methylcellulose and Chronic-Disease

The aim of this review is to provide an overview of the clinical assessment and evidence-based treatment options for managing diabetes-associated chronic constipation.. A literature search of published medical reports in English language was performed using the OVID Portal, from PUBMED and the Cochrane Database of Systematic Reviews, from inception to October 2015. A total of 145 abstracts were identified; duplicate publications were removed and 95 relevant full-text articles were retrieved for potential inclusion.. Chronic constipation is one of the most common gastrointestinal symptoms in patients with diabetes, and occurs more frequently than in healthy individuals. Treatment goals include improving symptoms and restoring bowel function by accelerating colonic transit and facilitating defecation. Based on guidelines and data from published literature, food and dietary change with exercise and lifestyle change should be the first step in management. For patients recalcitrant to these changes, laxatives should be the next step of treatment. Treatment should begin with bulking agents such as psyllium, bran or methylcellulose followed by osmotic laxatives if response is poor. Lactulose, polyethylene glycol and lactitol are the most frequently prescribed osmotic agents. Lactulose has a prebiotic effect and a carry-over effect (continued laxative effect for at least 6 to 7 days, post cessation of treatment). Stimulants such as bisacodyl, sodium picosulphate and senna are indicated if osmotic laxatives are not effective. Newer agents such as chloride-channel activators and 5-HT4 agonist can be considered for severe or resistant cases.. The primary aim of intervention in diabetic patients with chronic constipation is to better manage the diabetes along with management of constipation. The physician should explain the rationale for prescribing laxatives and educate patients about the potential drawbacks of long-term use of laxatives. They should contact their physician if short-term use of prescribed laxative fails to provide relief.

Topics: Bisacodyl; Chloride Channel Agonists; Chronic Disease; Citrates; Constipation; Diabetes Complications; Dietary Fiber; Evidence-Based Medicine; Exercise Therapy; Healthy Lifestyle; Humans; Laxatives; Methylcellulose; Organometallic Compounds; Picolines; Psyllium; Senna Extract; Serotonin 5-HT4 Receptor Agonists

Topics: Acute Disease; Agar; Animals; B-Lymphocytes; Cells, Cultured; Chronic Disease; Colony-Forming Units Assay; Humans; Leukemia, Lymphoid; Methylcellulose; Multiple Myeloma

Topics: Adult; Animals; Blood Cell Count; Blood Sedimentation; Cecum; Child; Chronic Disease; Colonic Diseases, Functional; Constipation; Diarrhea; Diet; Diverticulum, Colon; Female; Fruit; Gastrointestinal Motility; Humans; Intestines; Male; Methylcellulose; Milk; Pain; Parasympatholytics; Psychotherapy; Sigmoidoscopy; Stress, Psychological; Syndrome

Chronic cough (CC) is a pervasive and expensive health problem in the United States. Almost as diverse as its etiologies are the available therapeutic options. When vocal fold paresis and CC coincide, injection augmentation may provide an alternative to standard medical and behavioral treatments for CC. Our objective was to assess the effect of injection augmentation in a selected group of patients with CC who had failed multiple medical and behavioral treatments.. The study design is a retrospective case review.. Our study group included six subjects (1 male and 5 females; aged 24-84 y) who presented for laryngologic evaluation with a chief complaint of CC unresponsive to conventional medical and behavioral management. The cough severity index (CSI), reflux symptom index (RSI), dyspnea severity index (DSI), and voice handicap index-10 (VHI-10), as well as subjective evaluation were assessed before and after the injection augmentation of the vocal folds was undertaken.. Five of six patients reported subjective improvement in cough. CSI scores improved in all six (average change 7.3, range 2-13). RSI and DSI scores also improved significantly after injection, whereas VHI-10 scores did not significantly change. One patient reported transient hoarseness after injection that completely resolved. One patient received injection augmentation three times, as the material resorbed and symptoms returned.. Injection augmentation effected relief from CC in a select group of patients with CC refractory to previous medical and/or behavioral treatments. This intervention is a novel option for such patients and offers an alternative approach to medical treatment.

