15 months we have very interesting results. Some patients / 15%/ were perfect treated only with this possibility but excellent results are acquired from combination with dye laser.

  12. Effect of two-stage coagulant addition on coagulation-ultrafiltration process for treatment of humic-rich water.

    PubMed

    Liu, Ting; Chen, Zhong-lin; Yu, Wen-zheng; Shen, Ji-min; Gregory, John

    2011-08-01

    A novel two-stage coagulant addition strategy applied in a coagulation-ultrafiltration (UF) process for treatment of humic-rich water at neutral pH was investigated in this study. When aluminum sulfate (alum) doses were set at a ratio of 3:1 added during rapid mix stage and half way through flocculation stage, the integrated process of two-stage alum addition achieved almost the same organic matter removal as that of conventional one-stage alum addition at the same overall dose. Whereas membrane fouling could be effectively mitigated by the two-stage addition exhibited by trans-membrane pressure (TMP) developments. The TMP developments were found to be primarily attributed to external fouling on membrane surface, which was closely associated with floc characteristics. The results of jar tests indicated that the average size of flocs formed in two-stage addition mode roughly reached one half larger than that in one-stage addition mode, which implied a beneficial effect on membrane fouling reduction. Moreover, the flocs with more irregular structure and lower effective density resulted from the two-stage alum addition, which caused higher porosity of cake layer formed by such flocs on membrane surface. Microscopic observations of membrane surface demonstrated that internal fouling in membrane pores could be also remarkably limited by two-stage alum addition. It is likely that the freshly formed hydroxide precipitates were distinct in surface characteristics from the aged precipitates due to formation of more active groups or adsorption of more labile aluminum species. Consequently, the flocs could further connect and aggregate to contribute to preferable properties for filtration performance of the coagulation-UF process. As a simple and efficient approach, two-stage coagulant addition strategy could have great practical significance in coagulation-membrane processes. PMID:21704354

  13. Efficacy of Single and Combined Antibiotic Treatments of Anthrax in Rabbits.

    PubMed

    Weiss, Shay; Altboum, Zeev; Glinert, Itai; Schlomovitz, Josef; Sittner, Assa; Bar-David, Elad; Kobiler, David; Levy, Haim

    2015-12-01

    Respiratory anthrax is a fatal disease in the absence of early treatment with antibiotics. Rabbits are highly susceptible to infection with Bacillus anthracis spores by intranasal instillation, succumbing within 2 to 4 days postinfection. This study aims to test the efficiency of antibiotic therapy to treat systemic anthrax in this relevant animal model. Delaying the initiation of antibiotic administration to more than 24 h postinfection resulted in animals with systemic anthrax in various degrees of bacteremia and toxemia. As the onset of symptoms in humans was reported to start on days 1 to 7 postexposure, delaying the initiation of treatment by 24 to 48 h (time frame for mass distribution of antibiotics) may result in sick populations. We evaluated the efficacy of antibiotic administration as a function of bacteremia levels at the time of treatment initiation. Here we compare the efficacy of treatment with clarithromycin, amoxicillin-clavulanic acid (Augmentin), imipenem, vancomycin, rifampin, and linezolid to the previously reported efficacy of doxycycline and ciprofloxacin. We demonstrate that treatment with amoxicillin-clavulanic acid, imipenem, vancomycin, and linezolid were as effective as doxycycline and ciprofloxacin, curing rabbits exhibiting bacteremia levels of up to 10(5) CFU/ml. Clarithromycin and rifampin were shown to be effective only as a postexposure prophylactic treatment but failed to treat the systemic (bacteremic) phase of anthrax. Furthermore, we evaluate the contribution of combined treatment of clindamycin and ciprofloxacin, which demonstrated improvement in efficacy compared to ciprofloxacin alone. PMID:26392505

  14. Insights on the solubilization products after combined alkaline and ultrasonic pre-treatment of sewage sludge.

    PubMed

    Tian, Xinbo; Wang, Chong; Trzcinski, Antoine Prandota; Lin, Leonard; Ng, Wun Jern

    2015-03-01

    This work provides insights on the solubilization products after a simultaneous combination of alkaline and ultrasonic (ALK+ULS) pre-treatment of sewage sludge. Soluble chemical oxygen demand (SCOD) increased from 1200 to 11,000 mg/L after such treatment. Organics with molecular weight around 5.6 kDa were solubilized because of the synergistic effect of ultrasound and alkali. Organics with molecular weight larger than 300 kDa increased from 7.8% to 60%, 16% and 42.3% after ULS, ALK and ALK+ULS treatment, respectively. Excitation emission matrix fluorescence spectroscopy analysis identified soluble microbial product-like and humic acid-like matters as the main solubilization products. Sludge anaerobic biodegradability was significantly enhanced with the simultaneous application of ALK+ULS pre-treatment. ALK+ULS pre-treatment resulted in 37.8% biodegradability increase compared to the untreated sludge. This value was higher compared to the biodegradability increase induced by individual ALK pre-treatment (5.7%) or individual ULS pre-treatment (20.7%) under the same conditions applied. PMID:25766017

  15. Serum lipids and proteins during treatment with a new oral contraceptive combination containing desogestrel.

    PubMed

    Penttilä, I M; Bergink, E W; Holma, P; Hulkko, S; Makkonen, M; Pyörälä, T; Castrén, O

