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Meds optimisation

Adam Tucker, Darren McCusker, Nidhi Gupta, Jonathon Bunn, Mark Murnaghan
INTRODUCTION: Arthroplasty is commonplace in orthopaedic practice, and post operative pain has been shown to substantially hinder recovery and discharge from hospital. OBJECTIVES: The current study assessed a multidisciplinary, multimodal Orthopaedic ERP in terms of its effect on patient perceived post operative pain in hip and knee arthroplasty. Secondary outcome was in the form of a cost analysis. METHODS: A prospective study was performed on consecutive arthroplasty patients across a 6 week period in a district orthopaedic unit...
May 2016: Ulster Medical Journal
T A Manuck
UNLABELLED: Pharmacogenomics and personalised medicine incorporate genetic factors, historical data, and environmental exposures to predict individual variation in response to medications. The study of pharmacology and pharmacogenomics is challenging in obstetrics, and our knowledge in this area lags behind other disciplines of medicine. Some preliminary data, however, suggest that some of the interindividual variation seen in response to medications given for the prevention (progesterone) and the treatment (nifedipine, terbutaline, and others) of preterm labour may be caused by pharmacogenomic effects...
February 2016: BJOG: An International Journal of Obstetrics and Gynaecology
N Smee, H Moss, J Gibson, L Jackson
INTRODUCTION: Neonatal hypoxic-ischaemic encephalopathy (HIE) is the most common cause of long term neurological deficit in term and near-term infants. Controlled hypothermia has been available within tertiary level Neonatal Units in NHS GGC from the time of the seminal UK randomised controlled trial of cooling(1) and is now the standard of care as endorsed by the National Institute for Heath and Clinical Excellence in 2010.(2) AIMS: To compare 'cooling' service provision in NHS GGC against local and national standards for initial inpatient management over a three year time period (01/01/2008 to 31/12/2010)...
June 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
U Rajesh, K Merrick
UNLABELLED: : The implementation of the European Working Time Directive, safer childbirth requirements and changes to the structure of training continue to impact upon maternity care provision. Consultant decision-making is crucial to optimise safety in labour. There is little data on pregnancy outcomes during resident consultant shifts.(1,2) In York Hospital, consultant resident on-call was introduced from July 2010. We have published preliminary retrospective data on the impact of the introduction of these posts in the unit...
June 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
Helen M Conaglen, Ryan G Paul, Tania Yarndley, Jozef Kamp, Marianne S Elston, John V Conaglen
INTRODUCTION: Testosterone undecanoate depot (TUD) administered intramuscularly is an effective form of testosterone replacement therapy (TRT) for male hypogonadism. Because of the ease of administration, TUD therapy may be preferable to subcutaneously implanted extended release T pellet implants (TI). AIM: The primary objective was to retrospectively assess the efficacy and safety of long-term (≥ 2 years therapy) TUD therapy in the clinical setting. The secondary objective was to retrospectively compare TUD with TI therapy...
February 2014: Journal of Sexual Medicine
E Polykandriotis, V J Schmidt, U Kneser, S Jianming, A R Boccaccini, R E Horch
With the advent of the era of tissue engineering (TE), experimental settings have been developed that allow for a defined environment with optimised cell growth conditions and/or the production of specific substitutes. These isolated systems have been termed "bioreactors". By translating the principles of bioreactors into an in vivo context, advances in biomaterial sciences and cell biology have been merged into an integrative research concept. Even today, in the age of regenerative Medicine (RegMed) the transfer of experimental in vitro findings into a clinical in vivo approach still remains a vast challenge...
August 2012: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Daniel Spinks, Han B Ong, Chidochangu P Mpamhanga, Emma J Shanks, David A Robinson, Iain T Collie, Kevin D Read, Julie A Frearson, Paul G Wyatt, Ruth Brenk, Alan H Fairlamb, Ian H Gilbert
Genetic studies indicate that the enzyme pteridine reductase 1 (PTR1) is essential for the survival of the protozoan parasite Trypanosoma brucei. Herein, we describe the development and optimisation of a novel series of PTR1 inhibitors, based on benzo[d]imidazol-2-amine derivatives. Data are reported on 33 compounds. This series was initially discovered by a virtual screening campaign (J. Med. Chem., 2009, 52, 4454). The inhibitors adopted an alternative binding mode to those of the natural ligands, biopterin and dihydrobiopterin, and classical inhibitors, such as methotrexate...
