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https://www.readbyqxmd.com/read/29330240/structured-management-of-chronic-nonmalignant-pain-with-opioids-in-a-rural-primary-care-office
#1
Kevin S McCann, Shawndra Barker, Raymond Cousins, Adam Franks, Clinton McDaniel, Stephen Petrany, Eric Riley
INTRODUCTION: The use of opioid medication for nonmalignant chronic pain (NMCP) increased dramatically during the last 20 years. There have been regulatory changes implemented to reduce the risk of harm to both patients and society. Much of the burden of monitoring these patients is falling on primary care physicians (PCPs), who do not have the time or resources to handle what is entailed in a best-practice approach to NMCP. METHODS: A retrospective study was conducted with all patients on opioid medication for NMCP who were enrolled onto an individual PCP's practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329796/the-evolving-face-of-myocardial-reperfusion-in-acute-coronary-syndromes-a-primer-for-the-internist
#2
REVIEW
R Jay Widmer, Peter M Pollak, Malcolm R Bell, Bernard J Gersh, Nandan S Anavekar
Acute coronary syndromes (ACSs) account for a large proportion of disease burden in the United States and worldwide, and our understanding of ACS management continues to evolve. In this review we take a practical approach to evaluating and treating a patient with ACS, focusing on the optimal timing and methods of coronary reperfusion. Beginning with initial assessment and risk stratification, a provider managing the patient with ACS must be able to expeditiously decide on and implement the correct guideline-directed pathway to optimize outcomes...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29325489/creating-effective-biocontainment-facilities-and-maintenance-protocols-for-raising-specific-pathogen-free-severe-combined-immunodeficient-scid-pigs
#3
Ellis J Powell, Sara Charley, Adeline N Boettcher, Lisa Varley, Justin Brown, Martine Schroyen, Malavika K Adur, Susan Dekkers, Dean Isaacson, Mary Sauer, Joan Cunnick, N Matthew Ellinwood, Jason W Ross, Jack Cm Dekkers, Christopher K Tuggle
Severe combined immunodeficiency (SCID) is defined by the lack of an adaptive immune system. Mutations causing SCID are found naturally in humans, mice, horses, dogs, and recently in pigs, with the serendipitous discovery of the Iowa State University SCID pigs. As research models, SCID animals are naturally tolerant of xenotransplantation and offer valuable insight into research areas such as regenerative medicine, cancer therapy, as well as immune cell signaling mechanisms. Large-animal biomedical models, particularly pigs, are increasingly essential to advance the efficacy and safety of novel regenerative therapies on human disease...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29324604/preterm-birth-and-gestational-length-in-four-race-nativity-groups-including-somali-americans
#4
Emily A Oliver, Mark Klebanoff, Lina Yossef-Salameh, Reena Oza-Frank, Soheil Moosavinasab, Patricia Reagan, Louis Muglia, Catalin S Buhimschi, Irina A Buhimschi
OBJECTIVE: To compare preterm birth rates and gestational length in four race-nativity groups including Somali Americans. METHODS: Using a retrospective cohort study design of Ohio birth certificates, we analyzed all singleton births between 2000 and 2015 from four groups of women categorized as U.S.-born, non-Hispanic white (USBW), U.S.-born, non-Hispanic black (USBB), African-born black (ABB, primarily of West African birth country), and Somalia-born (SB). An algorithm trained on maternal names was used to confirm Somali ethnicity...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324318/a-feasibility-study-of-a-multidimensional-breastfeeding-support-intervention-in-ireland
#5
Goiuri Alberdi, Elizabeth J O'Sullivan, Helena Scully, Niamh Kelly, Regina Kincaid, Rosie Murtagh, Stephanie Murray, Denise McGuinness, Ashamole Clive, Mary Brosnan, Lucille Sheehy, Elizabeth Dunn, Fionnuala M McAuliffe
BACKGROUND: Breastfeeding is the optimum mode of infant feeding. Despite this, most global populations do not achieve the World Health Organisation's recommendation of exclusive breast milk for the first 6 months of life. Irish breastfeeding rates are among the lowest in Europe, necessitating a well-designed breastfeeding-support intervention. AIM: To evaluate the feasibility and acceptability of a multidimensional breastfeeding intervention in a rural and an urban maternity setting in Ireland...
