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Bikash Ranjan Meher
Materiovigilance is the coordinated system of identification, collection, reporting, and analysis of any untoward occurrences associated with the use of medical devices and protection of patient's health by preventing its recurrences. Postmarketing surveillance of medical devices has been initiated in many countries, but it is still not as developed and robust as that of medicines. Materiovigilance program of India was launched on July 6, 2015, at Indian Pharmacopeia Commission with objectives to track the adverse events associated with the use of medical devices, to generate safety data, create awareness among the different stakeholders, and recommend the best practices and interventions to improve the patient's safety...
October 2018: Perspectives in Clinical Research
Ajit C Kulkarni, Krishnan Srinivasan
Introduction: Tunnel boring machine (TBM) is used for constructing a tunnel. Worn out cutting tools have to be changed under difficult working conditions. Temperature is high and the work is strenuous. Work is often carried out under increased atmospheric pressure to ward off water ingress. Workers are at a very high risk. Aim: To evaluate heat stress during hyperbaric intervention on TBM during Chennai Metro Rail construction. Methodology: One hundred and eighty-eight miners after a thorough medical examination worked under increased atmospheric pressure for more than 45,000 man hours...
May 2018: Indian Journal of Occupational and Environmental Medicine
Romi Dasgupta, Indraneel Saha, Prajna Paramita Ray, Aniruddha Maity, Debajoyti Pradhan, Hari Prasad Sarkar, B R Maiti
Arecoline has biomedical importance, but it has untoward side effects on endocrine functions. The aim is to investigate its role on adrenal activity under thermal stress by ultrastructural and hormonal parameters in mice. Cold (4 °C) or heat (37 °C) stress, or arecoline (10 mg/kg body wt), each for 7 days in cold or heat stress stimulated adrenocortical activity ultrastructurally with an elevation of corticosterone level. Adrenomedullary activity was suppressed in cold stress with depletion of catecholamine levels...
October 13, 2018: Archives of Physiology and Biochemistry
Ritu Gupta, Huan Xie
At nanoscale, man-made materials may show unique properties that differ from bulk and dissolved counterparts. The unique properties of engineered nanomaterials not only impart critical advantages but also confer toxicity because of their unwanted interactions with different biological compartments and cellular processes. In this review, we discuss various entry routes of nanomaterials in the human body, their applications in daily life, and the mechanisms underlying their toxicity. We further explore the passage of nanomaterials into air, water, and soil ecosystems, resulting in diverse environmental impacts...
2018: Journal of Environmental Pathology, Toxicology and Oncology
Xiaodong Ma, Mengqi Hu, Hao Wang, Jiaming Li
P-glycoprotein (P-gp)-mediated multi-drug resistance (MDR) is a well-documented and predominant phenotype hampering patients' response to cancer chemotherapy. Although the past several decades have witnessed the development of three generations of P-gp inhibitors, they have not lived up to the high expectations owing to their drawbacks, as exemplified by limited efficacy, drug-drug interactions (DDIs) and severe untoward reactions. The discovery of artemisinin is a testimony of the importance of traditional Chinese medicine (TCM) in innovative drug discovery...
November 5, 2018: European Journal of Medicinal Chemistry
Leonard Berlin
Although radiologists want to avoid being sued for malpractice, their primary objective is to treat patients in the best way possible. Good risk management safeguards both patients and radiologists. The main objective is not to wait until an untoward event occurs and then manage it retrospectively, but rather to anticipate what may go wrong or cause an injury, so that it can be avoided. Thus, good risk management is characterized by two words: anticipate and avoid. Although avoiding lawsuits is the apparent objective of risk management, the real objective is to optimize the care and treatment of patients...
October 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Azizi Ray, Neha Milind Chitre, Cedrick Maceo Daphney, Bruce E Blough, Clinton E Canal, Kevin Sean Murnane
RATIONALE: Synthetic cathinones ("bath salts") are β-ketone analogs of amphetamines, yet few studies have examined their potential neurotoxic effects. OBJECTIVE: In the current study, we assessed the persistent behavioral and neurochemical effects of exposure to the second-generation synthetic cathinone α-pyrrolidinopropiophenone (α-PPP). METHODS: Male, Swiss-Webster mice were exposed to α-PPP (80 mg/kg) using a binge-like dosing regimen (QID, q2h)...
