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Georgios Gaitanis - One of the best experts on this subject based on the ideXlab platform.

  • Daptomycin-Based 3 Week Treatment Scheme for the First Cellulitis Episode: Low Recurrence Rate Indicative of Decreased Recurrence Propensity?
    Dermatology and Therapy, 2016
    Co-Authors: Ioannis D. Bassukas, Ioannis Chaniotakis, Georgios Gaitanis
    Abstract:

    Introduction Cellulitis recurrences are frequent, difficult to manage, and contribute considerably to overall Disease burden. This retrospective cases series reports recurrence rates of first community-acquired lower Limb Disease episode initially treated with daptomycin. Methods Treatment consisted of a 21-day two substances sequential scheme: intravenous daptomycin (4 mg/kg/day) during hospitalization and roxithromycin (2 × 150 mg per os) afterwards. Primary study end-point was the rate of recurrences during follow-up; recurrence rates and their binomial 95% confidence intervals (CI) were calculated with SPSS 22.0. Recurrences were identified by (1) review of hospital records and (2) telephone questionnaires. Results Twenty-seven patients hospitalized for first lower Limb cellulitis episodes were started on daptomycin and 26 patients completed the above three-week sequential treatment scheme. During follow-up (range 37–85 months) one recurrence occurred among the 26 patients who completed the treatment: 96.2% of these patients remained relapse free at the end of follow-up (CI 79.5–99.9%). Considering also treatment failure, the overall effectiveness of this combination treatment was 92.6% recurrence free after more than 3 years follow-up (25/27 patients; CI 75.5–99.0%). This study is limited by retrospective planning and the restricted number of included patients. Conclusion The choice of the treatment for the initial lower Limb cellulitis episode may impact the risk of Disease recurrences. Future studies should explore interventions for the first cellulitis episode as a means to modify the risk of the recurring course of this Disease.

  • Daptomycin-Based 3 Week Treatment Scheme for the First Cellulitis Episode: Low Recurrence Rate Indicative of Decreased Recurrence Propensity?
    Dermatology and therapy, 2016
    Co-Authors: Ioannis D. Bassukas, Ioannis Chaniotakis, Georgios Gaitanis
    Abstract:

    Introduction Cellulitis recurrences are frequent, difficult to manage, and contribute considerably to overall Disease burden. This retrospective cases series reports recurrence rates of first community-acquired lower Limb Disease episode initially treated with daptomycin.

Toshio Ogihara - One of the best experts on this subject based on the ideXlab platform.

Irene B.l. Boos - One of the best experts on this subject based on the ideXlab platform.

  • Intraarterial Infusion Therapy via a Subcutaneous Port for Limb-Threatening Ischemia: A Pilot Study
    CardioVascular and Interventional Radiology, 1998
    Co-Authors: Ernst-peter K. Strecker, Wladimir Ostheim-dzerowycz, Irene B.l. Boos
    Abstract:

    Purpose: To present the initial results of a new percutaneously implantable catheter port system (PIPS) used for long-term intraarterial infusion therapy in patients with severe ischemic Limb Disease. Methods: Ten patients with deep, extended ischemic ulcerations (all 10) and osteomyelitis (6/10) of the foot received intraarterial infusions of prostaglandine E_1 and antibiotics, if indicated, via a new port catheter system with the port placed subcutaneously above the groin after percutaneous introduction and the catheter tip placed into the superficial or deep femoral artery. Results: Port implantation and repeated port access were uncomplicated. During the follow-up period (mean 11 months, range 1 week–50 months), port migration, leakage, or infection was not observed. Three catheters thrombosed and were opened by fibrinolysis with recombinant tissue plasminogen activator instilled via the port. Treatment success was achieved in 8 patients: relief from rest pain (8 patients), reduction of ulcer size (4/8), and complete healing (4/8). Limb savage rate was 80%. In 2 patients amputation could not be avoided. Conclusion: Selective long-term arterial infusion therapy presents a valuable therapeutic regimen for Limb salvage. With the new catheter port system, repeated local intraarterial infusion is safe and simple.

  • intraarterial infusion therapy via a subcutaneous port for Limb threatening ischemia a pilot study
    CardioVascular and Interventional Radiology, 1998
    Co-Authors: Ernst-peter K. Strecker, Wladimir Ostheimdzerowycz, Irene B.l. Boos
    Abstract:

    Purpose: To present the initial results of a new percutaneously implantable catheter port system (PIPS) used for long-term intraarterial infusion therapy in patients with severe ischemic Limb Disease.

Bbr Kroon - One of the best experts on this subject based on the ideXlab platform.

