scholarly journals Comparative study utilizing different post-breeding treatment regimens in cyclic Arabian mares

2021 ◽  
pp. 2863-2868
Author(s):  
Khalid Mohammed Karam ◽  
Ahmed Saed Alebady ◽  
Haitham O. Alhilfi ◽  
Dhia Hussain Al-Delemi
Keyword(s):  
Treatment Regimen ◽  
Normal Saline ◽  
Prophylactic Treatment ◽  
Treatment Protocols ◽  
Treatment Groups ◽  
Treatment Regimens ◽  
Reproductive Management ◽  
Natural Breeding ◽  
Uterine Lavage ◽  
Age Category

Background and Aim: Post-breeding treatment is the most common practice in the reproductive management of mares. Oxytocin, uterine lavage, and intrauterine (I/U) antibiotic are usually used as prophylactic therapy. This study aimed to determine the most efficient prophylactic treatment regimen among six treatment protocols applied during natural breeding of cyclic Arabian mares. Materials and Methods: The current study was conducted on cyclic Arabian mares that were subdivided into three age categories (n=968): Category I (5-10 years, n=380), Category II (11-15 years, n=361), and Category III (≥16 years, n=227). Six prophylactic treatments were applied after 4 h of breeding. According to the treatment regimen, treated mares (n=483) were divided into six treatment groups: A (n=80), treated with I/U antibiotic (1 g gentamicin); B (n=81), I/U lavage (normal saline 500 mL); C (n=83), intramuscular (I/M) oxytocin (10 IU); D (n=82), I/U antibiotic and I/M oxytocin; E (n=78), I/U lavage and I/M oxytocin; and F (n=79), I/U lavage with I/U antibiotic and I/M oxytocin. Non-treated mares were classified as controls (n=485). Ultrasonography was performed to monitor pregnant mares 30 and 60 days after mating, and mares were followed until foaling. Results: Pregnancy and foaling results reveals that in age Category I, treatment with oxytocin alone or oxytocin with I/U lavage showed the highest pregnancy and foaling rates (p<0.01). In age Category II, the highest pregnancy and foaling rates were observed in lavage treatment (p<0.01), whereas, in age Category III, the good pregnancy and foaling rates were monitored in treatment with oxytocin and I/U lavage (p<0.01). Conclusion: Treatment with systemic I/M oxytocin is ideal in early age group mares (5-10 years of age). However, irrespective of the age categories, all mares exhibited high pregnancy and foaling rates after treatment with systemic I/M oxytocin and I/U lavage with normal saline (0.9%) 4 h post-breeding.

scholarly journals Comparison of eight-week and twelve-week corticosteroid treatment regimens in children with idiopathic nephrotic syndrome; A clinical trial

2020 ◽  
Vol 9 (3) ◽  
pp. e25-e25
Author(s):  
Hossein Emad Momtaz ◽  
Amin al Sadat Sharif ◽  
Ali Amri
Keyword(s):  
Clinical Trial ◽  
Nephrotic Syndrome ◽  
Relapse Rate ◽  
Steroid Treatment ◽  
Steroid Resistance ◽  
Treatment Protocols ◽  
Steroid Dependence ◽  
Treatment Groups ◽  
Treatment Regimens ◽  
Frequent Relapse

Introduction: Nephrotic syndrome (NS) is the commonest chronic glomerular disease in children. Idiopathic NS can perfectly be controlled using corticosteroids in most instances, but a significant relapse rate of NS is still a major problem. Several treatment protocols are suggested to decrease relapse rate of NS in children. Objectives: The current clinical trial aimed at comparing the relapse rate between two 8- and 12-week steroid treatment regimens. Patients and Methods: In the current non-randomized, clinical trial, a total of 68 children with primary NS were enrolled. Oral prednisolone was administered to 34 patients for eight weeks (2 mg/kg/d and 1.5 mg/kg/alternate-day/each for four weeks) and other 34 patients for 12 weeks (2 mg/kg/d and 1.5 mg/kg/alternate-day/each for six weeks). A one-year followup was completed for all the patients to evaluate relapse rate, steroid resistance, and steroid dependence. Results: The remission rates were 47.1% and 73.5%, respectively in children of the eight- and 12-week treatment groups because the difference was significant (P=0.026). The frequent relapse rates in the eight- and 12-week treatment groups were respectively 26.5% and 11.8%. Steroid dependence rate was 17.6% and 8.8% in the eight- and 12-week treatment groups respectively. The steroid resistance rates were respectively 8.8% and 5.9% in the eight- and 12-week treatment groups. Conclusion: Twelve-week steroid treatment can significantly decrease the relapse rate in comparison with eight-week treatment because no significant difference in steroid resistance, steroid dependence, and frequent relapse between the two treatment protocols was observed.