February 7, 2011: ChemMedChem
Charlotte J Mitchell, Stuart P Ballantine, Diane M Coe, Caroline M Cook, Christopher J Delves, Mike D Dowle, Chris D Edlin, J Nicole Hamblin, Stuart Holman, Martin R Johnson, Paul S Jones, Sue E Keeling, Michael Kranz, Mika Lindvall, Fiona S Lucas, Margarete Neu, Yemisi E Solanke, Don O Somers, Naimisha A Trivedi, Joanne O Wiseman
Following the discovery of 4-(substituted amino)-1-alkyl-pyrazolo[3,4-b]pyridine-5-carboxamides as potent and selective phosphodiesterase 4B inhibitors, [Hamblin, J. N.; Angell, T.; Ballentine, S., et al. Bioorg. Med. Chem. Lett.2008, 18, 4237] the SAR of the 5-position was investigated further. A range of substituted heterocycles showed good potencies against PDE4. Optimisation using X-ray crystallography and computational modelling led to the discovery of 16, with sub-nM inhibition of LPS-induced TNF-α production from isolated human peripheral blood mononuclear cells...
October 1, 2010: Bioorganic & Medicinal Chemistry Letters
P Covens, D Berus, F Vanhavere, V Caveliers
Significant staff exposure is generally expected during PET-and PET/CT applications. Whole-body doses as well as extremity doses are usually higher per procedure compared with SPECT applications. Dispensing individual patient doses and manual injection involves high extremity doses even when heavy weighted syringe shields are used. In some cases the external radiation causes an exposure to the fingertips of more than 500 mSv y(-1), which is the yearly limit. Whole-body doses per procedure are relatively lower compared with extremity doses and are generally spread over the entire procedure (Guillet, B...
August 2010: Radiation Protection Dosimetry
Matthew B Wall, Robin Walker, Andrew T Smith
Effective functional imaging of the human Superior Colliculus (SC) has often been regarded as difficult because of the small size of the SC and its proximity to sources of pulsatile (cardiac) noise. An optimised approach to functional imaging of the SC with fMRI is presented, based upon the novel finding that visually-induced BOLD responses in the SC are qualitatively different from responses in both cortical (V1) and sub-cortical (LGN) comparison areas. An optimised model with a Haemodynamic Response Function (HRF) which peaks early (4-5 s) and then falls rapidly is shown to be best suited for revealing SC responses, while a model peaking at 6 s and falling more slowly was most sensitive in the two comparison areas...
October 1, 2009: NeuroImage
Louise O'Neill, John Armstrong, Steve Buckney, Mushabbab Assiri, Mairin Cannon, Ola Holmberg
BACKGROUND: Patient immobilisation and position are important contributors to the reproducibility and accuracy of radiation therapy. In addition the choice of position can alter the external contour of the treated area and has the potential to alter the spatial relationship between internal organs. The published literature demonstrates variation in the use of the prone and supine position for prostate cancer radiation therapy. Previous investigators using different protocols for patient preparation, imaging and target volume definition have demonstrated changes in the calculated therapeutic ratio comparing the two positions...
July 2008: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Michael J Palmer, Andrew S Bell, David N A Fox, David G Brown
The clinical significance of phosphodiesterase 5 (PDE5) inhibition is increasingly understood following the pioneering work with sildenafil, and the continuing development programmes for both sildenafil and other marketed inhibitors. Since the initial launch of sildenafil for male erectile dysfunction (MED), approval has now been granted for treatment of pulmonary hypertension, whilst ongoing studies have indicated the potential of PDE5 inhibition for the treatment of a range of additional indications including cardioprotection, memory retention and diabetes...
2007: Current Topics in Medicinal Chemistry
Ugo Amaldi
In 1991 the author involved the Italian institute of nuclear physics (INFN) in R&D work in the field of hadrontherapy. In 1992 the TERA Foundation was created with the purpose of forming and employing people fully devoted to the design, promotion and construction of hadrontherapy centres in Italy and in Europe. The present contribution describes the main project of TERA, the CNAO (Centro Nazionale di Adroterapia Oncologica), and the status of its construction in Pavia. The Italian Centre is based on the optimised medical synchrotron designed in the framework of the "Proton Ion Medical Machine Study" (PIMMS) carried out at CERN from 1996 to 2000 with CERN, the Med-AUSTRO project, Oncology 2000 (Prague) and TERA as partners...
