Efficacy of topical cobalt chelate CTC-96 against adenovirus in a cell culture model and against adenovirus keratoconjunctivitis in a rabbit model

BACKGROUND: Adenovirus (Ad), associated with significant morbidity, has no topical treatment. A leading CTC compound (CTC-96), a Co(III )chelate, was found to have potent in vitro and in vivo antiviral efficacy against herpes viruses. In this study CTC-96 is being tested for possible anti-Adenovirus activity. METHODS: The biological anti-adenovirus activity of CTC-96 in concentrations from 5 to 250 ug/ml, was evaluated initially by viral inactivation (viral exposure to CTC-96 followed by dilution and inoculation of cells), virucidal (viral exposure to CTC-96 and inoculation of cells without dilution) and antiviral (effect of CTC-96 on previously adsorbed virus) plaque assays on HeLa (human cervical carcinoma), A549 (human lung carcinoma) and SIRC (rabbit corneal) cells. After verifying the antiviral activity, New Zealand White rabbits were infected with Ad-5 into: 1) the anterior cul-de-sac scarifying the conjunctiva (Group "C+"); 2) the anterior cul-de-sac scarifying the conjunctiva and cornea (Group "CC+"); 3) the stroma (Group "CI+"). Controls were sham-infected ("C-", "CC-", "CI-"). Other rabbits, after "CC", were treated for 21 days with: 1) placebo, 9x/day ("-"); 2) CTC-96, 50 ug/ml, 9x/day ("50/9"); CTC-96, 50 ug/ml, 6x/day ("50/6"); CTC-96, 25 ug/ml, 6x/day ("25/6"). All animals were monitored via examination and plaque assays. RESULTS: In vitro viral inactivation, virucidal and antiviral assays all demonstrated CTC-96 to be effective against Adenvirus type 5 (ad-5). The in vivo model of Ad keratoconjunctivitis most similar to human disease and producing highest viral yield was "CC". All eyes (6/6) developed acute conjunctivitis. "CI" yielded more stromal involvement (1/6) and iritis (5/6), but lower clinical scores (area × severity). Infection via "C" was inconsistent (4/6). Fifty (50) ug/ml was effective against Ad-5 at 6x, 9x dosings while 25 ug/ml (6x) was only marginally effective. CONCLUSION: CTC-96 demonstrated virucidal activity against Ad5 in tissue culture with HeLa, A549 and SIRC cell lines. Animal Model Development: 1) "CC" produced conjunctival infection with occasional keratitis similar to human disease; "CI" yielded primarily stromal involvement; 2) "C" consistently produced neither conjunctivitis nor keratitis. CTC Testing: 1) Conjunctivitis in all eyes; 2) Resolution fastest in "50/9" ("50/9". "50/6" > "25/6" > "-"); 3) Efficacy in "50/6" was not statistically different than "50/9"; 4) Conjunctival severity was lower in treatment groups then controls; 5) Little corneal or intra-ocular changes were noted

Medical interventions for fungal keratitis.

BACKGROUND: Fungal keratitis is a fungal infection of the cornea. It is common in agricultural tropical countries but relatively uncommon in developed countries. Although there are medications available, their effectiveness is unclear. OBJECTIVES: To examine the effect of different antifungal drugs in the management of fungal keratitis. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 8), MEDLINE (January 1950 to August 2011), EMBASE (January 1980 to August 2011), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2011), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) and ClinicalTrials.gov (www.clinicaltrials.gov). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 29 August 2011. SELECTION CRITERIA: We included all relevant randomised controlled trials (RCTs) on medical therapy for fungal keratitis. DATA COLLECTION AND ANALYSIS: Two review authors selected studies for inclusion into the review, assessed trials for risk of bias and extracted data. Interventions were compared by the proportions of participants that did not heal after a specific time of therapy. No meta-analysis was performed because the trials studied different medications with different concentrations. MAIN RESULTS: We included nine trials in this review; seven conducted in India, one in Bangladesh and one in Egypt. A total of 568 participants were randomised to the following comparisons: 1% topical itraconazole versus 1% topical itraconazole and oral itraconazole, different concentrations of silver sulphadiazine versus 1% miconazole, 1% silver sulphadiazine ointment versus 1% miconazole ointment, 2% econazole versus 5% natamycin, different concentrations of topical chlorhexidine gluconate versus 5% natamycin, 0.2% chlorhexidine gluconate versus 2.5% natamycin and voriconazole 1% versus natamycin 5%. The included trials were small and of variable quality. Differences between different regimens were not statistically different, which may reflect the low sample sizes. AUTHORS' CONCLUSIONS: Based on the trials included in this review, there is no evidence to date that any particular drug, or combination of drugs, is more effective in the management of fungal keratitis. The trials included in this review were of variable quality and were generally underpowered

Therapists who address client religious beliefs in therapy: a qualitative exploration