Topics: Adult; Aged; Aged, 80 and over; Biocompatible Materials; Chronic Disease; Cough; Durapatite; Female; Humans; Injections; Male; Methylcellulose; Middle Aged; Salvage Therapy; Young Adult

Although ileal pouch-anal anastomosis is the procedure of choice for most patients with ulcerative colitis or familial adenomatous polyposis, most patients have problems with stool frequency and/or consistency. Although most clinicians recommend fiber supplementation for these patients, we could find no studies that prove the efficacy of this practice. The first purpose of this study was to document the effect of fiber supplementation on intestinal function in patients after ileal pouch-anal anastomosis. Because pectin, a soluble fiber supplement, has been reported to slow gastric and intestinal transit, we also hypothesized that pectin would be a superior fiber supplement in these patients. The second purpose, therefore, was to determine whether the effects of pectin on intestinal transit would result in decreased stool frequency in patients with an ileal pouch.. Thirteen patients who had undergone ileal pouch-anal anastomosis for ulcerative colitis were entered into a 9-wk crossover study. The protocol consisted of three 2-wk study periods, each of which was preceded by a 1-wk washout period. During the three study periods patients supplemented their diets, in random order, with Citrucel, 1 tablespoon twice daily; pectin, 1 tablespoon twice daily; or no supplement. Patients maintained detailed dietary and bowel function diaries.. The effects (mean +/- SE) of Citrucel and pectin supplementation are summarized in Table 1. There was no significant effect of either supplement on stool frequency, pouch function, bloating, or stool consistency. In addition, there were no differences in continence.. We found no evidence to support the common practice of fiber supplementation in patients with an ileal pouch. Furthermore, this study did not find that stool frequency decreased during supplementation with pectin. We conclude that there is little role for fiber supplementation in patients with an ileal pouch.

Topics: Adult; Chronic Disease; Colitis, Ulcerative; Cross-Over Studies; Defecation; Diet Records; Dietary Fiber; Female; Gastrointestinal Motility; Humans; Intestines; Male; Methylcellulose; Middle Aged; Pectins; Proctocolectomy, Restorative

A study was conducted to evaluate the effects of local drug delivery on subgingival plaque flora using hydroxypropylmethylcellulose (HPMC) and methylcellulose (MC) base material containing 40% doxycycline (DOXY). Eleven patients who had at least four pockets exceeding 5 mm in depth associated with a single rooted tooth were selected from volunteers after an initial examination. Two of the pockets were chosen at random for insertion of the HPMC and MC strips twice a week for 6 w. One pocket received no treatment, and the other was debrided and root-planed only. Baseline and follow-up measurements at 0, 1, 3, 6, and 10w included probing depth, gingival shrinkage, bleeding on probing and crevicular fluid flow. Subgingival bacterial samples were also taken for dark-field microscopy. In vitro drug release from the HPMC strips was greater than that from MC. Significant improvements in many clinical parameters occurred in the pockets treated with HPMC or MC strips, or mechanical debridement. There was a marked decrease in the relative proportions of motile organisms during and after treatment.

Topics: Adult; Analysis of Variance; Biodegradation, Environmental; Chronic Disease; Delayed-Action Preparations; Doxycycline; Female; Humans; Hypromellose Derivatives; Male; Membranes, Artificial; Methylcellulose; Middle Aged; Periodontal Index; Periodontal Pocket; Root Planing

A study was carried out to compare the effects of subgingival applications of resorbable hydroxypropylmethylcellulose (HPMC) membranes containing 20% chlorhexidine (CHx) and 40% doxycycline (DOXY) placed subgingivally in periodontal pockets greater than 5 mm in depth. Each of 11 patients had at least four pockets. HPMC strips containing CHx and DOXY were inserted into each pocket twice a week for 6 w. One pocket was kept as a control and the other received subgingival scaling and root planing at 0, 1, 3 and 6 w. The microbial flora of 44 pockets from the 11 patients was examined using dark-field microscopy at the baseline and at 1, 3, 6 and 10 w. Clinical parameters including probing depth, crevicular fluid flow, bleeding on probing and gingival shrinkage were also recorded. The CHx and DOXY-administered or root-planed pockets showed marked reduction of both pocket depth and the number of motile organisms. Less bleeding was also observed in CHx and DOXY-inserted pockets.