    1983-12-01

    The present study was carried out to measure lipid and protein levels in serum of healthy women during treatment with a new oral contraceptive combination containing 0.075 mg desogestrel (Org 2969, 17 alpha-ethinyl-18-methyl-11-methylene-4-estren-17-ol) plus 0.050 mg ethinyloestradiol per tablet. All 30 volunteers took 1 tablet daily for 21 consecutive days, followed by a tablet-free period of 7 days. Treatment lasted 3 months. At the end of treatment serum total cholesterol had increased by 0.26 mmol/l (5.0%), high-density lipoprotein-cholesterol by 0.22 mmol/l (15.2%) and triglycerides by 0.43 mmol/l (50%); the calculated low-density lipoprotein cholesterol had decreased by 0.16 mmol/l (4.9%). All lipid concentrations had returned to initial levels 2 months after treatment stopped. After 3 months treatment serum ceruloplasmin, cortisol-binding globulin capacity, sex-hormone-binding globulin capacity and thyroxine-binding globulin had significantly increased by 85.2, 133, 206 and 101%, respectively. All protein levels returned to normal 2 months after treatment stopped. The relationship between serum lipids and hormone-binding proteins has been discussed, as well as the significance of the high-density lipoprotein level with regard to contraceptive treatment. PMID:6232161

  16. The Evolution of Fungicide Resistance Resulting from Combinations of Foliar-Acting Systemic Seed Treatments and Foliar-Applied Fungicides: A Modeling Analysis.

    PubMed

    Kitchen, James L; van den Bosch, Frank; Paveley, Neil D; Helps, Joseph; van den Berg, Femke

    2016-01-01

    For the treatment of foliar diseases of cereals, fungicides may be applied as foliar sprays or systemic seed treatments which are translocated to leaves. Little research has been done to assess the resistance risks associated with foliar-acting systemic seed treatments when used alone or in combination with foliar sprays, even though both types of treatment may share the same mode of action. It is therefore unknown to what extent adding a systemic seed treatment to a foliar spray programme poses an additional resistance risk and whether in the presence of a seed treatment additional resistance management strategies (such as limiting the total number of treatments) are necessary to limit the evolution of fungicide-resistance. A mathematical model was developed to simulate an epidemic and the resistance evolution of Zymoseptoria tritici on winter wheat, which was used to compare different combinations of seed and foliar treatments by calculating the fungicide effective life, i.e. the number of years before effective disease control is lost to resistance. A range of parameterizations for the seed treatment fungicide and different fungicide uptake models were compared. Despite the different parameterizations, the model consistently predicted the same trends in that i) similar levels of efficacy delivered either by a foliar-acting seed treatment, or a foliar application, resulted in broadly similar resistance selection, ii) adding a foliar-acting seed treatment to a foliar spray programme increased resistance selection and usually decreased effective life, and iii) splitting a given total dose-by adding a seed treatment to foliar treatments, but decreasing dose per treatment-gave effective lives that were the same as, or shorter than those given by the spray programme alone. For our chosen plant-pathogen-fungicide system, the model results suggest that to effectively manage selection for fungicide-resistance, foliar acting systemic seed treatments should be included as

  17. Rapid reduction of lead leachate from hazardous fly ash using microwave treatment with acid combination.

    PubMed

    Chou, Chih-Mei; Wang, Li-Pang; Kao, Jimmy C M; Lin, Kae-Long; Chang, Yu-Min

    2016-02-01

    The novelty of this study is to rapidly reduce hazardous lead leachates from solid waste using microwave digestion treatment, which is an energy-saving and low greenhouse gas emission technology. The article presents the reduction of toxic characteristic leaching procedure-extractable lead concentration in the municipal solid waste incineration fly ash by the microwave digestion treatment in HNO3/H2SO4 combination, and focuses on the effects of treatment time and temperature. The results obtained from this study indicated a significant reduction efficiency of toxic characteristic leaching procedure-extractable lead concentration and showed sufficient reduction in leaching levels to render the treated fly ash safe in lead compound leaching characteristics. The reduction efficiency of toxic characteristic leaching procedure-extractable lead concentration can reach 98% in 15 minutes of treatment time. This is equivalent to the original toxic characteristic leaching procedure-extractable lead concentration of 46.2 mg L(-1) in raw fly ash being reduced down to less than 1.0 mg L(-1). Based on the experimental data obtained in this study, a useful correlation between reduction efficiency and treatment conditions is proposed. For engineering applications, the necessary minimum treatment time is solved using a graphic illustration method, by which the minimum treatment time (t(min)) is obtained if the desired reduction efficiency (η) and treatment temperature (T) are known. The effects of treatment time and temperature are discussed. Some problems caused by the microwave digestion treatment method are also delineated in this article. PMID:26526019

  18. Combination of Levo-Tetrahydropalmatine and Low Dose Naltrexone: A Promising Treatment for Prevention of Cocaine Relapse.

    PubMed

    Sushchyk, Sarah; Xi, Zheng-Xiong; Wang, Jia Bei

    2016-05-01

    Relapse to drug use is often cited as the major obstacle in overcoming a drug addiction. Whereas relapse can occur for a myriad of reasons, it is well established that complex neuroadaptations that occur over the course of addiction are major factors. Cocaine, as a potent dopamine transporter blocker, specifically induces alterations in the dopaminergic as well as other monoaminergic neurotransmissions, which lead to cocaine abuse and dependence. Evidence also suggests that adaptations in the endogenous opioids play important roles in pathophysiology of cocaine addiction. Following this evidence, we investigated a combination medication, levo-tetrahydropalmatine (l-THP) and low dose naltrexone (LDN), targeting primarily dopaminergic and endogenous opioid systems as a cocaine-relapse-prevention treatment. In the present study Wistar rats were used to assess the effects ofl-THP and LDN on cocaine self-administration, drug-seeking behavior during cocaine reinstatement, spontaneous locomotion, and effects on the endogenous opioid system. We determined that the combination ofl-THP and LDN reduces drug-seeking behavior during reinstatement more potently thanl-THP alone. Additionally, the combination ofl-THP and LDN attenuates the sedative locomotor effect induced byl-THP. Furthermore, we revealed that treatment with the combination ofl-THP and LDN has an upregulatory effect on both plasmaβ-endorphin and hypothalamic POMC that was not observed inl-THP-treated groups. These results suggest that the combination ofl-THP and LDN has great potential as an effective and well-tolerated medication for cocaine relapse prevention. PMID:26903543

