Articles: treatment.
-
A genetic case-control study. ⋯ SNP rs10738445 were significantly associated with brace treatment effectiveness. The other four SNPs were not significantly associated with the outcome of bracing. More SNPs and predictors should be included in future study to develop a more accurate predictive model for clinical application.
-
Curr Opin Anaesthesiol · Feb 2025
Towards optimization in the use of hemostatic agents and blood products in the early treatment of patients with traumatic brain injury (TBI).
The treatment of patients with traumatic brain injury (TBI) with subsequently evolving hemostatic failure and hemorrhagic lesion progression remains challenging. New studies highlight windows of opportunity for treatment optimization. ⋯ Mortality in TBI with subsequent evolving hemostatic failure can be reduced through treatment optimization delivering early prehospital high-dose tranexamic acid and in-hospital goal-directed treatment algorithms to timely correct coagulopathy and restore hemostasis.
-
A review of the diagnostic and therapeutic management algorithm of the pathogen Clostridioides difficile for daily practice is presented. Its diagnosis, in any unformed stool sample sent to the laboratory, is based on a two-step algorithm, with demonstration of the pathogen by means of its enzyme glutamate dehydrogenase by immunoassay and subsequent PCR (polymerase chain reaction) of its toxin. The mainstay of step therapy, reserved for symptomatic patients, is fidaxomicin, over vancomycin. ⋯ Emerging therapies, such as faecal microbiota transplantation or the antibody bezlotoxumab, are gaining importance in patients with risk factors or relapses. Surgery is indicated in patients with worse prognosis and complications. Prevention is essential, based on vigilance and contact precautions, in addition to the elimination of spores from the environment.
-
Transthyretin (ATTR) amyloidosis is an ultimately fatal disease. While approved therapies slow disease progression, the cost of care can be significant for patients. The objective of this survey was to describe the factors associated with financial toxicity of ATTR amyloidosis and the economic burden of care and treatment. ⋯ Patients with ATTR amyloidosis experience significant financial distress that is comparable to patients with cancer, and as a result, many patients delay treatment or pay for treatment using savings and/or borrowing money. African American respondents (vs white) were significantly at risk.
-
Clinical decision-making after allogeneic stem cell transplantation (HSCT) is partially based on hematopoietic chimerism analysis. Short tandem repeat (STR), the current gold standard for quantitative chimerism analysis, has limited sensitivity. Digital polymerase chain reaction (dPCR) combines precise quantification and high reproducibility with excellent sensitivity (usually ≤ 0.1%) in a wide measurement range. However, the reported dPCR-based chimerism detection methods were developed in non-Chinese cohorts and may not be applicable in a Chinese population. ⋯ Our new system has great repeatability and sensitivity, especially in detecting micro-chimerism and in dual donor samples. It is expected to show good applicability in Chinese transplant patients. Selecting dPCR/STR testing according to each individual's chimerism status facilitates sensitive and accurate analysis, effective early treatment interventions, and relapse monitoring in clinical settings.