Neurological Complications of Biological Treatment of Psoriasis

In the available literature, little attention has been paid to the assessment of psoriasis and the biological therapy used for it and the nervous system. The purpose of this article is to discuss the relationship between psoriasis and the nervous system as well as to analyze the mechanisms that lead to neurological complications during anticytokine therapies in psoriasis. However, this connection requires further analysis. The use of biological drugs in psoriasis, although it yields positive therapeutic results, is not without numerous side effects. Serious neurological side effects of the therapy are most often visible with the use of anti-TNF-alpha, which is why patients should be monitored for their potential occurrence. Early detection of complications and rapid discontinuation of treatment with the drug may potentially increase the patient’s chances of a full recovery or improvement of his/her neurological condition. It also seems reasonable that, in the case of complications occurring during anti-TNF-alpha therapy, some of the drugs from other groups should be included in the therapy.

Tissue Engineering and Regeneration of the Human Hair Follicle in Androgenetic Alopecia: Literature Review

Androgenetic alopecia (AGA) is an androgen-dependent process and represents the most frequent non-scarring alopecia. Treatments for AGA do not always achieve a satisfactory result for the patient, and sometimes cause side effects that lead to discontinuation of treatment. AGA therapeutics currently includes topical and oral drugs, as well as follicular unit micro-transplantation techniques. Tissue engineering (TE) is postulated as one of the possible future solutions to the problem and aims to develop fully functional hair follicles that maintain their cyclic rhythm in a physiological manner. However, despite its great potential, reconstitution of fully functional hair follicles is still a challenge to overcome and the knowledge gained of the key processes in hair follicle morphogenesis and biology has not yet been translated into effective replacement therapies in clinical practice. To achieve this, it is necessary to research and develop new approaches, techniques and biomaterials. In this review, present and emerging hair follicle bioengineering strategies are evaluated. The current problems of these bioengineering techniques are discussed, as well as the advantages and disadvantages, and the future prospects for the field of TE and successful hair follicle regeneration.

Comparative Pharmacotherapy of Hypertension

The purpose of the study. This study aims to review the practice of the utilization of antihypertensive drugs of various pharmacological groups within the condition of the therapeutic hospital in Ukrainian and Egyptian patients, adherence to treatment in patients with hypertension in Ukraine and Egypt. Materials and methods. A study of 120 patients who were treated for hypertension II stage in a therapeutic hospital in Ternopil and Cairo was conducted. All subjects completed a questionnaire that included personal, socio-demographic, and medical data. The number and type of hypotensive drugs or drug combinations were analyzed. Results and discussion. Regarding the pharmacotherapy of hypertension the use of β-blockers among Ukrainian participants did not differ from Egyptian. The use of calcium channel antagonists was a little bit higher among Egyptians than Ukrainians. Diuretics were used more often by Ukrainians than by Egyptians. The use of ACEI/ARBs surpassed the use of all other classes of antihypertensives among both groups. Whereas the ACEI/ARBs use among Egyptians was lower than Ukrainians. In this study we conducted a determination of compliance which was defined as an act of adhering to the regimen of care recommended by the clinician and persisting with it over time. The majority of Ukrainian and Egyptian patients with hypertension do not always perform the doctor's prescription. The reason for the unfull implementation of medical prescriptions with the same frequency was called deficiency of funds and forgetfulness. Near 80% of Ukrainian respondents are ready to complete the prescription with understanding, however, 14% of the patients stated that they were not always ready to fulfill the prescription, and the smallest part of patients did not think it was necessary to follow the regularity of treatment and treatment regimen. We noted no significant difference in the adherence to antihypertensive therapy between Ukrainian and Egyptian participants. Early discontinuation of treatment and suboptimal daily use of the prescribed regimens are the foremost common facets of poor adherence to treatment as well as non-adherence to antihypertensive therapy correlates with a better risk of cardiovascular events. Conclusion. ACEI/ARBs are the most commonly used group of antihypertensive drugs among Ukrainian and Egyptian patients. The majority of Ukrainian and Egyptian participants with hypertension do not always perform the doctor's prescription. Only 50% had an objective reason for insufficient compliance