  19. A Preclinical Study Combining the DNA Repair Inhibitor Dbait with Radiotherapy for the Treatment of Melanoma1

    PubMed Central

    Biau, Julian; Devun, Flavien; Jdey, Wael; Kotula, Ewa; Quanz, Maria; Chautard, Emmanuel; Sayarath, Mano; Sun, Jian-Sheng; Verrelle, Pierre; Dutreix, Marie

    2014-01-01

    Melanomas are highly radioresistant tumors, mainly due to efficient DNA double-strand break (DSB) repair. Dbait (which stands for DNA strand break bait) molecules mimic DSBs and trap DNA repair proteins, thereby inhibiting repair of DNA damage induced by radiation therapy (RT). First, the cytotoxic efficacy of Dbait in combination with RT was evaluated in vitro in SK28 and 501mel human melanoma cell lines. Though the extent of RT-induced damage was not increased by Dbait, it persisted for longer revealing a repair defect. Dbait enhanced RT efficacy independently of RT doses. We further assayed the capacity of DT01 (clinical form of Dbait) to enhance efficacy of “palliative” RT (10 × 3 Gy) or “radical” RT (20 × 3 Gy), in an SK28 xenografted model. Inhibition of repair of RT-induced DSB by DT01 was revealed by the significant increase of micronuclei in tumors treated with combined treatment. Mice treated with DT01 and RT combination had significantly better tumor growth control and longer survival compared to RT alone with the “palliative” protocol [tumor growth delay (TGD) by 5.7-fold; median survival: 119 vs 67 days] or the “radical” protocol (TGD by 3.2-fold; median survival: 221 vs 109 days). Only animals that received the combined treatment showed complete responses. No additional toxicity was observed in any DT01-treated groups. This preclinical study provides encouraging results for a combination of a new DNA repair inhibitor, DT01, with RT, in the absence of toxicity. A first-in-human phase I study is currently under way in the palliative management of melanoma in-transit metastases (DRIIM trial). PMID:25379020

  20. Combination of Levo-Tetrahydropalmatine and Low Dose Naltrexone: A Promising Treatment for Prevention of Cocaine Relapse

    PubMed Central

    Sushchyk, Sarah; Xi, Zheng-Xiong

    2016-01-01

    Relapse to drug use is often cited as the major obstacle in overcoming a drug addiction. Whereas relapse can occur for a myriad of reasons, it is well established that complex neuroadaptations that occur over the course of addiction are major factors. Cocaine, as a potent dopamine transporter blocker, specifically induces alterations in the dopaminergic as well as other monoaminergic neurotransmissions, which lead to cocaine abuse and dependence. Evidence also suggests that adaptations in the endogenous opioids play important roles in pathophysiology of cocaine addiction. Following this evidence, we investigated a combination medication, levo-tetrahydropalmatine (l-THP) and low dose naltrexone (LDN), targeting primarily dopaminergic and endogenous opioid systems as a cocaine-relapse-prevention treatment. In the present study Wistar rats were used to assess the effects of l-THP and LDN on cocaine self-administration, drug-seeking behavior during cocaine reinstatement, spontaneous locomotion, and effects on the endogenous opioid system. We determined that the combination of l-THP and LDN reduces drug-seeking behavior during reinstatement more potently than l-THP alone. Additionally, the combination of l-THP and LDN attenuates the sedative locomotor effect induced by l-THP. Furthermore, we revealed that treatment with the combination of l-THP and LDN has an upregulatory effect on both plasma β-endorphin and hypothalamic POMC that was not observed in l-THP-treated groups. These results suggest that the combination of l-THP and LDN has great potential as an effective and well-tolerated medication for cocaine relapse prevention. PMID:26903543

  1. Enhanced performance of a submerged membrane bioreactor with powdered activated carbon addition for municipal secondary effluent treatment.

    PubMed

    Lin, Hongjun; Wang, Fangyuan; Ding, Linxian; Hong, Huachang; Chen, Jianrong; Lu, Xiaofeng

    2011-09-15

    The aim of this study was to investigate the feasibility of PAC-MBR process treating municipal secondary effluent. Two laboratory-scale submerged MBRs (SMBR) with and without PAC addition were continuously operated in parallel for secondary effluent treatment. Approximately 63%TOC, 95% NH(4)(+)-N and 98% turbidity in secondary effluent were removed by the PAC-MBR process. Most organics in the secondary effluent were found to be low molecular weight (MW) substances, which could be retained in the reactor and then removed to some extent by using PAC-MBR process. Parallel experiments showed that the addition of PAC significantly increased organic removal and responsible for the largest fraction of organic removal. Membrane fouling analysis showed the enhanced membrane performance in terms of sustainable operational time and filtration resistances by PAC addition. Based on these results, the PAC-MBR process was considered as an attractive option for the reduction of pollutants in secondary effluent. PMID:21794980

  2. [BALLOON DILATATION IN COMBINATION WITH A DOSED PAPILLOTOMY IN THE TREATMENT OF DIFFICULT FORMS OF CHOLEDOCHOLITHIASIS].

