Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication

BACKGROUND: To compare angioplasty (PTA), supervised exercise (SEP) and PTA + SEP in the treatment of intermittent claudication (IC) due to femoropopliteal disease. METHODS: Over a 6-year period, 178 patients (108 men; median age, 70 years) with femoropopliteal lesions suitable for angioplasty were randomized to PTA, SEP, or PTA + SEP. Patients were assessed prior to and at 1 and 3 months post treatment. ISCVS outcome criteria (ankle pressures, treadmill walking distances) and quality of life (QoL) questionnaires (SF-36 and VascuQoL) were analyzed. RESULTS: All groups were well matched at baseline. Twenty-one patients withdrew. Results are as follows: Intragroup analysis: All groups demonstrated significant clinical and QoL improvements (Friedman test, p 0.05). CONCLUSION: SEP should be the primary treatment for the patients with claudication and PTA should be supplemented by an SEP

Early result: randomized controlled trial of treatment for intermittent claudication

Objective: To compare angioplasty (PTA), supervised exercise (SEP) and PTA + SEP in the treatment of intermittent claudication (IC) due to femoro-popliteal disease Methods: Over a 6 years period, 178 patients (108 men, median age 70 years) with angioplastiable femoro-popliteal lesions were randomized to: PTA, SEP or PTA + SEP. Patients were assessed prior to and at 1 & 3 month post treatment. ISCVS outcome criteria (Ankle pressures, treadmill walking distances) and Quality of Life (QoL) questionnaires (SF36 and VascuQoL) were analysed. Results: All groups were well matched at baseline. 21 patients withdrew. Intra group analysis: All groups demonstrated significant clinical and QoL improvements (Friedman test, p < 0·05). SEP (59 patients, 8 withdrew) – 62·7% of patients (n = 32) improved following treatment [20 mild, 9 moderate, 3 marked], 27·4% (n = 14) no improvement and 9·8% (n = 5) deteriorated. PTA (60 patients, 3 withdrew) – 66·6% of patients (n = 38) improved following treatment [19mild, 10 moderate, 9 marked], 22·8% (n = 13) no improvement and 10·5% (n = 6) deteriorated. PTA + SEP (59 patients, 10 withdrew) – 81·6% of patients (n = 40) improved following treatment. [10 mild, 17 moderate, 13 marked], 14·2%% (n = 7) no improvement and 4·0% (n = 2) deteriorated Inter group Analysis: PTA + SEP produce a much greater improvement in clinical outcome measures than PTA or SEP alone, but there was no significant Q0L advantage (Kruskal Wallis test, p > 0·05). Conclusion: SEP should be the primary treatment for the patients with claudication and PTA should be supplemented by a SEP

Unravelling the role of nutraceutical supplements in treatment of Parkinson’s Disease

Parkinson’s Disease (PD) causes motor dysfunction that usually begins in the elderly population. The prevalence rate of PD is increasing significantly. Currently available therapies are able to manage the disease, however, they have certain side effects associated with long term usage. Hence, there is a dire need to bring therapies that can offer good treatment to PD with less side effects. Recent research has revealed that food supplements which are specifically rich in antioxidants and vitamins have shown better efficacy against PD with a better safety profile. Hence, the present study focuses on the role of nutraceuticals in treatment of PD. Nutritional supplements targeting PD pathology were explored between 2016 and 2022 through Scopus, google scholar and PubMed. The review deciphered the neuroprotective benefits of vitamins, minerals, natural compounds, and phytochemicals that might procrastinate or help in the prevention of PD’s progression by targeting some of the major pathological mechanisms such as oxidative stress, neuroinflammation, misfolding of alpha-synuclein, and mitochondrial dysfunction. Various studies indicating the potential of nutraceutical supplements are discussed in detail

Coinfections in Patients With Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Study

Background: The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection. Methods: We included adult (≥18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within ±2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality. Results: Among 8765 patients (hospitalized or not; median age, 65 years; 47.4% male), 16.6% developed coinfections: 12.1% bacterial, 2.1% viral, 0.9% fungal. An additional 6.4% only had clinical diagnosis of a coinfection. The adjusted risk of any coinfection was positively associated with age \u3e50 years, male sex, cardiovascular, pulmonary, and renal comorbidities, diabetes, hematologic malignancy, multiple malignancies, Eastern Cooperative Oncology Group Performance Status, progressing cancer, recent cytotoxic chemotherapy, and baseline corticosteroids; the adjusted risk of superinfection was positively associated with tocilizumab administration. Among hospitalized patients, high neutrophil count and C-reactive protein were positively associated with bacterial coinfection risk, and high or low neutrophil count with fungal coinfection risk. Adjusted mortality rates were significantly higher among patients with bacterial (odds ratio [OR], 1.61; 95% CI, 1.33-1.95) and fungal (OR, 2.20; 95% CI, 1.28-3.76) coinfections. Conclusions: Viral and fungal coinfections are infrequent among patients with cancer and COVID-19, with the latter associated with very high mortality rates. Clinical and laboratory parameters can be used to guide early empiric antimicrobial therapy, which may improve clinical outcomes

Hinge axis recording of the temporomandibular joint

The temporomandibular joint is called as ginglymoarthrodial joint. It is a complex joint in which two basic movements of the mandible can be distinguished. Rotary or hinge like movement taking place between the articular disk and condyle in the lower compartment of the temporomandibular articulation. Various studies have shown that an arbitrary location of the hinge axis is an acceptable alternative to its accurate location. With the availability of easy to use ear piece facebow, locating and transfer of hinge axis to the articulator is an easy and quick procedure.&nbsp; Precision is the key to prosthodontics and it is thus imperative that restorations are made as accurately as possible