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https://www.readbyqxmd.com/read/29151158/guidelines-to-reach-high-quality-purified-recombinant-proteins
#1
REVIEW
Carla Oliveira, Lucília Domingues
The final goal in recombinant protein production is to obtain high-quality pure protein samples. Indeed, the successful downstream application of a recombinant protein depends on its quality. Besides production, which is conditioned by the host, the quality of a recombinant protein product relies mainly on the purification procedure. Thus, the purification strategy must be carefully designed from the molecular level. On the other hand, the quality control of a protein sample must be performed to ensure its purity, homogeneity and structural conformity, in order to validate the recombinant production and purification process...
November 18, 2017: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/29149937/personalizing-sepsis-care
#2
REVIEW
Mervyn Singer
Sepsis describes a broad-based syndrome covering many infectious agents, affecting various sites in patients of differing age, gender, and comorbidity and resulting in varying degrees and combinations of organ dysfunction. Protocolized care with rigid goals may suit populations, assuming the evidence-lite recommendations are beneficial, but not necessarily individual patients. A personalized approach to management is rational and preferable. Other than clinical heterogeneity, a range of biological signatures exist in sepsis, and these fluctuate over the disease course...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149875/prevalence-of-antibiotic-prescription-in-pediatric-outpatients-in-italy-the-role-of-local-health-districts-and-primary-care-physicians-in-determining-variation-a-multilevel-design-for-healthcare-decision-support
#3
Mirko Di Martino, Adele Lallo, Ursula Kirchmayer, Marina Davoli, Danilo Fusco
BACKGROUND: According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well known. Antibiotic overprescribing generates high social costs and severe consequences for children. Our objectives were to analyze antibiotic prescription patterns in pediatric outpatients residing in the Lazio region (Italy), to identify physicians' characteristics associated with increased propensity for prescription, to identify the priority axes for action to improve the rational use of antibiotics...
November 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29148277/care-ful-definition-of-consent
#4
Emese Ilyes
This proposal is an attempt to intervene in psychology's violent past and troubling present by calling for notions of "care-ful" practice, compelling us to recognize and celebrate the permeable, porous, and flexible boundaries between bodies and selves. With this heuristic of care, this article hopes to trouble the separation between rigor and relational responsibility, to trouble objectivism, to oust the illusion of cool rationality, and to offer an affective understanding of consent that refuses to deny sexuality in bodies oppressed with the label of intellectually disabled...
November 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/29147530/programmed-serial-stereochemical-relay-and-its-application-in-the-synthesis-of-morphinans
#5
Kun Ho Kenny Park, Rui Chen, David Y-K Chen
Herein we report a rationally designed, serial point-to-axial and axial-to-point stereoinduction and its integration into multi-step and target-oriented organic synthesis. In this proof-of-concept study, the configurational stability of several carefully designed atropisomeric intermediates and the fidelity of their unconventional stereoinductions were systematically investigated. The highly functionalized prepared synthetic intermediate was further applied in a novel chemical method to access the morphinans and it is potentially applicable to other structurally related alkaloids...
October 1, 2017: Chemical Science
https://www.readbyqxmd.com/read/29146654/diagnostic-and-laboratory-test-ordering-in-northern-portuguese-primary-health-care-a-cross-sectional-study
#6
Luísa Sá, Andreia Sofia Costa Teixeira, Fernando Tavares, Cristina Costa-Santos, Luciana Couto, Altamiro Costa-Pereira, Alberto Pinto Hespanhol, Paulo Santos, Carlos Martins
OBJECTIVES: To characterise the test ordering pattern in Northern Portugal and to investigate the influence of context-related factors, analysing the test ordered at the level of geographical groups of family physicians and at the level of different healthcare organisations. DESIGN: Cross-sectional study. SETTING: Northern Primary Health Care, Portugal. PARTICIPANTS: Records about diagnostic and laboratory tests ordered from 2035 family physicians working at the Northern Regional Health Administration, who served approximately 3...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#7
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29132581/resuscitation-resequenced-a-rational-approach-to-patients-with-trauma-in-shock
#8
REVIEW
Andrew Petrosoniak, Christopher Hicks
Trauma resuscitation is a complex and dynamic process that requires a high-performing team to optimize patient outcomes. More than 30 years ago, Advanced Trauma Life Support was developed to formalize and standardize trauma care; however, the sequential nature of the algorithm that is used can lead to ineffective prioritization. An improved understanding of shock mandates an updated approach to trauma resuscitation. This article proposes a resequenced approach that (1) addresses immediate threats to life and (2) targets strategies for the diagnosis and management of shock causes...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29130951/prehospital-computed-tomography-angiography-in-acute-stroke-management
