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Sample records for kanpo medicine regimen

  1. Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines

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    HIV Treatment Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines (Last updated 3/2/2017; last reviewed 3/2/2017) ... maintain long-term medication adherence. Before starting an HIV regimen, talk to your health care provider about ...

  2. Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines

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    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets Following ... m. ET) Send us an email Following an HIV Regimen: Steps to Take Before and After Starting ...

  3. [Health and dietetics in medieval preventive medicine: the health regimen of Peter of Spain (thirteenth century)].

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    Santos, Dulce O Amarante Dos; Fagundes, Maria Daílza da Conceição

    2010-06-01

    This text is an analysis of a preventive medical work, Liber de conservanda sanitate, composed in the thirteenth century by the Portuguese physician and doctor, Peter of Spain (?1210-1277). His work enables us to look at the conceptions of health and hygiene and understand the social role of university physicians in medieval preventive medicine. The work constantly displays the notion of the balance in corporal health between internal elements, or natural things (complexion, for example), and external ones, or non-natural things (air, sleep, exercise, food, baths, passions of the soul).

  4. Local resistance patterns to antimicrobials in internal medicine: a focused report from the REGIMEN (REGistro Infezioni in MEdicina INterna) study.

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    Cei, Marco; Pardelli, Riccardo; Sani, Spartaco; Mumoli, Nicola

    2014-02-01

    The treatment for infections in hospitalized patients can be summarized in the timely start of empirical therapy, followed by adjustment on the basis of isolates and microbial susceptibilities. Initial therapy may be based on international guidelines. However, to know local frequencies of bacterial and fungal strains together with patterns of drug resistance should be a better approach to therapy. REGIMEN is a retrospective observational study of all consecutive recorded bacterial and fungal isolates, collected between October 2009 and August 2011 from patients admitted in a 53-bedded ward of internal medicine of a non-teaching Italian hospital. We investigated type of samples and of microorganisms, patterns of susceptibility and resistance to antibiotics, and in-hospital mortality. A total of 504 samples were examined (244 from urine, 189 from blood and 71 from skin and various exudates). Participants were old (mean age, 83 years), and so overall mortality was high (20 %). There were high frequencies of drug resistance; only 27.9 % of urinary gram-negatives and 52.6 % of blood gram-negatives were susceptible to levofloxacin. Susceptibility profiles compatible with the presence of extended-spectrum beta-lactamases were present in 64.2 % of gram-negative strains, and 10.1 % were also resistant to carbapenems. ESKAPE organisms account for a third of all bacterial infections. Local patterns of drug resistance should influence empirical antibiotic therapy for patients admitted in internal medicine wards, where mortality is high.

  5. Classifying insulin regimens

    DEFF Research Database (Denmark)

    Neu, A; Lange, K; Barrett, T

    2015-01-01

    Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1...... diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin...... variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides...

  6. Searching for synergistic bronchodilators and novel therapeutic regimens for chronic lung diseases from a traditional Chinese medicine, Qingfei Xiaoyan Wan.

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    Yuanyuan Hou

    Full Text Available Classical Chinese pharmacopeias describe numerous excellent herbal formulations, and each prescription is an outstanding pool of effective compounds for drug discovery. Clarifying the bioactivity of the combined mechanisms of the ingredients in complex traditional Chinese medicine formulas is challenging. A classical formula known as Qingfei Xiaoyan Wan, used clinically as a treatment for prevalent chronic lung disease, was investigated in this work. A mutually enhanced bioactivity-guided ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF-MS characterization system was proposed, coupled with a dual-luciferase reporter assay for β2AR-agonist cofactor screening. Arctiin, arctigenin, descurainoside and descurainolide B, four lignin compounds that showed synergistic bronchodilation effects with ephedrine, were revealed. The synergistic mechanism of arctigenin with the β2ARagonist involved with the reduction of free Ca2+ was clarified by a dual-luciferase reporter assay for intracellular calcium and the Ca2+ indicator fluo-4/AM to monitor changes in the fluorescence. The relaxant and contractile responses of airway smooth muscle are regulated by crosstalk between the intracellular cAMP and calcium signaling pathways. Our data indicated the non-selective βAR agonist ephedrine as the principal bronchodilator of the formula, whereas the lignin ingredients served as adjuvant ingredients. A greater understanding of the mechanisms governing the control of these pathways, based on conventional wisdom, could lead to the identification of novel therapeutic targets or new agents for the treatment of asthma and COPD.

  7. Searching for Synergistic Bronchodilators and Novel Therapeutic Regimens for Chronic Lung Diseases from a Traditional Chinese Medicine, Qingfei Xiaoyan Wan

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    Hou, Yuanyuan; Cheng, Binfeng; Zhou, Mengge; Fang, Runping; Jiang, Min; Hou, Wenbin; Bai, Gang

    2014-01-01

    Classical Chinese pharmacopeias describe numerous excellent herbal formulations, and each prescription is an outstanding pool of effective compounds for drug discovery. Clarifying the bioactivity of the combined mechanisms of the ingredients in complex traditional Chinese medicine formulas is challenging. A classical formula known as Qingfei Xiaoyan Wan, used clinically as a treatment for prevalent chronic lung disease, was investigated in this work. A mutually enhanced bioactivity-guided ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF-MS) characterization system was proposed, coupled with a dual-luciferase reporter assay for β2AR-agonist cofactor screening. Arctiin, arctigenin, descurainoside and descurainolide B, four lignin compounds that showed synergistic bronchodilation effects with ephedrine, were revealed. The synergistic mechanism of arctigenin with the β2ARagonist involved with the reduction of free Ca2+ was clarified by a dual-luciferase reporter assay for intracellular calcium and the Ca2+ indicator fluo-4/AM to monitor changes in the fluorescence. The relaxant and contractile responses of airway smooth muscle are regulated by crosstalk between the intracellular cAMP and calcium signaling pathways. Our data indicated the non-selective βAR agonist ephedrine as the principal bronchodilator of the formula, whereas the lignin ingredients served as adjuvant ingredients. A greater understanding of the mechanisms governing the control of these pathways, based on conventional wisdom, could lead to the identification of novel therapeutic targets or new agents for the treatment of asthma and COPD. PMID:25397687

  8. A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study.

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    Patel, Manish V; Patel, Kalapi B; Gupta, Shivenarain; Michalsen, Andreas; Stapelfeldt, Elmar; Kessler, Christian S

    2015-01-01

    Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.

  9. A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study

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    Manish V. Patel

    2015-01-01

    Full Text Available Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda. The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA. In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.

  10. Clinical study on the regimen of medicinal wine based on constitution distinction of TCM%药酒辨体养生研究

    Institute of Scientific and Technical Information of China (English)

    程志源; 吴苏柳; 徐旭枝; 董春富; 潘林文; 陈建平; 潘淑平

    2014-01-01

    Objective To observe the effect of medicinal wine regimen which is guided by the theory of constitution distinction of TCM.Methods 76 patients were selected from all patients enrolled in wine style health experience from February 2011 to December 2011 in line with the corresponding physical characteristics.Among these 76 patients,23 patients were Yang deficiency constitution,34 were phlegm dampness constitution,and 19 were yin deficiency constitution.All these patients were taken a physical and chemical examination after taking the medicinal wine for a month.Results ①Examination index comparison before and after the treatment in different physical constitution patients:in phlegm dampness constitution patients the pulse were slowed (t=2.122,P<0.05) after taking the blood fat reducing wine,and physical type of conversion points were lowered (t=4.86,P<0.01); in Yang constitution patients,the systolic blood pressure (FT4),free thyroxine T4,physical type of conversion points were all significantly decreased [t values were 2.735,3.672,12.93,P<0.05 or 0.01] after taking Guilu Erxian wine; in Yin deficiency patients,adrenocorticotropic hormone (ACTH),interleukin-1 (IL-1),interleukin-2 (IL-2) were all increased [t values were 2.355,2.645,3.829,P<0.05 or 0.01] after taking Ziyin-Buxue wine.② Comparison of the clinical curative effect:according to the type of constitution transformation changes,the total effective rate was more than 70%.According to Ridit test,except yin deficiency physique (t=1.85,P>0.05),patients in both phlegm dampness constitution and yang deficiency constitution groups showed statistical difference after the treatment than before (t=4.86 and 12.93,P <0.01).Conclusions Blood fat reducing wine can improve phlegm dampness constitution; Ziyin-Buxue wine can improve Yin deficiency constitution and enhance immune function; Guilu Erxian wine can lower blood pressure and improve Yang deficiency constitution.%目的 观察中医辨体养生理

  11. Does Regular Use of a Complementary Medicine of Olea Europe and Ficus carica Have Adverse Effects on Lipid Profile and Fasting Blood Glucose of Rheumatoid Arthritis (RA) Patients Under Treatment with DMARD Regimens Containing Methotrexate?

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    Bahadori, Shahnaz; Ahmadzadeh, Arman; Shams Ardekani, Mohammad Reza; Kamalinejad, Mohammad; Keshavarz, Mansoor; Salamzadeh, Jamshid

    2016-01-01

    Rheumatoid arthritis (RA) patients are vulnerable to cardiovascular morbidity and mortality in which atherosclerosis plays a major role. In this study, the lipid profile and fasting blood sugar (FBS) of RA patients receiving a complementary medicine of olive and fig, as add-on therapy for routine disease-modifying antirheumatic drugs (DMARDs) regimen containing low dose methotrexate (MTX), were studied. A randomized controlled clinical trial was designed. Adult RA patients were randomly allocated in two groups receiving routine DMARDs regimen (control group) and routine DMARDs regimen plus the herbal supplementary formulation of olive oil, fig and olive fruits (intervention group). Patients were followed every 4 weeks for total study period of 16 weeks. In addition to demographic and medical history of the patients, the total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), the atherogenic index of plasma (AIP) defined as log(TG/HDL-C), and the fasting blood sugar (FBS) were determined and recorded. 56 patients (control = 27 and intervention = 29), with mean ± sd age of 50.9 ± 12.3 years completed the study. Average MTX dose received by intervention and control groups were 24.30 ± 18.39 and 17.61 ± 15.53 mg/week, respectively (p = 0.11). Repeated measures analysis of variance (ANOVA) revealed that differences between lipid profile indicators and FBS in the two study groups were not statistically significant (P>0.05). No additional substantial adverse reaction was seen in the study groups. Our findings are more reassuring for patients and their doctors to trust on the safety of the investigated complementary preparation to be used as add-on therapy to manage rheumatoid arthritis.

  12. Internal Medical Regimen for Treatment of Cervical Vertigo by Integrative Medicine%中西医结合治疗颈性眩晕内科方案的研究

    Institute of Scientific and Technical Information of China (English)

    霍清萍; 梁芳; 魏德芝; 王宇新; 黄侃

    2013-01-01

    目的 探讨中西医结合治疗颈性眩晕内科方案,评估临床疗效.方法 将170例确诊为颈性眩晕的患者随机分为中西医结合(颈复汤低、中、高剂量分别联合西药倍他司汀)组,中药颈复汤中剂量组,西药倍他司汀对照组,共计5组,每组34例,疗程1周.临床观察指标:DHI眩晕障碍评分量表,眩晕缓解天数量表,症状视觉模拟评分(VAS评分).结果 治疗后中西医结合三组DHI眩晕障碍评分量表、眩晕缓解天数量表、症状积分比较均较中药对照组有统计学意义(P<0.05);低、中、高剂量三组间比较有统计学意义(P<0.05);中、高剂量组DHI眩晕障碍评分量表与症状积分较西药对照组有统计学意义(P<0.05).结论 中西医结合治疗方案优于单纯中药组和单纯西药组;中、高剂量组疗效优于低剂量组.中西医结合治疗颈性眩晕更有优势,是有效、安全、科学、规范、便捷、经济的内科综合诊疗方案.%Objective To study the internal medical regimen for treatment of cervical vertigo by integrative medicine. Methods One hundred and seventy patients with cervical vertigo were randomly assigned to integrative medicine group (treated by betahistine and Jingfu decoction with low, medium and high dose), Jingfu decoction group, and betahistine group. DHI vertigo disorder evaluation scale, stun mitigation day scale, symptoms of visual analog score (VAS) were observed. Results The therapeutic effects evaluated by DHI vertigo disorder evaluation scale, stun mitigation day scale, symptoms of VAS score in integrative medicine group was better than that in neck complex soup and betahistine group (P<0. 05). The therapeutic effect in low, medium and high dose of integrative medicine group were differences significantly (P<0. 05). The therapeutic effect evaluated by DHI vertigo disorder evaluation scale and symptoms of VAS score in medium and high dose group of integrative medicine group were better than that

  13. What to Start: Selecting a First HIV Regimen

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    HIV Treatment What to Start: Choosing an HIV Regimen (Last updated 2/24/2016; last reviewed 2/24/ ... of HIV medicines used to treat HIV infection. HIV treatment (also called antiretroviral therapy or ART) begins with ...

  14. Metronomic chemotherapy regimens in oncology

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    M. Yu. Fedyanin

    2016-01-01

    Full Text Available Metronomic chemotherapy implies the regular use of cytotoxic agents in doses much smaller than the maximum tolerable doses for a long time. Preclinical experiments show that this treatment option has a many-sided (antiangiogenic, immunostimulating, and direct cytotoxic effect on tumor. Moreover, this approach has gained the widest acceptance in treating patients with metastatic breast cancer in clinical practice. By taking into account the high activity of angiogenesis in colon cancer progression, it is interesting to study the impact of metronomic chemotherapy regimens for this nosological entity as well. This literature review considers not only the history of metronomic chemotherapy, the mechanisms of action, and a range of drugs having an antitumor effect in the metronomic regimens, but also analyzes clinical trials of metronomic chemotherapy regimens in patients with metastatic colon cancer.

  15. Clinical study of traditional Chinese medicines based on the regimen of psychosomatic mutual aid treatment in treatment of menstrual disorders women with diminished ovarian reserve%中医心身同治方案对卵巢储备功能下降妇女月经失调的临床疗效

    Institute of Scientific and Technical Information of China (English)

    陈玲; 王小云

    2014-01-01

    目的:观察中医心身同治方案对卵巢储备功能下降妇女月经失调的临床疗效。方法采取随机平行对照临床研究,将50例患者随机分为中医心身同治治疗组25例(中药+情志治疗),对照组25例,采用上市中成药逍遥丸+六味地黄丸治疗。治疗前后观察月经周期、经期、经量状况并对其进行评分量化。同时治疗前后均采用抑郁自评量表( SDS)、焦虑自评量表( SAS)对患者情绪情况进行量化比较。结果治疗后2组SDS评分、SAS均有改善,与治疗前比较差异有统计学意义( P<0.01)。治疗组在改善月经失调积分方面优于对照组,2组差异有统计学意义( P<0.01)。结论中医心身同治方案可以有效改善卵巢储备功能下降妇女月经失调状况,值得推广应用。%Objective To evaluate the clinical efficacy of traditional Chinese medicines based on the regimen of psychosomatic mutual aid treatment in treatment of menstrual disorders women with diminished ovarian reserve . Methods Fifty patients were enrolled and randomized into two groups,namely the experiment group ( using Chinese medicines plus Chinese psychosomatic mutual aid treatment) and the control group( using Xiao yao wan plus Liu wei di huang wan intervention ) . The menstrual cycle, menstrual period and the volume status were evaluated. The self-rating depression scale( SDS) and self-rating anxiety scale( SAS) were used to evaluate patients with emotional situation. Results SDS and SAS scores improved greatly in both groups compared with before treatment(P<0.01). The score of menstrual disorders in the treatment group was higher than that in the control group(P<0.01). Conclusion Chinese medicines based on the regimen of psychosomatic mutual aid treatment can effectively improve the menstrual disorders in women with diminished ovarian reserve,which may be widely applied.

  16. Establishment of TCM Standardized Therapeutic Regimen for Treating Tumor

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    林洪生

    2004-01-01

    @@ It has been of a long long history to treat tumor with traditional Chinese medicine (TCM), in the last 50years, Chinese medicine (CM) has been accepted by more and more medical professionals and patients, and used as one of the principal methods for treating tumor in China. But, tumor is a kind of disease with rapid progress and complicated causes, and applying CM in treating tumor has to meet some requirement, as improper application could induce contrary effects. To reduce the chance of blind and improper application of CM in the treatment of tumor, it is vital to work out a standardized therapeutic regimen that can be used as the guideline.

  17. Clinical observation on standardized integrative regimen in Chinese medicine for lumbar intervertebral disc hernia%规范有序的中医综合疗法治疗腰椎间盘突出症临床疗效观察

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    潘畅

    2011-01-01

    目的 观察规范有序的中医综合疗法治疗腰椎间盘突出症的临床疗效.方法 将184例患者按就诊顺序随机分为5组:A组采用电针+TDP照射+中药离子导入+推拿+牵引治疗,B组采用电针+TDP照射+中药离子导入+推拿治疗,C组采用电针+TDP照射+中药离子导入+牵引治疗,D组采用电针+TDP照射+推拿+牵引治疗,E组采用中药离子导入+推拿+牵引治疗;疗程15天,观察各组临床疗效.结果 A组的治愈率为81.58%,总有效率:94.74%,高于其余4组的治愈率和总有效率(P<0.01).结论 规范有序的中医综合疗法治疗腰椎间盘突出症可明显提高临床疗效.%Objective To observe the clinical efficacy of standardized integrative regimen in Chinese medicine in the treatment of lumbar intervertebral disc hernia. Methods A total of 184 cases were randomized into five groups by registration order: Group A was treated by electric acupuncture, TDP irradiation, herbal iron introduction, massage and traction, group B by electric acupuncture, TDP irradiation, herbal iron introduction and massage, group C by electric acupuncture,TDP irradiation, herbal iron introduction and traction, group D by electric acupuncture, TDP irradiation, massage and traction, and group E by herbal iron introduction, massage and traction; all groups were treated once a day for 15 days. Results The cure rate was 81.58% and the total effective rate was 94.74% in the group A, higher than those in the other four groups( P <0.01 ). Conclusion The standardized integrative regimen in Chinese medicine is quite effective for lumbar intervertebral disc hernia.

  18. Once-daily dose regimen of ribavirin is interchangeable with a twice-daily dose regimen: randomized open clinical trial

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    Balk JM

    2015-08-01

    Full Text Available Jiska M Balk,1 Guido RMM Haenen,1 Özgür M Koc,2 Ron Peters,3 Aalt Bast,1 Wim JF van der Vijgh,1 Ger H Koek,4 1Department of Toxicology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, 2Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 3DSM Resolve, Geleen, 4Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands Background: The combination of ribavirin (RBV and pegylated interferon (PEG-IFN is effective in the treatment of chronic hepatitis C infection. Reducing the frequency of RBV intake from twice to once a day will improve compliance and opens up the opportunity to combine RBV with new and more specific direct-acting agents in one pill. Therefore, the purpose of this study was to evaluate the pharmacokinetic profile of RBV in a once-daily to twice-daily regimen. The secondary aim was to determine tolerability as well as the severity and differences in side effects of both treatment regimens. Methods: In this randomized open-label crossover study, twelve patients with chronic type 1 hepatitis C infection and weighing more than 75 kg were treated with 180 µg of PEG-IFN weekly and 1,200 mg RBV daily for 24 weeks. The patients received RBV dosed as 1,200 mg once-daily for 12 weeks followed by RBV dosed as 600 mg twice-daily for 12 weeks, or vice versa. In addition to the pharmacokinetic profile, the hematological profile and side effects were recorded. The RBV concentrations in plasma were determined using liquid chromatography-tandem mass spectrometry. Results: Eight of twelve patients completed the study. Neither the time taken for RBV to reach peak plasma concentration nor the AUC0-last (adjusted for difference in dose was significantly different between the two groups (P>0.05. Furthermore, the once-daily regimen did not give more side effects than the twice-daily regimen (P>0

  19. Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients: A randomized controlled study

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    Asha Yadav

    2015-01-01

    Conclusions: Yoga regimen was found to improve lung functions and diffusion capacity in CAD patients besides improving cardiovascular functions. Thus, it can be used as a complimentary or adjunct therapy along with the conventional medicine for their treatment and rehabilitation.

  20. Effect of Chinese Medicine Comprehensive Regimen as the Maintenance Therapy on Time to Progression and Quality of Life of Patients with Advanced Non-small-cell Lung Cancer%中医综合方案维持治疗晚期非小细胞肺癌对疾病进展时间和生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    姜怡; 刘苓霜; 李春杰; 田建辉; 沈丽萍; 李和根

    2011-01-01

    目的 观察中医综合方案维持治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)对疾病进展时间(time to progression,TTP)和生活质量(quality of life,QOL)的影响.方法 采用前瞻性、随机、对照研究方法,将50例晚期NSCLC一线治疗后疾病无进展者按1∶1分为治疗组(中药制剂静脉滴注、中药汤剂口服及穴位敷贴联合应用的中医综合方案,25例)和对照组(单药维持化疗,25例),21天为1周期,治疗直至疾病进展或出现不能耐受的毒副反应或患者拒绝继续治疗.终点指标为TTP,次要指标为QOL.统计分析符合方案集,包括50例患者的TTP和43例患者2周期治疗前后的EORTC QLQ-LC43评分.结果 (1)治疗组较对照组延长TTP 23天,差异无统计学意义(87天vs64天,P=0.063);(2)治疗组患者QOL明显改善,EORTC QLQ-LC43中的各功能领域及总健康状况得分上升,各症状领域得分下降,除社会功能、认知功能、咽下困难、其他部位痛外,与对照组比较,差异均有统计学意义(P<0.05).结论 (1)中医综合方案维持治疗晚期NSCLC在延长TTP方面具有与单药维持化疗相当的疗效,在提高QOL方面更具优势.(2)需要扩大样本量进一步肯定中医药维持治疗晚期NSCLC的临床疗效.%Objective To observe the effect of Chinese medicine (CM) comprehensive regimen as the maintenance therapy (MT) on time to progression (TTP) and quality of life (QOL) of patients with advanced non-small-cell lung cancer (NSCLC). Methods The study was a prospective, randomized and controlled clinical trial. Fifty non-progressive patients with advanced NSCLC who responded to first-line therapy were randomized into the test group (25 cases, treated with CM comprehensive regimen: intravenous dripping of Chinese herbal preparation, oral administration of Chinese herbal decoction, and point application) and the control group [25 cases, treated with one of three single-agent maintenance chemotherapy regimens

  1. Sedation regimens for gastrointestinal endoscopy.

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    Moon, Sung-Hoon

    2014-03-01

    Sedation allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces a patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. Sedation is therefore considered by many endoscopists to be an essential component of gastrointestinal endoscopy. Endoscopic sedation by nonanesthesiologists is a worldwide practice and has been proven effective and safe. Moderate sedation/analgesia is generally accepted as an appropriate target for sedation by nonanesthesiologists. This focused review describes the general principles of endoscopic sedation, the detailed pharmacology of sedatives and analgesics (focused on midazolam, propofol, meperidine, and fentanyl), and the multiple regimens available for use in actual practice.

  2. Pharmacoeconomic analysis on six kinds of regimens using oral antidiabetic drugs in national essential medicines%国家基本药物中口服降糖药6种用药方案的药物经济学分析

    Institute of Scientific and Technical Information of China (English)

    江丽欢; 陈月婵; 霍彩凤

    2013-01-01

      目的:运用药物经济学方法评价国家基本药物中口服降糖药的6种用药方案治疗2型糖尿病的药物经济学效果,为治疗2型糖尿病的药物选择提供参考。方法:将我院2011年3月–2012年8月在门诊治疗的300例2型糖尿病患者平均分为6组,每组50例,分别给予二甲双胍(A组),格列齐特缓释胶囊(B组),格列美脲(C组),二甲双胍+格列本脲(D组),二甲双胍+格列美脲(E组),二甲双胍+格列齐特缓释胶囊(F组)进行治疗。观察12周后空腹血糖、餐后2 h血糖及HbA1c,利用成本-效果分析方法,比较其药物经济学效果。结果:治疗12周后,A、B、C、D、E、F组的成本分别为70.56、198.24、136.08、42.84、171.36、233.52元;总有效率分别为86.0%、88.0%、88.0%、84.0%、94.0%、92.0%。经过成本-效果分析,D组C/E为51.00,最小,E组ΔC/ΔE值为12.85,A组ΔC/ΔE值为13.86。结论:从药物经济学的角度分析,D组治疗2型糖尿病方案最经济,但是E组疗效最佳,单一用药方案中A组是最佳选择,在临床治疗中应根据具体情况合理选择。%  Objective:To evaluate the pharmacoeconomic effect on the six kinds of regimens using oral antidiabetic drugs in national essential medicines for treating type 2 diabetes mellitus, and provide reference for drug choice. Methods:A total of 300 type 2 diabetic patients in outpatient of our hospital collected from March 2011 to August 2012 were assigned into 6 groups with 50 cases in each group. Metformin (group A), gliclazide sustained release tablets (group B), glimepiride (group C), metformin and glibenclamide (group D), metformin and glimepiride (group E) and metformin and gliclazide sustained release tablets (group F) were given in different groups, respectively. The treatment effect was observed 12 weeks later by evaluating fasting blood glucose, postprandial 2 h blood glucose and HbA1c

  3. ON THE SELECTION OF DRUGS DOSAGE REGIMEN

    Directory of Open Access Journals (Sweden)

    E. N. Bochanova

    2015-09-01

    Full Text Available A complex system of hemostasis regulation, insufficient data on drugs pharmacokinetics, multiple factors effecting treatment, including patient’s adherence to therapy, that can lead to the need for the dosage regimen specification are presented.

  4. Prophylactic antibiotic regimens in tumour surgery (PARITY)

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hettwer, Werner H; Grum-Schwensen, Tomas

    2015-01-01

    -day regimen of post-operative antibiotics, in comparison to a 24-hour regimen, decreases surgical site infections in patients undergoing endoprosthetic reconstruction for lower extremity primary bone tumours. METHODS: We performed a pilot international multi-centre RCT. We used central randomisation......% at one year (the remainder with partial data or pending queries). In total, 18 participants missed at least one dose of antibiotics or placebo post-operatively, but 93% of all post-operative doses were administered per protocol. CONCLUSIONS: It is feasible to conduct a definitive multi-centre RCT of post-operative...... to conceal treatment allocation and sham antibiotics to blind participants, surgeons, and data collectors. We determined feasibility by measuring patient enrolment, completeness of follow-up, and protocol deviations for the antibiotic regimens. RESULTS: We screened 96 patients and enrolled 60 participants...

  5. Intravenous and intramuscular magnesium sulphate regimens in ...

    African Journals Online (AJOL)

    1993-09-03

    Sep 3, 1993 ... Pritchard' and a continuous intravenous (IV) infusion described by Zuspan! ... in the treatment of severe pre-eclampsia with the IM regimen of ..... people under the age of 50 years and more men died than women. In 40% of ...

  6. Classifying insulin regimens--difficulties and proposal for comprehensive new definitions.

    Science.gov (United States)

    Neu, A; Lange, K; Barrett, T; Cameron, F; Dorchy, H; Hoey, H; Jarosz-Chobot, P; Mortensen, H B; Robert, J-J; Robertson, K; de Beaufort, C

    2015-09-01

    Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.

  7. Nuclear Medicine

    Science.gov (United States)

    ... for Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive ... NIBIB-funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that ...

  8. "Rescue" regimens after Helicobacter pylori treatment failure

    Institute of Scientific and Technical Information of China (English)

    Javier P Gisbert

    2008-01-01

    Helicobacter pylori (H pylori)infection is the main cause of gastritis,gastroduodenal ulcer disease,and gastric cancer.After more than 20 years of experience in Hpylori treatment,in my opinion,the ideal regimen to treat this infection is still to be found.Currently,apart from having to know first-line eradication regimens well,we must also be prepared to face lyeatment failures.Therefore,in designing a treatment strategy we should not focus on the results of primary therapy alone,but also on the final (overall) eradication rate.The choice of a "rescue" treatment depends on which treatment is used initially.If a clarithromycinbased regimen was used initially,a subsequent metronidazole-based treatment (quadruple therapy)may be used afterwards,and then a levofloxacinbased combination would be a third "rescue" option.Alternatively,it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy,representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure,with the advantage of efficacy,simplicity and safety.In this case,a quadruple regimen may be reserved as a third-line rescue option.Finally,rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin.Even after two consecutive failures,several studies have demonstrated that H pylor/eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given.Therefore,the attitude in H pylori eradication therapy failure,even after two or more unsuccessful attempts,should be to fight and not to surrender.

  9. New Treatment Regimen for Latent Tuberculosis Infection

    Centers for Disease Control (CDC) Podcasts

    2012-03-15

    In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses the December 9, 2011 CDC guidelines for the use of a new regimen for the treatment of persons with latent tuberculosis infection.  Created: 3/15/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/15/2012.

  10. Assessment of adherence to tuberculosis drug regimen

    Directory of Open Access Journals (Sweden)

    Khalili H.

    2008-03-01

    Full Text Available Background and the purpose of the study: Tuberculosis is curable if patients take sufficient uninterrupted therapy. Most experts acknowledge importance of patient adherence in efforts to control of the disease. This cross-sectional study was designed to evaluate the rate of compliance to anti-tuberculosis regimens by means of urine tests in newly diagnosed tuberculosis patients.Method: Investigation was carried out in Tehran University of Medical Sciences Teaching Hospitals, Tehran, IRAN. Fifty patients completed the study. The patients' urine samples were obtained at 0, 1, 2, 4 and 6 months of the study. Simple chemical methods were used to detect Isoniazid, Rifampin, and pyrazinamide, the three main drugs in tuberculosis treatment regimens. Urine tests at months of 0 and l of the study were considered as control tests.Results: After the first month, the patients' compliance was about 96%. At months of second, fourth and sixth, the whole adherence rates were 56 %, 76% and 81% respectively. Conclusion: About 30% of patients were non-compliant with treatment regimen which was more frequent than presumed; therefore detection of non-adherent patients is an essential subject in developing countries.

  11. Review of basal-plus insulin regimen options for simpler insulin intensification in people with Type 2 diabetes mellitus.

    Science.gov (United States)

    Raccah, D; Huet, D; Dib, A; Joseph, F; Landers, B; Escalada, J; Schmitt, H

    2017-09-01

    To identify simple insulin regimens for people with Type 2 diabetes mellitus that can be accepted and implemented earlier in primary and specialist care, taking into consideration each individual's needs and capabilities. Using randomized clinical trials identified by a search of the PubMed database, as well as systematic reviews, meta-analyses and proof-of-concept studies, this review addresses topics of interest related to the progressive intensification of a basal insulin regimen to a basal-plus regimen (one basal insulin injection plus stepwise addition of one to three preprandial short-acting insulin injections/day) vs a basal-bolus regimen (basal insulin plus three short-acting insulin injections per day) in people with Type 2 diabetes. The review explores approaches that can be used to define the meal for first prandial injection with basal-plus regimens, differences among insulin titration algorithms, and the importance of self-motivation and autonomy in achieving optimum glycaemic control. A basal-plus regimen can provide glycaemic control equivalent to that obtained with a full basal-bolus regimen, with fewer injections of prandial insulin. The first critical step is to optimize basal insulin dosing to reach a fasting glucose concentration of ~6.7 mmol/l; this allows ~40% of patients with baseline HbA1c >75 mmol/mol (9%) to be controlled with only one basal insulin injection per day. Compared with a basal-bolus regimen, a basal-plus insulin regimen is as effective but more practical, and has the best chance of acceptance and success in the real world. © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  12. Improving adherence to medical regimens for juvenile rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Lindsley Carol B

    2007-05-01

    Full Text Available Abstract Poor adherence to medical regimens can compromise the efficacy of treatments for children and adolescents with juvenile rheumatoid arthritis (JRA. The purpose of this review is to describe medical regimens for the treatment of JRA and the rates of adherence to these regimens. We also summarize and critically the few research studies aimed at improving adherence to regimens for JRA. Finally, we summarize strategies for enhancing adherence in clinical practice.

  13. Relationship among Translational Medicine, Evidence-Based Medicine and Precision Medicine

    Directory of Open Access Journals (Sweden)

    Xin-en HUANG

    2016-03-01

    Full Text Available Translational medicine is a new concept in international medical field. It integrates experimental research results and clinical guidance into the optimal implementation criteria for promoting the prediction, prevention and treatment of diseases. Based on people’s higher demand for medicine and health, appearance of translational medicine changes the mode of medical research.Evidence-based medicine (EBM refers to cautious and accurate application of the current best research evidence and combination of the clinician’s professional skills and abundant clinical experience to consider the patients willing and value, consequently making the best diagnostic regimens for patients. Recently, some scholars have begun to question why the patients with the same diagnosis, course of disease and pathological condition have different efficacies and prognosis after treatment with the same drug. So far, an accurate answer cannot be given based on the research data of EBM to implement translational medicine. The concept of precision medicine is accepted gradually with the development of disease management model. In this study, practice and enlightenment of translational medicine, effect of EBM on translational medicine, EBM limitations as well as emergence and development trend of precision medicine were all reviewed in order to investigate the relationship among translational medicine, EBM and precision medicine.

  14. Relationship among Translational Medicine, Evidence-Based Medicine and Precision Medicine

    Institute of Scientific and Technical Information of China (English)

    HUANG Xin-en

    2016-01-01

    Translational medicine is a new concept in international medical ifeld. It integrates experimental research results and clinical guidance into the optimal implementation criteria for promoting the prediction, prevention and treatment of diseases. Based on people’s higher demand for medicine and health, appearance of translational medicine changes the mode of medical research. Evidence-based medicine (EBM) refers to cautious and accurate application of the current best research evidence and combination of the clinician’s professional skills and abundant clinical experience to consider the patients willing and value, consequently making the best diagnostic regimens for patients. Recently, some scholars have begun to question why the patients with the same diagnosis, course of disease and pathological condition have different efifcacies and prognosis after treatment with the same drug. So far, an accurate answer cannot be given based on the research data of EBM to implement translational medicine. The concept of precision medicine is accepted gradually with the development of disease management model. In this study, practice and enlightenment of translational medicine, effect of EBM on translational medicine, EBM limitations as well as emergence and development trend of precision medicine were all reviewed in order to investigate the relationship among translational medicine, EBM and precision medicine.

  15. Medication regimen complexity in ambulatory older adults with heart failure

    Directory of Open Access Journals (Sweden)

    Cobretti MR

    2017-04-01

    Full Text Available Michael R Cobretti,1 Robert L Page II,2 Sunny A Linnebur,2 Kimberly M Deininger,1 Amrut V Ambardekar,3 JoAnn Lindenfeld,4 Christina L Aquilante1 1Department of Pharmaceutical Sciences, 2Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, 3Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO, 4Advanced Heart Failure and Cardiac Transplant Program, Vanderbilt Heart and Vascular Institute, Nashville, TN, USA Purpose: Heart failure prevalence is increasing in older adults, and polypharmacy is a major problem in this population. We compared medication regimen complexity using the validated patient-level Medication Regimen Complexity Index (pMRCI tool in “young-old” (60–74 years versus “old-old” (75–89 years patients with heart failure. We also compared pMRCI between patients with ischemic cardiomyopathy (ISCM versus nonischemic cardiomyopathy (NISCM.Patients and methods: Medication lists were retrospectively abstracted from the electronic medical records of ambulatory patients aged 60–89 years with heart failure. Medications were categorized into three types – heart failure prescription medications, other prescription medications, and over-the-counter (OTC medications – and scored using the pMRCI tool.Results: The study evaluated 145 patients (n=80 young-old, n=65 old-old, n=85 ISCM, n=60 NISCM, mean age 73±7 years, 64% men, 81% Caucasian. Mean total pMRCI scores (32.1±14.4, range 3–84 and total medication counts (13.3±4.8, range 2–30 were high for the entire cohort, of which 72% of patients were taking eleven or more total medications. Total and subtype pMRCI scores and medication counts did not differ significantly between the young-old and old-old groups, with the exception of OTC medication pMRCI score (6.2±4 young-old versus 7.8±5.8 old-old, P=0.04. With regard to heart failure etiology, total pMRCI scores and medication

  16. Mesenteric panniculitis: Various presentations and treatment regimens

    Institute of Scientific and Technical Information of China (English)

    Iyad Issa; Hassan Baydoun

    2009-01-01

    Mesenteric panniculitis is a rare, benign and chronic fibrosing inflammatory disease that affects the adipose tissue of the mesentery of the small intestine and colon. The specific etiology of the disease is unknown. The diagnosis is suggested by computed tomography and is usually confirmed by surgical biopsies. Treatment is empirical and based on a few selected drugs. Surgical resection is sometimes attempted for definitive therapy, although the surgical approach is often limited. We report two cases of mesenteric panniculitis with two different presentations and subsequently varying treatment regimens. Adequate response was obtained in both patients. We present details of these cases as well as a literature review to compare various presentations, etiologies and potential treatment modalities.

  17. Sasang Constitutional Medicine and Traditional Chinese Medicine: A Comparative Overview

    Directory of Open Access Journals (Sweden)

    Junghee Yoo

    2012-01-01

    Full Text Available Sasang constitutional medicine (SCM is a holistic typological constitution medicine which balances psychological, social, and physical aspects of an individual to achieve wellness and increase longevity. SCM has the qualities of preventative medicine, as it emphasizes daily health management based on constitutionally differentiated regimens and self-cultivation of the mind and body. This review's goal is to establish a fundamental understanding of SCM and to provide a foundation for further study. It compares the similarities and differences of philosophical origins, perspectives on the mind (heart, typological systems, pathology, and therapeutics between SCM and traditional Chinese medicine (TCM. TCM is based on the Taoist view of the universe and humanity. The health and longevity of an individual depends on a harmonious relationship with the universe. On the other hand, SCM is based on the Confucian view of the universe and humanity. SCM focuses on the influence of human affairs on the psyche, physiology, and pathology.

  18. Aerospace Medicine

    Science.gov (United States)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  19. Nuclear Medicine.

    Science.gov (United States)

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  20. Use and Safety of Respiratory Medicines in Children

    NARCIS (Netherlands)

    E.F. Sen (Fatma)

    2011-01-01

    textabstractThe lack of appropriately authorised and formulated medicines for use in the pediatric population is a longstanding problem and cause for concern. As a result, most medicines are prescribed to children on an off -label or an unlicensed basis. Dosing regimens approved for adults are extra

  1. Determining optimal dosing regimen of oral administration of dicloxacillin using Monte Carlo simulation

    Directory of Open Access Journals (Sweden)

    Yu W

    2017-06-01

    Full Text Available Wei Yu,1,2,* Jinru Ji,1,* Tingting Xiao,1 Chaoqun Ying,1 Jiaheng Fang,3 Ping Shen,1 Yonghong Xiao1 1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 2Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, 3Department of Gastroenterology, Hang Zhou Normal University Affiliated Hospital, Hangzhou, People’s Republic of China *These authors contributed equally to this work Background: Dicloxacillin, a semisynthetic isoxazolyl penicillin, exhibits antimicrobial activity against a wide variety of Gram-positive bacteria, as well as stability against penicillinases and low level of toxicity. The objective of this study was to obtain optimal dosing regimen of oral administration of dicloxacillin by analyzing the pharmacokinetic (PK index in healthy volunteers and in vitro antibacterial activity by using Monte Carlo simulation. Materials and methods: A total of 867 clinical isolates from community-onset infections were collected from 31 secondary hospitals in People’s Republic of China. The minimum inhibitory concentration (MIC values of dicloxacillin were determined by the agar dilution method. Based on the MICs and the PK parameters of different dosage regimens, Monte Carlo simulation was performed to simulate the PK/pharmacodynamic indices of 250 mg once-daily (qd, 500 mg qd, 1,000 mg qd, 2,000 mg qd, 250 mg every 6 hours (q6h, and 500 mg q6h, respectively. The probability of target attainment was estimated at each MIC value, and the cumulative fraction of response (CFR was calculated to evaluate the efficacy of these regimens. Results: Dicloxacillin showed poor antibacterial activity against Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae. Resistance to dicloxacillin was observed in 7.5% of coagulase

  2. The Sex Res Non Naturales and the Regimen of Health

    DEFF Research Database (Denmark)

    Agerholm, Frank Juul

    2013-01-01

    The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle......The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle...

  3. Adherence to asthma controller medication regimens.

    Science.gov (United States)

    Stempel, D A; Stoloff, S W; Carranza Rosenzweig, J R; Stanford, R H; Ryskina, K L; Legorreta, A P

    2005-10-01

    Improved adherence to inhaled corticosteroids (ICS) is recognized as an important factor in reduced morbidity, mortality and consumption of health care resources. The present study was designed to replicate previous reports of patient adherence with fluticasone/salmeterol in a single inhaler (FSC), fluticasone and salmeterol in separate inhalers (FP+SAL), fluticasone and montelukast (FP+MON), fluticasone alone (FP) and montelukast alone (MON). A 24-month observational retrospective study was conducted using administrative claims data. Subjects were 12 years old with 24 months of continuous enrollment; had 1 asthma claim (ICD-9: 493), 1 short-acting beta(2)-agonist claim, and 1 FSC, FP, SAL, or MON claim. Outcomes included asthma medication refill rates and persistence measured by treatment days. This study was designed with a unique population of patients with asthma from different health plans to validate previous findings. A total of 3,503 subjects were identified based on their index medication: FSC (996), FP+SAL (259), FP+MON (101), FP (1254) and MON (893). Mean number of prescription refills for FSC (3.98) was significantly higher than FP (2.29) and the FP component of FP+SAL (2.36), and FP+MON (2.15), P<0.05. No significant differences were observed between FSC and MON fill rates (4.33). Mean number of treatment days was greater for FSC compared to FP, FP+SAL, and FP+MON (P<0.0001). This study confirms a previous report that adherence profiles of fluticasone and salmeterol in a single inhaler are significantly better when compared to the controller regimens of fluticasone and salmeterol in separate inhalers, fluticasone and montelukast, or fluticasone alone and similar to montelukast alone.

  4. Among once-daily regimens, single tablet regimens (STRs are associated with better adherence

    Directory of Open Access Journals (Sweden)

    R Murri

    2012-11-01

    Full Text Available Previous published evidences showed that taking HAART once-daily (OD is associated to better adherence when compared to BID or TID regimens. However, no further studies investigated whether, among OD regimens, adherence levels can be differently influenced. Aim of the study was to evaluate levels of self-reported adherence in HIV+ people according to type of HAART dosing (STR, OD with more than one pill or BID. To limit reporting biases, the study was performed in five different non-clinic settings covering North and Central Italy. A total of 230 patients on stable HAART were asked to complete a semi-structured, anonymous questionnaire reporting their attitude toward HAART, their adherence and the acceptability of their regimen. Self-perception of adherence was also investigated with a single item for comparison with real adherence behavior. Most of the subjects were males (66% with a mean age of 46 years, with higher education level (72% and a long history of HIV infection (mean 13.6 years. 17% of patients were on a first-line regimen. 21% reported to miss at least one dose during the past week (STR: 6%; OD >1 pill 23% and BID 21%; p<0.05. People taking STR and BID tend to report less discontinuations (all the drug of the day for at least 3 times in a month compared to OD>1 pill (6 and 4% vs 11%. People taking therapies other than HAART reported similar adherence levels of people taking only HAART, even when stratified for dosing groups. Even people judging their adherence as ‘optimal’ or ‘very good’, 10 and 17% respectively, reported having missed a dose during the last week. At stepwise regression model, optimal adherence was correlated to being male (OR: 2.38; 95% CI: 1.19–4.74, younger (OR: 3.04; 95% CI: 1.01–9.13 and with a shorter HIV infection (OR: 3.58; 95% CI: 1.04–12.38. People taking simpler once-daily STR tend to report better adherence than people taking OD>1 pill or BID. Perception of optimal adherence is largely

  5. STUDY OF EFFICACY OF LOW DOSE MAGNESIUM SULPHATE REGIMEN (DHAKA REGIMEN AS COMPARED TO STANDARD REGIMEN (PRITCHARD IN THE MANAGEMENT OF ECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Prosun

    2015-07-01

    Full Text Available BACKGROUND : Eclampsia is one of the most important cause of maternal mortality and morbidity worldwide Dr . J . A . Pritchard in 1955 , introduced magnesium sulphate for control of convulsions in eclampsia and now magnesium sulfate is the anticonvulsant drug of choice for both prevention and treatment of eclampsia , but due to its narrow therapeutic window its dose - related toxicity is a major concern . Considering the lower body weight of Indian women than wes tern counter part , different low dose magnesium sulphate regime has been formulated in different parts of India and Bangladesh and these modifications appeared to reduce drug toxicity . The Objective was to compare the efficacy of low dose magnesium sulphat e regimen ( Dhaka regimen with standard Pritchard’s regimen for management of eclampsia . METHODS: This was a hospital based prospective study conducted in the Dept . of O & G of VSSMCH , Burla from Oct . 2012 to S ept . 2014 . Total 300 patients with eclampsia were included in study and randomly distributed into two groups containing 150 patients each in both Dhaka & Pritchard groups . The statistical software SPSS version 20 has been used for the analysis . An alpha error of 5% has been taken as significant . RESU LTS: In the present study , there is no recurrence of convulsion among both the groups . The Dhaka regimen was associated with significantly lower deep tendon reflex loss ( 2 . 67% vs 8 . 0%; P =0 . 040 , significantly lower total amount of Mgso4 requirement , and lower maternal mortality ( 3 . 33% vs 6 . 67%; P = 0 . 185 as compared with the standerd Pritchard regimen . CONCLUSIONS : The maternal morbidity and mortality in the present study were comparable to those of standard Pritchard’s regimen . The Dhaka regimen was equ ally effective and more safe for the management of eclampsia in a region where most women are of low body weight KEYWORDS: Antepartum E clampsia ; Magnesium S ulphate; Dhaka R egimen; Pritchard R

  6. Treatment-time regimen of hypertension medications significantly affects ambulatory blood pressure and clinical characteristics of patients with resistant hypertension.

    Science.gov (United States)

    Hermida, Ramón C; Ríos, María T; Crespo, Juan J; Moyá, Ana; Domínguez-Sardiña, Manuel; Otero, Alfonso; Sánchez, Juan J; Mojón, Artemio; Fernández, José R; Ayala, Diana E

    2013-03-01

    Patients with resistant hypertension (RH) are at greater risk for stroke, renal insufficiency, and cardiovascular disease (CVD) events than are those for whom blood pressure (BP) is responsive to and well controlled by therapeutic interventions. Although all chronotherapy trials have compared the effects on BP regulation of full daily doses of medications when ingested in the morning versus at bedtime, prescription of the same medications in divided doses twice daily (BID) is frequent. Here, we investigated the influence of hypertension treatment-time regimen on the circadian BP pattern, degree of BP control, and relevant clinical and laboratory medicine parameters of RH patients evaluated by 48-h ambulatory BP monitoring (ABPM). This cross-sectional study evaluated 2899 such patients (1701 men/1198 women), 64.2 ± 11.8 (mean ± SD) yrs of age, enrolled in the Hygia Project. Among the participants, 1084 were ingesting all hypertension medications upon awakening (upon-awakening regimen), 1436 patients were ingesting the full daily dose of ≥1 of them at bedtime (bedtime regimen), and 379 were ingesting split doses of ≥1 medications BID upon awakening and at bedtime (BID regimen). Patients of the bedtime regimen compared with the other two treatment-time regimens had lower likelihood of microalbuminuria and chronic kidney disease; significantly lower albumin/creatinine ratio, glucose, total cholesterol, and low-density lipoprotein (LDL) cholesterol; plus higher estimated glomerular filtration rate and high-density lipoprotein (HDL) cholesterol. The bedtime regimen was also significantly associated with lower asleep systolic (SBP) and diastolic (DBP) BP means than the upon-awakening and BID regimens. The sleep-time relative SBP and DBP decline was significantly attenuated by the upon-awakening and BID regimens (p pattern, associated with highest CVD risk, was much greater, 31.0% and 29.8%, respectively, among patients of the upon-awakening and BID

  7. Saúde e dietética na medicina preventiva medieval: o regimento de saúde de Pedro Hispano (século XIII Health and dietetics in medieval preventive medicine: the health regimen of Peter of Spain (thirteenth century

    Directory of Open Access Journals (Sweden)

    Dulce O. Amarante dos Santos

    2010-06-01

    Full Text Available Analisa o Livro sobre a conservação da saúde, obra médica preventiva, composta no século XIII pelo físico/médico português Pedro Hispano (?1210-1277, que nos permite observar as concepções de saúde e higiene e compreender o papel social dos físicos universitários na medicina preventiva medieval. A obra mostra sempre a noção de equilíbrio na saúde corporal entre os elementos internos, as coisas naturais (compleição, por exemplo, e os externos, as coisas não naturais (ar, sono, exercício, alimentos, banhos, paixões da alma.This text is an analysis of a preventive medical work, Liber de conservanda sanitate, composed in the thirteenth century by the Portuguese physician and doctor, Peter of Spain (?1210-1277. His work enables us to look at the conceptions of health and hygiene and understand the social role of university physicians in medieval preventive medicine. The work constantly displays the notion of the balance in corporal health between internal elements, or natural things (complexion, for example, and external ones, or non-natural things (air, sleep, exercise, food, baths, passions of the soul.

  8. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Song; Jian Liu; Li-Ya Zhou

    2016-01-01

    Objective:Helicobacterpylori (H.pylori) eradication remains a challenge with increasing antibiotic resistance.Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety.However,many issues on hybrid therapy are still unclear such as the eradication efficacy,safety,compliance,influencing factors,correlation with antibiotic resistance,and comparison with other regimens.Therefore,a comprehensive review on the evidence of hybrid therapy for H.pylori infection was conducted.Data Sources:The data used in this review were mainly from PubMed articles published in English up to September 30,2015,searching by the terms of"Helicobacterpylori" or "H.pylori",and "hybrid".Study Selection:Clinical research articles were selected mainly according to their level of relevance to this topic.Results:Totally,1871 patients of 12 studies received hybrid therapy.The eradication rates were 77.6-97.4% in intention-to-treat and 82.6-99.1% in per-protocol analyses.Compliance was 93.3-100.0%,overall adverse effects rate was 14.5-67.5%,and discontinued medication rate due to adverse effects was 0-6.7%.H.pylori culture and sensitivity test were performed only in 13.3% patients.Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible,isolated metronidazole or clarithromycin resistance,and dual clarithromycin and metronidazole resistance were 98.5%,97.6%,92.9%,and 80.0%,respectively.Overall,the efficacy,compliance,and safety of hybrid therapy were similar with sequential or concomitant therapy.However,hybrid therapy might be superior to sequential therapy in Asians.Conclusions:Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions.Dual clarithromycin and metronidazole resistance were the key factor to efficacy.Hybrid therapy was similar to sequential or concomitant therapy in the efficacy,safety,and compliance.

  9. Alternative Medicine

    Science.gov (United States)

    ... Involved News About Us Donate In This Section Alternative Medicine en Español email Send this article to a ... Dr. Yvonne Ou on Lifestyle Modifications and Glaucoma Alternative medicine may be defined as non-standard, unconventional treatments ...

  10. Diabetes Medicines

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  11. Herbal Medicine

    Science.gov (United States)

    ... for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are ... and fresh or dried plants. People use herbal medicines to try to maintain or improve their health. ...

  12. Controlled-protein dietary regimens for Parkinson's disease.

    Science.gov (United States)

    Cereda, Emanuele; Barichella, Michela; Pezzoli, Gianni

    2010-02-01

    Continuous levodopa replacement still is the most efficacious treatment for patients with Parkinson's disease. Unfortunately, the neutral aromatic amino acids contained in dietary proteins may compete with this drug for intestinal absorption and transport across the blood-brain barrier, thus limiting its efficacy and being responsible for the occurrence of motor fluctuations. Current guidelines recommend low-protein dietary regimens with protein redistribution, as shifting protein intake to the evening has proved to ameliorate the response to levodopa. However, adherence to this dietary regimen does not seem to be satisfactory and response is variable. Recent studies have shown that low-protein products designed for chronic renal failure patients are safe, tasty, well-tolerated and useful in improving both adherence to low-protein dietary regimens and levodopa-related motor fluctuations. However, there still is the need to define the selection criteria for the patients who may benefit the most from adherence to this regimen.

  13. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

    Science.gov (United States)

    A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.

  14. Single-tablet regimens (STRs enhance patients’ acceptability of HAART

    Directory of Open Access Journals (Sweden)

    F Maggiolo

    2012-11-01

    Full Text Available Patients’ acceptability of HAART is a subjective variable that may deeply influence therapeutic outcome. The feeling of the patient may alter adherence and lead to virologic failure. Acceptability may depend on various variables often difficulty evaluated by the care-giver. In a clinical setting the evaluation of acceptability is difficult, too, as patients may feel a judgement and be less sincere. Aim of this study was to asses adherence and acceptability of HAART. To limit reporting biases, the study was performed in five different non-clinic settings covering North and Central Italy. A total of 230 patients on stable HAART were asked to complete a semi-structured, anonymous questionnaire reporting their attitude toward HAART, their adherence and the acceptability of their regimen. In these notes we focus on this last patient-oriented outcome. Most of the subjects were males (66% with a mean age of 46 years, with higher education level (72% and a long history of HIV infection (mean 13.6 years. Consequently only 17% of patients were on a first-line regimen. Patients reporting a high or very high acceptability of HAART were 60% compared to a 31% reporting a fair grade of satisfaction and a 9% indicating low or null acceptability. However the type of the regimen significantly influenced patients’ acceptability. Single-tablet regimens (STRs, OD regimens with more than one tablet/day or BID regimens were scored as highly acceptable in 84%; 61%; and 53% of cases, respectively (P < 0.0001 (Figure. Statistical significance was retained when the dosing schedule was entered in a multivariate logistic model. When the analysis was restricted to experienced patients 62% of them were currently on a regimen based on a reduced number of pills compared to the previous one. Patients scored the previous regimen as more difficult to comply with in 72% of cases; as difficult in 22% and less difficult in 6%. The eventuality of AEs (40%; respect of timing of

  15. Induction regimens for transplant-eligible patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Zeng ZH

    2017-07-01

    Full Text Available Zi-Hang Zeng,1,2 Jia-Feng Chen,1,2 Yi-Xuan Li,1,2 Ran Zhang,1,2 Ling-Fei Xiao,1,2 Xiang-Yu Meng1,2 1Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, 2Department of Evidence-Based Medicine and Clinical Epidemiology, Second Clinical College of Wuhan University, Wuhan, People’s Republic of China Objective: The aim of this study was to compare the early efficacy and survivals of induction regimens for transplant-eligible patients with untreated multiple myeloma. Materials and methods: A comprehensive literature search in electronic databases was conducted for relevant randomized controlled trials (RCTs. Eligible studies were selected according to the predefined selection criteria, before they were evaluated for methodological quality. Basic characteristics and data for network meta-analysis (NMA were extracted from included trials and pooled in our meta-analysis. The end points were the overall response rate (ORR, progression-free survival (PFS, and overall survival (OS. Results: A total of 14 RCTs that included 4,763 patients were analyzed. The post-induction ORR was higher with bortezomib plus thalidomide plus dexamethasone (VTD regimens, and VTD was better than the majority of other regimens. For OS, VTD plus cyclophosphamide (VTDC regimens showed potential superiority over other regimens, but the difference was not statistically significant. The PFS was longer with thalidomide plus doxorubicin plus dexamethasone (TAD regimens for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM. Conclusion: The NMA demonstrated that the VTD, VTDC, and TAD regimens are most beneficial in terms of ORR, OS, and PFS for transplant-eligible patients with NDMM, respectively. Keywords: multiple myeloma, newly diagnosed, transplant-eligible, induction therapies, network meta-analysis

  16. Hypofractionation regimens for stereotactic radiotherapy for large brain tumors.

    Science.gov (United States)

    Yuan, Jiankui; Wang, Jian Z; Lo, Simon; Grecula, John C; Ammirati, Mario; Montebello, Joseph F; Zhang, Hualin; Gupta, Nilendu; Yuh, William T C; Mayr, Nina A

    2008-10-01

    To investigate equivalent regimens for hypofractionated stereotactic radiotherapy (HSRT) for brain tumor treatment and to provide dose-escalation guidance to maximize the tumor control within the normal brain tolerance. The linear-quadratic model, including the effect of nonuniform dose distributions, was used to evaluate the HSRT regimens. The alpha/beta ratio was estimated using the Gammaknife stereotactic radiosurgery (GKSRS) and whole-brain radiotherapy experience for large brain tumors. The HSRT regimens were derived using two methods: (1) an equivalent tumor control approach, which matches the whole-brain radiotherapy experience for many fractions and merges it with the GKSRS data for few fractions; and (2) a normal-tissue tolerance approach, which takes advantages of the dose conformity and fractionation of HSRT to approach the maximal dose tolerance of the normal brain. A plausible alpha/beta ratio of 12 Gy for brain tumor and a volume parameter n of 0.23 for normal brain were derived from the GKSRS and whole-brain radiotherapy data. The HSRT prescription regimens for the isoeffect of tumor irradiation were calculated. The normal-brain equivalent uniform dose decreased as the number of fractions increased, because of the advantage of fractionation. The regimens for potential dose escalation of HSRT within the limits of normal-brain tolerance were derived. The designed hypofractionated regimens could be used as a preliminary guide for HSRT dose prescription for large brain tumors to mimic the GKSRS experience and for dose escalation trials. Clinical studies are necessary to further tune the model parameters and validate these regimens.

