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https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#1
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917625/reduced-neuroprotective-potential-of-the-mesenchymal-stromal-cell-secretome-with-ex-vivo-expansion-age-and-progressive-multiple-sclerosis
#2
Pamela Sarkar, Juliana Redondo, Kevin Kemp, Mark Ginty, Alastair Wilkins, Neil J Scolding, Claire M Rice
BACKGROUND: Clinical trials using ex vivo expansion of autologous mesenchymal stromal cells (MSCs) are in progress for several neurological diseases including multiple sclerosis (MS). Given that environment alters MSC function, we examined whether in vitro expansion, increasing donor age and progressive MS affect the neuroprotective properties of the MSC secretome. METHODS: Comparative analyses of neuronal survival in the presence of MSC-conditioned medium (MSCcm) isolated from control subjects (C-MSCcm) and those with MS (MS-MSCcm) were performed following (1) trophic factor withdrawal and (2) nitric oxide-induced neurotoxicity...
September 13, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28917332/-benzodiazepine-withdrawal-syndrome-in-the-elderly-patient
#3
Aurélien Martin-Kleisch, Abrar-Ahmad Zulfiqar
Withdrawal syndrome is a well known diagnostic entity. As the symptomatology related to this syndrome is extremely unspecific, care must be taken not to ignore withdrawal syndrome, the consequences of which, while rare, can lead to often long and complicated hospitalisations.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28917206/maternal-and-infant-outcomes-following-third-trimester-exposure-to-marijuana-in-opioid-dependent-pregnant-women-maintained-on-buprenorphine
#4
Alane B O'Connor, Brandon K Kelly, Liam M O'Brien
BACKGROUND: To determine whether maternal and infant outcomes are associated with exposure to marijuana during the third trimester in a population of opioid dependent pregnant women maintained on buprenorphine. METHODS: This retrospective cohort study of 191 maternal-infant dyads exposed to buprenorphine during pregnancy examines a variety of variables including gestational age, birthweight, method of delivery, Apgar scores at one and five minutes, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS in infants exposed to marijuana during the third trimester as compared to infants not exposed to marijuana during the third trimester...
September 7, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28916830/the-effects-of-different-enrofloxacin-dosages-on-clinical-efficacy-and-resistance-development-in-chickens-experimentally-infected-with-salmonella-typhimurium
#5
Jun Li, Haihong Hao, Guyue Cheng, Xu Wang, Saeed Ahmed, Muhammad Abu Bakr Shabbir, Zhenli Liu, Menghong Dai, Zonghui Yuan
To investigate the optimal dosage which can improve clinical efficacy and minimize resistance, pharmacokinetics/pharmacodynamics model of enrofloxacin was established. Effect of enrofloxacin treatments on clearance of Salmonella in experimentally infected chickens and simultaneously resistance selection in Salmonella and coliforms were evaluated in three treatment groups (100, PK/PD designed dosage of 4, 0.1 mg/kg b.w.) and a control group. Treatment duration was three rounds of 7-day treatment alternated with 7-day withdrawal...
September 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28916664/safety-of-simultaneous-coronary-artery-bypass-grafting-and-carotid-endarterectomy-versus-isolated-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#6
Christian Weimar, Konstantinos Bilbilis, Jan Rekowski, Torulv Holst, Friedhelm Beyersdorf, Martin Breuer, Manfred Dahm, Anno Diegeler, Arne Kowalski, Sven Martens, Friedrich W Mohr, Jiri Ondrášek, Beate Reiter, Peter Roth, Ralf Seipelt, Markus Siggelkow, Gustav Steinhoff, Anton Moritz, Mathias Wilhelmi, Gerhard Wimmer-Greinecker, Hans-Christoph Diener, Heinz Jakob, Claudia Ose, Andre Scherag, Stephan C Knipp
BACKGROUND AND PURPOSE: The optimal operative strategy in patients with severe carotid artery disease undergoing coronary artery bypass grafting (CABG) is unknown. We sought to investigate the safety and efficacy of synchronous combined carotid endarterectomy and CABG as compared with isolated CABG. METHODS: Patients with asymptomatic high-grade carotid artery stenosis ≥80% according to ECST (European Carotid Surgery Trial) ultrasound criteria (corresponding to ≥70% NASCET [North American Symptomatic Carotid Endarterectomy Trial]) who required CABG surgery were randomly assigned to synchronous carotid endarterectomy+CABG or isolated CABG...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28915478/studying-the-interactive-effects-of-menthol-and-nicotine-among-youth-an-examination-using-e-cigarettes
#7
Suchitra Krishnan-Sarin, Barry G Green, Grace Kong, Dana A Cavallo, Peter Jatlow, Ralitza Gueorguieva, Eugenia Buta, Stephanie S O'Malley
BACKGROUND: Tobacco products containing menthol are widely used by youth. We used e-cigarettes to conduct an experimental evaluation of the independent and interactive effects of menthol and nicotine among youth. PROCEDURES: Pilot chemosensory experiments with fourteen e-cigarette users identified low (barely perceptible, 0.5%) and high (similar to commercial e-liquid, 3.5%) menthol concentrations. Sixty e-cigarette users were randomized to a nicotine concentration (0mg/ml, 6mg/ml, 12mg/ml) and participated in 3 laboratory sessions...
