Over the counter

Insomnia is a common problem in older people, especially in patients with mild cognitive impairment (MCI) whose circadian rhythm is often compromised. Insomnia exerts such a toll on caregivers that it is frequently the primary reason for seeking to institutionalize their loved ones. Three different types of insomnia are recognized: sleep-onset or initial insomnia, sleep maintenance or middle insomnia, and early morning awakening or late insomnia. Nocturnal hypoglycemia, as a cause of middle insomnia, is the main focus of this case study...

The Na+/Ca2+ exchanger (NCX) is a ubiquitous single-chain membrane protein that plays a major role in regulating the intracellular Ca2+ homeostasis by the counter transport of Na+ and Ca2+ across the cell membrane. Other than its prokaryotic counterpart, which contains only the transmembrane domain and is self-sufficient as an active ion transporter, the eukaryotic NCX protein possesses in addition a large intracellular loop that senses intracellular calcium signals and controls the activation of ion transport across the membrane...

OBJECTIVE To quantify vitamin D3 (VitD3 ) concentrations in commercial dog foods and compare those concentrations with Association of American Feed Control Officials (AAFCO) recommendations and manufacturer-reported concentrations. DESIGN Cross-sectional study. SAMPLE 82 commercial dog foods. PROCEDURES Samples of commercially available dog foods were obtained from owners of healthy dogs in the Guelph, ON, Canada, area and owners of dogs that were patients at the Ontario Veterinary College Health Sciences Centre's Mona Campbell Centre for Animal Cancer...

An estimated 28,000 French people infected with HIV remain undiagnosed, leading to HIV transmission and late-stage HIV infections. An over-the-counter HIV self-test has been available since September 2015. We thus aimed to explore people's perceptions of and intentions to use the test. An anonymous online questionnaire, targeting the general population and men who have sex with men (MSM) was distributed between November 2015 and January 2016. It explored at-risk sexual behavior, perceptions of the HIV self-test, and past and intended future use...

OBJECTIVES: The objective of this study was to quantify the financial impact of a pharmacist-driven pilot medication therapy management (MTM) program within a visiting nurse service (VNS) and identify types of medication-related problems affecting the home health care population. METHODS: Patients were contacted to schedule a home visit with the primary investigator. At the appointment, a comprehensive medication review (CMR) was completed, and data collected included primary reason for VNS care, comorbid diagnoses, number of prescription and nonprescription medications at time of visit, and type of pharmacist-identified medication therapy intervention(s)...

OBJECTIVE: The purpose of this study was to quantify the persistence of immediate changes in adolescents' alcohol-related beliefs associated with exposure to alcohol advertising. METHOD: Middle school students (N = 606) carried handheld devices for 14 days and logged all of their exposures to alcohol advertisements as they naturally occurred. Perceptions of the typical person one's age who drinks ("prototype perceptions") and perceived norms regarding alcohol use were assessed after each exposure to advertising and at random prompts issued daily throughout the assessment period...

INTRODUCTION: Amoxicillin is the first-line antibiotic recommended by most scientific societies for the treatment of uncomplicated acute otitis media (AOM) in children and adults. In low-income and middle-income countries however, absence of setting-specific recommendations and antibiotic resistance, promoted by higher population density and over-the-counter antibiotic availability, could hamper the effectiveness of amoxicillin. We aim to provide updated information to enable evidence-based decisions for first-line therapy of uncomplicated AOM in our setting...

Acetaminophen is absorbed rapidly after oral intake, and serum concentration peaks within 4 hours. The Rumack-Matthew (RM) nomogram is widely used to identify the potential risk of liver dysfunction. However, the RM nomogram was intended for use only when a single agent was ingested. We report the case of a patient with overdose ingestion of an over-the-counter combination cold medication that contained acetaminophen, where the patient's serum concentration increased over time. Over-the-counter combination cold medications are designed to relieve cold symptoms...

In order to assess the effects of prescription-only (Rx) to over-the-counter (OTC) drug switches and related policies, it is imperative to distinguish self-medication from OTC drug use. The objective of this study was to estimate the OTC drug use in the adult population in Germany, to identify its predictors and to highlight methodological differences when compared to the study of a self-medication prevalence. Seven-day prevalence of OTC drug use was calculated on the basis of information provided by 7091 participants of the German Health Interview and Examination Survey for Adults (DEGS1) conducted between 2008 to 2011...

OBJECTIVE: To present findings of a narrative review on the implementation and effectiveness of 17 Articles of the WHO Framework Convention on Tobacco Control (FCTC) during the Treaty's first decade. DATA SOURCES: Published reports on global FCTC implementation; searches of four databases through June 2016; hand-search of publications/online resources; tobacco control experts. STUDY SELECTION: WHO Convention Secretariat global progress reports (2010, 2012, 2014); 2015 WHO report on the global tobacco epidemic; studies of social, behavioural, health, economic and/or environmental impacts of FCTC policies...