  17. Oxytocin regimen for labor augmentation, labor progression, and perinatal outcomes.

    Science.gov (United States)

    Zhang, Jun; Branch, D Ware; Ramirez, Mildred M; Laughon, S Katherine; Reddy, Uma; Hoffman, Mathew; Bailit, Jennifer; Kominiarek, Michelle; Chen, Zhen; Hibbard, Judith U

    2011-08-01

    To examine the effects and safety of high-dose (compared with low-dose) oxytocin regimen for labor augmentation on perinatal outcomes. Data from the Consortium on Safe Labor were used. A total of 15,054 women from six hospitals were eligible for the analysis. Women were grouped based on their oxytocin starting dose and incremental dosing of 1, 2, and 4 milliunits/min. Duration of labor and a number of maternal and neonatal outcomes were compared among these three groups stratified by parity. Multivariable logistic regression and generalized linear mixed model were used to adjust for potential confounders. Oxytocin regimen did not affect the rate of cesarean delivery or other perinatal outcomes. Compared with 1 milliunit/min, the regimens starting with 2 milliunits/min and 4 milliunits/min reduced the duration of first stage by 0.8 hours (95% confidence interval 0.5-1.1) and 1.3 hours (1.0-1.7), respectively, in nulliparous women. No effect was observed on the second stage of labor. Similar patterns were observed in multiparous women. High-dose regimen was associated with a reduced risk of meconium stain, chorioamnionitis, and newborn fever in multiparous women. High-dose oxytocin regimen (starting dose at 4 milliunits/min and increment of 4 millliunits/min) is associated with a shorter duration of first-stage of labor for all parities without increasing the cesarean delivery rate or adversely affecting perinatal outcomes. II.

  18. Development of antibiotic regimens using graph based evolutionary algorithms.

    Science.gov (United States)

    Corns, Steven M; Ashlock, Daniel A; Bryden, Kenneth M

    2013-12-01

    This paper examines the use of evolutionary algorithms in the development of antibiotic regimens given to production animals. A model is constructed that combines the lifespan of the animal and the bacteria living in the animal's gastro-intestinal tract from the early finishing stage until the animal reaches market weight. This model is used as the fitness evaluation for a set of graph based evolutionary algorithms to assess the impact of diversity control on the evolving antibiotic regimens. The graph based evolutionary algorithms have two objectives: to find an antibiotic treatment regimen that maintains the weight gain and health benefits of antibiotic use and to reduce the risk of spreading antibiotic resistant bacteria. This study examines different regimens of tylosin phosphate use on bacteria populations divided into Gram positive and Gram negative types, with a focus on Campylobacter spp. Treatment regimens were found that provided decreased antibiotic resistance relative to conventional methods while providing nearly the same benefits as conventional antibiotic regimes. By using a graph to control the information flow in the evolutionary algorithm, a variety of solutions along the Pareto front can be found automatically for this and other multi-objective problems.

  19. [Expedition medicine].

    Science.gov (United States)

    Donlagić, Lana

    2009-01-01

    Expedition and wildeness medicine is a term that combines rescue medicine, sport medicine as well as more specific branches as polar or high altitude medicine. It is being intensively studied both at the reaserch institutes and on expeditions. Ophtalmologists are concentrated on the reaserch of HARH (High Altitude Retinal Hemorrhage), neurologists on HACE reaserch (High Altitude Cerebral Edema), psychologists are developing tests to decsribe cognitive functions and many physicians are being trained to work in extreme enviroment. The result of all this effort are numerous new findings in pathophysiology and therapy of altitude illness, increased security on expedition and further development of expeditionism.

  20. From Evidence Based Medicine to Medicine Based Evidence.

    Science.gov (United States)

    Horwitz, Ralph I; Hayes-Conroy, Allison; Caricchio, Roberto; Singer, Burton H

    2017-07-12

    Evidence based medicine, using randomized controlled trials and meta-analyses as the major tools and sources of evidence about average results for heterogeneous groups of patients, developed as a reaction against poorly designed observational treatment research and physician reliance on personal experience with other patients as a guide to decision-making about a patient at hand. However, these tools do not answer the clinician's question: "Will a given therapeutic regimen help my patient at a given point in her/his clinical course?" We introduce fine-grained profiling of the patient at hand, accompanied by comparative evidence of responses from approximate matches to this patient on whom a contemplated treatment has/has not been administered. This represents medicine based evidence that is tuned to decision-making for the particular patient. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Characteristics of HIV antiretroviral regimen and treatment adherence

    Directory of Open Access Journals (Sweden)

    Vera Lúcia da Silveira

    2003-06-01

    Full Text Available The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demographic variables were collected through direct questionnaires. The antiretroviral regimen and clinical data were copied from the patients' records. Associations between the independent variables and adherence were analyzed by means of logistic regression. The multivariate analysis included characteristics of the antiretroviral regimens, social-demographic variables, as well as perception of negative effects, negative physiological states, and adverse effects of the treatment. Among the 224 selected patients, 194 participated in our study. Their ages varied from 17 to 67 years; most patients were men, with few years of schooling and a low family income. Only 49% adhered to the treatment. Adherence to treatment regimens was reduced when more daily doses were indicated: three to four doses (odds ratio of adherence to treatment (OR=0.47, 95% confidence interval (CI 0.22-1.01 and five to six (OR=0.24, 95% CI 0.09-0.62; two or more doses taken in a fasting state (OR=0.59, 95% CI 0.11-0.68, and for patients who reported adverse effects to the treatment (OR=0.39, 95% CI 0.19-0.77. Most of the regimens with more than two daily doses of medication included at least one dose apart from mealtimes. The results suggest that, if possible, regimens with a reduced number of doses should be chosen, with no compulsory fasting, and with few adverse effects. Strategies to minimize these effects should be discussed with the patients.

  2. Characteristics of HIV antiretroviral regimen and treatment adherence

    Directory of Open Access Journals (Sweden)

    Vera Lúcia da Silveira

    Full Text Available The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demographic variables were collected through direct questionnaires. The antiretroviral regimen and clinical data were copied from the patients' records. Associations between the independent variables and adherence were analyzed by means of logistic regression. The multivariate analysis included characteristics of the antiretroviral regimens, social-demographic variables, as well as perception of negative effects, negative physiological states, and adverse effects of the treatment. Among the 224 selected patients, 194 participated in our study. Their ages varied from 17 to 67 years; most patients were men, with few years of schooling and a low family income. Only 49% adhered to the treatment. Adherence to treatment regimens was reduced when more daily doses were indicated: three to four doses (odds ratio of adherence to treatment (OR=0.47, 95% confidence interval (CI 0.22-1.01 and five to six (OR=0.24, 95% CI 0.09-0.62; two or more doses taken in a fasting state (OR=0.59, 95% CI 0.11-0.68, and for patients who reported adverse effects to the treatment (OR=0.39, 95% CI 0.19-0.77. Most of the regimens with more than two daily doses of medication included at least one dose apart from mealtimes. The results suggest that, if possible, regimens with a reduced number of doses should be chosen, with no compulsory fasting, and with few adverse effects. Strategies to minimize these effects should be discussed with the patients.

  3. [Sport medicine].

    Science.gov (United States)

    Epstein, Yoram

    2012-02-01

    It is only since the late 20th century that Sport and Exercise Medicine has emerged as a distinct entity in health care. In Israel, sports medicine is regulated by a State Law and a sport physician is certified after graduating a structured program. In the past, sports medicine was related to the diagnosis and treatment of injuries encountered by top athletes. In recent years, the scope of sport medicine has broadened to reflect the awareness of modern society of the dangers of physical inactivity. In this perspective the American College of Sport Medicine (ACSM) recently launched a program--"Exercise is Medicine", to promote physical activity in order to improve health and well-being and prevention of diseases through physical activity prescriptions. This program is from doctors and healthcare providers, adjusted to the patient or trainee. The sport physician does not replace a medical specialist, but having a thorough understanding about the etiology of a sport-related injury enables him to better focus on treatment and prevention. Therefore, Team Physicians in Elite Sport often play a role regarding not only the medical care of athletes, but also in the physiological monitoring of the athlete and correcting aberrations, to achieve peak physical performance. The broad spectrum of issues in sport and exercise medicine cannot be completely covered in one issue of the Journal. Therefore, the few reports that are presented to enhance interest and understanding in the broad spectrum of issues in sports and exercise medicine are only the tip of the iceberg.

  4. Vulnerable Medicine

    Science.gov (United States)

    Bochner, Arthur P.

    2009-01-01

    In "Narrative Medicine: Honoring the Stories of Illness," Rita Charon paints an original and humane portrait of what it can mean to be a doctor, to live a life immersed in sickness and dedicated to wellness. Charon drops the veil, inviting readers to look at the secret, subjective, emotional face of medicine, a zone of self-censored feelings and…

  5. Septic shock due to Klebsiella pneumoniae after medical abortion with misoprostol-only regimen.

    Science.gov (United States)

    Kaponis, Apostolos; Papatheodorou, Stefania; Makrydimas, George

    2010-09-01

    To report a case of a healthy woman who was admitted to the hospital with septic shock caused by a common uropathogen after self-administration of misoprostol for pregnancy termination. Case report. Tertiary hospital. A 38-year-old woman, gravida 5, para 3, who developed septic shock after medical termination of pregnancy. Suction curettage, antibiotic treatment, plasma and platelet transfusions. Klebsiella pneumoniae was isolated from blood samples. Ten days after her admission she was discharged home in good condition on oral antibiotics. Severe infections leading to septic shock from common pathogen bacteria can occur after medical termination of pregnancy, independently of the regimen used. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients: A randomized controlled study.

    Science.gov (United States)

    Yadav, Asha; Singh, Savita; Singh, Kp; Pai, Preeti

    2015-01-01

    Lung functions are found to be impaired in coronary artery disease (CAD), congestive heart failure, left ventricular dysfunction, and after cardiac surgery. Diffusion capacity progressively worsens as the severity of CAD increases due to reduction in lung tissue participating in gas exchange. Pranayama breathing exercises and yogic postures may play an impressive role in improving cardio-respiratory efficiency and facilitating gas diffusion at the alveolo-capillary membrane. This study was done to see the effect of yoga regimen on lung functions particularly diffusion capacity in CAD patients. A total of 80 stable CAD patients below 65 years of age of both sexes were selected and randomized into two groups of 40 each. Group I CAD patients were given yoga regimen for 3 months which consisted of yogic postures, pranayama breathing exercises, dietary modification, and holistic teaching along with their conventional medicine while Group II CAD patients were put only on conventional medicine. Lung functions including diffusion capacity were recorded thrice in both the groups: 0 day as baseline, 22(nd) day and on 90(th) day by using computerized MS medisoft Cardio-respiratory Instrument, HYP'AIR Compact model of cardio-respiratory testing machine was manufactured by P K Morgan, India. The recorded parameters were statistically analyzed by repeated measures ANOVA followed by Tukey's test in both the groups. Cardiovascular parameters were also compared before and after intervention in both the groups. Statistically significant improvements were seen in slow vital capacity, forced vital capacity, peak expiratory flow rate, maximum voluntary ventilation, and diffusion factor/ transfer factor of lung for carbon monoxide after 3 months of yoga regimen in Group I. Forced expiratory volume in 1(st) sec (FEV1), and FEV1 % also showed a trend toward improvement although not statistically significant. HR, SBP and DBP also showed significant improvement in Group-I patients who

  7. Comparison of different insulin regimens in elderly patients with NIDDM

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P; Nieuwenhuijzen Kruseman, A C

    1996-01-01

    OBJECTIVE: To compare the metabolic effects of three different frequently used regimens of insulin administration on blood glucose control and serum lipids, and the costs associated with this treatment, in subjects with NIDDM, who were poorly controlled with oral antihyperglycemic agents. RESEARCH D

  8. Comparison of different insulin regimens in elderly patients with NIDDM

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P; Nieuwenhuijzen Kruseman, A C

    1996-01-01

    OBJECTIVE: To compare the metabolic effects of three different frequently used regimens of insulin administration on blood glucose control and serum lipids, and the costs associated with this treatment, in subjects with NIDDM, who were poorly controlled with oral antihyperglycemic agents. RESEARCH D

  9. Outcomes of CAG Regimen for Refractory Biphenotypic Acute Leukemia Patients

    Institute of Scientific and Technical Information of China (English)

    Guang-sheng He; Xiang Zhang; De-pei Wu; Ai-ning Sun; Zheng-ming Jin; Hui-ying Qiu; Miao Miao; Xiao-wen Tang; Zheng-zheng Fu; Yue Han

    2009-01-01

    Objective To evaluated the efficiency of low-dose cytosine arabinoside plus aclarubicin with concurrent administration of granulocyte colony-stimulating factor(CAG)regimen for refractory biphenotypic acute leukemia(BAL).Methods We treated 5 refractory BAL patients by CAG regimen(10 mg·m 2 cytosine arabinoside subcutaneously administrated every 12 hours,day 1-14;5-7 mg·m2 aclarubicin intravenously administrated daily,day 1-8;and concurrently used 200 μg.m-2·d-1 granulocyte colony-stimulating factor subcutaneously)from November 2002 to April 2007.The efficacy of the regimen was evaluated by response rate,and the side effects were also measured.Results The complete remission rate was 80% ,median duration of absolute neutrophil count<5.0×108/L and platelet count<2.0×1010/L was day 13 and day 1,respectively;and the infection rate was low(Ⅲ-Ⅳ infection rate,20.00% ).Conclusion CAG regimen as remission induction chemotherapy for BAL patients is effective with a high remission rate and low toxicity.

  10. Tuberculous meningitis: is a 6-month treatment regimen sufficient?

    NARCIS (Netherlands)

    Loenhout-Rooyackers, J.H. van; Keyser, A.J.M.; Laheij, R.J.F.; Verbeek, A.L.M.; Meer, J.W.M. van der

    2001-01-01

    SETTING: The British Thoracic Society and the American Thoracic Society advise 12 months treatment for tuberculous meningitis, with at least isoniazid (H), rifampicin (R) and pyrazinamide (Z). OBJECTIVE: To establish whether a 6-month treatment regimen for tuberculous meningitis is equally as effect

  11. Are calcineurin inhibitors-free regimens ready for prime time?

    Science.gov (United States)

    Vincenti, Flavio

    2012-11-01

    The goal of research in transplant therapeutics is to achieve safe and effective immunosuppression strategies that allow durable engraftment free of toxicities. The calcineurin inhibitors (CNIs) regimens, because of their inherent toxicities (including nephrotoxicity), have been unable to meet these promises. Over the past decade acute cellular rejection decreased dramatically with a concomitant robust increase in 1-year graft survival; however, long-term graft outcome showed only modest improvement. This is due in part to the toxicities of the immunosuppressive drugs. The quest for a toxicity-free-CNI-free regimen has been both intense and frustrating. A turning point in CNIs-free therapy may have occurred with the recent approval of belatacept, which represents a new paradigm in immunosuppression: biological therapy for chronic immunosuppression devoid of the usual toxicities associated with the CNIs. Belatacept, a fusion receptor protein, blocks costimulation signals necessary for the activation of T cells. Although costimulation blockade has not been shown to induce tolerance, it can provide safe and effective immunosuppression without renal or cardiovascular toxicities. The approval of belatacept in both the United States and Europe for use in renal transplantation will finally push CNI-free regimens into prime time. Novel biologics such as ASKP1240 (a human anti-CD40 monoclonal antibody) and one small molecule, tofacitinib, may advance further the use of CNI-free regimens in organ transplantation.

  12. Gonzalez Regimen (PDQ®)—Health Professional Version

    Science.gov (United States)

    The Gonzalez regimen is a specialized diet that uses enzymes, supplements, and other factors in cancer management based on a theory that involves the use of pancreatic enzymes to help the body get rid of toxins that lead to cancer. Read about existing clinical data in this expert-reviewed summary.

  13. Efficacy of Some Combination Regimens of Oral Hypoglycaemic ...

    African Journals Online (AJOL)

    Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights ... Hypoglycaemic Agents in Type 2 Diabetes Mellitus Patients ... levels induced by several OHA cobmination regimens were documented. ... highlighting the important benefits conferred by the use of multiple OHAs.

  14. Aggressive regimens for multidrug-resistant tuberculosis reduce recurrence.

    Science.gov (United States)

    Franke, Molly F; Appleton, Sasha C; Mitnick, Carole D; Furin, Jennifer J; Bayona, Jaime; Chalco, Katiuska; Shin, Sonya; Murray, Megan; Becerra, Mercedes C

    2013-03-01

    Recurrent tuberculosis disease occurs within 2 years in as few as 1% and as many as 29% of individuals successfully treated for multidrug-resistant (MDR) tuberculosis. A better understanding of treatment-related factors associated with an elevated risk of recurrent tuberculosis after cure is urgently needed to optimize MDR tuberculosis therapy. We conducted a retrospective cohort study among adults successfully treated for MDR tuberculosis in Peru. We used multivariable Cox proportional hazards regression analysis to examine whether receipt of an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion from positive to negative was associated with a reduced rate of recurrent tuberculosis. Among 402 patients, the median duration of follow-up was 40.5 months (interquartile range, 21.2-53.4). Receipt of an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion was associated with a lower risk of recurrent tuberculosis (hazard ratio, 0.40 [95% confidence interval, 0.17-0.96]; P = .04). A baseline diagnosis of diabetes mellitus also predicted recurrent tuberculosis (hazard ratio, 10.47 [95% confidence interval, 2.17-50.60]; P = .004). Individuals who received an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion experienced a lower rate of recurrence after cure. Efforts to ensure that an aggressive regimen is accessible to all patients with MDR tuberculosis, such as minimization of sequential ineffective regimens, expanded drug access, and development of new MDR tuberculosis compounds, are critical to reducing tuberculosis recurrence in this population. Patients with diabetes mellitus should be carefully managed during initial treatment and followed closely for recurrent disease.

  15. Oxytocin Regimen for Labor Augmentation, Labor Progression, Perinatal Outcomes

    Science.gov (United States)

    Zhang, Jun; Branch, D. Ware; Ramirez, Mildred M.; Laughon, S. Katherine; Reddy, Uma; Hoffman, Mathew; Bailit, Jennifer; Kominiarek, Michelle; Chen, Zhen; Hibbard, Judith U.

    2013-01-01

    Objective To examine the effects and safety of high-dose (compared with low-dose) oxytocin regimen for labor augmentation on perinatal outcomes. Methods Data from the Consortium on Safe Labor were used. A total of 15,054 women from six hospitals were eligible for the analysis. Women were grouped based on their oxytocin starting dose and incremental dosing: 1, 2, and 4 mU/min. Duration of labor and a number of maternal and neonatal outcomes were compared among these three groups stratified by parity. Multivariable logistic regression and generalized linear mixed model were used to adjust for potential confounders. Results Oxytocin regimen did not affect the rate of cesarean delivery or other perinatal outcomes. Compared to 1 mU/min, the regimens starting with 2 mU/min and 4 mU/min reduced the duration of 1st stage by 0.8 hours (95% confidence interval 0.5 – 1.1) and 1.3 hours (1.0 – 1.7), respectively, in nulliparas. No effect was observed on the second stage of labor. Similar patterns were observed in multiparas. High-dose regimen was associated with a reduced risk of meconium stain, chorioamnionitis, and newborn fever in multiparas. Conclusion High-dose oxytocin regimen (starting dose at 4 mU/min and increment of 4 mU/min) is associated with a shorter duration of first stage of labor in all parities without increasing the cesarean delivery rate or adversely affecting perinatal outcomes. PMID:21775839

  16. Beliefs about medicines in Dutch acenocoumarol and phenprocoumon users

    NARCIS (Netherlands)

    Verhoef, Talitha I; Redekop, W Ken; Bouvy, Marcel L; Dorenbos, Brenda; Karwar, Zamiera; van Schie, Rianne M F; de Boer, Anthonius; Maitland-van der Zee, Anke-Hilse

    2014-01-01

    AIMS: Adherence to the generally complex regimen of coumarin derivatives is vital in order to keep patients in the adequate International Normalized Ratio range. Patients' beliefs about medicines are associated with the level of therapy adherence. Our first aim was to assess beliefs about coumarins.

  17. COPD Medicine

    Science.gov (United States)

    ... Education & Training Home Treatment & Programs Medications COPD Medications COPD Medications Make an Appointment Ask a Question Refer ... control the symptoms of chronic obstructive pulmonary disease (COPD). Most people with COPD take long-acting medicine ...

  18. Herbal Medicine

    Science.gov (United States)

    ... resources Diseases and Conditions Acupuncture Art, Dance, and Music Ayurveda Biofeedback Body Movement Chinese Medicine Electromagnetic Therapy ... conditions associated with aging, including poor circulation and memory loss. Ginseng Used as a general tonic to ...

  19. Mitochondrial medicine

    National Research Council Canada - National Science Library

    Bandyopadhyay, S K; Dutt, Anita

    2010-01-01

    .... With the coming of age for mitochondrial medicine, it is now appropriate that physicians keep themselves well-acquainted with the recent developments in this expanding field of biomedical research.

  20. Medicine Man

    OpenAIRE

    Paola, Frederick Adolf

    2012-01-01

    It becomes imperative that our doctors bring to the practice of medicine a true scientific perspective; it may be just as important that those of us doing biomedical research try to learn more of what doctors know.

  1. Medicinal Moves

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Traditional Chinese medicine is becoming a new source of growth in China-Africa trade LIU Tao never expected that his traditional Chinese medicine (TCM) products would be so warmly welcomed at the annual Canton Fair last year.His surprise came after a large number of African businessmen expressed a keen interest in importing the products.That knowledge left a broad smile on his face.

  2. Network medicine

    DEFF Research Database (Denmark)

    Pawson, Tony; Linding, Rune

    2008-01-01

    for new therapeutic intervention. We argue that by targeting the architecture of aberrant signaling networks associated with cancer and other diseases new therapeutic strategies can be implemented. Transforming medicine into a network driven endeavour will require quantitative measurements of cell...... signaling processes; we will describe how this may be performed and combined with new algorithms to predict the trajectories taken by a cellular system either in time or through disease states. We term this approach, network medicine....

  3. Clinical practice on the horizon: personalized medicine.

    Science.gov (United States)

    Chadwell, Katherine

    2013-01-01

    With the advent of the human genome project, we have never known so much about the uniqueness of individuals. Personalized medicine is poised to use this genetic and genomic information along with the impact of environment and clinical presentation to provide healthcare from an individual perspective. This offers the opportunity to improve our ability to diagnose and predict disease, provide earlier intervention, identify new treatment regimens, and address the safety and efficacy of drug use. The impact of personalized medicine to our current model of healthcare delivery is tremendous, and although strides have been made, there are still challenges and barriers to overcome before personalized medicine can be fully implemented. Advanced practice nurses may not be fully aware of the personalized medicine initiative or may not be well versed on genetic and genomic content, which is a key concept of personalized medicine. The role of advanced practice nurses is an integral part of the healthcare system, and as such, they are poised to be key providers and contributors to personalized medicine. The personalized medicine initiative is discussed along with examples of genetic and genomic information that lend to our understanding, diagnosis, and treatment of disease, as well as the role and responsibilities of advanced practice nurses. Resources for personalized medicine and genetic and genomic content are provided.

  4. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  6. General Nuclear Medicine

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z General Nuclear Medicine Nuclear medicine imaging uses small amounts of ... limitations of General Nuclear Medicine? What is General Nuclear Medicine? Nuclear medicine is a branch of medical ...

  7. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  8. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  10. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  11. Basis for selecting optimum antibiotic regimens for secondary peritonitis.

    Science.gov (United States)

    Maseda, Emilio; Gimenez, Maria-Jose; Gilsanz, Fernando; Aguilar, Lorenzo

    2016-01-01

    Adequate management of severely ill patients with secondary peritonitis requires supportive therapy of organ dysfunction, source control of infection and antimicrobial therapy. Since secondary peritonitis is polymicrobial, appropriate empiric therapy requires combination therapy in order to achieve the needed coverage for both common and more unusual organisms. This article reviews etiological agents, resistance mechanisms and their prevalence, how and when to cover them and guidelines for treatment in the literature. Local surveillances are the basis for the selection of compounds in antibiotic regimens, which should be further adapted to the increasing number of patients with risk factors for resistance (clinical setting, comorbidities, previous antibiotic treatments, previous colonization, severity…). Inadequate antimicrobial regimens are strongly associated with unfavorable outcomes. Awareness of resistance epidemiology and of clinical consequences of inadequate therapy against resistant bacteria is crucial for clinicians treating secondary peritonitis, with delicate balance between optimization of empirical therapy (improving outcomes) and antimicrobial overuse (increasing resistance emergence).

  12. Noncompliance with Medical Regimen in Haemodialysis Treatment: A Case Study

    Directory of Open Access Journals (Sweden)

    Paraskevi Theofilou

    2011-01-01

    Full Text Available Patients undergoing haemodialysis treatment have a high burden of disease (particularly cardiovascular comorbidities affecting their quality of life and dramatically shortening life expectancy. Effective chronic kidney disease (CKD control requires regular preventive medication and a response to that medication. Poor receptiveness to CKD medication can be related to individual variability in the dose needed to achieve a response, as well as to low-adherent behaviour in relation to the CKD medication regimen. Some patients, though not many, according to studies' findings, abuse the medical regimen as a result of suicidal tendencies. The present case gave us the opportunity to consider the causes and clinical findings and review the specific psychological interventions for patients with CKD.

  13. Predictive tools for designing new insulins and treatment regimens

    DEFF Research Database (Denmark)

    Klim, Søren

    The thesis deals with the development of "Predictive tools for designing new insulins and treatments regimens" and consists of two parts: A model based approach for bridging properties of new insulin analogues from glucose clamp experiments to meal tolerance tests (MTT) and a second part that des......The thesis deals with the development of "Predictive tools for designing new insulins and treatments regimens" and consists of two parts: A model based approach for bridging properties of new insulin analogues from glucose clamp experiments to meal tolerance tests (MTT) and a second part...... on ordinary differential equations. The absence of such a program motivated the development of new a tool with PK/PD features, SDEs and mixed effects. Part II presents a software package which was developed in order to be able to handle SDEs with mixed effects. The package was implemented in R which allowed...

  14. Efficacy of a Morinda citrifolia Based Skin Care Regimen

    Directory of Open Access Journals (Sweden)

    Brett J. West

    2012-04-01

    Full Text Available A six week clinical trial of a Morinda citrifolia (noni based skin care regimen was conducted with 49 women, ages 38 to 55 years. Daily application of three product formulations to the face and neck resulted in significant reductions in lateral canthal fine lines and wrinkles (crow’s feet, as measured by technician scoring and digital image analysis. Use of the regimen also improved skin elasticity and firmness Cutometer® measurements. No evidence of skin irritation was present in any participant at any time during the trial. A study questionnaire revealed that the measured improvements were visibly perceptible to more than 90% of the participants. The trial results substantiate traditional uses of the noni plant to improve skin health.

  15. Dalak (Massage in Unani Medicine: A Review

    Directory of Open Access Journals (Sweden)

    Kamal Ahmed

    2014-01-01

    Full Text Available Regimental therapies are mostly non medicinal procedures for health promotion in Unani system of medicine. Several regimens have been used by Unani physicians since ancient time, among which Dalak (massage is the most common and widely practiced regimen that is used for restorative, preventive as well as for therapeutic purposes. Massage which has been used in almost all the civilizations in the history, evidence of this is present in several manuscripts. According to Hippocrates (460 BC–370 BC, the father of medicine, massage, balanced diet, exercise, rest and fresh air are essential to maintain health of a person. According to Ibne Rushd, massage is a type of exercise used for removal of toxins or waste metabolites from the body. In Unani medicine, Dalak is one of the very important regimes among the procedures of Ilaj Bil-Tadbeer (Regimental therapy for neurological and musculoskeletal disorders. A number of Unani physicians recommended Dalak as preventive as well as curative measure. Historical background of Dalak, timing, duration, its types and importance, mechanism of action, recent scientific reports and the disorders in which massage can be used have been discussed in this paper.

  16. Antiepileptic drug regimens and major congenital abnormalities in the offspring.

    Science.gov (United States)

    Samrén, E B; van Duijn, C M; Christiaens, G C; Hofman, A; Lindhout, D

    1999-11-01

    To assess the risk of major congenital abnormalities associated with specific antiepileptic drug regimens, a large retrospective cohort study was performed. The study comprised 1,411 children born between 1972 and 1992 in four provinces in The Netherlands who were born to mothers with epilepsy and using antiepileptic drugs during the first trimester of pregnancy, and 2,000 nonepileptic matched controls. We found significantly increased risks of major congenital abnormalities for carbamazepine and valproate monotherapy, with evidence for a significant dose-response relationship for valproate. The risk of major congenital abnormalities was nonsignificantly increased for phenobarbital monotherapy when caffeine comedication was excluded, but a significant increase in risk was found when caffeine was included. Phenytoin monotherapy was not associated with an increased risk of major congenital abnormalities. Regarding polytherapy regimens, increased risks were found for several antiepileptic drug combinations. Clonazepam, in combination with other antiepileptic drugs, showed a significantly increased relative risk. Furthermore, there were significantly increased relative risks for the combination of carbamazepine and valproate and the combination of phenobarbital and caffeine with other antiepileptic drugs. This study shows that most antiepileptic drug regimens were associated with an increased risk of major congenital abnormalities in the offspring, in particular valproate (dose-response relationship) and carbamazepine monotherapy, benzodiazepines in polytherapy, and caffeine comedication in combinations with phenobarbital.

  17. Care of Patients With HIV Infection: Antiretroviral Drug Regimens.

    Science.gov (United States)

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    The advent of combination antiretroviral drug regimens has transformed HIV infection from a fatal illness into a manageable chronic condition. All patients with HIV infection should be considered for antiretroviral therapy, regardless of CD4 count or HIV viral load, for individual benefit and to prevent HIV transmission. Antiretroviral drugs affect HIV in several ways: entry inhibitors block HIV entry into CD4 T cells; nucleotide and nucleoside reverse transcriptase inhibitors prevent reverse transcription from RNA to DNA via chain-terminating proteins; nonnucleoside reverse transcriptase inhibitors prevent reverse transcription through enzymatic inhibition; integrase strand transfer inhibitors block integration of viral DNA into cellular DNA; protease inhibitors block maturation and production of the virus. Current guidelines recommend six combination regimens for initial therapy. Five are based on tenofovir and emtricitabine; the other uses abacavir and lamivudine. Five include integrase strand transfer inhibitors. HIV specialists should assist with treating patients with complicated HIV infection, including patients with treatment-resistant HIV infection, coinfection with hepatitis B or C virus, pregnancy, childhood infections, severe opportunistic infections, complex drug interactions, significant drug toxicity, or comorbidities. Family physicians can treat most patients with HIV infection effectively by choosing appropriate treatment regimens, monitoring patients closely, and retaining patients in care.

  18. [Medicinal cannabis].

    Science.gov (United States)

    Van der Meersch, H; Verschuere, A P; Bottriaux, F

    2006-01-01

    Pharmaceutical grade cannabis is available to Dutch patients from public pharmacies in the Netherlands. The first part of this paper reviews the pharmaceutical and pharmacological properties of medicinal cannabis. Detailed information about its composition and quality, potential applications, methods of administration, adverse reactions, drug interactions and safety during pregnancy or breastfeeding are given. The second part deals with the legal aspects of dispensing medicinal cannabis through pharmacies in view of the Belgian and Dutch legislation. The last part discusses the present Belgian regulation about the possession of cannabis.

  19. [The Essenes and medicine].

    Science.gov (United States)

    Kottek, Samuel

    2011-01-01

    The Essenes were a Jewish sect, which flourished around the first century. We have limited our study to hygienic and medical aspects, as documented in the works of Josephus Flavius, Philo of Alexandria, and Pliny the Elder; Josephus and Philo were personally in contact with these sectarian Jews. We have described the regimen of life of these communities, who lived in strictly organised fashion, their meals taken in common, their bathing in cold water, their clothing, the Sabbath rest, the lavatories, and more. Most Essenes remained single, they adopted however small children, and educated them in accordance to their principles. There was no private property, but old people and sick residents were taken care of by the community. The Essenes, as well as the Therapeuts described by Philo, were knowledgeable in medical lore, they treasured old books and studied the virtues of medicinal plants. There is no clear-cut consensus whether the Essenes, the Therapeuts, and the Qumran residents were one and the same sect, or whether they were similar sub-sects. The calm, strictly regulated and frugal way of life of the Essenes enabled them to attain old age, often beyond 100 years.

  20. The clinical outcomes of oldest old patients with tuberculosis treated by regimens containing rifampicin, isoniazid, and pyrazinamide

    Directory of Open Access Journals (Sweden)

    Lin HS

    2016-03-01

    Full Text Available Huang-Shen Lin,1,2 Chun-Wen Cheng,3 Ming-Shyan Lin,4 Yen-Li Chou,5 Pey-Jium Chang,2 Jing-Chi Lin,6 Jung-Jr Ye3 1Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chia-Yi, 2Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, 3Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, 4Division of Cardiology, Chang Gung Memorial Hospital, Yunlin, 5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Chia-Yi, 6Division of Allergy and Immunology and Rheumatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan Objectives: To investigate the clinical characteristics, adverse drug reactions, and outcomes of the oldest old patients (aged ≥80 years with tuberculosis (TB treated with rifampicin, isoniazid, and pyrazinamide (RIP-containing regimens. Design: A retrospective chart review study. Setting: A 1,200-bed tertiary teaching hospital in southwest Taiwan. Participants: We conducted a retrospective observational study between January 1, 2005 and December 31, 2011. Seven hundred adult patients (aged ≥18 years with TB treated with RIP-containing anti-TB regimens were reviewed, including 161 oldest old patients. Outcome measures: Clinical outcomes included clinical responsiveness and microbiological eradication. Adverse outcomes included drug-induced hepatitis, and other symptoms included gastrointestinal upset (eg, abdominal pain, vomiting, diarrhea, or dyspepsia, skin rash, joint pain, and hyperuricemia. Results: Compared with the non-oldest old adult patients, the oldest old patients more frequently had hepatitis (P=0.014, gastrointestinal upset (P=0.029, and unfavorable outcomes (P<0.001. In a multivariate analysis, hepatitis during treatment (adjusted odds ratio

  1. Drug regimens identified and optimized by output-driven platform markedly reduce tuberculosis treatment time

    Science.gov (United States)

    Lee, Bai-Yu; Clemens, Daniel L.; Silva, Aleidy; Dillon, Barbara Jane; Masleša-Galić, Saša; Nava, Susana; Ding, Xianting; Ho, Chih-Ming; Horwitz, Marcus A.

    2017-01-01

    The current drug regimens for treating tuberculosis are lengthy and onerous, and hence complicated by poor adherence leading to drug resistance and disease relapse. Previously, using an output-driven optimization platform and an in vitro macrophage model of Mycobacterium tuberculosis infection, we identified several experimental drug regimens among billions of possible drug-dose combinations that outperform the current standard regimen. Here we use this platform to optimize the in vivo drug doses of two of these regimens in a mouse model of pulmonary tuberculosis. The experimental regimens kill M. tuberculosis much more rapidly than the standard regimen and reduce treatment time to relapse-free cure by 75%. Thus, these regimens have the potential to provide a markedly shorter course of treatment for tuberculosis in humans. As these regimens omit isoniazid, rifampicin, fluoroquinolones and injectable aminoglycosides, they would be suitable for treating many cases of multidrug and extensively drug-resistant tuberculosis. PMID:28117835

  2. Insulin therapy for diabetes mellitus: treatment regimens and associated costs.

    Science.gov (United States)

    Charbonnel, B; Penfornis, A; Varroud-Vial, M; Kusnik-Joinville, O; Detournay, B

    2012-04-01

    To describe insulin therapy in patients with diabetes, to determine treatment costs and to compare costs among treatment regimens. This observational study was performed by 734 French pharmacists. Adult patients filling an insulin prescription were invited to participate. Participants provided information on their diabetes history and management. Levels of intensification of insulin therapy were determined by the number of injections in type 1 diabetes mellitus (T1DM) patients, and by the different schemes used in type 2 (T2DM) patients, such as basal/intermediate-acting insulin only, and regimens using both basal and rapid-acting insulin. Costs were evaluated according to official medication costs, nurse visits and glucose monitoring kits. A total of 361 patients with T1DM and 1902 with T2DM were enrolled in the survey. Patients with T1DM more frequently took 1-2 injections per day (46.3% of patients) and used single-dose basal insulin together with ≥1 dose of rapid insulin (43.8%). Patients with T2DM used multiple treatment regimens, with 58 different combinations documented. Most took basal/intermediate insulin only (42.5%) or combinations of basal/intermediate and rapid insulins (52.7%). Mean cost of insulin therapy was €27.4/week for T1DM and €45.4/week for T2DM. In T1DM, insulin was the biggest cost component and increased with the number of injections/day. In T2DM, nurse visits were the most important cost contributors irrespective of treatment regimen. Overall, the cost of insulin therapy increased with the complexity of the insulin schemes. Considerable heterogeneity is found in insulin treatment regimens used in everyday diabetes care. Payers should consider the full costs associated with the use of insulin rather than the cost of insulin alone. Treatment algorithms to harmonize insulin therapy should help to improve care, while encouraging patients to self-inject insulin should help to reduce costs. Copyright © 2011 Elsevier Masson SAS. All rights

  3. Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection

    Science.gov (United States)

    Nielsen-Saines, Karin; Watts, D. Heather; Veloso, Valdilea G.; Bryson, Yvonne J.; Joao, Esau C.; Pilotto, Jose Henrique; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa M.; Ceriotto, Mariana; Machado, Daisy; Bethel, James; Morgado, Marisa G.; Dickover, Ruth; Camarca, Margaret; Mirochnick, Mark; Siberry, George; Grinsztejn, Beatriz; Moreira, Ronaldo I.; Bastos, Francisco I.; Xu, Jiahong; Moye, Jack; Mofenson, Lynne M.

    2013-01-01

    Background The safety and efficacy of adding antiretroviral drugs to standard zidovudine prophylaxis in infants of mothers with human immunodeficiency virus (HIV) infection who did not receive antenatal antiretroviral therapy (ART) because of late identification are unclear. We evaluated three ART regimens in such infants. Methods Within 48 hours after their birth, we randomly assigned formula-fed infants born to women with a peripartum diagnosis of HIV type 1 (HIV-1) infection to one of three regimens: zidovudine for 6 weeks (zidovudine-alone group), zidovudine for 6 weeks plus three doses of nevirapine during the first 8 days of life (two-drug group), or zidovudine for 6 weeks plus nelfinavir and lamivudine for 2 weeks (three-drug group). The primary outcome was HIV-1 infection at 3 months in infants uninfected at birth. Results A total of 1684 infants were enrolled in the Americas and South Africa (566 in the zidovudine-alone group, 562 in the two-drug group, and 556 in the three-drug group). The overall rate of in utero transmission of HIV-1 on the basis of Kaplan–Meier estimates was 5.7% (93 infants), with no significant differences among the groups. Intra-partum transmission occurred in 24 infants in the zidovudine-alone group (4.8%; 95% confidence interval [CI], 3.2 to 7.1), as compared with 11 infants in the two-drug group (2.2%; 95% CI, 1.2 to 3.9; P = 0.046) and 12 in the three-drug group (2.4%; 95% CI, 1.4 to 4.3; P = 0.046). The overall transmission rate was 8.5% (140 infants), with an increased rate in the zidovudine-alone group (P = 0.03 for the comparisons with the two- and three-drug groups). On multivariate analysis, zidovudine monotherapy, a higher maternal viral load, and maternal use of illegal substances were significantly associated with transmission. The rate of neutropenia was significantly increased in the three-drug group (P<0.001 for both comparisons with the other groups). Conclusions In neonates whose mothers did not receive ART

  4. Sports Medicine

    Institute of Scientific and Technical Information of China (English)

    刘洪毓

    2004-01-01

    Sports medicine has become one of the biggest and fastest growing medical fields in recent years. That is because sports have become a major part of most societies. As work becomes more stressful (紧张的,压力重

  5. Medicinal Mushrooms

    NARCIS (Netherlands)

    Lindequist, U.; Won Kim, H.; Tiralongo, E.; Griensven, van L.J.L.D.

    2014-01-01

    Since beginning of mankind nature is the most important source of medicines. Bioactive compounds produced by living organisms can be used directly as drugs or as lead compounds for drug development. Besides, the natural material can be used as crude drug for preparation of powder or extracts. Plants

  6. Medicinal Mushrooms

    NARCIS (Netherlands)

    Lindequist, U.; Won Kim, H.; Tiralongo, E.; Griensven, van L.J.L.D.

    2014-01-01

    Since beginning of mankind nature is the most important source of medicines. Bioactive compounds produced by living organisms can be used directly as drugs or as lead compounds for drug development. Besides, the natural material can be used as crude drug for preparation of powder or extracts. Plants

  7. Predictive medicine

    NARCIS (Netherlands)

    Boenink, Marianne; Have, ten Henk

    2015-01-01

    In the last part of the twentieth century, predictive medicine has gained currency as an important ideal in biomedical research and health care. Research in the genetic and molecular basis of disease suggested that the insights gained might be used to develop tests that predict the future health sta

  8. Personalized medicine

    DEFF Research Database (Denmark)

    Bendtzen, Klaus

    2013-01-01

    engineered anti-TNF-alpha antibody constructs now constitute one of the heaviest medicinal expenditures in many countries. All currently used TNF antagonists may dramatically lower disease activity and, in some patients, induce remission. Unfortunately, however, not all patients respond favorably, and safety...

  9. Medicinal Plants.

    Science.gov (United States)

    Phillipson, J. David

    1997-01-01

    Highlights the demand for medicinal plants as pharmaceuticals and the demand for health care treatments worldwide and the issues that arise from this. Discusses new drugs from plants, anticancer drugs, antiviral drugs, antimalarial drugs, herbal remedies, quality, safety, efficacy, and conservation of plants. Contains 30 references. (JRH)

  10. Toxicities of different first-line chemotherapy regimens in the treatment of advanced ovarian cancer

    Science.gov (United States)

    Qu, Chang-Ping; Sun, Gui-Xia; Yang, Shao-Qin; Tian, Jun; Si, Jin-Ge; Wang, Yi-Feng

    2017-01-01

    Abstract Background: Ovarian cancer (OC) is the 5th leading cause of cancer-related deaths around the world, and several chemotherapy regimens have been applied in the treatment of OC. We aim to compare toxicities of different chemotherapy regimens in the treatment of advanced ovarian cancer (AOC) using network meta-analysis. Methods: Literature research in Cochrane Library, PubMed, and EMBASE was performed up to November 2015. Eligible randomized controlled trials (RCTs) of different chemotherapy regimens were included. Network meta-analysis combined direct and indirect evidence to assess pooled odds ratios (ORs) and draw the surface under the cumulative ranking (SUCRA) curves. Results: Thirteen eligible RCTs were included in this network meta-analysis, including 8 chemotherapy regimens (paclitaxel + carboplatin [PC], pegylated liposomal doxorubicin [PLD] + carboplatin, carboplatin, gemcitabine + carboplatin, paclitaxel, PC + epirubicin, PC + topotecan, docetaxel + carboplatin). Gemcitabine + carboplatin regimen exerted higher incidence of anemia when compared with carboplatin and paclitaxel regimens. The incidence of febrile neutropenia of gemcitabine + carboplatin regimen was higher than that of PC, PLD + carboplatin, carboplatin, and PC + topotecan regimens. Topotecan PC + epirubicin regimen had a higher toxicity, comparing with PC, PLD + carboplatin, and PC + topotecan regimens. As for thrombocytopenia, gemcitabine + carboplatin chemotherapy regimen produced an obviously higher toxicity than PC and carboplatin. As for nausea, PLD + carboplatin chemotherapy regimen had a significantly higher toxicity than that of carboplatin chemotherapy regimen. Moreover, when compared with PC and carboplatin chemotherapy regimens, the toxicity of PC + epirubicin was greatly higher to patients with AOC. Conclusion: The nonhematologic toxicity of PLD + carboplatin regimen was higher than other regimens, which

  11. The Relationship between Cognitive Appraisal and Adherence to Medical Regimens in Type 2 Diabetic Patients

    OpenAIRE

    Shahnaz Ahrari; Ali Mohammadpour; Zahra Amouzeshi; Alireza Agha-Yousefi

    2014-01-01

    Introduction: Non-adherence to medical regimen has remained a challenge to the medical profession as well as to social sciences. To achieve positive results, the factors negatively impacting patient adherence to medical regimens (i.e., diet, drug and exercise regimen) must be scrutinized in detail. The objective of this research was to explore the relationship between cognitive appraisal and adherence to medical regimens in type 2 diabetic patients. Methods: In this correla...

  12. Tibetan traditional medicine

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Tibetan medicine companies in T.A.R can manufacture more than 360 Tibetan patent medicines. There are 18 Tibetan medicine factories in Tibet, and total out value exceeds 3 billion yuan. 24 kinds of Tibetan patent medicines have been incorporated into State Fundamental Medicine List, in which 14 Tibetan patent medicines are listed in national protected traditional medicine category.

  13. Ayurvedic herbal medicine and lead poisoning

    Directory of Open Access Journals (Sweden)

    Gunturu Krishna S

    2011-12-01

    Full Text Available Abstract Although the majority of published cases of lead poisoning come from occupational exposures, some traditional remedies may also contain toxic amounts of lead. Ayurveda is a system of traditional medicine that is native to India and is used in many parts of world as an alternative to standard treatment regimens. Here, we report the case of a 58-year-old woman who presented with abdominal pain, anemia, liver function abnormalities, and an elevated blood lead level. The patient was found to have been taking the Ayurvedic medicine Jambrulin prior to presentation. Chemical analysis of the medication showed high levels of lead. Following treatment with an oral chelating agent, the patient's symptoms resolved and laboratory abnormalities normalized. This case highlights the need for increased awareness that some Ayurvedic medicines may contain potentially harmful levels of heavy metals and people who use them are at risk of developing associated toxicities.

  14. Comparison of two once-daily regimens with a regimen consisting of nelfinavir, didanosine, and stavudine in antiretroviral therapy-naive adults : 48-week results from the antiretroviral regimen evaluation study (ARES)

    NARCIS (Netherlands)

    Lowe, SH; Wensing, AMJ; Hassink, EAM; ten Kate, RW; Richter, C; Schreij, G; Koopmans, PP; Juttmann, J.; van der Tweel, I.; Lange, JMA; Borleffs, JCC

    2005-01-01

    Background: To improve the dosing frequency and pill burden of antiretroviral therapy, we compared two once-daily dosed regimens to a twice-daily dosed regimen. Method: HIV-1-infected, antiretroviral drug-naive adults were randomized to either twice-daily nelfinavir and stavudine and once-daily dida

  15. Comparison of two once-daily regimens with a regimen consisting of nelfinavir, didanosine, and stavudine in antiretroviral therapy-naive adults: 48-week results from the Antiretroviral Regimen Evaluation Study (ARES).

    NARCIS (Netherlands)

    Lowe, S.H.; Wensing, B.M.; Hassink, E.A.M.; Kate, R.W. ten; Richter, C.; Schreij, G.; Koopmans, P.P.; Juttmann, J.R.; Tweel, I. van de; Lange, J.M.A.; Borleffs, J.C.

    2005-01-01

    BACKGROUND: To improve the dosing frequency and pill burden of antiretroviral therapy, we compared two once-daily dosed regimens to a twice-daily dosed regimen. METHOD: HIV-1-infected, antiretroviral drug-naive adults were randomized to either twice-daily nelfinavir and stavudine and once-daily dida

  16. Labour induction with an intermediate-dose oxytocin regimen has advantages over a high-dose regimen.

    Science.gov (United States)

    Manjula, B G; Bagga, R; Kalra, J; Dutta, S

    2015-05-01

    A total of 200 women planned for labour induction were randomised to receive high-dose oxytocin (6 mU/min with similar increments every 45 min) or intermediate-dose oxytocin (3 mU/min with similar increments every 45 min). Oxytocin solution was prepared with 30 units in 500 ml saline with which the infusion rate in ml/h is numerically equal to oxytocin in mU/min. We observed that the caesarean rate (18% vs 6%, p = 0.009), contraction abnormalities (35% vs 14%, p = 0.0005) and neonatal bilirubin levels (7.99 ± 2.70 vs 6.80 ± 2.65, p = 0.002) were higher with high-dose than with intermediate-dose. The induction-delivery interval (IDI) was similar (10 h 13 min with high-dose and 11 h 5 min with intermediate-dose; p = 0.237, NS). Nulliparous women benefited more with intermediate-dose as the caesarean rate was higher with high-dose (24.6% vs 7.9%, p = 0.011). Although the caesarean rate was higher in multiparous women with high-dose oxytocin, it was statistically not significant (5.7% vs 2.7%; p = 0.609). Oxytocin regimens for labour induction are usually high-dose (4-6 mU/min) or low-dose (1-1.5 mU/min). The former is associated with more contraction abnormalities and the latter with prolonged IDI; both result in an increased caesarean rate. In order to offset these disadvantages, an intermediate- dose regimen was selected. The increment interval of 45 min was selected in accordance with the pharmacokinetics of oxytocin. We observed a lower caesarean rate when compared with the high-dose regimen, without any increase in the IDI. Hence, we propose that the intermediate-dose oxytocin regimen should be preferred to the high-dose regimen for labour induction.

  17. [Educational strategy for improving patient compliance with the tuberculosis treatment regimen in Chiapas, Mexico].

    Science.gov (United States)

    Alvarez Gordillo, Guadalupe del Carmen; Alvarez Gordillo, Julio Félix; Dorantes Jiménez, José Eugenio

    2003-12-01

    To implement a training program for physicians and patients and assess its effectiveness in terms of patient compliance with the pulmonary tuberculosis treatment regimen in the border region of Chiapas, Mexico. A controlled intervention study was performed with patients over 15 years of age who had pulmonary tuberculosis diagnosed by direct microscopy (bacilloscopy) between 1 February 2001 and 31 January 2002 in health units randomly selected in the border region of Chiapas, Mexico. The sample was made up of patients who sought consultation at 23 and 25 health units over that period (intervention and control group, respectively). The intervention group took part in a training program for health personnel in which the following were discussed: the social, cultural, and economic aspects of tuberculosis; the theoretical and practical underpinnings of the diagnosis and treatment of the illness, and the establishment of self-help groups. Selfhelp groups were also created for all patients at the 23 units where the intervention group sought consultation. All patients were given a short-term treatment regimen with isoniazid, rifampin, pyrazinamide, and ethambutol for a total of 25 weeks, until completing a total of 105 doses. Patient follow-up was extended through December 2003. The intervention and control groups were compared by means of the chi square test, and Student's t test was used to compare means. The relative risk of non-compliance (RR) was calculated along with 95% confidence intervals (95% CI). Eighty-seven patients participated in the study; 44 were exposed to the intervention, and 43 made up the control group. Compliance with treatment was considerably greater in the intervention group than in the control group (97.7% vs. 81.4%, respectively; RR = 1.20; 95% CI: 1.03 to 1.39; P = 0.0015). It was noted that physicians in the border region of Chiapas gear their activities toward curative medicine, rather than preventive medicine or understanding the social

  18. Predictors of nonadherence with blood pressure regimens in hemodialysis

    Directory of Open Access Journals (Sweden)

    Kauric-Klein Z

    2013-09-01

    Full Text Available Zorica Kauric-KleinCollege of Nursing, Wayne State University, Detroit, MI, USABackground: Hypertension is very poorly controlled in patients on hemodialysis (HD. Demographic and psychosocial predictors of nonadherence with blood pressure (BP regimens in HD have not been investigated. A study of 118 HD patients from six outpatient HD units was conducted to determine the relationship between demographic/psychosocial factors and adherence with BP-related regimens, ie, fluid restriction, BP medication adherence, and HD treatment adherence.Methods: Descriptive statistics, Pearson correlations, and multiple regressions were conducted to analyze and determine the relationships between variables.Results: Younger age was related to increased fluid gains (r = -0.37, P < 0.01, decreased medication adherence (r = -0.19, P = 0.04, increased missed HD treatments (r = -0.37, P < 0.01, and diastolic BP (r = -0.60, P < 0.01. Female sex was significantly related to decreased fluid gains (r = -0.28, P < 0.01. Race was related to increased missed HD treatments (r = 0.22, P = 0.02. Increased social support was related to decreased missed HD treatments (r = -0.22, P = 0.02. Depression scores were inversely related to decreased medication adherence scores (r = 0.24, P = 0.01.Conclusion: By identifying risk factors for nonadherence with BP-related regimens (young age, male sex, decreased social support, and depression, health care providers can plan early clinical intervention to minimize the risk of nonadherence.Keywords: nonadherence, hemodialysis, blood pressure, demographic predictors, psychosocial predictors

  19. Esquemas alternativos de hemodiálise Alternative hemodialysis regimens

    Directory of Open Access Journals (Sweden)

    Jorge Paulo Strogoff de Matos

    2010-03-01

    Full Text Available A taxa de mortalidade entre os pacientes em hemodiálise (HD é extremamente elevada. A expectativa de vida restante de um paciente ao iniciar HD é apenas cerca de um quarto daquela da população geral com a mesma idade. O esquema convencional de HD, com três sessões semanais de cerca de quatro horas, foi estabelecido de maneira empírica há cerca de quatro décadas e merece ser reavaliado criticamente. Desde a falha do Estudo HEMO em demonstrar benefícios clínicos com o aumento do Kt/V de ureia nos pacientes em esquema convencional de HD, tem havido um crescente interesse pelos esquemas alternativos de HD com o intuito de prover um tratamento associado com uma melhor sobrevida. Dentre os esquemas mais promissores, destacam-se a HD diária de curta duração e a HD noturna prolongada. As limitações econômicas que inibem a aplicação dos conhecimentos emergentes nesta área devem ser vencidas.The mortality rate among patients on hemodialysis (HD is extremely high. Remaining life expectancy for a patient initiating HD is only approximately one quarter of that of the general population at the same age bracket. The conventional HD regimen based on four-hour sessions three times a week was empirically established nearly four decades ago and needs to be revisited. Since the failure of the HEMO Study to demonstrate the clinical benefits of higher urea Kt/V for patients on conventional HD, an increasing interest for alternative HD regimens has emerged aiming at providing a treatment for improving survival rates. Short daily HD and long nocturnal HD stand out as the most promising alternative regimens. Economical obstacles which could hinder the clinical application of emerging knowledge in the field should be overcome.