  • Palliative isolated Limb perfusion for advanced Limb Disease in stage IV melanoma patients.
    Journal of surgical oncology, 2005
    Co-Authors: R.b. Takkenberg, Bart C. Vrouenraets, A.n. Van Geel, O. E. Nieweg, Eva M. Noorda, A. M. M. Eggermont, Bbr Kroon
    Abstract:

    Introduction: Two to three percent of the patients with extremity melanoma develop in-transit metastases in the course of their Disease. When local treatments fail, isolated Limb perfusion (ILP) is a reasonable option, but is generally only applied to patients without evidence of distant metastases. We assessed the value of ILP in stage IV melanoma patients with symptomatic unresectable Limb melanoma at our institutions. Patients and Methods: A computerized database, containing all patient, tumor, ILP, and follow-up data of 505 ILPs performed in 451 patients between 1978 and 2001, allowed the selection of eight (1.8%) stage IV patients who underwent a palliative ILP for unresectable melanoma lesions on the Limbs. All patients had high tumor burden Limb Disease, according to the combined Fraker and Rossi criteria. Results: The overall tumor response rate was 88%, with 13% complete and 75% partial response rates. One patient did not respond to ILP. Three partial responding patients attained a complete remission (CR) after excision of the remaining Limb lesions. The median duration of hospital stay was 12 days and acute regional toxicity was mild with slight erythema and edema in six and no signs of reaction in two patients. The median Limb recurrence-free interval after CR was 6 months and the median duration from the time of distant metastases to death was 15 months. Overall ILP leads to the desired palliative effect in six patients (75%). Conclusion: ILP should be considered as a palliative treatment in selected stage IV melanoma patients with symptomatic advanced Limb Disease.

  • Is there an indication for a double perfusion schedule with melphalan for patients with recurrent melanoma of the Limbs
    Melanoma research, 1994
    Co-Authors: Joost M. Klaase, A. M. M. Eggermont, Bbr Kroon, Van Geel An, H. R. Franklin, Van Dongen Ja
    Abstract:

    It has been reported that a double perfusion schedule shows a better complete remission rate than does the single procedure for recurrent melanoma of the Limb. As more perfusion strategies approach the ideal of a 100% complete remission rate, the main issue now is to prolong the period of Disease control in the Limb, ie to reduce the Limb recurrence rate. The follow up of 42 patients treated with a double perfusion schedule and of 45 patients treated with a single perfusion procedure was updated to compare the duration of Limb Disease control. Both treatment groups were well balanced with respect to patient and tumour characteristics. For patients treated with a double schedule, the dose of melphalan given in the first perfusion was low (6 mg/l Limb volume; 1 h; normothermic) in order to make it possible to carry out a second perfusion (9 mg/l; 1 h; normothermic) with a planned short interval of 3-4 weeks. In the single perfusion group a normothermic perfusion with 10 mg melphalan/l was carried out. The acute tissue reactions and long-term side effects did not differ between the two treatment modalities. The response rate was significantly higher in the double perfusion group owing to a higher complete remission rate (76% vs 48%; P = 0.006). However, no significant difference was seen in Limb Disease control rates 3 years after perfusion (double schedule, 36%; single schedule, 30%), nor in overall 3-year survival (double schedule, 52%; single schedule, 45%). When evaluating perfusion regimens with equally high complete remission rates, attention should be focused on the duration of Limb Disease control.

Jianhua Huang - One of the best experts on this subject based on the ideXlab platform.

  • Transplantation of Sendai viral angiopoietin-1-modified mesenchymal stem cells for ischemic Limb Disease.
    Angiogenesis, 2010
    Co-Authors: Wenhua Piao, Makoto Inoue, Mamoru Hasegawa, Hirofumi Hamada, Huishan Wang, Jianhua Huang
    Abstract:

    Sendai viral vector (SeV) is emerging as a promising vector for gene therapy. However, little information is available regarding the combination of SeV-mediated gene and mesenchymal stem cell (MSC) therapy in dealing with ischemic Diseases. In this study, we infected SeV to the MSCs in vitro; and injected MSCs modified with SeV harboring human angiopoietin-1 gene (SeVhAng-1) into the ischemic Limb of rats in vivo. We found SeV had high transductive efficiency to the MSCs. Both MSCs and SeVhAng-1-modified MSCs improved the blood flow recovery and increased the capillary density of the ischemic Limb, compared with the control. However, in contrast to MSCs, SeVhAng-1-modified MSCs had a better improvement of blood flow recovery in the ischemic Limb. We further found the ischemic Limb injected with SeVhAng-1-modified MSCs had strong expression of p-Akt, which improved survival of MSCs injected into the ischemic Limb. This indicated SeVhAng-1 modification enhanced angiogenetic effect of MSCs by both angiogenesis and cell protection. We conclude that SeVhAng-1-modified MSCs may serve as a more effective tool in dealing with ischemic Limb Disease.

  • Sendai viral vector mediated angiopoietin-1 gene transfer for experimental ischemic Limb Disease.
    Angiogenesis, 2009
    Co-Authors: Jianhua Huang, Makoto Inoue, Mamoru Hasegawa, Kei Tomihara, Toshihiro Tanaka, Jiahua Chen, Hirofumi Hamada
    Abstract:

    Sendai virus vector is emerging as a promising vector for gene therapy, and angiopoietin-1 (Ang-1) has been reported to improve the blood flow recovery in the ischemic Limb or heart. In this study, we constructed a human Ang-1-expressing Sendai viral vector (SeVhAng-1) and injected it into the ischemic Limb of rats. We found that SeVhAng-1 improved the blood flow recovery and increased the capillary density of the ischemic Limb, compared with the controls. We also found that SeVhAng-1 increased p-Akt during the early period of Limb ischemia, and decreased apoptosis in ischemic Limb. It suggests that SeVhAng-1 may serve as a potential therapeutic tool in ischemic Limb Disease.