    PubMed

    Shapovalova, E I; Grubnik, V V; Tkachenko, A I; Gerasimov, D V; Romak, R P

    2016-04-01

    Results of treatment was studied in 2008 - 2015 yrs in 57 patients, suffering "difficult stones" (choledocholithiasis), in whom a dosed papillotomy in combination with the balloon dilatation. The advantages of application of combined dosed endoscopic papillosphincterotomy and balloon dilatation, comparing with complete endoscopic papillosphincterotomy, while treating "difficult stones" of common biliary duct, were established. Application of the procedure have guaranteed a good access through the duodenal papilla magna and have permitted to perform the calculi extraction in a less traumatic way, what have promoted its function preservation, and reduction of a postoperative complications rate, the patients' stationary treatment duration, and the remote complications rate. Using questionnaire SF-36, the quality of life was analyzed in patients, in whom in remote period the duodenal papilla magna function was preserved. PMID:27434947

  3. INCREASED RISK OF OCCURRENCE OF NEUROLEPTIC MALIGNANT SYNDROME ON COMBINED TREATMENT WITH LITHIUM AND NEUROLEPTIC

    PubMed Central

    Alexander, P. John; Thomas, Ranji Mathai

    1997-01-01

    Whether there is an increased risk of occurrence of neuroleptic malignant syndrome (NMS) on combined treatment with lithium and neuroleptic is a controversial issue. Patients seen in a general psychiatry unit of a university hospital in India were prospectively screened for NMS over a 2 year period. Diagnosis of NMS was made on operational criteria and the details of treatment at the time of occurrence of NMS were collected systematically. Eight cases of NMS were identified during the period of the study, out of which 5 (62.5%). were taking lithium and a neuroleptic together at the time of occurrence of NMS. The high prevalence of patients on lithium and neuroleptic concomitantly in our sample of NMS, and the similar findings in many of the earlier prospective studies, makes it possible to speculate whether there is an association between combined use of lithium and neuroleptic and occurrence of NMS. Findings are discussed. PMID:21584083

  4. Recent Developments in Active Tumor Targeted Multifunctional Nanoparticles for Combination Chemotherapy in Cancer Treatment and Imaging

    PubMed Central

    Glasgow, Micah D. K.; Chougule, Mahavir B.

    2016-01-01

    Nanotechnology and combination therapy are two major fields that show great promise in the treatment of cancer. The delivery of drugs via nanoparticles helps to improve drug’s therapeutic effectiveness while reducing adverse side effects associated with high dosage by improving their pharmacokinetics. Taking advantage of molecular markers over-expressing on tumor tissues compared to normal cells, an “active” molecular marker targeted approach would be beneficial for cancer therapy. These actively targeted nanoparticles would increase drug concentration at the tumor site, improving efficacy while further reducing chemo-resistance. The multidisciplinary approach may help to improve the overall efficacy in cancer therapy. This review article summarizes recent developments of targeted multifunctional nanoparticles in the delivery of various drugs for a combinational chemotherapy approach to cancer treatment and imaging. PMID:26554150

  5. Sterilization of ready-to-cook Bibimbap by combined treatment with gamma irradiation for space food

    NASA Astrophysics Data System (ADS)

    Park, Jae-Nam; Song, Beom-Seok; Kim, Jae-Hun; Choi, Jong-il; Sung, Nak-Yun; Han, In-Jun; Lee, Ju-Woon

    2012-08-01

    Bibimbap, Korean traditional cooked rice mixed with various kinds of vegetables, together with mushrooms and a ground meat, and seasoned with red pepper paste, was developed as a ready-to-cook food by combined treatment with irradiation for the use in space. By gamma irradiation of 25 kGy, the total aerobic bacteria of Bibimbap that was initial by 6.3 log CFU/g decreased to below detection limit, but its sensory qualities were drastically decreased. To enhance the sensory quality, the effects of antioxidant in Bibimbap were evaluated. A treatment with 0.1% of vitamin C, vacuum packaging and gamma-irradiated at 25 kGy and -70 °C showed higher sensory scores than only the irradiation process. This result indicates that the radiation technology may be useful to produce a variety of space foods with high quality of taste and flavor, when combined with other methods.

  6. Improving the efficiency of polymer solar cells based on furan-flanked diketopyrrolopyrrole copolymer via solvent additive and methanol treatment

    NASA Astrophysics Data System (ADS)

    Zhou, Weilong; Chen, Huajie; Lv, Junjie; Chen, Youchun; Zhang, Weifeng; Yu, Gui; Li, Fenghong

    2015-09-01

    We present a furan-flanked DPP copolymer, poly{3,6-difuran-2-yl-2,5-di(2-octyldodecyl)-pyrrolo [3,4-c]pyrrole-1,4-dione-altthienylenevinylene} (PDVF-8), and highlight the improvement in the power conversion efficiency (PCE) of polymer solar cells (PSCs) based on the PDVF-8 as an electron donor via solvent additive and methanol treatment. When 3 vol% 1,8-diiodooctane (DIO) or 1-chloronaphthalene (CN) were used as a solvent additive to the PDVF-8:PC71BM solution in chloroform (CF), the PCE can increase from 0.79% to 3.73% or 4.26%. Methanol treatment (MT) can further enhance the PCE to 4.03% (DIO) and 4.69% (CN). The effect of the solvent additives (DIO and CN) and MT on the phase separation of the PDVF-8:PC71BM thin film has been investigated in detail using atomic force microscopy, transmission electron microscopy (TEM), TEM-energy dispersive spectroscopy and X-ray photoemission spectroscopy depth profiling.We present a furan-flanked DPP copolymer, poly{3,6-difuran-2-yl-2,5-di(2-octyldodecyl)-pyrrolo [3,4-c]pyrrole-1,4-dione-altthienylenevinylene} (PDVF-8), and highlight the improvement in the power conversion efficiency (PCE) of polymer solar cells (PSCs) based on the PDVF-8 as an electron donor via solvent additive and methanol treatment. When 3 vol% 1,8-diiodooctane (DIO) or 1-chloronaphthalene (CN) were used as a solvent additive to the PDVF-8:PC71BM solution in chloroform (CF), the PCE can increase from 0.79% to 3.73% or 4.26%. Methanol treatment (MT) can further enhance the PCE to 4.03% (DIO) and 4.69% (CN). The effect of the solvent additives (DIO and CN) and MT on the phase separation of the PDVF-8:PC71BM thin film has been investigated in detail using atomic force microscopy, transmission electron microscopy (TEM), TEM-energy dispersive spectroscopy and X-ray photoemission spectroscopy depth profiling. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr04393j