  20. Remote medicine

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-04-29

    The international oil industry, catalyzed by a surge in exploration and production projects in remote regions, is giving health care for its travelers and expatriates a high priority. L.R. Aalund, the Journal`s Managing Editor--Technology, reports on why and how this is happening now. He covers this in articles on: health care in Russia, air ambulance evacuations, and the deployment of remote paramedics. Aalund gathered the information during trips to Finland and Russia and interviews with oil industry personnel, physicians, and other medical professionals in North America, Europe, and Siberia. Titles of the four topics presented in this special section on remote medicine are as follows: Oil companies focus on emergency care for expats in Russia; Air ambulance plan can be critical; Remote paramedics have high level of training; and Other facets of remote medicine.

  1. Management of patients using unproven regimens for arthritis.

    Science.gov (United States)

    Wolman, P G

    1987-09-01

    Such treatments as vegetarian diets, fresh or raw diets, allergy diets, no-dairy-products diets, fasting, vitamin and mineral supplementation, apple cider vinegar, and honey drinks are touted in the popular press as effective for the treatment of arthritis. In contrast to conventional therapies, the unproven treatments promise not only relief from symptoms but freedom from the disease as long as the diet regimen is followed. Several of the remedies appear to be harmless, but others are dangerous, especially if followed for prolonged periods. Nutrition professionals should be aware of the nature of these treatments and be prepared to offer sound, scientifically based but nonjudgmental care and information.

  2. Galeazzi fractures: our modified classification and treatment regimen.

    Science.gov (United States)

    Fayaz, H C; Jupiter, J B

    2014-02-01

    While diaphyseal fractures of the forearm are a common orthopedic injury, Galeazzi fractures are difficult to treat. The current knowledge on pathobiomechanics and modified therapeutic decisions implicate the need to devise an updated classification and treatment regimen of Galeazzi fractures. We challenge the concept that isolated fractures of the radius should be considered as a Galeazzi fractures as long as stability of the distal radioulnar joint is not proven. Contrary to others we demonstrate that the fracture location alone is not sufficient to determine the stability of the distal radioulnar joint. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Prophylactic antibiotic regimens in tumor surgery (PARITY survey

    Directory of Open Access Journals (Sweden)

    Hasan Khaled

    2012-06-01

    Full Text Available Abstract Background Deep infection following endoprosthetic limb reconstruction for sarcoma of the long bones is a devastating complication occurring in 15% of sarcoma patients. Optimizing infection protocols and conducting definitive surgical trials are critical to improving outcomes. In this study, the PARITY (Prophylactic Antibiotic Regimens in Tumor Surgery investigators aimed to examine surgeon preferences in antibiotic prophylaxis and perceptions about current evidence, as well as to ascertain interest in resolving uncertainty in the evidence with clinical trials. Methods We used a cross-sectional survey to examine current practice in the prescription of prophylactic antibiotics in Musculoskeletal Tumor Surgery. The survey was approved by our institution’s Ethics Board and emailed to all Active Members of the Musculoskeletal Tumor Society (MSTS and Canadian Orthopaedic Oncology Society (CANOOS. Survey answers were collected using an anonymous online survey tool. Results Of the 96 surgeons who received the questionnaire, 72 responded (75% response rate (% CI: 65.5, 82.5%. While almost all respondents agreed antibiotic regimens were important in reducing the risk of infection, respondents varied considerably in their choices of antibiotic regimens and dosages. Although 73% (95% CI: 61, 82% of respondents prescribe a first generation cephalosporin, 25% favor additional coverage with an aminoglycoside and/or Vancomycin. Of those who prescribe a cephalosporin, 33% prescribe a dosage of one gram for all patients and the reminder prescribe up to 2 grams based on body weight. One in three surgeons (95% CI: 25, 48% believes antibiotics could be discontinued after 24 hours but 40% (95% CI: 30, 53% continue antibiotics until the suction drain is removed. Given the ongoing uncertainty in evidence to guide best practices, 90% (95% CI: 81, 95% of respondents agreed that they would change their practice if a large randomized controlled trial showed

  4. Adherence to diabetes regimens: empirical status and clinical applications.

    Science.gov (United States)

    Kurtz, S M

    1990-01-01

    Adherence to diabetes treatment regimens has proved to be a conceptual and empirical enigma. Consequently, reliable and valid applications to the clinical practice of diabetes care and education have been wanting. Rates of nonadherence are staggeringly high, regardless of the methodology employed, and verification of self-reports is complicated by social desirability to appear compliant. Low intertask correlations further complicate our understanding of adherence-metabolic control relationships. Studies relating to the Health Belief Model, social learning theory, and the psychology of interpersonal relationships that have sought to identify determinants of adherence behaviors have specific relevance to the clinical practice of diabetes education.

  5. Corticosteroid and calcineurin inhibitor sparing regimens in kidney transplantation.

    Science.gov (United States)

    Cortazar, Frank; Diaz-Wong, Roque; Roth, David; Isakova, Tamara

    2013-11-01

    Chronic kidney disease is a major public health problem that is associated with increased risks of kidney disease progression, cardiovascular disease and death. Kidney transplantation remains the renal replacement therapy of choice for patients with end-stage kidney disease. Despite impressive strides in short-term allograft survival, there has been little improvement in long-term kidney graft survival, and rates of death with a functioning allograft remain high. Long-term safety profiles of existing immunosuppressive regimens point to a need for continued search for alternative agents. This overview discusses emerging evidence on a few promising therapeutic approaches, juxtaposes conflicting findings and highlights remaining knowledge gaps.

  6. Energy Medicine

    OpenAIRE

    Srinivasan T

    2012-01-01

    Energy medicine is the most comprehensive concept introduced in medical diagnostics and therapy to account for a whole range of phenomena and methods available to help an individual proceed from sickness to health. The modern medical theories do not account for, much less accept many traditional therapies due to deep suspicion that the older methods are not scientific. However, the Holistic Health groups around the world have now created an environment for therapies which work at subtle energ...

  7. Transfusion medicine

    Energy Technology Data Exchange (ETDEWEB)

    Murawski, K.; Peetoom, F.

    1986-01-01

    These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application.

  8. Transfusion Medicine

    Directory of Open Access Journals (Sweden)

    Smit Sibinga CT

    2013-07-01

    Full Text Available Cees Th. Smit Sibinga ID Consulting, Zuidhorn, The NetherlandsTransfusion Medicine is a bridging science, spanning the evidence-based practice at the bedside with the social sciences in the community.     Transfusion Medicine starts at the bedside. Surprisingly, only recently that has become rediscovered with the development of ‘patient blood management’ and ‘patient centered’ approaches to allow the growth of an optimal and rational patient care through supportive hemotherapy – safe and effective, affordable and accessible.1    Where transfusion of blood found its origin in the need of a patient, it has drifted away for a long period of time from the bedside and has been dominated for almost a century by laboratory sciences. At least the first ten editions of the famous and well reputed textbook Mollison’s Blood Transfusion in Clinical Medicine contained only a fraction on the actual bedside practice of transfusion medicine and did not focus at all on patient blood management.2    This journal will focus on all aspects of the transfusion chain that immediately relate to the bedside practice and clinical use of blood and its components, and plasma derivatives as integral elements of a human transplant tissue. That includes legal and regulatory aspects, medical, ethical and cultural aspects, pure science and pathophysiology of disease and the impact of transfusion of blood, as well as aspects of the epidemiology of blood transfusion and clinical indications, and cost-effectiveness. Education through timely and continued transfer of up to date knowledge and the application of knowledge in clinical practice to develop and maintain clinical skills and competence, with the extension of current educational approaches through e-learning and accessible ‘apps’ will be given a prominent place.

  9. [Travel medicine].

    Science.gov (United States)

    Schubert, S; Grimm, M

    2009-07-01

    Travel medicine deals with travellers' diseases. The target group is therefore distinct from tropical medicine. It has gained in significance due to the increase in tourism and professional work abroad in the last 50 years. Dangerous and widespread diseases in tropical countries, in particular tropical malaria, have come into focus in industrialized countries because of their appearance in travellers. Travel medicine deals not only with infectious or transmittable diseases, but also with the ability of patients with chronic diseases to travel, the medical aspects of flying, as well as the health hazards of professional work or high-risk sports abroad. The risk of disease as a result of travelling can be minimized by advice and prophylactic measures, such as vaccinations and drug prophylaxis against malaria, if indicated. On return, medical symptoms should be investigated promptly to ensure early detection of life-threatening disease courses, particularly tropical malaria, as well as to prevent the occurrence of small-scale epidemics. A small number of diseases can also emerge after several years, such as benign types of malaria, amoebic liver abscess and visceral leishmaniasis (kala-azar). Aids also belongs to these diseases. Therefore, in this era of HIV pandemic travellers concerned should be made aware of the risks.

  10. Managing Your Medicines

    Science.gov (United States)

    ... Problems & Solutions for Being Active - FAQs About Physical Activity Managing Your Medicines - Introduction - Taking Control of Your Medicines - Medicine Assistance Programs - Medicine Checklist - Medication Tracker Communicating with Professionals - Introduction - Preparing for Medical Visits - ...

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... are the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a ... of your child's body. top of page How is the procedure performed? Nuclear medicine imaging is usually ...

  12. Adherence to insulin treatment in insulin-naïve type 2 diabetic patients initiated on different insulin regimens

    Directory of Open Access Journals (Sweden)

    Gogas Yavuz D

    2015-08-01

    Full Text Available Dilek Gogas Yavuz, Sevim Ozcan, Oguzhan DeyneliDepartment of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, TurkeyObjective: We aimed to evaluate adherence to insulin treatment in terms of treatment persistence and daily adherence to insulin injections among insulin-naïve type 2 diabetic patients initiating insulin therapy with basal (long acting, basal-bolus, and premixed insulin regimens in a tertiary endocrinology outpatient clinic.Methods: A total of 433 (mean age of 55.5±13.0 years; 52.4% females insulin-naïve type 2 diabetic patients initiated on insulin therapy were included in this questionnaire-based phone interview survey at the sixth month of therapy. Via the telephone interview questions, patients were required to provide information about persistence to insulin treatment, self-reported blood glucose values, and side effects; data on demographics and diabetes characteristics were obtained from medical records.Results: Self-reported treatment withdrawal occurred in 20.1% patients, while 20.3% patients were nonadherent to daily insulin. Negative beliefs about insulin therapy (24.1% and forgetting injections (40.9% were the most common reasons for treatment withdrawal and dose skipping, respectively. Younger age (49.5±15.0 vs 56.4±12.0 years (P=0.001 and shorter duration of diabetes (4.8±4.3 vs 8.8±6.3 years (P=0.0008 and treatment duration (5.2±2.4 vs 10.7±2.4 months (P=0.0001 were noted, respectively, in discontinuers vs continuers. Basal bolus was the most commonly prescribed insulin regimen (51.0%, while associated with higher likelihood of skipping a dose than regular use (61.3% vs. 46.0%, P=0.04.Conclusions: Persistence to insulin therapy was poorer than anticipated but appeared to be higher in patients with the basal bolus regimen. Negative perceptions about insulin therapy seemed to be the main cause for poor adherence in our cohort.Keywords: type 2 diabetes, insulin treatment adherence

  13. Recent advances in tuberculosis: New drugs and treatment regimens.

    Science.gov (United States)

    Sloan, Derek J; Davies, Geraint R; Khoo, Saye H

    2013-06-01

    The current treatment regimen against drug susceptible tuberculosis (DS-TB) was defined by the 1980s. Since then the emergence of the global HIV pandemic and the escalation of drug resistant (DR-) forms of TB have presented new challenges for therapeutic research. Priority goals include shortening DS-TB treatment, improving DR-TB treatment and making combined TB-HIV therapy easier. To help achieve these goals, a range of new drugs and treatment strategies are currently being evaluated. Phase IIb and III clinical trials are ongoing to assess combinations involving the high-dose rifamycins, the 8-methoxyquinolones, a diarylquinoline (bedaquiline) and the nitroimidazoles. Other compounds (e.g. novel oxazolidinones and ethylenediamines) are at earlier stages of clinical development. Overall, there are grounds for optimism that recent advances will contribute towards achievement of new treatment regimens in the foreseeable future. However, long-term investment, political commitment and scientific endeavour are crucial to ensure that progress is sustained and the benefits of recent advances reach those in the greatest need.

  14. Postcesarean Thromboprophylaxis with Two Different Regimens of Bemiparin

    Directory of Open Access Journals (Sweden)

    Milagros Cruz

    2011-01-01

    Full Text Available Objectives. To compare the effectiveness of postcesarean thromboprophylaxis with two different regimens of bemiparin. Material and Methods. The study included 646 women with cesarean delivery in our hospital within a 1-year period, randomly assigned to one of two groups for prophylaxis with 3500 IU bemiparin once daily for 5 days or 3500 IU bemiparin once daily for 10 days. Results. There was one case of pulmonary embolism (first day following cesarean. An additional risk factor was present in 98.52% of the women, most frequently emergency cesarean, anemia, or obesity. The only risk factors for thromboembolic disease significantly related to pulmonary thromboembolism were placental abruption and prematurity. There were no differences in thromboembolic events among the two thromboprophylaxis regimens. Conclusions. Cesarean-related thromboembolic events were reduced in our study population due to the thromboprophylactic measures taken. Thromboprophylaxis with 3500 IU bemiparin once daily for 5 days following cesarean was sufficient to avoid thromboembolic events.

  15. [Psychiatric medicine].

    Science.gov (United States)

    Ibañez Dominguez, J

    1984-06-01

    The author, after a short historical introduction which shows the Medicine, especially the Neurology, as the predecessor of the Psychiatry, intents to relate in a theorico-practical way the anxiety and the depression within a bio-chemical and endocrinological frame. He presents the hipo and hipercalcemia signals and symptoms demonstrating with a casuistic from his clinical practice the similitude between anxiety and depression respectively. Finally he realizes a theorical analysis about the investigations published over the AMP-ciclic and infers about the hormonal interference and the clinical data linked with the manic-depressive disease.

  16. Plasma medicine

    CERN Document Server

    Fridman, Alexander

    2012-01-01

    This comprehensive text is suitable for researchers and graduate students of a 'hot' new topic in medical physics. Written by the world's leading experts,  this book aims to present recent developments in plasma medicine, both technological and scientific, reviewed in a fashion accessible to the highly interdisciplinary audience consisting of doctors, physicists, biologists, chemists and other scientists, university students and professors, engineers and medical practitioners. The book focuses on major topics and covers the physics required to develop novel plasma discharges relevant for medic

  17. The Effect of Electroacupuncture on Osteosarcoma Tumor Growth and Metastasis: Analysis of Different Treatment Regimens

    Directory of Open Access Journals (Sweden)

    Branden A. Smeester

    2013-01-01

    Full Text Available Osteosarcoma is the most common malignant bone tumor found in children and adolescents and is associated with many complications including cancer pain and metastasis. While cancer patients often seek complementary and alternative medicine (CAM approaches to treat cancer pain and fatigue or the side effects of chemotherapy and treatment, there is little known about the effect of acupuncture treatment on tumor growth and metastasis. Here we evaluate the effects of six different electroacupuncture (EA regimens on osteosarcoma tumor growth and metastasis in both male and female mice. The most significant positive effects were observed when EA was applied to the ST-36 acupoint twice weekly (EA-2X/3 beginning at postimplantation day 3 (PID 3. Twice weekly treatment produced robust reductions in tumor growth. Conversely, when EA was applied twice weekly (EA-2X/7, starting at PID 7, there was a significant increase in tumor growth. We further demonstrate that EA-2X/3 treatment elicits significant reductions in tumor lymphatics, vasculature, and innervation. Lastly, EA-2X/3 treatment produced a marked reduction in pulmonary metastasis, thus providing evidence for EA’s potential antimetastatic capabilities. Collectively, EA-2X/3 treatment was found to reduce both bone tumor growth and lung metastasis, which may be mediated in part through reductions in tumor-associated vasculature, lymphatics, and innervation.

  18. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy.

    Science.gov (United States)

    Guinto, Valerie T; De Guia, Blanca; Festin, Mario R; Dowswell, Therese

    2010-09-08

    Asymptomatic bacteriuria occurs in 5% to 10% of pregnancies and, if left untreated, can lead to serious complications. To assess which antibiotic is most effective and least harmful as initial treatment for asymptomatic bacteriuria in pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010) and reference lists of retrieved studies. Randomized controlled trials comparing two antibiotic regimens for treating asymptomatic bacteriuria. Review authors independently screened the studies for inclusion and extracted data. We included five studies involving 1140 women with asymptomatic bacteriuria. We did not perform meta-analysis; each trial examined different antibiotic regimens and so we were not able to pool results. In a study comparing a single dose of fosfomycin trometamol 3 g with a five-day course of cefuroxime, there was no significant difference in persistent infection (risk ratio (RR) 1.36, 95% confidence interval (CI) 0.24 to 7.75), shift to other antibiotics (RR 0.08, 95% CI 0.00 to 1.45), or in allergy or pruritus (RR 2.73, 95% CI 0.11 to 65.24). A comparison of seven-day courses of 400 mg pivmecillinam versus 500 mg ampicillin, both given four times daily, showed no significant difference in persistent infection at two weeks or recurrent infection, but there was an increase in vomiting (RR 4.57, 95% CI 1.40 to 14.90) and women were more likely to stop treatment early with pivmecillinam (RR 8.82, 95% CI 1.16 to 66.95). When cephalexin 1 g versus Miraxid(R) (pivmecillinam 200 mg and pivampicillin 250 mg) were given twice-daily for three days, there was no significant difference in persistent or recurrent infection. A one- versus seven-day course of nitrofurantoin resulted in more persistent infection with the shorter course (RR 1.76, 95% CI 1.29 to 2.40), but no significant difference in symptomatic infection at two weeks, nausea, or preterm birth. Comparing cycloserine with sulphadimidine, no significant differences in

  19. Switching regimens in virologically suppressed HIV-1-infected patients: evidence base and rationale for integrase strand transfer inhibitor (INSTI)-containing regimens.

    Science.gov (United States)

    Raffi, F; Esser, S; Nunnari, G; Pérez-Valero, I; Waters, L

    2016-10-01

    In an era when most individuals with treated HIV infection can expect to live into old age, clinicians should proactively review their patients' current and future treatment needs and challenges. Clinical guidelines acknowledge that, in the setting of virological suppression, treatment switch may yield benefits in terms of tolerability, regimen simplification, adherence, convenience and long-term health considerations, particularly in the context of ageing. In this paper, we review evidence from six key clinical studies on switching virologically suppressed patients to regimens based on integrase strand transfer inhibitors (INSTIs), the antiretroviral class increasingly preferred as initial therapy in clinical guidelines. We review these studies and focus on the virological efficacy, safety, and tolerability of switching to INSTI-based regimens in suppressed HIV-positive individuals. We review the early switch studies SWITCHMRK and SPIRAL [assessing a switch from a ritonavir-boosted protease inhibitor (PI/r) to raltegravir (RAL)-containing regimens], together with data from STRATEGY-PI [assessing a switch to elvitegravir (EVG)-containing regimens; EVG/cobicistat (COBI)/emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) vs. remaining on a PI/r-containing regimen], STRATEGY-NNRTI [assessing a switch to EVG/COBI/FTC/TDF vs. continuation of a nonnucleoside reverse transcriptase inhibitor (NNRTI) and two nucleoside reverse transcriptase inhibitors (NRTIs)], STRIIVING [assessing a switch to a dolutegravir (DTG)-containing regimen (abacavir (ABC)/lamivudine (3TC)/DTG) vs. staying on the background regimen], and GS study 109 [assessing a switch to EVG/COBI/FTC/tenofovir alafenamide fumarate (TAF) vs. continuation of FTC/TDF-based regimens]. Switching to INSTI-containing regimens has been shown to support good virological efficacy, with evidence from two studies demonstrating superior virological efficacy for a switch to EVG-containing regimens. In addition, switching

  20. Evolutionary medicine.

    Science.gov (United States)

    Swynghedauw, B

    2004-04-01

    Nothing in biology makes sense except in the light of evolution. Evolutionary, or darwinian, medicine takes the view that contemporary diseases result from incompatibility between the conditions under which the evolutionary pressure had modified our genetic endowment and the lifestyle and dietary habits in which we are currently living, including the enhanced lifespan, the changes in dietary habits and the lack of physical activity. An evolutionary trait express a genetic polymorphism which finally improve fitness, it needs million years to become functional. A limited genetic diversity is a necessary prerequisite for evolutionary medicine. Nevertheless, search for a genetic endowment would become nearly impossible if the human races were genetically different. From a genetic point of view, homo sapiens, is homogeneous, and the so-called human races have only a socio-economic definition. Historically, Heart Failure, HF, had an infectious origin and resulted from mechanical overload which triggered mechanoconversion by using phylogenically ancient pleiotropic pathways. Adaptation was mainly caused by negative inotropism. Recently, HF was caused by a complex remodelling caused by the trophic effects of mechanics, ischemia, senescence, diabetes and, neurohormones. The generally admitted hypothesis is that cancers were largely caused by a combination of modern reproductive and dietary lifestyles mismatched with genotypic traits, plus the longer time available for a confrontation. Such a concept is illustrated for skin and breast cancers, and also for the link between cancer risk and dietary habits.

  1. Efficacy and safety of herbal medicines in treating gastric ulcer: a review.

    Science.gov (United States)

    Bi, Wei-Ping; Man, Hui-Bin; Man, Mao-Qiang

    2014-12-01

    Gastric ulcer is a common disorder of the digestive system. Current therapeutic regimens largely rely on Western medicine. However, numerous studies have demonstrated that herbal medicines can effectively treat gastric ulcer in humans and various animal models via divergent mechanisms. This review updates the efficacy and safety of herbal medicines in treating gastric ulcer, and the mechanisms of their action in humans and animal models. Studies have demonstrated that the efficacy of herbal medicines is comparable or superior to that of drugs such as omeprazole or cimetidine in humans and animal models, and herbal medicines display fewer adverse effects. The mechanisms by which herbal medicines benefit gastric ulcer include stimulation of mucous cell proliferation, anti-oxidation, and inhibition of gastric acid secretion and H(+)/K(+)-ATPase activity. Some herbal medicines also exhibit antimicrobial properties. Utilization of herbal medicines could be a valuable alternative to treat gastric ulcer in humans effectively, with few adverse effects.

  2. Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial

    DEFF Research Database (Denmark)

    Brandstrup, Birgitte; Tønnesen, Hanne; Beier-Holgersen, Randi;

    2003-01-01

    To investigate the effect of a restricted intravenous fluid regimen versus a standard regimen on complications after colorectal resection.......To investigate the effect of a restricted intravenous fluid regimen versus a standard regimen on complications after colorectal resection....

  3. Genomic Medicine

    Directory of Open Access Journals (Sweden)

    Ignacio Briceño Balcázar

    2011-04-01

    Full Text Available Until the twilight of the 20th century, genetics was a branch of medicine applied to diseases of rare occurrence.  The advent of the human genome sequence and the possibility of studying it at affordable costs for patients and healthcare institutions, has permitted its application in high-priority diseases like cancer, cardiovascular disease, diabetes, and Alzheimer’s, among others. There is great potential in predictive and preventive medicine, through studying polymorphic genetic variants associated to risks for different diseases. Currently, clinical laboratories offer studies of over 30,000 variants associated with susceptibilities, to which individuals can access without much difficulty because a medical prescription is not required. These exams permit conducting a specific plan of preventive medicine.  For example, upon the possibility of finding a deleterious mutation in the BRCA1 and BRCA2 genes, the patient can prevent the breast cancer by mastectomy or chemoprophylaxis and in the presence of polymorphisms associated to cardiovascular risk preventive action may be undertaken through changes in life style (diet, exercise, etc.. Legal aspects are also present in this new conception of medicine.  For example, currently there is legislation for medications to indicate on their labels the different responses such medication can offer regarding the genetic variants of the patients, given that similar doses may provoke adverse reactions in an individual, while for another such dosage may be insufficient. This scenario would allow verifying the polymorphisms of drug response prior to administering medications like anticoagulants, hyperlipidemia treatments, or chemotherapy, among others. We must specially mention recessive diseases, produced by the presence of two alleles of a mutated gene, which are inherited from the mother, as well as the father. By studying the mutations, we may learn if a couple is at risk of bearing children with the

  4. GENOMIC MEDICINE

    Directory of Open Access Journals (Sweden)

    Ignacio Briceño Balcázar

    2011-03-01

    Full Text Available Until the twilight of the 20th century, genetics was a branch of medicine applied to diseases of rare occurrence. The advent of the human genome sequence and the possibility of studying it at affordable costs for patients and healthcare institutions, has permitted its application in high-priority diseases like cancer, cardiovascular disease, diabetes, and Alzheimer’s, among others.There is great potential in predictive and preventive medicine, through studying polymorphic genetic variants associated to risks for different diseases. Currently, clinical laboratories offer studies of over 30,000 variants associated with susceptibilities, to which individuals can access without much difficulty because a medical prescription is not required. These exams permit conducting a specific plan of preventive medicine. For example, upon the possibility of finding a deleterious mutation in the BRCA1 and BRCA2 genes, the patient can prevent the breast cancer by mastectomy or chemoprophylaxis and in the presence of polymorphisms associated to cardiovascular risk preventive action may be undertaken through changes in life style (diet, exercise, etc..Legal aspects are also present in this new conception of medicine. For example, currently there is legislation for medications to indicate on their labels the different responses such medication can offer regarding the genetic variants of the patients, given that similar doses may provoke adverse reactions in an individual, while for another such dosage may be insufficient. This scenario would allow verifying the polymorphisms of drug response prior to administering medications like anticoagulants, hyperlipidemia treatments, or chemotherapy, among others.We must specially mention recessive diseases, produced by the presence of two alleles of a mutated gene, which are inherited from the mother, as well as the father. By studying the mutations, we may learn if a couple is at risk of bearing children with the disease

  5. Toward the definition of immunosuppressive regimens with antitumor activity.

    Science.gov (United States)

    Casadio, F; Croci, S; D'Errico Grigioni, A; Corti, B; Grigioni, W F; Landuzzi, L; Lollini, P-L

    2005-06-01

    Immunosuppressive therapies associated with organ transplantation produce an increased risk of cancer development. Malignancies are increased in transplant recipients because of the impaired immune system. Moreover, experimental data point to a tumor-promoting activity of various immunosuppressive agents. In this study, we compared the effects of 4 immunosuppressive agents with different mechanisms of action (cyclosporine, rapamycin, mycophenolic acid, and leflunomide) on the in vitro growth of various tumor cell lines and umbilical vein endothelial cells. To varying degrees rapamycin (10 ng/mL), mycophenolic acid (300 nmol/L), and leflunomide (30 micromol/L) highly inhibited the growth of human rhabdomyosarcoma, hepatocellular carcinoma, colorectal carcinoma, and endothelial cells. In contrast, cyclosporine (100 ng/mL) did not affect their growth. Our data suggest that regimens containing rapamycin, mycophenolic acid, or leflunomide, which have both immunosuppressive and antitumor activities, should be preferred in transplant recipients to minimize the risk of tumors.

  6. Comparison of different anthelminthic drug regimens against Mansonella perstans filariasis.

    Science.gov (United States)

    Bregani, Enrico Rino; Rovellini, Angelo; Mbaïdoum, Narassem; Magnini, Maria Giovanna

    2006-05-01

    Mansonella perstans filariasis is widely present in Africa and equatorial America and its pathogenicity has recently been reconsidered. Effective treatment is lacking and there is no consensus on the optimal therapeutic approach. The aim of this study was to compare the effects of different drug regimens on M. perstans infection. Six different anthelminthic therapeutic protocols were undertaken on 165 subjects with M. perstans infection and their effects on microfilariae burden were evaluated. Diethylcarbamazine (DEC) was able to reduce microfilariae density in the majority of cases, but it seldom eliminated infection after a single treatment. Mebendazole appeared to be more active than DEC in eliminating the infection, with a comparable rate of overall responses. Ivermectin and praziquantel showed no modification of microfilariae concentration. Thiabendazole showed a small but significant activity against the infection. Combination treatments (DEC plus mebendazole) resulted in a significantly higher activity than the single drugs.

  7. Levothyroxine treatment in pregnancy: indications, efficacy, and therapeutic regimen.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Burman, Kenneth D; Van Nostrand, Douglas; Wartofsky, Leonard

    2011-01-01

    The prevalence of overt and subclinical hypothyroidism during pregnancy is estimated to be 0.3-0.5% and 2-3%, respectively. Thyroid autoantibodies are found in 5-18% of women in the childbearing age. The aim of this review is to underscore the clinical significance of these findings on the health of both the mother and her offspring. Methods of evaluation of thyroid function tests (TFTs) during pregnancy are described as are the threshold values for the diagnosis of overt and subclinical hypothyroidism or hypothyroxinemia. Anticipated differences in TFTs in iodine-sufficient and iodine-deficient areas are discussed and data are provided on potential complications of hypothyroidism/hypothyroxinemia and autoimmune thyroid disease during pregnancy and adverse effects for the offspring. The beneficial effects of levothyroxine therapy on pregnancy outcomes and offspring development are discussed with a proposed treatment regimen and follow up strategy.

  8. Levothyroxine Treatment in Pregnancy: Indications, Efficacy, and Therapeutic Regimen

    Directory of Open Access Journals (Sweden)

    Joanna Klubo-Gwiezdzinska

    2011-01-01

    Full Text Available The prevalence of overt and subclinical hypothyroidism during pregnancy is estimated to be 0.3–0.5% and 2–3%, respectively. Thyroid autoantibodies are found in 5–18% of women in the childbearing age. The aim of this review is to underscore the clinical significance of these findings on the health of both the mother and her offspring. Methods of evaluation of thyroid function tests (TFTs during pregnancy are described as are the threshold values for the diagnosis of overt and subclinical hypothyroidism or hypothyroxinemia. Anticipated differences in TFTs in iodine-sufficient and iodine-deficient areas are discussed and data are provided on potential complications of hypothyroidism/hypothyroxinemia and autoimmune thyroid disease during pregnancy and adverse effects for the offspring. The beneficial effects of levothyroxine therapy on pregnancy outcomes and offspring development are discussed with a proposed treatment regimen and follow up strategy.

  9. Comparison of antiplatelet regimens in secondary stroke prevention

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Pallisgaard, Jannik; Gerds, Thomas Alexander

    2015-01-01

    BACKGROUND: In patients with ischemic stroke of non-cardioembolic origin, acetylsalicylic acid, clopidogrel, or a combination of acetylsalicylic acid and dipyridamole are recommended for the prevention of a recurrent stroke. The purpose of this study was to examine the risk of bleeding or recurrent...... were calculated for each antiplatelet regimen. RESULTS: Among patients discharged after first-time ischemic stroke, 3043 patients were treated with acetylsalicylic acid, 12,295 with a combination of acetylsalicylic acid and dipyridamole, and 3885 with clopidogrel. Adjusted HRs for clopidogrel versus...... the combination of acetylsalicylic acid and dipyridamole were 1.02 (95% confidence interval [CI]: 0.89-1.17) for ischemic stroke and 1.06 (95% CI: 0.83-1.35) for bleeding. Adjusted HRs for acetylsalicylic acid versus the combination of acetylsalicylic acid and dipyridamole were 1.48 (95% CI: 1.31-1.67) for stroke...

  10. Breast Cancer Screening in an Era of Personalized Regimens

    Science.gov (United States)

    Onega, Tracy; Beaber, Elisabeth F.; Sprague, Brian L.; Barlow, William E.; Haas, Jennifer S.; Tosteson, Anna N.A.; Schnall, Mitchell D.; Armstrong, Katrina; Schapira, Marilyn M.; Geller, Berta; Weaver, Donald L.; Conant, Emily F.

    2014-01-01

    Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women’s health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for “overdiagnosis,” and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a “1-size-fits-all” guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women’s risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. PMID:24830599

  11. Antimicrobial outcomes in plasma medicine

    Science.gov (United States)

    Ryan, Thomas P.; Stalder, Kenneth R.; Woloszko, Jean

    2015-03-01

    Plasma is referred to as the fourth state of matter and is frequently generated in the environment of a strong electric field. The result consists of highly reactive species--ions, electrons, reactive atoms and molecules, and UV radiation. Plasma Medicine unites a number of fields, including Physics, Plasma Chemistry, Cell Biology, Biochemistry, and Medicine. The treatment modality utilizes Cold Atmospheric Plasma (CAP), which is able to sterilize and treat microbes in a nonthermal manner. These gas-based plasma systems operate at close to room temperature and atmospheric pressure, making them very practical for a range of potential treatments and are highly portable for clinical use throughout the health care system. The hypothesis is that gas based plasma kills bacteria, fungus, and viruses but spares mammalian cells. This paper will review systematic work which shows examples of systems and performance in regards to antimicrobial effects and the sparing of mammalian cells. The mechanism of action will be discussed, as well as dosing for the treatment of microbial targets, including sterilization processes, another important healthcare need. In addition, commercial systems will be overviewed and compared, along with evidence-based, patient results. The range of treatments cover wound treatment and biofilms, as well as antimicrobial treatment, with little chance for resistance and tolerance, as in drug regimens. Current clinical studies include applications in dentistry, food treatment, cancer treatment, wound treatment for bacteria and biofilms, and systems to combat health care related infections.

  12. Medicinal cannabis.

    Science.gov (United States)

    Murnion, Bridin

    2015-12-01

    A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4.

  13. Evaluation of the efficacy and safety of three dosing regimens of agalsidase alfa enzyme replacement therapy was underpowered

    Directory of Open Access Journals (Sweden)

    Ortiz A

    2015-11-01

    Full Text Available Alberto Ortiz,1,2 Maria Dolores Sanchez-Niño1,2 1Department of Nephrology, IIS-Fundacion Jimenez Diaz, School of Medicine, Universidad Autónoma de Madrid, 2Department of Nephrology, Instituto Reina Sofia de Investigación Nefrológica, Madrid, Spain We read with interest the report by Goláň et al on the “Evaluation of the efficacy and safety of three dosing regimens of agalsidase alfa enzyme replacement therapy in adults with Fabry disease”.1 Based on the reported results, the authors conclude that no efficacy or safety differences were found when the approved every-other-week (EOW dosage of agalsidase alfa was increased to weekly administration. However, the key question is whether the study, as designed and performed, could have had a different outcome. View original article by Goláň et al.

  14. ['Translational medicine as a way from fundamental biomedical science to public health services].

    Science.gov (United States)

    Ipatova, O M; Medvedeva, N V; Archakov, A I; Grigor'ev, A I

    2012-01-01

    Increasing distance between practical public health services and collecting of theoretical information in the field of biomedical researches reflects the necessity of professional contact between clinicians and scientists in many areas associated with medicine for active carrying over ("translation") of the modern basic researches in which mechanisms of basic metabolic processes and possibilities of their correction are detected, to effective medical help to individual patient, i.e., personified medicine. Such approach was called transmitting medicine. Examples of the personified medicine in which biomedical researches together with the anamnesis morbi of individual patient that are responsible for treatment strategy including doses and regimens are discussed.

  15. Toward a noncytotoxic glioblastoma therapy: blocking MCP-1 with the MTZ Regimen

    Directory of Open Access Journals (Sweden)

    Salacz ME

    2016-04-01

    Full Text Available Michael E Salacz,1,2 Richard E Kast,3 Najmaldin Saki,4 Ansgar Brüning,5 Georg Karpel-Massler,6 Marc-Eric Halatsch6 1Department of Internal Medicine, 2Department of Neurosurgery, University of Kansas, Kansas City, KS, USA; 3IIAIGC Study Center, Burlington, VT, USA; 4Health Research Institute, Research Center of Thalassemia and Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 5Molecular Biology Laboratory, University Hospital Munich, Munich, Germany; 6Department of Neurosurgery, University of Ulm, Ulm, Germany Abstract: To improve the prognosis of glioblastoma, we developed an adjuvant treatment directed to a neglected aspect of glioblastoma growth, the contribution of nonmalignant monocyte lineage cells (MLCs (monocyte, macrophage, microglia, dendritic cells that infiltrated a main tumor mass. These nonmalignant cells contribute to glioblastoma growth and tumor homeostasis. MLCs comprise of approximately 10%–30% of glioblastoma by volume. After integration into the tumor mass, these become polarized toward an M2 immunosuppressive, pro-angiogenic phenotype that promotes continued tumor growth. Glioblastoma cells initiate and promote this process by synthesizing 13 kDa MCP-1 that attracts circulating monocytes to the tumor. Infiltrating monocytes, after polarizing toward an M2 phenotype, synthesize more MCP-1, forming an amplification loop. Three noncytotoxic drugs, an antibiotic – minocycline, an antihypertensive drug – telmisartan, and a bisphosphonate – zoledronic acid, have ancillary attributes of MCP-1 synthesis inhibition and could be re-purposed, singly or in combination, to inhibit or reverse MLC-mediated immunosuppression, angiogenesis, and other growth-enhancing aspects. Minocycline, telmisartan, and zoledronic acid – the MTZ Regimen – have low-toxicity profiles and could be added to standard radiotherapy and temozolomide. Re-purposing older drugs has advantages of established safety and low

  16. Risedronate once monthly: a potential new regimen for the treatment of postmenopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    María J Moro-Álvarez

    2008-06-01

    Full Text Available María J Moro-Álvarez1, Manuel Díaz-Curiel21Hospital Central Cruz Roja, Madrid, 2Fundación Jiménez Díaz, Madrid, Spain, Internal Medicine, Metabolic Bone Disease UnitAbstract: Postmenopausal osteoporosis increases susceptibility to low-trauma fractures due to reduced bone volume and microarchitectural deterioration. Daily nitrogen-containing bisphosphonates have shown antifracture efficacy in many studies and are the most commonly prescribed treatment for women with postmenopausal osteoporosis. However, optimal efficacy is often not achieved due to poor patient adherence to medication. Current dosing schedules are often inconvenient or impractical for patients. Poor adherence increases risk of fracture, which itself increases morbidity, healthcare costs and, potentially, mortality. Although weekly rather than daily dosing of bisphosphonates has improved adherence, significant problems remain. Efforts to reduce dosing frequency as a possible means for further improving adherence (compliance and persistence, and therefore treatment outcomes, are ongoing. Risedronate, a third-generation bisphosphonate, has been shown in multiple clinical trials to reduce fracture risk and improve bone mineral density in postmenopausal women with osteoporosis. Risedronate has a specific structure and set of characteristics that enable less frequent dosing. This paper reviews the structure of risedronate, and how this translates into high antiresorptive potency, favorable bone binding, persistence in bone, and good tolerability that permits less frequent dosing. The paper also reviews the clinical evidence for risedronate, demonstrating the viability of less frequent dosing, with its potential benefits for patient convenience and adherence to therapy. Two equivalence or non-inferiority bridging studies have demonstrated the option of novel risedronate dosing regimens. These studies are reviewed to demonstrate the efficacy and safety of two different monthly

  17. The Relationship between Cognitive Appraisal and Adherence to Medical Regimens in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Shahnaz Ahrari

    2014-12-01

    Full Text Available Introduction: Non-adherence to medical regimen has remained a challenge to the medical profession as well as to social sciences. To achieve positive results, the factors negatively impacting patient adherence to medical regimens (i.e., diet, drug and exercise regimen must be scrutinized in detail. The objective of this research was to explore the relationship between cognitive appraisal and adherence to medical regimens in type 2 diabetic patients. Methods: In this correlational study, 218 type 2 diabetes patients receiving treatment at the Diabetes Clinic affiliated with Gonabad University of Medical Sciences were selected through non-probability (convenience sampling from April 2012 to May 2013. Two valid and reliable questionnaires of cognitive appraisal and adherence to medical regimens were completed by each patient. The data were analyzed using SPSS ver 13. Results: A relationship was observed between perceived cognitive and adherence to some aspects of medical regimen. Also direct relationship was observedbetween perceived cognitive in form challenge and adherence of diet in patients with diabetes. There was no statistically significant relationship between aspects of cognitive appraisal and adherence to the drug regimen. Conclusion: The results suggest that interventions undertaken to improve adherence to medical regimen, particularly to drug regimen in patients with type 2 diabetes, should be focused on enriching cognitive appraisal. Nurses need to help patients perceive diabetes as less of a threat and in fact should empower them, so as to look upon it as more of a challenge.

  18. Therapeutic Response In Mycetoma â€" A Study Of Different Regimens

    Directory of Open Access Journals (Sweden)

    Kaliswaran A V

    2003-01-01

    Full Text Available Treatment of mycetoma is always considered a challenge to the dermatologists. Hence this study was undertaken to determine the efficacy of various therapeutic regimens in actinomycotic and eumycotic mycetoma. A total of 25 patients including 18 cases of actinomycotic mycetoma and 7 cases of eumycotic mycetoma was included. Combinations of trimethoprim-sulfamethoxazole (TS with rifampicin (regimen-3, and TS monotherapy (regimen-4 were used in 9,2,1 and 6 patients with actinomycotic mycetoma respectively. Ketoconazole (regimen-A and itraconazole (regimen-B were used in patients with eumycotic mycetoma along with surgical excision (in amenable cases. Remission was observed in 10 cases of actinomycotic mycetoma (eight with Welsh regimen and one case of eumycetoma who was subjected to surgical excision followed by oral ketoconazole. Improvement was seen in 2 cases of actinomycetoma treated one each with Welsh regimen and regimen4: in 2 cases of eumycetoma treated with ketoconazole in one and itraconazole in the other. No significant adverse effect was noted in the study except ototoxicity and reaction to streptomycin in one patient. In general, therapeutic outcome was excellent in patients with actinomycotic mycetoma particularly with Welsh regimen, whereas the response to medical therapy in eumycetoma is not satisfactory. Complete surgical excision followed by antifungal therapy at an early stage for eumycotic mycetoma is perhaps the best possible therapeutic modality in the present scenario.

  19. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy

    Science.gov (United States)

    Guinto, Valerie T; De Guia, Blanca; Festin, Mario R; Dowswell, Therese

    2014-01-01

    Background Asymptomatic bacteriuria occurs in 5% to 10% of pregnancies and, if left untreated, can lead to serious complications. Objectives To assess which antibiotic is most effective and least harmful as initial treatment for asymptomatic bacteriuria in pregnancy. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (March 2010) and reference lists of retrieved studies. Selection criteria Randomized controlled trials comparing two antibiotic regimens for treating asymptomatic bacteriuria. Data collection and analysis Review authors independently screened the studies for inclusion and extracted data. Main results We included five studies involving 1140 women with asymptomatic bacteriuria. We did not perform meta-analysis; each trial examined different antibiotic regimens and so we were not able to pool results. In a study comparing a single dose of fosfomycin trometamol 3 g with a five-day course of cefuroxime, there was no significant difference in persistent infection (risk ratio (RR) 1.36, 95% confidence interval (CI) 0.24 to 7.75), shift to other antibiotics (RR 0.08, 95% CI 0.00 to 1.45), or in allergy or pruritus (RR 2.73, 95% CI 0.11 to 65.24). A comparison of seven-day courses of 400 mg pivmecillinam versus 500 mg ampicillin, both given four times daily, showed no significant difference in persistent infection at two weeks or recurrent infection, but there was an increase in vomiting (RR 4.57, 95% CI 1.40 to 14.90) and women were more likely to stop treatment early with pivmecillinam (RR 8.82, 95% CI 1.16 to 66.95). When cephalexin 1 g versus Miraxid® (pivmecillinam 200 mg and pivampicillin 250 mg) were given twice-daily for three days, there was no significant difference in persistent or recurrent infection. A one- versus seven-day course of nitrofurantoin resulted in more persistent infection with the shorter course (RR 1.76, 95% CI 1.29 to 2.40), but no significant difference in symptomatic infection at two weeks

  20. Alternative medicine - pain relief

    Science.gov (United States)

    Alternative medicine refers to treatments that are used instead of conventional (standard) ones. If you use an alternative ... with conventional medicine or therapy, it is considered complementary therapy. There are many forms of alternative medicine. Acupuncture ...

  1. Personalized Medicine and Pharmacogenomics

    Science.gov (United States)

    ... medications. Pharmacogenomics is part of a field called personalized medicine — also called individualized or precision medicine — that ... may be part of routine medical care. References Personalized medicine. U.S. Food and Drug Administration. http://www. ...

  2. Medicines by Design

    Science.gov (United States)

    ... Order Search the NIGMS Website Search the NIGMS Website NIGMS Home Research Funding Research Training News & Meetings Science Education About NIGMS NIGMS Home > Science Education > Medicines By Design Medicines By Design Spotlight Nature's Medicine Cabinet A ...

  3. Traveling Safely with Medicines

    Science.gov (United States)

    ... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

  4. Depression - stopping your medicines

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000570.htm Depression - stopping your medicines To use the sharing features ... prescription medicines you may take to help with depression, anxiety, or pain. Like any medicine, there are ...

  5. Storing your medicines

    Science.gov (United States)

    ... potent, or they may go bad before the expiration date. Pills and capsules are easily damaged by heat ... of unused medicine safely and promptly. Check the expiration date on your medicine. Throw out medicines that are ...

  6. Complementary and Integrative Medicine

    Science.gov (United States)

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  7. Cough & Cold Medicine Abuse

    Science.gov (United States)

    ... A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold Medicine Abuse ... DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  8. Medicine organizer

    Science.gov (United States)

    Martins, Ricardo; Belchior, Ismael

    2015-04-01

    In the last year of secondary school, students studying physics and chemistry are incentivized to do a project where they must put in practice their improvement of scientific knowledge and skills, like observation of phenomena and analysis of data with scientific knowledge. In this project a group of students, tutored by the teacher, wanted to build an instrument that helps people to take their medical drugs at the right time. This instrument must have some compartments with an alarm and an LED light where the people can put their medical drugs. The instrument must be easily programed using an android program that also registers if the medicine has been taken. The students needed to simulate the hardware and software, draw the electronic system and build the final product. At the end of the school year, a public oral presentation was prepared by each group of students and presented to the school community. They are also encouraged to participate in national and international scientific shows and competitions.

  9. [Disaster medicine].

    Science.gov (United States)

    Carli, Pierre; Telionri, Caroline

    2015-01-01

    For over 30 years, the French hospital and pre-hospital medical teams are trained in disaster medicine. In fact, they are regularly confronted with the management of multiple casualties in accidents or even terrorist attacks, and more rarely to large-scale disasters. The intervention of physicians of the EMS system (SAMU-SMUR) in the field allows an original healthcare organization: in an advanced medical post, the victims are triaged according to their severity and benefit if needed of initial resuscitation. SAMU medical regulating center then organize their transport and repartition in several hospitals put on alert. To cope with a mass casualty situation, the hospital also has a specific organization, the White Plan. This plan, initiated by the director, assisted by a medico-administrative cell crisis can mobilize all the resources of the institution. Personnel are recalled and the ability of emergency units is increased. Care, less urgent, other patients are postponed. There are many plans for responding to disasters. ORSEC plans of the ministry of Interior articulate with the ORSAN plans of the ministry of Health. This complementarity allows a global mobilization of public services in disasters or exceptional medical situations.

  10. Aggressive regimens for multidrug-resistant tuberculosis decrease all-cause mortality.

    Directory of Open Access Journals (Sweden)

    Carole D Mitnick

    Full Text Available RATIONALE: A better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen. OBJECTIVES: This study assessed the impact of an aggressive regimen-one containing at least five likely effective drugs, including a fluoroquinolone and injectable-on treatment outcomes in a large MDR-TB patient cohort. METHODS: This was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death. MEASUREMENTS AND MAIN RESULTS: In total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7 drugs. Cure or completion was achieved in 66.1% (442 of patients; death occurred in 20.8% (139. Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89, compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93. CONCLUSIONS: The aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB.

  11. Aggressive regimens for multidrug-resistant tuberculosis decrease all-cause mortality.

    Science.gov (United States)

    Mitnick, Carole D; Franke, Molly F; Rich, Michael L; Alcantara Viru, Felix A; Appleton, Sasha C; Atwood, Sidney S; Bayona, Jaime N; Bonilla, Cesar A; Chalco, Katiuska; Fraser, Hamish S F; Furin, Jennifer J; Guerra, Dalia; Hurtado, Rocio M; Joseph, Keith; Llaro, Karim; Mestanza, Lorena; Mukherjee, Joia S; Muñoz, Maribel; Palacios, Eda; Sanchez, Epifanio; Seung, Kwonjune J; Shin, Sonya S; Sloutsky, Alexander; Tolman, Arielle W; Becerra, Mercedes C

    2013-01-01

    A better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB) is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen. This study assessed the impact of an aggressive regimen-one containing at least five likely effective drugs, including a fluoroquinolone and injectable-on treatment outcomes in a large MDR-TB patient cohort. This was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death. In total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7) drugs. Cure or completion was achieved in 66.1% (442) of patients; death occurred in 20.8% (139). Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89), compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93). The aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB.

  12. Alternative medicine studies

    National Research Council Canada - National Science Library

    2011-01-01

    A peer-reviewed, open-access journal about alternative medicine systems including acupuncture, anthroposophic medicine, ayurveda, chiropractic, herbalism and natural products, homeopathy, naturopathy...

  13. Medicines for osteoporosis

    Science.gov (United States)

    ... Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... when: A bone density test shows you have osteoporosis, even if you have not had a fracture ...

  14. Medicines for sleep

    Science.gov (United States)

    Benzodiazepines; Sedatives; Hypnotics; Sleeping pills; Insomnia - medicines; Sleep disorder - medicines ... are commonly used to treat allergies. While these sleep aids are not addictive, your body becomes used ...

  15. Pharmacist-patient communication about medication regimen adjustment during Ramadan.

    Science.gov (United States)

    Amin, Mohamed E K; Chewning, Betty

    2016-12-01

    During Ramadan, Muslims fast from dawn to sunset while abstaining from food and drink. Although Muslim patients may be aware of their religious exemption from fasting, many patients still choose not to take that exemption and fast. This study examines pharmacists' initiation and timing of communication about medication regimen adjustment (MRA) with patients related to Ramadan. Predictors for initiating this communication with patients were also explored. A probability sample of community pharmacists in Alexandria, Egypt was surveyed. The self-administered instrument covered timing and likelihood of initiating discussion about MRA. Using ordered logistic regression, a model was estimated to predict pharmacists' initiation of the conversation on MRA during Ramadan. Ninety-three percent of the 298 approached pharmacists completed surveys. Only 16% of the pharmacists reported that they themselves usually initiated the conversation on MRA. Pharmacists' initiation of these conversations was associated with pharmacists' perceived importance of MRA on pharmacy revenue odds ratio ((OR) = 1.24, CI = 1.03-1.48). Eighty percent of the responding pharmacists reported the MRA conversation for chronic conditions started either 1-3 days before, or during the first week of Ramadan. These results suggest considerable pharmacist patient communication gaps regarding medication use during Ramadan. It is especially important for pharmacists and other health professionals to initiate communication with Muslim patients early enough to identify how best to help patients transition safely into and out of Ramadan as they fast. © 2016 Royal Pharmaceutical Society.

  16. TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA WITH AIDA BASED REGIMEN

    Directory of Open Access Journals (Sweden)

    Ramzi Jeddi

    2011-09-01

    Full Text Available In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens combining ATRA and an anthracycline with cytarabine (APL93, and without cytarabine (LPA99. From 2004, 51 patients with confirmed APL either by t(15;17 or PML/RARA were treated according to the PETHEMA LPA 99 trial. Forty three patients achieved CR (86%. The remaining seven patients had early death (one died before treatment onset: four caused by differentiation syndrome (DS and three died from central nervous system hemorrhage. Multivariate analysis revealed that female gender (P=0.045, baseline WBC> 10 G/L ( P=0.041 and serum creatinine > 1.4mg/dl ( P=0.021 were predictive of mortality during induction. DS was observed in 16 patients (32% after a median onset time of 15 days from treatment onset (range, 2–29. Body mass index ≥ 30 (P=0.01 was the only independent predictor of DS. Occurrence of hypertensive peaks significantly predicted occurrence of DS (P=0.011 and was significantly associated with high BMI (p=0.003. With a median follow-up of 50 months, 5 year cumulative incidence of relapse, event free and overall survival were 4.7%, 74% and 78%, respectively.

  17. Obstetric medicine

    Directory of Open Access Journals (Sweden)

    L. Balbi

    2013-05-01

    Full Text Available BACKGROUND Obstetric assistance made major advances in the last 20 years: improved surgical technique allows quicker caesarean sections, anaesthesiology procedures such as peripheral anaesthesia and epidural analgesia made safer operative assistance, remarkably reducing perioperative morbidity and mortality, neonatology greatly improved the results of assistance to low birth weight newborns. A new branch of medicine called “obstetric medicine” gained interest and experience after the lessons of distinguished physicians like Michael De Swiet in England. All together these advances are making successful pregnancies that 20 years ago would have been discouraged or even interrupted: that’s what we call high risk pregnancy. High risk of what? Either complications of pregnancy on pre-existing disease or complications of pre-existing disease on pregnancy. Nowadays, mortality in pregnancy has a medical cause in 80% of cases in Western countries (Confidential Enquiry on Maternal Deaths, UK, 2004. DISCUSSION The background is always changing and we have to take in account of: increase of maternal age; widespread use of assisted fertilization techniques for treatment of infertility; social feelings about maternity desire with increasing expectations from medical assistance; immigration of medically “naive” patients who don’t know to have a chronic disease, but apt and ready to conceive; limited knowledge of feasibility of drug use in pregnancy which may induce both patients and doctors to stopping appropriate drug therapy in condition of severe disease. Preconception counseling, planning the pregnancy, wise use of drugs, regular follow-up throughout the pregnancy and, in selected cases, preterm elective termination of pregnancy may result in excellent outcome both for mother and foetus. CONCLUSIONS Highly committed and specifically trained physicians are required to counsel these patients and to plan their treatment before and during pregnancy.