December 2004: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Francisco Sánchez-Doblado, Roberto Capote, Joan V Roselló, Antonio Leal, Juan I Lagares, Rafael Arráns, Günther H Hartmann
BACKGROUND AND PURPOSE: Absolute dose measurements for Intensity Modulated Radiotherapy (IMRT) beamlets is difficult due to the lack of lateral electron equilibrium. Recently we found that the absolute dosimetry in the penumbra region of the IMRT beamlet, can suffer from significant errors (Capote et al., Med Phys 31 (2004) 2416-2422). This work has the goal to estimate the error made when measuring the Planning Target Volume's (PTV) absolute dose by a micro ion chamber (microIC) in typical IMRT treatment...
June 2005: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Frank Buttgereit, Gerd-Rüdiger Burmester, Brian J Lipworth
CONTEXT: Glucocorticoids are frequently and successfully used drugs that mediate important immunosuppressive and anti-inflammatory effects. These drugs are also relatively inexpensive, but it is their broad range of adverse reactions that continuously stimulate efforts to optimise glucocorticoid treatment. STARTING POINT: Last year, Mary Leonard and colleagues studied 60 children and adolescents with nephrotic syndrome intermittently treated with high-dose glucocorticoids (N Engl J Med 2004; 351: 868-75)...
February 26, 2005: Lancet
Christoph Kaiser, Gabriela M Kuster, Paul Erne, Wolfgang Amann, Barbara Naegeli, Stefan Osswald, Peter Buser, Heinz Schläpfer, Wolfgang Brett, Hans-Reinhard Zerkowski, Christian Schindler, Matthias Pfisterer et al.
AIM: To assess treatment effects of optimised medical therapy and PCI or CABG surgery on one-year outcome in patients 75 years old with chronic angina. METHODS AND RESULTS: On-treatment analysis of the TIME data: all re-vascularised patients (REVASC n=174: 112 randomised to revascularisation and 62 to drugs with late revascularisation) were compared to all patients on continued drug therapy (MED n=127: 86 randomised to drugs and 41 to revascularisation only). Baseline characteristics of both groups were similar (age 80 +/- 4 years)...
June 2004: European Heart Journal
Kees H Polderman, Armand R J Girbes
CONTEXT: Important advances have been made in our understanding of severe sepsis. Outcome can be improved by targeted interventions, including early and appropriate antibiotic therapy and goal-directed resuscitation, and might be further improved by selective decontamination of the digestive tract, tight control of glucose, and possibly by giving corticosteroids to selected patients. Drugs that target specific steps in the septic cascade include cytokine inhibitors, anti-endotoxins, and the three naturally occurring anticoagulants...
May 22, 2004: Lancet
Katarina Gårdfeldt, Milena Horvat, Jonas Sommar, Joze Kotnik, Vesna Fajon, Ingvar Wängberg, Oliver Lindqvist
A comparison of manual procedures for measurements of dissolved gaseous mercury (DGM) in seawater was accomplished. The experiments were performed on board the Italian research vessel Urania during July 2000 as a subtask in the CNR "Med-Oceanor Project 2000". Water samples for DGM were collected by Go-Flo bottles and subsequently analysed for DGM on board the ship. Determinations of DGM were made in parallel by two groups using different analytical routines. The two sets of data obtained compare favourably...
November 2002: Analytical and Bioanalytical Chemistry
U Amaldi
In 1991 INFN was first involved in R&D work in the field of hadrontherapy. In 1992 the TERA Foundation was created with the purpose of forming and employing people fully devoted to the design, promotion and construction of hadrontherapy centres in Italy and in Europe. This contribution reviews the present status of therapy with ion beams and describes the main TERA project CNAO (Centro Nazionale di Adroterapia Oncologica) based on the optimised medical synchrotron designed in the framework of the "Proton Ion Medical Machine Study" (PIMMS) carried out at CERN from 1996 to 1999 with CERN, the Med-AUSTRO project, GSI, Oncology 2000 (Prague) and TERA as partners...
2001: Physica Medica: PM
C Fiorino, S Broggi, D Corletto, G M Cattaneo, R Calandrino
BACKGROUND: In the case of concave-shaped PTVs including prostate (P) and seminal vesicles (SV), intensity-modulated radiation therapy (IMRT) should improve the therapeutic ratio of the treatment of prostate cancer. PURPOSE: Comparing IMRT by simple 1D modulations with conventional 3D conformal therapy (i.e. non-IMRT) in the treatment of concave-shaped PTVs including P+SV. MATERIALS AND METHODS: For five patients having a concave-shaped PTV (P+SV) previously treated at our Institute with conformal radiotherapy, conventional 3- and 4-fields conformal plans were compared with IMRT plans in terms of biological indices...
April 2000: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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