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M J Friedrich
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June 19, 2018: JAMA: the Journal of the American Medical Association
April M Randle, Rachel B Spigler, Susan Kalisz
Coexisting plant congeners often experience strong competition for resources. Competition for pollinators can result in direct fitness costs via reduced seed set or indirect costs via heterospecific pollen transfer (HPT), causing subsequent gamete loss and unfit hybrid offspring production. Autonomous selfing may alleviate these costs, but to preempt HPT, selfing should occur early, before opportunities for HPT occur (i.e. "preemptive selfing hypothesis"). We evaluated conditions for this hypothesis in Collinsia sister species, C...
June 19, 2018: Evolution; International Journal of Organic Evolution
Lorenzo Di Cesare Mannelli, Laura Micheli, Elena Lucarini, Carla Ghelardini
The facilitation of opioid medication is eliciting a nemetic problem since increasing overdose deaths involve prescription of opioid pain relievers. Chronic painful diseases require higher doses of opioids, progressively with the development of tolerance to the antinociceptive effect. Novel strategies for the maintenance of low dosed opioid effectiveness are necessary to relieve pain and decrease abuse, overdose, and side effects. N -Palmitoylethanolamine (PEA) is an endogenous compound able to preserve the homeostasis of the nervous system and to delay the development of morphine tolerance...
2018: Frontiers in Pharmacology
Gregg S Tracton, Lukasz M Mazur, Prithima Mosaly, Lawrence B Marks, Shiva Das
PURPOSE: The aim of this study is to propose a set of innovative principles for the effective design of electronic checklists to enhance safety mindfulness (a specific safety mindful mindset that offers the opportunity to operate more preemptively during routine quality assurance tasks) and discuss some of our preliminary results from testing our proposed electronic checklist with dosimetrists and physicists. METHODS AND MATERIALS: A multidisciplinary team designed, developed, and evaluated the utility of the electronic checklist (vs paper-based checklist) to promote safety mindfulness...
May 16, 2018: Practical Radiation Oncology
Lukasz M Mazur, Lawrence B Marks, Ron McLeod, Waldemar Karwowski, Prithima Mosaly, Gregg Tracton, Robert D Adams, Lesley Hoyle, Shiva Das, Bhishamjit Chera
There is a need to better prepare radiation therapy (RT) providers to safely operate within the health information technology (IT) sociotechnical system. Simulation-based training has been preemptively used to yield meaningful improvements during providers' interactions with health IT, including RT settings. Therefore, on the basis of the available literature and our experience, we propose principles for the effective design and use of simulated scenarios and describe a conceptual framework for a debriefing approach to foster successful training that is focused on safety mindfulness during RT professionals' interactions with health IT...
April 2018: Advances in Radiation Oncology
Ashley N Edes, Barbara A Wolfe, Douglas E Crews
  Animal welfare, conservation, and stress assessment are all critical components of species survival. As organisms experience stressors, they accumulate physiologic dysregulation, leading to multiple negative health outcomes. This brief review suggests measuring the degree of stress-induced damage, known as allostatic load, and then using allostatic load to evaluate changes implemented to improve animal welfare and conservation efforts. Over the past two decades, human clinical research has developed multiple allostatic load indices constructed from composites of neuroendocrine, cardiovascular, metabolic, and immune biomarkers...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Carlos Solano, Estela Giménez, Eliseo Albert, Eva María Mateo, Montserrat Gómez, Rosa Goterris, Ariadna Pérez, Paula Amat, Juan Carlos Hernández-Boluda, Marc Poch, José Luis Piñana, David Navarro
To gauge the risk of delaying initiation of prophylaxis with letermovir from the time of donor infusion to prevent CMV infection in allo-HSCT recipients we investigated the clinical outcomes of CMV DNAemia episodes occurring before engraftment, and compared to that of episodes developing after engraftment (up to day +365). A total of 197 consecutive adult patients were included. Plasma CMV DNA load was monitored by real-time PCR assays [limit of detection: 31 IU/ml]. A total of 150 out of 197 patients had CMV DNAemia (cumulative incidence of 77%; 95% CI, 73-81%), and 38 out of the 197 patients developed it before engraftment (cumulative incidence, 19%; 95% CI, 10-30...