Long-wavelength ultraviolet A (UVA-1) phototherapy for the treatment of patients with atopic dermatitis

One of the methods of therapy for atopic dermatitis is long-wavelength ultraviolet therapy A (UVA-1- therapy). This review aims to provide the mechanisms of action of UVA-1-therapy an overview about the effectiveness of UVA-1-therapy in patients with atopic dermatitis taking into account factors that can affect the effectiveness of treatment radiation dose, skin phototype of patients, concomitant drug therapy. The available data on a decrease in the severity of atopic dermatitis as a result of the course of UVA-1-therapy and on a decrease in the severity of itching in patients are presented. The data on the rate of onset of the therapeutic effect of UVA-1-therapy and the duration of its maintenance are considered. The safety of UVA-1-therapy is discussed, and the most frequent undesirable effects a feeling of warmth, fever, itching, hyperpigmentation, are given. The possibility of developing side effects requiring discontinuation of treatment is assessed. The data obtained indicate the effectiveness and safety of the UFA-1-radiation in the treatment of patients with moderate-to-severe atopic dermatitis.

Overcoming Immune Depletion is the Main Goal of Developing New Therapies

In recent years, immunotherapy has revolutionized the treatment of cancer; However, inflammatory reactions in healthy tissues often have side effects that can be serious and lead to permanent discontinuation of treatment. This toxicity is not yet well understood and is a major obstacle to the use of immunotherapy. When the immune system is so severely activated, the resulting inflammatory reaction can have detrimental effects and sometimes serious damage to healthy tissue. We wanted to know if there was a difference between an optimal immune response that aims to kill cancer and an unwanted response that could affect healthy tissue. Identifying the distinctive elements between these two immune responses allows the development of new, more effective and less toxic therapeutic approaches. Keywords: Cancer; Cells; Tissues; Tumors; Prevention; Prognosis; Diagnosis; Imaging; Screening, Treatment; Management

A study to evaluate the efficacy and safety of intradermal and intralesional Purified Protein Derivative (PPD) for treatment of common warts in children

: Viral warts are common dermatological diseases with wide range of treatment modalities. Utilization of various vaccines and skin test antigens has broadened the horizon of available immunotherapeutic agents for the treatment of warts. In this study, we compared efficacy and safety of intradermal and intralesional purified protein derivative (PPD) for treating common warts in children. Toevaluate efficacy and safety of intradermal and intralesional PPD in treatment of common warts in children.: 180 children (aged 5-15 years) with common warts were randomly divided to receive intradermal (n=90) PPD 10 TU/0.1 ml at middle third of right forearm or intralesional PPD (n=90) 0.1 ml in the largest wart once in 2-weeks till there is complete clearance or maximum of five injections whichever is earlier. Patients were followed at 4 week after last injection for assessment of response, adverse effects, and recurrence of common warts. : Complete, partial clearance and no response in 51.2%, 45.3% and 2.3% children was observed in intradermal group as compared to 54.2%, 42.5% and 1.1% response in intralesional group respectively. Recurrence of warts was observed in 1.2% and 2.2% children in intradermal and intralesional group respectively. Pain was the most common adverse effect in both groups followed by erythema lasting for 2-3 days not warranting for discontinuation of treatment in any patient.: Overall 96.5% and 96.7% patients in both intradermal and intralesional group responded to treatment respectively. We conclude that immunotherapy with PPD appears safe, effective, and acceptable treatment modality for common warts in children. Although intralesional group showed slightly higher efficacy for warts (0.2%), intradermal PPD has advantage of less pain, high patient satisfaction, less spillage of injection material onto surroundings and better compliance over intralesional group and hence can be considered as valuable first line treatment in children in resource poor developing countries.