  18. Cycle regimens for frozen-thawed embryo transfer.

    Science.gov (United States)

    Ghobara, Tarek; Gelbaya, Tarek A; Ayeleke, Reuben Olugbenga

    2017-07-05

    Among subfertile couples undergoing assisted reproductive technology (ART), pregnancy rates following frozen-thawed embryo transfer (FET) treatment cycles have historically been found to be lower than following embryo transfer undertaken two to five days following oocyte retrieval. Nevertheless, FET increases the cumulative pregnancy rate, reduces cost, is relatively simple to undertake and can be accomplished in a shorter time period than repeated in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) cycles with fresh embryo transfer. FET is performed using different cycle regimens: spontaneous ovulatory (natural) cycles; cycles in which the endometrium is artificially prepared by oestrogen and progesterone hormones, commonly known as hormone therapy (HT) FET cycles; and cycles in which ovulation is induced by drugs (ovulation induction FET cycles). HT can be used with or without a gonadotrophin releasing hormone agonist (GnRHa). This is an update of a Cochrane review; the first version was published in 2008. To compare the effectiveness and safety of natural cycle FET, HT cycle FET and ovulation induction cycle FET, and compare subtypes of these regimens. On 13 December 2016 we searched databases including Cochrane Gynaecology and Fertility's Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL. Other search sources were trials registers and reference lists of included studies. We included randomized controlled trials (RCTs) comparing the various cycle regimens and different methods used to prepare the endometrium during FET. We used standard methodological procedures recommended by Cochrane. Our primary outcomes were live birth rates and miscarriage. We included 18 RCTs comparing different cycle regimens for FET in 3815 women. The quality of the evidence was low or very low. The main limitations were failure to report important clinical outcomes, poor reporting of study methods and imprecision due to low event rates. We found no

  19. Drug susceptibility testing and pharmacokinetics question current treatment regimens in Mycobacterium simiae complex disease.

    NARCIS (Netherlands)

    Ingen, J. van; Totten, S.E.; Heifets, L.B.; Boeree, M.J.; Daley, C.L.

    2012-01-01

    The Mycobacterium simiae complex bacteria can cause opportunistic infections in humans. In the case of definite disease, there are no evidence-based treatment regimens and outcomes are very disappointing. To increase the evidence base underpinning treatment regimens for M. simiae complex disease, dr

  20. STUDY OF WHO SAFE ABORTION REGIMEN IN MEDICAL ABORTIONS IN A TERTIARY CENTRE

    OpenAIRE

    Joylene Diana; Sujaya V.

    2015-01-01

    Medical abortion is the use of drugs to induce abortion of a fetus. Due to the advances in the field of research , numerous regimens have been formulated to ensure a fast and complete expulsion of the fetus. These regimens also aim to towards reduced post abortal side effects and to decrease the need for surgical evacuation ...

  1. A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers

    Science.gov (United States)

    2013-10-01

    Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers Authors: DISTRIBUTION STATEMENT A. Paul C. Algra, LT, MC...May 2012 – May 2013 4. TITLE AND SUBTITLE A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers...SUPPLEMENTARY NOTES 14. ABSTRACT To prevent acute otitis externa (AOE) in the saturation setting and to decrease the side effects

  2. Efficacy of combination of glycolic acid peeling with topical regimen in treatment of melasma.

    Science.gov (United States)

    Chaudhary, Savita; Dayal, Surabhi

    2013-10-01

    Various treatment modalities are available for management of melasma, ranging from topical and oral to chemical peeling, but none is promising alone. Very few studies are available regarding efficacy of combination of topical treatment with chemical peeling. Combination of chemical peeling and topical regimen can be a good treatment modality in the management of this recalcitrant disorder. To assess the efficacy of combination of topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling in the treatment of melasma in Indian patients. Forty Indian patients of moderate to severe epidermal variety melasma were divided into two groups of 20 each. One Group i.e. peel group received topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling and other group i.e. control group received topical regimen (2% hydroquinone, 1% hydrocortisone, 0.05% tretinoin). There was an overall decrease in MASI from baseline in 24 weeks of therapy in both the groups (P value glycolic acid peel with topical regimen showed early and greater improvement than the group which was receiving topical regimen only. This study concluded that combining topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling significantly enhances the therapeutic efficacy of glycolic acid peeling. The combination of glycolic acid peeling with the topical regimen is a highly effective, safe and promising therapeutic option in treatment of melasma.

  3. [Comparison of clinical efficacy between decitabine combined with CAG regimen and CAG regimen alone in patients with intermediate to high-risk myelodysplastic syndromes].

    Science.gov (United States)

    Zhang, Yun-Ping; Wu, Wen-Zhong; Cui, Guo-Xing

    2014-10-01

    This study was purposed to compare the clinical efficacy and adverse reactions of low-dose decitabine combined with CAG regimen (aclarubicin, Ara-C, and G-CSF) and CAG regimen alone in intermediate to high-risk myelodysplastic syndromes (MDS), and evaluate the validity and efficacy of the former regimen as new treatment method of intermediate to high-risk myelodysplastic syndromes. A total of 12 patients with intermediate (IR) to high-risk (HR) MDS treated by low-dose decitabine combined with CAG regimen and 10 patients with IR to HR MDS treated by CAG regimen alone were evaluated after treatment of 1 cycle and at least after 2 cycles. The complete remission (CR) after 1 cycle, overall remission rate (ORR), progression free survival (PFS) and overall survival (OS) between them were analyzed. The results showed that 9 patients treated by low-dose decitabine combined with CAG regimen achieved complete remission after 1 cycle, 2 patients achieved partial remission, 1 patient did not show reaction. The complete remission rate was 75.0% and overall response rate was 91.7%. The median time of disease free survival was 9 months (0-27 months). The median overall survival time was 16 months (3-28 months). 4 patients suffered from pulmonary infection after treatment and then were all cured after treatment with anti-infective therapy. The 5 patients treated by CAG regimen alone achieved complete remission,3 patients achieved partial remission, 2 patients showed non-reaction. The complete remission rate was 50.0% and overall response rate was 80.0%. The median time of disease free survival was 6 months(0-18 months). The median overall survival time was 13 months(3-31 months), 4 patients suffered from pulmonary infection, 1 patient suffered from enteric infection and 1 patient suffered from Escherichia coli septicemia after treatment, all of them becomed better after active treatment. Two groups of patients all had no serious adverse reactions, All patients could tolerate, no

  4. Heterologous prime-boost regimens using rAd35 and rMVA vectors elicit stronger cellular immune responses to HIV proteins than homologous regimens.

    Directory of Open Access Journals (Sweden)

    Silvia Ratto-Kim

    Full Text Available We characterized prime-boost vaccine regimens using heterologous and homologous vector and gene inserts. Heterologous regimens offer a promising approach that focuses the cell-mediated immune response on the insert and away from vector-dominated responses. Ad35-GRIN/ENV (Ad35-GE vaccine is comprised of two vectors containing sequences from HIV-1 subtype A gag, rt, int, nef (Ad35-GRIN and env (Ad35-ENV. MVA-CMDR (MVA-C, MVA-KEA (MVA-K and MVA-TZC (MVA-T vaccines contain gag, env and pol genes from HIV-1 subtypes CRF01_AE, A and C, respectively. Balb/c mice were immunized with different heterologous and homologous vector and insert prime-boost combinations. HIV and vector-specific immune responses were quantified post-boost vaccination. Gag-specific IFN-γ ELISPOT, intracellular cytokine staining (ICS (CD107a, IFN-γ, TNF-α and IL-2, pentamer staining and T-cell phenotyping were used to differentiate responses to inserts and vectors. Ad35-GE prime followed by boost with any of the recombinant MVA constructs (rMVA induced CD8+ Gag-specific responses superior to Ad35-GE-Ad35-GE or rMVA-rMVA prime-boost combinations. Notably, there was a shift toward insert-focus responses using heterologous vector prime-boost regimens. Gag-specific central and effector memory T cells were generated more rapidly and in greater numbers in the heterologous compared to the homologous prime-boost regimens. These results suggest that heterologous prime-boost vaccination regimens enhance immunity by increasing the magnitude, onset and multifunctionality of the insert-specific cell-mediated immune response compared to homologous vaccination regimens. This study supports the rationale for testing heterologous prime-boost regimens in humans.

  5. TRADITIONAL CHINESE HERBAL MEDICINE

    NARCIS (Netherlands)

    ZHU, YP; WOERDENBAG, HJ

    1995-01-01

    Herbal medicine, acupuncture and moxibustion, and massage and the three major constituent parts of traditional Chinese medicine. Although acupuncture is well known in many Western countries, Chinese herbal medicine, the mos important part of traditional Chinese medicine, is less well known in the We

  6. TRADITIONAL CHINESE HERBAL MEDICINE

    NARCIS (Netherlands)

    ZHU, YP; WOERDENBAG, HJ

    1995-01-01

    Herbal medicine, acupuncture and moxibustion, and massage and the three major constituent parts of traditional Chinese medicine. Although acupuncture is well known in many Western countries, Chinese herbal medicine, the mos important part of traditional Chinese medicine, is less well known in the

  7. TRADITIONAL CHINESE HERBAL MEDICINE

    NARCIS (Netherlands)

    ZHU, YP; WOERDENBAG, HJ

    1995-01-01

    Herbal medicine, acupuncture and moxibustion, and massage and the three major constituent parts of traditional Chinese medicine. Although acupuncture is well known in many Western countries, Chinese herbal medicine, the mos important part of traditional Chinese medicine, is less well known in the We

  8. New reduced volume preparation regimen in colon capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Yasuo Kakugawa; Kazuhide Higuchi; Shinji Tanaka; Hideki Ishikawa; Hisao Tajiri; Yutaka Saito; Shoichi Saito; Kenji Watanabe; Naoki Ohmiya; Mitsuyuki Murano; Shiro Oka; Tetsuo Arakawa; Hidemi Goto

    2012-01-01

    AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method" (group A) with the "conventional volume method" (group B) preparation regimens.Group A did not drink polyethylene glycol electrolyte lavage solution (PEGELS) the day before the capsule procedure,while group B drank 2 L.During the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule (PillCam COLON(R) capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time.Capsule videos were reviewed for grading of cleansing level.RESULTS:Sixty-four subjects were enrolled,with results from 60 analyzed.Groups A and B included 31 and 29 subjects,respectively.Twenty-nine (94%) subjects in group A and 25 (86%) subjects in group B had adequate bowel preparation (ns).Twenty-two (71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16 (55%) of the 29 subjects in group B (ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than recommended.CONCLUSION:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.

  9. Personalized laboratory medicine

    DEFF Research Database (Denmark)

    Pazzagli, M.; Malentacchi, F.; Mancini, I.

    2015-01-01

    Developments in "omics" are creating a paradigm shift in Laboratory Medicine leading to Personalised Medicine. This allows the increasing in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether Laboratory Medicine is able to implement new...... diagnostic tools and expertise and commands proper state-of-the-art knowledge about Personalized Medicine and Laboratory Medicine in Europe, the joint Working Group "Personalized Laboratory Medicine" of the EFLM and ESPT societies compiled and conducted the Questionnaire "Is Laboratory Medicine ready...... for the era of Personalized Medicine?". 48 laboratories from 18 European countries participated at this survey. The answers of the participating Laboratory Medicine professionals indicate that they are aware that Personalized Medicine can represent a new and promising health model. Whereas they are aware...

  10. Personalized laboratory medicine

    DEFF Research Database (Denmark)

    Pazzagli, M.; Malentacchi, F.; Mancini, I.

    2015-01-01

    Developments in "omics" are creating a paradigm shift in Laboratory Medicine leading to Personalised Medicine. This allows the increasing in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether Laboratory Medicine is able to implement new...... diagnostic tools and expertise and commands proper state-of-the-art knowledge about Personalized Medicine and Laboratory Medicine in Europe, the joint Working Group "Personalized Laboratory Medicine" of the EFLM and ESPT societies compiled and conducted the Questionnaire "Is Laboratory Medicine ready...... for the era of Personalized Medicine?". 48 laboratories from 18 European countries participated at this survey. The answers of the participating Laboratory Medicine professionals indicate that they are aware that Personalized Medicine can represent a new and promising health model. Whereas they are aware...

  11. Personalized medicine could transform healthcare.

    Science.gov (United States)

    Mathur, Sunil; Sutton, Joseph

    2017-07-01

    Personalized medicine (PM) is about tailoring a treatment as individualized as the disease. The approach relies on identifying genetic, epigenomic, and clinical information that allows the breakthroughs in our understanding of how a person's unique genomic portfolio makes them vulnerable to certain diseases. PM approach is a complete extension of traditional approach (One-Size-Fits-All) to increasing our ability to predict which medical treatments will be safe and effective for individual patient, and which ones will not be, based on the patient's unique genetic profile. Implementation of PM has the potential to reduce financial and time expenditure, and increase quality of life and life extension of patients. Knowledge of PM facilitates earlier disease detection via enhanced use of existing biomarkers and detection of early genomic and epigenomic events in disease development, particularly carcinogenesis. The PM approach predominantly focuses on preventative medicine and favours taking pro-active actions rather than just reactive. This approach delays or prevents the need to apply more severe treatments which are usually less tolerated and with increased quality of life and financial considerations. Increasing healthcare costs have placed additional pressure on government funded healthcare systems globally, especially regarding end of life care. PM may increase the effectiveness of existing treatments and negate the inherent problems associated with non-PM approaches. PM is a young but rapidly expanding field of healthcare where a physician can select a treatment based on a patient's genetic profile that may not only minimize harmful side effects and guarantee a more successful result, but can be less cost effective compared with a 'trial-and-error' approach to disease treatment. The less efficient non-PM ('trial-and-error') approach, which can lead to drug toxicity, severe side effects, reactive treatment and misdiagnosis continue to contribute to increasing

  12. International Organization of Standardization (ISO) and Cambridge Filter Test (CFT) Smoking Regimen Data Comparisons in Tobacco Product Marketing Applications.

    Science.gov (United States)

    Chae, Changyu; Walters, Matthew J; Holman, Matthew R

    2017-07-01

    We investigated the differences in TNCO (tar, nicotine, and carbon monoxide) smoke yields generated under the International Organization of Standardization (ISO) and Federal Trade Commission (FTC) Cambridge Filter Test (CFT) smoking regimens. Twenty-nine commercial cigarette products from the US marketplace were acquired in 2015 and tested by measuring the TNCO smoke yields generated under these 2 nonintense smoking regimens. Data obtained demonstrated a linear relationship between the TNCO yields produced under the 2 smoking regimens (R(2) > 0.99). TNCO yields produced by each product were higher under the CFT smoking regimen than the ISO smoking regimen. We found that tar, nicotine, and carbon monoxide yields were consistently 10% to 13% higher under the CFT smoking regimen than under the ISO smoking regimen. This strong correlation indicates that the 2 smoking regimens can be used to apply a correlation correction to CFT TNCO data and allow its comparison to ISO TNCO data in tobacco product marketing applications.

  13. Transcriptome profiling of Arabian horse blood during training regimens.

    Science.gov (United States)

    Ropka-Molik, Katarzyna; Stefaniuk-Szmukier, Monika; Żukowski, Kacper; Piórkowska, Katarzyna; Gurgul, Artur; Bugno-Poniewierska, Monika

    2017-04-05

    Arabian horses are believed to be one of the oldest and most influential horse breeds in the world. Blood is the main tissue involved in maintaining body homeostasis, and it is considered a marker of the processes taking place in the other tissues. Thus, the aim of our study was to identify the genetic basis of changes occurring in the blood of Arabian horses subjected to a training regimen and to compare the global gene expression profiles between different training periods (T1: after a slow canter phase that is considered a conditioning phase, T2: after an intense gallop phase, and T3: at the end of the racing season) and between trained and untrained horses (T0). RNA sequencing was performed on 37 samples with a 75-bp single-end run on a HiScanSQ platform (Illumina), and differentially expressed genes (DEGs) were identified based on DESeq2 (v1.11.25) software. An increase in the number of DEGs between subsequent training periods was observed, and the highest amount of DEGs (440) was detected between untrained horses (T0) and horses at the end of the racing season (T3). The comparisons of the T2 vs. T3 transcriptomes and the T0 vs. T3 transcriptomes showed a significant gain of up-regulated genes during long-term exercise (up-regulation of 266 and 389 DEGs in the T3 period compared to T2 and T0, respectively). Forty differentially expressed genes were detected between the T1 and T2 periods, and 296 between T2 and T3. Functional annotation showed that the most abundant genes up-regulated in exercise were involved in pathways regulating cell cycle (PI3K-Akt signalling pathway), cell communication (cAMP-dependent pathway), proliferation, differentiation and apoptosis, as well as immunity processes (Jak-STAT signalling pathway). We investigated whether training causes permanent transcriptome changes in horse blood as a reflection of adaptation to conditioning and the maintenance of fitness to compete in flat races. The present study identified the overrepresented

  14. STUDY OF WHO SAFE ABORTION REGIMEN IN MEDICAL ABORTIONS IN A TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Joylene Diana

    2015-07-01

    Full Text Available Medical abortion is the use of drugs to induce abortion of a fetus. Due to the advances in the field of research , numerous regimens have been formulated to ensure a fast and complete expulsion of the fetus. These regimens also aim to towards reduced post abortal side effects and to decrease the need for surgical evacuation post medical abortion. The objective of this cros s sectional analysis was to study the effectiveness of the WHO safe abortion regimen in a tertiary care hospital . METHODS: A total of 60 patients with pregnancies of 12 to 30 weeks of gestation and in whom a medical abortion was deemed necessary were chosen . After instituting the WHO SAFE ABORTION regimen they were analysed based on indication for pregnancy termination , onset of pain with WHO regimen and time of expulsion as well as post abortal side effects and the need for surgical evacuation due to failure of the WHO safe abortion regimen. Post abortion an ultrasound was done to confirm the success of the regimen . RESULTS: Majority of patients in our study was multiparous and Mean gestational age for pregnancy termination was 20.6 weeks . The most common indication for medical abortion was incidental diagnosis of fetal demise or fetal anomaly on ultrasonography ( 43.6% . The average duration for onset of pain was 3 hours and the average time needed for expulsion was 6 hours from the start of the Abortion regimen . The most common post abortal side effect was excessive bleeding . Only about 13.3 percent patients needed a surgical evacuation due to failure of the regimen. CONCLUSION: This study showed that the WHO safe abortion regimen is highly effective and a desirable method for medical termination of pregnancy , especially in early pregnancy and in patients in whom a surgical method of abortion could pose as a risk . The WHO SAFE ABORTION regimen has minimal post abortal side effects , need for surgical intervention and the time needed for expulsion is less. Hence it

  15. Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy.

    Science.gov (United States)

    Jiménez-Galán, Rocio; Cantudo Cuenca, Maria-Rosa; Robustillo-Cortés, María Aguas; Borrego Izquierdo, Y; Almeida-Gonzalez, Carmen Victoria; Morillo-Verdugo, Ramón

    2016-06-01

    Objetivos: Analizar y comparar la persistencia entre las estrategias basadas en Single-Tablet Regimen (STR) y Less Drug Regimen (LDR) en pacientes VIH+. El objetivo secundario del estudio fue determinar factores predictores de persistencia. Material y métodos: Estudio observacional retrospectivo que incluyo los siguientes criterios: pacientes VIH+ con tratamiento antirretroviral (TAR) con un regimen basado en STR o LDR. Se recogieron variables demograficas, factores de riesgo de adquisicion, consumo de drogas, presencia de algun trastorno psiquiatrico y coinfeccion por el virus de la hepatitis B o C. Para comparar la persistencia entre ambas estrategias se realizo un analisis de supervivencia de Kaplan-Meir y se aplico el metodo de log-rank. Se realizo un analisis de regresion de Cox para identificar los factores predictores de persistencia. Resultados: Se incluyeron 244 pacientes, 176 con STR y 68 con LDR. El 34,1% (n = 60) de los pacientes que recibieron un regimen STR abandonaron y en el LDR el 19,1% (n = 13). Los efectos adversos fueron la principal causa de abandono del tratamiento en los pacientes que recibieron STR y el fallo virologico en el regimen LDR. La persistencia de las estrategias STR y LDR fue similar, no encontrandose diferencias estadisticamente significativas entre ambas. El consumo de drogas fue el unico factor predictivo asociado con una menor persistencia (HR = 2,59; p = 0,005). Conclusiones: La persistencia entre los regimenes STR y LDR fue similar, no detectandose diferencias significativas entre ambos. El consumo de drogas fue el unico factor independiente asociado con una menor persistencia del tratamiento antirretroviral.

  16. Evaluation of Tensile Strength of the Superficial Digital Flexor Tendon in Horses Subjected to Transcutaneous Electrical Neural Stimulation Therapeutic Regimen

    Directory of Open Access Journals (Sweden)

    Davood Sharifi

    2009-01-01

    Full Text Available We would like to sincerely express our gratitude to the university of Tehran and faculty of veterinary medicine research council for approval and financial support for this extensive evaluation of tensile strength of the superficial digital flexor tendon in horses subjected to Transcutaneous Electrical Neural Stimulation (TENS therapeutic regimen Problems statement: The purpose of this study was to determine the effect of TENS on the tensile strength of experimentally traumatized SDFT in horses. Approach: Eight adult castrated horses between 4-9 years -old and 310- 395 Kg body - weight were considered. The left fore -limb superficial digital flexor tendon of each horse was splitted longitudinally in the middle portion in full thickness of 10 cm in length using B.P. blade (15 Times strike, then the connective tissue and skin were approximated using No 2 Nylon. Horses were divided into two groups of control and treated with 4 horses each. No treatment was given to control one, whereas treated group was subjected to the transcutaneous electrical neural stimulation (Newtens 900c therapeutic regimens10 min daily with intensity of 80 µs, 100 Hz frequency for 14 days. After 60 days, the full length of SDFT (20 cm was removed from the right normal countralaleral and left traumatized tendon of control and treated limbs of all horses to be subjected to test of tensile strength using Zwick/Roell MDTL Machine with speed of 0.07 mM sec-1 having Proportional Integral Deferential (PID controller. In assessing the variation obtained data was analyzed using paired-t-test. Results: Data of the tensile strength was revealed an average 0.6625 KN for normal SDFT, 0.6375 KN for treated tendon and 0.6175 KN for control tendon .There was significant improvement in regaining tensile strength in treated tendons comparison to control ones in Conclusion: TENS significantly accelerated healing and remodeling of traumatized tendon to regain its tensile strength.

  17. Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen

    DEFF Research Database (Denmark)

    Engsig, Frederik N; Gerstoft, Jan; Helleberg, Marie

    2014-01-01

    1, 2011 to obtain economic savings. METHODS AND FINDINGS: From the Capital Region of Denmark (covering two-thirds of the Danish HIV patients), we included combination antiretroviral therapy (cART)-naive patients who administered STR-TEE from April 1, 2010 to March 31, 2011 (n = 111) or TTR-TEL from......BACKGROUND: To assess the impact on virological outcomes of a switch from branded single-tablet regimen (STR) including tenofovir, efavirenz, and emtricitabine (STR-TEE) to generic triple-tablet regimen (TTR), including tenofovir, efavirenz, and lamivudine (TTR-TEL), which was implemented on April...

  18. Reflections on preventive medicine.

    Science.gov (United States)

    Miettinen, Olli S

    2014-10-01

    Having thought much about medicine in my career-long effort to understand it and the research for its advancement, I have come to views rather different form the now-prevailing ones in respect to what preventive medicine is about; what epidemiology is in relation to preventive medicine; what distinguishes preventive medicine in preventive healthcare at large; the relation of preventive medicine to public health; the concept of health promotion; and also the core principles of preventive medicine. All of these views I set forth in this article, for the readers' critical reflection.

  19. Herbal medicines that benefit epidermal permeability barrier function

    Directory of Open Access Journals (Sweden)

    Lizhi Hu

    2015-06-01

    Full Text Available Epidermal permeability barrier function plays a critical role in regulating cutaneous functions. Hence, researchers have been searching for effective and affordable regimens to enhance epidermal permeability barrier function. In addition to topical stratum corneum lipids, peroxisome proliferator-activated receptor, and liver X receptor ligands, herbal medicines have been proven to benefit epidermal permeability barrier function in both normal and diseased skin, including atopic dermatitis, glucocorticoid-induced skin damage, and UVB-damaged skin. The potential mechanisms by which herbal medicines improve the permeability barrier include stimulation of epidermal differentiation, lipid production, antimicrobial peptide expression, and antioxidation. Therefore, utilization of herbal medicines could be a valuable alternative approach to enhance epidermal permeability barrier function in order to prevent and/or treat skin disorders associated with permeability barrier abnormalities.

  20. Solidified self-nanoemulsifying formulation for oral delivery of combinatorial therapeutic regimen

    DEFF Research Database (Denmark)

    Jain, Amit K; Thanki, Kaushik; Jain, Sanyog

    2014-01-01

    PURPOSE: The present work reports rationalized development and characterization of solidified self-nanoemulsifying drug delivery system for oral delivery of combinatorial (tamoxifen and quercetin) therapeutic regimen. METHODS: Suitable oil for the preparation of liquid SNEDDS was selected based o...

  1. [Use of maraviroc, the first CCR5 receptor antagonist, in HIV treatment regimens].

    Science.gov (United States)

    Kravchenko, A V

    2013-01-01

    The paper gives the results of international trials of and guidelines for the use of maraviroc, the first CCR5 receptor antagonist, in treatment regimens for HIV-infected patients. The trials have convincingly shown that the maraviroc-containing antiretroviral therapy (ART) regimens are highly effective and safe for R5-tropic HIV-infected patients regardless of previous ART, baseline HIV RNA levels, and CD4+ lymphocyte count. Maraviroc can be recommended for HIV-infected patients who have previously received ART and who have been found to have a R5-tropic virus. The changes in the ART regimen and inclusion of maraviroc may be associated with both an ineffective previous treatment regimen and therapy-induced adverse events. In 2012, Russia's first reagent kit for the determination of HIV tropism was put to tests and registered at the Russian Inspectorate for the Protection of Consumer Rights and Human Welfare.

  2. Priority-Setting for Novel Drug Regimens to Treat Tuberculosis: An Epidemiologic Model

    Science.gov (United States)

    Cohen, Ted; Nuermberger, Eric; Dooley, Kelly E.; Gonzalez-Angulo, Lice; Churchyard, Gavin J.; Nahid, Payam; Rich, Michael L.; Bansbach, Cathy; Forissier, Thomas; Dowdy, David W.

    2017-01-01

    Background Novel drug regimens are needed for tuberculosis (TB) treatment. New regimens aim to improve on characteristics such as duration, efficacy, and safety profile, but no single regimen is likely to be ideal in all respects. By linking these regimen characteristics to a novel regimen’s ability to reduce TB incidence and mortality, we sought to prioritize regimen characteristics from a population-level perspective. Methods and Findings We developed a dynamic transmission model of multi-strain TB epidemics in hypothetical populations reflective of the epidemiological situations in India (primary analysis), South Africa, the Philippines, and Brazil. We modeled the introduction of various novel rifampicin-susceptible (RS) or rifampicin-resistant (RR) TB regimens that differed on six characteristics, identified in consultation with a team of global experts: (1) efficacy, (2) duration, (3) ease of adherence, (4) medical contraindications, (5) barrier to resistance, and (6) baseline prevalence of resistance to the novel regimen. We compared scale-up of these regimens to a baseline reflective of continued standard of care. For our primary analysis situated in India, our model generated baseline TB incidence and mortality of 157 (95% uncertainty range [UR]: 113–187) and 16 (95% UR: 9–23) per 100,000 per year at the time of novel regimen introduction and RR TB incidence and mortality of 6 (95% UR: 4–10) and 0.6 (95% UR: 0.3–1.1) per 100,000 per year. An optimal RS TB regimen was projected to reduce 10-y TB incidence and mortality in the India-like scenario by 12% (95% UR: 6%–20%) and 11% (95% UR: 6%–20%), respectively, compared to current-care projections. An optimal RR TB regimen reduced RR TB incidence by an estimated 32% (95% UR: 18%–46%) and RR TB mortality by 30% (95% UR: 18%–44%). Efficacy was the greatest determinant of impact; compared to a novel regimen meeting all minimal targets only, increasing RS TB treatment efficacy from 94% to 99

  3. Evaluation of the adverse reactions of antiretroviral drug regimens in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Zahoor A Rather

    2013-01-01

    Conclusion: The most common adverse effects associated with currently used ART regimens are anemia, hepatic toxicity, itching, skin rash, elevated triglycerides, and peripheral neuropathy. Gender differences were seen mainly with skin rash, which was significantly more in females.

  4. Physicians should increase focus on poor medicine adherence among chronically ill patients

    DEFF Research Database (Denmark)

    Tøttenborg, Sandra Søgaard; Topp, Marie; Ingebrigtsen, Truls Sylvan

    2014-01-01

    Non-adherence to medicine is common in patients with chronic diseases, contributing to significant worsening of disease, increased mortality and health expenditure. Methods of measuring adherence include self report, prescription refill rates, biomarkers, electronic monitoring and therapeutic...... outcomes. Yet, no "gold standard" for assessing adherence and no consensus on what is an acceptable level exist. Physicians should be aware of non-adherence and, although it may not always be identical with the evidence-based regimen, they can facilitate good adherence by simplifying regimens and adapting...... treatments to the patient's lifestyle and preferences....

  5. Non-adherence to medication regimens among older African-American adults.

    Science.gov (United States)

    Bazargan, Mohsen; Smith, James; Yazdanshenas, Hamed; Movassaghi, Masoud; Martins, David; Orum, Gail

    2017-07-25

    Despite concerns about racial differences on adherence to prescribed medication rigimens among older adults, current information about nonadherence among underserved elderly African Americans with co-morbidities is limited. This study examines the association between adherence to drug regimens and an array of medication-related factors, including polypharmacy, medication regimen complexity, use of Potentially Inappropriate Medications (PIM), and knowledge about the therapeutic purpose and instructions of medication use. Four-hundred African Americans, aged 65 years and older, were recruited from South Los Angeles. Structured, face-to-face interviews and visual inspection of participants' medications were conducted. From the medication container labels, information including strength of the drug, expiration date, instructions, and special warnings were recorded. The Medication Regimen Complexity Index (MRCI) was measured to quantify multiple features of drug regimen complexity. The Beers Criteria was used to measure the PIM use. Participants reported taking an average of 5.7 prescription drugs. Over 56% could not identify the purpose of at least one of their medications. Only two-thirds knew dosage regimen of their medications. Thirty-five percent of participants indicated that they purposely had skipped taking at least one of their medications within last three days. Only 8% of participants admitted that they forgot to take their medications. The results of multivariate analysis showed that co-payment for drugs, memory deficits, MRCI, and medication-related knowledge were all associated with adherence to dosage regimen of medications. Participants with a higher level of knowledge about therapeutic purpose and knowledge about dosage regimen of their medications were seven times (CI: 4.2-10.8) more likely to adhere to frequency and dose of medications. Participants with a low complexity index were two times (CI: 1.1-3.9) more likely to adhere to the dosage regimen

  6. Herbal medicinal oils in traditional Persian medicine.

    Science.gov (United States)

    Hamedi, Azadeh; Zarshenas, Mohammad M; Sohrabpour, Maryam; Zargaran, Arman

    2013-09-01

    In Iran, conventional production methods of herbal oils are widely used by local practitioners. Administration of oils is rooted in traditional knowledge with a history of more than 3000 years. Scientific evaluation of these historical documents can be valuable for finding new potential use in current medicine. The current study (i) compiled an inventory of herbal oils used in ancient and medieval Persia and (ii) compared the preparation methods and therapeutic applications of ancient times to current findings of medicinal properties in the same plant species. Information on oils, preparation methods and related clinical administration was obtained from ancient Persian documents and selected manuscripts describing traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plant species used for herbal oils through a search of the PubMed, Scopus and Google Scholar databases. In Iran, the application of medicinal oils date back to ancient times. In medieval Persian documents, 51 medicinal oils produced from 31 plant species, along with specific preparation methods, were identified. Flowers, fruits and leaves were most often used. Herbal oils have been traditionally administered via oral, topical and nasal routes for gastrointestinal, musculoskeletal, and neural diseases, respectively. According to current investigations, most of the cited medicinal plant species were used for their anti-inflammatory and analgesic properties. Medicinal oils are currently available in Iranian medicinal plant markets and are prepared using traditional procedures for desirable clinical outcomes. Other than historical clarification, the present study provides data on clinical applications of the oils that should lead to future opportunities to investigate their potential medicinal use.

  7. Cost description of chemotherapy regimens for the treatment of metastatic pancreas cancer.

    Science.gov (United States)

    Goldstein, Daniel A; Krishna, Kavya; Flowers, Christopher R; El-Rayes, Bassel F; Bekaii-Saab, Tanios; Noonan, Anne M

    2016-05-01

    Multiple chemotherapy regimens are available for the treatment of metastatic pancreas cancer (mPCA). Choice of regimen is based on the patient's performance status and toxicity profile of the regimen. The objective of this study was to analyze the costs of first-line regimens to further aid in decision-making and develop a platform upon which to assess value. We calculated the monthly cost for individual standard regimens (gemcitabine, gemcitabine/nab-paclitaxel, gemcitabine/erlotinib and FOLFIRINOX) and the overall treatment cost for a course of therapy based on the median progression-free survival achieved in published studies. In addition to cost of drugs, we included administration costs and costs of toxicities (including growth factor support, blood product transfusion and hospitalization for toxicities). Costs for administration and management of adverse events were based on Medicare reimbursement rates for hospital and physician services. Drug costs were based on Medicare average sale prices (all 2014 US$). The monthly costs for gemcitabine, FOLFIRINOX, gemcitabine/erlotinib and gemcitabine/nab-paclitaxel were $1363, $7234, $8007 and $12,221, respectively. The overall treatment costs for a course of the same regimens based on median PFS were $5043, $46,298, $51,004 and $67,216, respectively. The choice of chemotherapy regimen for mPCA should be based on tolerability and efficacy of the regimen individualized to patient's performance status. Healthcare systems have finite resources; thus, there is increasing emphasis on metrics to define value in health care when outcomes of therapy are similar or produce marked differences in value. These data provide useful financial information to incorporate into the decision-making process.

  8. Twice-Daily versus Once-Daily Pramipexole Extended Release Dosage Regimens in Parkinson's Disease.

    Science.gov (United States)

    Yun, Ji Young; Kim, Young Eun; Yang, Hui-Jun; Kim, Han-Joon; Jeon, Beomseok

    2017-01-01

    This open-label study aimed to compare once-daily and twice-daily pramipexole extended release (PER) treatment in Parkinson's disease (PD). PD patients on dopamine agonist therapy, but with unsatisfactory control, were enrolled. Existing agonist doses were switched into equivalent PER doses. Subjects were consecutively enrolled into either once-daily-first or twice-daily-first groups and received the prescribed amount in one or two, respectively, daily doses for 8 weeks. For the second period, subjects switched regimens in a crossover manner. The forty-four patients completed a questionnaire requesting preference during their last visit. We measured the UPDRS-III, Hoehn and Yahr stages (H&Y) in medication-on state, Parkinson's disease sleep scale (PDSS), and Epworth Sleepiness Scale. Eighteen patients preferred a twice-daily regimen, 12 preferred a once-daily regimen, and 14 had no preference. After the trial, 14 subjects wanted to be on a once-daily regimen, 25 chose a twice-daily regimen, and 5 wanted to maintain the prestudy regimen. Main reasons for choosing the twice-daily regimen were decreased off-duration, more tolerable off-symptoms, and psychological stability. The mean UPDRS-III, H&Y, and PDSS were not different. Daytime sleepiness was significantly high in the once-daily regimen, whereas nocturnal hallucinations were more common in the twice-daily. Multiple dosing should be considered if once-daily dosing is unsatisfactory. This study is registered as NCT01515774 at ClinicalTrials.gov.

  9. [Studies on small dosage regimen of minocycline in the treatment of urinary tract infections (author's transl)].

    Science.gov (United States)

    Saito, T; Sitan, N

    1979-11-01

    In the course of treating twenty patients with acute urinary tract infections, the toxicity and efficacy of a small dosage regimen (50 mg p.o., t.i.d.) of minocycline were evaluated. No vestibular symptoms attributable to minocycline treatment were observed in any of the cases entered in this study. Adverse reactions included mild nausea in 1 case and urticaria in another case. Minocycline with this dosage regimen sterilized the urine of 90% of patients with acute urinary tract infections.

  10. Dietary regimens of athletes competing at the Delhi 2010 Commonwealth Games.

    Science.gov (United States)

    Pelly, Fiona E; Burkhart, Sarah J

    2014-02-01

    The aim of this study was to investigate the dietary regimens reported by athletes competing at a major international competition and report whether these were based on nutrient composition, religious beliefs, cultural eating style, food intolerance or avoidance of certain ingredients. A questionnaire was randomly distributed to 351 athletes in the main dining hall of the athletes' village over the three main meal periods during the Delhi 2010 Commonwealth Games (23rd Sept-14th Oct, 2010). The majority (n = 218, 62%) of athletes reported following one or more dietary regimens, with 50% (n = 174) following a diet based on the nutrient composition of the food. Significantly more athletes from weight category and aesthetic sports (28%, p = .005) and from power/sprint sports (41%, p = .004) followed low fat and high protein regimens respectively. Other specialized dietary regimens were followed by 33% of participants, with avoidance of red meat (13%), vegetarian (7%), Halal (6%), and low lactose regimens (5%) reported most frequently. Significantly more athletes from non-Western regions followed a vegetarian diet (p < .001), while more vegetarians reported avoiding additives (p = .013) and wheat (p ≤ .001). A Western style of eating was the most commonly reported cultural regimen (72% of total with 23% from non-Western regions). Those following a Western diet were significantly more likely to report following a regimen based on nutrient composition (p = .02). As a high proportion of athletes from differing countries and sports follow specialized dietary regimens, caterers and organizers should ensure that adequate nutrition support and food items are available at similar events.

  11. Evaluation of various gentamicin dosage regimens in geriatric patients: a simulation study.

    Science.gov (United States)

    Bourguignon, Laurent; Goutelle, Sylvain; De Saint-Martin, Julie Burdin; Maire, Pascal; Ducher, Michel

    2010-02-01

    The aim of this simulation study was to evaluate the ability of three regimens proposed in official French recommendations for gentamicin to hit defined pharmacokinetic (PK) and pharmacodynamic targets in a population of elderly patients. The first drug regimen tested consisted of a loading dose of 1 mg/kg and a maintenance dose weighted by creatininemia, every 8 h. The second regimen consisted of a fixed dose of 1 mg/kg at various intervals of time, calculated from creatinine clearance. The last regimen was a fixed dose of 3 mg/kg once a day. All regimens were for 5 days. We used a bicompartmental PK model and implemented a Monte Carlo simulation to generate a large sample of geriatric subjects. The analysis examined three ranges of creatinine clearance. Simulations showed that for the two regimens using multiple doses per day, neither was able to reach an efficacy level without significant toxicity after 5 days of treatment, regardless of the level of renal function. The use of creatininemia or creatinine clearance to adjust the drug dose did not alter these findings. The once-a-day dosing regimen gave better results both in efficacy and toxicity, except for patients with creatinine clearance lower than 60 mL/min, where the incidence of potential toxicity was above 25%. These results strongly suggest that official French recommendations about aminoglycoside dosage regimens in elderly patients with renal impairment should be updated, and that the frequent need for therapeutic drug monitoring and dosage individualization should be clearly stated.

  12. Twice-Daily versus Once-Daily Pramipexole Extended Release Dosage Regimens in Parkinson's Disease

    Science.gov (United States)

    Kim, Young Eun; Yang, Hui-Jun; Kim, Han-Joon

    2017-01-01

    This open-label study aimed to compare once-daily and twice-daily pramipexole extended release (PER) treatment in Parkinson's disease (PD). PD patients on dopamine agonist therapy, but with unsatisfactory control, were enrolled. Existing agonist doses were switched into equivalent PER doses. Subjects were consecutively enrolled into either once-daily-first or twice-daily-first groups and received the prescribed amount in one or two, respectively, daily doses for 8 weeks. For the second period, subjects switched regimens in a crossover manner. The forty-four patients completed a questionnaire requesting preference during their last visit. We measured the UPDRS-III, Hoehn and Yahr stages (H&Y) in medication-on state, Parkinson's disease sleep scale (PDSS), and Epworth Sleepiness Scale. Eighteen patients preferred a twice-daily regimen, 12 preferred a once-daily regimen, and 14 had no preference. After the trial, 14 subjects wanted to be on a once-daily regimen, 25 chose a twice-daily regimen, and 5 wanted to maintain the prestudy regimen. Main reasons for choosing the twice-daily regimen were decreased off-duration, more tolerable off-symptoms, and psychological stability. The mean UPDRS-III, H&Y, and PDSS were not different. Daytime sleepiness was significantly high in the once-daily regimen, whereas nocturnal hallucinations were more common in the twice-daily. Multiple dosing should be considered if once-daily dosing is unsatisfactory. This study is registered as NCT01515774 at ClinicalTrials.gov. PMID:28265478

  13. Kidney injury associated with telavancin dosing regimen in an animal model.

    Science.gov (United States)

    Tam, Vincent H; Ledesma, Kimberly R; Bowers, Dana R; Zhou, Jian; Truong, Luan D

    2015-05-01

    The elevation of serum creatinine levels is a concern with telavancin therapy. We examined the onset of kidney injury associated with telavancin in an animal model. Urine samples were collected at baseline and daily to determine the concentrations of kidney injury molecule 1 (KIM-1), a marker for early kidney injury. When a clinically relevant exposure of telavancin was given daily to rats, some differences in kidney injury were attributed to the dosing regimen. Further investigations of alternative telavancin dosing regimens are warranted.

  14. National Farm Medicine Center

    Science.gov (United States)

    Research Areas Applied Sciences Biomedical Informatics Clinical Research Epidemiology Farm Medicine Human Genetics Oral-Systemic Health Clinical ... Consulting Agritourism Farm MAPPER Lyme Disease ROPS Rebate Zika Virus National Farm Medicine Center The National Farm ...

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Nuclear Medicine? Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to ... a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you ...

  16. Veterinary medicines update.

    Science.gov (United States)

    2017-03-11

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  17. Taking multiple medicines safely

    Science.gov (United States)

    ... in your wallet and at home. Review your medicine list with your health care providers and pharmacists. Discuss ... all of your providers a copy of your medicine list. Ask questions about any new drugs you are ...

  18. Giving Medicine to Children

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Articulos en Espanol Giving Medicine to Children Share Tweet ... right medicine and the right amount More in Articulos en Espanol Alimentos y Bebidas Cosméticos Dispositivos Médicos ...

  19. Technology in respiratory medicine

    African Journals Online (AJOL)

    Repro

    Respiratory medicine is the subspecialty in medicine which ... The very nature of respiratory physiology ... of this essential step with resultant loss of accuracy in .... intensity of treatment, or for medicolegal .... likened to trying to manage dia-.

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine ... physicians diagnose and evaluate medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers . Depending ...

  1. Cold and Cough Medicines

    Science.gov (United States)

    ... What can you do for your cold or cough symptoms? Besides drinking lots of fluids and getting ... medicines. There are lots of different cold and cough medicines, and they do different things. Nasal decongestants - ...

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... its earliest stages as well as a patient’s immediate response to therapeutic interventions. Children's (pediatric) nuclear medicine ... leaving the nuclear medicine facility. Through the natural process of radioactive decay, the small amount of radiotracer ...

  3. Society for Vascular Medicine

    Science.gov (United States)

    ... Certification with this new online course from the Society for Vascular Medicine. Learn more. Looking for a ... jobs are listed right now. Copyright © 2016 The Society for Vascular Medicine. All Rights Reserved.

  4. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Tell your doctor about your child’s recent illnesses, medical conditions, medications and allergies. Depending on the type ... Nuclear Medicine? Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material ...

  5. Medicine safety and children

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000619.htm Medicine safety and children To use the sharing features ... especially careful if you have toddlers around. Keep Medicines out of Reach and Sight Safety tips: DO ...

  6. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed ... the thyroid gland. top of page How does the nuclear medicine procedure work? With ordinary x-ray ...

  7. ADHD Medicines (for Kids)

    Science.gov (United States)

    ... de los dientes Video: Getting an X-ray ADHD Medicines KidsHealth > For Kids > ADHD Medicines Print A ... Help en español Medicamentos para el TDAH About ADHD Have you ever been so bored that you ...

  8. Interferon-free regimens in patients with hepatitis C infection and renal dysfunction or kidney transplantation

    Science.gov (United States)

    Cholongitas, Evangelos; Pipili, Chrysoula; Papatheodoridis, George V

    2017-01-01

    Treatment of patients with chronic kidney disease (CKD) and chronic hepatitis C (CHC) differs from that used in the general CHC population mostly when glomerular filtration rate (GFR) is below 30 mL/min, as sofosbuvir, the backbone of several current regimens, is officially contraindicated. Given that ribavirin free regimens are preferable in CKD, elbasvir/grazoprevir is offered in CHC patients with genotype 1 or 4 and ombitasvir/paritaprevir and dasabuvir in genotype 1b for 12 wk. Although regimens containing peginterferon with or without ribavirin are officially recommended for patients with CKD and genotype 2, 3, 5, 6, such regimens are rarely used because of their low efficacy and the poor safety and tolerance profile. In this setting, especially in the presence of advanced liver disease, sofosbuvir-based regimens are often used, despite sofosbuvir contraindication. It seems to have good overall safety with only 6% or 3.4% of CKD patients to discontinue therapy or develop serious adverse events without drug discontinuation. In addition, sustained virological response (SVR) rates with sofosbuvir based regimens in CKD patients appear to be comparable with SVR rates in patients with normal renal function. Treatment recommendations for kidney transplant recipients are the same with those for patients with CHC, taking into consideration potential drug-drug interactions and baseline GFR before treatment initiation. This review summarizes recent data on the current management of CHC in CKD patients highlighting their strengths and weaknesses and determining their usefulness in clinical practice. PMID:28217256

  9. Comparison Between 10- and 14-Day Hybrid Regimens for Helicobacter pylori Eradication: A Randomized Clinical Trial.

    Science.gov (United States)

    Metanat, Hassan Ali; Valizadeh, Seyed Mohammad; Fakheri, Hafez; Maleki, Iradj; Taghvaei, Tarang; Hosseini, Vahid; Bari, Zohreh

    2015-08-01

    Helicobacter pylori (H. pylori) eradication has always been a concern. In our previous study, 14-day hybrid regimen showed ideal results. Based on these findings, we decided to compare the efficacy of 10- and 14-day hybrid regimens for H. pylori eradication. Two hundred and seventy patients with peptic ulcer disease and H. pylori infection were enrolled in the study. One hundred and thirty-four patients received 10-day hybrid regimen (PACT-10): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice daily for 10 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just during the last 5 days. One hundred and thirty-six patients received 14-day hybrid regimen (PACT-14): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice a day for 14 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just for the last 7 days. Eight weeks after treatment, (14) C-urea breath test was performed to evaluate H. pylori eradication. Two hundred and fifty patients (124 patients in PACT-10 and 126 patients in PACT-14 regimens) completed the study. The intention-to-treat eradication rates were 77.6% (95% confidence interval (CI): 70.6-84.6%) and 86% (95% CI: 80-92%) for the two regimens, respectively (p = .17). Per-protocol eradication rates were 83.8% (95% CI: 80-86%) and 92.8% (95% CI: 88-96%), respectively (p pylori eradication in Iran. © 2015 John Wiley & Sons Ltd.

  10. A preliminary evaluation of comparative effectiveness of riluzole in therapeutic regimen for irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Surya Prakash Mishra; Sunit Kumar Shukla; Bajrang Lal Pandey

    2014-01-01

    Objective: To develop agents that are specifically effective in controlling the key disturbance of visceral hyperalgesia besides abating of associated multiple symptoms, and evaluate comparative effectiveness for IBS symptom relief for standard regimen (antispasmodic and probiotic) and add-on amitriptyine or riluzole regimens following two weeks administration.Methods:groups were studied. First group received standard treatment (mebeverine 200 mg twice daily and probiotic 200 mg twice daily). Second group received add-on amitriptyline 25 mg before bedtime, while the third group got add-on riluzole 50 mg twice daily. Overall gastrointestinal symptom rating scale improving symptoms and hospital anxiety depression scale improving associated psychological morbidity were employed as measures at induction and at two-week follow-up period. Individual symptom scores were also examined to define the outcome profiles.Results:108 patients with visceral hypersensitivity accompanying IBS, divided into three rating scale score, not the other two regimens. Pain relief was seen with both riluzole and amitriptyline regimens significantly superior to standard treatment regimen, but riluzole effect appeared specific and independent anxiolytic effect. Amitriptyline caused relief in diarrhea and did not benefit in constipation point to non-specific remedial role in IBS. Riluzole regimen resulted in significant reduction of overall gastrointestinal symptom Conclusions: Riluzole specifically relieves visceral hypersensitivity and is proved to be superior to current treatments in IBS patients. It appears a lead remedy based on glutamate transporter mechanisms in visceral hypersensititvity.

  11. Thalidomide-based induction regimens are as effective as bortezomib-based regimens in elderly patients with multiple myeloma with cereblon expression.

    Science.gov (United States)

    Jung, Sung-Hoon; Choi, Hyun-Jung; Shin, Myung-Geun; Lee, Seung-Shin; Hwang, Eu Chang; Jung, Tae-Young; Cho, Min-Seok; Yang, Deok-Hwan; Ahn, Jae-Sook; Kim, Yeo-Kyeoung; Kim, Hyeoung-Joon; Lee, Je-Jung

    2016-10-01

    Cereblon (CRBN) has been identified as a primary target of immunomodulatory drugs and is considered a biomarker for the prediction of outcomes after thalidomide- or lenalidomide-based treatments. In this study, we evaluated CRBN expression in bone marrow (BM) tissue at diagnosis and investigated the relationship between CRBN expression and treatment outcomes after thalidomide- or bortezomib-based front-line therapies in 89 elderly patients with multiple myeloma (MM). CRBN expression at the time of diagnosis was evaluated with immunohistochemical (IHC) staining for myeloma cells in paraffin wax-embedded BM tissue. CRBN-immunostained slides were scored by intensity and diffuseness, and a total score of >6 was defined as CRBN-positive (CRBN(+)). Thirty-eight patients (45.2 %) were CRBN(+). Among patients treated with thalidomide-based regimens, CRBN(+) patients showed a better treatment response than did CRBN-negative patients (35.0 vs. 11.8 % complete response rate, respectively; HR = 4.038, P = 0.137). During a median follow-up of 31.8 months, patients treated with bortezomib-based regimens had a longer time to progression (TTP) than did patients treated with thalidomide-based regimens (15.6 vs. 13.2 months, respectively; P = 0.047), but early mortality occurred frequently in patients treated with bortezomib-based regimens. Additionally, there was no significant difference in survival outcomes between thalidomide- and bortezomib-based regimens in CRBN(+) patients (median TTP, 13.8 vs. 15.6 months, respectively; P = 0.842 and median OS, 39.3 vs. 30.1 months, respectively; P = 0.074). These data suggest that thalidomide-based regimens are as effective as bortezomib-based regimens in elderly patients with MM who are CRBN(+). Thus, CRBN positivity, by IHC staining, may be useful in deciding appropriate treatment options in elderly patients with MM.

  12. Mind-Body Medicine Practices in Complementary and Alternative Medicine

    Science.gov (United States)

    ... Home > Mind-Body Medicine Practices in Complementary and Alternative Medicine Small Text Medium Text Large Text Mind-Body Medicine Practices in Complementary and Alternative Medicine YESTERDAY The concept that the mind is important ...

  13. Metronomic capecitabine in gastroenteropancreatic neuroendrocrine tumors: a suitable regimen and review of the literature

    Directory of Open Access Journals (Sweden)

    Bongiovanni A

    2014-10-01

    Full Text Available Alberto Bongiovanni,1 Nada Riva,1 Sebastiano Calpona,1 Marianna Ricci,1 Erica Gunelli,1 Chiara Liverani,1 Federico La Manna,1 Alessandro De Vita,1 Manuela Monti,1 Stefano Severi,2 Federica Pieri,3 Elena Amadori,1 Riccardo Galassi,1 Davide Cavaliere,4 Alberto Zaccaroni,5 Andreas Tartaglia,6 Veronica Lunedei,7 Andrea Gardini,8 Laura Mercatali,1 Dino Amadori,1 Toni Ibrahim11Osteoncology and Rare Tumors Center, 2Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST IRCCS, Meldola, 3Pathology Unit, 4Unit of Oncological Surgery and Advanced Therapies, 5Endocrine Surgery Unit, 6Endocrinology Unit, 7Gastroenterology and Digestive Endoscopy Unit, 8Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì, ItalyBackground: We present a retrospective analysis of metronomic capecitabine in metastatic gastroenteropancreatic neuroendrocrine tumors (GEP-NETs. A review of the literature is also presented.Methods: From January 2007 to December 2013, ten patients with metastatic GEP-NETs (four pancreatic and six ileal who progressed after treatment with somatostatin analogs and other cytotoxic agents received oral capecitabine 1,500 mg/day continuously. The median patient age was 68 (range 29–82 years. The median treatment duration was 8 months.Results: Five (50% patients achieved a partial radiographic response, four (40% showed stable disease, and one (10% progressed. Median overall survival was 56 months. Three of the four pancreatic patients achieved a partial radiographic response that lasted for a median of 15.5 months; overall survival and progression-free survival in this subgroup was 58 and 6 months, respectively.Conclusion: Data in the literature show that capecitabine has only occasionally been used as a single agent, with increased toxicity. Only one study using single-agent capecitabine reported a progression-free survival of 9.9 months and overall survival of 36.5 months, without an objective

  14. Comparison of caloric intake and weight outcomes of an ad lib feeding regimen for preterm infants in two nurseries.

    Science.gov (United States)

    Pridham, K F; Kosorok, M R; Greer, F; Kayata, S; Bhattacharya, A; Grunwald, P

    2001-09-01

    Effects on caloric intake and weight gain of an ad libitum (ad lib) feeding regimen for preterm infants may be specific to a special care nursery. To explore across two nurseries the similarity of effect on caloric intake and weight gain of an ad lib feeding regimen compared with a prescribed regimen and the similarity of effect of caloric intake on weight gain. All infants participating in the multi-site randomized clinical trial (RCT) of the ad lib feeding regimen were lib. After accounting for caloric intake, the ad lib regimen did not affect weight gain. The time-by-regimen interaction effect on caloric intake was significant in both nurseries. Caloric intake for infants fed ad lib increased significantly over 5 days. Despite differences between nurseries in infant characteristics and in protocol implementation, the feeding regimen effect was consistent for caloric intake and weight gain. Further support was found for the development of infant self-regulatory capacity.