December 24, 2017: Midwifery
https://www.readbyqxmd.com/read/29314251/clinical-and-hematological-data-to-group-different-chronic-kidney-disease-patients-a-practical-approach-to-establish-different-groups-of-patients
#6
Vinícius B Péterle, Jéssica de O Souza, Fernanda de O Busato, Frederico J Eutrópio, Gisele de A P da Costa, David N Olivieri, Carlos E Tadokoro
BACKGROUND: Chronic kidney disease (CKD) is the convergent point of several pathological processes, and its evolution is insidious and characterized by a progressive and irreversible loss of kidney function. This impaired function induces the accumulation of uremic toxins and individuals with terminal CKD often have altered physiological responses, including a persistent state of immuno-suppression and development of diseases. A better characterization and stratification of these patients with CKD in different immuno-compromised groups would contribute to more effective and personalized treatments...
January 4, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29305107/five-threads-how-u-shaped-thinking-weaves-together-dogs-men-selenium-and-prostate-cancer-risk
#7
REVIEW
David J Waters, Emily C Chiang
Prostate cancer is one of the leading causes of cancer-related mortality among men living in developed countries, making the development of safe, practical approaches to prostate cancer risk reduction a high research priority. The relationship between prostate cancer risk and selenium, an essential nutrient required for a number of metabolically important enzymes including glutathione peroxidases, has been investigated, but a satisfactory integration of results has proven elusive. Dogs, like men, naturally develop prostate cancer during aging, providing an appropriate context to study the effects of selenium supplementation on the dysregulation of homeostasis that drives cancer development within the aging prostate...
January 2, 2018: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29296267/optimization-of-effective-minerals-on-riboflavin-production-by-bacillus-subtilis-subsp-subtilis-atcc-6051-using-statistical-designs
#8
Marjan Oraei, Seyed Hadi Razavi, Faramarz Khodaiyan
Background: Riboflavin (vitamin B2) is an essential component of the basic metabolism, and an important nutritional and growth factor in humans, animals, plants and micro-organisms. It has been widely used in the fields of pharmaceuticals, feed and food additives. The industrial production of riboflavin mostly relies on the microbial fermentation. Designing an appropriate fermentation medium is of crucial importance to improve the riboflavin production. Methods: In this study, sequential methodology combining a screening test of minerals by Plackett-Burman (PB) and an optimization test by Central Composite Design (CCD) was applied to enhance riboflavin production by Bacillus subtilis ATCC 6051 in shake flasks...
January 2018: Avicenna Journal of Medical Biotechnology
https://www.readbyqxmd.com/read/29289400/shared-decision-making-as-the-future-of-emergency-cardiology
#9
REVIEW
Marc A Probst, Peter A Noseworthy, Juan P Brito, Erik P Hess
Shared decision-making is playing an increasingly large role in emergency cardiovascular care. Although there are many challenges to successfully performing shared decision-making in the emergency department, there are numerous clinical scenarios in which it should be used. In this article, we explore new research and emerging decision aids in the following emergency care scenarios: (1) low-risk chest pain; (2) new-onset atrial fibrillation; and (3) moderate-risk syncope. These decision aids are designed to engage patients and facilitate shared decision-making for specific treatment and disposition (admit vs discharge) decisions...
September 22, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29287474/practical-considerations-challenges-and-limitations-of-bioconjugation-via-azide-alkyne-cycloaddition
#10
Chad J Pickens, Stephanie N Johnson, Melissa M Pressnall, Martin Leon, Cory Berkland
Interrogating biological systems is often limited by access to biological probes. The emergence of "click chemistry" has revolutionized bioconjugate chemistry by providing facile reaction conditions amenable to both biologic molecules and small molecule probes such as fluorophores, toxins, or therapeutics. One particularly popular version is the copper-catalyzed azide-alkyne cycloaddition (AAC) reaction, which has spawned new alternatives such as the strain-promoted azide-alkyne cycloaddition reaction, among others...