The over increasing demand of eco-friendly materials to counter various problems, such as environmental issues, economical, sustainability, biodegradability and biocompatibility, open up new fields of research highly focusing on nature-based products. Edible polymers based materials mainly consist of polysaccharides, proteins and lipids could be a prospective contender to handle such problems. Hydrogels are three-dimensionally crosslinked macromolecular network structures that can absorb and retain a significant amount of water without dissolving in it...

Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that is defined by symptoms of orthostatic intolerance. According to the current criteria for adults, currently, POTS is defined as a heart rate increment of 30 beats/minute or more after 10 minutes of standing in the absence of orthostatic hypotension. There is a vast majority that remains misdiagnosed due to the heterogeneity of the disorder. Due to a lack of Food and Drug Administration (FDA) approved therapy, alternative therapies and over the counter medications are used to alleviate the symptoms...

Major challenges of miniaturizing flow cytometry include obviating the need for bulky, expensive, and complex pump-based fluidic and laser-based optical systems, while retaining the ability to detect target cells based on their unique surface receptors. We addressed these critical challenges by (i) using a viscous liquid additive to control flow rate pas-sively, without external pumping equipment, and (ii) adopting an immunobead assay that can be quantified with a portable fluorescence cell counter based on a blue light-emitting diode...

We perform experiments on an active granular material composed of individually-driven, spinning disks confined within a circular arena. Small bumps at the outer edges of the disks provide a variable amount of interparticle coupling in the form of geometric friction. The disks each spin counter-clockwise, but undergo a transition in their collective circulation around the center of the arena, from a clockwise orbit to a counter-clockwise orbit, as a function of packing fraction φ. We identify that, unlike for vibrated granular gases, the particles' velocity distributions are Gaussian over a large range of φ...

Casson nanofluid, unsteady flow over an isothermal vertical plate with Newtonian heating (NH) is investigated. Sodium alginate (base fluid)is taken as counter example of Casson fluid. MHD and porosity effects are considered. Effects of thermal radiation along with heat generation are examined. Sodium alginate with Silver, Titanium oxide, Copper and Aluminum oxide are added as nano particles. Initial value problem with physical boundary condition is solved by using Laplace transform method. Exact results are obtained for temperature and velocity fields...

Opioids are potent analgesics used for the treatment of acute and chronic pain. Side-effects are common and among the most bothersome are those associated with opioid-induced bowel dysfunction, which includes opioid-induced constipation. In this Review, we provide a summary of the pathophysiology, diagnosis, and management of opioid-induced constipation, which can be defined as a change in baseline bowel habit or defecatory patterns following initiation, alteration, or increase of opioid therapy. Opioid-induced constipation is a consequence of the action of opioids on their receptors in the gastrointestinal tract...

BACKGROUND CONTEXT: Surgical site infections (SSI) following spine surgery are debilitating complications to patients and costly to the healthcare system. PURPOSE: Review the impact and cost effectiveness of five SSI prevention interventions on SSI rates in an orthopaedic spine surgery practice at a major quaternary healthcare system over a 10-year period. STUDY DESIGN: Retrospective observational study. PATIENT SAMPLE: All of the surgical patients of five spine surgeons in our department over a 10-year period were included in this study...

Vasomotor symptoms are the most common manifestation of the menopause transition and postmenopausal phases of reproductive life. They interfere not only in quality of life, but also contribute to sleep and mood disturbances that potentially compromise home and work effectiveness. Treatment options include hormone therapy (HT), nonhormonal prescription drugs, mind body and behavior therapies, and over-the-counter preparations. Evidence confirms that HT is the most effective option. The initial reticence to prescribe HT immediately following publication of the Women's Health Initiative has been replaced by clear guidelines for confidently identifying women for whom this therapy will be safe...

As terrorist actors revise their tactics to outmaneuver increasing counter-terrorism security measures, a recent trend toward less-sophisticated attack methods has emerged. Most notable of these "low tech" trends are the Targeted Automobile Ramming MAss Casualty (TARMAC) attacks. Between 2014 and November 2017, 18 TARMAC attacks were reported worldwide, resulting in 181 deaths and 679 injuries. TARMAC attack-related injuries are unique compared to accidental pedestrian trauma and other causes of mass casualty incidents (MCI), and therefore they require special consideration...

Species have different strategies for loading sugars into the phloem, which vary in the route that sugars take to enter the phloem and the energetics of sugar accumulation. Species with passive phloem loading are hypothesized to have less flexibility in response to changes in some environmental conditions because sucrose export from mesophyll cells is dependent on fixed anatomical plasmodesmatal connections. Passive phloem loaders also have high mesophyll sugar content, and may be less likely to exhibit sugar-mediated down-regulation of photosynthetic capacity at elevated CO2 concentrations...