October 1, 2018: Psychopharmacology
Kristen Radcliff, Harvey Smith, Bobby Kalantar, Robert Isaacs, Barrett Woods, Alexander R Vaccaro, James Brannon
Background: Perforations of the pedicle wall during cannulation can occur with experienced surgeons. Direct endoscopic visualization has not been used to inspect pedicles previously due to bone bleeding obscuring the camera visualization. The hypothesis of this study was that endoscopic visualization of pedicle wall integrity was technically feasible and would enable identification of clinically significant pedicle breaches. Methods: A live porcine model was used...
April 2018: International Journal of Spine Surgery
Keith A Sonneveld, Peter T Mai, Maritzabel Hogge, Eun Y Choi, Jason E Portnof
PURPOSE: This case presentation and retrospective review of cone-beam computed tomograms is to evaluate prevalence, classification, and demographics of bifid mandibular canals (BMC) to inform practitioners on this variation and avoid untoward complications due to failure to diagnose. MATERIALS AND METHODS: Two thousand one hundred thirty scans were evaluated by 2 oral and maxillofacial radiologists. BMCs were noted and classified according to Naitoh. Demographic data were also collected and analyzed...
September 27, 2018: Implant Dentistry
Robert D Eden, Mark I Evans, David W Britt, Shara M Evans, Barry S Schifrin
OBJECTIVE: The cardiotocograph (CTG) or electronic fetal monitoring (EFM) was developed to prevent fetal asphyxia and subsequent neurological injury. From a public health perspective, it has failed these objectives while increasing emergency operative deliveries (emergency operative deliveries (EODs) - emergency cesarean delivery or operative vaginal delivery) for newborns, who in retrospect, actually did not require the assistance. EODs increase the risks of complications and stress for patients, families, and medical personnel...
October 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
T Celeste Napier, Amanda L Persons
Impulsive-compulsive spectrum disorders are associated with dopamine agonist therapy in some patients. These untoward outcomes occur with direct-acting, full and partial agonists at D2 dopamine family receptors. The disorders typically emerge during chronic treatment, and exhibit common features that are independent of the neurological or psychiatric pathology for which the initial therapy was indicated. It is well-documented that the brain is 'plastic', changing in response to alterations to internal factors (e...
September 30, 2018: European Journal of Neuroscience
Lisa S Chen, Prithviraj Bose, Nichole D Cruz, Yongying Jiang, Qi Wu, Philip A Thompson, Shuju Feng, Michael H Kroll, Wei Qiao, Xuelin Huang, Nitin Jain, William G Wierda, Michael J Keating, Varsha Gandhi
Ibrutinib is highly efficacious and used at 420 mg/d for treatment of chronic lymphocytic leukemia (CLL). We previously demonstrated a decline in BTK protein levels in CLL cells after 1 cycle of ibrutinib, suggesting that ibrutinib dose could be lowered after the first cycle without loss of biological effect. To test this postulate, a pilot study (NCT02801578) was designed to systematically reduce ibrutinib dosing within the same patient with CLL over three 28-day cycles. Following an initial cycle of 420 mg/d, the dose was reduced to 280 mg/d in cycle 2 and then to 140 mg/d in cycle 3...
September 25, 2018: Blood
Rita J Valentino, Nora Volkow
Mu opioid receptor agonists are among the most powerful analgesic medications but also among the most addictive. The current opioid crisis has energized a quest to develop opioid analgesics that are devoid of untoward effects. Since their discovery in the 1970's, there have been major advances in our understanding of the endogenous opioid systems that these drugs target. Yet many questions remain and the development of non-addictive opioid analgesics has not been achieved. However, access to new molecular, genetic and computational tools have begun to elucidate the structural dynamics of opioid receptors, the scaffolding that links them to intracellular signaling cascades, their cellular trafficking and the distinct ways that various opioid drugs modify them...
September 24, 2018: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Kirti Singh, Mainak Bhattacharyya, Ankush Mutreja, Sonal Dangda
Purpose: To report long-term safety and efficacy of trabeculectomy with collagen implant in Indian population. Methods: All cases of trabeculectomy with Ologen® Collagen Matrix implant performed over a 7-year period from May 2008 through April 2015 at a tertiary referral institute were reviewed. A total of 30 eyes of 28 patients were included in the study with two patients undergoing bilateral trabeculectomy. Outcomes measured included intraocular pressure (IOP) control, number of antiglaucoma medications used, bleb morphology, and complications/reoperations...
