Establishment of Standardized Diagnostic System for Brucella Spondylitis in the Elderly and Clinical Application of Precise Treatment Strategy
Yang Xinming,
Zhang Zhe,
Yang Chaowei,
Zhang Xuyang
Issue:
Volume 12, Issue 2, March 2023
Pages:
19-29
Received:
4 April 2023
Accepted:
21 April 2023
Published:
27 April 2023
Abstract: Objectives Establish a clinical standardized diagnosis and treatment strategy system for senile brucellosis spondylitis, and evaluate the clinical effect of applying this diagnosis and treatment system in order to improve the diagnosis rate and cure rate of the disease. Methods A diagnostic system was established based on the medical history, clinical, imaging, laboratory, bacteriological and pathological examinations of 70 elderly patients with brucellosis spondylitis admitted from January 2002 to December 2017. All patients received standardized drug therapy, anti-osteoporosis therapy and adjuvant hyperbaric oxygen therapy. Forty-two patients with spinal nerve injury received surgical treatment. Follow-up and evaluation were conducted at 2 weeks, 1 month, 3 months, 6 months, and 12 months after treatment. Results All patients were diagnosed after admission according to the diagnostic system standard examination. In this group, 28 patients (40%) received standardized drug therapy for non-surgical indications (group A), and 42 patients (60%) received surgical treatment for surgical indications (group B). VAS scores were significantly different between the two groups (P<0.05), group B was better than group a. Imaging scores showed that in group B, the myelopathy segments were stable without abscess and inflammatory granuloma, except for slow bone repair in the debridement area of the original myelopathy. Group A had no obvious vertebral lesion infiltration and interstitial infection absorption after 3 months of treatment, and gradually absorbed vertebral inflammatory infiltration and interstitial infection after 6 months. Clinical efficacy evaluation showed that both groups achieved good cure rates over time, and group B was better than group A (P<0.05). Conclusion Elderly brucellosis spondylitis has characteristic manifestations, and the establishment of a standardized diagnosis system will help improve the diagnosis rate; Synchronous drug therapy for BS and osteoporosis according to the treatment strategy has a good effect, and for patients who meet the indications for surgery, timely surgery can relieve or relieve pain, maintain spinal stability, and promote rapid recovery of nerve and spinal functions. It has obvious advantages and can better improve the clinical cure rate.
Abstract: Objectives Establish a clinical standardized diagnosis and treatment strategy system for senile brucellosis spondylitis, and evaluate the clinical effect of applying this diagnosis and treatment system in order to improve the diagnosis rate and cure rate of the disease. Methods A diagnostic system was established based on the medical history, clini...
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Expanding the Abu Dhabi Bone Marrow Transplant Program (AD-BMT®) Scope with the Collection and Cryopreservation of Cord Blood Stem Cells
Rene Antonio Rivero-Jimenez,
Antonio Alfonso Bencomo-Hernandez,
Yandy Marx Castillo-Aleman,
Fatema Mohammed Al Kaabi,
Yendry Ventura-Carmenate
Issue:
Volume 12, Issue 2, March 2023
Pages:
30-47
Received:
12 April 2023
Accepted:
27 April 2023
Published:
10 May 2023
Abstract: Introduction: The umbilical cord blood (UCB) is the blood from the placenta's blood vessels and the portion of the umbilical cord that remains attached to the newborn after the delivery when the cord is clamped and cut. UCB is rich in hematopoietic stem cells (HSC) and other stem cells (SC). Between 1974 and 1988, scientific knowledge and UCB application possibilities for human therapy opened a new significative era in cell therapy, using UCB HSC as an alternative source of SC for bone marrow transplant and the cure of patients with malignant hematological diseases. Objective: The possibility of having a UCB bank (UCB-B) in Abu Dhabi encouraged us to make this analysis. Method: A literature review from Google Scholar, PubMed, SciELO, Scopus, and other sources, about the increasing application of UCB-SC and storage in UCB-B was done to update about all the possibilities for translational medicine. Results: We prepared a UCB overview, including the pioneering use of UCB-SC for HSC transplantation, their biological composition, characteristics, and the UC-associated tissues like Wharton-Jelly and the human term placenta, UCB advantages, and disadvantages in HSC transplantation, the number of clinical trials applying UCB donation samples, and promising possibilities for regenerative medicine. The existence of different types of UCB-Bs, and the development of new specific cellular manipulation techniques. The UCB-B regulatory framework and some ethical issues were also included in the review. Conclusions: After 30 years of UCB-B, more than 100 public UCB-Bs worldwide, with millions of UCB units donated altruistically, more than 800,000 clinical-grade products are now available: a great source of transplantable SC and other cellular material for the development of new therapies. Even though the UCB as a source of HSC for transplantation has been recently statistical ranked in third place, after HSC apheresis collected and bone marrow aspirates, until now, more than 50,000 UCB HSC allogeneic transplants (HSC-Allo-T) have been performed worldwide in both children and adults to treat many different diseases, including hematologic, metabolic, immunologic, neoplastic, and neurologic disorders. A significant effort has been focused on enhancing engraftment to reduce the risk of infection and cost. Recommendations: To that end, we must understand in detail the molecular mechanisms controlling SC self-renewal that may lead to the development of ex-vivo systems for HSCs expansion, characterize the mechanisms regulating the homing of HSC and determine the relative place of UCB HSC-Allo-T, as compared to other sources.
Abstract: Introduction: The umbilical cord blood (UCB) is the blood from the placenta's blood vessels and the portion of the umbilical cord that remains attached to the newborn after the delivery when the cord is clamped and cut. UCB is rich in hematopoietic stem cells (HSC) and other stem cells (SC). Between 1974 and 1988, scientific knowledge and UCB appli...
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