82 research outputs found

    Experimental phage therapy of burn wound infection : difficult first steps

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    Antibiotic resistance has become a major public health problem and the antibiotics pipeline is running dry. Bacteriophages (phages) may offer an ‘innovative’ means of infection treatment, which can be combined or alternated with antibiotic therapy and may enhance our abilities to treat bacterial infections successfully. Today, in the Queen Astrid Military Hospital, phage therapy is increasingly considered as part of a salvage therapy for patients in therapeutic dead end, particularly those with multidrug resistant infections. We describe the application of a well-defined and quality controlled phage cocktail, active against Pseudomonas aeruginosa and Staphylococcus aureus, on colonized burn wounds within a modest clinical trial (nine patients, 10 applications), which was approved by a leading Belgian Medical Ethical Committee. No adverse events, clinical abnormalities or changes in laboratory test results that could be related to the application of phages were observed. Unfortunately, this very prudent ‘clinical trial’ did not allow for an adequate evaluation of the efficacy of the phage cocktail. Nevertheless, this first ‘baby step’ revealed several pitfalls and lessons for future experimental phage therapy and helped overcome the psychological hurdles that existed to the use of viruses in the treatment of patients in our burn unit

    Noncultured Autologous Adipose-Derived Stem Cells Therapy for Chronic Radiation Injury

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    Increasing concern on chronic radiation injuries should be treated properly for life-saving improvement of wound management and quality of life. Recently, regenerative surgical modalities should be attempted with the use of noncultured autologous adipose-derived stem cells (ADSCs) with temporal artificial dermis impregnated and sprayed with local angiogenic factor such as basic fibroblast growth factor, and secondary reconstruction can be a candidate for demarcation and saving the donor morbidity. Autologous adipose-derived stem cells, together with angiogenic and mitogenic factor of basic fibroblast growth factor and an artificial dermis, were applied over the excised irradiated skin defect and tested for Patients who were uneventfully healed with minimal donor-site morbidity, which lasts more than 1.5 years

    Medical Treatment of Radiological Casualties: Current Concepts

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    The threat of radiologic or nuclear terrorism is increasing, yet many physicians are unfamiliar with basic treatment principles for radiologic casualties. Patients may present for care after a covert radiation exposure, requiring an elevated level of suspicion by the physician. Traditional medical and surgical triage criteria should always take precedence over radiation exposure management or decontamination. External contamination from a radioactive cloud is easily evaluated using a simple Geiger-Müller counter and decontamination accomplished by prompt removal of clothing and traditional showering. Management of surgical conditions in the presence of persistent radioactive contamination should be dealt with in a conventional manner with health physics guidance. To be most effective in the medical management of a terrorist event involving high-level radiation, physicians should understand basic manifestations of the acute radiation syndrome, the available medical countermeasures, and the psychosocial implications of radiation incidents. Health policy considerations include stockpiling strategies, effective use of risk communications, and decisionmaking for shelter-in-place versus evacuation after a radiologic incident

    Application of Therapeutic Phages in Medicine

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    THERMOTECHNICAL APPROACHES TO THE INVESTIGATION OF LOCAL INJURIES CAUSED BY IONIZING RADIATION

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    Skin temperature has been used as an indicator of the physiological and pathological condition of the human body for centuries. The infrared (IR) thermogrammetry (TGM)/thermography gives new vistas for the transient skin surface temperature measurements, too. IR-TGM can also be advantageously applied in radiation biology for comparative and quantitative diagnostic investigations. In Hungary, the technique was first applied in 1984, when the authors published a case study on a local radiation injury [4] and suggested that both contact and infrared thermography were useful tools in detection of the areas of radiation injury. While in 1984 a serious injury of a hand (20-30 Gy, locally) was described, later [10,15] an injury caused by a much lower dose (1-2 Gy, locally) was reported when IR-TGM could still assist the diagnosis. The measurement results obtained enabled the authors to compare the radiation burden and the temperature distribution detected at the involved skin surface

    Electrospun biodegradable polymers loaded with bactericide agents

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    Development of materials with an antimicrobial activity is fundamental for different sectors, including medicine and health care, water and air treatment, and food packaging. Electrospinning is a versatile and economic technique that allows the incorporation of different natural, industrial, and clinical agents into a wide variety of polymers and blends in the form of micro/nanofibers. Furthermore, the technique is versatile since different constructs (e.g. those derived from single electrospinning, co-electrospinning, coaxial electrospinning, and miniemulsion electrospinning) can be obtained to influence the ability to load agents with different characteristics and stability and to modify the release behaviour. Furthermore, antimicrobial agents can be loaded during the electrospinning process or by a subsequent coating process. In order to the mitigate burst release effect, it is possible to encapsulate the selected drug into inorganic nanotubes and nanoparticles, as well as in organic cyclodextrine polysaccharides. In the same way, processes that involve covalent linkage of bactericide agents during surface treatment of electrospun samples may also be considered.; The present review is focused on more recent works concerning the electrospinning of antimicrobial polymers. These include chitosan and common biodegradable polymers with activity caused by the specific load of agents such as metal and metal oxide particles, quaternary ammonium compounds, hydantoin compounds, antibiotics, common organic bactericides, and bacteriophages.Peer ReviewedPostprint (published version

    Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles

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    Fortunately radiation accidents are infrequent occurrences, but since they have the potential of large scale events like the nuclear accidents of Chernobyl and Fukushima, preparatory planning of the medical management of radiation accident victims is very important. Radiation accidents can result in different types of radiation exposure for which the diagnostic and therapeutic measures, as well as the outcomes, differ. The clinical course of acute radiation syndrome depends on the absorbed radiation dose and its distribution. Multi-organ-involvement and multi-organ-failure need be taken into account. The most vulnerable organ system to radiation exposure is the hematopoietic system. In addition to hematopoietic syndrome, radiation induced damage to the skin plays an important role in diagnostics and the treatment of radiation accident victims. The most important therapeutic principles with special reference to hematopoietic syndrome and cutaneous radiation syndrome are reviewed

    Вариант профилактики лучевого цистита

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    External Beam Radiation Therapy (EBRT) is an efficient method of treatment for many types of tumors. But with different approaches, fields, and combinations of doses, the bladder lesions are inevitable. Therefore, one of the priority unsolved issues in the present day radiology is the issue of prevention and control of radiation reactions and injuries. The purpose of the present study was to develop a method for the prevention and treatment of radiation reactions in the treatment of patients with bladder cancer receiving gamma-ray teletherapy (GRT) and to substantiate the antioxidant and reparative role of the Emoxypin drug in this pathology. The severity of radiation reactions in patients receiving radiation therapy in the usual fractionation mode and with multi-fractionation of dose was under study. The total of 27 patients participated in the observation, those with bladder cancer diagnosed and subjected to the EBRT on the definitive treatment program. Analyzing the results obtained, it can be noted that the use of EBRT in the mode of the daily dose multifraction reliably (p = 0.05) reduces the reaction of the bladder mucosa. Thus, the reactions of the 3rd degree (ulcerative) differ by 4.31 times in favor of group II (experimental) where the mode of multifraction and the Emoxypin drug was used. Reactions of the 2nd degree (erosive-desquamated) differ by 1.24 times and also favor group II, but this indicator is unreliable. Reactions of 1 degree (catarrhal) differ by 3.72 times, which has a sufficient reliability in favor of the treatment performed in the patients of group II. The effect of bladder installations in patients with radiation cystitis, complicated with an infectious process, compared with the traditional methods of therapy, permitted to reduce the term of patients’ stay in hospital by 6-7 days. Дистанционная лучевая терапия (ДПТ) является эффективным методом лечения для многих видов новообразований. Но при различных подходах, полях и комбинациях доз лучевые поражения мочевого пузыря неизбежны. Поэтому одним из приоритетных вопросов в современной радиологии – это предупреждение и борьба с лучевыми реакциями и повреждениями. Целью работы стала разработка способа профилактики и лечения лучевых реакций при лечении больных раком мочевого пузыря, у больных которые получают дистанционную гамма-терапию (ДГТ) и обоснование антиоксидантной и репарационной роли препарата «Эмоксипин» при данной патологии. Изучалась выраженность лучевых реакций у больных, получавших лучевое лечение в режиме обычного фракционирования и при мультифракционировании дозы. В наблюдении принимало участие 27 больных с диагнозом рак мочевого пузыря и которым проводили ДПТ по радикальной программе. Анализируя полученные результаты, можно отметить, что применение ДПТ в режиме мультифракционирования дневной дозы достоверно (р = 0,05) снижает лучевые реакции слизистой мочевого пузыря. Так, реакции 3 степени (язвенные) различаются в 4,31 раза в пользу ИИ (опытной) группы где использовали режим мультифракционирования и заливки препарата «Эмоксипин». Реакции 2 степени (эрозивно-дескваматозные) отличаются в 1,24 раза и также говорят в пользу II группы, но этот показатель не достоверен. Реакции 1 степени (катаральные) отличаются в 3,72 раза, что имеет достаточную вероятность в пользу лечения проведенного во II группе больных. Действие инсталляций мочевого пузыря у больных с лучевыми циститами, отягощенные инфекционным процессом, по сравнению с традиционными методами терапии позволило сократить время пребывания больных в стационаре на 6-7 дней. Дистанційна променева терапія (ДПТ) є ефективним методом лікування для багатьох видів новоутворень. Але при різних підходах, полях та комбінаціях доз променеві ураження сечового міхура неминучі. Тому одним з пріоритетних невирішених питань у сучасній радіології є питання попередження та боротьби з променевими реакціями та ушкодженнями. Ціллю роботи стала розробка способу профілактики та лікування променевих реакцій при лікуванні хворих на рак сечового міхура, що отримують дистанційну гамма-терапію (ДГТ) та обґрунтування антиоксидантної і репараційної ролі препарату «Емоксипін» при даній патології. Вивчалась вираженість променевих реакцій у хворих, які отримували променеве лікування в режимі звичайного фракціонування та при мультифракціюванні дози. У спостереженні приймало участь 27 хворих з діагнозом рак сечового міхура і яким проводили ДПТ по радикальній програмі. Аналізуючи отримані результати, можна відзначити, що застосування ДПТ в режимі мультифракціювання денної дози вірогідно (р=0,05) знижує променеві реакції слизової сечового міхура. Так, реакції 3 ступеню (виразкові) різняться в 4,31 рази на користь ІІ (дослідної) групи де використовували режим мультифракціювання та заливки препарату «Емоксипін». Реакції 2 ступеню (ерозивно-десквамативні) різняться в 1,24 рази і також говорять на користь ІІ групи, але цей показник не вірогідний. Реакції 1 ступеню (катаральні) різняться в 3,72 рази, що має достатню вірогідність на користь лікування проведеного в ІІ групі хворих. Дія інсталяцій сечового міхура у хворих з променевими циститами, що обтяжені інфекційним процесом, в порівнянні з традиційними методами терапії дозволило скоротити час перебування хворих у стаціонарі на 6-7 днів
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