August 31, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28915458/physical-water-scarcity-metrics-for-monitoring-progress-towards-sdg-target-6-4-an-evaluation-of-indicator-6-4-2-level-of-water-stress
#8
REVIEW
D Vanham, A Y Hoekstra, Y Wada, F Bouraoui, A de Roo, M M Mekonnen, W J van de Bund, O Batelaan, P Pavelic, W G M Bastiaanssen, M Kummu, J Rockström, J Liu, B Bisselink, P Ronco, A Pistocchi, G Bidoglio
Target 6.4 of the recently adopted Sustainable Development Goals (SDGs) deals with the reduction of water scarcity. To monitor progress towards this target, two indicators are used: Indicator 6.4.1 measuring water use efficiency and 6.4.2 measuring the level of water stress (WS). This paper aims to identify whether the currently proposed indicator 6.4.2 considers the different elements that need to be accounted for in a WS indicator. WS indicators compare water use with water availability. We identify seven essential elements: 1) both gross and net water abstraction (or withdrawal) provide important information to understand WS; 2) WS indicators need to incorporate environmental flow requirements (EFR); 3) temporal and 4) spatial disaggregation is required in a WS assessment; 5) both renewable surface water and groundwater resources, including their interaction, need to be accounted for as renewable water availability; 6) alternative available water resources need to be accounted for as well, like fossil groundwater and desalinated water; 7) WS indicators need to account for water storage in reservoirs, water recycling and managed aquifer recharge...
September 12, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28915275/long-term-efficacy-and-safety-of-rituximab-in-igg4-related-disease-data-from-a-french-nationwide-study-of-thirty-three-patients
#9
Mikael Ebbo, Aurélie Grados, Maxime Samson, Matthieu Groh, Anderson Loundou, Aude Rigolet, Benjamin Terrier, Constance Guillaud, Clarisse Carra-Dallière, Frédéric Renou, Agnieszka Pozdzik, Pierre Labauge, Sylvain Palat, Jean-Marie Berthelot, Jean-Loup Pennaforte, Alain Wynckel, Céline Lebas, Noémie Le Gouellec, Thomas Quémeneur, Karine Dahan, Franck Carbonnel, Gaëlle Leroux, Antoinette Perlat, Alexis Mathian, Patrice Cacoub, Eric Hachulla, Nathalie Costedoat-Chalumeau, Jean-Robert Harlé, Nicolas Schleinitz
OBJECTIVES: To assess efficacy and safety of rituximab (RTX) as induction therapy, maintenance of remission and treatment of relapses in a cohort of IgG4-related disease (IgG4-RD) patients. METHODS: Nationwide retrospective multicenter study of IgG4-RD patients treated with at least one course of RTX. Clinical, biological and radiological response, relapse rate and drug tolerance were analyzed. Kaplan-Meier curves were plotted and risk factors for relapse studied with a Cox regression model...
2017: PloS One
https://www.readbyqxmd.com/read/28915221/metformin-exerts-beneficial-effects-in-hemorrhagic-shock-in-an-ampk%C3%AE-1-independent-manner
#10
Paul Kim, Giovanna Piraino, Michael O'Connor, Paul W Hake, Vivian Wolfe, Patrick Lahni, Basilia Zingarelli
Despite therapeutic advances in hemorrhagic shock, mortality from multiple organ failure remains high. AMP-activated protein kinase (AMPK) is involved in cellular energy homeostasis. Two catalytic subunits, α1 and α2, have been identified, with α1 subunit largely expressed in major organs. Here, we hypothesized that genetic deficiency of AMPKα1 worsens hemorrhage-induced multiple organ failure. We also investigated whether treatment with metformin, a clinically used drug for metabolic homeostasis, affords beneficial effects...