Refinement and reduction through application of a quantitative score system for estimation of TB-induced disease burden using computed tomography

2018 ◽  
Vol 52 (6) ◽  
pp. 599-610 ◽  
Author(s):  
Sally A Sharpe ◽  
Donna Smyth ◽  
Anthony McIntyre ◽  
Fergus Gleeson ◽  
Mike J Dennis
Keyword(s):  
Computed Tomography ◽  
Disease Burden ◽  
Test Model ◽  
Score System ◽  
Global Epidemic ◽  
Treatment Groups ◽  
Additional Tool ◽  
Treatment Regimens ◽  
Improved Outcomes ◽  
Quantitative Score

Until validated correlates of protection are identified, animal models remain the only way to test the efficacy of the new vaccines and drugs urgently needed to fight the global epidemic caused by infection with Mycobacterium tuberculosis. Non-human primates (NHP) offer the most relevant models of human tuberculosis (TB) and are central to the development process for new interventions. Efficacy evaluations are dependent on the capability of the test model to discriminate improved outcomes between treated groups after experimental exposure to M. tuberculosis and therefore the ability to measure TB-induced disease burden is central to the process. We have developed a score system that allows us to quantify the disease burden induced in macaques by infection with M. tuberculosis, based on the extent and features of disease visible on computed tomography (CT) images. The CT determined disease burden was then verified against that obtained using an established pathology-based approach. Trials of the system as a tool to measure disease burden have shown the approach capable of revealing differences between treatment groups in order to: (a) characterise outcome of infection and enable model refinement; (b) demonstrate the efficacy of drug treatment regimens by showing differences in outcome between test groups. Initial trials suggest that the imaging-based score system provides a valuable additional tool for the measurement of TB-induced disease burden that offers the opportunity to apply both refinement and reduction within studies.

scholarly journals Drugs that target early stages of Onchocerca volvulus: A revisited means to facilitate the elimination goals for onchocerciasis

2021 ◽  
Vol 15 (2) ◽  
pp. e0009064
Author(s):  
Shabnam Jawahar ◽  
Nancy Tricoche ◽  
Christina A. Bulman ◽  
Judy Sakanari ◽  
Sara Lustigman
Keyword(s):  
Worm Burden ◽  
Prophylactic Treatment ◽  
Clinical Development ◽  
Onchocerca Volvulus ◽  
Complementary Treatment ◽  
Comprehensive Strategy ◽  
Treatment Regimens ◽  
Therapeutic Drugs ◽  
Helminth Infections ◽  
Prophylactic Drugs

Several issues have been identified with the current programs for the elimination of onchocerciasis that target only transmission by using mass drug administration (MDA) of the drug ivermectin. Alternative and/or complementary treatment regimens as part of a more comprehensive strategy to eliminate onchocerciasis are needed. We posit that the addition of “prophylactic” drugs or therapeutic drugs that can be utilized in a prophylactic strategy to the toolbox of present microfilaricidal drugs and/or future macrofilaricidal treatment regimens will not only improve the chances of meeting the elimination goals but may hasten the time to elimination and also will support achieving a sustained elimination of onchocerciasis. These “prophylactic” drugs will target the infective third- (L3) and fourth-stage (L4) larvae of Onchocerca volvulus and consequently prevent the establishment of new infections not only in uninfected individuals but also in already infected individuals and thus reduce the overall adult worm burden and transmission. Importantly, an effective prophylactic treatment regimen can utilize drugs that are already part of the onchocerciasis elimination program (ivermectin), those being considered for MDA (moxidectin), and/or the potential macrofilaricidal drugs (oxfendazole and emodepside) currently under clinical development. Prophylaxis of onchocerciasis is not a new concept. We present new data showing that these drugs can inhibit L3 molting and/or inhibit motility of L4 at IC50 and IC90 that are covered by the concentration of these drugs in plasma based on the corresponding pharmacological profiles obtained in human clinical trials when these drugs were tested using various doses for the therapeutic treatments of various helminth infections.

