The study aimed to display that clinical and microbiologic research of patientswithmicrobialeczema. The study revealed that the usage of co — formulated medication Supirocin — B was rather eficient, it promotes statistically au- thentic reduction of eczematous foci with pathogenic St.aureus and Str.spp. Besides, it has strong anti — inlammatory effect and reduces eczematous process.
daily for 8 weeks. Topical DTZ gel lowered maximal anal pressure by 20% and fissures healed in 49% of patients within 8 weeks. Hence, the authors concluded that topical DTZ (2%) was effective treatment for GTN-resistant chronic anal fissure. Similarly Behnam et al  2009 compared the effect of topical GTN ointment withtopical DTZ ointment in the treatment of chronic anal fissure found both DTZ and GTN were equally effective and could be the preferred first-line treatment of chronic anal fissure. However, GTN was associated with a higher rate of headache, and it could be replaced by DTZ. In our study post-defecatory pain, bleeding and irritation were significantly reduced after 2 week of therapy and a primary healing rate of 86% (43 out of 50) at 6 week of therapy. The primary side- effects of DTZ 2% ointment appear to be perianal dermatitis and pruritis ani in 14% cases. Overall compliance was 100%. The follow up period available after successful treatment with DTZ gel was short and therefore no long term conclusions could be drawn.
ABSTRACT – Atopic eczema is a common inflammatory skin disease, affecting up to 20% of children and 3% of adults in industrialized countries. Most cases of atopic eczema are mild to moderate and will be adequately managed withtopicaltherapy. Persistent or severe cases may require periods of systemic treatment, which can be broadly grouped into conven- tional and biologic agents. Conventional systemic agents are associated with potential toxicities that limit the continued use and often do not provide adequate therapeutic responses. More recently, biologic agents have been proposed for the treatment of severe atopic eczema, holding promise for a more targeted and less toxic approach. However, none of the biologics have been approved for atopic eczematherapy yet. At present, its off-label use is advisable only in severe atopic eczema refractory to conventional treatments. In this report, the authors comprehensively review the literature regarding the use of biologic therapyin severe EA.
Objective: This study investigated in vitro the photodynamic antimicrobial effects of the photosensitizer mala- chite green on clinical strains of Staphylococcus, Enterobacteriaceae, and Candida. Materials and Methods: Thirty- six microbial strains isolated from the oral cavity of patients undergoing prolonged antibiotic therapy, including 12 Staphylococcus, 12 Enterobacteriaceae, and 12 Candida strains, were studied. The number of cells of each microorganism was standardized to 10 6 cells/mL. Twenty-four assays were carried out for each strain according to the following experimental conditions: gallium-aluminum-arsenide laser and photosensitizer (n ¼ 6, LþPþ), laser and physiologic solution (n ¼ 6, LþP), photosensitizer (n ¼ 6, LPþ), and physiologic solution (n ¼ 6, LP). Next, cultures were prepared on brain–heart infusion agar for the growth of Staphylococcus and En- terobacteriaceae, and on Sabouraud dextrose agar for the growth of Candida, and incubated for 48 h at 378C. The results are reported as the number of colony-forming units (CFU/mL) and were analyzed with analysis of variance and the Tukey test. Results: The Staphylococcus, enterobacterial, and Candida strains were sensitive to photodynamic therapywith malachite green (LþPþ). A reduction of *7 log 10 for Staphylococcus, 6 log 10 for
During the 3-month treatment and follow-up of each patient, all subjects were instructed to brush their dentures with coconut soap  followed by toothpaste, after every meal and before going to sleep. They also received instructions to immerse the dentures in ﬁltered water overnight. According to the stratiﬁed randomization list, the patients were ran- domly assigned to one of two treatment groups of 20 sub- jects each. In the nystatin (NYT) group, patients were submitted to topical antifungal treatment with nystatin oral suspension 100 000 IU. Each patient received the medication and was instructed to swish it for 1 min, gargle, and then expectorate it four times daily for 15 days. In the PDT group, each patient had his/her maxillary denture and palate individually submitted to PDT as described previously . Approximately 5 mL of photosensitizer was sprayed on the inner and outer surfaces of each denture. After this, the den- ture was placed in a transparent plastic bag and left in the dark for 30 min (the pre-irradiation time). To perform illumi- nation, the denture was placed inside the LED device and irradiated for 26 min (37.5 J/cm 2 ). The denture was centred
ABSTRACT – The increasing number of drugs used in dermatological a venereological practice demands from the dermatologist an updated knowledge on their safety. In the case of pregnant women or those breastfeeding, the decision on whether or not to prescribe a particular drug must be based on a thoughtful evaluation of the benefits for maternal health and the potential risks to fetus' or infant's well-being. Whenever these patients require topical or systemic therapies, most can be adequately treated with safe and effective options.
Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used inpatientswith intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.
AIDS patientswith CD4 counts ,300 cells/ml were recruited at the Lemuel Shattuck Hospital (n = 49) or at 4 sites in the National NeuroAIDS Tissue Consortium (NNTC) (Manhattan HIV Brain Bank, National Neurological AIDS Bank, California NeuroAIDS Tissue Network, Texas NeuroAIDS Research Center) (n = 70) with written informed consent and IRB approval. HIV-/HCV- uninfected blood was from Research Blood Components (Brighton, MA). Shattuck Hospital subjects were recruited based on presence or absence of an HAD diagnosis. NNTC subjects were selected by database searches based on patterns of substance abuse (determined by PRISM (psychiatric research interview for substance and mental disorders) diagnoses and urine tox screens) irrespective of HAD or other forms of NCI. HAD or MCMD diagnoses were determined using American Academy of Neurol- ogy diagnostic criteria [19,23] and asymptomatic neurocognitive impairment (ANI) diagnosis was determined using HIV Neurobe- havioral Research Center (HNRC) criteria  based on formal neurocognitive testing and/or neurological evaluation and lack of other known cause for NCI. Patientswith severe psychiatric diagnoses that might confound neurological evaluation, a confounding neurological disorder (i.e., CNS opportunistic infection, brain neoplasm), or active bacterial or opportunistic infection were excluded.
Of the 161 patients enrolled in the Speech Therapyin the analyzed period, 20 adults and elderly were included in the survey, as meeting the criteria for participation, namely: having suffered previous or current stroke, with symptoms of oropharyngeal dysphagia; breathing ambiet air; present clinically stable and respond to simple verbal commands. Patients who showed abnormalities in phonatory structures, tracheostomy, ventilator dependency, lowered level of consciousness and clinically very committed were excluded.
Methods:Patients admitted for elective angioplasty in chronic use of ASA and clopidogrel between January 2007 and January 2010 were studied. One hour after the procedure, platelet aggregation was measured using optical aggregometry with adenosine diphosphate 5 mmoles / l as agonist. At that moment, in a cross-sectional cohort, we determined the prevalence of clopidogrel resistance, defined as the value of platelet aggregation ≥ 43% and a logistic regression model to the variables associated with it.
10 had chromoblastomycosis that was progressing significantly prior to initiating treatment. Posaconazole therapy halted the progression and resulted in significant symptomatic improvements for most of the first year of treatment. Although this patient was considered to have stable disease at the end of therapy, the clinical improvement associated with posaconazole therapy improved patient’s ability to walk and to perform daily chores. Regaining the ability to perform these activities may offer some therapeutic advantage in these challenging-to-manage chronic diseases. After completing the study, patient 10 continued to receive posaconazole therapy as part of a treatment-use extension protocol. The first few months of additional posaconazole therapy were associated with symptomatic improvement; however, after 11 months, the patient suffered a relapse and posaconazole therapy was discontinued owing to treatment failure. The failure was not thought to be due to diabetes, as this condition had been well controlled.