September 14, 2017: Shock
https://www.readbyqxmd.com/read/28915146/engendered-responses-to-and-interventions-for-shame-in-dissociative-disorders-a-survey-and-experimental-investigation
#11
Martin J Dorahy, Julia Gorgas, Lenaire Seager, Warwick Middleton
This study examined shame and responses to it in adult dissociative disorder (DD; n = 24) and comparison psychiatric (n = 14) samples. To investigate how helpful different therapeutic responses are after shame disclosures in therapy, participants heard two vignettes from "mock" patients disclosing a) shame and b) surprise. Participants rated the helpfulness of five potential responses. Interventions covered withdrawing from the affect (withdrawal focused) to feeling it (feeling focused), with other interventions on cognitions (cognitive focused), management strategies (management focused), and previous experiences (history focused)...
September 14, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28915050/one-pot-synthesis-of-1-2-disubstituted-4-5-6-and-7-azaindoles-from-amino-o-halopyridines-via-n-arylation-sonogashira-cyclization-reaction
#12
Sara I Purificação, Marina J D Pires, Rafael Rippel, A Sofia Santos, M Manuel B Marques
A direct synthesis of several 1,2-disubstituted 4-, 5-, 6-, and 7-azaindoles from available amino-o-halopyridines is described. This procedure involves a palladium-catalyzed N-arylation followed by a Sonogashira reaction and subsequent cyclization in a one-pot manner, exhibiting a wide scope and compatibility with electron-withdrawing and electron-donating groups. The strategy represents an advancement in azaindole chemistry with a straightforward approach toward 1,2-disubstituted azaindoles, while avoiding complex N-arylations of hindered 2-substituted azaindoles and difficult purification steps of intermediates...
September 15, 2017: Organic Letters
https://www.readbyqxmd.com/read/28914784/antiallodynic-effects-of-bee-venom-in-an-animal-model-of-complex-regional-pain-syndrome-type-1-crps-i
#13
Sung Hyun Lee, Jae Min Lee, Yun Hong Kim, Jung Hyun Choi, Seung Hwan Jeon, Dong Kyu Kim, Hyeon Do Jeong, You Jung Lee, Hue Jung Park
Neuropathic pain in a chronic post-ischaemic pain (CPIP) model mimics the symptoms of complex regional pain syndrome type I (CRPS I). The administration of bee venom (BV) has been utilized in Eastern medicine to treat chronic inflammatory diseases accompanying pain. However, the analgesic effect of BV in a CPIP model remains unknown. The application of a tight-fitting O-ring around the left ankle for a period of 3 h generated CPIP in C57/Bl6 male adult mice. BV (1 mg/kg ; 1, 2, and 3 times) was administered into the SC layer of the hind paw, and the antiallodynic effects were investigated using the von Frey test and by measuring the expression of neurokinin type 1 (NK-1) receptors in dorsal root ganglia (DRG)...
September 15, 2017: Toxins
https://www.readbyqxmd.com/read/28914627/antinociceptive-effects-of-jwh015-in-female-and-male-rats
#14
Rebecca M Craft, Nicholas Z Greene, Alexa A Wakley
Despite greater chronic pain prevalence in females compared with males, and the analgesic potential of cannabinoid receptor type 2 (CB2) agonists, CB2 agonists have rarely been tested in females. The aim of the present study was to compare the antinociceptive effects of a CB2-preferring agonist, (2-methyl-1-propyl-1H-indol-3-yl)-1-naphthalenylmethanone (JWH015), in female and male rats against acute pain and persistent inflammatory pain. JWH015 (5-20 mg/kg, intraperitoneally) produced dose-dependent and time-dependent increases in latency to respond on the tail withdrawal and paw pressure tests that did not differ statistically between the sexes...