October 2018: Indian Journal of Ophthalmology
Myoung H Kim, Ki Y Lee, Sun J Bae, Minju Jo, Jin S Cho
BACKGROUND: Surgical stress induces stress hormone release and sympathetic hyperactivation, resulting in hemodynamic instability. Dexmedetomidine has sympatholytic and hemodynamic stabilizing effects. We investigated whether dexmedetomidine could attenuate stress responses in major spine surgery. METHODS: In this prospective randomized study, 52 patients undergoing spine fusion surgery were randomized to placebo (n=26) or to dexmedetomidine (n=26) groups. Dexmedetomidine at a rate of 0...
September 18, 2018: Minerva Anestesiologica
Roger J W Truscott, Michael G Friedrich
Recent discoveries may change the way that multiple sclerosis (MS) is viewed, particularly with regard to the reasons for the untoward immune response. The fact that myelin proteins are long-lived, and that by the time we are adults, they are extensively degraded, alters our perspective on the reasons for the onset of autoimmunity and the origin of MS. For example, myelin basic protein (MBP) from every human brain past the age of 20 years, is so greatly modified, that it is effectively a different protein from the one that was laid down in childhood...
September 14, 2018: Journal of Clinical Medicine
Amir Kazory, Claudio Ronco
BACKGROUND: Accumulating evidence on the pathophysiology of hepatorenal syndrome has challenged the conventional model of liver-kidney connection. While liver cirrhosis is traditionally considered the origin of a cascade of pathophysiologic mechanisms directly affecting other organs such as the kidney, emerging data point to the heart as the potential mediator of the untoward renal effects. SUMMARY: Herein, we briefly review the often-overlooked contribution of the heart to circulatory dysfunction in hepatorenal syndrome and put forward evidence arguing for the involvement of systemic inflammation and endothelial dysfunction in this setting...
September 17, 2018: Cardiorenal Medicine
Kendra J Homan, Susan L Crowley, Leslie A Sim
In light of conflicting research regarding eating disorder risk and sports participation, the current study examined the relationship between specific aspects of sports participation (i.e., level of competition, leanness requirements, and physical/cardiovascular intensity level), an individual's motivation for sports participation, and eating disorder symptomatology/risk. Participants included 319 female collegiate athletes (M age = 19.88; SD = 1.62) representing a variety of sports and competition levels...
September 17, 2018: Eating Disorders
Niranjan Das, Abhijit Bhattacharya, Sudip Kumar Mandal, Utsab Debnath, Biswanath Dinda, Subhash C Mandal, Prabir Kumar Sinhamahapatra, Amresh Kumar, M Dutta Choudhury, Sabyasachi Maiti, Partha Palit
Ichnocarpus frutescens, a climber plant, is distributed all over India. As its different parts are used as anti-inflammatory agent, so we re-investigated the roots to isolate compounds and evaluate its biological efficacy. Also, in-silico molecular docking was carried out to elucidate the structure activity relationship (SAR) of isolated compounds toward identifies the drug target enzyme with validation, which was further supported by anti-inflammatory in-vitro and in-vivo experimental models. The compounds have been undertaken mainly to investigate the anti-inflammatory and analgesic efficacy along with molecular docking investigation followed by anti-proteinase, anti-denaturation and cyclooxygenase (COX) inhibition studies...
September 12, 2018: Steroids
Peter J Holmberg, Grace Arteaga, Brenda M Schiltz, James Homme
Selective serotonin reuptake inhibitors are a commonly used and often effective class of medications in the treatment of mood disorders such as anxiety and depression. Sertraline (1S,4S-N-methyl-4-[3,4-dichlorophenyl]-1,2,3,4-tetrahydro-1-naphthylamine [Zoloft; Pfizer, New York City, NY]) is a frequently used selective serotonin reuptake inhibitor that has shown efficacy in children, adolescents, and adults. We report the case of a 13-year-old boy with sertraline-induced rhabdomyolysis and renal failure, trismus, and cardiopulmonary arrest...
October 2018: Pediatrics
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