Treatment of ocular allergies:nonpharmacologic, pharmacologic and immunotherapy

Ocular allergy is a significant and growing issue worldwide but for many patients, it is often not differentiated from systemic conditions, such as hay fever. Management of seasonal and perennial allergic conjunctivitis is often poor. Management is principally through avoidance measures (blocking or hygiene), nonpharmaceutical (such as artificial tears and cold compresses) and pharmaceutical (such as topical antihistamines and prophylactic mast cell stabilizers). Vernal and atopic keratoconjunctivitis are more severe and generally need treatment with NSAIDs, steroids and immunomodulators. Giant papillary conjunctivitis can be related to allergy but also is often contact lens related and in such cases can be managed by a period of abstinence and replacement of the lens or a change in lens material and/or design. Immunotherapy can be efficacious in severe, persistent cases of contact lens or allergic conjunctivitis

Effectiveness of An Ionic Toothbrush on the Removal of Plaque in Orthodontic Patients: A Clinical Study

For centuries, people have used various methods for cleaning their teeth. Today, individuals most commonly utilize toothbrushes in their oral hygiene methods. In an effort to increase the amount of plaque removed at each brushing, toothbrushes of different sizes, shapes, designs, and materials have been developed. The Hukuba Dental hyg ionic toothbrush is a new concept in toothbrush design. This toothbrush has an ionic action mechanism which creates a polarity change in the teeth. It is held that the Hukuba toothbrush changes the tooth polarity from negative to positive, thereby encouraging plaque ions to be repelled from the teeth. The purpose of this study was to determine the effectiveness of the Hukuba Dental hyg ionic toothbrush in the removal of plaque and gingivitis in patients wearing orthodontic appliances. Sixty volunteers with a mean age of 14.9 years agreed to participate in the study at Marquette University School of Dentistry, Orthodontic Department. The sample consisted of 23 males and 29 females who were wearing orthodontic appliances for the duration of the six-week study. Subjects were randomly assigned to one of two groups: Group 1 - control group using the Hukuba Dental hyg ionic toothbrush with an active battery, Group 2 - test group using the Hukuba Dental hyg ionic toothbrush with an inactive battery. The Hukuba Dental hyg ioniic toothbrush with the active battery did not show any improvement in plaque removal or gingivitis reduction when compared to use of the same toothbrush with an inactive battery. Although within groups there was a reduction in plaque and gingivitis scores over the course of the six week study, at no time was a difference noted between groups

Impact of siltuximab on patient-related outcomes in multicentric Castleman’s disease

Jenna Sitenga,1 Gregory Aird,1 Aabra Ahmed,1 Peter T Silberstein2 1Division of Education, Creighton University School of Medicine, Omaha, NE, USA; 2Division of Hematology/Oncology, Creighton University School of Medicine, Omaha, NE, USA Abstract: Multicentric Castleman’s disease (MCD) is a rare, widespread lymphoproliferative disorder and a life-threatening disease involving hyperactivity of the immune system, excessive proinflammatory cytokine release, immune cell proliferation, and organ system dysfunction. Interleukin-6 (IL-6) is a cytokine that plays a key role in the pathogenesis of MCD, as it is involved in the synthesis of acute-phase reactants and aids in the induction of B-cell proliferation. Siltuximab is an anti-IL-6 chimeric monoclonal antibody that acts as a novel treatment modality to bind to IL-6 with high affinity, thus neutralizing the cytokine bioactivity and inhibiting B-cell proliferation. Clinical trials with siltuximab have shown early clinical promise for patients with MCD for many years, leading to recent US Food and Drug Administration approval as a novel agent for the treatment of MCD. Here, a systematic review was conducted to include 171 cases of MCD patients treated with siltuximab. While traditional treatment methods were able to achieve a 5-year survival rate of only 55%–77%, results of siltuximab treatment demonstrated 5-year survival rates of nearly 96.4% (only 2 deaths reported out of 55 patients with follow-up data). Ultimately, the results from multiple clinical trials have demonstrated that siltuximab is extremely efficacious in alleviating disease symptoms (fatigue, pain, and lymphadenopathy) while simultaneously achieving disease remission, thus extending progression-free survival for years longer than the average 5-year survival rates for MCD. Keywords: Castleman’s disease, angiofollicular lymph node hyperplasia, giant lymph node hyperplasia, siltuximab, IL-6 recepto