  7. Combined endothelin a blockade and chlorthalidone treatment in a rat model of metabolic syndrome.

    PubMed

    Jin, Chunhua; Jeon, Yejoo; Kleven, Daniel T; Pollock, Jennifer S; White, John J; Pollock, David M

    2014-11-01

    Experiments determined whether the combination of endothelin A (ETA) receptor antagonist [ABT-627, atrasentan; (2R,3R,4S)-4-(1,3-benzodioxol-5-yl)-1-[2-(dibutylamino)-2-oxoethyl]-2-(4-methoxyphenyl)pyrrolidine-3-carboxylic acid] and a thiazide diuretic (chlorthalidone) would be more effective at lowering blood pressure and reducing renal injury in a rodent model of metabolic syndrome compared with either treatment alone. Male Dahl salt-sensitive rats were fed a high-fat (36% fat), high-salt (4% NaCl) diet for 4 weeks. Separate groups of rats were then treated with vehicle (control), ABT-627 (ABT; 5 mg/kg per day, in drinking water), chlorthalidone (CLTD; 5 mg/kg per day, in drinking water), or both ABT plus CLTD. Mean arterial pressure (MAP) was recorded continuously by telemetry. After 4 weeks, both ABT and CLTD severely attenuated the development of hypertension, whereas the combination further reduced MAP compared with ABT alone. All treatments prevented proteinuria. CLTD and ABT plus CLTD significantly reduced nephrin (a podocyte injury marker) and kidney injury molecule-1 (a tubulointerstitial injury marker) excretion. ABT, with or without CLTD, significantly reduced plasma 8-oxo-2'-deoxyguanosine, a measure of DNA oxidation, whereas CLTD alone had no effect. All treatments suppressed the number of ED1(+) cells (macrophages) in the kidney. Plasma tumor necrosis factor receptors 1 and 2 were reduced only in the combined ABT and CLTD group. These results suggest that ABT and CLTD have antihypertensive and renal-protective effects in a model of metabolic syndrome that are maximally effective when both drugs are administered together. The findings support the hypothesis that combined ETA antagonist and diuretic treatment may provide therapeutic benefit for individuals with metabolic syndrome consuming a Western diet. PMID:25189702

  8. Sex differences in attenuation of nicotine reinstatement after individual and combined treatments of progesterone and varenicline.

    PubMed

    Swalve, Natashia; Smethells, John R; Carroll, Marilyn E

    2016-07-15

    Tobacco use is the largest cause of preventable mortality in the western world. Even after treatment, relapse rates for tobacco are high, and more effective pharmacological treatments are needed. Progesterone (PRO), a female hormone used in contraceptives, reduces stimulant use but its effects on tobacco addiction are unknown. Varenicline (VAR) is a commonly used medication that reduces tobacco use. The present study examined sex differences in the individual vs. combined effects of PRO and VAR on reinstatement of nicotine-seeking behavior in a rat model of relapse. Adult female and male Wistar rats self-administered nicotine (NIC, 0.03mg/kg/infusion) for 14days followed by 21days of extinction when no cues or drug were present. Rats were then divided into 4 treatment groups: control (VEH+SAL), PRO alone (PRO+SAL), VAR alone (VEH+VAR) and the combination (PRO+VAR). Reinstatement of nicotine-seeking behavior induced by priming injections of NIC or caffeine (CAF), presentation of cues (CUES), and the combination of drugs and cues (e.g. NIC+CUES, CAF+CUES) were tested after extinction. Male and female rats did not differ in self-administration of nicotine or extinction responding, and both showed elevated levels of responding to the CAF+CUES condition. However, males, but not females, reinstated active lever-pressing to the NIC+CUES condition, and that was attenuated by both VAR and VAR+PRO treatment. Thus, males were more sensitive to NIC+CUE-induced reinstatement than females, and VAR alone and VAR combined with PRO effectively reduced nicotine relapse. PMID:27091301

  9. Local utilization of metacresolsulfonic acid combined with streptomycin in the treatment of actinomycosis.

    PubMed

    Silva, L A F; Fioravanti, M C S; Oliveira, K S; Atayde, I B; Andrade, M A; Jayme, V S; Rabelo, R E; Romani, A F; Araújo, E G

    2004-10-01

    The effectiveness of combining metacresolsufonic acid with streptomycin in the treatment of actinomycosis, diagnosed either clinically or in the laboratory, was evaluated in 12 bovines and 2 equines. Eighty-seven percent of treated animals were considered clinically cured and did not show any signs of relapse after a six-month follow-up period. Therapeutic diagnosis by clinical observation was the procedure of choice when it was not possible to obtain laboratory diagnosis. PMID:15604505

  10. Percutaneous microwave ablation combined with simultaneous transarterial chemoembolization for the treatment of advanced intrahepatic cholangiocarcinoma