Topics: Adult; Analysis of Variance; Biodegradation, Environmental; Chlorhexidine; Chronic Disease; Delayed-Action Preparations; Doxycycline; Female; Humans; Hypromellose Derivatives; Male; Membranes, Artificial; Methylcellulose; Middle Aged; Periodontal Index; Periodontal Pocket

We studied a bulk laxative containing methylcellulose in a group of normal subjects as well as in a group of chronically constipated individuals. The initial study in normal subjects was performed to show that the compound could increase fecal weight without significant side effects. Fifty healthy subjects were studied. Methylcellulose in daily doses of 4 g demonstrated a statistically significant increase in fecal frequency, fecal water, and fecal solids. In the second phase, we studied a group of 59 chronically constipated individuals treated with daily doses of the laxative containing either 1, 2, or 4 g of methylcellulose or 3.4 g psyllium. All of these doses resulted in statistically significant increases in stool frequency, water content, and fecal solids. There was no increase in individual stool weight from any of the laxative doses. Methylcellulose, in a daily dose as low as 1 g, is an effective laxative.

Topics: Adolescent; Adult; Aged; Cathartics; Chronic Disease; Clinical Trials as Topic; Constipation; Defecation; Dietary Fiber; Drug Evaluation; Feces; Female; Humans; Methylcellulose; Middle Aged; Prospective Studies; Random Allocation

Topics: Chronic Disease; Clinical Trials as Topic; Drug Synergism; Drug Therapy, Combination; Glaucoma; Guanethidine; Humans; Intraocular Pressure; Methylcellulose; Ophthalmic Solutions; Pilocarpine

Diltiazem hydrochloride, topically applied at 2% concentration, is considered effective for the treatment of chronic anal fissures, although it involves several side effects among which anal pruritus and postural hypotension. To test the hypothesis that a sustained delivery system of diltiazem hydrochloride may be helpful for the treatment of chronic anal fissures, in the present study we evaluated the potential of gels containing diltiazem hydrochloride entrapped in microsponges. Such microsponges were based on Eudragit RS 100 and the effect of some formulation variables was assessed by a 2

Topics: Acrylic Resins; Administration, Rectal; Animals; Chronic Disease; Diltiazem; Drug Delivery Systems; Drug Liberation; Fissure in Ano; Gels; Methylcellulose; Mucous Membrane; Poloxamer; Swine

To determine the effect of injection augmentation of the vocal folds on chronic cough symptoms in patients with glottic insufficiency.. Medical records from 146 consecutive patients who underwent vocal fold injection augmentation by a fellowship-trained laryngologist between 2013 and 2015 were reviewed. Twenty-three patients (12 male) met inclusion criteria of a vocal fold augmentation injection, cough symptoms lasting more than 8 weeks, and glottic insufficiency as determined by shortened closed phase on stroboscopy. Exclusion criteria included lack of cough complaints, diagnosis of vocal fold immobility, previous history of vocal fold augmentation, and incomplete data sets. Data collected included age, gender, pre- and 1-month postinjection Cough Severity Index (CSI) scores, location of injection (unilateral or bilateral), and patient statement of percent change in symptoms that was recorded at 1-month postinjection visit.. Paired t test indicated a significant decrease in CSI scores from pre- (m = 18.5) to 1-month postinjection (m = 12.1) (P = 0.004). Eighteen patients (78.2%) reported a 50% or greater improvement in cough symptoms at the 1-month postinjection visit.. Injection augmentation of the vocal folds in the presence of glottic insufficiency appears to improve cough symptoms, as was reported by CSI in patients who are refractory to other medical and behavioral treatments.. 4. Laryngoscope, 128:1316-1319, 2018.

Topics: Aged; Aged, 80 and over; Chronic Disease; Cough; Female; Glottis; Humans; Hyaluronic Acid; Injections; Male; Methylcellulose; Middle Aged; Vocal Cord Paralysis; Vocal Cords

Treatment of chronic spinal cord injury (SCI) is challenging due to cell loss, cyst formation, and the glial scar. Previously, we reported on the therapeutic potential of a neural progenitor cell (NPC) and chondroitinase ABC (ChABC) combinatorial therapy for chronic SCI. However, the source of NPCs and delivery system required for ChABC remained barriers to clinical application. Here, we investigated directly reprogrammed human NPCs biased toward an oligodendrogenic fate (oNPCs) in combination with sustained delivery of ChABC using an innovative affinity release strategy in a crosslinked methylcellulose biomaterial for the treatment of chronic SCI in an immunodeficient rat model. This combinatorial therapy increased long-term survival of oNPCs around the lesion epicenter, facilitated greater oligodendrocyte differentiation, remyelination of the spared axons by engrafted oNPCs, enhanced synaptic connectivity with anterior horn cells and neurobehavioral recovery. This combinatorial therapy is a promising strategy to regenerate the chronically injured spinal cord.