June 13, 2018: Bone Marrow Transplantation
Tetsushi Yoshikawa
Two of the four betaherpesviruses, Cytomegalovirus (CMV) and human herpesvirus 6B (HHV-6B), play an important role in opportunistic infections in hematopoietic stem cell transplant (HSCT) recipients. These viruses are ubiquitous in humans and can latently infect mononuclear lymphocytes, complicating the diagnosis of the diseases they cause. Although the detection of viral DNA in a patient's peripheral blood by real-time PCR is widely used for monitoring viral infection, it is insufficient for the diagnosis of virus-associated disease...
2018: Advances in Experimental Medicine and Biology
Farhad Ravandi, Roland B Walter, Sylvie D Freeman
Mounting evidence indicates that the presence of measurable ("minimal") residual disease (MRD), defined as posttherapy persistence of leukemic cells at levels below morphologic detection, is a strong, independent prognostic marker of increased risk of relapse and shorter survival in patients with acute myeloid leukemia (AML) and can be used to refine risk-stratification and treatment response assessment. Because of the association between MRD and relapse risk, it has been postulated that testing for MRD posttreatment may help guide postremission treatment strategies by identifying high-risk patients who might benefit from preemptive treatment...
June 12, 2018: Blood Advances
Jacob S Diamond, Daniel McLaughlin, Robert Slesak, Anthony D'Amato, Brian Palik
Wetlands self-organize through reciprocal controls between vegetation and hydrology, but external disturbance may disrupt these feedbacks with consequent changes to ecosystem state. Imminent and widespread emerald ash borer (EAB) infestation throughout North American forested wetlands has raised concern over possible ecosystem state shifts (i.e., wetter, more herbaceous systems) and loss of forest function, calling for informed landscape-scale management strategies. In response, we employed a large-scale manipulative study to assess the ecohydrologic response of black ash wetlands to three alternative EAB management strategies: 1) a do-nothing approach (i...
June 9, 2018: Journal of Environmental Management
Brian T Fisher, Craig L K Boge, Hans Petersen, Alix E Seif, Matthew Bryan, Richard L Hodinka, Ana Maria Cardenas, Dale R Purdy, Brandon Loudon, Adriana E Kajon
Background: Human adenoviruses (HAdVs) are associated with significant morbidity and death after hematopoietic cell transplantation (HCT). In this study, we sought to determine the incidence of HAdV infection among pediatric HCT recipients in the polymerase chain reaction (PCR) testing era, identify risk factors for viremia among patients undergoing HAdV surveillance, and assess the effectiveness of preemptive cidofovir. Methods: A single-center retrospective cohort of patients who underwent a transplant within a 10-year period was assembled...
June 8, 2018: Journal of the Pediatric Infectious Diseases Society
Zhan Lu, Yan-Bo Chen, Bo Huang, Sheng Peng, Qian-Wen Wang, Dan-Lei Liu, Hua Wang
We report the clinical characteristics, treatments and outcomes of 4 rare cases of mixed amanita fuliginea and amanita rimosa poisoning with rhabdomyolysis, and review the research progress in the intoxication mechanism and treatment. The latent time of amanita poisoning, defined as the period from the ingestion of poisonous mushroom to the onset of gastrointestinal symptoms, was about 8 days, and the severity of poisoning was associated with the amount of mushroom ingested. All the 4 patients developed multiple organ dysfunctions within 3 to 4 days after mushroom ingestion, predominantly in the liver, kidney and central nervous system accompanied with acute gastrointestinal injury and rhabdomyolysis...
May 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Erin T Carey, Janelle K Moulder
Enhanced recovery after surgery (ERAS) programs are a multimodal approach to optimize the surgical experience. Intraoperative and postoperative pain management is essential because the stress of surgery results in significant neurohormonal and metabolic shifts that can influence patient analgesia. Enhanced recovery after surgery programs address the physiologic and psychological factors that contribute to pain outcomes and overall satisfaction scores. A multimodal approach to recovery throughout the perioperative surgical experience is representative of successful pathways...
June 6, 2018: Obstetrics and Gynecology
Bérangère S Joly, Paul Coppo, Agnès Veyradier
Child-onset thrombotic thrombocytopenic purpura (TTP) is a rare entity of thrombotic microangiopathy (TMA). The pathophysiology of the disease is based on a severe functional deficiency of ADAMTS13 (activity <10%), the specific von Willebrand factor (VWF)-cleavage protease. This deficiency may be either acquired (associated anti-ADAMTS13 autoantibodies) or congenital (resulting from biallelic mutations of ADAMTS13 gene). ADAMTS13 deficiency is responsible for the accumulation of high molecular weight multimers of VWF and the formation of platelet thrombi in the microcirculation...