Unlocking the Potential of Vaccines Built on Messenger RNA

In recent years, immunotherapy has revolutionized the treatment of cancer; however, inflammatory reactions in healthy tissues often have side effects that can be serious and lead to permanent discontinuation of treatment. This toxicity is not yet well understood and is a major obstacle to the use of immunotherapy. When the immune system is so severely activated, the resulting inflammatory reaction can have detrimental effects and sometimes serious damage to healthy tissue. We wanted to know if there was a difference between an optimal immune response that aims to kill cancer and an unwanted response that could affect healthy tissue. Identifying the distinctive elements between these two immune responses allows the development of new, more effective and less toxic therapeutic approaches. Keywords: Cancer; Cells; Tissues, Tumors; Prevention, Prognosis; Diagnosis; Imaging; Screening; Treatment; Management

Counseling in psoriasis: overcoming the concerns and challenges

<p>Psoriasis is a systemic, immune-mediated disorder, characterized by systemic inflammation predominantly in skin and joints with significant physical and psychosocial consequences. It is a chronic disease with an unpredictable journey consisting of flares and remissions. Psoriasis has also been linked to loss of self-esteem in patients, depression and suicidal tendencies. In addition, it also contributes to financial burden due to the long-term management. This results in negative impact on the caregivers and family of the patient. Due to these multiple factors, there has been low compliance to therapy and higher likelihood of discontinuation of treatment. Considering the emotional aspect involved in this disease, counseling of the patients becomes one of the integral pillars for the management of the disease. Hence, the clinician’s role becomes significant, due to limited access to counselors, therapists and social groups, in our country. The present reviewdescribes the impact of psoriasis on the patient’s life and the practical approaches that may be taken to counsel the patient of psoriasis.</p>

Clinical safety of ibuprofen in pediatric practice

The article presents a review of the literature on the side effects of ibuprofen in children. The international guidelines recommend ibuprofen as an antipyretic and analgesic drug in pediatrics. The drug is characterized by a high profile of efficacy and safety in the treatment of children with fever, mild to moderate pain. Ibuprofen in over-the-counter doses has a low probability of serious side effects from the gastrointestinal tract and kidneys. Side effects of ibuprofen are transient and resolve after discontinuation of treatment. Circumstances associated with a higher risk of adverse events are highlighted. The use of ibuprofen is contraindicated in children with dehydration, which is associated with a risk of acute kidney damage. Caution should be exercised when prescribing ibuprofen to children with community-acquired pneumonia due to the risk of purulent complications. Ibuprofen should not be prescribed to patients with chickenpox to avoid bacterial superinfections. Ibuprofen should be used with caution in children with diseases of the gastrointestinal tract, liver, renal failure, hemorrhagic syndrome, anticoagulant therapy. Ibuprofen is allowed in children with bronchial asthma unless a personal or family history of aspirin-induced asthma. Caution should be exercised when treating premature infants or low birth weight infants due to the reduction in nephron mass and, therefore, the increased risk of renal damage. Ibuprofen should not be used in patients who are sensitive to this drug or other non-steroidal anti-inflammatory drugs. Ibuprofen should be taken in the minimum effective dose and discontinued as soon as possible — no more than 3 days for fever and 5 days for pain.

Attitudes of patients with a rheumatic disease on drug use in the COVID-19 pandemic

Background Anti-rheumatic drugs can increase the predisposition to infection, and patients may be unaware of continuing their treatment during the COVID-19 pandemic. Objective This study aimed to assess whether patients maintain their treatment for rheumatic conditions during the pandemic period and determine the factors responsible for discontinuation. Methods Patients were randomly selected from the prospectively collected database of our tertiary referral center. The patients were interviewed by telephone through a standardized closed-ended questionnaire, which is targeting the continuity of the treatment plan and the considerations related to the individual choice. The patients were asked whether they hesitated to visit the hospital for follow-up or intravenous drug administration. Results A total of 278 patients completed the questionnaire. While 62 of the patients (22.3%) had reduced or interrupted the treatment, only 11 patients (3.9%) stopped the treatment completely. A significant difference was observed between the duration of illness and the discontinuation of treatment. (p = 0.023) There was a significant difference in disease activity between the group that stopped treatment and continued treatment. (p = 0.001) There was no statistically significant difference in other demographic characteristics. One hundred thirty-five patients (48.6%) made the treatment decision by themselves, and 80% continued the treatment. Reasons for stopping the treatment were anxiety (48.4%), not being able to go to the hospital for intravenous treatment (45.1%), and not being able to find the drug (6.5%). Conclusion Since patients with long-term illnesses were found to be significantly more likely to stop their treatment, this group of patients should be monitored.