    PubMed Central

    Yang, Guo-Wei; Zhao, Qing; Qian, Sheng; Zhu, Liang; Qu, Xu-Dong; Zhang, Wei; Yan, Zhi-Ping; Cheng, Jie-Min; Liu, Qing-Xin; Liu, Rong; Wang, Jian-Hua

    2015-01-01

    Aim To retrospectively evaluate the safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) combined with simultaneous transarterial chemoembolization (TACE) in the treatment of patients with advanced intrahepatic cholangiocarcinoma (ICC). Methods All patients treated with ultrasound-guided percutaneous MWA combined with simultaneous TACE for advanced ICC at our institution were included. Posttreatment contrast-enhanced computed tomography and/or magnetic resonance imaging were retrieved and reviewed for tumor response to the treatment. Routine laboratory studies, including hematology and liver function tests were collected and analyzed. Procedure-related complications were reviewed and survival rates were analyzed. Results From January 2011 to December 2014, a total of 26 advanced ICC patients were treated at our single institute with ultrasound-guided percutaneous MWA combined with simultaneous TACE. There were 15 males and eleven females with an average age of 57.9±10.4 years (range, 43–75 years). Of 26 patients, 20 (76.9%) patients were newly diagnosed advanced ICC without any treatment, and six (23.1%) were recurrent and treated with surgical resection of the original tumor. The complete ablation rate was 92.3% (36/39 lesions) for advanced ICC. There were no major complications observed. There was no death directly from the treatment. Median progression-free survival and overall survival were 6.2 and 19.5 months, respectively. The 6-, 12-, and 24-month survival rates were 88.5%, 69.2%, and 61.5%, respectively. Conclusion The study suggests that ultrasound-guided percutaneous MWA combined with simultaneous TACE therapy can be performed safely in all patients with advanced ICC. The complete ablation rate was high and there was no major complication. The overall 24-month survival was 61.5%. PMID:26060410

  11. Optimal Combination Treatment and Vascular Outcomes in Recent Ischemic Stroke Patients by Premorbid Risk Level

    PubMed Central

    Park, Jong-Ho; Ovbiagele, Bruce

    2015-01-01

    Background Optimal combination of secondary stroke prevention treatment including antihypertensives, antithrombotic agents, and lipid modifiers is associated with reduced recurrent vascular risk including stroke. It is unclear whether optimal combination treatment has a differential impact on stroke patients based on level of vascular risk. Methods We analyzed a clinical trial dataset comprising 3680 recent non-cardioembolic stroke patients aged ≥35 years and followed for 2 years. Patients were categorized by appropriateness level 0 to III depending on the number of the drugs prescribed divided by the number of drugs potentially indicated for each patient (0=none of the indicated medications prescribed and III=all indicated medications prescribed [optimal combination treatment]). High-risk was defined as having a history of stroke or coronary heart disease (CHD) prior to the index stroke event. Independent associations of medication appropriateness level with a major vascular event (stroke, CHD, or vascular death), ischemic stroke, and all-cause death were analyzed. Results Compared with level 0, for major vascular events, the HR of level III in the low-risk group was 0.51 (95% CI: 0.20–1.28) and 0.32 (0.14–0.70) in the high-risk group; for stroke, the HR of level III in the low-risk group was 0.54 (0.16–1.77) and 0.25 (0.08–0.85) in the high-risk group; and for all-cause death, the HR of level III in the low-risk group was 0.66 (0.09–5.00) and 0.22 (0.06–0.78) in the high-risk group. Conclusion Optimal combination treatment is related to a significantly lower risk of future vascular events and death among high-risk patients after a recent non-cardioembolic stroke. PMID:26044963

  12. Combination therapy with finasteride and low-dose dutasteride in the treatment of androgenetic alopecia.

    PubMed

    Boyapati, Ann; Sinclair, Rodney

    2013-02-01

    We report on a 47-year-old man who was initially treated with finasteride for androgenetic alopecia. Despite continuous treatment, after year 4 his hair density was not as good as at year 2, and low-dose dutasteride at 0.5 mg/week was added to the finasteride therapy. This resulted in a dramatic increase in his hair density, demonstrating that combined therapy with finasteride and dutasteride can improve hair density in patients already taking finasteride. PMID:22686691

  13. Evaluation of combined famotidine with quercetin for the treatment of peptic ulcer: in vivo animal study

    PubMed Central

    Abourehab, Mohammed AS; Khaled, Khaled A; Sarhan, Hatem AA; Ahmed, Osama AA

    2015-01-01

    The aim of this work was to prepare a combined drug dosage form of famotidine (FAM) and quercetin (QRT) to augment treatment of gastric ulcer. FAM was prepared as freeze-dried floating alginate beads using ion gelation method and then coated with Eudragit RL100 to sustain FAM release. QRT was prepared as solid dispersion with polyvinyl pyrrolidone K30 to improve its solubility. Photo images and scanning electron microscope images of the prepared beads were carried out to detect floating behavior and to reveal surface and core shape of the prepared beads. Anti-ulcerogenic effect and histopathological examination of gastric tissues were carried out to investigate the effect of the combined drug formulation compared with commercial FAM tablets and FAM beads. Gastric glutathione (GSH), superoxide dismutase, catalase, tissue myeloperoxidase, and lipid peroxidation enzyme activities and levels in rat stomach tissues were also determined. Results revealed that spherical beads were formed with an average diameter of 1.64±0.33 mm. They floated immediately with no lag time before floating, and remained buoyant throughout the test period. Treatment with a combination of FAM beads plus QRT showed the absence of any signs of inflammation or hemorrhage, and significantly prevented the indomethacin-induced decrease in GSH levels (P<0.05) with regain of normal GSH gastric tissue levels. Also, there was a significant difference in the decrease of malondialdehyde level compared to FAM commercial tablets or beads alone (P<0.05). The combined formula significantly improved the myeloperoxidase level compared to both the disease control group and commercial FAM tablet-treated group (P<0.05). Formulation of FAM as floating beads in combination with solid dispersion of QRT improved the anti-ulcer activity compared to commercially available tablets, which reveals a promising application for treatment of peptic ulcer. PMID:25926722