  15. Nuclear medicine physics

    CERN Document Server

    De Lima, Joao Jose

    2011-01-01

    Edited by a renowned international expert in the field, Nuclear Medicine Physics offers an up-to-date, state-of-the-art account of the physics behind the theoretical foundation and applications of nuclear medicine. It covers important physical aspects of the methods and instruments involved in modern nuclear medicine, along with related biological topics. The book first discusses the physics of and machines for producing radioisotopes suitable for use in conventional nuclear medicine and PET. After focusing on positron physics and the applications of positrons in medicine and biology, it descr

  16. Integrative Medicine Preferences Among Coccidioidomycosis (Valley Fever) Patients.

    Science.gov (United States)

    Short, Jack H; Bradley, Constance; Blair, Janis E; Stewart, Terry D; Burns, Mark W; Patron, Roberto L; Millstine, Denise M

    2017-02-01

    To understand the extent and modalities of integrative medicine strategies that patients with coccidioidomycosis (valley fever) have incorporated into their treatment regimens. A direct patient survey was distributed, with 100 unique responses, at a single infectious diseases clinic at an academic medical center in Arizona. Eligible patients, defined as those with confirmed coccidioidomycosis or currently under evaluation, were polled on their personal use of 36 integrative medicine modalities. Patients were also asked to indicate their level of fatigue on a 10-point scale in an attempt to correlate levels of fatigue to use of specific integrative medicine modalities. Of the patients surveyed, 64% had used at least one integrative medicine modality, and 53% used two or more, along with conventional medical therapy. The top three modalities were nutrition (39%), massage (27%), and breathing exercises (26%). The mean reported fatigue level was 4.7 on a 10-point scale, with a standard deviation of 3.0. There was no statistically significant association between use of a specific modality and reported level of fatigue. Nearly two thirds of patients (64%) surveyed had used at least one integrative medicine modality throughout the course of their therapy. Clinicians are probably unaware of the extent to which many patients, including this population, have embraced integrative medicine. Awareness of patients' goal and preferences is valuable in shared clinical decision making.

  17. [Contribution of occupational medicine to social medicine].

    Science.gov (United States)

    Geraut, Christian

    2010-01-01

    Occupational medicine has always been part of social medicine, but focuses on the part of the population in paid employment. Investigations of occupational diseases have identified several toxic chemicals that can affect other sectors of society: examples include cancers due to sawdust, asbestos, benzene, as well as carcinogens, mutagens and reproductive toxins. Better knowledge of the risks posed by epoxy resins, cements, formaldehyde, lead, toluene and other chemical agents has helped to understand certain diseases in the population. Knowledge of musculoskeletal disorders due to repetitive work has been of help in other areas; gradual resumption of appropriate activity seems to be the best basic treatment. Studies of mental overload and its consequences in the workplace (suicide, depression, etc.) have implications for human relations in society as a whole. Multidisciplinary networking helps to regularly take stock of findings in occupational medicine that may be applicable to social medicine.

  18. Outcome after Transplantation According to Reduced-Intensity Conditioning Regimen in Patients Undergoing Transplantation for Myelofibrosis.

    Science.gov (United States)

    Robin, Marie; Porcher, Raphael; Wolschke, Christine; Sicre de Fontbrune, Flore; Alchalby, Haefaa; Christopeit, Maximilian; Cassinat, Bruno; Zabelina, Tatjana; Peffault de Latour, Régis; Ayuk, Francis; Socié, Gérard; Kröger, Nicolaus

    2016-07-01

    Allogeneic hematopoietic stem cell transplantation remains the sole curative option for myelofibrosis. Many transplantation recipients receive a reduced-intensity conditioning (RIC) regimen owing to age or comorbidities; however, there is little published evidence to guide the choice of RIC regimen. In this study, we compared outcomes in patients who received 1 of 2 frequently used RIC regimens for patients with myelofibrosis: fludarabine-busulfan (FB) and fludarabine-melphalan (FM). A total of 160 patients underwent a RIC allograft procedure (FB group, n = 105; FM group, n = 55). We have developed a complex statistical model involving weighting and adjustment to permit comparison between these 2 groups. After weighting, the incidence of acute graft-versus-host disease (GVHD) was 62% in the FM group and 31% in the FB group (P = .001), and the corresponding incidence of chronic GVHD was 49% and 53%, respectively. The 7-year progression-free survival was were 52% in the FM group versus 33% in the FB group, and the 7-year overall survival rate 52% in the FM group versus 59% in the FB group. Nonrelapse mortality (NRM) was 43% in the FM group and 31% in the FB group. Multivariable analyses revealed no significant differences in PFS between the 2 groups; however, the relapse rate was significantly lower in the FM group (hazard ratio, 9.21; P = .008), whereas a trend toward reduced NRM was seen in the FB group (hazard ratio, 0.51; P = .068). In conclusion, both regimens appear to be efficient in mediating disease control and can be used to successfully condition patients with myelofibrosis. The FM regimen appears to induce more NRM than the FB regimen, but with augmented control of disease, leading to comparable overall survival rates for both regimens.

  19. HER2 over-expression and response to different chemotherapy regimens in breast cancer

    Institute of Scientific and Technical Information of China (English)

    Jin ZHANG; Yan LIU

    2008-01-01

    Purpose: To exam the relationship between HER2 over-expression and different adjuvant chemotherapies in breast cancer. Patients and Methods: A total of 1625 primary breast cancer patients who received post-surgery adjuvant chemotherapy in Tianjin Cancer Hospital, China, from July 2002 to November 2005 were included in the study. Among them, 600 patients were given CMF (CTX+MTX+5-Fu) regimen, 600 given CEF (CTX+E-ADM+5-Fu) regimen, and 425 given anthracyclines plus taxanes regimen, with mean follow-up time of 42 months. Results: In CMF treatment group, the 3-year disease free survival (DFS)in HER2 over-expressed patients was lower than that of the HER2-negative ones (89.80% vs 91.24%, P=0.0348); in node-positive subgroup, the 3-year DFS was 84.72% in HER2 over-expressed patients, and 90.18% in the HER-2-negative ones (P=0.0271).Compared to CMF regimen, anthracyclines and anthracyclines plus taxanes regimens are more effective (P<0.05) in node-positive HER2 over-expression than those in the node-negative. Conclusion: HER2 over-expression is an independent index for predicting poor prognosis and short DFS for breast cancer patients. HER2 over-expressed patients are resistant to CMF regimen chemotherapy, but sensitive to anthracyclines-based or anthracyclines plus taxanes regimen. HER2 expression can be taken as a marker for therapies in breast cancer.

  20. Bioavailability of the Yuzpe and levonorgestrel regimens of emergency contraception: vaginal vs. oral administration.

    Science.gov (United States)

    Kives, Sari; Hahn, Philip M; White, Emily; Stanczyk, Frank Z; Reid, Robert L

    2005-03-01

    Separate crossover studies compared the bioavailability of oral vs. vaginal routes of administration for the Yuzpe (n=5) and levonorgestrel regimens (n=4) of emergency contraception. Twice the standard dose of the Yuzpe regimen (200 microg of ethinyl estradiol, 1000 microg of levonorgestrel) or the levonorgestrel regimen (1500 microg of levonorgestrel) was self-administered vaginally. One week later, each subject received orally the standard dose of the assigned medication. Serial blood samples were collected over 24 h and assayed for levonorgestrel and ethinyl estradiol (for the Yuzpe regimen only). Paired t tests were used to compare oral vs. vaginal administration for maximum concentration (Cmax), time to maximum concentration (Tmax) and area under the curve over 24 h (AUC0-24). Relative bioavailability (vaginal/oral) was derived from AUC0-24. Vaginal administration of double the standard dose of the Yuzpe regimen resulted in a lower Cmax (vaginal=5.4 vs. oral=14.6 ng/mL, p=.038) and a later Tmax (5.9 vs. 2.0 h, p=.066) for levonorgestrel, compared to oral administration. Corresponding ethinyl estradiol concentrations were higher (786 vs. 391 pg/mL, p=.039) and peaked later (4.0 vs. 1.9 hr, p=.154) with vaginal administration. Relative bioavailabilities for levonorgestrel and ethinyl estradiol were 58% and 175%, respectively. Similarly, vaginal administration of the levonorgestrel regimen resulted in a lower Cmax (vaginal=5.4 vs. oral=15.2 ng/mL, p=.006) and a later Tmax (7.4 vs. 1.3 h, p=.037) for levonorgestel, compared to oral administration. The relative bioavailability was 62%. Our preliminary data suggest that vaginal administration of these emergency contraception regimens appears to require at least three times the standard oral dose to achieve equivalent systemic levonorgestrel concentrations.

  1. Hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Matsuyama, Takaharu; Kato, Koji [Nagoya First Red Cross Hospital (Japan). Children' s Medical Center; Hanada, Ryoji [Saitama Children' s Medical Center, Iwatsuki (Japan)] [and others

    2002-07-01

    A multicenter comparative study was carried out to investigate the efficacy and safety of hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia. One hundred twenty three patients at a variety of remission stages were eligible for study participation. Eighty-nine were transplanted with allogeneic grafts and 34 patients with autologous grafts (23 cases with bone marrow and 11 cases with peripheral blood stem cells). Conditioning regimens used were as follows: melphalan and busulfan for 40 patients, melphalan, busulfan and TBI for 44 patients, other regimens for 39 patients. To accelerate engraftment G-CSF (lenograstim) was administered as a 1-hour or 24-hour drip infusion daily at 5 {mu}g/kg from day 5 until hematological recovery. The five year disease free survival (DFS) was 63% for 42 patients at CR1, 41% for 41 patients at CR2 and 33% for 40 patients at other stages. There was no significant difference in the DFS between allogeneic-transplantation and autologous-transplantation in all disease stages. In patients at remission stage for CR1 and CR2, the 5-year DFS by conditioning regimen was 63% for regimen with melphalan and busulfan, 54% for regimen with melphalan, busulfan and TBI and 54% for regimens with melphalan and TBI. There was no significant difference in the DFS between the groups. Serious complications such as renal failure were observed in 11%, veno-occlusive disease in 9%, and interstitial pneumonia in 9%. The most dominating cause of death was relapse in the disease (48% of deaths) which was most commonly observed in autologous transplantation. Contrary to that, treatment related toxic death was the most frequent cause of deaths in allogeneic-transplantation. (author)

  2. Perspectives of patients on factors relating to adherence to post-acute coronary syndrome medical regimens

    Directory of Open Access Journals (Sweden)

    Lambert-Kerzner A

    2015-07-01

    Full Text Available Anne Lambert-Kerzner,1,2 Edward P Havranek,2,3 Mary E Plomondon,1,2 Katherine M Fagan,1 Marina S McCreight,1 Kelty B Fehling,1 David J Williams,2 Alison B Hamilton,4 Karen Albright,2 Patrick J Blatchford,2 Renee Mihalko-Corbitt,5 Chris L Bryson,6 Hayden B Bosworth,7 Miriam A Kirshner,7 Eric J Del Giacco,5 P Michael Ho1,2 1Department of Cardiology, Veterans Health Administration (VA Eastern Colorado Health Care System, Denver, CO, 2School of Public Health or School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, 3Cardiology, Denver Health Medical Center, Denver, CO, 4Health Services Research, Veterans Health Administration (VA Greater Los Angeles Healthcare System, Los Angeles, CA, 5Internal Medicine, John L. McClellan Memorial Veterans Hospital, Little Rock, AR, 6Health Services Research, Veterans Health Administration (VA Puget Sound Health Care System, Seattle, WA, 7Health Services Research, Durham Veterans Affairs Medical Center, Durham, NC, USA Purpose: Poor adherence to cardioprotective medications after acute coronary syndrome (ACS hospitalization is associated with increased risk of rehospitalization and mortality. Clinical trials of multifaceted interventions have improved medication adherence with varying results. Patients’ perspectives on interventions could help researchers interpret inconsistent outcomes. Identifying factors that patients believe would improve adherence might inform the design of future interventions and make them more parsimonious and sustainable. The objective of this study was to obtain patients’ perspectives on adherence to medical regimens after experiencing an ACS event and their participation in a medication adherence randomized control trial following their hospitalization. Patients and methods: Sixty-four in-depth interviews were conducted with ACS patients who participated in an efficacious, multifaceted, medication adherence randomized control trial. Interview transcripts were

  3. [Interaction between medicines and medicinal plants].

    Science.gov (United States)

    Tres, J C

    2006-01-01

    In recent years there has been a notable increase in the consumption of medicinal plants in Spanish society. This might be due to the fact that in some cases they have shown themselves to be efficient in treating certain pathologies and to the erroneous perception that these products are innocuous. Medicinal plants behave as authentic medicines since the chemical substances of which they are formed can have a biological activity in humans. For this reason, their joint administration with "conventional medicines" can produce variations in the magnitude of the effect. This type of interaction, just like those produced between two or more medicines, can produce pharmacokinetic mechanisms if they affect the processes of absorption, distribution, metabolism and excretion, or pharmacodynamic mechanisms if they affect the result of the pharmacological action. In the medical literature there are few articles and notifications of cases concerning the adverse effects and interactions that affect medicinal plants, which probably reflects an under-notification of these phenomena. If we add to this the lack of experimental data and controlled studies, perception of their prevalence is difficult or nearly impossible. This article sets out, in an order that will be explained later, the findings of an exhaustive review of the medical literature with the aim of making its existence known to the reader, without going into other considerations, such as the degree of evidence for example, which will be the subject of forthcoming articles.

  4. Variability in Antibiotic Regimens for Surgical Necrotizing Enterocolitis Highlights the Need for New Guidelines.

    Science.gov (United States)

    Blackwood, Brian P; Hunter, Catherine J; Grabowski, Julia

    Necrotizing enterocolitis or NEC is the most common gastrointestinal emergency in the newborn. The etiology of NEC remains unknown, and treatment consists of antibiotic therapy and supportive care with the addition of surgical intervention as necessary. Unlike most surgical diseases, clear guidelines for the type and duration of peri-operative antibiotic therapy have not been established. Our aim was to review the antibiotic regimen(s) applied to surgical patients with NEC within a single neonatal intensive care unit (NICU) and to evaluate outcomes and help develop guidelines for antibiotic administration in this patient population. A single-center retrospective review was performed of all patients who underwent surgical intervention for NEC from August 1, 2005 through August 1, 2015. Relevant data were extracted including gestational age, age at diagnosis, gender, pre-operative antibiotic treatment, post-operative antibiotic treatment, development of stricture, and mortality. Patients were excluded if there was incomplete data documentation. A total of 90 patients were identified who met inclusion criteria. There were 56 male patients and 34 female patients. The average gestational age was 30 5/7 wks and average age of diagnosis 16.7 d. A total of 22 different pre-operative antibiotic regimens were identified with an average duration of 10.6 d. The most common pre-operative regimen was ampicillin, gentamicin, and metronidazole for 14 d. A total of 15 different post-operative antibiotic regimens were identified with an average duration of 6.6 d. The most common post-operative regimen was ampicillin, gentamicin, and metronidazole for two days. There were 26 strictures and 15 deaths. No regimen or duration proved superior. We found that there is a high degree of variability in the antibiotic regimen for the treatment of NEC, even within a single NICU, with no regimen appearing superior over another. As data emerge that demonstrate the adverse effects of

  5. Hand hygiene regimens for the reduction of risk in food service environments.

    Science.gov (United States)

    Edmonds, Sarah L; McCormack, Robert R; Zhou, Sifang Steve; Macinga, David R; Fricker, Christopher M

    2012-07-01

    Pathogenic strains of Escherichia coli and human norovirus are the main etiologic agents of foodborne illness resulting from inadequate hand hygiene practices by food service workers. This study was conducted to evaluate the antibacterial and antiviral efficacy of various hand hygiene product regimens under different soil conditions representative of those in food service settings and assess the impact of product formulation on this efficacy. On hands contaminated with chicken broth containing E. coli, representing a moderate soil load, a regimen combining an antimicrobial hand washing product with a 70% ethanol advanced formula (EtOH AF) gel achieved a 5.22-log reduction, whereas a nonantimicrobial hand washing product alone achieved a 3.10log reduction. When hands were heavily soiled from handling ground beef containing E. coli, a wash-sanitize regimen with a 0.5% chloroxylenol antimicrobial hand washing product and the 70% EtOH AF gel achieved a 4.60-log reduction, whereas a wash-sanitize regimen with a 62% EtOH foam achieved a 4.11-log reduction. Sanitizing with the 70% EtOH AF gel alone was more effective than hand washing with a nonantimicrobial product for reducing murine norovirus (MNV), a surrogate for human norovirus, with 2.60- and 1.79-log reductions, respectively. When combined with hand washing, the 70% EtOH AF gel produced a 3.19-log reduction against MNV. A regimen using the SaniTwice protocol with the 70% EtOH AF gel produced a 4.04-log reduction against MNV. These data suggest that although the process of hand washing helped to remove pathogens from the hands, use of a wash-sanitize regimen was even more effective for reducing organisms. Use of a high-efficacy sanitizer as part of a wash-sanitize regimen further increased the efficacy of the regimen. The use of a well-formulated alcohol-based hand rub as part of a wash-sanitize regimen should be considered as a means to reduce risk of infection transmission in food service facilities.

  6. [Sports medicine in Germany].

    Science.gov (United States)

    Dickhuth, H-H

    2005-08-01

    Sports medicine covers many different aspects, ranging from clinical specialties, such as internal medicine, orthopedics or pediatrics to physiology and sports sciences. The requirements for sports medicine evolve mainly from exercise physiology (elite, leisure and health oriented physical activity), orthopedics and traumatology as well as from preventive and rehabilitative issues. In the new German curriculum, sports medicine is defined as a subspecialty. Historically, sports medicine in Germany has a federal structure with a governing body (Deutsche Gesellschaft für Sportmedizin und Prävention). Due to these facts, University Departments of Sports Medicine (which vary greatly in size and performance) are either attached to Medical or non-Medical Faculties, such as Sports Sciences. In medical schools, sports medicine can be selected as an elective subject. However, the main part of teaching sports medicine is covered by Sports Science Faculties. In an international context, the strength of German sports medicine is its clinical orientation and close cooperation with the sport itself, especially high-performance sports. In the future, like in the Anglo- American countries, sports medicine in Germany will play a major role in health prevention and rehabilitation.

  7. Niacin Alternatives for Dyslipidemia: Fool's Gold or Gold Mine? Part I: Alternative Niacin Regimens.

    Science.gov (United States)

    Dunbar, Richard L; Goel, Harsh

    2016-02-01

    Niacin was the first drug demonstrating lowered cholesterol prevents coronary heart disease (CHD) events, with two clinical CHD outcome studies establishing a cardioprotective niacin regimen: 1 g thrice daily with meals. Though cardioprotective, skin toxicity limits niacin's use, fostering several variations to improve tolerability. One of these, an extended-release (ER) alternative, proved immensely successful commercially, dominating clinical practice despite departing from the established regimen in several critical ways. Hence, improved tolerability may have come at the cost of diminished efficacy, posing a conundrum: Does it still help the population at risk for CHD to broaden a drug's acceptance by "watering it down"? This question is crucial at this stage now that the ER alternative failed to recapitulate the benefits of the established cardioprotective niacin regimen in two trials of the alternative approach: AIM-HIGH and HPS2-THRIVE. Part I of this review discusses how vastly the ER alternative departs from the established cardioprotective regimen, why that is important physiologically, and how it may explain the findings of AIM-HIGH and HPS2-THRIVE. Given important gaps left by statin therapy, the established cardioprotective niacin regimen remains an important evidence-based therapy for the statin intolerant or statin averse.

  8. Experimental endocrine manipulation by contraceptive regimen in the male marmoset (Callithrix jacchus).

    Science.gov (United States)

    Wistuba, Joachim; Luetjens, C Marc; Ehmcke, Jens; Redmann, Klaus; Damm, Oliver S; Steinhoff, Antje; Sandhowe-Klaverkamp, Reinhild; Nieschlag, Eberhard; Simoni, Manuela; Schlatt, Stefan

    2013-04-01

    Marmosets are used as preclinical model in reproductive research. In contrast to other primates, they display short gestation times rendering this species valid for exploration of effects on fertility. However, their peculiar endocrine regulation differs from a those of macaques and humans. We subjected male marmosets to previously clinically tested hormonal regimens that are known to effectively suppress spermatogenesis. Beside a control group, seven groups (each n=6) were investigated for different periods of up to 42 months: regimen I, (four groups) received testosterone undecanoate (TU) and norethisterone enanthate (NETE); regimen II, (two groups) received TU and NETE followed by NETE only; and regimen III, (one group) received NETE only. Testicular volume, cell ploidy and histology, endocrine changes and fertility were monitored weekly. TU and NETE and initial TU and NETE treatment followed by NETE failed to suppress spermatogenesis and fertility. Testicular volumes dropped, although spermatogenesis was only mildly affected; however, testicular cellular composition remained stable. Serum testosterone dropped when NETE was given alone but the animals remained fertile. Compared with controls, no significant changes were observed in sperm motility and fertility. Administration of TU and NETE affected testicular function only mildly, indicating that the regulatory role of chorionic gonadotrophin and testosterone on spermatogenesis is obviously limited and testicular function is maintained, although the endocrine axis is affected by the treatment. In conclusion, marmosets showed a different response to regimens of male contraception from macaques or men and have to be considered as a problematic model for preclinical trials of male hormonal contraception.

  9. Potential economic viability of two proposed rifapentine-based regimens for treatment of latent tuberculosis infection.

    Directory of Open Access Journals (Sweden)

    David P Holland

    Full Text Available RATIONALE: Rifapentine-based regimens for treating latent tuberculosis infection (LTBI are being considered for future clinical trials, but even if they prove effective, high drug costs may limit their economic viability. OBJECTIVES: To inform clinical trial design by estimating the potential costs and effectiveness of rifapentine-based regimens for treatment of latent tuberculosis infection (LTBI. METHODS: We used a Markov model to estimate cost and societal benefits for three regimens for treating LTBI: Isoniazid/rifapentine daily for one month, isoniazid/rifapentine weekly for three months (self-administered and directly-observed, and isoniazid daily for nine months; a strategy of "no treatment" used for comparison. Costs, quality-adjusted life-years gained, and instances of active tuberculosis averted were calculated for all arms. RESULTS: Both daily isoniazid/rifapentine for one month and weekly isoniazid/rifapentine for three months were less expensive and more effective than other strategies under a wide variety of clinically plausibly parameter estimates. Daily isoniazid/rifapentine for one month was the least expensive and most effective regimen. CONCLUSIONS: Daily isoniazid/rifapentine for one month and weekly isoniazid/rifapentine for three months should be studied in a large-scale clinical trial for efficacy. Because both regimens performed well even if their efficacy is somewhat reduced, study designers should consider relaxing non-inferiority boundaries.

  10. Efavirenz Conceptions and Regimen Management in a Prospective Cohort of Women on Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Sheree Schwartz

    2012-01-01

    Full Text Available Use of the antiretroviral drug efavirenz (EFV is not recommended by the WHO or South African HIV treatment guidelines during the first trimester of pregnancy due to potential fetal teratogenicity; there is little evidence of how clinicians manage EFV-related fertility concerns. Women on antiretroviral therapy (ART were enrolled into a prospective cohort in four public clinics in Johannesburg, South Africa. Fertility intentions, ART regimens, and pregnancy testing were routinely assessed during visits. Women reporting that they were trying to conceive while on EFV were referred for regimen changes. Kaplan-Meier estimators were used to assess incidence across ART regimens. From the 822 women with followup visits between August 2009–March 2011, 170 pregnancies were detected during study followup, including 56 EFV conceptions. Pregnancy incidence rates were comparable across EFV, nevirapine, and lopinavir/ritonavir person-years (95% 100/users (P=0.25; incidence rates on EFV were 18.6 Confidence Interval: 14.2–24.2. Treatment substitution from EFV was made for 57 women, due to pregnancy intentions or actual pregnancy; however, regimen changes were not systematically applied across women. High rates of pregnancy on EFV and inconsistencies in treatment management suggest that clearer guidelines are needed regarding how to manage fertility-related issues in. women on EFV-based regimens.

  11. Rolling out Efavirenz for HIV Precision Medicine in Africa

    DEFF Research Database (Denmark)

    Masimirembwa, Collen; Dandara, Collet; Leutscher, Peter Derek Christian

    2016-01-01

    adverse events (AEs). If EFV use is not monitored, a huge burden of neuropsychiatric AEs and elevated risk of drug resistance due to nonadherence are likely to follow. A monumental EFV-based ART regimen rollout program, through the UNAIDS 90-90-90 and option B plus programs/approaches, is planned, which...... AEs due to EFV therapy, incorporation of pharmacogenetics testing for CYP2B6 to assist in EFV dosing, and measurement of plasma EFV concentration, as a three-pronged rational therapeutic drug monitoring strategy to guide EFV treatment toward precision medicine....

  12. Ethics in sports medicine.

    Science.gov (United States)

    Dunn, Warren R; George, Michael S; Churchill, Larry; Spindler, Kurt P

    2007-05-01

    Physicians have struggled with the medical ramifications of athletic competition since ancient Greece, where rational medicine and organized athletics originated. Historically, the relationship between sport and medicine was adversarial because of conflicts between health and sport. However, modern sports medicine has emerged with the goal of improving performance and preventing injury, and the concept of the "team physician" has become an integral part of athletic culture. With this distinction come unique ethical challenges because the customary ethical norms for most forms of clinical practice, such as confidentiality and patient autonomy, cannot be translated easily into sports medicine. The particular areas of medical ethics that present unique challenges in sports medicine are informed consent, third parties, advertising, confidentiality, drug use, and innovative technology. Unfortunately, there is no widely accepted code of sports medicine ethics that adequately addresses these issues.

  13. Characterization of HIV-1 from patients with virological failure to a boosted protease inhibitor regimen

    DEFF Research Database (Denmark)

    Lillemark, Marie Rathcke; Gerstoft, Jan; Obel, Niels

    2011-01-01

    The use of highly active antiretroviral treatment (HAART) regimens with unboosted protease inhibitors (PIs) has resulted in a high level of virological failure primarily due to the development of resistant virus. Current boosted PI regimens combine successfully low-dose ritonavir (r) with a second...... PI. The aim of the study was to estimate the proportion of patients, in a population based setting, who develop virological failure on a PI/r regimen. Through The Danish HIV Cohort Study 1,007 patients who received PI/r based treatment between 1995 and 2008 were identified. Twenty-three (2.......3%) experienced virological failure, of whom 19 (83%) started PI/r treatment before 2001. Patients from Copenhagen (n=19) were selected to study the development of protease (PR) and gag cleavage site (CS) mutations during PI/r treatment and PI plasma levels at the time of virological failure. Three patients (16...

  14. Treatment regimens for rifampicin-resistant tuberculosis: highlighting a research gap.

    Science.gov (United States)

    Stagg, H R; Hatherell, H-A; Lipman, M C; Harris, R J; Abubakar, I

    2016-07-01

    Treatment guidance for non-multidrug-resistant (MDR) rifampicin-resistant (RMP-R) tuberculosis (TB) is variable. We aimed to undertake a systematic review and meta-analysis of the randomised controlled trial (RCT) data behind such guidelines to identify the most efficacious treatment regimens. Ovid MEDLINE, the Web of Science and EMBASE were mined using search terms for TB, drug therapy and RCTs. Despite 12 604 records being retrieved, only three studies reported treatment outcomes by regimen for patients with non-MDR RMP-R disease, preventing meta-analysis. Our systematic review highlights a substantial gap in the literature regarding evidence-based treatment regimens for RMP-R TB.

  15. Effect of feeding regimens on polyhydroxybutyrate production from food wastes by Cupriavidus necator.

    Science.gov (United States)

    Hafuka, Akira; Sakaida, Kenji; Satoh, Hisashi; Takahashi, Masahiro; Watanabe, Yoshimasa; Okabe, Satoshi

    2011-02-01

    We investigated the effects of different feeding regimens (1-pulse, stepwise, and continuous) of fermented food-waste liquid on polyhydroxybutyrate (PHB) production. The fermentation liquid was filtered with a membrane filter (pore size, 0.45 μm) to remove anaerobic microorganisms and solids and used as a carbon source for Cupriavidus necator. One-pulse feeding yielded the highest cell concentration of C. necator. However, the PHB concentration was higher in the stepwise- and continuous-feeding regimens. Therefore, the continuous-feeding regimen was used for continuous PHB production. PHB could be produced over 259 h (8 draw-fill cycles) with a maximal PHB content of 87%, but the PHB concentration and content decreased with an increase in the operation time. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Occupational medicine and toxicology

    OpenAIRE

    2006-01-01

    Abstract This editorial is to announce the Journal of Occupational Medicine and Toxicology, a new Open Access, peer-reviewed, online journal published by BioMed Central. Occupational medicine and toxicology belong to the most wide ranging disciplines of all medical specialties. The field is devoted to the diagnosis, prevention, management and scientific analysis of diseases from the fields of occupational and environmental medicine and toxicology. It also covers the promotion of occupational ...

  17. Advances in Regenerative medicine

    OpenAIRE

    2011-01-01

    PREFACE In order to better introduce this book, it is important to define regenerative medicine as this field is built through a combination of multiple elements including living cells, matrix to support the living cells (i.e. a scaffold), and cell communicators (or signaling systems) to stimulate the cells, and their surrounding environment to grow and develop into new tissue or organ. Indeed, regenerative medicine is an emerging multidisciplinary field involving biology, medicine, and ...

  18. Implementations of translational medicine

    OpenAIRE

    Sonntag Kai-Christian

    2005-01-01

    Abstract New developments in science are rapidly influencing and shaping basic and clinical research and medicine. This has led to the emergence of multiple opportunities and challenges on many levels in the bio-medical and other associated fields. To face these opportunities and challenges, new concepts and strategies are needed. These can be provided by translational research/medicine as an integrative concept based on a multidirectional understanding of research and medicine embedded in a ...

  19. Drospirenone/ethinyl estradiol 3 mg/20 µg (24/4 day regimen: hormonal contraceptive choices – use of a fourth-generation progestin

    Directory of Open Access Journals (Sweden)

    Gloria Bachmann

    2009-08-01

    Full Text Available Gloria Bachmann, Sharon KopaczWomen’s Health Institute, University of Medicine and Dentistry of New Jersey, USAAbstract: The combined oral contraceptive pill (COC consisting of drospirenone 3 mg/ethinyl estradiol 20 µg (3 mg DRSP/20 µg EE-24/4 supplies 24 days of pills with hormones followed by 4 days of hormone-free pills. This regimen is called the 24/4 regimen. The progesterone component of this oral contraceptive pill (OCP, drospirenone (DRSP, is a fourth-generation progestin that has potent progestogenic, antimineralocorticoid, and antiandrogenic activity, which are unique characteristics compared with the other progestogens contained in most of the other OCPs currently marketed. This formulation, in addition to being an effective long-term OCP, has the additional medical benefit of providing a good parallel treatment for premenstrual dysphoric disorder and moderate acne. The effectiveness of 3 mg DRSP/20 µg EE-24/4, its tolerability and safety, and its additional non-contraceptive benefits are discussed.Keywords: drospirenone, premenstrual dysphoric disorder, acne vulgaris, contraception, antimineralocorticoid activity, antiandrogenic activity

  20. Fluorine in medicinal chemistry.

    Science.gov (United States)

    Swallow, Steven

    2015-01-01

    Since its first use in the steroid field in the late 1950s, the use of fluorine in medicinal chemistry has become commonplace, with the small electronegative fluorine atom being a key part of the medicinal chemist's repertoire of substitutions used to modulate all aspects of molecular properties including potency, physical chemistry and pharmacokinetics. This review will highlight the special nature of fluorine, drawing from a survey of marketed fluorinated pharmaceuticals and the medicinal chemistry literature, to illustrate key concepts exploited by medicinal chemists in their attempts to optimize drug molecules. Some of the potential pitfalls in the use of fluorine will also be highlighted.

  1. Personalized medicine in psychiatry

    DEFF Research Database (Denmark)

    Wium-Andersen, Ida Kim; Vinberg, Maj; Kessing, Lars Vedel

    2017-01-01

    Background: Personalized medicine is a model in which a patient’s unique clinical, genetic, and environmental characteristics are the basis for treatment and prevention.  Aim, method, and results: This review aims to describe the current tools, phenomenological features, clinical risk factors......, and biomarkers used to provide personalized medicine. Furthermore, this study describes the target areas in which they can be applied including diagnostics, treatment selection and response, assessment of risk of side-effects, and prevention.  Discussion and conclusion: Personalized medicine in psychiatry....... The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine....

  2. Music and medicine

    Directory of Open Access Journals (Sweden)

    Donatella Lippi

    2010-08-01

    Full Text Available Donatella Lippi1, Paolo Roberti di Sarsina2, John Patrick D’Elios11History of Medicine, Department of Anatomy, Histology, and Forensic Medicine, University of Florence, Florence, Italy; 2Health Local Unit, Department of Mental Health, Bologna, ItalyAbstract: Healing sounds have always been considered in the past an important aid in medical practice, and nowadays, medicine has confirmed the efficacy of music therapy in many diseases. The aim of this study is to assess the curative power of music, in the frame of the current clinical relationship.Keywords: history of medicine, medical humanities, healing music

  3. Technologists for Nuclear Medicine

    Science.gov (United States)

    Barnett, Huey D.

    1974-01-01

    Physicians need support personnel for work with radioisotopes in diagnosing dangerous diseases. The Nuclear Medicine Technology (NMT) Program at Hillsborough Community College in Tampa, Florida, is described. (MW)

  4. Cough & Cold Medicine Abuse

    Science.gov (United States)

    ... Know Getting Rid of Old Medicines Dealing With Addiction Understanding Medications and What They Do Prescription Drug Abuse Bath Salts Depressants Ketamine MDMA (Ecstasy) Contact Us Print Resources ...

  5. Pharmacogenetics, pharmacogenomics and ayurgenomics for personalized medicine: a paradigm shift.

    Science.gov (United States)

    Gupta, Pooja D

    2015-01-01

    The value of health care can be increased tremendously through individualized medicine. With the promise of individualized medicine, healthcare professionals will be able to better predict disease risk, prevent development of disease and manage treatments more efficiently thereby allowing people to be healthier and active longer. The developments in the area of pharmacogenetics/pharmacogenomics can help the physicians achieve the target of personalized medicine. Personalized medicine will come to mean not just the right drug for the right individual, but the right drug for the specific disease affecting a specific individual. The use of personalized medicine will make clinical trials more efficient by lowering the costs that would arise due to adverse drug effects and prescription of drugs that have been proven ineffective in certain genotypes. The genotypic experiments have laid valuable insights into genetic underpinnings of diseases. However it is being realized that identification of sub-groups within normal controls corresponding to contrasting disease susceptibility could lead to more effective discovery of predictive markers for diseases. However there are no modern methods available to look at the inter-individual differences within ethnically matched healthy populations. Ayurveda, an exquisitely elaborate system of predictive medicine which has been practiced for over 3500 years in India, can help in bridging this gap. In contrast to the contemporary system of medicine, the therapeutic regimen in Ayurveda is implicated on tridoshas and prakriti. According to this system, every individual is born with his or her own basic constitution, which to a great extent regulates inter-individual variability in susceptibility to diseases and response to external environment, diet and drugs. Thus the researchers in India have demonstrated that integration of this stratified approach of Ayurveda into genomics i.e. Ayurgenomics could complement personalized medicine.

  6. [Herbal medicines alternative to synthetical medicines].

    Science.gov (United States)

    Beer, A M; Schilcher, H; Loew, D

    2013-12-16

    Herbal pharmaceuticals in medical practice are similarly used as chemically well defined drugs. Like other synthetical drugs, they are subject to pharmaceutical legislature (AMG) and EU directives. It is to differentiate between phytopharmaceuticals with effectiveness of proven indications and traditional registered herbal medicine. Through the Health Reform Act January 2004 and the policy of the Common Federal Committee (G-BA)on the contractual medical care from March 2009--with four exceptions--Non-prescription Phytopharmaka of the legal Health insurance is no longer (SHI) refundable and must be paid by the patients. The result is that more and more well-established preparations disappear from the market. This article gives an overview of practical relevant indications for herbal medicines, which according to its licensing status, the scientific assessment by the Cochrane Collaboration and the Institute for Quality and Efficiency in Health Care (IQWiG) and evidence-based Medicine (EBM)/ meta-analyzes as an alternative to synthetics can be used.

  7. [Stability of high-dose etoposide dilutions for use in hematopoietic stem cell transplantation conditioning regimens].

    Science.gov (United States)

    Bauters, T; Vandenbroucke, J; Commeyne, S

    2015-12-01

    High-dose etoposide is used in conditioning regimens for allogeneic stem cell transplantation. The limited stability of the drug induces barriers for its use for pharmacists, nurses and patients. When using a concentration of 10 mg/mL etoposide in physiologic saline, limitations can be overcome. This study provides stability data for etoposide in a high concentration that can be used in conditioning regimens. The solution was stable for 48h at 5°C, for 48h at 5°C followed by 8h at 25°C and for 24 h at 25°C.

  8. Application of Radial Basis Network Model for HIV/AIDs Regimen Specifications

    CERN Document Server

    Balasubramanie, P

    2009-01-01

    HIV/AIDs Regimen specification one of many problems for which bioinformaticians have implemented and trained machine learning methods such as neural networks. Predicting HIV resistance would be much easier, but unfortunately we rarely have enough structural information available to train a neural network. To network model designed to predict how long the HIV patient can prolong his/her life time with certain regimen specification. To learn this model 300 patient's details have taken as a training set to train the network and 100 patients medical history has taken to test this model. This network model is trained using MAT lab implementation.

  9. Different treatment regimens of magnesium sulphate for tocolysis in women in preterm labour.

    Science.gov (United States)

    McNamara, Helen C; Crowther, Caroline A; Brown, Julie

    2015-12-14

    Magnesium sulphate has been used to inhibit preterm labour to prevent preterm birth. There is no consensus as to the safety profile of different treatment regimens with respect to dose, duration, route and timing of administration. To assess the efficacy and safety of alternative magnesium sulphate regimens when used as single agent tocolytic therapy during pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2015) and reference lists of retrieved studies. Randomised trials comparing different magnesium sulphate treatment regimens when used as single agent tocolytic therapy during pregnancy in women in preterm labour. Quasi-randomised trials were eligible for inclusion but none were identified. Cross-over and cluster trials were not eligible for inclusion. Health outcomes were considered at the level of the mother, the infant/child and the health service. intravenous or oral magnesium sulphate given alone for tocolysis.Comparison: alternative dosing regimens of magnesium sulphate given alone for tocolysis. Two review authors independently assessed trial eligibility and quality and extracted data. Three trials including 360 women and their infants were identified as eligible for inclusion in this review. Two trials were rated as low risk of bias for random sequence generation and concealment of allocation. A third trial was assessed as unclear risk of bias for these domains but did not report data for any of the outcomes examined in this review. No trials were rated to be of high quality overall.Intravenous magnesium sulphate was administered according to low-dose regimens (4 g loading dose followed by 2 g/hour continuous infusion and/or increased by 1 g/hour hourly until successful tocolysis or failure of treatment), or high-dose regimens (4 g loading dose followed by 5 g/hour continuous infusion and increased by 1 g/hour hourly until successful tocolysis or failure of treatment, or 6 g loading dose followed by 2 g

  10. Esomeprazole regimens for reflux symptoms in Chinese patients with chronic gastritis.

    Science.gov (United States)

    Sun, Jing; Yuan, Yao-Zong; Hou, Xiao-Hua; Zou, Duo-Wu; Lu, Bin; Chen, Min-Hu; Liu, Fei; Wu, Kai-Chun; Zou, Xiao-Ping; Li, Yan-Qing; Zhou, Li-Ya

    2015-06-14

    To compare symptom control with esomeprazole regimens for non-erosive reflux disease and chronic gastritis in patients with a negative endoscopy. This randomized, open-label study was designed in line with clinical practice in China. Patients with typical reflux symptoms for ≥ 3 mo and a negative endoscopy who had a Gastroesophageal Reflux Disease Questionnaire score ≥ 8 were randomized to initial treatment with esomeprazole 20 mg once daily either for 8 wk or for 2 wk. Patients with symptom relief could enter another 24 wk of maintenance/on-demand treatment, where further courses of esomeprazole 20 mg once daily were given if symptoms recurred. The primary endpoint was the symptom control rate at week 24 of the maintenance/on-demand treatment period. Secondary endpoints were symptom relief rate, success rate (defined as patients who had symptom relief after initial treatment and after 24 wk of maintenance treatment), time-to-first-relapse and satisfaction rate. Based on the data collected in the modified intention-to-treat population (MITT; patients in the ITT population with symptom relief after initial esomeprazole treatment, n = 262), the symptom control rate showed a small but statistically significant difference in favor of the 8-wk regimen (94.9% vs 87.3%, P = 0.0473). Among the secondary endpoints, based on the data collected in the ITT population (n = 305), the 8-wk group presented marginally better results in symptom relief after initial esomeprazole treatment (88.3% vs 83.4%, P = 0.2513) and success rate over the whole study (83.8% vs 72.8%, P = 0.0258). The 8-wk regimen was found to provide a 46% reduction in risk of relapse vs the 2-wk regimen (HR = 0.543; 95%CI: 0.388-0.761). In addition, fewer unscheduled visits and higher patient satisfaction supported the therapeutic benefits of the 8-wk regimen over the 2-wk regimen. Safety was comparable between the two groups, with both regimens being well tolerated. Chinese patients diagnosed with chronic

  11. Camptothecin-Based Regimens for Treatment of Ewing Sarcoma: sPast Studies and Future Directions

    Directory of Open Access Journals (Sweden)

    Lars Wagner

    2011-01-01

    Full Text Available New therapies are needed to improve survival for patients with Ewing sarcoma. Over the past decade, camptothecin agents such as topotecan and irinotecan have demonstrated activity against Ewing sarcoma, especially in combination with alkylating agents. Previous studies have shown camptothecin-based combinations to be tolerable outpatient strategies that are attractive for salvage therapy. This paper highlights important issues related to drug dosing, schedule of administration, pharmacokinetics, toxicity, and activity of commonly used camptothecin-based regimens. Also discussed are strategies for incorporating these regimens into therapy for newly diagnosed patients, including several potential possibilities for combination with targeted agents.

  12. Remission induction and remission maintenance in adult acute nonlymphocytic leukemia employing a modified cytostatic (COAP) regimen.

    Science.gov (United States)

    Gerecke, D; Hirschmann, W D; Voigtmann, R; Gross, R

    1979-07-01

    Thirty adult patients suffering from acute nonlymphocytic leukemia (ANLL) were treated according to a modified COAP regimen. Vincristine, cyclophosphamide, and prednisone were given by push injection, while cytosine arabinoside was infused over periods of 8 h. Nineteen patients (63%) achieved complete remission. Remission maintenance therapy consisted of 6-mercaptopurine daily and methotrexate twice weekly. Later in the study, COAP consolidation and reinduction was added, which improved the median duration of complete remission from 7 to 24 months. Comparison of the results with the literature shows that the modified COAP regimen is one of the most effective treatment schedules for adult ANLL.

  13. Infusional mitoxantrone plus bolus melphalan as a stem cell transplant conditioning regimen for multiple myeloma.

    Science.gov (United States)

    Beaven, Anne W; Moore, Dominic T; Sharf, Andrew; Serody, Jonathan S; Shea, Thomas C; Gabriel, Don A

    2011-03-01

    This study combined infusional mitoxantrone with bolus melphalan as a transplant preparative regimen for multiple myeloma. Mitoxantrone was infused over 6 hr on days 6 and 5. Melphalan was given as a 15 min bolus on day 1 followed by autologous transplant on day 0. Thirty-five patients were enrolled; 57% of enrollees had received ≥ 2 prior treatments. The median overall survival was 5 years and 8 months, with 37% of the subjects alive >7 years posttransplantation. Myelosuppression and mucositis were the most frequent adverse events. This regimen is well tolerated and the survival compares well to other transplant trials.

  14. Kidney Injury Associated with Telavancin Dosing Regimen in an Animal Model

    Science.gov (United States)

    Ledesma, Kimberly R.; Bowers, Dana R.; Zhou, Jian; Truong, Luan D.

    2015-01-01

    The elevation of serum creatinine levels is a concern with telavancin therapy. We examined the onset of kidney injury associated with telavancin in an animal model. Urine samples were collected at baseline and daily to determine the concentrations of kidney injury molecule 1 (KIM-1), a marker for early kidney injury. When a clinically relevant exposure of telavancin was given daily to rats, some differences in kidney injury were attributed to the dosing regimen. Further investigations of alternative telavancin dosing regimens are warranted. PMID:25712358

  15. Efavirenz versus boosted atazanavir-containing regimens and immunologic, virologic, and clinical outcomes

    Science.gov (United States)

    Cain, Lauren E.; Caniglia, Ellen C.; Phillips, Andrew; Olson, Ashley; Muga, Roberto; Pérez-Hoyos, Santiago; Abgrall, Sophie; Costagliola, Dominique; Rubio, Rafael; Jarrín, Inma; Bucher, Heiner; Fehr, Jan; van Sighem, Ard; Reiss, Peter; Dabis, François; Vandenhende, Marie-Anne; Logan, Roger; Robins, James; Sterne, Jonathan A. C.; Justice, Amy; Tate, Janet; Touloumi, Giota; Paparizos, Vasilis; Esteve, Anna; Casabona, Jordi; Seng, Rémonie; Meyer, Laurence; Jose, Sophie; Sabin, Caroline; Hernán, Miguel A.

    2016-01-01

    Abstract Objective: To compare regimens consisting of either ritonavir-boosted atazanavir or efavirenz and a nucleoside reverse transcriptase inhibitor (NRTI) backbone with respect to clinical, immunologic, and virologic outcomes. Design: Prospective studies of human immunodeficiency virus (HIV)-infected individuals in Europe and the United States included in the HIV-CAUSAL Collaboration. Methods: HIV-positive, antiretroviral therapy-naive, and acquired immune deficiency syndrome (AIDS)-free individuals were followed from the time they started an atazanavir or efavirenz regimen. We estimated an analog of the “intention-to-treat” effect for efavirenz versus atazanavir regimens on clinical, immunologic, and virologic outcomes with adjustment via inverse probability weighting for time-varying covariates. Results: A total of 4301 individuals started an atazanavir regimen (83 deaths, 157 AIDS-defining illnesses or deaths) and 18,786 individuals started an efavirenz regimen (389 deaths, 825 AIDS-defining illnesses or deaths). During a median follow-up of 31 months, the hazard ratios (95% confidence intervals) were 0.98 (0.77, 1.24) for death and 1.09 (0.91, 1.30) for AIDS-defining illness or death comparing efavirenz with atazanavir regimens. The 5-year survival difference was 0.1% (95% confidence interval: −0.7%, 0.8%) and the AIDS-free survival difference was −0.3% (−1.2%, 0.6%). After 12 months, the mean change in CD4 cell count was 20.8 (95% confidence interval: 13.9, 27.8) cells/mm3 lower and the risk of virologic failure was 20% (14%, 26%) lower in the efavirenz regimens. Conclusion: Our estimates are consistent with a smaller 12-month increase in CD4 cell count, and a smaller risk of virologic failure at 12 months for efavirenz compared with atazanavir regimens. No overall differences could be detected with respect to 5-year survival or AIDS-free survival. PMID:27741139

  16. Chemotherapy-induced nausea and vomiting. Easing patients' fear and discomfort with effective antiemetic regimens.

    Science.gov (United States)

    Bilgrami, S; Fallon, B G

    1993-10-01

    Patients receiving chemotherapy should be given optimal antiemetic therapy to maximize their comfort initially and to prevent development of delayed and anticipatory nausea and vomiting. Understanding the mechanisms of chemotherapy-induced nausea and vomiting allows the healthcare team to design drug regimens capable of avoiding these side effects. Prevention is important, because side effects can be debilitating and sometimes dose-limiting, and up to 10% of patients refuse chemotherapy altogether to avoid them. In general, combination antiemetic therapy is preferred over single-agent therapy for chemotherapeutic regimens that produce moderate to severe adverse effects.

  17. Teaching evidence based medicine in family medicine

    Directory of Open Access Journals (Sweden)

    Davorka Vrdoljak

    2012-05-01

    Full Text Available The concept of evidence based medicine (EBM as the integrationof clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980’s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP in a short time is not easy. Five useful steps are described –represented by the acronym “5A+E”: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search “on the spot’’ is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GP’s office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning. Conclusion. EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GP’s everyday work is becoming a part of everyday practice.

  18. Adherence in HIV-positive patients treated with single-tablet regimens and multi-pill regimens: findings from the COMPACT study

    Directory of Open Access Journals (Sweden)

    A Antinori

    2012-11-01

    Full Text Available The use of Combination AntiRetroviral Therapy (cART has decreased the morbidity and mortality of patients infected with HIV. However, adherence to cART remains crucial to prevent virological failure and disease progression. The aim of this study was to assess adherence to treatment among patients treated with Single Tablet Regimen (STR or with multi-pill regimens based on Protease Inhibitors (PI, Non-Nucleoside Reverse-Transcriptase Inhibitors (NNRTI, or raltegravir (RAL. An observational retrospective cohort analysis based on administrative and clinical databases was conducted at the National Institute for Infectious Diseases (Rome, Italy. HIV-positive patients treated with a cART between Jan 1st, 2008–Dec 31st, 2010 were included. Patients were followed-up for one year since the first prescription during the inclusion period or up to death or switch of at least one drug of the regimen. Adherence and selective non-adherence (days without backbone or 3rd drug were calculated using pharmacy refill compliance [1]. cART regimens were classified based on number of daily pills (STR vs multi-pill regimen and on type of third drug. Viral Load (VL and CD4 cell counts at the end of the follow-up were evaluated. A total of 1,604 patients were analyzed, 70.0% male, age 45.0±8.7, 14.3% newly treated. Patients on STR were 159 (9.9%, PI 878 (54.7%, NNRTI 523 (32.6%, RAL 44 (2.7%. Presence of at least one AIDS-defining conditions (according to Centers for Disease Control classification was 30% in the STR group, 34% PI, 26% NNRTI, 34% RAL (p=n.s.. Adherence was 80.4±14.7% for STR, 71.8±21.8% PI, 77.1±20.3% NNRTI, 74.0±22.4% RAL. Selective non-adherence was 5.5% (18 days PI, 2.8% (8 days NNRTI, 12.5% (43 days RAL (Figure 1. At the end of the follow-up, VL/CD4 values were available among 709 patients (44%; CD4 count >500 cell/mm3 was observed among 61% of patients on STR, 44% PI, 48% NNRTI, 42% RAL and VL < 50 copies/ml was observed among 96% of patients

  19. Role of music in intensive care medicine.

    Science.gov (United States)

    Trappe, Hans-Joachim

    2012-01-01

    The role of music in intensive care medicine is still unclear. However, it is well known that music may not only improve quality of life but also effect changes in heart rate (HR) and heart rate variability (HRV). Reactions to music are considered subjective, but studies suggest that cardio/cerebrovascular variables are influenced under different circumstances. It has been shown that cerebral flow was significantly lower when listening to "Va pensioero" from Verdi's "Nabucco" (70.4+3.3 cm/s) compared to "Libiam nei lieti calici" from Verdi's "La Traviata" (70.2+3.1 cm/s) (Peffectiveness and absence of apparent adverse effects make relaxing, preoperative music a useful alternative to midazolam. In addition, there is sufficient practical evidence of stress reduction suggesting that a proposed regimen of listening to music while resting in bed after open-heart surgery is important in clinical use. After 30 min of bed rest, there was a significant difference in cortisol levels between the music (484.4 mmol/l) and the non-music group (618.8 mmol/l) (PMozart or Italian composers) music and meditation music, whereas heavy metal music or techno are not only ineffective but possibly dangerous and can lead to stress and/or life-threatening arrhythmias, particularly in intensive care medicine patients.

  20. Antiretroviral therapy in HIV-infected patients: a proposal to assess the economic value of the single-tablet regimen

    Directory of Open Access Journals (Sweden)

    Colombo GL

    2013-02-01

    Full Text Available Giorgio L Colombo,1,2 Sergio Di Matteo,2 Franco Maggiolo31University of Pavia, Department of Drug Sciences, School of Pharmacy, Pavia, Italy, 2Studi Analisi Valutazioni Economiche, Milan, Italy, 3Division of Infectious Diseases, Ospedali Riuniti, Bergamo, ItalyBackground: The aim of this study was to assess the economic value of a reduced number of pills in patients infected with the immunodeficiency virus (HIV and on highly active antiretroviral therapy by a cost-effectiveness model.Methods: An incremental cost-effectiveness analysis of efavirenz, tenofovir, and emtricitabine (TDF-FTC-EFV as a single-tablet regimen versus a multipill regimen, with reference to untreated HIV-infected patients, was carried out from the perspective of the Italian National Health Service. The comparisons were performed with the help of a Markov decision model over a 10-year time horizon. Based on the ADONE (ADherence to ONE pill study, it was then possible to identify the utility score increment in patients switching from a multipill regimen of TDF-FTC + EFV therapy to a single-tablet regimen.Results: The single-tablet regimen (0.755 quality-adjusted life-years [QALYs]/year resulted in better patient quality of life, with a higher number of QALYs than for the TDF-FTC + EFV multipill regimen (0.716 QALYs/year. The single-tablet regimen was the most cost-effective treatment strategy, with an incremental cost-effectiveness ratio of €22,017.00 versus €26,558.00 for the multipill regimen. A 24% decrease in cost of the multipill regimen determined equivalence with the single-tablet regimen in terms of the incremental cost-effectiveness ratio. Univariate sensitivity and probabilistic analysis carried out on the main variables did not highlight significant variations with respect to the base case scenario.Conclusion: The single-tablet regimen resulted in better adherence, and therefore better quality of life as perceived by patients, corresponding to a €4541.00 lower

  1. Personalized Regenerative Medicine.

    Science.gov (United States)

    Arjmand, Babak; Goodarzi, Parisa; Mohamadi-Jahani, Fereshteh; Falahzadeh, Khadijeh; Larijani, Bagher

    2017-03-01

    Personalized medicine as a novel field of medicine refers to the prescription of specific therapeutics procedure for an individual. This approach has established based on pharmacogenetic and pharmacogenomic information and data. The terms precision and personalized medicines are sometimes applied interchangeably. However, there has been a shift from "personalized medicine" towards "precision medicine". Although personalized medicine emerged from pharmacogenetics, nowadays it covers many fields of healthcare. Accordingly, regenerative medicine and cellular therapy as the new fields of medicine use cell-based products in order to develop personalized treatments. Different sources of stem cells including mesenchymal stem cells, embryonic stem cells and induced pluripotent stem cells (iPSCs) have been considered in targeted therapies which could give many advantages. iPSCs as the novel and individual pluripotent stem cells have been introduced as the appropriate candidates for personalized cell therapies. Cellular therapies can provide a personalized approach. Because of person-to-person and population differences in the result of stem cell therapy, individualized cellular therapy must be adjusted according to the patient specific profile, in order to achieve best therapeutic results and outcomes. Several factors should be considered to achieve personalized stem cells therapy such as, recipient factors, donor factors, and the overall body environment in which the stem cells could be active and functional. In addition to these factors, the source of stem cells must be carefully chosen based on functional and physical criteria that lead to optimal outcomes.