December 29, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/29250440/estimation-of-the-corneal-young-s-modulus-in-vivo-based-on-a-fluid-filled-spherical-shell-model-with-scheimpflug-imaging
#11
Po-Jen Shih, Chun-Ju Huang, Tzu-Han Huang, Hung-Chou Lin, Jia-Yush Yen, I-Jong Wang, Hui-Jyun Cao, Wen-Pin Shih, Chi-An Dai
Current intraocular pressure (IOP) measurement using air puff could be erroneous without applying proper corrections. Although noncontact tonometry is not considered to be accurate, it is still popularly used by eye clinics. It is thus necessary to extract the correct information from their results. This study proposes a practical approach to correctly measure IOP in vivo. By embedding a new model-based correction to the Corvis® ST, we can extract the corneal Young's modulus from the patient data. This Young's modulus can be used to correct the IOP readings...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/29249865/heparin-induced-thrombocytopenia-and-thrombosis-preventing-your-thrombolysis-practice-from-taking-a-hitt
#12
REVIEW
Eric Wannamaker, Kimi Kondo, D Thor Johnson
Heparin-induced thrombocytopenia and thrombosis (HITT) is an under-recognized cause of deep venous thrombosis treatment failure and of complications during catheter-directed thrombolysis. After a review of HITT pathophysiology, diagnosis, and management, three different cases are presented in this article. Each case highlights subtleties and challenges of HITT diagnosis and management. An example of a practical approach to the diagnosis of HITT is presented.
December 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29243352/a-review-on-gradient-hydrogel-fiber-scaffolds-for-osteochondral-regeneration
#13
REVIEW
Sajedeh Khorshidi, Akbar Karkhaneh
Osteochondral tissue regeneration is a complicated field due to the distinct properties and healing potential of osseous and chondral phases. In a natural osteochondral region, the composition, mechanics and structure vary smoothly from bony to cartilaginous phase. Therefore, a homogeneous scaffold cannot satisfy the complexity of the osteochondral matrix. In essence, a natural extracellular matrix (ECM) is composed of fibrous proteins elongated into a gelatinous background. A hydrogel/fiber scaffold possessing gradient in both phases would be of the utmost interest to imitate tissue arrangement of a native osteochondral interface...
December 15, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/29241062/a-paper-supported-aptasensor-based-on-upconversion-luminescence-resonance-energy-transfer-for-the-accessible-determination-of-exosomes
#14
Xiaosong Chen, Jianming Lan, Yingxin Liu, Li Li, Liu Yan, Yaokun Xia, Fang Wu, Chunyan Li, Shirong Li, Jinghua Chen
Exosomes, as potential cancer diagnostic markers have received close attention in recent years. However, there is still a lack of simple and convenient methods to detect and quantitate exosomes. Herein, we used a simple paper-supported aptasensor based on luminescence resonance energy transfer (LRET) from upconversion nanoparticles (UCNPs) to gold nanorods (Au NRs) for the accessible determination of exosomes. When exosomes are present, the two sections of the aptamer can combine with the CD63 protein on the surface of exosomes and form a conjugation to close the distance between UCNPs and Au NRs, which initiates the LRET and promotes luminescence quenching...
December 8, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29239525/isolation-of-sinapic-acid-from-broccoli-using-molecularly-imprinted-polymers
#15
Heba Hosny, Nesrine El Gohary, Engy Saad, Heba Handoussa, Rasha M El Nashar
A molecularly imprinted polymer was synthesized for the purpose of sinapic acid isolation from Egyptian nutraceutical Botrytis italica, L. (broccoli) due to its prominent medicinal and wide pharmacological activities. A computational study was first developed to determine the optimal template to functional monomer molar ratio. Based on the computational results, five polymers were synthesized using a bulk polymerization method with sinapic acid as the template molecule. Evaluation of the synthesized polymers binding performance was carried out using batch rebinding assay, which revealed that the molecularly imprinted polymer of molar ratio (1:4:20), template to functional monomer (4-vinyl pyridine) to crosslinker (ethylene glycol dimethacrylate) was of optimum performance, thus, this polymer was applied for sinapic acid isolation from closely related analogues...