  14. Evaluation of combined famotidine with quercetin for the treatment of peptic ulcer: in vivo animal study.

    PubMed

    Abourehab, Mohammed A S; Khaled, Khaled A; Sarhan, Hatem A A; Ahmed, Osama A A

    2015-01-01

    The aim of this work was to prepare a combined drug dosage form of famotidine (FAM) and quercetin (QRT) to augment treatment of gastric ulcer. FAM was prepared as freeze-dried floating alginate beads using ion gelation method and then coated with Eudragit RL100 to sustain FAM release. QRT was prepared as solid dispersion with polyvinyl pyrrolidone K30 to improve its solubility. Photo images and scanning electron microscope images of the prepared beads were carried out to detect floating behavior and to reveal surface and core shape of the prepared beads. Anti-ulcerogenic effect and histopathological examination of gastric tissues were carried out to investigate the effect of the combined drug formulation compared with commercial FAM tablets and FAM beads. Gastric glutathione (GSH), superoxide dismutase, catalase, tissue myeloperoxidase, and lipid peroxidation enzyme activities and levels in rat stomach tissues were also determined. Results revealed that spherical beads were formed with an average diameter of 1.64±0.33 mm. They floated immediately with no lag time before floating, and remained buoyant throughout the test period. Treatment with a combination of FAM beads plus QRT showed the absence of any signs of inflammation or hemorrhage, and significantly prevented the indomethacin-induced decrease in GSH levels (P<0.05) with regain of normal GSH gastric tissue levels. Also, there was a significant difference in the decrease of malondialdehyde level compared to FAM commercial tablets or beads alone (P<0.05). The combined formula significantly improved the myeloperoxidase level compared to both the disease control group and commercial FAM tablet-treated group (P<0.05). Formulation of FAM as floating beads in combination with solid dispersion of QRT improved the anti-ulcer activity compared to commercially available tablets, which reveals a promising application for treatment of peptic ulcer. PMID:25926722

  15. Effects of plasmochemical treatments and cerium additions on the structural characteristics and activity of copper catalyst particles in isopropanol dehydrogenation

    NASA Astrophysics Data System (ADS)

    Platonov, E. A.; Lobanov, N. N.; Galimova, N. A.; Protasova, I. A.; Yagodovskii, V. D.

    2012-08-01

    The effect of the treatment of the 5 wt % Cu/SiO2 (I) and (5 wt % Cu + 0.5 wt % Ce)/SiO2 (II) catalysts with glow discharge plasma in O2, H2, and Ar on their structural characteristics was studied by X-ray phase analysis; the influence of cerium additions and plasmochemical treatments on the catalyst activity in isopropanol dehydrogenation was also investigated. Under the plasmochemical treatment, the diameters of Cu particles in catalyst I nearly doubled and microstresses in the metal particles also changed. Catalyst II was X-ray amorphous both before and after plasmochemical treatments. The activity of I after plasmochemical treatment increased because of the increase in the number of centers and changes in their composition. Growth of the activity of I compared with the activity of II was explained by the formation of new catalytic centers due to positive charging of the Ce+α adatom on the surface of the copper particle.

  16. Heat treatment and the use of additives to improve the stability of paralytic shellfish poisoning toxins in shellfish tissue reference materials for internal quality control and proficiency testing.

    PubMed

    Burrell, Stephen; Clion, Valentin; Auroy, Virginie; Foley, Barry; Turner, Andrew D

    2015-06-01

    The need for homogenous reference materials stable for paralytic shellfish toxins is vital for the monitoring and quality assurance of these potent neurotoxins in shellfish. Two stabilisation techniques were investigated, heat treatment through autoclaving and the addition of preserving additives into the tissue matrix. Short and long-term stability experiments as well as homogeneity determination were conducted on materials prepared by both techniques in comparison with an untreated control using two LC-FLD methods. Both techniques improved the stability of the matrix and the PSP toxins present compared to the controls. A material was prepared using the combined techniques of heat treatment followed by spiking with additives and data is presented from this optimised reference material as used over a two year period in the Irish national monitoring program and in a development exercise as part of a proficiency testing scheme operated by QUASIMEME (Quality Assurance of Information for Marine Environmental Monitoring in Europe) since 2011. The results were indicative of the long-term stability of the material as evidenced through consistent assigned values in the case of the proficiency testing scheme and a low relative standard deviation of 10.5% for total toxicity data generated over 24 months. PMID:25816999

  17. Does addition of `mud-pack and hot pool treatment' to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study

    NASA Astrophysics Data System (ADS)

    Bağdatlı, Ali Osman; Donmez, Arif; Eröksüz, Rıza; Bahadır, Güler; Turan, Mustafa; Erdoğan, Nergis