scholarly journals 509. Clinical Characteristics and Outcomes in Patients Infected with SARS-CoV-2 Treated with Remdesivir, Tocilizumab, and/or Dexamethasone at a Mid-Atlantic Hospital Consortium

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S356-S357
Author(s):  
Nellie Darling ◽  
Kristen R Kent ◽  
Gavin Clark ◽  
Xue Geng ◽  
Marybeth Kazanas ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Length Of Stay ◽  
Ventilatory Support ◽  
Combination Group ◽  
Delivery Device ◽  
Research Support ◽  
Material Support ◽  
Treatment Groups ◽  
Treatment Regimens ◽  
All Treatment

Abstract Background Treatment strategies for COVID-19 have evolved based on clinical trials. We performed a retrospective analysis to determine treatment outcomes for Remdesivir (RDV), Tocilizumab (TOCI), and/or Dexamethasone (DEX) in a representative population from the Mid-Atlantic region. Methods A retrospective chart review was performed for patients admitted to MedStar hospitals within the D.C./Baltimore corridor from 03/01/2020 to 12/31/2020, and diagnosed with COVID-19 using a NP SARS-CoV-2 RT PCR assay. The MedStar Pharmacy Database was utilized to stratify based on any combination of RDV, TOCI, DEX treatment. Our primary endpoints included O2 delivery device, length of stay (LOS), and mortality. Results A total of 2488 patients were included. Overall, the average age of patients was 62yrs, 53% male, and the majority of patients were of Black (54%) or White (27%) race. The average length of stay was 11 days (SD = 12) with a mortality of 14%. Using univariate analyses, all combinations of RDV, TOCI, and DEX treatment regimens were evaluated. Patients who received DEX required the most ventilatory support on Day 1 (5%, p&lt; 0.001) compared to all other groups. These same patients, however, did not go on to have higher ventilatory needs (17%, p&lt; 0.001) compared to the group which ultimately required the most ventilatory support, TOCI plus DEX (94%, p&lt; 0.001) at Day 28 of treatment. TOCI use alone was associated with a 4% to 63% (p&lt; 0.001) increase in need for ventilatory support over the course of 28 days (Figure 1). The shortest LOS was seen in those treated with DEX alone (9.5 days, p&lt; 0.001). Longer LOS outcomes were associated with all treatment groups which included TOCI use (19 to 22 days, p&lt; 0.001, Figure 2). Mortality was similarly higher among all treatment groups which contained TOCI (30% to 62.5%, p&lt; 0.001, Figure 3) when compared to those with RDV and/or DEX use alone (10% to 14%, p&lt; 0.001). Barplot of Oxygen Delivery Device at Admission and within 28 Days among Treatments Figure 1. Largest increase in ventilatory support from Day 1 of treatment (left) to Day 28 of treatment (right) was seen among TOCI and DEX (0% to 93.8%), RDV and TOCI (0% to 72.2%) and TOCI alone (3.7% to 63.4%). Figure 2. LOS was higher among all treatments containing TOCI (p&lt;0.001), with the highest being the combination group of RDV, TOCI, and DEX (22.4 days, p&lt;0.001). Figure 3. Treatment regimens containing TOCI accounted for the highest mortality rates as seen in TOCI and DEX use (62.5%), RDV and TOCI (44.4%), and TOCI use alone (30.4%). Conclusion Our study demonstrates that “real-world” clinical outcomes for patients with COVID-19 treated with Remdesivir, Tocilizumab, and Dexamethasone are consistent with what has been reported in clinical trials. The higher mortality associated with Tocilizumab treatment may reflect the use of this agent in critically ill patients with COVID-19. Disclosures Princy N. Kumar, MD, AMGEN (Other Financial or Material Support, Honoraria)Eli Lilly (Grant/Research Support)Gilead (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)GSK (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)Merck & Co., Inc. (Grant/Research Support, Shareholder, Other Financial or Material Support, Honoraria)