Research has reported that the majority of Americans view religion as being important in their lives, and can have a beneficial influence on a client’s mental health. However, fewer than half of therapists assess a client’s religious beliefs, and rarely is religion discussed in the treatment setting. This study attempted to address this rift between the importance of religious and spiritual beliefs of clients and the hesitance of therapists to discuss these beliefs by looking at psychologists who do address religion in their practice. In this qualitative study, the focus was to determine how these therapists work with a client’s religious beliefs. Twelve clinical psychologists, who identified themselves as addressing a client’s religious and spiritual beliefs in therapy, were interviewed about how they work with the client’s beliefs. These psychologists, between the ages of 44 and 64, whose clinical experience ranged between 9 and 34 years, were recruited from New Jersey and Pennsylvania through professional contacts. The interviews where semi-structured, with open questions designed to look at how the psychologists conceptualized religion and psychology, how they conceptualized bringing religion into therapy, how they worked with a client’s beliefs in therapy, and the ethical considerations surrounding addressing religion in therapy. Grounded theory was used to analyze the interviews and examine the major themes that emerged. From these themes, specific guidance was found from the various answers to the individual questions of the interviews. In addition, a more in depth qualitative analysis supported a theory in which therapists address a client’s beliefs by creating a collaborative dialogue between religion and psychology, similar to that discussed by Stanton Jones (1996). This emergent theory suggests that religion can be brought into therapy via the client’s world view that includes the client’s individual spiritual beliefs. The therapist acts as a representative of psychology, namely the therapist monitors boundaries carefully to maintain this specific role as the psychologist. Once these two roles are established, the collaborative dialogue occurs when discussing those areas of the client’s life where the domains of religion and psychology overlap. Finally, the psychologists interviewed also offered guidelines for addressing religion in therapy.Psy. D.Includes bibliographical referencesby Zachary Maichu

Algorithm of Risk Group Formation for Having Children With Neural Tube Defects Among Reproductive-Age Women and Differentiated Approach to Spinal Dysraphia Prevention

Congenital neural tube defects (NTDs) are the most common central nervous system congenital defect and among the most common congenital malformations of all organ systems. NTDs are the leading cause of neonatal and infant mortality and childhood disability. The objective was to develop risk groups for having children with NTDs among reproductive-age women based on the detection of endogenous and exogenous risk factors and to offer a differentiated approach to fetal NTD prevention

CHOICE OF DRUGS BY A GRADUATOR OF A MEDICAL UNIVERSITY IN INDIVIDUAL STANDARD SITUATIONS OF OUTPATIENT PRACTICE

The article is devoted to the study and analysis of the pharmacotherapeutic competence of the graduates of the medical university on the threshold of the independent medical activity in the primary link of public health. 169 students of the 6th year of the Medical Department of Yevdokimov MGMSU responded in writing to 8 tasks which proposed to name the optimal medicinal products (MP) in a number of standard situations of outpatient practice. The mean median of the selection evaluation was 11 points out of 16 impliable meanings. Each respondent indicated his average academic performance and assessed his/her own confidence in reasonable command of pharmacotherapy – the mean median for these indicators was 3 out of 5 and 6 out of 10 points, respectively. All 3 studied parameters showed a very weak positive relationship between themselves in ρ range from 0.19 to 0.24 for p <0.05. In the separate analysis of these indicators in the subgroups of students with high and average academic performance, no relationship between performance, assessment of drug choice and self-assessment of pharmacotherapeutic competence has been identified. The average assessment of the choice of drugs between these subgroups did not differ either. The data given indicate that the best average academic performance does not guarantee higher competence of respondents in the choice of medicines. The authors recommend purposeful pharmacotherapeutic preparation of students on the graduate course, taking into account the specificity of the forthcoming medical activity

Drugs in general medical practice: practical advice for a starting practitioner

The article is intended for starting primary care practitioners and senior students of medical schools. The authors provide the main principles of choosing and prescribing drugs in general medical practice on the ground of personal medical and teaching experience, and modern domestic and foreign literature. Practical advice is provided with up-to-date references to available electronic resources containing important background information on the key issues of modern pharmacotherapy. Reading the presented material will help to avoid making some typical mistakes and enhance the professional competence of a practitioner who starts working in the primary health care

The experience of using acetylsalicylic acid in a comorbid patient with cad and type 2 diabetes

The CVD death rates remain high now. The concurrent course of coronary artery disease (CAD) and diabetes mellitus (DM) has an unfavourable prognosis, requires specific therapy and the use of measures to prevent severe complications. DM sometimes hinders the timely diagnosis of CAD, which in this case is characterized by an atypical course and has no florid symptoms. This often causes serious pathological complications or death. The atherothrombosis forms the basis of pathogenesis of severe conditions. Atherothrombosis is not only a generalized, but also a constantly progressive disease, for which reason it is necessary to carry out both primary and secondary prevention. According to the existing guidelines of European Society of Cardiology and Society of Cardiology of Russian Federation, acetylsalicylic acid (ASA) is recommended at small doses as the first-line drug for the prevention of vascular events in patients with CAD. This article discusses the experience of using ASA according to the conducted studies and in practical medicine by the clinical example of a female patient