#9
Michael Kettner, Stefan Alexander Helwig, Andreas Ragoschke-Schumm, Lenka Schwindling, Safwan Roumia, Isabel Keller, Daniel Martens, Johann Kulikovski, Matthias Manitz, Martin Lesmeister, Silke Walter, Iris Quasar Grunwald, Thomas Schlechtriemen, Wolfgang Reith, Klaus Fassbender
BACKGROUND: An ambulance equipped with a computed tomography (CT) scanner, a point-of-care laboratory, and telemedicine capabilities (mobile stroke unit [MSU]) has been shown to enable the delivery of thrombolysis to stroke patients directly at the emergency site, thereby significantly decreasing time to treatment. However, work-up in an MSU that includes CT angiography (CTA) may also potentially facilitate triage of patients directly to the appropriate target hospital and specialized treatment, according to their individual vascular pathology...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29130601/scaling-up-hiv-viral-load-lessons-from-the-large-scale-implementation-of-hiv-early-infant-diagnosis-and-cd4-testing
#10
Trevor Peter, Clement Zeh, Zachary Katz, Ali Elbireer, Bereket Alemayehu, Lara Vojnov, Alex Costa, Naoko Doi, Ilesh Jani
INTRODUCTION: The scale-up of effective HIV viral load (VL) testing is an urgent public health priority. Implementation of testing is supported by the availability of accurate, nucleic acid based laboratory and point-of-care (POC) VL technologies and strong WHO guidance recommending routine testing to identify treatment failure. However, test implementation faces challenges related to the developing health systems in many low-resource countries. The purpose of this commentary is to review the challenges and solutions from the large-scale implementation of other diagnostic tests, namely nucleic-acid based early infant HIV diagnosis (EID) and CD4 testing, and identify key lessons to inform the scale-up of VL...
November 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29127137/ethics-of-treatment-interruption-trials-in-hiv-cure-research-addressing-the-conundrum-of-risk-benefit-assessment
#11
Gail E Henderson, Holly L Peay, Eugene Kroon, Rosemary Jean Cadigan, Karen Meagher, Thidarat Jupimai, Adam Gilbertson, Jill Fisher, Nuchanart Q Ormsby, Nitiya Chomchey, Nittaya Phanuphak, Jintanat Ananworanich, Stuart Rennie
Though antiretroviral therapy is the standard of care for people living with HIV, its treatment limitations, burdens, stigma and costs lead to continued interest in HIV cure research. Early-phase cure trials, particularly those that include analytic treatment interruption (ATI), involve uncertain and potentially high risk, with minimal chance of clinical benefit. Some question whether such trials should be offered, given the risk/benefit imbalance, and whether those who choose to participate are acting rationally...
November 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29126909/-demographic-analysis-of-a-congenital-heart-disease-clinic-of-the-mexican-institute-of-social-security-with-special-interest-in-the-adult
#12
Horacio Márquez-González, Lucelli Yáñez-Gutiérrez, Jimena Lucely Rivera-May, Diana López-Gallegos, Eduardo Almeida-Gutiérrez
INTRODUCTION: Congenital heart disease (CHD) has an incidence of 8-10 cases per 1000 live births. In Mexico, there are 18,000-20,000 new cases per year. Most tertiary care centers for CHD attend only pediatric population; the Mexican Institute of Social Security (IMSS) has a clinic that attends pediatric and adult population. OBJECTIVE: To analyze the demographic aspects of the CHD clinic of IMSS. METHODS: From 2011 to 2016 a cross-sectional study of the CC clinic of a third level hospital of the IMSS, including all patients with confirmed structural heart disease of recent diagnosis was carried out...
November 7, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29120648/the-role-of-nanoparticle-design-in-determining-analytical-performance-of-lateral-flow-immunoassays
#13
Li Zhan, Shuang-Zhuang Guo, Fayi Song, Yan Gong, Feng Xu, David R Boulware, Michael C McAlpine, Warren C W Chan, John C Bischof
Rapid, simple, and cost-effective diagnostics are needed to improve healthcare at the point of care (POC). However, the most widely used POC diagnostic, the lateral flow immunoassay (LFA), is ∼1000-times less sensitive and has a smaller analytical range than laboratory tests, requiring a confirmatory test to establish truly negative results. Here, a rational and systematic strategy is used to design the LFA contrast label (i.e., gold nanoparticles) to improve the analytical sensitivity, analytical detection range, and antigen quantification of LFAs...
November 15, 2017: Nano Letters
https://www.readbyqxmd.com/read/29119993/a-study-of-the-reactivity-of-s-vi-f-containing-warheads-with-nucleophilic-amino-acid-side-chains-under-physiological-conditions
#14
H Mukherjee, J Debreczeni, J Breed, S Tentarelli, B Aquila, J E Dowling, A Whitty, N P Grimster
Sulfonyl fluorides (SFs) have recently emerged as a promising warhead for the targeted covalent modification of proteins. Despite numerous examples of the successful deployment of SFs as covalent probe compounds, a detailed exploration of the factors influencing the stability and reactivity of SFs has not yet appeared. In this work we present an extensive study on the influence of steric and electronic factors on the reactivity and stability of the SF and related S(VI)-F groups. While SFs react rapidly with N-acetylcysteine, the resulting adducts were found to be unstable, rendering SFs inappropriate for the durable covalent inhibition of cysteine residues...
