Search results for "treatment strategy"
showing 10 items of 40 documents
Comparison between two different cardiovascular models during a hemorrhagic shock scenario
2020
Hemorrhagic shock is a form of hypovolemic shock determined by rapid and large loss of intravascular blood volume and represents the first cause of death in the world, whether on the battlefield or in civilian traumatology. For this, the ability to prevent hemorrhagic shock remains one of the greatest challenges in the medical and engineering fields. The use of mathematical models of the cardiocirculatory system has improved the capacity, on one hand, to predict the risk of hemorrhagic shock and, on the other, to determine efficient treatment strategies. In this paper, a comparison between two mathematical models that simulate several hemorrhagic scenarios is presented. The models considere…
Adaptive treatment of anemia on hemodialysis patients: A reinforcement learning approach
2011
The aim of this work is to study the applicability of reinforcement learning methods to design adaptive treatment strategies that optimize, in the long-term, the dosage of erythropoiesis-stimulating agents (ESAs) in the management of anemia in patients undergoing hemodialysis. Adaptive treatment strategies are recently emerging as a new paradigm for the treatment and long-term management of the chronic disease. Reinforcement Learning (RL) can be useful to extract such strategies from clinical data, taking into account delayed effects and without requiring any mathematical model. In this work, we focus on the so-called Fitted Q Iteration algorithm, a RL approach that deals with the data very…
Genome-Wide Inhibition of Pro-atherogenic Gene Expression by Multi-STAT Targeting Compounds as a Novel Treatment Strategy of CVDs.
2018
Cardiovascular diseases (CVDs), including atherosclerosis, are globally the leading cause of death. Key factors contributing to onset and progression of atherosclerosis include the pro-inflammatory cytokines Interferon (IFN)a and IFN? and the Pattern Recognition Receptor (PRR) Toll-like receptor 4 (TLR4). Together, they trigger activation of Signal Transducer and Activator of Transcription (STAT)s. Searches for compounds targeting the pTyr-SH2 interaction area of STAT3, yielded many small molecules, including STATTIC and STX-0119. However, many of these inhibitors do not seem STAT3-specific. We hypothesized that multi-STAT-inhibitors that simultaneously block STAT1, STAT2, and STAT3 activit…
Role of Hemodynamic Forces in Unruptured Intracranial Aneurysms: An Overview of a Complex Scenario.
2017
Background An understanding of the natural history of unruptured intracranial aneurysms (IAs) has always played a critical role in presurgical or endovascular planning, to avoid possibly fatal events. Size, shape, morphology, and location are known risk factors for rupture of an aneurysm, but morphologic parameters alone may not be sufficient to perform proper rupture risk stratification. Methods We performed a systematic PubMed search and focused on hemodynamics forces that may influence aneurysmal initiation, growth, and rupture. Results We included 223 studies describing several hemodynamic parameters related to aneurysm natural history. In these studies, different modalities of aneurysm…
Natalizumab Discontinuation and Treatment Strategies in Patients with Multiple Sclerosis (MS): A Retrospective Study from Two Italian MS Centers
2015
Introduction Natalizumab (NTZ) discontinuation can be followed by multiple sclerosis (MS) disease reactivation. Currently no disease-modifying drug (DMD) has been shown to be able to abolish disease reactivation. The aims of the current study were: (1) to determine the frequency of MS reactivation after NTZ discontinuation; (2) to evaluate predictors of reactivation risk, and (3) to compare the effect of different treatments in reducing this risk. Methods Data from 132 patients with MS followed-up for 2 years before NTZ treatment and 1 year after interruption were collected from two Italian MS centers and retrospectively evaluated. Results Overall, 72 of 132 patients (54.5%) had relapses af…
Patient selection, echocardiographic screening and treatment strategies for interventional tricuspid repair using the edge-to-edge repair technique
2018
Severe tricuspid regurgitation (TR) has long been neglected despite its well-known association with mortality. While surgical mortality rates remain high in isolated tricuspid valve surgery, interventional TR repair is rapidly evolving as an alternative to cardiac surgery in selected patients at high surgical risk. Currently, interventional edge-to-edge repair is the most frequently applied technique for TR repair even though a device has not been developed for this particular indication. Due to the inherent differences in tricuspid and mitral valve anatomy and pathology, percutaneous repair of the tricuspid valve is challenging due to a variety of factors including the complexity and varia…
Treatment strategies for cancer patients with breakthrough pain.
2009
Breakthrough pain (BTP) is a transitory flare of pain superimposed on an otherwise stable pain pattern in patients treated with opioids. It is normally severe in intensity, has a rapid onset, has a variable duration (on average 30 min) and is considered a negative prognostic factor. OBJECTIVE: To verify the data in the literature about therapy strategies for BTP in cancer patients. METHODS: To find clinical trials investigating drug therapy for BTP. CONCLUSION: The treatment of BTP in cancer patients receiving opioids is principally based on the use of opioids, preferentially with a short onset. Fentanyl delivered by recently developed systems seems to be the best option to cover the tempor…
Surgical disaster following hernia mesh infection and erroneous treatment strategy: A case report
2020
Highlights • Hernia mesh infection is easier to prevent than to cure. • A late infected hernia mesh explantation is more challenging than an early one. • Hernia mesh fragmentation following partial explantation burdens its complete removal. • An incorrect surgical strategy could catalyze a chain reaction of complications.
Ultrasound in Varicose Vein Treatment
2014
Diagnosis is a prerequisite for all treatment strategies. Duplex ultrasound is the best diagnostic tool for varicose veins for all expressions of the disease (Nicolaides Circulation 102:126–163, 2000). All types of intervention on varicose veins have their own special demands on ultrasound. Ultrasound-guided vein mapping on the skin is very helpful prior to saphenous stripping (See Sect. 12.1), and it is absolutely indispensible for CHIVA (See Sect. 12.2). In endovascular thermal therapies (See Sect. 12.3) or foam sclerotherapy of trunk veins (See Sect. 12.4), ultrasound is an essential part of the treatment process. The actual procedures will only be explained here in relation to ultrasoun…
Treatment strategies and outcome of the exstrophy–epispadias complex in germany: data from the german CURE-Net
2020
Introduction: To evaluate the impact of reconstructive strategies and post-operative management on short- and long-term surgical outcome and complications of classical bladder exstrophy (CBE) patients' comprehensive data of the multicenter German-wide Network for Congenital Uro-Rectal malformations (CURE-Net) were analyzed. Methods: Descriptive analyses were performed between 34 prospectively collected CBE patients born since 2009, median 3 months old [interquartile range (IQR), 2–4 months], and 113 cross-sectional patients, median 12 years old (IQR, 6–21 years). Results: The majority of included individuals were males (67%). Sixty-eight percent of the prospectively observed and 53% of the …