Prospective Randomized Trial of the Treatment of Patients With Metastatic Melanoma Using Chemotherapy With Cisplatin, Dacarbazine, and Tamoxifen Alone or in Combination With Interleukin-2 and Interferon Alfa-2b

1999 ◽  
Vol 17 (3) ◽  
pp. 968-968 ◽  
Author(s):  
Steven A. Rosenberg ◽  
James C. Yang ◽  
Douglas J. Schwartzentruber ◽  
Patrick Hwu ◽  
Francesco M. Marincola ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Metastatic Melanoma ◽  
Interleukin 2 ◽  
Interferon Alfa ◽  
Prospective Randomized Trial ◽  
Treatment Groups ◽  
Treatment Regimens ◽  
Randomized Protocols ◽  
To Receive

PURPOSE: The combination of chemotherapy with immunotherapeutic agents such as interleukin-2 and interferon alfa-2b has been reported to provide improved treatment results in patients with metastatic melanoma, compared with the use of chemotherapy alone. We have performed a prospective randomized trial in patients with metastatic melanoma, comparing treatment with chemotherapy to treatment with chemoimmunotherapy. PATIENTS AND METHODS: One hundred two patients with metastatic melanoma were prospectively randomized to receive chemotherapy composed of tamoxifen, cisplatin, and dacarbazine or this same chemotherapy followed by interferon alfa-2b and interleukin-2. Objective responses, survival, and toxicity in the two groups were evaluated at a median potential follow-up of 42 months. RESULTS: In 52 patients randomized to receive chemotherapy, there were 14 objective responses (27%), including four complete responses. In 50 patients randomized to receive chemoimmunotherapy, there were 22 objective responses (44%) (P2 = .071), including three complete responses. In both treatment groups, the duration of partial responses was often short, and there was a trend toward a survival advantage for patients receiving chemotherapy alone (P2 = .052; median survival of 15.8 months compared with 10.7 months). Treatment-related toxicities were greater in patients receiving chemoimmunotherapy. CONCLUSION: With the treatment regimens used in this study, the addition of immunotherapy to combination chemotherapy increased toxicity but did not increase survival. The use of combination chemoimmunotherapy regimens is not recommended in the absence of well-designed, prospective, randomized protocols showing the benefit of this treatment strategy.

scholarly journals Postoperative Analgesia for Haemorrhoid Surgery

1983 ◽  
Vol 11 (1) ◽  
pp. 27-30 ◽  
Author(s):  
D. A. Pybus ◽  
B. E. D'Bras ◽  
G. Goulding ◽  
H. Liberman ◽  
T. A. Torda
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Postoperative Analgesia ◽  
Normal Saline ◽  
Morphine Sulphate ◽  
Control Group ◽  
Treatment Groups ◽  
Number Of Patients ◽  
Caudal Analgesia ◽  
The Mean

Seventy patients undergoing haemorrhoidectomy under general anaesthesia were randomly allocated to one of five treatment groups in order to compare the effectiveness of various caudal agents in the control of postoperative pain. Four groups were given a caudal injection of either 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulphate 4 mg or normal saline + morphine sulphate 4 mg, while the fifth (control) group did not receive an injection. The number of patients requiring postoperative opiates was significantly higher in the lignocaine group than in the morphine (p <0.05) and morphine-lignocaine (p <0.05) groups. No agent significantly reduced the number requiring opiates. In those who received opiates, the mean analgesic period was 228 minutes in the control group, and was significantly longer following bupivacaine (577 min, p <0.01), morphine-lignocaine (637 min, p <0.05) and morphine (665 min, p <0.01). The mean analgesic period following lignocaine (349 min) was not significantly different from control. The incidence of catheterisation was lowest in those patients who did not receive caudal analgesia.