September 13, 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/28914429/a-systematic-review-of-patient-and-caregiver-experiences-with-a-tracheostomy
#15
REVIEW
Ivana Nakarada-Kordic, Niamh Patterson, Jill Wrapson, Stephen D Reay
BACKGROUND: A tracheostomy is a surgically created opening through the anterior neck tissues and the trachea, into which a tube is inserted. Despite its influence on basic human needs such as respiration, communication and nutrition, little is known about the impact of tracheostomy on patients and their caregivers or what could be done to enable better care and quality of life (QoL) for these individuals. OBJECTIVE: The aim of this review was to better understand the current knowledge related to the experience and QoL of adults living with a tracheostomy and their caregivers so as to be able to improve these experiences...
September 15, 2017: Patient
https://www.readbyqxmd.com/read/28914323/the-spectroscopic-impact-of-interactions-with-the-four-gouterman-orbitals-from-peripheral-decoration-of-porphyrins-with-simple-electron-withdrawing-and-donating-groups
#16
Angel Zhang, Lydia Kwan, Martin J Stillman
Tetrapyrroles are of great interest for solar cell and photodynamic therapy applications due to their structural analogy with chlorophyll, a natural photosensitizer. Unsubstituted symmetric porphyrins exhibit weak absorption in the red region which makes them unsuitable for these applications. The push-pull peripheral decoration modifies the energies of the frontier molecular orbitals, which in turn influences the tetrapyrrole's spectroscopic properties. The absorption, magnetic circular dichroism, and emission spectra were measured for four zinc tetratolylporphyrin compounds substituted peripherally with a fused dimethoxybenzo group as an electron withdrawing group (EWG) on one pyrrole and on the opposite pyrrole, a single acetamido (1), a nitro (2), a proton (3), or a benzoylamino (4) substituent...
September 15, 2017: Organic & Biomolecular Chemistry
https://www.readbyqxmd.com/read/28914190/perioperative-considerations-of-herbal-medications
#17
Ryan M Chadha, Brian J Egan
BACKGROUND: A considerable portion of the US population uses herbal supplements on a daily basis for their various proposed beneficial effects. However, the over-the-counter nature of these medications and lack of knowledge of adverse effect profiles can have unexpected serious impact on the perioperative course. The growing list of supplements presents a pharmacologic conundrum to the anesthesiologist. OBJECTIVE: To compile a comprehensive list of vitamins, herbals, and supplements used commonly by patients, describe the risks associated with them, and identify recommendations for perioperative management...
September 13, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28913956/regioselective-intermolecular-allylic-c-h-amination-of-disubstituted-olefins-via-rh-%C3%AF-allyl-intermediates
#18
Jacob S Burman, Simon B Blakey
A method for catalytic intermolecular allylic C-H amination of trans-disubstituted olefins is reported. The reaction is efficient for a range of common nitrogen nucleophiles bearing electron withdrawing group and proceeds under mild conditions. Good levels of regioselectivity are observed for a wide range of electronically diverse trans-ß-alkyl styrene substrates.
September 14, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28913843/food-and-functional-dyspepsia-a-systematic-review
#19
REVIEW
K R Duncanson, N J Talley, M M Walker, T L Burrows
BACKGROUND: Functional dyspepsia (FD) is a debilitating functional gastrointestinal disorder characterised by early satiety, post-prandial fullness or epigastric pain related to meals, which affects up to 20% of western populations. A high dietary fat intake has been linked to FD and duodenal eosinophilia has been noted in FD. We hypothesised that an allergen such as wheat is a risk factor for FD and that withdrawal will improve symptoms of FD. We aimed to investigate the relationship between food and functional dyspepsia...
September 15, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28912414/polish-experience-with-liver-transplantation-and-post-transplant-outcomes-in-children-with-urea-cycle-disorders
#20
Edyta Szymańska, Piotr Kaliciński, Joanna Pawłowska, Sylwia Szymańska, Maciej Pronicki, Marek Stefanowicz, Joanna Teisseyre, Dorota Broniszczak, Dariusz Rokicki
BACKGROUND Liver transplantation (LT) is recommended for various metabolic diseases, including urea cycle disorders (UCDs). The aim of this study was to determine indications and outcomes of LT for UCDs in the tertiary reference Children's Hospital in Warsaw, Poland. MATERIAL AND METHODS Medical charts of children with UCD who underwent LT between 2008 and July 2016 were retrospectively reviewed. The following parameters were analyzed: symptoms at time of diagnosis, age at diagnosis, age at transplantation, graft characteristics and survival, postsurgical complications, and biochemical and laboratory results before and after transplantation...
September 15, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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