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ENT Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Give prednisolone 50 mg orally once daily for 5 days, in a patient with Bell's palsy if seen within 3 days of onset. Add hypromellose artificial tears, tape or pad the eye closed at night, and refer to the next ENT clinic.The role of additional antiviral therapy is inconclusive.
Corneal Ulcers and Contact Lens Keratitis
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Viral keratitis: Herpetic epithelial keratitis responds to aciclovir 3% ointment or ganciclovir 0.15% gel, each administered 5 times daily for 7–10 days. Oral antiviral therapy is indicated in immunodeficient patients and may also be effective alternatives to topical treatment when the latter is poorly tolerated, or in resistant cases. Some centres advocate swab confirmation and debridement. Almost certainly avoid topical steroids.
Neurological Disease in Herpes Simplex Virus Type 2 (HSV-2) Infection
Published in Marie Studahl, Paola Cinque, Tomas Bergström, Herpes Simplex Viruses, 2017
The spectrum of neurological HSV-2 disease is broad. Fortunately, the most serious manifestations in the brain, brainstem, and spinal cord are relatively rare but should be recognized at an early stage and antiviral therapy instituted promptly. The much more common and less severe HSV-2 meningitis nevertheless carries a risk of considerable neurological morbidity, not least through its tendency to recur. Although the condition could be readily diagnosed when thought of, it is probably still underdiagnosed. For the patient, the mere diagnosis may be of considerable medical and psychological benefit as well as time and cost saving. Antiviral therapy is available and may be considered for acute and prophylactic use.
Development and validation of a nomogram to predict recompensation in HBV-related cirrhosis with ascites as the single first decompensating event
Published in Scandinavian Journal of Gastroenterology, 2023
Shifei Wen, Jiajia Ruan, Jiaming Shen, Xia Wang, Guangde Yang, Juanjuan Fu, Li Li, Xiucheng Pan
Patients hospitalized for the first decompensation of hepatitis B cirrhosis with the first decompensating event of ascites only were included in this study. We divided the enrolled patients into the training cohort (from March 2010 to March 2020) and the validation cohort (from April 2020 to April 2022) according to their admission time. Comprehensive treatments were received for all patients, such as antiviral therapy, and symptomatic, supportive therapies. All patients started antiviral therapy within 3 months before admission or immediately after admission and were treated with oral antiviral drugs daily. Antiviral drugs include entecavir, tenofovir disoproxil fumarate and tenofovir alafenamide fumarate tablets. This study was approved by the Affiliated Hospital of Xuzhou Medical University Medical Ethics Committee.
Comparative efficacy and safety of antiviral traditional Chinese medicine injections for viral pneumonia: a systematic review and network meta-analysis
Published in Expert Review of Anti-infective Therapy, 2022
Meng-Ting Li, Jia Wang, Jia Hu, Han-Biao Wu, Wei-Shang Deng, Zhi-Kun Qiu, Ji-Sheng Chen
Antiviral therapy should be the key to treatment, but due to the high variability of most viruses, it brings difficulties to the development of therapeutic drugs. At present, the treatment for most respiratory viral infections lacks specificity, and clinically specific antiviral therapy is also limited to influenza virus, and the drugs mainly include abidol, oseltamivir, zanamivir, and peramivir. Traditional Chinese medicine (TCM) has the characteristics of systematic regulation and multi-target therapy, which can improve human immune function while reducing fever, reducing inflammation, and anti-virus, and has more advantages than single antiviral drugs in reducing upper respiratory tract symptoms. TCMIs are the product of the modernization of TCM dosage forms, which change the traditional model of administration of TCM, with rapid absorption and rapid action. The new coronavirus diagnosis and treatment plan recommends 7 kinds of traditional Chinese medicine injections according to the severity of the disease [3]. Although, TCM in being applied for COVID-19 pneumonia, its effectiveness remains uncertainly [4]. Therefore, integrating more clinical data becomes urgently needed. Furthermore, many RCTs of TCMIs in patients with VP have been completed. A reassessment of the available evidence to support clinical decision-making is urgently needed.
Recent trends in the development of Toll-like receptor 7/8-targeting therapeutics
Published in Expert Opinion on Drug Discovery, 2021
Xuan Huang, Xiaoyong Zhang, Mengji Lu
Chronic viral infections, such as that caused by hepatitis B virus (HBV) or human immunodeficiency virus (HIV), are characterized by a weak virus-specific T-cell response that allows sustained viral replication but results in progressive inflammatory injury [59]. Antiviral therapy can suppress viral replication and reduce the risk of disease progression. Antiviral therapy has little to no effect on the restoration of virus-specific immunity in the host and the majority of patients cannot achieve functional cure of chronic viral infection even with life-long treatment [60]. Therefore, therapeutic approaches are needed to boost the host innate and adaptive immunity [61]. TLR7 can bind to guanine and uracil-rich ssRNA in virus-infected cells [62]. Virally infected pDCs can secrete IFN-I and related cytokines. IFN-I interferes directly with viral replication or indirectly enhances the killing capacity of NK-cells and the functionality of B-cells and T-cells, thereby exerting antiviral effects [63]. If ssRNA from the environment is recognized by TLR7, the transcription factor nuclear factor κB and interferon regulatory factors are activated after a series of cascade reactions, inducing secretion of various proinflammatory cytokines including type-I IFNs, IL-1, IL-6, IL-12, and TNF-α [64]. Thus, triggering the TLR7 pathway is an ideal strategy for the reconstruction of host immunity [65].