November 9, 2017: Organic & Biomolecular Chemistry
https://www.readbyqxmd.com/read/29103378/estimating-local-costs-associated-with-clostridium-difficile-infection-using-machine-learning-and-electronic-medical-records
#15
Theodore R Pak, Kieran I Chacko, Timothy O'Donnell, Shirish S Huprikar, Harm van Bakel, Andrew Kasarskis, Erick R Scott
BACKGROUND Reported per-patient costs of Clostridium difficile infection (CDI) vary by 2 orders of magnitude among different hospitals, implying that infection control officers need precise, local analyses to guide rational decision making between interventions. OBJECTIVE We sought to comprehensively estimate changes in length of stay (LOS) attributable to CDI at a single urban tertiary-care facility using only data automatically extractable from the electronic medical record (EMR). METHODS We performed a retrospective cohort study of 171,938 visits spanning a 7-year period...
November 6, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29100870/rationing-potentially-inappropriate-treatment-in-newborn-intensive-care-in-developed-countries
#16
REVIEW
Dominic Wilkinson, Stavros Petrou, Julian Savulescu
In newborn intensive care, parents sometimes request treatment that professionals regard as 'futile' or 'potentially inappropriate'. One reason not to provide potentially inappropriate treatment is because it would be excessively costly relative to its benefit. Some public health systems around the world assess the cost-effectiveness of treatments and selectively fund those treatments that fall within a set threshold. This article explores the application of such thresholds to questions in newborn intensive care: (i) when a newborn infant's chance of survival is too small; (ii) how long treatment should continue; (iii) when quality of life is too low; and (iv) when newborn infants are too premature for cost-effective intensive care...
October 31, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29098342/preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#17
REVIEW
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery, and may help to optimize the patient's preoperative medical condition and guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29096701/assessment-of-utilization-pattern-of-fixed-dose-drug-combinations-in-primary-secondary-and-tertiary-healthcare-centers-in-nepal-a-cross-sectional-study
#18
Arjun Poudel, Mohamed Izham Mohamed Ibrahim, Pranaya Mishra, Subish Palaian
BACKGROUND: Prescription practices, especially in South Asian countries, have come under investigation for quality. Although there have been no studies in Nepal that have analyzed the prescription pattern of FDCs for different levels of health care centers, several studies from Nepal and other countries in the region have revealed poor medicine use practices, including irrational use of fixed-dose drug combinations (FDCs). This research aimed at assessing the utilization pattern of FDCs among primary (PHC), secondary (SHC) and tertiary health care (THC) centers in Western region of Nepal...
November 2, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29092052/long-lasting-successful-dissemination-of-resistance-to-oxazolidinones-in-mdr-staphylococcus-epidermidis-clinical-isolates-in-a-tertiary-care-hospital-in-france
#19
Laurent Dortet, Philippe Glaser, Najiby Kassis-Chikhani, Delphine Girlich, Philippe Ichai, Marc Boudon, Didier Samuel, Elodie Creton, Dilek Imanci, Rémy Bonnin, Nicolas Fortineau, Thierry Naas
Objectives: Patient- and procedure-related changes in modern medicine have turned CoNS into one of the major nosocomial pathogens. Treatments of CoNS infections are challenging owing to the large proportion of MDR strains and oxazolidinones often remain the last active antimicrobial molecules. Here, we have investigated a long-lasting outbreak (2010-13) due to methicillin- and linezolid-resistant (LR) CoNS (n = 168), involving 72 carriers and 49 infected patients. Methods: Antimicrobial susceptibilities were tested by the disc diffusion method and MICs were determined by broth microdilution or Etest...
October 30, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29091149/interventions-of-the-clinical-pharmacist-in-an-intermediate-care-unit-for-elderly-patients
#20
Stéphanie de Souza Costa Viana, Tiago Arantes, Sabrina Corrêa da Costa Ribeiro
OBJECTIVE: To discuss the role of the clinical pharmacist in hospital care of critical elderly patients. METHODS: Critical patients aged 60 years and over admitted by the clinical staff to an Intermediate Care Unit were followed-up for 4 months regarding their drug therapies. Medical prescriptions were reviewed daily on the basis of patients' clinical conditions, with the view to identify opportunities for optimization of drug therapies, contributing to safer prescribing, reduced discomfort and correct and rational use of drugs...
July 2017: Einstein
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