E-selectin inhibition with GMI-1271 decreases venous thrombosis without profoundly affecting tail vein bleeding in a mouse model

2017 ◽  
Vol 117 (06) ◽  
pp. 1171-1181 ◽  
Author(s):  
Dorian L. Culmer ◽  
Misha L. Dunbar ◽  
Angela E. Hawley ◽  
Suman Sood ◽  
Robert E. Sigler ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Thrombus Formation ◽  
Coagulation Cascade ◽  
Thrombosis Prophylaxis ◽  
Dependent Manner ◽  
Vein Wall ◽  
Treatment Protocols ◽  
Treatment Groups ◽  
Cell Counts ◽  
Dose Dependent

SummarySelectins, such as E-selectin (CD62E), function in venous thrombosis by binding and activating immune cells to initiate the coagulation cascade. GMI-1271 is a small molecule antagonist that inhibits E-selectin activity. Here we determine whether inhibition of E-selectin is sufficient to decrease acute venous thrombosis and associated inflammatory events in both prophylactic and treatment protocols without significantly affecting haemostasis. Male C57BL/6 mice underwent surgery for experimental thrombosis induction and were harvested at peak thrombus formation in our animal model, two days post induction. Groups included non-thrombosed true controls, shams, controls, and prophylactic or treatment groups of GMI-1271 (10 mg/kg intraperitoneal BID (twice a day) and low-molecular-weight heparin (LMWH, Lovenox 6 mg/kg subcutaneously (SC), once a day (SID). Compared with control animals, prophylaxis or treatment with LMWH and GMI-1271 in a dose-dependent manner significantly decreased thrombosis. GMI-1271 significantly lowered tail bleeding times when compared to LMWH. GMI-1271 and LMWH prophylactically administered significantly decreased vein wall neutrophil cell extravasation. However, all treatment and prophylactic therapies significantly decreased vein wall monocyte extravasation versus controls. GMI-1271 prophylactic therapy significantly decreased intra-thrombus cell counts versus control animals and other treatment groups. Immunohistochemistry confirmed that both treatments with GMI-1271 and LMWH significantly decreased activated leukocyte migration. GMI-1271 therapy significantly decreased thrombus weight and resulted in significantly lower bleeding times than LMWH. GMI-1271 treated mice showed decreased local and systemic inflammatory effects while modulating neutrophil activation, suggesting that GMI-1271 is a viable therapeutic candidate for venous thrombosis prophylaxis and treatment.

scholarly journals Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

2006 ◽  
Vol 50 (9) ◽  
pp. 2996-3002 ◽  
Author(s):  
P. Diz Dios ◽  
I. Tomás Carmona ◽  
J. Limeres Posse ◽  
J. Medina Henríquez ◽  
J. Fernández Feijoo ◽  
...  
Keyword(s):  
Prophylactic Treatment ◽  
Venous Blood ◽  
Control Group ◽  
Anesthesia Induction ◽  
Beta Lactams ◽  
Blood Samples ◽  
Treatment Groups ◽  
Microbiological Techniques ◽  
Group A ◽  
Aerobic And Anaerobic

ABSTRACT We evaluated the efficacies of oral prophylactic treatment with amoxicillin (AMX), clindamycin (CLI), and moxifloxacin (MXF) in the prevention of bacteremia following dental extractions (BDE). Two hundred twenty-one adults who required dental extractions under general anesthesia were randomly assigned to a control group, an AMX group, a CLI group, and an MXF group (the individuals in the drug treatment groups received 2 g, 600 mg, and 400 mg, respectively, 1 to 2 h before anesthesia induction). Venous blood samples were collected from each patient at the baseline and 30 s, 15 min, and 1 h after the dental extractions. The samples were inoculated into BACTEC Plus aerobic and anaerobic blood culture bottles and were processed in a BACTEC 9240 instrument. Subculture and the further identification of the isolated bacteria were performed by conventional microbiological techniques. The prevalences of BDE in the control group, AMX group, CLI group, and MXF group were 96, 46, 85, and 57%, respectively, at 30 s; 64, 11, 70, and 24%, respectively, at 15 min; and 20, 4, 22, and 7%, respectively, at 1 h. Streptococcus spp. were the most frequently identified bacteria in all groups (44 to 68%), with the lowest percentage being detected in the AMX group (44%). AMX and MXF prophylaxis showed high efficacies in reducing the prevalence and duration of BDE, but CLI prophylaxis was noneffective. As a consequence, MXF prophylaxis is a promising antibiotic alternative for the prevention of BDE when beta-lactams are not indicated.

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