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... scan being performed, you will receive specific preparation instructions for what your child may eat and drink before the exam, especially ... Epilepsy Images related to Children's (Pediatric) Nuclear Medicine ... Videos related to Children's (Pediatric) Nuclear Medicine Sponsored by Please note RadiologyInfo. ...

  3. [Opening medicine containers].

    Science.gov (United States)

    Glerup, E; Dengsø, H

    1990-07-09

    In connection with self-administration of medicine for patients with rheumatoid arthritis, patients with weak hands and elderly patients in general, the design of many medicine containers makes them awkward to handle for the patients. In this investigation 12 different medicine containers were tested. The 12 containers represent the antirheumatic medicine containers available on the market in Denmark in 1988. Sixty patients participated in the investigation. Thirty had rheumatoid arthritis and 30 had normal hand function. The age range was 40-85 years The patients had the choice between five possible answers concerning each container. In all patients, grip strength was measured. The patients with rheumatoid arthritis were classified in four functional classes, and pulpa-vola distance end thumb--5th MCP point distance were measured. The opening mechanisms of 29% of the antirheumatic medicine containers are unacceptable; these are plastic containers with a "push-off" top and suppository packs. 46%--(containers with screw cap or pressure dispensing) are considered acceptable. For 25% (tablet and capsule blister packs) the patients' estimate varied. It is important that medicine containers can be opened by the patients without difficulty, so that they do not present a hindrance to a correct intake of medicine or result in an unnecessary admission to hospital. The results of this investigation show that it is of continuous importance to encourage the production of medicine containers that comply with the requirements of the patients.

  4. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... medicine exams will involve an injection in a vein in your child’s arm or hand. Your child should wear loose, comfortable clothing and ... medicine exams will involve an injection into a vein in your child's arm or hand. Children should wear comfortable, loose-fitting clothing to ...

  5. Preventive Medicine Redefined.

    Science.gov (United States)

    Moore, George

    1981-01-01

    Departments of preventive medicine can survive through unity, which can be achieved through majority agreement on a new and specific definition of preventive medicine. A definition is proposed that is based on a review and analysis of recent progress in the prevention of the major causes of mortality. (MLW)

  6. Implementation of an Integrative Medicine Curriculum for Preventive Medicine Residents.

    Science.gov (United States)

    Chiaramonte, Delia R; D'Adamo, Christopher; Amr, Sania

    2015-11-01

    The University of Maryland Department of Epidemiology and Public Health collaborated with the Center for Integrative Medicine at the same institution to develop and implement a unique integrative medicine curriculum within a preventive medicine residency program. Between October 2012 and July 2014, Center for Integrative Medicine faculty provided preventive medicine residents and faculty, and occasionally other Department of Epidemiology and Public Health faculty, with comprehensive exposure to the field of integrative medicine, including topics such as mind-body medicine, nutrition and nutritional supplements, Traditional Chinese Medicine, massage, biofield therapies, manual medicine, stress management, creative arts, and the use of integrative medicine in the inpatient setting. Preventive medicine residents, under the supervision of Department of Epidemiology and Public Health faculty, led integrative medicine-themed journal clubs. Resident assessments included a case-based knowledge evaluation, the Integrative Medicine Attitudes Questionnaire, and a qualitative evaluation of the program. Residents received more than 60 hours of integrative medicine instruction, including didactic sessions, experiential workshops, and wellness retreats in addition to clinical experiences and individual wellness mentoring. Residents rated the program positively and recommended that integrative medicine be included in preventive medicine residency curricula. The inclusion of a wellness-focused didactic, experiential, and skill-based integrative medicine program within a preventive medicine residency was feasible and well received by all six preventive medicine residents.

  7. HIV Medicines and Side Effects

    Science.gov (United States)

    Side Effects of HIV Medicines HIV Medicines and Side Effects (Last updated 1/17/2017; last reviewed 1/17/2017) Key Points HIV medicines help people with ... will depend on a person’s individual needs. Can HIV medicines cause side effects? HIV medicines help people ...

  8. ¹⁸F-FDG PET/CT for the Early Evaluation of Response to Neoadjuvant Treatment in Triple-Negative Breast Cancer: Influence of the Chemotherapy Regimen.

    Science.gov (United States)

    Groheux, David; Biard, Lucie; Giacchetti, Sylvie; Teixeira, Luis; Hindié, Elif; Cuvier, Caroline; Vercellino, Laetitia; Merlet, Pascal; de Roquancourt, Anne; de Cremoux, Patricia; Resche-Rigon, Matthieu; Espié, Marc

    2016-04-01

    Patients with triple-negative breast cancer (TNBC) have poor outcome when pathologic complete response (pCR) is not reached after neoadjuvant chemotherapy. Early prediction would be helpful. We evaluated the association between metabolic response after 2 cycles of neoadjuvant chemotherapy, pCR, and outcome in patients receiving 2 different anthracycline-based regimens (conventional and intensified). Of 77 consecutive TNBC patients, 23 received EC-D (4 cycles of epirubicin + cyclophosphamide followed by 4 cycles of docetaxel at conventional doses) and 55 received a dose-intensified, dose-dense concomitant regimen of epirubicin + cyclophosphamide (historically called SIM) for 6 cycles. PET/CT with (18)F-FDG was performed at baseline and after 2 cycles of neoadjuvant chemotherapy. The associations between clinical factors, biologic factors, early metabolic change, pCR, and event-free survival (EFS) were examined (log-rank test). Of the 78 patients, 29 (37%) achieved pCR. The change in SUVmax (∆SUVmax) after 2 cycles was more pronounced in patients who achieved pCR (-72% vs. -42%;P< 0.0001). ∆SUVmax was more pronounced under SIM than under EC-D (-68% vs. -35%, P= 0.009), and there was a trend for a higher pCR rate (44% vs. 22%, P= 0.078). Twenty-two patients relapsed and 10 of them died (median follow-up, 34 mo). pCR was associated with EFS (log-rank, P= 0.001). ∆SUVmax was also significantly associated with EFS both in patients receiving SIM (P= 0.028) and in those receiving EC-D (P= 0.021). The optimal ∆SUVmax for predicting pCR and EFS was, however, specific to the treatment regimen. EFS was not associated with tumor grade (P= 0.98), histologic subtype (P= 0.17), or clinical stage (P= 0.097). Early metabolic change during neoadjuvant chemotherapy can predict pathologic response and EFS in TNBC patients under different chemotherapy regimens. However, the metabolic response varies with the type of chemotherapy. © 2016 by the Society of Nuclear Medicine and

  9. Maimonides’ Appreciation for Medicine

    Directory of Open Access Journals (Sweden)

    Benjamin Gesundheit

    2011-01-01

    Full Text Available Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides’ motivation regarding and deep appreciation for medicine: (A The physician fulfills the basic biblical obligation to return lost objects to their owner, for with his knowledge and experience the physician can restore good health to his sick fellow human being; (B medicine provides a unique opportunity to practice imitatio dei, as it reflects the religious duty to maintain a healthy life-style; (C as an important natural science, medicine offers tools to recognize, love, and fear God. These three aspects address man’s relationship and obligation towards his fellow-man, himself and God. Biographical insights supported by additional sources from Maimonides’ writings are discussed.

  10. Evolutionary molecular medicine.

    Science.gov (United States)

    Nesse, Randolph M; Ganten, Detlev; Gregory, T Ryan; Omenn, Gilbert S

    2012-05-01

    Evolution has long provided a foundation for population genetics, but some major advances in evolutionary biology from the twentieth century that provide foundations for evolutionary medicine are only now being applied in molecular medicine. They include the need for both proximate and evolutionary explanations, kin selection, evolutionary models for cooperation, competition between alleles, co-evolution, and new strategies for tracing phylogenies and identifying signals of selection. Recent advances in genomics are transforming evolutionary biology in ways that create even more opportunities for progress at its interfaces with genetics, medicine, and public health. This article reviews 15 evolutionary principles and their applications in molecular medicine in hopes that readers will use them and related principles to speed the development of evolutionary molecular medicine.

  11. Foucault and modern medicine.

    Science.gov (United States)

    Peerson, A

    1995-06-01

    Modernity as a concept or ideal, resulting from the age of Enlightenment and the French Revolution gave hope of a better future and new possibilities. To be modern means an 'enlightened' individual and society, welcoming change and development. In this paper, I will discuss Foucault's analysis (1973) of problematics in medicine in eighteenth century France. Three themes prominent in the text are: 'the birth of the clinic', 'the clinical gaze' and the power-knowledge relationship. Three problematics identified in modern medicine by Foucault and which are particularly relevant to twentieth century medicine are: (i) the extension of the clinical gaze from the individual body to the wider population; (ii) the increasing medical intervention and use of technology in fundamental life processes; and (iii) the relationship between society and medicine. I will argue that Foucault's analysis is fraught with ambiguities. It is useful, however, for establishing an explanation for medicine today and for presenting a particular interpretation of modernity.

  12. A randomized trial evaluating a block-replacement regimen during radioiodine therapy

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Grupe, Peter; Boel-Jørgensen, Henrik

    2011-01-01

    Eur J Clin Invest 2010 ABSTRACT: Background  Lack of consensus regarding the antithyroid drug regimen in relation to radioiodine ((131) I) therapy of hyperthyroidism prompted this randomized trial comparing two strategies. Design  Patients with Graves' disease (GD, n = 51) or toxic nodular goitre...

  13. [Use of mathematical models in study of nitric oxide, myoglobin and cell oxygen regimen].

    Science.gov (United States)

    Liabakh, K H

    2011-01-01

    The influence ofnanomolar concentrations of NO on oxygen regimen of muscle cells was investigated. The intracellular distribution of oxygen consumption rates, pO2, NO and myoglobin was calculated by mathematical modeling of diffusion reactions of O2, NO and myoglobin in the muscle cell. The diffusion of O2, and NO from blood vessel surface into cell was taken into account. According to calculations, NO roughly regulates the oxygen regimen of cell, because it increases the tissue pO2 level by inhibition of mitochondria activity in the whole cell space. The presence ofmyoglobin is capable potentially to modulate the influence of NO on oxygen regimen. Myoglobin not only contributes to tissue O2 supply, but it can locally affect the NO concentration. Acting as an NO scavenger under normoxia and as an NO producer under hypoxia, myoglobin together with NO can provide fine adjustment of muscle oxygen regimen via an increase in tissue pO, and elimination a mismatch between oxygen supply and demand.

  14. Plasma concentrations of caspofungin at two different dosage regimens in a patient with hepatic dysfunction

    NARCIS (Netherlands)

    Elst, K.C. van der; Bruggemann, R.J.M.; Rodgers, M.G.; Alffenaar, J.W.C.

    2012-01-01

    The currently recommended dosage regimen of caspofungin (50 mg/day) was developed for patients with invasive candidiasis. With invasive aspergillosis, successful outcomes occur in less than half the patients. We evaluate the pharmacokinetics in a patient with elevated liver enzyme levels after liver

  15. Intestinal Microbiota of Broiler Chickens As Affected by Litter Management Regimens.

    Science.gov (United States)

    Wang, Lingling; Lilburn, Mike; Yu, Zhongtang

    2016-01-01

    Poultry litter is a mixture of bedding materials and enteric bacteria excreted by chickens, and it is typically reused for multiple growth cycles in commercial broiler production. Thus, bacteria can be transmitted from one growth cycle to the next via litter. However, it remains poorly understood how litter reuse affects development and composition of chicken gut microbiota. In this study, the effect of litter reuse on the microbiota in litter and in chicken gut was investigated using 2 litter management regimens: fresh vs. reused litter. Samples of ileal mucosa and cecal digesta were collected from young chicks (10 days of age) and mature birds (35 days of age). Based on analysis using DGGE and pyrosequencing of bacterial 16S rRNA gene amplicons, the microbiota of both the ileal mucosa and the cecal contents was affected by both litter management regimen and age of birds. Faecalibacterium, Oscillospira, Butyricicoccus, and one unclassified candidate genus closely related to Ruminococcus were most predominant in the cecal samples, while Lactobacillus was predominant in the ileal samples at both ages and in the cecal samples collected at day 10. At days 10 and 35, 8 and 3 genera, respectively, in the cecal luminal microbiota differed significantly in relative abundance between the 2 litter management regimens. Compared to the fresh litter, reused litter increased predominance of halotolerant/alkaliphilic bacteria and Faecalibacterium prausnitzii, a butyrate-producing gut bacterium. This study suggests that litter management regimens affect the chicken GI microbiota, which may impact the host nutritional status and intestinal health.

  16. Outcomes of Patients With Burkitt Lymphoma Older Than Age 40 Treated With Intensive Chemotherapeutic Regimens

    NARCIS (Netherlands)

    Kelly, Jennifer L.; Toothaker, Stephen R.; Ciminello, Lauren; Hoelzer, Dieter; Holte, Harald; LaCasce, Ann S.; Mead, Graham; Thomas, Deborah; Van Imhoff, Gustaaf W.; Kahl, Brad S.; Cheson, Bruce D.; Magrath, Ian T.; Fisher, Richard I.; Friedberg, Jonathan W.

    2009-01-01

    Burkitt lymphoma is a highly curable disorder when treated with modern intensive chemotherapy regimens. The majority of adult patients with Burkitt lymphoma in the United States are over age 40 years. Older patients have historically been underrepresented in published clinical trials of modern inten

  17. First-line treatment of chronic lymphocytic leukemia with three combined chemotherapy regimens

    Directory of Open Access Journals (Sweden)

    Matevž Škerget

    2012-12-01

    Conclusions: RFC is the first-line treatment of choice for younger fit patients without deletion 17. For older and frail patients, alternative newer chemotherapy regimens should be sought. Patients with deletion 17 should receive alemtuzumab treatment, and allogeneic bone marrow transplantation should be considered.

  18. Efficacy of homecare regimens for mechanical plaque removal in managing gingivitis: a meta review

    NARCIS (Netherlands)

    van der Weijden, F.A.; Slot, D.E.

    2015-01-01

    Focused question Based on evidence as presented in systematic reviews what is the efficacy and safety of available homecare toothbrush regimens for mechanical plaque removal on plaque and gingivitis in adults? Material & Methods Three Internet sources were used (up to and including August 2014) to

  19. To evaluate of the effect of adding licorice to the standard treatment regimen of Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Ali Akbar Hajiaghamohammadi

    Full Text Available ABSTRACT Objective: The aim of this study was to evaluate the effect of licorice in H. pylori eradication in patients suffering from dyspepsia either with peptic ulcer disease (PUD or non-ulcer dyspepsia (NUD in comparison to the clarithromycin-based standard triple regimen. Methods: In this randomized controlled clinical trial, 120 patients who had positive rapid urease test were included and assigned to two treatment groups: control group that received a clarithromycin-based triple regimen, and study group that received licorice in addition to the clarithromycin-based regimen for two weeks. H. pylori eradication was assessed six weeks after therapy. Data was analyzed by chi-square and t-test with SPSS 16 software. Results: Mean ages and SD were 38.8 ± 10.9 and 40.1 ± 10.4 for the study and control groups, respectively, statistically similar. Peptic ulcer was found in 30% of both groups. Response to treatment was 83.3% and 62.5% in the study and control groups, respectively. This difference was statistically significant. Conclusion: Addition of licorice to the triple clarithromycin-based regimen increases H. pylori eradication, especially in the presence of peptic ulcer disease.

  20. Differences between the different conditioning regimens for allogeneic stem cell transplantation.

    NARCIS (Netherlands)

    Schattenberg, A.V.M.B.; Levenga, T.H.

    2006-01-01

    PURPOSE OF REVIEW: The aim of this article is to compare the differences in efficacy and toxicity between the various conditioning regimens for allogeneic stem cell transplantation. RECENT FINDINGS: Several studies, all retrospective, that compare the impact of various different conditioning

  1. Immunoparesis status in immunoglobulin light chain amyloidosis at diagnosis affects response and survival by regimen type

    Science.gov (United States)

    Muchtar, Eli; Dispenzieri, Angela; Kumar, Shaji K.; Dingli, David; Lacy, Martha Q.; Buadi, Francis K.; Hayman, Suzanne R.; Kapoor, Prashant; Leung, Nelson; Chakraborty, Rajshekhar; Russell, Stephen; Lust, John A.; Lin, Yi; Go, Ronald S.; Zeldenrust, Steven; Kyle, Robert A.; Rajkumar, S. Vincent; Gertz, Morie A.

    2016-01-01

    Clinical tools to guide in the appropriate treatment selection in immunoglobulin light chain (AL) amyloidosis are not well developed. We evaluated the response and outcome for various regimens at first-line treatment (n=681) and first progression (n=240) stratified by the immunoparesis status at diagnosis. Immunoparesis was assessed by the average relative difference of the uninvolved immunoglobulins, classifying patients into a negative average relative difference (i.e. significant immunoparesis) or a positive average relative difference (no/modest immunoparesis). Treatment was categorized as autologous stem cell transplant and four non-transplant regimens (melphalan-based; bortezomib-based, immunomodulatory drug-based and dexamethasone alone). Patients with significant immunoparesis who underwent stem cell transplant had a significantly lower rate of very good partial response or better response (58%), progression-free survival (median 30 months) and overall survival (108 months), compared to those without significant immunoparesis (80%, 127 months, median not reached, respectively; Pcomparisons). Among the non-transplant regimens, melphalan resulted in an unfavorable progression-free survival (11 vs. 27 months; Pcompared to those without significant immunoparesis. In contrast, no significant difference in outcomes between the immunoparesis groups was seen for those treated with bortezomib or immunomodulatory drugs. At first progression, immunoparesis status did not impact response or survival of any regimen. Melphalan at first-line provided poorer outcomes for patients with significant immunoparesis, while bortezomib or immunomodulatory drugs were more likely to overcome the adverse prognosis associated with significant immunoparesis. PMID:27479823

  2. TAC-TIC use of tacrolimus-based regimens in lupus nephritis

    Science.gov (United States)

    Bredewold, Obbo W; Trompet, Stella; Huizinga, Tom W J; Rabelink, Ton J; de Craen, Anton J M; Teng, Y K Onno

    2016-01-01

    Current guidelines do not mention tacrolimus (TAC) as a treatment option and no consensus has been reported on the role of TAC in lupus nephritis (LN). The present study aimed to guide clinical judgement on the use of TAC in patients with LN. A meta-analysis was performed for clinical studies investigating TAC regimens in LN on the basis of treatment target (induction or maintenance), concomitant immunosuppression and quality of the data. 23 clinical studies performed in patients with LN were identified: 6 case series, 9 cohort studies, 2 case-control studies and 6 randomised controlled trials (RCTs). Of the 6 RCTs, 5 RCTs investigated TAC regimens as induction treatment and 1 RCT as maintenance treatment. Five RCTs investigated TAC in combination with steroids and 2 TAC with mycophenolate plus steroids. All RCTs were performed in patients of Asian ethnicity. In a meta-analysis, TAC regimens achieved a significantly higher total response (relative risk (RR) 1.23, 95% CI 1.12 to 1.34, pstudies on TAC regimens for LN are limited to patients of Asian ethnicity and hampered by significant heterogeneity. The positive results on clinical efficacy of TAC as induction treatment in LN cannot be extrapolated beyond Asian patients with LN. Therefore, further confirmation in multiethnic, randomised trials is mandatory. Until then, TAC can be considered in selected patients with LN. PMID:28123768

  3. Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe

    DEFF Research Database (Denmark)

    Stahlberg, Claudia; Pedersen, Anette Tønnes; Lynge, Elsebeth

    2004-01-01

    Epidemiologic studies have shown an increased risk of breast cancer following hormone replacement therapy (HRT). The aim of this study was to investigate whether different treatment regimens or the androgenecity of progestins influence the risk of breast cancer differently. The Danish Nurse Cohort...

  4. Metabolic drug interactions - the impact of prescribed drug regimens on the medication safety.

    NARCIS (Netherlands)

    Fialova, D.; Vrbensky, K.; Topinkova, E.; Vlcek, J.; Soerbye, L.W.; Wagner, C.; Bernabei, R.

    2005-01-01

    Background and objective: Risk/benefit profile of prescribed drug regimens is unkown. Over 60% of commonly used medications interact on metabolic pathways (cytochrom P450 (CYP450), uridyl-glucuronyl tranferasis (UGT I, II) and P-glycoprotein (PGP) transport). Using an up-to-date knowledge on metabo

  5. Carbon Assimilation and Leaf Water Status in Sugar Beet Leaves during a Simulated Natural Light Regimen.

    Science.gov (United States)

    Geiger, D R; Shieh, W J; Lu, L S; Servaites, J C

    1991-11-01

    Carbon assimilation and leaf water status were studied in sugar beet (Beta vulgaris L., Klein E-type multigerm) leaves during a light period in which illumination either increased rapidly to full irradiance or changed gradually in a sinusoidal manner as generally occurs during a natural day. A light regimen that simulated the light of a natural day was produced by adjusting irradiance with a neutral-density filter under the control of a computer. Under this light regimen, photosynthesis, transpiration, and stomatal conductance followed the irradiance pattern very closely and ribulose bisphosphate carboxylase was nearly fully activated. When illumination was increased rapidly at the beginning of a light period, transpiration also increased quickly, causing leaves to wilt to some extent. The activation state of ribulose bisphosphate carboxylase increased to only 52%, but ribulose bisphosphate level was nearly twice as high as during the simulated natural day. In spite of the differences in activation state and ribulose bisphosphate levels, photosynthesis rates were very similar under both regimens. Nevertheless, differences in parameters between leaves under the two irradiance regimens can affect how a plant responds to internal or external factors, and therefore, the rate at which irradiance increases at the beginning of a light period is an important consideration when interpreting data.

  6. A Patient Education Program to Improve Adherence Rates with Antituberculosis Drug Regimens.

    Science.gov (United States)

    Morisky, Donald E.; And Others

    1990-01-01

    An incentive scheme to reward positive health behaviors (adherence to antituberculosis drug regimens) was tested with 88 active and 117 preventive patients randomly assigned to intervention and control groups. Preventive patients who received incentives were significantly more likely to continue care and had higher adherence levels. Actives showed…

  7. Rituximab and new regimens for indolent lymphoma: a brief update from 2012 ASCO Annual Meeting

    Directory of Open Access Journals (Sweden)

    Zhao Jiangning

    2012-08-01

    Full Text Available Abstract Indolent lymphoma (IL, the second most common lymphoma, remains incurable with chemotherapy alone. While R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone remains the standard frontline regimen for diffuse Large B –cell lymphoma, the optimal chemotherapy regimen for frontline therapy of advanced IL remains uncertain. FCR (fludarabine, cyclophosphamide, rituximab has been shown to be better than fludarabine alone and fludarabine plus cyclophosphamide for IL. In FOLL05 trial, R-CHOP was compared with R-CVP (cyclophosphamide, vincristine, prednisone and R-FM (fludarabine, mitoxantrone. The study showed that R-CHOP appears to have the best risk-benefit ratio for IL. The StiL NHL1 trial showed that BR (bendamustine, rituximab has longer progression free survival and is better tolerated than R-CHOP. Long-term complications with secondary malignancies between the two regimens appear to be comparable. In this review, new combination regimens reported at 2012 ASCO annual meeting were evaluated for frontline and salvage therapy of indolent lymphoma.

  8. Effectiveness of a triple-drug regimen for global elimination of lymphatic filariasis: A modelling study

    NARCIS (Netherlands)

    M.A. Irvine (Michael A.); W.A. Stolk (Wilma); Smith, M.E. (Morgan E); S.V. Subramanian; B.K. Singh (Brajendra K.); G.J. Weil (Gary); E. Michael (Edwin); T.D. Hollingsworth (T. Déirdre)

    2017-01-01

    textabstractBackground: Lymphatic filariasis is targeted for elimination as a public health problem by 2020. The principal approach used by current programmes is annual mass drug administration with two pairs of drugs with a good safety profile. However, one dose of a triple-drug regimen (ivermectin

  9. Revisiting Dosing Regimen Using Pharmacokinetic/Pharmacodynamic Mathematical Modeling: Densification and Intensification of Combination Cancer Therapy.

    Science.gov (United States)

    Meille, Christophe; Barbolosi, Dominique; Ciccolini, Joseph; Freyer, Gilles; Iliadis, Athanassios

    2016-08-01

    Controlling effects of drugs administered in combination is particularly challenging with a densified regimen because of life-threatening hematological toxicities. We have developed a mathematical model to optimize drug dosing regimens and to redesign the dose intensification-dose escalation process, using densified cycles of combined anticancer drugs. A generic mathematical model was developed to describe the main components of the real process, including pharmacokinetics, safety and efficacy pharmacodynamics, and non-hematological toxicity risk. This model allowed for computing the distribution of the total drug amount of each drug in combination, for each escalation dose level, in order to minimize the average tumor mass for each cycle. This was achieved while complying with absolute neutrophil count clinical constraints and without exceeding a fixed risk of non-hematological dose-limiting toxicity. The innovative part of this work was the development of densifying and intensifying designs in a unified procedure. This model enabled us to determine the appropriate regimen in a pilot phase I/II study in metastatic breast patients for a 2-week-cycle treatment of docetaxel plus epirubicin doublet, and to propose a new dose-ranging process. In addition to the present application, this method can be further used to achieve optimization of any combination therapy, thus improving the efficacy versus toxicity balance of such a regimen.

  10. Efficacy of homecare regimens for mechanical plaque removal in managing gingivitis: a meta review

    NARCIS (Netherlands)

    van der Weijden, F.A.; Slot, D.E.

    2015-01-01

    Focused question Based on evidence as presented in systematic reviews what is the efficacy and safety of available homecare toothbrush regimens for mechanical plaque removal on plaque and gingivitis in adults? Material & Methods Three Internet sources were used (up to and including August 2014) to s

  11. Effectiveness of a triple-drug regimen for global elimination of lymphatic filariasis: A modelling study

    NARCIS (Netherlands)

    M.A. Irvine (Michael A.); W.A. Stolk (Wilma); Smith, M.E. (Morgan E); S.V. Subramanian; B.K. Singh (Brajendra K.); G.J. Weil (Gary); E. Michael (Edwin); T.D. Hollingsworth (T. Déirdre)

    2017-01-01

    textabstractBackground: Lymphatic filariasis is targeted for elimination as a public health problem by 2020. The principal approach used by current programmes is annual mass drug administration with two pairs of drugs with a good safety profile. However, one dose of a triple-drug regimen

  12. Mixed chimerism and permanent specific transplantation tolerance induced by a nonlethal preparative regimen

    Energy Technology Data Exchange (ETDEWEB)

    Sharabi, Y.; Sachs, D.H.

    1989-02-01

    The use of allogeneic bone marrow transplantation as a means of inducing donor-specific tolerance across MHC barriers could provide an immunologically specific conditioning regimen for organ transplantation. However, a major limitation to this approach is the toxicity of whole body irradiation as currently used to abrogate host resistance and permit marrow engraftment. The present study describes methodology for abrogating host resistance and permitting marrow engraftment without lethal irradiation. Our preparative protocol involves administration of anti-CD4 and anti-CD8 mAbs in vivo, 300-rad WBI, 700-rad thymic irradiation, and unmanipulated fully MHC-disparate bone marrow. B10 mice prepared by this regimen developed stable mixed lymphohematopoetic chimerism without any clinical evidence of graft-vs.-host disease. Engraftment was accompanied by induction of specific tolerance to donor skin grafts (B10.D2), while third-party skin grafts (B10.BR) were promptly rejected. Mice treated with the complete regimen without bone marrow transplantation appeared healthy and enjoyed long-term survival. This study therefore demonstrates that stable mixed chimerism with donor-specific tolerance can be induced across an MHC barrier after a nonlethal preparative regimen, without clinical GVHD and without the risk of aplasia.

  13. Individualized Ranibizumab Regimen Driven by Stabilization Criteria for Central Retinal Vein Occlusion

    DEFF Research Database (Denmark)

    Larsen, Michael; Waldstein, Sebastian M; Boscia, Francesco

    2016-01-01

    PURPOSE: To assess the 12-month efficacy and safety profile of an individualized regimen of ranibizumab 0.5 mg driven by stabilization criteria in patients with macular edema secondary to central retinal vein occlusion (CRVO). DESIGN: A 24-month, prospective, open-label, single-arm, multicenter...

  14. Effect of a novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen).

    Science.gov (United States)

    Azuma, Haruhito; Inamoto, Teruo; Takahara, Kiyoshi; Nomi, Hayahito; Uehara, Hiroshi; Komura, Kazumasa; Minami, Koichiro; Kouno, Junko; Kotake, Yatsugu; Abe, Hirokazu; Takagi, Shizuko; Yamamoto, Kazuhiro; Narumi, Yoshihumi; Kiyama, Satoshi

    2013-07-01

    We have developed a novel form of bladder preservation therapy [OMC (Osaka Medical College)-regimen] involving balloon-occluded-arterial-infusion (BOAI) of an anticancer agent (cisplatin/gemcitabine), used concomitantly with hemodialysis, which delivers an extremely high concentration of anticancer agent to the site of a tumor without systemic adverse effects, along with concurrent radiation. We previously reported that the OMC-regimen elicited a complete response (CR) in >90% of patients with organ confined tumors, while LN(+), T4 tumors and a non-UC histological type were statistically significant risk factors for treatment failure and patient survival. In this study, we investigated the effects of the OMC-regimen in patients with organ confined urothelial cancer tumors and the outcomes were compared to those with total cystectomy. Three hundred and one patients were assigned to receive either the OMC-regimen (n=162) or total cystectomy (n=139). Patients in the OMC-regimen group who failed to achieve CR underwent cystectomy, or secondary BOAI with an increased amount of CDDP or gemcitabine (1600 mg). The OMC-regimen yielded 98.1% of clinical response; CR in 93.8% (152/162) of patients; PR in 4.3% (7/162). More than 96% of the CR patients (146/152) were alive with no evidence of recurrence after a mean follow-up of 166 (range 23-960) weeks. No patients suffered grade III toxicity; all patients successfully completed this therapy. The patient survival was significantly better compared to the cystectomy group; the overall 5-, 10- and 15-year survival rates were 87.3, 79.6 and 59.7%, respectively. Moreover, the 5-, 10- and 15-year bladder intact survival rates, the most important issue for bladder preservation therapy, were 85.7, 78.4 and 58.8%, respectively. In conclusion, the OMC-regimen is a useful bladder-preservation strategy, not only in those for whom cystectomy is indicated, but also in patients whose condition is not amenable to curative treatment and for

  15. Novel Kivexa-based regimens in early courses of treatment for HIV infection

    Directory of Open Access Journals (Sweden)

    B Conway

    2012-11-01

    Full Text Available Background: As the long-term efficacy of antiretroviral therapy regimens is confirmed, we need to identify additional combinations with long-term safety and potency, while also favoring simplicity of administration. In this light, we have undertaken a review of the use of abacavir/lamivudine (Kivexa, KVX-based regimens using integrase or CCR5 inhibitors as the third agent. Methods: A retrospective chart review was undertaken, with informed patient consent. We identified all the patients in whom KVX was prescribed (following appropriate HLA-B5701 screening with either raltegravir (RGV or maraviroc (MVC as initial therapy or as a switch from another regimen for reasons other than virologic failure. Virologic efficacy over 48 weeks was evaluated, along with specific drug-associated toxicity, adherence, and regimen modifications. Results: A total of 38 patients (5 women were evaluated, 24 on KVX/RGV, 13 on KVX/MVC, 1 on KVX/RGV/MVC. This was used as initial therapy in drug-naïve subjects in three cases, and was selected as a modification of previous (current or not therapy in 35 cases. Switches included replacement of the third agent with RGV or MVC (n=13, replacement of the NRTI backbone with KVX (n=13 or both. In all cases, the change was implemented to address a current or previous medication-associated toxicity, most commonly to address jaundice (n=8, diarrhea (n=5 or reduced renal function (n=5. Patients were predominantly MSMs (n=17 or IDUs (n=13 with a mean baseline CD4 cell count of 363 cells/mm3, and plasma viral load of 46407 copies/mL (20 with full suppression at time of study entry. At 48 weeks, 34/38 (89% achieved or maintained full suppression, with a mean CD4 count of 553 cells/mm3. Virologic failure with the development of the M184V mutation was observed in 3/4 non-suppressed patients, and a loss of CCR5 tropism and RGV resistance were observed in one case each, all in the context of reduced adherence. There were no treatment

  16. Comparison of different glucocorticoid regimens in the management of classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency

    Directory of Open Access Journals (Sweden)

    T P Ajish

    2014-01-01

    Full Text Available Background: There are recommendations regarding the total dose of hydrocortisone to be administered in the treatment of classical congenital adrenal hyperplasia (CAH to achieve the twin objectives of glucocorticoid replacement and control of hyperandrogenism. However, there is evidence gap regarding the breakup, timing and type of the steroid regimen. Objectives: Efficacy of three different glucocorticoid regimens having the same total dose of steroid, differing in either the timing or type of evening steroid administered, in achieving biochemical control of the disease was assessed. Materials and Methods: The study was done in 13 prepubertal children with classical CAH over a 6-month period with 2 months devoted to each regimen. We used a prospective cross-over design using 10-15 mg/m 2 total dose of hydrocortisone. Two-fifths of the total dose of hydrocortisone was administered in the morning and one-fifth of the total dose was administered at noon in all the regimens. The regimens differed in the timing of the evening dose of hydrocortisone, 06.00-07.00 pm in regimen 1 and 09.00-10.00 pm in regimen 2. The third regimen had the evening dose of hydrocortisone replaced by an equivalent dose of prednisolone suspension which was administered at 10.00 pm. Serum 17-hydroxyprogesterone and testosterone levels were compared to assess the efficacy of treatment regimens. Results: The three different regimens were found to be similar in their ability to control 17-hydroxyprogesterone and testosterone levels. The percentage of patients with predefined criteria for biochemically controlled disease was similar in all the three regimens. However, there was a trend toward better control of 17-hydroxyprogesterone levels in patients receiving evening dose of prednisolone. Conclusions: There is no significant advantage in administering the hydrocortisone dose late at night in patients with classical CAH.

  17. Dentine microhardness changes following conventional and alternate irrigation regimens: An in vitro study

    Directory of Open Access Journals (Sweden)

    Anusree Das

    2014-01-01

    Full Text Available Aim: To compare the changes in microhardness of root dentin caused by two novel irrigation regimens with conventional irrigation. Materials and Methods: Forty extracted human permanent incisor teeth were selected. Decoronated roots were separated longitudinally to get 80 specimens that were embedded in autopolymerizing acrylic resin and grounded flat with silicon carbide abrasive papers. Of these, 60 root segments without any cracks or defects were selected and divided into four groups according to the irrigation regimen used (n = 15. Group I: 5% sodium hypochlorite (NaOCl + 17% ethylenediaminetetraacetic acid (EDTA + 0.2% chlorhexidine digluconate (CHX (conventional. Group II: 6% Morinda Citrifolia Juice + 17% EDTA (MCJ. Group III: 5% NaOCl + Q Mix 2 in 1 (QMix. Group IV: Distilled water (control. Irrigation regimens were performed for 5 minutes. Dentin microhardness was measured with a Vickers indenter under a 200-g load and a 20-s dwell time at the midroot level of root dentin. The data were analyzed using Kruskal Wallis test and Dunn′s multiple comparison tests. Results: A significant difference was seen in the median values of the four groups. The control group showed the least reduction in microhardness when comparison with the other groups. Except for Group III (Q Mix, the other groups that were tested (MCJ and conventional regimens showed statistically significant difference from the control group. Conclusion: Within the limitation of this study, it was concluded that NaOCl + Q Mix were least detrimental to root dentin microhardness when compared with MCJ and conventional irrigation regimens.

  18. Intermittent Versus Daily Pulmonary Tuberculosis Treatment Regimens: A Meta-Analysis

    Science.gov (United States)

    Kasozi, Samuel; Clark, Justin; Doi, Suhail A. R.

    2015-01-01

    Background Several systematic reviews suggest that intermittent pulmonary tuberculosis (TB) chemotherapy is effective, but intensity (daily versus intermittent) and duration of rifampicin use (intensive phase only versus both phases) have not been distinguished. In addition, the various outcomes (success, failure, relapse, and default) have only selectively been evaluated. Methods We conducted a meta-analysis of proportions using all four outcomes as multi-category proportions to examine the effectiveness of WHO category 1 TB treatment regimens. Database searches of studies reporting treatment outcomes of HIV negative subjects were included and stratified by intensity of therapy and duration of rifampicin therapy. Using a bias-adjusted statistical model, we pooled proportions of the four treatment outcome categories using a method that handles multi-category proportions. Results A total of 27 studies comprising of 48 data sets with 10,624 participants were studied. Overall, treatment success was similar among patients treated with intermittent (I/I) (88%) (95% CI, 81–92) and daily (D/D) (90%) (95% CI, 84–95) regimens. Default was significantly less with I/I (0%) (95% CI, 0–2) compared to D/D regimens (5%) (95% CI, 1–9). Nevertheless, I/I relapse rates (7%) (95% CI, 3–11) were higher than D/D relapse rates (1%) (95% CI, 0–3). Conclusion Treatment regimens that are offered completely intermittently versus completely daily are associated with a trade-off between treatment relapse and treatment default. There is a possibility that I/I regimens can be improved by increasing treatment duration, and this needs to be urgently addressed by future studies. PMID:26056374

  19. Dissolved oxygen regimen (PO2 may affect osmorespiratory compromise in European sea bass (Dicentrarchus labrax, L.

    Directory of Open Access Journals (Sweden)

    Genciana Terova

    2010-02-01

    Full Text Available Fundamentally, in land based mediterranean aquaculture, two techniques are applied to supply water with oxygen: paddling water aeration and application of pure oxygen. The two oxygenation techniques result in quite different PO2 regimens and, consequently, different fish growth performance and gill morphology. Data exist showing a reduction in total respiratory surface (RSA and increasing gas diffusion distance (GDD in gills of sea bass (Dicentrarchus labrax, L. farmed under elevated PO2 regimens. That such a modification might have an effect on the ion regulation has been defined elsewhere as osmorespiratory compromise. In this study, European sea bass previously acclimatized to two PO2 regimens, mild hypoxia and mild hyperoxia (70-80% and 130-140% of the saturation value, respectively, were challenged for 1 hour with hypo-osmotic plus manipulation stress in two separate trials. During the first trial, when only Na+ loss was determined, the ion efflux during the first 5 min resulted in a rate of 163.72±31 and 112.23±87 nmol g-1min-1 from hypoxia and hyperoxia sea bass groups, respectively, and, if sustained, would approach 15.3 and 11.2% per hour of the total body Na+, respectively. During the second trial, in which both Na+ and Cl- loss were determined, after 60 min the Na+ loss was shown to be 76.86±12 and 179.28±32 nmol g-1 min-1 for the fish previously acclimatized to hyperoxia and hypoxia regimens, respectively, whereas for Cl- this loss was 62.02±11 and 157.28±28 nmol g-1min-1, respectively. Our data are compatible with the hypothesis of an osmotic advantage of sea bass exposed to an elevated PO2 regimen, achievable with application of pure oxygen, instead of simple water aeration.

  20. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org ... I’d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify ...

  1. Medicine's Life Inside the Body

    Science.gov (United States)

    ... All Articles | Inside Life Science Home Page A Medicine's Life Inside the Body By Alison Davis Posted ... field that studies how the body reacts to medicines and how medicines affect the body. Scientists funded ...

  2. American Academy of Oral Medicine

    Science.gov (United States)

    ... Statements Newsletters AAOM: Representing the Discipline of Oral Medicine Oral Medicine is the discipline of dentistry concerned with the ... offers credentialing, resources and professional community for oral medicine practitioners. Our membership provides care to thousands. We ...

  3. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org ... I’d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify ...

  4. American Academy of Sleep Medicine

    Science.gov (United States)

    ... the field of sleep medicine. Join the American Academy of Sleep Medicine to further your career and ... MD Sept. 21 - As president of the American Academy of Sleep Medicine, I am keenly aware of ...

  5. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! ... d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify disease ...

  6. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... nuclear medicine. Nuclear medicine offers the potential to identify disease in its earliest stage, often before symptoms ... benefit of an accurate diagnosis far outweighs any risk. To learn more about nuclear medicine, visit Radiology ...

  7. Women and Diabetes -- Diabetes Medicines

    Science.gov (United States)

    ... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

  8. Alternative Medicine and Your Child

    Science.gov (United States)

    ... 1- to 2-Year-Old Complementary and Alternative Medicine KidsHealth > For Parents > Complementary and Alternative Medicine A ... works. previous continue How CAM Differs From Traditional Medicine CAM is frequently distinguished by its holistic methods, ...

  9. Your Radiologist Explains Nuclear Medicine

    Science.gov (United States)

    ... Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! ... I’d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify disease ...

  10. Generic and biosimilar medicines: quid?

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2012-12-01

    Full Text Available Once intellectual property protection, data and marketing exclusivity of reference medicines have expired, generic medicines and biosimilar medicines can enter the off-patent market. This market entry is conditional on the approval of marketing authorization, pricing and reimbursement. Given that there tends to be confusion surrounding generic and biosimilar medicines, this Editorial introduces basic concepts related to generic and biosimilar medicines and presents the different studies and articles included in this supplement dedicated to generic and biosimilar medicines.

  11. Combination Therapy of Gefitinib and Korean Herbal Medicines Could be a Beneficial Option for Patients with Non-Small-Cell Lung Cancer

    OpenAIRE

    2016-01-01

    Abstract Abstract Lung cancer has a high mortality rate and is often diagnosed at the metastatic stage. Gefitinib is a targeted molecular therapeutic drug used to treat patients with non-small-cell lung cancer (NSCLC). Korean herbal medicines may also have therapeutic efficacy against lung cancer, reduce the side effects associated with chemotherapy, and improve patient quality of life (QOL). This case report describes the effects of a Korean herbal medicine regimen combined with gefitinib in...

  12. Practical nuclear medicine

    CERN Document Server

    Gemmell, Howard G; Sharp, Peter F

    2006-01-01

    Nuclear medicine plays a crucial role in patient care, and this book is an essential guide for all practitioners to the many techniques that inform clinical management. The first part covers the scientific basis of nuclear medicine, the rest of the book deals with clinical applications. Diagnostic imaging has an increasingly important role in patient management and, despite advances in other modalities (functional MRI and spiral CT), nuclear medicine continues to make its unique contribution by its ability to demonstrate physiological function. This book is also expanded by covering areas of d

  13. Robotics in reproductive medicine.

    Science.gov (United States)

    Sroga, Julie; Patel, Sejal Dharia; Falcone, Tommaso

    2008-01-01

    In the past decade, robotic technology has been increasingly incorporated into various industries, including surgery and medicine. This chapter will review the history, development, current applications, and future of robotic technology in reproductive medicine. A literature search was performed for all publications regarding robotic technology in medicine, surgery, reproductive endocrinology, and its role in both surgical education and telepresence surgery. As robotic assisted surgery has emerged, this technology provides a feasible option for minimally invasive surgery, impacts surgical education, and plays a role in telepresence surgery.

  14. Nuclear Medicine Annual, 1989

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, L.M.; Weissmann, H.S.

    1989-01-01

    Among the highlights of Nuclear Medicine Annual, 1989 are a status report on the thyroid scan in clinical practice, a review of functional and structural brain imaging in dementia, an update on radionuclide renal imaging in children, and an article outlining a quality assurance program for SPECT instrumentation. Also included are discussions on current concepts in osseous sports and stress injury scintigraphy and on correlative magnetic resonance and radionuclide imaging of bone. Other contributors assess the role of nuclear medicine in clinical decision making and examine medicolegal and regulatory aspects of nuclear medicine.

  15. Association of hypoglycemic treatment regimens with cardiovascular outcomes in overweight and obese subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Ghotbi, Adam Ali; Køber, Lars; Finer, Nick;

    2013-01-01

    To assess the association of hypoglycemic treatment regimens with cardiovascular adverse events and mortality in a large population of type 2 diabetic patients at increased cardiovascular risk.......To assess the association of hypoglycemic treatment regimens with cardiovascular adverse events and mortality in a large population of type 2 diabetic patients at increased cardiovascular risk....

  16. A Combination Regimen Design Program Based on Pharmacodynamic Target Setting for Childhood Tuberculosis: Design Rules for the Playground

    Science.gov (United States)

    Srivastava, Shashikant; Deshpande, Devyani; Pasipanodya, Jotam G.; Thomas, Tania; Swaminathan, Soumya; Nuermberger, Eric; Gumbo, Tawanda

    2016-01-01

    Children with tuberculosis are treated with drug regimens copied from adults despite significant differences in antibiotic pharmacokinetics, pathology, and the microbial burden between childhood and adult tuberculosis. We sought to develop a new and effective oral treatment regimen specific to children of different ages. We investigated and validated the concept that target drug concentrations associated with therapy failure and death in children are different from those of adults. On that basis, we proposed a 4-step program to rapidly develop treatment regimens for children. First, target drug concentrations for optimal efficacy are derived from preclinical models of disseminated tuberculosis that recapitulate pediatric pharmacokinetics, starting with monotherapy. Second, 2-drug combinations were examined for zones of synergy, antagonism, and additivity based on a whole exposure–response surface. Exposures associated with additivity or synergy were then combined and the regimen was compared to standard therapy. Third, several exposures of the third drug were added, and a 3-drug regimen was identified based on kill slopes in comparison to standard therapy. Fourth, computer-aided clinical trial simulations are used to identify clinical doses that achieve these kill rates in children in different age groups. The proposed program led to the development of a 3-drug combination regimen for children from scratch, independent of adult regimens, in <2 years. The regimens and doses can be tested in animal models and in clinical trials. PMID:27742637

  17. A once-daily HAART regimen containing indinavir + ritonavir plus one or two nucleoside reverse transcriptase inhibitors (PIPO study).

    NARCIS (Netherlands)

    Burger, D.M.; Aarnoutse, R.E.; Dieleman, J.P.; Gyssens, I.C.J.; Nouwen, J.; Marie, S. de; Koopmans, P.P.; Stek Jr, M.; Ende, M.E. van der

    2003-01-01

    INTRODUCTION: There is an increased interest in developing once-daily regimens for the treatment of HIV-infected patients. A Phase II study was conducted to investigate the pharmacokinetics, and short-term safety and efficacy of an indinavir/ritonavir combination as part of a once-daily regimen. MET

  18. Adherence to Medical Regimens: Understanding the Effects of Cognitive Appraisal, Quality of Life, and Perceived Family Resiliency

    Science.gov (United States)

    Frain, Michael P.; Bishop, Malachy; Tschopp, Molly K.; Ferrin, Micheal J.; Frain, Judy

    2009-01-01

    Adherence studies have taken center stage due to the life-threatening risks associated with nonadherence to highly active antiretroviral therapy (HAART) regimens for people with HIV/AIDS. This study examines adherence through self-report of individuals on HAART regimens in a manner to account for demand characteristic bias, while still attempting…

  19. Adherence to Medical Regimens: Understanding the Effects of Cognitive Appraisal, Quality of Life, and Perceived Family Resiliency

    Science.gov (United States)

    Frain, Michael P.; Bishop, Malachy; Tschopp, Molly K.; Ferrin, Micheal J.; Frain, Judy

    2009-01-01

    Adherence studies have taken center stage due to the life-threatening risks associated with nonadherence to highly active antiretroviral therapy (HAART) regimens for people with HIV/AIDS. This study examines adherence through self-report of individuals on HAART regimens in a manner to account for demand characteristic bias, while still attempting…

  20. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Stuart A. [University College Hospital, Department of Specialist Radiology, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom); Slater, Andrew [John Radcliffe Hospital, Oxford (United Kingdom); Burling, David N.; Tam, Emily; Gartner, Louise; Scarth, Julia; Bassett, Paul [St Mark' s Hospital, Northwick Park (United Kingdom); Greenhalgh, Rebecca; Pearce, Robert; Halligan, Steve [University College Hospital, Department of Specialist Radiology, London (United Kingdom)

    2008-01-15

    To establish the optimum barium-based reduced-laxative tagging regimen prior to CT colonography (CTC). Ninety-five subjects underwent reduced-laxative (13 g senna/18 g magnesium citrate) CTC prior to same-day colonoscopy and were randomised to one of four tagging regimens using 20 ml 40%w/v barium sulphate: regimen A: four doses, B: three doses, C: three doses plus 220 ml 2.1% barium sulphate, or D: three doses plus 15 ml diatriazoate megluamine. Patient experience was assessed immediately after CTC and 1 week later. Two radiologists graded residual stool (1: none/scattered to 4: >50% circumference) and tagging efficacy for stool (1: untagged to 5: 100% tagged) and fluid (1: untagged, 2: layered, 3: tagged), noting the HU of tagged fluid. Preparation was good (76-94% segments graded 1), although best for regimen D (P = 0.02). Across all regimens, stool tagging quality was high (mean 3.7-4.5) and not significantly different among regimens. The HU of layered tagged fluid was higher for regimens C/D than A/B (P = 0.002). Detection of cancer (n = 2), polyps {>=}6 mm (n = 21), and {<=}5 mm (n = 72) was 100, 81 and 32% respectively, with only four false positives {>=}6 mm. Reduced preparation was tolerated better than full endoscopic preparation by 61%. Reduced-laxative CTC with three doses of 20 ml 40% barium sulphate is as effective as more complex regimens, retaining adequate diagnostic accuracy. (orig.)

  1. Beneficial Effects of an Alternating High- Fat Dietary Regimen on Systemic Insulin Resistance, Hepatic and Renal Inflammation and Renal Function

    NARCIS (Netherlands)

    Yakala, Gopala K.; van der Heijden, Roel; Molema, Grietje; Schipper, Martin; Wielinga, Peter Y.; Kleemann, Robert; Kooistra, Teake; Heeringa, Peter

    2012-01-01

    Background: An Alternating high-cholesterol dietary regimen has proven to be beneficial when compared to daily high-cholesterol feeding. In the current study we explored whether the same strategy is applicable to a high-fat dietary regimen. Objective: To investigate whether an alternating high-fat d

  2. Beneficial Effects of an Alternating High- Fat Dietary Regimen on Systemic Insulin Resistance, Hepatic and Renal Inflammation and Renal Function

    NARCIS (Netherlands)

    Yakala, G.K.; Heijden, R. van der; Molema, G.; Schipper, M.; Wielinga, P.Y.; Kleemann, R.; Kooistra, T.; Heeringa, P.

    2012-01-01

    Background: An Alternating high- cholesterol dietary regimen has proven to be beneficial when compared to daily high- cholesterol feeding. In the current study we explored whether the same strategy is applicable to a high- fat dietary regimen. Objective: To investigate whether an alternating high- f

  3. A rare phenomenon of atypical lipodystrophy in a patient on HAART in the absence of a protease inhibitor regimen

    Directory of Open Access Journals (Sweden)

    Mohammed Mitha

    2010-11-01

    Full Text Available Lipodystrophy is a complication of patients on antiretroviral (ARV medication; however, it is commonest in patients on long-term treatment and those on protease inhibitor (PI regimens.1,2 We present a rare case of atypical lipodystrophy, presenting as multiple subcutaneous lipomas, in a patient who had been on a non-PI ART regimen for 6 weeks.

  4. Beneficial Effects of an Alternating High- Fat Dietary Regimen on Systemic Insulin Resistance, Hepatic and Renal Inflammation and Renal Function

    NARCIS (Netherlands)

    Yakala, Gopala K.; van der Heijden, Roel; Molema, Grietje; Schipper, Martin; Wielinga, Peter Y.; Kleemann, Robert; Kooistra, Teake; Heeringa, Peter

    2012-01-01

    Background: An Alternating high-cholesterol dietary regimen has proven to be beneficial when compared to daily high-cholesterol feeding. In the current study we explored whether the same strategy is applicable to a high-fat dietary regimen. Objective: To investigate whether an alternating high-fat d

  5. Beneficial Effects of an Alternating High- Fat Dietary Regimen on Systemic Insulin Resistance, Hepatic and Renal Inflammation and Renal Function

    NARCIS (Netherlands)

    Yakala, G.K.; Heijden, R. van der; Molema, G.; Schipper, M.; Wielinga, P.Y.; Kleemann, R.; Kooistra, T.; Heeringa, P.

    2012-01-01

    Background: An Alternating high- cholesterol dietary regimen has proven to be beneficial when compared to daily high- cholesterol feeding. In the current study we explored whether the same strategy is applicable to a high- fat dietary regimen. Objective: To investigate whether an alternating high- f

  6. Evolution of drug resistance in HIV infected patients remaining on a virologically failing cART regimen

    DEFF Research Database (Denmark)

    Cozzi-Lepri, A; Phillips, AN; Ruiz, L

    2007-01-01

    OBJECTIVE: To estimate the extent of drug resistance accumulation in patients kept on a virologically failing regimen and its determinants in the clinical setting. DESIGN: The study focused on 110 patients of EuroSIDA on an unchanged regimen who had two genotypic tests performed at two time point...

  7. Beneficial Effects of an Alternating High- Fat Dietary Regimen on Systemic Insulin Resistance, Hepatic and Renal Inflammation and Renal Function

    NARCIS (Netherlands)

    Yakala, G.K.; Heijden, R. van der; Molema, G.; Schipper, M.; Wielinga, P.Y.; Kleemann, R.; Kooistra, T.; Heeringa, P.

    2012-01-01

    Background: An Alternating high- cholesterol dietary regimen has proven to be beneficial when compared to daily high- cholesterol feeding. In the current study we explored whether the same strategy is applicable to a high- fat dietary regimen. Objective: To investigate whether an alternating high-

  8. Beneficial Effects of an Alternating High- Fat Dietary Regimen on Systemic Insulin Resistance, Hepatic and Renal Inflammation and Renal Function

    NARCIS (Netherlands)

    Yakala, Gopala K.; van der Heijden, Roel; Molema, Grietje; Schipper, Martin; Wielinga, Peter Y.; Kleemann, Robert; Kooistra, Teake; Heeringa, Peter

    2012-01-01

    Background: An Alternating high-cholesterol dietary regimen has proven to be beneficial when compared to daily high-cholesterol feeding. In the current study we explored whether the same strategy is applicable to a high-fat dietary regimen. Objective: To investigate whether an alternating high-fat

  9. More about ... Paediatric emergency medicine

    African Journals Online (AJOL)

    Director, Poisons Information Centre, Red Cross War Memorial Children's Hospital, Cape Town ... there is a second peak, due to deliberate ... management regimens need many subjects ... a number of days, to control pain or fever: so-.

  10. Essentials of periodontal medicine in preventive medicine

    Directory of Open Access Journals (Sweden)

    Minkle Gulati

    2013-01-01

    Full Text Available Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer′s disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. This review article highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.