    2015-12-01

    The aim of this randomized controlled single-blind study is to explore whether addition of mud-pack and hot pool treatments to patient education make a significant difference in short and mild term outcomes of the patients with fibromyalgia. Seventy women with fibromyalgia syndrome were randomly assigned to either balneotherapy with mud-pack and hot pool treatments (35) or control (35) groups. After randomization, five patients from balneotherapy group and five patients from control group were dropped out from the study with different excuses. All patients had 6-h patient education programme about fibromyalgia syndrome and were given a home exercise programme. The patients in balneotherapy group had heated pool treatment at 38 °C for 20 min a day, and mud-pack treatment afterwards on back region at 45 °C. Balneotherapy was applied on weekdays for 2 weeks. All patients continued to take their medical treatment. An investigator who was blinded to the intervention assessed all the patients before and after the treatment, at the first and the third months of follow-up. Outcome measures were FIQ, BDI and both patient's and physician's global assessments. Balneotherapy group was significantly better than control group at after the treatment and at the end of the first month follow-up assessments in terms of patient's and physician's global assessment, total FIQ score, and pain intensity, fatigue, non-refreshed awaking, stiffness, anxiety and depression subscales of FIQ. No significant difference was found between the groups in terms of BDI scores. It is concluded that patient education combined with 2 weeks balneotherapy application has more beneficial effects in patients with fibromyalgia syndrome as compared to patient education alone.

  18. Long-term improvement of arterial wall characteristics in patients with diabetes mellitus type 1 using cyclic, intermittent treatment with a low-dose fluvastatin and valsartan combination

    PubMed Central

    SAVIĆ, VEDRAN; JANIĆ, MIODRAG; LUNDER, MOJCA; KANC, KARIN; JANEŽ, ANDREJ; ERŽEN, BARBARA; ŠABOVIČ, MIŠO

    2015-01-01

    Improvement of arterial wall (AW) characteristics decreases cardiovascular risk. In a previous study, it was observed that AW characteristics in patients with diabetes mellitus type 1 are significantly improved by short-term treatment with a low-dose combination of fluvastatin and valsartan. Additionally, a unique phenomenon of prolonged effect after treatment discontinuation was suggested. The present study tested whether repeated treatm ent after a certain period results in the same beneficial effect, th ereby advancing the hypothesis that cyclic treatment can provide a long-term improvement of AW characteristics. A total of 44 patients with diabetes mellitus type 1 that participated in the previous study were recruited. Six months after the discontinuation of the initial treatment, the same treatment with a low-dose fluvastatin (10 mg daily) and valsartan (20 mg daily) combination (n=22) or placebo (n=22) was repeated. Brachial artery flow-mediated dilation (FMD), pulse wave velocity (PWV) and carotid artery β-stiffness were measured. It was found that the beneficial effect achieved with an initial 1-month treatment was completely regained following treatment repetition: FMD improved by 50.9% (P<0.01), PWV by 5.7% (P<0.001) and β-stiffness by 9.9% (P<0.001). In addition, a gradual decline of the obtained effects was observed, reaching the level of 9.6% for FM D, 6.3% for PWV and 9.5% for β-stiffness 6 months after treatm ent discontinuation. It was observed that repetition of treatment was similarly effective as the initial intervention. The benefits achieved by treatment steadily declined with time. Combining these findings, cyclic intermittent treatment with a low-dose fluvastatin and valsartan combination is proposed as a new cardiovascular preventive strategy in patients with DM1. PMID:26622466

  19. Effect of water treatment additives on lime softening residual trace chemical composition--implications for disposal and reuse.

    PubMed

    Cheng, Weizhi; Roessler, Justin; Blaisi, Nawaf I; Townsend, Timothy G

    2014-12-01

    Drinking water treatment residues (WTR) offer potential benefits when recycled through land application. The current guidance in Florida, US allows for unrestricted land application of lime softening WTR; alum and ferric WTR require additional evaluation of total and leachable concentrations of select trace metals prior to land application. In some cases a mixed WTR is produced when lime softening is accompanied by the addition of a coagulant or other treatment chemical; applicability of the current guidance is unclear. The objective of this research was to characterize the total and leachable chemical content of WTR from Florida facilities that utilize multiple treatment chemicals. Lime and mixed lime WTR samples were collected from 18 water treatment facilities in Florida. Total and leachable concentrations of the WTR were measured. To assess the potential for disposal of mixed WTR as clean fill below the water table, leaching tests were conducted at multiple liquid to solid ratios and under reducing conditions. The results were compared to risk-based soil and groundwater contamination thresholds. Total metal concentrations of WTR were found to be below Florida soil contaminant thresholds with Fe found in the highest abundance at a concentration of 3600 mg/kg-dry. Aluminum was the only element that exceeded the Florida groundwater contaminant thresholds using SPLP (95% UCL = 0.23 mg/L; risk threshold = 0.2 mg/L). Tests under reducing conditions showed elevated concentrations of Fe and Mn, ranging from 1 to 3 orders of magnitude higher than SPLP leachates. Mixed lime WTR concentrations (total and leachable) were lower than the ferric and alum WTR concentrations, supporting that mixed WTR are appropriately represented as lime WTR. Testing of WTR under reducing conditions demonstrated the potential for release of certain trace metals (Fe, Al, Mn) above applicable regulatory thresholds; additional evaluation is needed to assess management options where

  20. Cardiovascular effects of phentermine and topiramate: a new drug combination for the treatment of obesity

    PubMed Central

    Jordan, Jens; Astrup, Arne; Engeli, Stefan; Narkiewicz, Krzysztof; Day, Wesley W.; Finer, Nick

    2014-01-01

    Weight loss can reduce the increased cardiovascular risk associated with obesity. Pharmacotherapy is a recognized weight loss treatment option; however, cardiovascular safety issues with some previous weight loss drugs raise concerns for newly approved pharmacotherapies. Phentermine is approved for short-term obesity treatment in conjunction with lifestyle modifications, but is commonly used chronically. Topiramate, approved for tre