June 11, 2018: European Journal of Haematology
Mohamad Kabach, Abdulah Alrifai, Lawrence Lovitz, Mark Rothenberg, Cristiano Faber, Marcos Nores
Transcatheter aortic valve replacement has been recently approved for patients who are high or intermediate risk for surgical aortic valve replacement. The procedure is associated with several known complications including coronary related complications. Coronary obstruction is rare but disastrous complication, and it is associated with a high mortality rate. Coronary protection technique has emerged as a preemptive technique to avoid this complication. We present a case of successful coronary protection during TAVR in severely calcified left cusp in patient with short and low left ostium...
2018: Case Reports in Cardiology
I P Lodding, C da Cunha Bang, S S Sørensen, F Gustafsson, M Iversen, N Kirkby, M Perch, A Rasmussen, H Sengeløv, A Mocroft, J D Lundgren
Background: Transplant recipients presenting with cytomegalovirus (CMV) disease at the time of diagnosis of CMV DNAemia pose a challenge to a preemptive CMV management strategy. However, the rate and risk factors of such failure remain uncertain. Methods: Solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) recipients with a first episode of CMV polymerase chain reaction (PCR) DNAemia within the first year posttransplantation were evaluated (n = 335)...
May 2018: Open Forum Infectious Diseases
Steven P Cohen, Anuj Bhatia, Asokumar Buvanendran, Eric S Schwenk, Ajay D Wasan, Robert W Hurley, Eugene R Viscusi, Samer Narouze, Fred N Davis, Elspeth C Ritchie, Timothy R Lubenow, William M Hooten
BACKGROUND: Over the past 2 decades, the use of intravenous ketamine infusions as a treatment for chronic pain has increased dramatically, with wide variation in patient selection, dosing, and monitoring. This has led to a chorus of calls from various sources for the development of consensus guidelines. METHODS: In November 2016, the charge for developing consensus guidelines was approved by the boards of directors of the American Society of Regional Anesthesia and Pain Medicine and, shortly thereafter, the American Academy of Pain Medicine...
June 7, 2018: Regional Anesthesia and Pain Medicine
Marcel Hochreiter, Maria Uhling, Leila Sisic, Thomas Bruckner, Alexandra Heininger, Andreas Hohn, Katja Ott, Thomas Schmidt, Marc Moritz Berger, Daniel Christoph Richter, Markus Büchler, Markus Alexander Weigand, Cornelius Johannes Busch
PURPOSE: Thoracoabdominal esophageal resection for malignant disease is frequently associated with pulmonary infection. Whether prolonged antibiotic prophylaxis beyond a single perioperative dose is advantageous in preventing pulmonary infection after thoracoabdominal esophagectomy remains unclear. METHODS: In this retrospective before-and-after analysis, 173 patients between January 2009 and December 2014 from a prospectively maintained database were included. We evaluated the effect of a 5-day postoperative course of moxifloxacin, which is a frequently used antimicrobial agent for pneumonia, on the incidence of pulmonary infection and mortality after thoracoabdominal esophagectomy...
June 5, 2018: Infection
Joseph R Bardeen, Thomas A Daniel
The purpose of the present study was to examine anxiety sensitivity, attentional bias to threat (ABT), and the aggregate influence of these constructs as prospective predictors of anxiety. Participants (N = 176) completed a baseline assessment session which included the completion of self-report measures of anxiety and anxiety sensitivity, as well as an eye-tracking task in which eye movements were recorded during the viewing of neutral and threat images. Measures of anxiety and anxiety sensitivity were completed again as part of an online questionnaire battery at a 1-year follow-up session...
June 5, 2018: Cognitive Behaviour Therapy
Carlos H Guerra Sanchez, Cherish D Lorica, Kristopher L Arheart, Michelle M Perez, Akin Tekin, Ivan A Gonzalez
ADV is frequently seen in our pediatric SOT population. It presents in a variety of clinical presentation and can cause severe disease. In this population, there are very few studies to determine the safety of CDV as a potential therapeutic agent. We present the findings of our retrospective study evaluating the efficacy and safety of CDV as 2 separate dosing regimens. Regimen A uses the standard 5 mg/kg once a week (Regimen A), and the second uses the 1 mg/kg 3 times per week (Regimen B). Overall, the dosing regimen did not differ in nephrotoxicity, but Regimen B had a higher, although non-significant, rate of viral load clearance...
June 3, 2018: Pediatric Transplantation
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