  11. Some Medicinal Plants Used in Chinese Medicine.

    Science.gov (United States)

    2007-11-02

    prescriptions for treating dysentery, nephritis, hypertension and other diseases. The bark is also a sourse for the production of the alkaloid berberine ...which is produced in large wuantities in the Chinese People’s Republic. Berberine preparations have become widely used in medicine for treating...many alkaloids (up to 6-9$), the most important being berberine . There is an annual harvest of approximately 900 tons of wild coptis which is also a

  12. Respiratory medicine of reptiles.

    Science.gov (United States)

    Schumacher, Juergen

    2011-05-01

    Noninfectious and infectious causes have been implicated in the development of respiratory tract disease in reptiles. Treatment modalities in reptiles have to account for species differences in response to therapeutic agents as well as interpretation of diagnostic findings. Data on effective drugs and dosages for the treatment of respiratory diseases are often lacking in reptiles. Recently, advances have been made on the application of advanced imaging modalities, especially computed tomography for the diagnosis and treatment monitoring of reptiles. This article describes common infectious and noninfectious causes of respiratory disease in reptiles, including diagnostic and therapeutic regimen.

  13. High-Definition Medicine.

    Science.gov (United States)

    Torkamani, Ali; Andersen, Kristian G; Steinhubl, Steven R; Topol, Eric J

    2017-08-24

    The foundation for a new era of data-driven medicine has been set by recent technological advances that enable the assessment and management of human health at an unprecedented level of resolution-what we refer to as high-definition medicine. Our ability to assess human health in high definition is enabled, in part, by advances in DNA sequencing, physiological and environmental monitoring, advanced imaging, and behavioral tracking. Our ability to understand and act upon these observations at equally high precision is driven by advances in genome editing, cellular reprogramming, tissue engineering, and information technologies, especially artificial intelligence. In this review, we will examine the core disciplines that enable high-definition medicine and project how these technologies will alter the future of medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Personalized medicine in psychiatry.

    Science.gov (United States)

    Wium-Andersen, Ida Kim; Vinberg, Maj; Kessing, Lars Vedel; McIntyre, Roger S

    2017-01-01

    Personalized medicine is a model in which a patient's unique clinical, genetic, and environmental characteristics are the basis for treatment and prevention. Aim, method, and results: This review aims to describe the current tools, phenomenological features, clinical risk factors, and biomarkers used to provide personalized medicine. Furthermore, this study describes the target areas in which they can be applied including diagnostics, treatment selection and response, assessment of risk of side-effects, and prevention. Personalized medicine in psychiatry is challenged by the current taxonomy, where the diagnostic categories are broad and great biological heterogeneity exists within each category. There is, thus, a gap between the current advanced research prospects and clinical practice, and the current taxonomy is, thus, a poor basis for biological research. The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine.

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... beforehand, especially if sedation is to be used. Most nuclear medicine exams will involve an injection in ... PET/CT, SPECT/CT and PET/MR) are most often used in children with cancer, epilepsy and ...

  16. [Palliative psychosomatic medicine].

    Science.gov (United States)

    Rosin, U

    2001-07-01

    Psychotherapeutic medicine, the area of medicinal specialisation dealing with the foundations of psychosomatic medicine, so far dealt mostly with diagnosis and therapy of acute diseases. The course of illness in patients with bio-psycho-social disorders however ist most often chronic. Sigmund Freud the founder of scientific psychotherapy himself was a patient in palliative care for 26 years and underwent over 30 surgical procedures to treat his carcinoma of the palate and jaw. Some goals and psychotherapeutic strategies of intervention that can be used in palliative psychosomatic medicine are laid out. This important field has in itself so far not reached a wide spread recognition and there are hardly any theoretical concepts or empirical validation to be found.

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... nuclear medicine imaging uses small amounts of radioactive materials called radiotracers, a special camera and a computer ... medical imaging that uses small amounts of radioactive material to diagnose and determine the severity of or ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed ... the thyroid gland. top of page How does the procedure work? With ordinary x-ray examinations, an ...

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... necessitate sedation for your child. You will receive instructions prior to the exam if your child will ... child has been sedated, you will receive specific instructions to be followed after leaving the nuclear medicine ...

  20. The medicine from behind

    NARCIS (Netherlands)

    Andel, Van Tinde; Onselen, Van Sabine; Myren, Britt; Towns, Alexandra; Quiroz, Diana

    2015-01-01

    Ethnopharmacological relevance Purgative enemas form an integral part of African traditional medicine. Besides possible benefits, serious health risks of rectal herbal therapy have been described in literature. To design appropriate health education programs, it is essential to understand

  1. Occupational medicine and toxicology

    Directory of Open Access Journals (Sweden)

    Fischer Axel

    2006-02-01

    Full Text Available Abstract This editorial is to announce the Journal of Occupational Medicine and Toxicology, a new Open Access, peer-reviewed, online journal published by BioMed Central. Occupational medicine and toxicology belong to the most wide ranging disciplines of all medical specialties. The field is devoted to the diagnosis, prevention, management and scientific analysis of diseases from the fields of occupational and environmental medicine and toxicology. It also covers the promotion of occupational and environmental health. The complexity of modern industrial processes has dramatically changed over the past years and today's areas include effects of atmospheric pollution, carcinogenesis, biological monitoring, ergonomics, epidemiology, product safety and health promotion. We hope that the launch of the Journal of Occupational Medicine and Toxicology will aid in the advance of these important areas of research bringing together multi-disciplinary research findings.

  2. Astronomy, Astrology, and Medicine

    Science.gov (United States)

    Greenbaum, Dorian Gieseler

    Astronomy and astrology were combined with medicine for thousands of years. Beginning in Mesopotamia in the second millennium BCE and continuing into the eighteenth century, medical practitioners used astronomy/astrology as an important part of diagnosis and prescription. Throughout this time frame, scientists cited the similarities between medicine and astrology, in addition to combining the two in practice. Hippocrates and Galen based medical theories on the relationship between heavenly bodies and human bodies. In an enduring cultural phenomenon, parts of the body as well as diseases were linked to zodiac signs and planets. In Renaissance universities, astronomy and astrology were studied by students of medicine. History records a long tradition of astrologer-physicians. This chapter covers the topic of astronomy, astrology, and medicine from the Old Babylonian period to the Enlightenment.

  3. Submarine Medicine Team

    Data.gov (United States)

    Federal Laboratory Consortium — The Submarine Medicine Team conducts basic and applied research on biomedical aspects of submarine and diving environments. It focuses on ways to optimize the health...

  4. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... of page How does the nuclear medicine procedure work? With ordinary x-ray examinations, an image is ... placed over the patient's body. SPECT involves the rotation of the gamma camera heads around the patient's ...

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... bladder. bones. liver and gallbladder. gastrointestinal tract. heart. lungs. brain. thyroid. Nuclear medicine scans are typically used ... gas via a mask, such as with a lung scan. Bladder: some exams require a catheter to ...

  6. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... the procedure. top of page Who interprets the results and how do we get them? A radiologist ... radiotracer administered are small, diagnostic nuclear medicine procedures result in low radiation exposure, acceptable for diagnostic exams. ...

  7. Medicine and Pregnancy

    Science.gov (United States)

    ... Consumer Information by Audience For Women Medicine and Pregnancy Share Tweet Linkedin Pin it More sharing options ... reporting problems to FDA . Sign Up for a Pregnancy Registry Pregnancy Exposure Registries are research studies that ...

  8. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... to be followed after leaving the nuclear medicine facility. Through the natural process of radioactive decay, the ... Please note RadiologyInfo.org is not a medical facility. Please contact your physician with specific medical questions ...

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... body. jaundice in newborns and older children. epilepsy . location, anatomy and function of the thyroid gland. top ... to be followed after leaving the nuclear medicine facility. Through the natural process of radioactive decay, the ...

  10. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... used. Most nuclear medicine exams will involve an injection in a vein in your child’s arm or ... are noninvasive and, with the exception of intravenous injections, are usually painless medical tests that help physicians ...

  11. Pregnancy and Medicines

    Science.gov (United States)

    ... control long-term health problems like asthma, diabetes, depression, or seizures. Also, some women have a pregnancy problem that needs treatment with medicine. These problems might include severe nausea and vomiting, ...

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... top of page What are the benefits vs. risks? Benefits The information provided by nuclear medicine examinations ... diagnosis or to determine appropriate treatment, if any. Risks Because the doses of radiotracer administered are small, ...

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... liver and gallbladder. gastrointestinal tract. heart. lungs. brain. thyroid. Nuclear medicine scans are typically used to help ... children. epilepsy . location, anatomy and function of the thyroid gland. top of page How does the procedure ...

  14. Darwin, medicine and cancer.

    Science.gov (United States)

    Purushotham, A D; Sullivan, R

    2010-02-01

    'Nothing in biology makes sense except in the light of evolution'! So said Theodore Dobzhansky. It is extraordinary how little Darwinism and post-Darwinian evolutionary science has penetrated medicine despite the fact that all biology is built upon its foundations. Randy Nesse, one of the fathers of Darwinian medicine, recently observed that doctors 'know the facts but not the origins'. Clearly, then, in this auspicious year-200 years since Charles Darwin's birth and 150 years since the first edition of the Origin of Species-it is time to reconsider Darwin's legacy to medicine and to invite evolution back into the biomedical fold. Here, we consider the legacy of Darwin and the contribution of the other great evolutionists such as Ernst Mayr to cancer and medicine.

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... jaundice in newborns and older children. epilepsy . location, anatomy and function of the thyroid gland. top of ... full size with caption Related Articles and Media General Nuclear Medicine Children's (Pediatric) CT (Computed Tomography) Epilepsy ...

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... organs and tissues in your body. Hybrid imaging techniques (PET/CT, SPECT/CT and PET/MR) are ... equipment look like? The special camera and imaging techniques used in nuclear medicine include the gamma camera ...

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... diagnostic nuclear medicine procedures result in low radiation exposure, acceptable for diagnostic exams. Thus, the radiation risk ... long-term adverse effects from such low-dose exposure. For more information about safety in pediatric radiology ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... molecular information. In many centers, nuclear medicine images can be superimposed with computed tomography (CT) or magnetic ... small hand-held device resembling a microphone that can detect and measure the amount of the radiotracer ...

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... painless medical tests that help physicians diagnose and evaluate medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers . Depending on the type of nuclear medicine exam, the radiotracer is either ...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other abnormalities within the body. Because nuclear medicine procedures are able to pinpoint molecular activity within ...

  1. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... variety of diseases, including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other abnormalities ... and bladder. bones. liver and gallbladder. gastrointestinal tract. heart. lungs. brain. thyroid. Nuclear medicine scans are typically ...

  2. Occupational Space Medicine

    Science.gov (United States)

    Tarver, William J.

    2012-01-01

    Learning Objectives are: (1) Understand the unique work environment of astronauts. (2) Understand the effect microgravity has on human physiology (3) Understand how NASA Space Medicine Division is mitigating the health risks of space missions.

  3. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... will be inhaled as a gas via a mask, such as with a lung scan. Bladder: some ... A radiologist or other physician who has specialized training in nuclear medicine will interpret the images and ...

  4. Terpenoids for medicine

    NARCIS (Netherlands)

    Fischedick, Justin

    2013-01-01

    This thesis is concerns research on monoterpenoids, sesquiterpenoids, and diterpenoids with medicinal properties. Terpenoids from commond herbs as well as Cannabis sativa, Inula britannica, Tanacetum parthenium, and Salvia officinalis were investigated

  5. Exercise as medicine

    DEFF Research Database (Denmark)

    Pedersen, Bente Klarlund; Saltin, Bengt

    2015-01-01

    This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis...

  6. Challenges in sexual medicine

    DEFF Research Database (Denmark)

    Cellek, Selim; Giraldi, Annamaria

    2012-01-01

    The sexual medicine field has been in mode of revolution until recently. Like all other fields of biomedical research, the economic situation around the world has had a negative impact on the field's momentum-research funding bodies, regulatory bodies and pharmaceutical companies seem to have...... placed sexual medicine in their low-priority list. But this is not the only challenge the field is facing. The successful development of phosphodiesterase type 5 (PDE5) inhibitors for treatment of erectile dysfunction (ED) means that research in this area seems to have slowed. However, there remain...... several unmet medical needs within sexual medicine such as premature ejaculation, severe ED and hypoactive sexual desire disorder, which await novel therapeutic approaches. Despite these challenges, research into finding and developing such therapies is likely to continue in the sexual medicine field...

  7. Arts and Medicine

    DEFF Research Database (Denmark)

    2017-01-01

    The paper describes the design, delivery and student engagement with a course on Medicine and the Arts offered at a College of Medicine in a Middle Eastern country. The paper shows how the course tries to provide students with the knowledge, skills and attitudes to develop an appreciation...... for the Arts, and an understanding of their connection to medicine. Literature shows that such an understanding contributes to sharpening students’ social skills, highlighting focus on the humane aspects of medical practice, and linking professional and ethical behavior with an understanding of human essence...... to disease, death and dying, pain, empathy, and influence the way in which they practice medicine, manage their own emotions, and communicate with patients. 2) Honed their critical thinking skills, creative aptitudes and emotional intelligence. 3) Helped them appreciate the move beyond the binaries that have...

  8. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... determine appropriate treatment, if any. Risks Because the doses of radiotracer administered are small, diagnostic nuclear medicine procedures result in low radiation exposure, acceptable for diagnostic exams. Thus, the radiation ...

  9. Radical curative efficacy of tafenoquine combination regimens in Plasmodium cynomolgi-infected Rhesus monkeys (Macaca mulatta

    Directory of Open Access Journals (Sweden)

    Kenworthy David

    2011-07-01

    Full Text Available Abstract Background Tafenoquine is an 8-aminoquinoline being developed for radical cure (blood and liver stage elimination of Plasmodium vivax. During monotherapy treatment, the compound exhibits slow parasite and fever clearance times, and toxicity in glucose-6-phosphate dehydrogenase (G6PD deficiency is a concern. Combination with other antimalarials may mitigate these concerns. Methods In 2005, the radical curative efficacy of tafenoquine combinations was investigated in Plasmodium cynomolgi-infected naïve Indian-origin Rhesus monkeys. In the first cohort, groups of two monkeys were treated with a three-day regimen of tafenoquine at different doses alone and in combination with a three-day chloroquine regimen to determine the minimum curative dose (MCD. In the second cohort, the radical curative efficacy of a single-day regimen of tafenoquine-mefloquine was compared to that of two three-day regimens comprising tafenoquine at its MCD with chloroquine or artemether-lumefantrine in groups of six monkeys. In a final cohort, the efficacy of the MCD of tafenoquine against hypnozoites alone and in combination with chloroquine was investigated in groups of six monkeys after quinine pre-treatment to eliminate asexual parasites. Plasma tafenoquine, chloroquine and desethylchloroquine concentrations were determined by LC-MS in order to compare doses of the drugs to those used clinically in humans. Results The total MCD of tafenoquine required in combination regimens for radical cure was ten-fold lower (1.8 mg/kg versus 18 mg/kg than for monotherapy. This regimen (1.8 mg/kg was equally efficacious as monotherapy or in combination with chloroquine after quinine pre-treatment to eliminate asexual stages. The same dose of (1.8 mg/kg was radically curative in combination with artemether-lumefantrine. Tafenoquine was also radically curative when combined with mefloquine. The MCD of tafenoquine monotherapy for radical cure (18 mg/kg appears to be biologically

  10. Ophthalmology in Persian medicine

    OpenAIRE

    Tabatabaei, Seyed Mahmoud; Sabetkish, Nastaran; Tabatabaei, Seyed Mohammad Ali

    2014-01-01

    Despite the fact that ophthalmology is one of the foremost branches of medicine, conceptualization of the structure and function of the eye barely advanced in ancient Western civilizations. At the early recovery of Persian civilization (9th century AD) after the extinction of the Sassanid Empire (7th century AD), translations of Greek medical textbooks played an important role in the development of medicine and the emergence of great Persian physicians such as Rhazes, Avicenna and others. Rha...

  11. Death, medicine & bioethics.

    Science.gov (United States)

    Hunt, G

    1994-12-01

    The assumptions of philosophy need scrutiny as much the assumptions of medicine do. Scrutiny shows that the philosophical method of bioethics is compromised, for it shares certain fundamental assumptions with medicine itself. To show this requires an unorthodox style of philosophy--a literary one. To show the compromised status of bioethics the paper discusses some seminal utilitarian discussions of the definition of death, of whether it is a bad thing, and of when it ought to occur.

  12. Biomarkers in Veterinary Medicine.

    Science.gov (United States)

    Myers, Michael J; Smith, Emily R; Turfle, Phillip G

    2017-02-08

    This article summarizes the relevant definitions related to biomarkers; reviews the general processes related to biomarker discovery and ultimate acceptance and use; and finally summarizes and reviews, to the extent possible, examples of the types of biomarkers used in animal species within veterinary clinical practice and human and veterinary drug development. We highlight opportunities for collaboration and coordination of research within the veterinary community and leveraging of resources from human medicine to support biomarker discovery and validation efforts for veterinary medicine.

  13. Biobanking for Personalized Medicine.

    Science.gov (United States)

    Liu, Angen; Pollard, Kai

    2015-01-01

    A biobank is an entity that collects, processes, stores, and distributes biospecimens and relevant data for use in basic, translational, and clinical research. Biobanking of high-quality human biospecimens such as tissue, blood and other bodily fluids along with associated patient clinical information provides a fundamental scientific infrastructure for personalized medicine. Identification of biomarkers that are specifically associated with particular medical conditions such as cancer, cardiovascular disease and neurological disorders are useful for early detection, prevention, and treatment of the diseases. The ability to determine individual tumor biomarkers and to use those biomarkers for disease diagnosis, prognosis and prediction of response to therapy is having a very significant impact on personalized medicine and is rapidly changing the way clinical care is conducted. As a critical requirement for personalized medicine is the availability of a large collection of patient samples with well annotated patient clinical and pathological data, biobanks thus play an important role in personalized medicine advancement. The goal of this chapter is to explore the role of biobanks in personalized medicine and discuss specific needs regarding biobank development for translational and clinical research, especially for personalized medicine advancement.

  14. Robotics in medicine

    Science.gov (United States)

    Kuznetsov, D. N.; Syryamkin, V. I.

    2015-11-01

    Modern technologies play a very important role in our lives. It is hard to imagine how people can get along without personal computers, and companies - without powerful computer centers. Nowadays, many devices make modern medicine more effective. Medicine is developing constantly, so introduction of robots in this sector is a very promising activity. Advances in technology have influenced medicine greatly. Robotic surgery is now actively developing worldwide. Scientists have been carrying out research and practical attempts to create robotic surgeons for more than 20 years, since the mid-80s of the last century. Robotic assistants play an important role in modern medicine. This industry is new enough and is at the early stage of development; despite this, some developments already have worldwide application; they function successfully and bring invaluable help to employees of medical institutions. Today, doctors can perform operations that seemed impossible a few years ago. Such progress in medicine is due to many factors. First, modern operating rooms are equipped with up-to-date equipment, allowing doctors to make operations more accurately and with less risk to the patient. Second, technology has enabled to improve the quality of doctors' training. Various types of robots exist now: assistants, military robots, space, household and medical, of course. Further, we should make a detailed analysis of existing types of robots and their application. The purpose of the article is to illustrate the most popular types of robots used in medicine.

  15. Integration of Traditional Chinese Medicine and modern medicine promotes the unification of human medicine

    Directory of Open Access Journals (Sweden)

    Peng Zhang

    2010-10-01

    Full Text Available "nThere are two mutually supportive systems in medical profession: modern medicines and traditional medicine. The current status is that although the modern medicine occupies the major position in healthcare system, the therapeutic effect of traditional medicines should not be omitted. If all of them merged and unified as one, it will be beneficial to the development of human medicine. In this paper, the integration of Traditional Chinese Medicine (TCM and modern medicine was exemplified to elucidate the mutual complements, mutual benefits of traditional medicines and modern medicine to maintain the unification of human medicine via the development of molecular biology, cytology etc. We believed that TCM theory may share the same mechanism with western medicine at some extent which need to be explored in the future research. In our point of view, although the road may twist and turn, the results are promising.

  16. Triple Active Antiretroviral Regimen Including Enfuvirtide Via the Biojector is Effective and Safe

    Directory of Open Access Journals (Sweden)

    Mona Loutfy

    2007-01-01

    Full Text Available For full HIV virological suppression, three fully active antiretroviral agents are required. New drug classes should be included to ensure that agents are fully active. The addition of enfuvirtide and efavirenz to the present patient’s new antiretroviral regimen ensured that two fully active agents were in use in the setting of a moderate degree of nucleoside resistance and a high level of protease resistance, and where non-nucleoside reverse transcriptase inhibitors were still fully active. Both viral load and CD4 count responded favourably to this regimen. The patient received support from physicians and clinic staff in the introduction and use of enfuvirtide. To reduce injection site reactions, a needle-free injection system (Biojector proved effective.

  17. Oral antidiabetic therapy in a large Italian sample: drug supply and compliance for different therapeutic regimens

    CERN Document Server

    Vittorino Gaddi, A; Capello, F; Di Pietro, C; Cinconze, E; Rossi, E; De Sando, V; Cevenini, M; D'Alò, G

    2014-01-01

    Objectives: To define the main features of patients treated with oral antidiabetics, evaluating monotherapy (MT), loose-dose combination therapy (LDCT) and fixed-dose combination therapy (FDCT); to describe medication adherence to the different therapies; and to evaluate the differences in compliance with the prescribed therapy regimen among prevalent and incident patient cohorts. Study design: This study was a retrospective cohort analysis based on the ARNO database, a national record that tracks reimbursable prescription claims submitted from selected pharmacies to the Italian national health system. In total, 169,375 subjects, from an overall population of 4,040,624 were included in this study. The patients represented 12 different local health units. Each patient had at least one oral antidiabetic prescription claim (A10B ATC code). Methods: Patients were divided into four groups according to their treatment regimen during the recruitment period (1 January 2008-31 December 2008): MT, FDCT, LDCT and swi...

  18. Modelling and analysis of the feeding regimen induced entrainment of hepatocyte circadian oscillators using petri nets.

    Directory of Open Access Journals (Sweden)

    Samar Hayat Khan Tareen

    Full Text Available Circadian rhythms are certain periodic behaviours exhibited by living organism at different levels, including cellular and system-wide scales. Recent studies have found that the circadian rhythms of several peripheral organs in mammals, such as the liver, are able to entrain their clocks to received signals independent of other system level clocks, in particular when responding to signals generated during feeding. These studies have found SIRT1, PARP1, and HSF1 proteins to be the major influencers of the core CLOCKBMAL1:PER-CRY circadian clock. These entities, along with abstracted feeding induced signals were modelled collectively in this study using Petri Nets. The properties of the model show that the circadian system itself is strongly robust, and is able to continually evolve. The modelled feeding regimens suggest that the usual 3 meals/day and 2 meals/day feeding regimens are beneficial with any more or less meals/day negatively affecting the system.

  19. Modelling and analysis of the feeding regimen induced entrainment of hepatocyte circadian oscillators using petri nets.

    Science.gov (United States)

    Tareen, Samar Hayat Khan; Ahmad, Jamil

    2015-01-01

    Circadian rhythms are certain periodic behaviours exhibited by living organism at different levels, including cellular and system-wide scales. Recent studies have found that the circadian rhythms of several peripheral organs in mammals, such as the liver, are able to entrain their clocks to received signals independent of other system level clocks, in particular when responding to signals generated during feeding. These studies have found SIRT1, PARP1, and HSF1 proteins to be the major influencers of the core CLOCKBMAL1:PER-CRY circadian clock. These entities, along with abstracted feeding induced signals were modelled collectively in this study using Petri Nets. The properties of the model show that the circadian system itself is strongly robust, and is able to continually evolve. The modelled feeding regimens suggest that the usual 3 meals/day and 2 meals/day feeding regimens are beneficial with any more or less meals/day negatively affecting the system.

  20. Comparative Study of L-Asparaginase-Based LOP Regimen Over CHOP Regimen Before Radiotherapy for Stage IIE Extranodal Nasal Type NK/T Cell Lymphoma: A Study of 2 Centers.

    Science.gov (United States)

    Huang, Limin; Yuan, Bin; Wu, Haixia; Chu, Hongliang; Liu, Yayun; Wu, Shuang; Li, Hong; Lu, He; Chen, Hui

    2017-03-01

    In this study we evaluated the efficacy of an L-asparaginase-based LOP (L-asparaginase, vincristine, and dexamethasone) regimen in extranodal Natural Killer (NK)/T-cell lymphoma (ENKTL) patients in the Guizhou province of China. Forty-eight patients were treated with the LOP (L-asparaginase, vincristine and dexamethasone) regimen chemotherapy (CT) and 32 patients with the CHOP (cyclophosphamide, tetrahydropyanyl adriamycin, vincristine, and prednisone) regimen. These patients then received involved-field radiotherapy (RT) with the doses of DT = 49-59 Gy. A significant improvement of clinical end points with the LOP regimen was noticed compared with the CHOP regimen: 33 (68.8%) versus 16 (50.0%) for complete responses; 10 (20.8%) versus 5 (15.6%) for partial responses. There were statistical differences in objective response rates (43 [89.6%] for LOP vs. 21 [65.6%] for CHOP; P = .009), 3 years of overall survival (42 [87.5%] for LOP vs. 20 [62.5%] for CHOP; P = .006) and progression-free survival (32 [79.2%] for LOP vs. 16 [50.0%] for CHOP; P = .007). The results showed that the LOP regimen is safe and much more efficient than the CHOP regimen for stage IIE ENKTL patients. They indicate that the LOP regimen is a satisfying alternative protocol among the other L-asparaginase-based regimens reported so far, such as SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide), GELOX (gemcitabine, oxaliplatin, and L-asparaginase), CHOP-L, and sandwich (CT, then RT, then CT). Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Regulatory acceptance of animal models of disease to support clinical trials of medicines and advanced therapy medicinal products.

    Science.gov (United States)

    Cavagnaro, Joy; Silva Lima, Beatriz

    2015-07-15

    The utility of animal models of disease for assessing the safety of novel therapeutic modalities has become an increasingly important topic of discussion as research and development efforts focus on improving the predictive value of animal studies to support accelerated clinical development. Medicines are approved for marketing based upon a determination that their benefits outweigh foreseeable risks in specific indications, specific populations, and at specific dosages and regimens. No medicine is 100% safe. A medicine is less safe if the actual risks are greater than the predicted risks. The purpose of preclinical safety assessment is to understand the potential risks to aid clinical decision-making. Ideally preclinical studies should identify potential adverse effects and design clinical studies that will minimize their occurrence. Most regulatory documents delineate the utilization of conventional "normal" animal species to evaluate the safety risk of new medicines (i.e., new chemical entities and new biological entities). Animal models of human disease are commonly utilized to gain insight into the pathogenesis of disease and to evaluate efficacy but less frequently utilized in preclinical safety assessment. An understanding of the limitations of the animal disease models together with a better understanding of the disease and how toxicity may be impacted by the disease condition should allow for a better prediction of risk in the intended patient population. Importantly, regulatory authorities are becoming more willing to accept and even recommend data from experimental animal disease models that combine efficacy and safety to support clinical development.

  2. Genomic medicine, precision medicine, personalized medicine: what's in a name?

    Science.gov (United States)

    Roden, D M; Tyndale, R F

    2013-08-01

    This issue of Clinical Pharmacology & Therapeutics is devoted to genomic medicine, and a reader may reasonably ask what we mean when we use those words. In the initial issue of the journal Genomics in 1987, McKusick and Ruddle pointed out that the descriptor "genome" had been coined in 1920 as a hybrid of "gene" and "chromosome," and that their new journal would focus on the "newly-developing discipline of mapping/sequencing (including analysis of the information)." A key milestone in the field was the generation of the first draft of a human genome in 2000, but this success really represents only one of many milestones in the journey from Mendel to MiSeq.

  3. La evolucion de la financiacion de las comunidades autonomas de regimen comun, 2002-2011

    OpenAIRE

    Angel de la Fuente

    2013-01-01

    En este trabajo se construyen series de financiacion a competencias homogeneas e igual esfuerzo fiscal para las comunidades autonomas de regimen comun durante el periodo 2002-11, asi como series complementarias de financiacion por caja y financiacon destinada a competencias singulares. Tambien se recopilan otros agregados de interes que pueden servir para relativizar la financiacion autonomica, incluyendo la poblacion ajustada regional. Estas series se utilizan en la segunda parte del trabajo...

  4. La evolucion de la financiacion de las comunidades autonomas de regimen comun, 2002-2012

    OpenAIRE

    Angel de la Fuente

    2014-01-01

    En este trabajo se construyen series homogeneizadas de financiacion a competencias homogeneas e igual esfuerzo fiscal para las comunidades autonomas de regimen comun durante el periodo 2002-12, asi como series complementarias de financiacion por caja y financiacion destinada a competencias singulares. Tambien se recopilan otros agregados de interes que pueden servir para relativizar la financiacion autonomica, incluyendo la poblacion ajustada regional. Estas series se utilizan en la segunda p...

  5. Effect of different cleaning regimens on the adhesion of resin to saliva-contaminated ceramics

    OpenAIRE

    2015-01-01

    PURPOSE: The aim of this study was to evaluate the influence of different cleaning regimens on the microshear bond strength (μSBS) of three different all-ceramic surfaces after saliva contamination. MATERIAL AND METHODS: Cubic ceramic specimens (3 × 3 × 3 mm(3) ) were prepared from three types of ceramics: zirconium dioxide (Z), leucite-reinforced glass ceramic (E), lithium disilicate glass ceramic (EX; n = 12/subgroup). A total of 144 composite resin cylinders (diameter: 1 mm, height: 3 m...

  6. TAC-TIC use of tacrolimus-based regimens in lupus nephritis.

    Science.gov (United States)

    Kraaij, Tineke; Bredewold, Obbo W; Trompet, Stella; Huizinga, Tom W J; Rabelink, Ton J; de Craen, Anton J M; Teng, Y K Onno

    2016-01-01

    Current guidelines do not mention tacrolimus (TAC) as a treatment option and no consensus has been reported on the role of TAC in lupus nephritis (LN). The present study aimed to guide clinical judgement on the use of TAC in patients with LN. A meta-analysis was performed for clinical studies investigating TAC regimens in LN on the basis of treatment target (induction or maintenance), concomitant immunosuppression and quality of the data. 23 clinical studies performed in patients with LN were identified: 6 case series, 9 cohort studies, 2 case-control studies and 6 randomised controlled trials (RCTs). Of the 6 RCTs, 5 RCTs investigated TAC regimens as induction treatment and 1 RCT as maintenance treatment. Five RCTs investigated TAC in combination with steroids and 2 TAC with mycophenolate plus steroids. All RCTs were performed in patients of Asian ethnicity. In a meta-analysis, TAC regimens achieved a significantly higher total response (relative risk (RR) 1.23, 95% CI 1.12 to 1.34, p<0.05) and significantly higher complete response (RR 1.48, 95% CI 1.23 to 1.77, p<0.05). The positive outcome was predominantly defined by the largest RCT investigating TAC with mycophenolate plus steroids. Regarding safety, the occurrence of leucopoenia was significantly lower, while the occurrence of increased creatine was higher. Clinical studies on TAC regimens for LN are limited to patients of Asian ethnicity and hampered by significant heterogeneity. The positive results on clinical efficacy of TAC as induction treatment in LN cannot be extrapolated beyond Asian patients with LN. Therefore, further confirmation in multiethnic, randomised trials is mandatory. Until then, TAC can be considered in selected patients with LN.

  7. Study of hypothalamic pituitary adrenal axis in patients of membranous nephropathy receiving modified Ponticelli regimen

    Directory of Open Access Journals (Sweden)

    R Ramachandran

    2015-01-01

    Full Text Available Pulse methyl prednisolone followed by oral prednisolone and abrupt switch to chlorambucil/cyclophosphamide (Ponticelli/modified Ponticelli regimen is used in patients with idiopathic membranous nephropathy. This therapy where steroids are stopped abruptly is unphysiologic and expected to have hypothalamic pituitary adrenal (HPA axis suppression; however, this has not been evaluated. A total of 13 consecutive adult patients with idiopathic membranous nephropathy who had completed modified Ponticelli regimen were studied. The regimen included administration of pulse methylprednisolone 1 g for 3 days followed by oral prednisolone 0.5 mg/kg/day for 27 days followed by oral cyclophosphamide at a dose of 2 mg/kg/day for the next month. This was repeated for three courses. Patients who had received corticosteroids prior to therapy were excluded. The HPA axis was evaluated after 1 month of completing the last course of steroid therapy. The evaluation was done using a low-dose adrenocorticotropic hormone stimulation test. A single intravenous bolus dose of synacthen (1 μg was given at 9.00 am and the serum cortisol levels were estimated by radioimmunoassay at 0, 30, and 60 min. A peak cortisol level of 550 nmol/L or higher was considered as normal. Mean baseline cortisol levels was 662.3 ± 294.6 nmol/L and peak cortisol level was 767 ± 304.4 nmol/L. A total of 6 patients (46.2% had low basal cortisol levels, only 3 (23% had both basal and peak cortisol levels < 550 nmol/L suggestive of HPA axis suppression. To conclude, 23% of patients had suppression of HPA axis after modified Ponticelli regimen.

  8. Analysis of combination drug therapy to develop regimens with shortened duration of treatment for tuberculosis.

    Science.gov (United States)

    Drusano, George L; Neely, Michael; Van Guilder, Michael; Schumitzky, Alan; Brown, David; Fikes, Steven; Peloquin, Charles; Louie, Arnold

    2014-01-01

    Tuberculosis remains a worldwide problem, particularly with the advent of multi-drug resistance. Shortening therapy duration for Mycobacterium tuberculosis is a major goal, requiring generation of optimal kill rate and resistance-suppression. Combination therapy is required to attain the goal of shorter therapy. Our objective was to identify a method for identifying optimal combination chemotherapy. We developed a mathematical model for attaining this end. This is accomplished by identifying drug effect interaction (synergy, additivity, antagonism) for susceptible organisms and subpopulations resistant to each drug in the combination. We studied the combination of linezolid plus rifampin in our hollow fiber infection model. We generated a fully parametric drug effect interaction mathematical model. The results were subjected to Monte Carlo simulation to extend the findings to a population of patients by accounting for between-patient variability in drug pharmacokinetics. All monotherapy allowed emergence of resistance over the first two weeks of the experiment. In combination, the interaction was additive for each population (susceptible and resistant). For a 600 mg/600 mg daily regimen of linezolid plus rifampin, we demonstrated that >50% of simulated subjects had eradicated the susceptible population by day 27 with the remaining organisms resistant to one or the other drug. Only 4% of patients had complete organism eradication by experiment end. These data strongly suggest that in order to achieve the goal of shortening therapy, the original regimen may need to be changed at one month to a regimen of two completely new agents with resistance mechanisms independent of the initial regimen. This hypothesis which arose from the analysis is immediately testable in a clinical trial.

  9. Intestinal microbiota of broiler chickens as affected by litter management regimens

    Directory of Open Access Journals (Sweden)

    Zhongtang eYu

    2016-05-01

    Full Text Available Poultry litter is a mixture of bedding materials and enteric bacteria excreted by chickens, and it is typically reused for multiple growth cycles in commercial broiler production. Thus, bacteria can be transmitted from one growth cycle to the next via litter. However, it remains poorly understood how litter reuse affects development and composition of chicken gut microbiota. In this study, the effect of litter reuse on the microbiota in litter and in chicken gut was investigated using 2 litter management regimens: fresh vs. reused litter. Samples of ileal mucosa and cecal digesta were collected from young chicks (10 days of age and mature birds (35 days of age. Based on analysis using DGGE and pyrosequencing of bacterial 16S rRNA gene amplicons, the microbiota of both the ileal mucosa and the cecal contents was affected by both litter management regimen and age of birds. Faecalibacterium, Oscillospira, Butyricicoccus, and one unclassified candidate genus closely related to Ruminococcus were most predominant in the cecal samples, while Lactobacillus was predominant in the ileal samples at both ages and in the cecal samples collected at day 10. At days 10 and 35, 8 and 3 genera, respectively, in the cecal luminal microbiota differed significantly in relative abundance between the 2 litter management regimens. Compared to the fresh litter, reused litter increased predominance of halotolerant/alkaliphilic bacteria and Faecalibacterium prausnitzii, a butyrate-producing gut bacterium. This study suggests that litter management regimens affect the chicken GI microbiota, which may impact the host nutritional status and intestinal health.

  10. Prospective evaluation of 1-day polyethylene glycol-3350 bowel preparation regimen in children.

    Science.gov (United States)

    Abbas, Mazen I; Nylund, Cade M; Bruch, Carol J; Nazareno, Luzviminda G; Rogers, Philip L

    2013-02-01

    The aim of the present study was to evaluate efficacy, safety, and tolerability of a pediatric colonoscopy bowel preparation regimen composed of polyethylene glycol-3350 (PEG-3350) and a sports drink completed in a few hours. A prospective, open-label trial of a colonoscopy bowel preparation in children ages 8 to 18 years that included 238 g of PEG-3350 mixed with 1.9 L of Gatorade completed in a few hours. Efficacy was determined using the Boston Bowel Preparation Scale. Basic metabolic profiles and questionnaires were obtained that assessed for safety, adverse effects, tolerability, and patient acceptability. Forty-six patients completed the study. Patients were predominately boys (56.5%) with a mean age of 14.50 years (SD ± 2.9 years). Forty-three (93.5%) were able to complete the regimen. All of the colonoscopies were completed to the cecum and 84% had terminal ileum visualization. Seventy-seven percent were found to be effective preparations. Nausea/vomiting were the most common reported adverse effect (60%) followed by abdominal pain/cramping (44%) and fatigue/weakness (40%). Overall, the regimen was acceptable with 1 exception being the large volume to drink. There were no clinically significant changes in basic metabolic profiles, although there was a statistically significant decrease in the mean potassium (0.16 mEq/L; P = 0.016), blood urea nitrogen (2.68 mg/dL; P Gatorade administered in a few hours is an effective, safe, and moderately tolerable bowel preparation regimen for colonoscopy in children.

  11. Efficacy of traditional treatment regimen on Kati Shoola with special reference to lumbar spondylolisthesis

    OpenAIRE

    Ediriweera, E. R. H. S. S.; Gunathilka, H. D. P.; Weerasinghe, K. D. C. M.; Kalawana, O. T. M. R. K. S. B.

    2013-01-01

    According to Ayurveda, Kati Shoola is a disease with pain in lumbar region. Lumbar spondylolisthesis, anterior displacement of a vertebra or the vertebral column in relation to the vertebrae below, is one of the common causes. Current case study was carried out at Ayurveda Teaching hospital, Borella, to evaluate the efficacy of a treatment regimen used by Sri Lankan traditional physician family “Weerasinghe.” A 59-year-old female with a 9-month history of lumbar spondylolisthesis was treated ...

  12. Evolution of treatment regimens in multiple myeloma: a social network analysis.

    Directory of Open Access Journals (Sweden)

    Helen Mahony

    Full Text Available BACKGROUND: Randomized controlled trials (RCTs are considered the gold standard for assessing the efficacy of new treatments compared to standard treatments. However, the reasoning behind treatment selection in RCTs is often unclear. Here, we focus on a cohort of RCTs in multiple myeloma (MM to understand the patterns of competing treatment selections. METHODS: We used social network analysis (SNA to study relationships between treatment regimens in MM RCTs and to examine the topology of RCT treatment networks. All trials considering induction or autologous stem cell transplant among patients with MM were eligible for our analysis. Medline and abstracts from the annual proceedings of the American Society of Hematology and American Society for Clinical Oncology, as well as all references from relevant publications were searched. We extracted data on treatment regimens, year of publication, funding type, and number of patients enrolled. The SNA metrics used are related to node and network level centrality and to node positioning characterization. RESULTS: 135 RCTs enrolling a total of 36,869 patients were included. The density of the RCT network was low indicating little cohesion among treatments. Network Betweenness was also low signifying that the network does not facilitate exchange of information. The maximum geodesic distance was equal to 4, indicating that all connected treatments could reach each other in four "steps" within the same pathway of development. The distance between many important treatment regimens was greater than 1, indicating that no RCTs have compared these regimens. CONCLUSION: Our findings show that research programs in myeloma, which is a relatively small field, are surprisingly decentralized with a lack of connectivity among various research pathways. As a result there is much crucial research left unexplored. Using SNA to visually and analytically examine treatment networks prior to designing a clinical trial can lead

  13. The Effectiveness of a Working Memory Training Regimen for Iranian University Students: Implications for Medical Students

    OpenAIRE

    Gholam Reza Kiany; Bahman Mehraban; Reza Ghafar Samar

    2016-01-01

    Introduction: Working memory is thought to serve as a part of memory structure where functions like temporary storage and manipulation of information take place. This study investigates the effectiveness of working memory training regimens with Iranian university students, while considering the implications for medical students. Methods: Thirty university students studying at different universities in Kermanshah took part in the study. They were divided into two groups as the experimental...

  14. The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

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    Vali A Mehrzad

    2012-01-01

    Full Text Available Background: Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen. Materials and Methods: In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS 19. Results: Out of the 25 patients, 8 patients (32% had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases. According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40% had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT. On the other hand, 13 patients (52%, who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment. Conclusion: This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure in Iran, it seems that FLANG therapy is an acceptable choice for these patients.

  15. New regimens for reducing the duration of the treatment of drug-susceptible pulmonary tuberculosis

    OpenAIRE

    Conde, Marcus B.; Lapa e Silva, José R.

    2011-01-01

    Tuberculosis (TB) remains an important health problem worlwide. The structure necessary for delivering TB treatment and implementing the directly observed treatment accounts for more than two-thirds of its final cost. Furthemore, although with efficacy greater than 90%, the effectiveness of present treatment regimens ranges from 55–85%, depending on the setting, mainly due to poor adherence. Duration of treatment with the current first-line anti-TB drugs is a minimum of 6 months. Reducing the...

  16. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa.

    Science.gov (United States)

    Kang, Sang Bum; Marchelletta, Ronald R; Penrose, Harrison; Docherty, Michael J; McCole, Declan F

    2015-03-01

    Linaclotide, a synthetic guanylyl cyclase C (GC-C) agonist, and the prostone analog, Lubiprostone, are approved to manage chronic idiopathic constipation and constipation-predominant irritable bowel syndrome. Lubiprostone also protects intestinal mucosal barrier function in ischemia. GC-C signaling regulates local fluid balance and other components of intestinal mucosal homeostasis including epithelial barrier function. The aim of this study was to compare if select dosing regimens differentially affect linaclotide and lubiprostone modulation of ion transport and barrier properties of normal human colonic mucosa. Normal sigmoid colon biopsies from healthy subjects were mounted in Ussing chambers. Tissues were treated with linaclotide, lubiprostone, or vehicle to determine effects on short-circuit current (I sc). Subsequent I sc responses to the cAMP agonist, forskolin, and the calcium agonist, carbachol, were also measured to assess if either drug caused desensitization. Barrier properties were assessed by measuring transepithelial electrical resistance. I sc responses to linaclotide and lubiprostone were significantly higher than vehicle control when administered bilaterally or to the mucosal side only. Single versus cumulative concentrations of linaclotide showed differences in efficacy while cumulative but not single dosing caused desensitization to forskolin. Lubiprostone reduced forskolin responses under all conditions. Linaclotide and lubiprostone exerted a positive effect on TER that was dependent on the dosing regimen. Linaclotide and lubiprostone increase ion transport responses across normal human colon but linaclotide displays increased sensitivity to the dosing regimen used. These findings may have implications for dosing protocols of these agents in patients with constipation.

  17. Fecal Bacterial Communities in treated HIV infected individuals on two antiretroviral regimens

    Science.gov (United States)

    Pinto-Cardoso, Sandra; Lozupone, Catherine; Briceño, Olivia; Alva-Hernández, Selma; Téllez, Norma; Adriana, Aguilar; Murakami-Ogasawara, Akio; Reyes-Terán, Gustavo

    2017-01-01

    Intestinal microbiome changes that occur in HIV positive individuals on different antiretroviral therapy (ART) regimens are important to understand, as they are potentially linked with chronic inflammation and microbiome-linked comorbidities that occur at increased incidence in this population. We conducted a cross-sectional study comparing the fecal microbiomes of HIV-uninfected (HIV SN) to HIV-infected individuals on long-term ART (HIV+ LTART) from Mexico using 16S ribosomal RNA (16sRNA) targeted sequencing. These individuals were on two ART regimens based on either Non-Nucleoside Reverse Transcriptase Inhibitors (EFV) or ritonavir-boosted Protease Inhibitors (PI) with the same backbone of Nucleoside Reverse Transcriptase Inhibitors. Microbiome diversity was reduced in treated HIV infection compared to HIV SN (p < 0.05). Several operational taxonomic units (OTUs) related to the Ruminococcaceae family including Faecalibacterium prausnitzii were depleted in EFV and PI compared to HIV SN and negatively correlated with intestinal gut dysfunction as measured by the intestinal fatty binding protein (p < 0.05). This is the first report to address the fecal bacterial communities in HIV-infected individuals on two ARV regimens from Mexico. PMID:28262770

  18. Differences in durability of treatment with initial PI-based regimens.

    Science.gov (United States)

    Pérez-Elías, Maria Jesús; Moreno, Ana; Moreno, Santiago; Antela, Antonio; Dronda, Fernando; Muñoz, Vicente; Casado, Jose Luis; Quereda, Carmen; Lopez, Dolores; Navas, Enrique

    2003-01-01

    The durability of virologic response to antiretroviral therapy is dependent on the potency, tolerability, and adherence level of the regimen. In a prospective, nonrandomized cohort study, we compared the treatment outcome of a nelfinavir-based highly active antiretroviral therapy (HAART) regimen with that of an indinavir-based regimen, over 1 year of routine clinical practice. Information was derived from 134 treatment-naïve HIV-1-infected patients initiated on triple therapy with either nelfinavir (n = 44) or indinavir (n = 90). The proportions of patients achieving a virological response were similar between treatment groups (>1 log(10) reduction in HIV RNA at 3 months in 95% of patients taking nelfinavir and 88% taking indinavir; HIV RNA 90% (p =.0001). Over 90% adherence was achieved in 70% of patients taking nelfinavir compared with 41% of those taking indinavir (p =.01). The probability of remaining on the initial protease inhibitor (PI) after 12 months was 77% in the nelfinavir group and 66% in the indinavir group, with the median time to changing treatment being 519 days and 462 days, respectively. Gastric intolerance and nephritic colic were the most common reasons for changing therapy in the indinavir group. In the clinical setting, HAART based on initial nelfinavir and indinavir therapy was associated with similarly good virological and immunological suppression at 1 year, however, nelfinavir-based treatment was associated with a longer durability, probably due to a better adherence and tolerance pattern.

  19. Food allergen selective thermal processing regimens may change oral tolerance in infancy.

    Science.gov (United States)

    Kosti, R I; Triga, M; Tsabouri, S; Priftis, K N

    2013-01-01

    Food allergy can be considered a failure in the induction of oral tolerance. Recently, great interest has been focused on understanding the mechanisms and the contributing factors of oral tolerance development, hoping for new definitive interventions in the prevention and treatment of food allergy. Given that food processing may modify the properties and the nature of dietary proteins, several food processing methods could affect the allergenicity of these proteins and consequently may favour oral tolerance induction to food allergic children. Indeed, effective thermal food processing regimens of altering food proteins to reduce allergenicity have been recently reported in the literature. This article is mainly focused on the effect of selective thermal processing regimens on the main infant allergenic foods, with a potential clinical relevance on their allergenicity and therefore on oral tolerance induction. In the light of recent findings, the acquisition of tolerance in younger age and consequently the ability of young children to "outgrow" food allergy could be achieved through the application of selective thermal processing regimens on certain allergenic foods. Therefore, the ability of processed foods to circumvent clinical disease and at the same time to have an impact on the immune system and facilitate tolerance induction could be invaluable as a component of a successful therapeutic strategy. The opening in the new avenues of research in the use of processed foods in clinical practice for the amelioration of the impact on the quality of life of patients and possibly in food allergy prevention is warranted.

  20. HIV-2 infection, end-stage renal disease and protease inhibitor intolerance: which salvage regimen?

    Science.gov (United States)

    Francisci, Daniela; Martinelli, Laura; Weimer, Liliana E; Zazzi, Maurizio; Floridia, Marco; Masini, Giulia; Baldelli, Franco

    2011-01-01

    Non-nucleoside reverse transcriptase inhibitors and enfuvirtide are ineffective against HIV-2 replication. These considerations may have particular significance in the formulation of second-line or salvage regimens for HIV-2 infection when resistance or toxicity precludes the use of protease inhibitors (PIs) or specific nucleoside analogues. We describe a case of a treatment-experienced patient with important limitations in therapeutic options dictated by the presence of HIV-2 infection, severe HIV nephropathy (requiring haemodialysis), intolerance to PIs and clinical contraindications to the use of some nucleoside analogues (anaemia, pancreatic toxicity and high cardiovascular risk). A three-drug regimen based on raltegravir, tenofovir disoproxil fumarate and lamivudine was given, with no major toxicity, good immunological response and complete viral suppression. Our case indicates that regimens based on integrase inhibitors could represent an effective alternative in PI-resistant or PI-intolerant patients with HIV-2, and that tenofovir disoproxil fumarate may be used in patients with end-stage renal disease requiring haemodialysis who cannot take other nucleoside analogues because of treatment-limiting adverse effects.

  1. Helicobacter pylori:Effect of coexisting diseases and update on treatment regimens

    Institute of Scientific and Technical Information of China (English)

    Shen-Shong; Chang; Hsiao-Yun; Hu

    2015-01-01

    The presence of concomitant diseases is an independentpredictive factor for non-Helicobacter pylori(H. pylori) peptic ulcers. Patients contracting concomitant diseases have an increased risk of developing ulcer disease through pathogenic mechanisms distinct from those of H. pylori infections. Factors other than H. pylori seem critical in peptic ulcer recurrence in end stage renal disease(ESRD) and cirrhotic patients. However, early H. pylori eradication is associated with a reduced risk of recurrent complicated peptic ulcers in patients with ESRD and liver cirrhosis. Resistances to triple therapy are currently detected using culture-based and molecular methods. Culture susceptibility testing before first- or second-line therapy is unadvisable. Using highly effective empiric first-line and rescue regimens can yield acceptable results. Sequential therapy has been included in a recent consensus report as a valid first-line option for eradicating H. pylori in geographic regions with high clarithromycin resistance. Two novel eradication regimens, namely concomitant and hybrid therapy, have proven more effective in patients with dual-(clarithromycin- and metronidazole-) resistant H. pylori strains. We aim to review the prevalence of and eradication therapy for H. pylori infection in patients with ESRD and cirrhosis. Moreover, we summarized the updated H. pylori eradication regimens.

  2. Evaluation of Blood Regimen on the Survival of Cimex lectularius L. Using Life Table Parameters

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    Edwin G. Rajotte

    2013-06-01

    Full Text Available Knowledge of bed bug development under varying conditions can lead to more sophisticated management techniques. Development rate, age and stage-specific life tables were compared for a laboratory strain (HS and field strain (ECL-05 of bed bug Cimex lectularius L. (Hemiptera: Heteroptera reared on two blood regimens: human or rabbit blood. Harlan and ECL-05 bed bugs reared on human blood had a life expectancy of 207 and 208 days respectively from the egg stage. Egg to adult development of HS bed bugs reared on human blood (~35 days was significantly longer than that of the ECL-05 strain (~33 days in the third, fourth, and fifth instars. The HS and ECL-05 bed bugs reared on rabbit blood had a life expectancy of 149 and 174 days respectively. Egg to adult development time of HS on rabbit blood (~52 days was significantly longer than ECL-05 (~37 days in every instar, and HS total life span was significantly shorter compared to ECL-05. Developmental differences based on strain and blood regimen suggest rabbit blood is an inferior blood source for colony maintenance, and strain has variable effects on bed bug development. Findings suggest that blood regimen should strongly be considered in bed bug colony maintenance.

  3. Common toxicities and objective response rate in metastatic colorectal cancer patients treated with irinotecan based regimens

    Institute of Scientific and Technical Information of China (English)

    Liu Huang; Xin Liao; Qianqian Yu; Qiang Fu; Kai Qin; Huanlei Wu; Lihong Zhang; Xianglin Yuan

    2013-01-01

    Objective: The aim of our study was to investigate if common toxicities are correlated to objective response rate (ORR) in metastatic colorectal cancer (mCRC) patients treated by irinotecan based regimens. Methods: Univariate and multivariate logistic regression analyses were performed to evaluate correlations between common toxicities and binary ORR in 106 mCRC patients from a prospective cohort treated with irinotecan based regimens. Results: The most frequent severe toxicities (Grade 3/4) were as follows: neutropenia (27.4%), diarrhea (16.9%), leucopenia (12.6%), vomiting (3.2%) and thrombocytopenia (2.1%). Thrombocytosis was observed in 25 (26.3%) patients. ORR was 25.3%. Thrombocytopenia (P = 0.014), line of chemotherapy (P = 0.028) and thrombocytosis (P = 0.033) were correlated with ORR in univariate analysis. In multivariate analysis, thrombocytopenia (odds ratio [OR] = 8.600, 95% confidence interval [CI] = 1.705–43.385, P = 0.009) and first line chemotherapy (OR = 5.155, 95% CI = 1.153–23.256, P = 0.032) positively related to ORR. Conclusion: Throm-bocytopenia may be an indicator of ORR in mCRC patients treated by irinotecan plus 5-fluorouracil/capecitabine. Evidence is not strong enough to prove that irinotecan based regimens-induced diarrhea, leucopenia, neutropenia or vomiting is associ-ated with ORR.

  4. Can scientific medicine incorporate alternative medicine?

    Science.gov (United States)

    Federspil, G; Vettor, R

    2000-06-01

    The authors examine the problem of defining alternative medicine, and after a brief analysis conclude that a satisfactory unifying definition of the different practices is not possible. Scientific knowledge is a function of scientific method. In turn the principle of falsifiability proposed by Karl Popper is used as a demarcation line between science and pseudoscience. They assert that the various alternative modalities do not represent authentic scientific disciplines, as they lack many of the minimum requirements of scientific discourse and, above all, because they violate the principle of falsifiability. Until they overcome these methodological shortcomings, alternative medical practices cannot become authentic scientific disciplines.

