Background
Therapeutic apheresis has been used in treating hematological and non‐hematological diseases. For a successful procedure, efficient vascular access is required. Presently, peripheral venous access (PVA), central venous catheterization (CVC), implantable ports, and arteriovenous fistulas (AVFs) are used. This review aims to evaluate different type of access and their pros and cons to help physicians determine the best venous access.
Methods
The electronic search included PubMed and Google Scholar up to November 2020. The Mesh terms were apheresis, peripheral catheterization, central catheterization, and arteriovenous fistula.
Results
A total of 228 studies were found through database searching. Two independent authors reviewed the articles using their titles and abstracts; 88 articles were selected and the full text was reviewed. Finally, 26 were included. The inclusion criteria were studies incorporating patients with any indication for apheresis.
Conclusion
PVA has been promoted in recent years in many centers across the United States to lower the rate of complications associated with vascular access and to make this procedure more accessible. Several factors are involved in selecting appropriate venous access, such as the procedure's duration and frequency, patient's vascular anatomy, and staff's experience. In short‐term procedures, temporary vascular access like PVA or CVC is preferred. Permanent vascular access such as AVF, tunneled cuffed central lines, and implantable ports are more beneficial in prolonged treatment period but each patient has to be evaluated individually by apheresis team for the most appropriate method.
Acute liver injury is a common disease without effective therapy in humans. We sought to evaluate a combination therapy of insulin‐like growth factor 1 (IGF‐I) and BTP‐2 in a mouse liver injury model induced by lipopolysaccharide (LPS). We chose this model because LPS is known to increase the expression of the transcription factors related to systemic inflammation (i.e., NFκB, CREB, AP1, IRF 3, and NFAT), which depends on calcium signaling. Notably, these transcription factors all have pleiotropic effects and account for the other observed changes in tissue damage parameters. Additionally, LPS is also known to increase the genes associated with a tissue injury (e.g., NGAL, SOD, caspase 3, and type 1 collagen) and systemic expression of pro‐inflammatory cytokines. Finally, LPS compromises vascular integrity. Accordingly, IGF‐I was selected because its serum levels were shown to decrease during systemic inflammation. BTP‐2 was chosen because it was known to decrease cytosolic calcium, which is increased by LPS. This current study showed that IGF‐I, BTP‐2, or a combination therapy significantly altered and normalized all of the aforementioned LPS‐induced gene changes. Additionally, our therapies reduced the vascular leakage caused by LPS, as evidenced by the Evans blue dye technique. Furthermore, histopathologic studies showed that IGF‐I decreased the proportion of hepatocytes with ballooning degeneration. Finally, IGF‐I also increased the expression of the hepatic growth factor (HGF) and the receptor for the epidermal growth factor (EGFR), markers of liver regeneration. Collectively, our data suggest that a combination of IGF‐I and BTP‐2 is a promising therapy for acute liver injury.
BackgroundMindfulness‐based stress reduction (MBSR) reduces pain, depression, and anxiety in patients suffering from various illnesses. MBSR and other complementary/alternative therapies can be used in conjunction with prescription medications. This article examines the effectiveness of MBSR as a mind-body intervention on the level of pain, depression, and anxiety in females with chronic low back pain (CLBP).MethodsA total of thirty patients diagnosed with CLBP by physicians enrolled in this study and randomly assigned to the experimental (MBSR+ usual medical care) and the control group (usual medical care only). The Beck Depression Inventory, the Beck Anxiety Inventory, and the pain rating scale were used to evaluate participants in three-time frames: before, right away, and eight weeks following the intervention. The final data were analyzed by ANCOVA using SPSS software.Our findings showed that MBSR was influential in reducing pain severity, depression, and anxiety of patients who practiced eight meditation sessions more than patients who only received usual medical care (P<0.001).ConclusionA short MBSR course could be a useful supplemental therapy that specifically reduces pain, anxiety, and depression in patients diagnosed with chronic low back pain. In contrast, a longer course may be necessary to detect unique improvements in total anxiety and cognitive aspects of depression.
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