Background/Aim. Hormone suppression therapy is used in men with advanced prostate cancer improving chances of longer survival. The aim of this study was to investigate the in- fluence of androgen blockades on testosterone and luteinizing hormone (LH) values inpatientswith locally advanced and metastatic prostatic cancer. Methods. The study included a total of 60 patients out of which 45 with prostatic cancer di- vided into 3 subgroups based on the type of the applied treatment protocol: 15 patients on monotherapy with lutein- izing-releasing hormone (LH-RH) agonists (group I), 15 pa- tients on total androgen blockade (group II) and 15 patients on monotherapy with antiandrogen (group III)). The control group consisted of 15 patientswith benign prostatic hyperpla-
Objective: Demonstrate brain perfusion changes due to neuronal activation after functional electrical stimulation (FES). Method: It was studied 14 patientswith hemiplegia who were submitted to a program with FES during fourteen weeks. Brain perfusion SPECT was performed before and after FES therapy. These patients were further separated into 2 groups according to the hemiplegia cause: cranial trauma and major vascular insults. All SPECT images were analyzed using SPM. Results: There was a significant statistical difference between the two groups related to patient’s ages and extent of hypoperfusion in the SPECT. Patientswith cranial trauma had a reduction in the hypoperfused area and patientswith major vascular insult had an increase in the hypoperfused area after FES therapy. Conclusion: FES therapy can result in brain perfusion improvement inpatientswith brain lesions due to cranial trauma but probably not inpatientswith major vascular insults with large infarct area.
form it increases the production of protoporphyrin type IX that accumulates, pre f e re n t i a l l y, in dysplastic and neoplastic cells. Photo-activation, in principle, can be effected with any visible light source that possesses specific spectrum charac - teristics, a powerful luminosity and a maximum absorption by the photosensitive substance. In initial clinical studies, incandescent lamps or slide projectors were used. Recently, p rofessional devices producing incoherent light have been developed. The wavelengths most successfully used in wor - king with T F D - A L A w e re found to be around 630nm. Laser devices can also be used, more commonly those of arg o n ( a rgon ion pumped dye laser, 630nm) and gold (gold vapor l a s e r, 628nm). It is also possible to achieve good results with diode lasers. 3
Grup terapisi bireysel terapiden farklı olarak üç avantaj sunmaktadır. Bunlardan ilki grup terapisi sırasındaki üyelerden alınan sosyal destektir. Bir grubun üyesi olmak kan- ser hastalığı ile başa çıkma sürecinde gerekli olan topluluk duygusu için fırsat sağlar. Bu sayede hastalar başka bir yerde bulamayacağı benzer süreçleri yaşayan adeta yol arkadaşı bulmuş olurlar. İkinci avantajı ise yardımcı terapi prensibi (The helper-therapy princip- le) dir. Bir grup ortamında hastalar birbirlerine destek verir ve aynı zamanda hastalar ailesi dışında birileriyle objektif olarak kaygılarını tartışmasına uygun zemin hazırlar. Grup terapisinin üçüncü ve son avantajı ise düşük maliyetli olmasıdır, grup terapisi bireysel terapiye göre daha düşük maliyet içerir. Grup terapileri ayrıca terapistin zama- nını daha etkili kullanabilmesini sağlar. Grup terapisi, genellikle rahatlama ve stres yönetimi, problem çözme, bilişsel yeniden yapılandırma ve psikoeğitimsel faaliyetleri içerir. Bunlarla birlikte Grup BDT de, sunumlar, grup tartışması, bildiriler ve haftalık ödevler uygulanabilir.