Topics: Animals; Anterior Horn Cells; Axons; Cell Differentiation; Cell Lineage; Cell Survival; Chondroitin ABC Lyase; Chondroitin Sulfate Proteoglycans; Chronic Disease; Cicatrix; Cross-Linking Reagents; Female; Humans; Methylcellulose; Motor Activity; Neural Stem Cells; Neuralgia; Neuronal Plasticity; Oligodendroglia; Rats; Recovery of Function; Remyelination; Spinal Cord Injuries; Synapses

A rat carcinogenicity bioassay (CaBio) of quinacrine was reanalyzed to investigate its mode of tumor induction. Quinacrine's effects in the rat uterus when administered as a slurry in methylcellulose were contrasted with the human clinical experience which uses a solid form of the drug, to determine the relevance of the tumors produced in the rat to safe clinical use of quinacrine for permanent contraception (QS). A review was performed of the study report, dose feasibility studies, and clinical evaluations of women who had undergone the QS procedure. The top three doses of quinacrine in the CaBio exceeded the maximum tolerated dose, and produced chronic damage, including inflammation, resulting in reproductive tract tumors. Chronic inflammation was significantly correlated with the tumors; there was no evidence of treatment-related tumors in animals without chronic inflammation or other reproductive system toxicity. Because such permanent uterine damage and chronic toxicity have not been observed in humans under therapeutic conditions, we conclude that this mode of action for tumor production will not occur at clinically relevant doses in women who choose quinacrine for permanent contraception.

Topics: Animals; Cell Transformation, Neoplastic; Chemistry, Pharmaceutical; Chronic Disease; Contraceptive Agents, Female; Dose-Response Relationship, Drug; Drug Carriers; Endometriosis; Female; Humans; Male; Maximum Tolerated Dose; Methylcellulose; Mice; Quinacrine; Rats, Sprague-Dawley; Risk Assessment; Species Specificity; Uterine Neoplasms; Uterus

Superior limbic keratoconjunctivitis (SLK) is an uncommon, painful inflammation of the ocular surface localized to the superior sectors of the cornea, limbus, and conjunctiva. The clinical course tends to be chronic, with alternating periods of remission and exacerbation. Many patients experience severe ocular discomfort for long periods. Corneal involvement may induce scarring, astigmatism, and ultimately decreased vision. SLK typically occurs in woman between 20 and 60 years of age. Little is known about the features of SLK in young children because the earliest age described in the literature is adolescence. We report the clinical presentation and management of SLK in a 7-year-old boy who responded well to topical steroids and lubricants.

Topics: Child; Chronic Disease; Conjunctiva; Drug Therapy, Combination; Fluorometholone; Glucocorticoids; Humans; Hyperemia; Hypromellose Derivatives; Keratoconjunctivitis; Limbus Corneae; Male; Methylcellulose; Ophthalmic Solutions; Vasculitis

Chronic suppurative otitis media in young children is a major problem in Africa, with socio-economic consequences at a later age. Common treatment regimens with antibiotics are expensive and often not practically feasible. Therefore, a project was started to develop a low-cost and effective treatment in a rural area of Malawi by studying the clinical efficacy of an inexpensive application regimen of ofloxacin (0.075%) in hydroxypropyl methylcellulose (1.5%) ear drops. In earlier studies with this treatment regimen, it was possible to cure approximately 70% of ears. The aim of this study was to find out whether the bacteriological spectrum cultured from wet ears before and after treatment, and patterns of resistance to antibiotics, played a role in the percentage of cures. Patients with long-standing chronic suppurative otitis media were clinically assessed and treated with suction cleaning and instillation of ear drops on days 1, 3, 7 and 10. Bacterial swabs were taken for culture and sensitivity tests for ofloxacin were on days 1 and 10 from the ears that were still discharging. After 21 weeks, the ears were assessed again clinically. Clinical cure was considered to be complete cessation of otorrhea. Ninety of 104 tested patients (124 ears) completed the study. About 73% of the ears had become dry by day 10. This dropped to 42% after 21 weeks. Before treatment, most ears (91%) harbored fecal bacteria, Proteus mirabilis (74%) and enterococci (60%) being the most frequently isolated microbes. The second group of frequently cultured bacteria were water bacteria e.g. Pseudomonas species and other non-fermenters (69%), whereas the classical otitis media pathogens were detected only in 15% of ears. Before treatment, 9.7% of strains were resistant to ofloxacin, most (30/35) of which were cultured from ears that were eventually cured. After treatment, fecal and water bacteria were still the most frequently found, with 36% new strains and an overall sensitivity to ofloxacin of 58%. Bacterial resistance did not appear to play an important role in the outcome of treatment. These data rather suggest a very high risk of infection due to poor hygiene conditions. Medical treatment can only have a longer-lasting effect if accompanied by community-based programs that focus on improvement of hygiene. A public health approach is necessary alongside a medical approach for the management of CSOM.