December 14, 2017: Journal of Separation Science
https://www.readbyqxmd.com/read/29230136/managing-the-adult-patient-with-short-bowel-syndrome
#16
Carol Rees Parrish, John K DiBaise
Short bowel syndrome (SBS) is a malabsorptive disorder associated with significant morbidity and mortality, reduced quality of life, and high health care costs. Managing the patient with SBS requires an understanding of gastrointestinal anatomy and physiology; a dedicated multidisciplinary team; and the coordination of dietary, fluid, pharmacologic, and comorbid disease management. This article provides an overview of the current state of management of SBS, including a practical approach to optimizing the care and quality of life of the adult patient with SBS...
October 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29229544/a-new-textured-polyphosphazene-biomaterial-with-improved-blood-coagulation-and-microbial-infection-responses
#17
Li-Chong Xu, Zhongjing Li, Zhicheng Tian, Chen Chen, Harry R Allcock, Christopher A Siedlecki
A new poly[bis(octafluoropentoxy) phosphazene] (OFP) was synthesized for the purpose of blood contacting medical devices. OFP was further either developed into crosslinkable polyphosphazene (X-OFP) or blended with polyurethane (PU) as the mixture (OFP/PU) for improvement of mechanical property of polyphosphazene polymers. All the materials were fabricated as smooth films or further textured with submicron pillars for the assay of antimicrobial and antithrombotic properties. Results showed that crosslinkable OFP (X-OFP) and blends of OFP/PU successfully improved the mechanical strength of OFP and fewer defects of pillars were found on the textured polyphosphazene surfaces...
December 8, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/29227134/evaluating-the-effect-of-the-practical-approach-to-care-kit-on-teaching-medical-students-primary-care-quasi-experimental-study
#18
Robert Mash, Michael Pather, Hilary Rhode, Lara Fairall
BACKGROUND: South Africa is committed to health reforms that strengthen primary health care. Preparing future doctors to work in primary care teams with other professionals is a priority, and medical schools have shifted towards community-based and decentralised training of medical students. AIM: To evaluate the effect on student performance of the Practical Approach to Care Kit (PACK) (an integrated decision-making tool for adult primary care) during the final phase of medical student training at Stellenbosch University...
December 8, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29221627/alkaline-diet-and-metabolic-acidosis-practical-approaches-to-the-nutritional-management-of-chronic-kidney-disease
#19
Larissa Rodrigues Neto Angéloco, Gabriela Cristina Arces de Souza, Elen Almeida Romão, Paula Garcia Chiarello
The kidneys play an extremely important role in maintaining the body acid-base balance by excreting nonvolatile acids and regenerating and reabsorbing bicarbonate in the kidney tubules. As the individual loses their kidney function, renal excretion of nonvolatile acid produced by metabolism of the diet is impaired, resulting in low-grade metabolic acidosis. With this in mind, it is relevant to better understand the dietary aspects related to the acid-base balance in chronic kidney disease metabolic acidosis and try to provide possible strategies for the nutritional management of these cases...
December 5, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29220200/a-practical-approach-to-severe-asthma-in-children
#20
Emily E Barsky, Lauren M Giancola, Sachin N Baxi, Jonathan M Gaffin
Severe asthma accounts for only a small proportion of the children with asthma, but a disproportionately high amount of resource utilization and morbidity. It is a heterogeneous entity and requires a step-wise, evidence based approach to evaluation and management by pediatric subspecialists. The first step is to confirm the diagnosis by eliciting confirmatory history and objective evidence of asthma and excluding possible masquerading diagnoses. The next step is to differentiate difficult-to-treat asthma, asthma which can be controlled with appropriate management, from asthma which requires the highest level of therapy to maintain control or remains uncontrolled despite management optimization...
December 8, 2017: Annals of the American Thoracic Society
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