compared different concentrations of adapalene, revealing a significant reduction in AK number of 32% versus 21%, with concentrations of 0.3% and 0.1% res- pectively. 34 Only one study showed no difference in terms of retinoid use concerning reduction in AK numbers, in all the groups analyzed (0.02% tretinoin, 0.02% tretinoin combined with calcipotriol, calcipo- triol and emollient). There were no clinical or histolo- gical changes after 6 weeks, though the authors explained that the follow-up period may have been too short for such an examination. 44
Introduction: Hemoglobin S (HbS) is unstable hemoglobin that easily oxidizes, causing methemoglobin (MetHb) increased production inpatientswith sickle-cell anemia (SCA). Objectives: To determine MetHb levels and the inluence of hydroxyurea (HU) therapy on this marker inpatientswith SCA. Materials and methods: Blood samples from 53 patientswith SCA at the steady-state, with and without HU therapy, and 30 healthy individuals were collected to evaluate MetHb levels. The MetHb measurement was performed by spectrophotometry. Complete blood count, HU measurements, and fetal hemoglobin (HbF) and HbS concentrations were taken from medical records. Results: MetHb levels were statically higher inpatientswith SCA when compared to control group (p < 0.001). There was no statistical difference in MetHb level between SCA patients, either using or not HU. We obtained a positive correlation between MetHb measurements and HbS concentration (r = 0.2557; p = 0.0323). Conclusion: HbS presence favored hemoglobin breaking down, and consequently increased MetHb production. Treatment with HU, however, did not inluence the levels of this marker.
An 18-year-old male was referred to the corneal service in August 2001 with a corneal ulcer of the right eye 28 days after glass trauma to the eye. The patient had been treated with neomycin, ciprofloxacin, and 0.1% dexamethasone for a week without improvement. His distance visual acuity was 20/400 in the right eye and 20/30 in the left at presentation. Intraocular pressure measured by bimanual examination was normal. There was a 3 x 2 mm diameter central epithelial defect with feathery borders. The anterior segment showed a mild inflam- matory reaction with a few keratic precipitates under the corneal infiltrate. The posterior segment was quiet.
The initial search identified 104 citations and 84 of them were excluded by reviewing the titles and abstracts. The remaining 20 articles were clinical studies, in which six studies investigated hypo- thermia inpatientswith brain injury, three involved infants or children, and five were observation- al studies. As a result, a total of 6 randomized controlled trials were included into final analysis (Fig. 1).[17–22] Three studies[17–19] included patientswith sepsis, one included severe sepsis and the remaining two[21,22] included septic shock. Studies included sepsis and septic shock did not mean that they excluded patientswith septic shock but the term “sepsis” covered severe sepsis and septic shock. Therefore, the proportions of septic shock were reported for four studies.[17–20] Severity of patients was presented by using APACHE score or SAPS-3. Three studies[17–19] used ibuprofen as the antipyretic medication and one used lornoxicam for antipyretic therapy. The remaining two studies[21,22] employed external cooling. The study protocol lasted for less than 48 hours in four studies[17–19,21] and for 72 hours in the remaining two studies[20,22]. With re- spect to definition of mortality, two studies[17,19] used 30-day mortality. Other secondary out- comes were various including shock reversal, serum concentrations of ibuprofen, organ failure, duration of mechanical ventilation, vasopressor use and tissue perfusion parameters (Table 1).
The effectiveness of specific antibiotic treatment in severe leptospirosis is still under debate. As part of a prospective study designed to evaluate renal function recovery after leptospirosis acute renal failure (ARF) (ARF was defined as P cr ³1.5 mg/dL), the clinical evolutions of 16 treated patients (T) were compared to those of 18 untreated patients (nT). Treatment or non-treatment was the option of each patient’s attending infectologist. The penicillin treatment was always with 6 million IU/day for 8 days. No difference was found between the two groups in terms of age, gender, number of days from onset of symptoms to hospital admission, or results of laboratory tests performed upon admission and during hospitalization, but proteinuria was higher in the treated group. There were no significant difference in the other parameters employed to evaluate patients’ clinical evolution as: length of hospital stay, days of fever, days to normalization of renal function, days to total bilirubins normalized or reached 1/3 of maximum value and days to normalization of platelet counts. Dialytic treatment indication and mortality were similar between group T and nT. In conclusion, penicillin therapy did not provide better clinical outcome inpatientswith leptospirosis and ARF.