Topics: Adolescent; Adult; Anti-Infective Agents; Bacteriological Techniques; Child; Child, Preschool; Chronic Disease; Drug Compounding; Drug Resistance, Bacterial; Enterococcus; Female; Humans; Hygiene; Hypromellose Derivatives; Infant; Infant, Newborn; Malawi; Male; Methylcellulose; Ofloxacin; Otitis Media, Suppurative; Proteus mirabilis; Pseudomonas; Rural Health; Treatment Outcome

The purpose of this study was to investigate the level of IL-8 in exudates clinically obtained from normal and inflamed human dental pulp tissues so as to reveal the possible relationship between IL-8 and pulpitis.. Samples of 2 microliters of pulpal exudate from each normal or clinically diagnosed as acute or chronic pulpitis teeth was obtained by filter paper strips and IL-8 level was measured by ELISA method.. No IL-8 was detected in the samples from normal pulp, but significant amount of IL-8 appeared in inflamed pulp tissues, and the level of IL-8 in exudates of acute stage of pulpitis was higher than that of chronic stage (P < 0.01).. This study demonstrates that IL-8 is produced and accumulated in pulp inflammation and may play a role in the occurrence and development of human pulpitis.

Topics: Acute Disease; Chronic Disease; Dental Pulp; Enzyme-Linked Immunosorbent Assay; Exudates and Transudates; Humans; Inflammation Mediators; Interleukin-8; Methylcellulose; Pulpitis

There are many unanswered questions about chronic glaucoma which cannot be investigated in the available animal models. The present experiments were designed to develop a rabbit model of chronic intraocular hypertension with characteristics similar to human chronic glaucoma by ligating vortex veins or by making single or multiple intraocular injections of 0.5% or 1% alpha-chymotrypsin, 20% chondroitin sulphate, 2% hydroxypropyl methylcellulose, 2% sodium carboxymethylcellulose or 1% or 2% methylcellulose. Evaluation was based on the clinical findings, intraocular pressure and the retrograde axoplasmic transport function of the optic nerve using a horseradish peroxidase histochemical technique. Most methods either failed to produce moderate chronic intraocular hypertension or were associated with other complications. However, a reliable and relatively long period (eight weeks) of intraocular hypertension was developed by a series of four intra-anterior chamber injections of 1% or 2% methylcellulose. This model has been proved suitable for the study of structural and functional damage to the retina and optic nerve caused by chronic glaucoma.

Topics: Animals; Anterior Chamber; Cell Count; Chronic Disease; Disease Models, Animal; Female; Intraocular Pressure; Male; Methylcellulose; Ocular Hypertension; Rabbits

Methyl cellulose instillation enhanced the values of BUT in healthy individuals, as well as in patients with trachoma stage III and chronic conjunctivitis, while no effect was observed in patients with squamous blepharitis.

Topics: Blepharitis; Chronic Disease; Conjunctivitis; Eyelid Diseases; Humans; Methylcellulose; Tears; Time Factors; Trachoma

Topics: Animals; Arteritis; Chronic Disease; Methylcellulose; Pulmonary Artery; Pulmonary Circulation; Rabbits

Topics: Animals; Budd-Chiari Syndrome; Chronic Disease; Hypertension, Portal; Injections, Intravenous; Liver; Mesenteric Veins; Methylcellulose; Models, Biological; Rabbits; Silicon Dioxide