  5. Medication regimen complexity and readmissions after hospitalization for heart failure, acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Nada Abou-Karam

    2016-02-01

    Full Text Available Objectives: Readmission rate is increasingly being viewed as a key indicator of health system performance. Medication regimen complexity index scores may be predictive of readmissions; however, few studies have examined this potential association. The primary objective of this study was to determine whether medication regimen complexity index is associated with all-cause 30-day readmission after admission for heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Methods: This study was an institutional review board–approved, multi-center, case–control study. Patients admitted with a primary diagnosis of heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease were randomly selected for inclusion. Patients were excluded if they discharged against medical advice or expired during their index visit. Block randomization was utilized for equal representation of index diagnosis and site. Discharge medication regimen complexity index scores were compared between subjects with readmission versus those without. Medication regimen complexity index score was then used as a predictor in logistic regression modeling for readmission. Results: Seven hundred and fifty-six patients were randomly selected for inclusion, and 101 (13.4% readmitted within 30 days. The readmission group had higher medication regimen complexity index scores than the no-readmission group (p < 0.01. However, after controlling for demographics, disease state, length of stay, site, and medication count, medication regimen complexity index was no longer a significant predictor of readmission (odds ratio 0.99, 95% confidence interval 0.97–1.01 or revisit (odds ratio 0.99, 95% confidence interval 0.98–1.02. Conclusion: There is little evidence to support the use of medication regimen complexity index in readmission prediction when other measures are available. Medication regimen complexity index

  6. Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy

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    Rocio Jiménez-Galán

    2016-07-01

    Full Text Available Background: Decreased antiretroviral therapy persistence is associated with increased rates of virologic failure, development of antiretroviral resistance, and increased morbidity and mortality. Different therapeutic strategies, such as single-tablet regimens (STR and less-drug regimens (LDR, have been developed in order to simplify antiretroviral therapy (ART and increase persistence. Objectives: The primary objective was to compare antiretroviral persistence among patients receiving STRs and patients receiving LDRs. A secondary objective was to identify factors associated with non-persistence. Methods: This was a retrospective study that included treatment- experienced HIV-infected patients who received ART based on STR or LDR. Baseline patient characteristics collected included demographic information, HIV risk transmission, substance abuse during the therapy, presence of psychiatric disorder and hepatitis B or C virus infection. Kaplan-Meier analysis and Log rank was utilized to compare persistence to STR and LDR. To identify independent predictors of non-persistence we developed a multivariate Cox regression analysis. Results: A total of 244 patients were included, 176 with STR and 68 with LDR. 60 (34.1% patients discontinued in the STR group and 13 (19.1% in the LDR group. The Cox regression model showed that the only variable associated with higher risk of non-persistence was the substance abuse (HR = 2.59; p = 0.005. Adverse events were the main reason for ART discontinuation in the STR group and virologic failure in the LDR group. Conclusions: Persistence to STR and LDR seems to be similar in pretreated HIV-infected patients. Drug abuse was the only factor identified with a higher risk of non-persistence.

  7. Response of broiler chickens to different dietary crude protein and feeding regimens

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    JO Oyedeji

    2005-09-01

    Full Text Available Five isocaloric (3200kcal/kg diets were used in an experiment designed to investigate the effects of dietary crude protein (CP and feeding regimens on broiler performance. Day-old broilers were randomly distributed into four groups using a completely randomized design. Each group was replicated three times with ten broiler chicks per replicate. The experiment lasted for eight weeks. Broilers in group 1 received 23% CP from 0 to 3 weeks, 20% CP from 3 to 6 weeks and 18% CP from 6 to 8 weeks, while broilers in group 2 received 23% CP between 0 and 6 weeks and 18% CP between 6 and 8 weeks. Besides, broilers in group 3 were fed 23% CP from 0 to 4 weeks and 16% CP from 4 to 8 weeks, whereas group 4 was given 18% CP from 0 to weeks. Water was supplied ad libitum for broilers in the different dietary groups. A metabolic trial was carried out on the third week of the experiment using a total collection method. Proximate analyses of diets and faecal samples were performed according to the methods outlined by the Association Of the Official Analytical Chemists. Results at market age showed that broiler performance with respect to feed intake, weight gain, feed to gain ratio and water intake were not significantly influenced by CP regimens (p>0.05. Furthermore, CP regimens did not significantly influence broilers liveability (p>0.05. Protein retention, fat utilization and available fiber were not significantly influenced among treatments (p> 0.05. Economic data showed that cost to benefit ratio of producing broilers was comparable among broilers for all CP regimens used in this trial (p>0.05. It was concluded that a single diet of 18% CP and 3200kcal/kg metabolizable energy would be most suitable and convenient for farmers who are engaged in on-farm feed production for broilers as compared with the standard feeding regimens of broiler starter and broiler finisher diets.

  8. Switch to raltegravir-based regimens and HIV DNA decrease in patients with suppressed HIV RNA

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    Claudia Bianco

    2014-11-01

    Full Text Available Introduction: Raltegravir intensification is associated with an increase in 2-LTR episomal HIV DNA= circles, indicating a persistent low-level replication, in some individuals in ART with suppressed HIV RNA. We aimed at monitoring residual plasma HIV RNA and cellular HIV DNA in virologically suppressed patients switching to a raltegravir-based regimen. Materials and Methods: Forty-six HIV-infected subjects on PI or NNRTI based-regimens, with plasma HIV RNA level 200 cells/µL for ≥12 months were enrolled. Thirty-four patients switched to raltegravir-based regimen (RASTA study group and 12 continued a PI or NNRTI based-regimen (control group. Ultrasensitive HIV residual viremia and total PBMC HIV DNA were assessed at baseline (W0, 24 (W24 and 48 (W48 weeks. HIV RNA levels were determined by an ultrasensitive test derived from a commercial real time PCR (limit of detection 5 copies/ml. A real time PCR was used to quantify HIV DNA copy numbers in PBMCs. Results: At W0, HIV DNA was detected in all patients while at W48 it was detectable in 82.3% of RASTA group vs 100% of controls (p=0.01. The difference between the average values of HIV DNA log10 copies/10°6 CD4 at W0 (median 3.11, IQR 2.70–3.45 and W48 (median 2.87, IQR 2.24–3.38 was statistically significant for RASTA group (p=0.035. Male gender (mean difference −0.37 log10 copies/10°6 PBMC, p=0.023 and previous PI based-ART (mean difference +0.39 log10 copies/10°6 PBMC, p=0.036 were predictive of HIV DNA level at W0. After adjusting for previous PI based-ART, male gender was the only variable independently associated with HIV DNA size at W0 (mean difference −0.326 log10 copies/10°6 PBMC, 95% CI −0.641, −0.011 p=0.043. Ultrasensitive HIV-1 RNA was detectable at W0 in 50% of RASTA group versus 66.7% of controls and at W48 in 32.4% versus 45.5%, respectively. No differences were found between HIV RNA levels at W0 and W48 within and between the two groups. Conclusions: Switching to

  9. Nephrolithiasis and renal failure among patients exposed to atazanavir, other PIs and PI-free regimens

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    Ella Nkhoma

    2014-11-01

    Full Text Available Introduction: Recent single-site studies and case reports have linked atazanavir (ATV with the occurrence of nephrolithiasis. The purpose of this study was to estimate and compare the incidence rate of nephrolithiasis and to characterize the occurrence of subsequent renal failure among patients on ATV, other protease inhibitors (PIs and PI-free regimens using real world data. Materials and Methods: This was a retrospective cohort analysis using claims data from a US commercial and a US public health insurance database (Medicaid spanning 2003–2011 and 2006–2011, respectively. We identified adult HIV patients who were prescribed ATV, other PIs or PI-free regimens with at least 6 months of continuous enrolment prior to the index claim. Nephrolithiasis was defined as an inpatient or outpatient ICD-9 diagnosis code for nephrolithiasis or an associated condition, plus an imaging/corrective procedure code. Renal failure was also identified using diagnosis codes among patients experiencing nephrolithiasis. Hazard ratios were estimated using propensity score (PS adjusted Cox regression, crude and adjusted for demographics, baseline comorbidities and comedications. Results: A total of 14,477 patients (ATV: 4,150; other PIs: 4,153; PI-free: 6,174 were identified in the commercial database: 83% male and 20% age ≥50 years. In the Medicaid database, 9,104 patients (ATV: 3,460; other PIs: 3,117; PI-free: 2,527 were identified: 53% male and 25% age ≥50 years. There were significant baseline differences in demographics, comorbidities and concomitant medications among the three cohorts. In adjusted analyses, ATV use was not significantly associated with nephrolithiasis when compared to other PIs. When ATV was compared to PI-free regimens, a positive association was observed in the commercial insurance but not the Medicaid database. In both databases, previous history of nephrolithiasis was the strongest predictor of nephrolithiasis in the ATV

  10. Evaluation of hippuric acid content in goat milk as a marker of feeding regimen.

    Science.gov (United States)

    Carpio, A; Bonilla-Valverde, D; Arce, C; Rodríguez-Estévez, V; Sánchez-Rodríguez, M; Arce, L; Valcárcel, M

    2013-09-01

    Organic producers, traders, and consumers must address 2 issues related to milk: authentication of the production system and nutritional differentiation. The presence of hippuric acid (HA) in goat milk samples has been proposed as a possible marker to differentiate the feeding regimen of goats. The objective of this work is to check the hypothesis that HA could be a marker for the type of feeding regimen of goats by studying the influence of production system (conventional or organic) and feeding regimen (with or without grazing fodder). With this purpose, commercial cow and goat milk samples (n=27) and raw goat milk samples (n=185; collected from different breeds, localizations, and dates) were analyzed. Samples were grouped according to breed, feeding regimen, production system, and origin to compare HA content by ANOVA and honestly significant difference Tukey test at a confidence level of ≥95%. Hippuric acid content was obtained by analyzing milk samples with capillary electrophoresis. This method was validated by analyzing part of the samples with HPLC as a reference technique. Sixty-nine raw goat milk samples (of the total 158 samples analyzed in this work) were quantified by capillary electrophoresis. In these samples, the lowest average content for HA was 7±3 mg/L. This value corresponds to a group of conventional raw milk samples from goats fed with compound feed. The highest value of this group was 28±10 mg/L, corresponding to goats fed compound feed plus grass. Conversely, for organic raw goat milk samples, the highest concentration was 67±14 mg/L, which corresponds to goats fed grass. By contrast, the lowest value of this organic group was 26±10 mg/L, which belongs to goats fed organic compounds. Notice that the highest HA average content was found in samples from grazing animals corresponding to the organic group. This result suggests that HA is a good marker to determine the type of goats feeding regimen; a high content of HA represents a diet

  11. Structured self-monitoring of blood glucose regimens improve glycemic control in poorly controlled Chinese patients on insulin therapy: Results from COMPASS.

    Science.gov (United States)

    Ji, Linong; Su, Qing; Feng, Bo; Shan, Zhongyan; Hu, Renming; Xing, Xiaoping; Xue, Yaoming; Yang, Tao; Hua, Yanyin

    2017-05-01

    The use of self-monitoring of blood glucose (SMBG) among patients with insulin-treated, type 2 diabetes (T2DM) in China is suboptimal. Herein we evaluated the effectiveness of structured SMBG for improving glycemic control and increasing the frequency of SMBG. Insulin-treated (>3 months) T2DM patients aged ≥18 years with HbA1c >8.0 % (64 mmol/mol) were recruited to the study. They received SMBG materials and were advised on a structured SMBG regimen for their insulin therapy. Patients were trained to self-adjust insulin dosage according to SMBG readings and were seen by physicians at Months 3 and 6. Endpoints included changes in HbA1c, SMBG frequency, and hypoglycemia frequency. The study enrolled 820 patients, with mean (± SD) age 55.1 ± 9.8 years, body mass index 24.9 ± 3.6 kg/m(2) , HbA1c 9.7 ± 1.6 % (83 mmol/mol), and diabetes duration 9.8 ± 7.1 years, with median insulin therapy of 30.3 (3.0-274.1) months, from 19 Chinese clinics. By Month 3, 99.9 % of patients performed daily SMBG. At Months 3 and 6, HbA1c had decreased from baseline (-1.81 % and -1.73 %, respective; P insulin therapy. A structured SMBG regimen, with training on interpretation of and responses to SMBG readings, increased SMBG frequency and improved HbA1c and the management of insulin-treated T2DM. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  12. Engineering in translational medicine

    CERN Document Server

    2014-01-01

    This book covers a broad area of engineering research in translational medicine. Leaders in academic institutions around the world contributed focused chapters on a broad array of topics such as: cell and tissue engineering (6 chapters), genetic and protein engineering (10 chapters), nanoengineering (10 chapters), biomedical instrumentation (4 chapters), and theranostics and other novel approaches (4 chapters). Each chapter is a stand-alone review that summarizes the state-of-the-art of the specific research area. Engineering in Translational Medicine gives readers a comprehensive and in-depth overview of a broad array of related research areas, making this an excellent reference book for scientists and students both new to engineering/translational medicine and currently working in this area.

  13. Traceability in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Zimmerman, B.E. [National Institute of Standards and Technology, Ionizing Radiation Div., Gaithersburg MD (United States); Judge, St. [National Physical Laboratory, Hampton Road, Teddington, Middlesex (United Kingdom)

    2007-08-15

    Accurate, reproducible measurement of radioactivity in nuclear medicine applications is vital to ensure the safety and effectiveness of disease diagnosis and treatment using unsealed radioactive sources. The need to maintain a high degree of confidence in those measurements requires that they be carried out so as to be traceable to national and international standards. In addition, measurement traceability for radioactivity in medicine helps ensure international consistency in measurement at all levels of practice (national measurement laboratories, research institutions, isotope producers, radiopharmaceutical manufacturers and clinics). This paper explores the importance of radioactivity measurement in nuclear medicine and demonstrates how traceability can be extended from international standards to the quantity of the drug administered to the patient. (authors)

  14. Anticipation and medicine

    CERN Document Server

    2017-01-01

    In this book, practicing physicians and experts in anticipation present arguments for a new understanding of medicine. Their contributions make it clear that medicine is the decisive test for anticipation. The reader is presented with a provocative hypothesis: If medicine will align itself with the anticipatory condition of life, it can prompt the most important revolution in our time. To this end, all stakeholders—medical practitioners, patients, scientists, and technology developers—will have to engage in the conversation. The book makes the case for the transition from expensive, and only marginally effective, reactive treatment through “spare parts” (joint replacements, organ transplants) and reliance on pharmaceuticals (antibiotics, opiates) to anticipation-informed healthcare. Readers will understand why the current premise of treating various behavioral conditions (attention deficit disorder, hyperactivity, schizophrenia) through drugs has to be re-evaluated from the perspective of anticipation...

  15. Pediatric nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  16. Traceability in nuclear medicine

    Science.gov (United States)

    Zimmerman, Brian E.; Judge, Steven

    2007-08-01

    Accurate, reproducible measurement of radioactivity in nuclear medicine applications is vital to ensure the safety and effectiveness of disease diagnosis and treatment using unsealed radioactive sources. The need to maintain a high degree of confidence in those measurements requires that they be carried out so as to be traceable to national and international standards. In addition, measurement traceability for radioactivity in medicine helps ensure international consistency in measurement at all levels of practice (national measurement laboratories, research institutions, isotope producers, radiopharmaceutical manufacturers and clinics). This paper explores the importance of radioactivity measurement in nuclear medicine and demonstrates how traceability can be extended from international standards to the quantity of the drug administered to the patient.

  17. Gender in medicine

    DEFF Research Database (Denmark)

    Hølge-Hazelton, Bibi; Malterud, Kirsti

    2009-01-01

    are regarded as normal to the extent that female values disappear or need to be blatantly highlighted in order to be recognized. We have applied this frame of reference to understand how the idea of gender neutrality has been established in medicine. The average medical practitioner, teacher, or researcher...... is a man. We suggest that notions of normality subtly construct gender in medicine in ways where men become normal, while women become deviant. Finally, we discuss strengths and pitfalls of three different strategies which have been used by gender researchers in health to challenge andronormativity......: demonstrating gender differences, revealing the consequences of gendered power inequalities, and deconstructing the meaning of gender. Conclusions: We conclude that gender still matters in medicine....

  18. Polypharmacy in Zoological Medicine

    Directory of Open Access Journals (Sweden)

    Robert P. Hunter

    2017-02-01

    Full Text Available Polypharmacy is a term that describes the inappropriate, concurrent use of multiple drugs in an individual patient. Zoological medicine practitioners must take approved agents (veterinary or human and extrapolate their use to non-approved species often with little species-specific pharmacological evidence to support their decisions. When considering polypharmacy, even less information exists concerning multi-drug pharmacokinetics, pharmacodynamics, or potential drug-drug interactions in non-domestic species. Unfortunately, captive, zoological species are susceptible, just like their domestic counterparts, to chronic diseases and co-morbidities that may lead to the usage of multiple drugs. Polypharmacy is a recognized and important issue in human medicine, as well as an emerging issue for veterinarians; thus, this paper will discuss the novel, potential risks of polypharmacy in zoological medicine. Hopefully, this discussion will help bring the attention of veterinarians to this issue and serve as an interesting discussion topic for pharmacologists in general.

  19. Cytomics in predictive medicine

    Science.gov (United States)

    Tarnok, Attila; Valet, Guenther K.

    2004-07-01

    Predictive Medicine aims at the detection of changes in patient's disease state prior to the manifestation of deterioration or improvement of the current status. Patient-specific, disease-course predictions with >95% or >99% accuracy during therapy would be highly valuable for everyday medicine. If these predictors were available, disease aggravation or progression, frequently accompanied by irreversible tissue damage or therapeutic side effects, could then potentially be avoided by early preventive therapy. The molecular analysis of heterogeneous cellular systems (Cytomics) by cytometry in conjunction with pattern-oriented bioinformatic analysis of the multiparametric cytometric and other data provides a promising approach to individualized or personalized medical treatment or disease management. Predictive medicine is best implemented by cell oriented measurements e.g. by flow or image cytometry. Cell oriented gene or protein arrays as well as bead arrays for the capture of solute molecules form serum, plasma, urine or liquor are equally of high value. Clinical applications of predictive medicine by Cytomics will include multi organ failure in sepsis or non infectious posttraumatic shock in intensive care, or the pretherapeutic identification of high risk patients in cancer cytostatic. Early individualized therapy may provide better survival chances for individual patient at concomitant cost containment. Predictive medicine guided early reduction or stop of therapy may lower or abrogate potential therapeutic side effects. Further important aspects of predictive medicine concern the preoperative identification of patients with a tendency for postoperative complications or coronary artery disease patients with an increased tendency for restenosis. As a consequence, better patient care and new forms of inductive scientific hypothesis development based on the interpretation of predictive data patterns are at reach.

  20. Benjamin Franklin and medicine.

    Science.gov (United States)

    Hirschmann, J V

    2005-12-01

    Benjamin Franklin, called Dr. Franklin after receiving an honorary degree in 1759 for his contributions to understanding electricity, was not formally trained as a physician. Nevertheless, he had numerous interests in medicine, including experimentation, shrewd observations about health and disease in himself and others, civic activities, and inventions of medical devices. These achievements show his capacity for detailed, perceptive insights; his fastidiousness in recording his observations; and his thoughtful analyses of scientific phenomena and human conduct. In medicine, perhaps uniquely in his life, his major interests intersected: scientific pursuits, civic activities, amused scrutiny of human behavior, and the desire to improve the lot of his fellow man.

  1. [Informatics, robotics and medicine].

    Science.gov (United States)

    Carpentier, A

    1999-01-01

    Information technology is becoming common use in Medicine. Among the numerous applications are data processing, image analysis, 3D reconstruction, telemedicine, to mention only few of them. The interest of computers in surgical research and development is lesser known. Two examples are given: computer aided conception and simulation of physiologic systems. Robotics has been introduced more recently. There are three types of robotics corresponding to three types of use: targetting used by neural surgeons to localize tumors or anatomical structures, visualization used by general surgeons to hold and mobilize laparoscopes, instrumentation introduced more recently by cardiac surgeons to perform totally endoscopic cardiac operations. All these techniques open new ways for tomorrow "Instrumental Medicine".

  2. Spreadsheets in Clinical Medicine

    CERN Document Server

    Croll, Grenville J

    2006-01-01

    There is overwhelming evidence that the continued and widespread use of untested spreadsheets in business gives rise to regular, significant and unexpected financial losses. Whilst this is worrying, it is perhaps a relatively minor concern compared with the risks arising from the use of poorly constructed and/or untested spreadsheets in medicine, a practice that is already occurring. This article is intended as a warning that the use of poorly constructed and/or untested spreadsheets in clinical medicine cannot be tolerated. It supports this warning by reporting on potentially serious weaknesses found while testing a limited number of publicly available clinical spreadsheets.

  3. Holistic pediatric veterinary medicine.

    Science.gov (United States)

    Pesch, Lisa

    2014-03-01

    Holistic veterinary medicine treats the whole patient including all physical and behavioral signs. The root cause of disease is treated at the same time as accompanying clinical signs. Herbal and nutritional supplements can help support tissue healing and proper organ functioning, thereby reducing the tendency of disease progression over time. Proper selection of homeopathic remedies is based on detailed evaluation of clinical signs. Herbal medicines are selected based on organ(s) affected and the physiologic nature of the imbalance. Many herbal and nutraceutical companies provide support for veterinarians, assisting with proper formula selection, dosing, drug interactions, and contraindications.

  4. Are mushrooms medicinal?

    Science.gov (United States)

    Money, Nicholas P

    2016-04-01

    Despite the longstanding use of dried mushrooms and mushroom extracts in traditional Chinese medicine, there is no scientific evidence to support the effectiveness of these preparations in the treatment of human disease. Consumers should evaluate assertions made by companies about the miraculous properties of medicinal mushrooms very critically. The potential harm caused by these natural products is another important consideration. In a more positive vein, the presence of potent toxins and neurotropic compounds in basidiomycete fruit bodies suggests that secondary metabolites with useful pharmacological properties are widespread in these fungi. Major investment in controlled experiments and objective clinical trials is necessary to develop this natural pharmacopeia.

  5. Technology And Medicine

    OpenAIRE

    C. Ashokan Nambiar

    2014-01-01

    One is stuck at the amazing strides in technology as applied to medicine these days. When I had just finished school and was about to join college my seniors said if you learn zoology it is the stepping-stone for a career in medicine. However I was fascinated with chemistry, physics and maths. Later in medical college I soon realized knowledge in chemistry and physics was worthwhile. Zoology was not relevant. Much later while training in cardiology it was that the advantage of learning mathem...

  6. Medicinal cannabis in oncology.

    Science.gov (United States)

    Engels, Frederike K; de Jong, Floris A; Mathijssen, Ron H J; Erkens, Joëlle A; Herings, Ron M; Verweij, Jaap

    2007-12-01

    In The Netherlands, since September 2003, a legal medicinal cannabis product, constituting the whole range of cannabinoids, is available for clinical research, drug development strategies, and on prescription for patients. To date, this policy, initiated by the Dutch Government, has not yet led to the desired outcome; the amount of initiated clinical research is less than expected and only a minority of patients resorts to the legal product. This review aims to discuss the background for the introduction of legal medicinal cannabis in The Netherlands, the past years of Dutch clinical experience in oncology practice, possible reasons underlying the current outcome, and future perspectives.

  7. Physics in nuclear medicine

    CERN Document Server

    Cherry, Simon R; Phelps, Michael E

    2012-01-01

    Physics in Nuclear Medicine - by Drs. Simon R. Cherry, James A. Sorenson, and Michael E. Phelps - provides current, comprehensive guidance on the physics underlying modern nuclear medicine and imaging using radioactively labeled tracers. This revised and updated fourth edition features a new full-color layout, as well as the latest information on instrumentation and technology. Stay current on crucial developments in hybrid imaging (PET/CT and SPECT/CT), and small animal imaging, and benefit from the new section on tracer kinetic modeling in neuroreceptor imaging.

  8. BHASMA AND NANO MEDICINE

    OpenAIRE

    Kulkarni, Santosh S.

    2013-01-01

    The Metals and Minerals are heavy, nonabsorbable and toxic substances. Metals are used as medicines in Ayurveda since from Samhita period in the fine powder form named as ‘Ayaskriti’1. Latter with the development of ‘Marana’ technique (7th Cent AD) the Metals and Minerals are converted in to very very fine and absorbable, therapeutically most effective and least or Nontoxic form of Medicines known as ‘Bhasma’2. According to Ayurvedic concept the change in the qualities is due to ‘Samskara’ do...

  9. [Intensive medicine in Spain].

    Science.gov (United States)

    2011-03-01

    Intensive care medicine is a medical specialty that was officially established in our country in 1978, with a 5-year training program including two years of common core training followed by three years of specific training in an intensive care unit accredited for training. During this 32-year period, intensive care medicine has carried out an intense and varied activity, which has allowed its positioning as an attractive and with future specialty in the hospital setting. This document summarizes the history of the specialty, its current situation, the key role played in the programs of organ donation and transplantation of the National Transplant Organization (after more than 20 years of mutual collaboration), its training activities with the development of the National Plan of Cardiopulmonary Resuscitation, with a trajectory of more than 25 years, its interest in providing care based on quality and safety programs for the severely ill patient. It also describes the development of reference registries due to the need for reliable data on the care process for the most prevalent diseases, such as ischemic heart disease or ICU-acquired infections, based on long-term experience (more than 15 years), which results in the availability of epidemiological information and characteristics of care that may affect the practical patient's care. Moreover, features of its scientific society (SEMICYUC) are reported, an organization that agglutinates the interests of more than 280 ICUs and more than 2700 intensivists, with reference to the journal Medicina Intensiva, the official journal of the society and the Panamerican and Iberian Federation of Critical Medicine and Intensive Care Societies. Medicina Intensiva is indexed in the Thompson Reuters products of Science Citation Index Expanded (Scisearch(®)) and Journal Citation Reports, Science Edition. The important contribution of the Spanish intensive care medicine to the scientific community is also analyzed, and in relation to

  10. Update in pulmonary medicine.

    Science.gov (United States)

    Marks, John H

    2013-04-01

    Pulmonary disorders are common and important causes of morbidity and even mortality in adolescents. Conditions that are considered in this article include asthma, cystic fibrosis, and vocal cord dysfunction. Chronic and recurrent exacerbations may occur in youth with such disorders; therefore, they must adhere to potentially many pharmacologic agents and therapeutic procedures on a regular basis for maximum medical and psychosocial outcomes. It is important that physicians use au courant evidence-based guidelines in the management of adolescents. It is also critical that physicians educate adolescents about these regimens to help them maximize management outcomes. If disease control is inadequate, referral to a pulmonary specialist can be helpful to verify the correct diagnosis(es) and ensure that the most appropriate therapies are used.

  11. Clinical Holistic Medicine: Holistic Adolescent Medicine

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2004-01-01

    Full Text Available The holistic medical approach seems to be efficient and can also be used in adolescent medicine. Supporting the teenager to grow and develop is extremely important in order to prevent many of the problems they can carry into adulthood. The simple consciousness-based, holistic medicine — giving love, winning trust, giving holding, and getting permission to help the patient feel, understand, and let go of negative beliefs — is easy for the physician interested in this kind of practice and it requires little previous training for the physician to be able to care for his/her patient. A deeper insight into the principles of holistic treatment and a thorough understanding of our fellow human beings are making it work even better. Holistic medicine is not a miracle cure, but rather a means by which the empathic physician can support the patient in improving his/her future life in respect to quality of life, health, and functional capacity — through coaching the patient to work on him/herself in a hard and disciplined manner. When the patient is young, this work is so much easier. During our lifetime, we have several emotional traumas arranged in the subconscious mind with the smallest at the top, and it is normal for the person to work on a large number of traumatic events that have been processed to varying degrees. Some traumas have been acknowledged, some are still being explored by the person, and yet others are still preconscious, which can be seen for example in the form of muscle tension. Sometimes the young dysfunctional patient carries severe traumas of a violent or sexual nature, but the physician skilled in the holistic medical toolbox can help the patient on his/her way to an excellent quality of life, full self-expression, a love and sex life, and a realization of his/her talents — all that a young patient is typically dreaming about. Biomedicine is not necessary or even recommended when the physical or mental symptoms are caused

  12. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe

    NARCIS (Netherlands)

    L.M. Hofstra (L. Marije); N. Sauvageot (Nicolas); J. Albert (Jan); I. Alexiev (Ivailo); F. Garcia (Federico); D. Struck (Daniel); D.A.M.C. van de Vijver (David); B. Asjö (Birgitta); D. Beshkov (Danail); S. Coughlan (Suzie); D. Descamps (Diane); A. Griskevicius (Algis); O. Hamouda (Osamah); A. Horban (Andrzej); M.E.E. van Kasteren (Marjo); T. Kolupajeva (Tatjana); L.G. Kostrikis (Leondios); K. Liitsola (Kirsi); M. Linka (Marek); O. Mor (Orna); C. Nielsen (Claus); D. Otelea (Dan); D. Paraskevis (Dimitrios); R. Paredes (Roger); M. Poljak (Mario); E. Puchhammer-Stockl E. (E.); A. Sonnerborg (Anders); D. Stanekova (Danica); M. Stanojevic (Maja); K. Van Laethem (Kristel); M. Zazzi (Maurizio); S. Zidovec Lepej (Snjezana); C.A.B. Boucher (Charles A. B.); J.-C. Schmit (Jean-Claude); A.M.J. Wensing (Annemarie); E. Puchhammer-Stöckl (Elisabeth); M. Sarcletti (M.); B. Schmied (B.); M. Geit (M.); G. Balluch (G.); A.-M. Vandamme; J. Vercauteren (Jurgen); I. Derdelinckx; A. Sasse; M. Bogaert; H. Ceunen (H.); A. de Roo (Annie); S. De Wit; F. Echahidi (F.); K. Fransen; J.-C. Goffard (J.); P. Goubau; E. Goudeseune (E.); J.-C. Yombi (J.); P. Lacor; C. Liesnard (C.); M. Moutschen; L.A. Pierard; R. Rens (R.); J. Schrooten; D. Vaira; L.P.R. Vandekerckhove; A. van den Heuvel (A.); B. van der Gucht (B.); M. Van Ranst; E. Van Wijngaerden; B. Vandercam; M. Vekemans; C. Verhofstede; N. Clumeck (N.); K. van Laethem (Kristel); D. Beshkov; I. Alexiev; S.Z. Lepej (Snjezana); J. Begovac; L.G. Kostrikis (Leondios); I. Demetriades (I.); I. Kousiappa (Ioanna); V.L. Demetriou (Victoria); J. Hezka (Johana); M. Linka; M. Maly; L. MacHala; C. Nielsen; L.B. Jørgensen; J. Gerstoft (J.); L. Mathiesen (L.); C. Pedersen (Court); H. Nielsen; A. Laursen (A.); B. Kvinesdal (B.); K. Liitsola (Kirsi); M. Ristola (M.); J. Suni; J. Sutinen (J.); D. Descamps; L. Assoumou; G. Castor; M. Grude; P. Flandre; A. Storto; O. Hamouda (Osamah); C. K̈ucherer (C.); T. Berg; P. Braun; G. Poggensee; M. Daumer (Martin); J. Eberle; H. Heiken; R. Kaiser; H. Knechten (H.); K. Korn; H. Müller; S. Neifer; B. Schmidt; H. Walter; B. Gunsenheimer-Bartmeyer (B.); T. Harrer (T.); D. Paraskevis (Dimitrios); A. Hatzakis (Angelos); A. Zavitsanou (A.); A. Vassilakis; M. Lazanas; L. Chini; A. Lioni; V. Sakka (V.); S. Kourkounti (S.); V. Paparizos (V.); A. Antoniadou (A.); A. Papadopoulos; G. Poulakou; I. Katsarolis; K. Protopapas; G. Chryssos (G.); S. Drimis (S.); P. Gargalianos; G. Xylomenos; G. Lourida; M. Psichogiou (M.); G.L. Daikos (G.); N.V. Sipsas; A. Kontos (Angelos); M.N. Gamaletsou; G. Koratzanis (G.); H. Sambatakou; H. Mariolis; A. Skoutelis; V. Papastamopoulos; O. Georgiou; P. Panagopoulos (P.); E. Maltezos; S. Coughlan (Suzie); C. de Gascun (Cillian); C. Byrne; M. Duffy; P. Bergin; D. Reidy; G. Farrell; J. Lambert; E. O'Connor; A. Rochford; J. Low; P. Coakely (P.); S. O'Dea; W. Hall; O. Mor; I. Levi (I.); D. Chemtob (D.); Z. Grossman (Zehava); M. Zazzi; A. de Luca (Andrea); C. Balotta (Claudia); C. Riva (Chiara); C. Mussini (C.); I. Caramma (I.); A. Capetti (A.); M. Colombo (Massimo); C. Rossi; F. Prati (Francesco); F. Tramuto; F. Vitale (F.); M. Ciccozzi; G. Angarano (Guiseppe); G. Rezza (G.); T. Kolupajeva; O. Vasins; A. Griskevicius (Algis); V. Lipnickiene; J.C. Schmit; D. Struck (Daniel); N. Sauvageot; R. Hemmer (R.); V. Arendt (V.); C. Michaux; T. Staub (T.); C. Sequin-Devaux; A.M.J. Wensing (Annemarie); C.A. Boucher (Charles); D.A.M.C. van de Vijver (David); A. Van Kessel; P.H.M. Van Bentum; K. Brinkman; B.J. Connell; M.E. van der Ende (Marchina); I.M. Hoepelman (Ilja Mohandas); M.E.E. van Kasteren (Marjo); M. Kuipers; N. Langebeek (Nienke); C. Richter; R.M.W.J. Santegoets (R. M W J); L. Schrijnders-Gudde (L.); R. Schuurman (Rob); B.J.M. van de Ven (B. J M); B. Åsjö (Birgitta); A.-M.B. Kran (A.-M. Bakken); V. Ormaasen (Vidar); P. Aavitsland (P.); A. Horban (Andrzej); J. Stanczak (J.); G.P. Stanczak (G.); E. Firlag-Burkacka (E.); A. Wiercinska-Drapalo; E. Jablonowska (E.); E. Maolepsza; M. Leszczyszyn-Pynka (M.); W. Szata (W.); R.J. Camacho (Ricardo Jorge); A. de Palma (Andre); F. Borges (F.); T. Paixão; V. Duque (V.); F. Araújo; D. Otelea; C. Paraschiv (Corina); A.M. Tudor; R. Cernat; C. Chiriac; F. Dumitrescu; L.J. Prisecariu; M. Stanojevic (Maja); D.J. Jevtovic (D.); D. Salemovic (D.); D. Stanekova; M. Habekova (M.); Z. Chabadová; T. Drobkova; P. Bukovinova; A. Shunnar; P. Truska; M. Poljak (Mario); M.M. Lunar (Maja M.); D. Babic; J. Tomazic (J.); S. Vidmar (Suzanna); T. Vovko; P. Karner (P.); F. Garcia; R. Paredes (Roger); S. Monge; S. Moreno; J. Del Amo; V. Asensi; J.L. Sirvent; C. de Mendoza (Carmen); R. Delgado; F. Gutiérrez; J. Berenguer; S. Garcia-Bujalance; N. Stella; I. De Los Santos; J.R. Blanco; D. Dalmau; M. Rivero; F. Segura; M.J.P. Elías (M. J. Pcrossed); M. Alvarez; N. Chueca; C. Rodríguez-Martín; C. Vidal; J.C. Palomares; I. Viciana; P. Viciana; J. Cordoba; A. Aguilera; P. Domingo; M.J. Galindo; C. Miralles; M.A. Del Pozo; E. Ribera; C. Iribarren (Carlos); L. Ruiz; J. De La Torre; F. Vidal; B. Clotet (Bonaventura); J. Albert; A. Heidarian; K. Aperia-Peipke (K.); M. Axelsson; M. Mild; A. Karlsson; A. Sonnerborg (Anders); A. Thalme; L. Navénr; G. Bratt (G.); A. Karlsson; A. Blaxhult; M. Gisslénn; B. Svennerholm; I.-M. Bergbrant (I.); P. Bj̈orkman (P.); C. Säll; A. Mellgren; A. Lindholm; N. Kuylenstierna; R. Montelius; F. Azimi; B. Johansson; M. Carlsson; E. Johansson; B. Ljungberg; H. Ekvall; A. Strand; S. Mäkitalo; S. Öberg; P. Holmblad; M. Höfer; H. Holmberg; P. Josefson; U. Ryding

    2016-01-01

    textabstractBackground. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, the

  13. Intensified regimen containing rifampicin and moxifloxacin for tuberculous meningitis: an open-label, randomised controlled phase 2 trial.

    NARCIS (Netherlands)

    Ruslami, R.; Ganiem, A.R.; Dian, S.; Apriani, L.; Achmad, T.H.; Ven, A.J.A.M. van der; Borm, G.F.; Aarnoutse, R.E.; Crevel, R. van

    2013-01-01

    BACKGROUND: Intensified antibiotic treatment might improve the outcome of tuberculous meningitis. We assessed pharmacokinetics, safety, and survival benefit of several treatment regimens containing high-dose rifampicin and moxifloxacin in patients with tuberculous meningitis in a hospital setting. M

  14. A randomized, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization.

    Science.gov (United States)

    Dryden, M S; Dailly, S; Crouch, M

    2004-04-01

    Two topical MRSA eradication regimes were compared in hospital patients: a standard treatment included mupirocin 2% nasal ointment, chlorhexidine gluconate 4% soap, silver sulfadiazine 1% cream versus a tea tree oil regimen, which included tea tree 10% cream, tea tree 5% body wash, both given for five days. One hundred and fourteen patients received standard treatment and 56 (49%) were cleared of MRSA carriage. One hundred and ten received tea tree oil regimen and 46 (41%) were cleared. There was no significant difference between treatment regimens (Fisher's exact test; P = 0.0286). Mupirocin was significantly more effective at clearing nasal carriage (78%) than tea tree cream (47%; P = 0.0001) but tea tree treatment was more effective than chlorhexidine or silver sulfadiazine at clearing superficial skin sites and skin lesions. The tea tree preparations were effective, safe and well tolerated and could be considered in regimens for eradication of MRSA carriage.

  15. Transmission of HIV drug resistance and the predicted effect on current first-line regimens in Europe

    NARCIS (Netherlands)

    Hofstra, L. Marije; Sauvageot, Nicolas; Albert, Jan; Alexiev, Ivailo; Garcia, Federico; Struck, Daniel; Van De Vijver, David A M C; Åsjö, Birgitta; Beshkov, Danail; Coughlan, Suzie; Descamps, Diane; Griskevicius, Algirdas; Hamouda, Osamah; Horban, Andrzej; Van Kasteren, Marjo; Kolupajeva, Tatjana; Kostrikis, Leontios G.; Liitsola, Kirsi; Linka, Marek; Mor, Orna; Nielsen, Claus; Otelea, Dan; Paraskevis, Dimitrios; Paredes, Roger; Poljak, Mario; Puchhammer-Stöckl, Elisabeth; Sönnerborg, Anders; Staneková, Danica; Stanojevic, Maja; Van Laethem, Kristel; Zazzi, Maurizio; Lepej, Snjezana Zidovec; Boucher, Charles A B; Schmit, Jean Claude; Wensing, Annemarie M J; Puchhammer-Stockl, E.; Sarcletti, M.; Schmied, B.; Geit, M.; Balluch, G.; Vandamme, A. M.; Vercauteren, J.; Derdelinckx, I.; Sasse, A.; Bogaert, M.; Ceunen, H.; De Roo, A.; De Wit, S.; Echahidi, F.; Fransen, K.; Goffard, J. C.; Goubau, P.; Goudeseune, E.; Yombi, J. C.; Lacor, P.; Liesnard, C.; Moutschen, M.; Pierard, D.; Rens, R.; Schrooten, Y.; Vaira, D.; Vandekerckhove, L. P R; Van Den Heuvel, A.; Van Der Gucht, B.; Van Ranst, M.; Van Wijngaerden, E.; Vandercam, B.; Vekemans, M.; Verhofstede, C.; Clumeck, N.; Van Laethem, K.; Beshkov, D.; Alexiev, I.; Lepej, S. Zidovec; Begovac, J.; Kostrikis, Leontios G.; Demetriades, I.; Kousiappa, I.; Demetriou, V.; Hezka, J.; Linka, M.; Maly, M.; Machala, L.; Nielsen, C.; Jørgensen, L. B.; Gerstoft, J.; Mathiesen, L.; Pedersen, C.; Nielsen, H.; Laursen, A.; Kvinesdal, B.; Liitsola, K.; Ristola, M.; Suni, J.; Sutinen, J.; Descamps, D.; Assoumou, L.; Castor, G.; Grude, M.; Flandre, P.; Storto, A.; Hamouda, O.; Kücherer, C.; Berg, T.; Braun, P.; Poggensee, G.; Däumer, M.; Eberle, J.; Heiken, H.; Kaiser, R.; Knechten, H.; Korn, K.; Müller, H.; Neifer, S.; Schmidt, B.; Walter, H.; Gunsenheimer-Bartmeyer, B.; Harrer, T.; Paraskevis, D.; Hatzakis, A.; Zavitsanou, A.; Vassilakis, A.; Lazanas, M.; Chini, M.; Lioni, A.; Sakka, V.; Kourkounti, S.; Paparizos, V.; Antoniadou, A.; Papadopoulos, A.; Poulakou, G.; Katsarolis, I.; Protopapas, K.; Chryssos, G.; Drimis, S.; Gargalianos, P.; Xylomenos, G.; Lourida, G.; Psichogiou, M.; Daikos, G. L.; Sipsas, N. V.; Kontos, A.; Gamaletsou, M. N.; Koratzanis, G.; Sambatakou, E.; Mariolis, H.; Skoutelis, A.; Papastamopoulos, V.; Georgiou, O.; Panagopoulos, P.; Maltezos, E.; Coughlan, S.; De Gascun, C.; Byrne, C.; Duffy, M.; Bergin, C.; Reidy, D.; Farrell, G.; Lambert, J.; O'Connor, E.; Rochford, A.; Low, J.; Coakely, P.; O'Dea, S.; Hall, W.; Mor, O.; Levi, I.; Chemtob, D.; Grossman, Z.; Zazzi, M.; De Luca, A.; Balotta, C.; Riva, C.; Mussini, C.; Caramma, I.; Capetti, A.; Colombo, M. C.; Rossi, C.; Prati, F.; Tramuto, F.; Vitale, F.; Ciccozzi, M.; Angarano, G.; Rezza, G.; Kolupajeva, T.; Kolupajeva, T.; Vasins, O.; Griskevicius, A.; Lipnickiene, V.; Schmit, J. C.; Struck, D.; Sauvageot, N.; Hemmer, R.; Arendt, V.; Michaux, C.; Staub, T.; Sequin-Devaux, C.; Wensing, A. M J; Boucher, C. A B; Van Kessel, A.; Van Bentum, P. H M; Brinkman, K.; Connell, B. J.; Van Der Ende, M. E.; Hoepelman, I. M.; Van Kasteren, M.; Kuipers, M.; Langebeek, N.; Richter, C.; Santegoets, R. M W J; Schrijnders-Gudde, L.; Schuurman, R.; Van De Ven, B. J M; Åsjö, B.; Kran, A. M Bakken; Ormaasen, V.; Aavitsland, P.; Horban, A.; Stanczak, J. J.; Stanczak, G. P.; Firlag-Burkacka, E.; Wiercinska-Drapalo, A.; Jablonowska, E.; Maolepsza, E.; Leszczyszyn-Pynka, M.; Szata, W.; Camacho, R.; Palma, C.; Borges, F.; Paixão, T.; Duque, V.; Araújo, F.; Otelea, D.; Paraschiv, S.; Tudor, A. M.; Cernat, R.; Chiriac, C.; Dumitrescu, F.; Prisecariu, L. J.; Stanojevic, M.; Jevtovic, Dj; Salemovic, D.; Stanekova, D.; Habekova, M.; Chabadová, Z.; Drobkova, T.; Bukovinova, P.; Shunnar, A.; Truska, P.; Poljak, M.; Lunar, M.; Babic, D.; Tomazic, J.; Vidmar, L.; Vovko, T.; Karner, P.; Garcia, F.; Paredes, R.; Monge, S.; Moreno, S.; Del Amo, J.; Asensi, V.; Sirvent, J. L.; De Mendoza, C.; Delgado, R.; Gutiérrez, F.; Berenguer, J.; Garcia-Bujalance, S.; Stella, N.; De Los Santos, I.; Blanco, J. R.; Dalmau, D.; Rivero, M.; Segura, F.; Elías, M. J Pérez; Alvarez, M.; Chueca, N.; Rodríguez-Martín, C.; Vidal, C.; Palomares, J. C.; Viciana, I.; Viciana, P.; Cordoba, J.; Aguilera, A.; Domingo, P.; Galindo, M. J.; Miralles, C.; Del Pozo, M. A.; Ribera, E.; Iribarren, J. A.; Ruiz, L.; De La Torre, J.; Vidal, F.; Clotet, B.; Albert, J.; Heidarian, A.; Aperia-Peipke, K.; Axelsson, M.; Mild, M.; Karlsson, A.; Sönnerborg, A.; Thalme, A.; Navér, L.; Bratt, G.; Karlsson, A.; Blaxhult, A.; Gisslén, M.; Svennerholm, B.; Bergbrant, I.; Björkman, P.; Säll, C.; Lindholm, A.; Kuylenstierna, N.; Montelius, R.; Azimi, F.; Johansson, B.; Carlsson, M.; Johansson, E.; Ljungberg, B.; Ekvall, H.; Strand, A.; Mäkitalo, S.; Öberg, S.; Holmblad, P.; Höfer, M.; Holmberg, H.; Josefson, P.; Ryding, U.

    2016-01-01

    Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline

  16. Radiotherapy. Non-standard feactionated regimens improving cancer treatment. Part II. Response of normal tissues to fractioned irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Villar, A.; Hernandez, M.; Pera, J.; Cambray, M.; Villa, S.; Arnaiz, M.D.

    1988-01-01

    The phenomena participating in the response of tissues to fractionated irradiation are analized with special emphasis on the most relevant points influencing the design of non-standard fractionated regimens.

  17. Sports Medicine: What is a Sports Medicine Specialist?

    Science.gov (United States)

    ... both the treatment and prevention of illness and injury. The Sports Medicine Specialist helps patients maximize function and minimize ... of these conditions. However, approximately 90% of all sports injuries are non-surgical. The Sports Medicine Specialist can ...

  18. Nanobiotechnology and personalized medicine.

    Science.gov (United States)

    Jain, K K

    2011-01-01

    This chapter will start with a definition and scope of personalized medicine and describe how various nanobiotechnologies will contribute to its development. Nanodiagnostics and its combination with therapeutics as well as nanoparticle-based drug delivery will play an important role. The most important applications of nanobiotechnology will be personalized management of cancer, neurological disorders, and cardiovascular diseases.

  19. The future of medicine.

    Science.gov (United States)

    Ray, Russ

    2012-03-01

    The recent innovation of prediction markets is examined, and their significant applications to the science of medicine are demonstrated. According to one comprehensive study, these markets make "uncannily accurate" predictions of every type of event. In the medical field, being able to predict cures, epidemics, medical discoveries, and myriad other medical variables can greatly further the advances of medical science and its clinical applications.

  20. Rational use of medicines.

    NARCIS (Netherlands)

    Holloway, K.; Dijk, L. van

    2011-01-01

    1. Irrational use of medicines is an extremely serious global problem that is wasteful and harmful. In developing and transitional countries, in primary care less than 40% of patients in the public sector and 30% of patients in the private sector are treated in accordance with standard treatment gui

  1. Rational use of medicines.

    NARCIS (Netherlands)

    Holloway, K.; Dijk, L. van

    2011-01-01

    1. Irrational use of medicines is an extremely serious global problem that is wasteful and harmful. In developing and transitional countries, in primary care less than 40% of patients in the public sector and 30% of patients in the private sector are treated in accordance with standard treatment

  2. [Phronesis: Medicine's indispensable virtue].

    Science.gov (United States)

    Moreno Villares, José Manuel

    2014-01-01

    Facing those who defend that Medicine is not but an applied science, Pellegrino argues that the ultimate goal of Medicine is facing to a human being in his illness condition. Thus, it is not sufficient to have scientific knowledge but proximity to man kindness. Cure is not the only goal -achievable in only a few cases- but healing, caring with a person as an ill person and as a person. For this reason, professional competence is not enough; the physician needs to have the necessary dispositions to be a good person, a good professional. To get the goals of Medicine, the physician has to achieve those qualities who allow him to do the good he is intended to, that is, he needs to be virtuous. Prudence -phronesis- is the virtue that allows him to apply a general rule to a particular case and, furthermore, addresses his actions to be not only technically correct, but excellent. Prudence is, then, the link between intellectual virtues and moral virtues. Pellegrino's main objective has been to elaborate a Philosophy of Medicine, different from the Philosophy of Science, useful for clinical practice and used by clinical practitioners. By nurturing prudence, a small bit of the final goal is reached: the healing, the goodness for the sick. This should be possible if we are embedded in a moral community, and for Pellegrino, sharing knowledge and ethical values is the way of being part of a moral community.

  3. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... like? Special camera or imaging devices used in nuclear medicine include the gamma camera and single-photon emission-computed tomography (SPECT). The gamma camera, also called a scintillation camera, detects radioactive energy that is emitted from the patient's body and ...

  4. History of Disaster Medicine.

    Science.gov (United States)

    Suner, Selim

    2015-10-01

    Erik Noji, mentioned, tongue in cheek, Noah as the first disaster manager during a lecture in 2005. The canonical description of "The Genesis Flood" does describe Noah as a master planner and executer of an evacuation of biblical proportions. After gaining knowledge of a potential catastrophic disaster he planned and executed an evacuation to mitigate the effects of the "Genesis Flood" by building the Ark and organizing a mass exodus. He had to plan for food, water, shelter, medical care, waste disposal and other needs of all the evacuees. Throughout history, management of large disasters was conducted by the military. Indeed, the military still plays a large role in disaster response in many countries, particularly if the response is overseas and prolonged. The histories of emergency preparedness, disaster management and disaster medicine have coevolved and are inextricably intertwined. While disaster management in one form or another existed as long as people started living together in communities, the development of disaster medicine took off with the emergence of modern medicine. Similar to disaster management, disaster medicine also has roots in military organizations.

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... diagnoses. In addition, manufacturers are now making single photon emission computed tomography/computed tomography (SPECT/CT) and ... nuclear medicine include the gamma camera and single-photon emission-computed tomography (SPECT). The gamma camera, also ...

  6. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help diagnose childhood disorders ...

  7. Swarm-based medicine.

    Science.gov (United States)

    Putora, Paul Martin; Oldenburg, Jan

    2013-09-19

    Occasionally, medical decisions have to be taken in the absence of evidence-based guidelines. Other sources can be drawn upon to fill in the gaps, including experience and intuition. Authorities or experts, with their knowledge and experience, may provide further input--known as "eminence-based medicine". Due to the Internet and digital media, interactions among physicians now take place at a higher rate than ever before. With the rising number of interconnected individuals and their communication capabilities, the medical community is obtaining the properties of a swarm. The way individual physicians act depends on other physicians; medical societies act based on their members. Swarm behavior might facilitate the generation and distribution of knowledge as an unconscious process. As such, "swarm-based medicine" may add a further source of information to the classical approaches of evidence- and eminence-based medicine. How to integrate swarm-based medicine into practice is left to the individual physician, but even this decision will be influenced by the swarm.

  8. Chinese Medicine Men

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Yan Xijun (闫希军) may have studied both busi- ness and medicine, but the founder of Tasly Group(天士力集团), one of China's leading pharmaceutical firms,attributes most of his success to his military background.

  9. Plants and Medicinal Chemistry

    Science.gov (United States)

    Bailey, D.

    1977-01-01

    This is the first of two articles showing how plants that have been used in folk medicine for many centuries are guiding scientists in the design and preparation of new and potent drugs. Opium and its chemical derivatives are examined at length in this article. (Author/MA)

  10. 50 Years: Veterinary Medicine.

    Science.gov (United States)

    Narlesky, Lynn

    1998-01-01

    Describes the history, research, teaching strategies, and specialties of the University of California at Davis School of Veterinary Medicine. Documents effects of changing societal attitudes toward wildlife, pets, working animals, and food animals on curriculum, the systems approach to disease, comparative genetics, biotechnology, the ecology of…

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Most nuclear medicine exams will involve an injection in a vein in your child’s arm or hand. Your child should ... body, they offer the potential to identify disease in its earliest stages as well as a patient’s ...

  12. Asthma Medicines: Quick Relief

    Science.gov (United States)

    ... 18-21yrs. Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & ... Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted ... Children > Health Issues > Conditions > Allergies & Asthma > Asthma Medicines: Quick ...

  13. Preventive medicine in 2030.

    Science.gov (United States)

    Freudenberg, Nicholas

    2012-12-01

    This invited commentary imagines two futures for preventive medicine and public health in the Year 2030. Using satire, the commentary describes one future in which large corporations control public health and another where a robust public sector plays the leading role.

  14. Complementary and Alternative Medicine

    Science.gov (United States)

    ... using or might want to try. As with modern medicine, CAM treatments that are effective for one problem ... All rights reserved. Images provided by The Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart.com

  15. Technology and medicine.

    Science.gov (United States)

    Booth, C

    1985-05-22

    Technology, which is older than science, has been of vital importance in the development of modern medicine. Even so, there are voices of dissent to be heard. The disenchantment with technology expressed by Aldous Huxley in Brave new world has been echoed by contemporary writers on the technology of modern medicine. Medicine is seen by some to have been dehumanized by technology, and techniques that are expensive are thought to be consuming a greater proportion of health resources than they deserve. The practice of medicine has, nevertheless, been transformed by modern technology and diagnostic techniques and therapeutic measures undreamed of a few short decades ago are now commonplace. There is no reason why these developments should be any more dehumanizing than the use of similar techniques in modern transportation or communication, nor is their expense out of proportion when compared with other demands on the nation's purse. British workers have been at the forefront of many recent advances. Yet, even though the National Health Service provides a ready market for the products of British medical technology, the nation depends to an inordinate degree on imported products. In the development of appropriate medical technology there is an urgent need for better communication between inventors, scientists, industrialists and the National Health Service. At the same time there is an equal need for improved evaluation of untried techniques. The pressure for a central integrating body to coordinate resources could well be supported by the establishment of evaluation units in the different health authorities in this country.

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... pictures and provides molecular information. In many centers, nuclear medicine images can be superimposed with computed tomography (CT) or magnetic resonance imaging (MRI) to produce special views, a practice known as image fusion or co-registration. These views allow the information ...

  17. Tablet Use within Medicine

    Science.gov (United States)

    Hogue, Rebecca J.

    2013-01-01

    This paper discusses the scholarly literature related to tablet computer use in medicine. Forty-four research-based articles were examined for emerging categories and themes. The most studied uses for tablet computers include: patients using tablets to complete diagnostic survey instruments, medical professionals using tablet computers to view…

  18. Cannabis; extracting the medicine

    NARCIS (Netherlands)

    Hazekamp, Arno

    2007-01-01

    The cannabis plant (Cannabis sativa L.) has a long history as a recreational drug, but also as part of traditional medicine in many cultures. Nowadays, it is used by a large number of patients worldwide, to ameliorate the symptoms of diseases varying from cancer and AIDS to multiple sclerosis and mi

  19. The medicine from behind

    NARCIS (Netherlands)

    Andel, Van Tinde; Onselen, Van Sabine; Myren, Britt; Towns, Alexandra; Quiroz, Diana

    2015-01-01

    Ethnopharmacological relevance Purgative enemas form an integral part of African traditional medicine. Besides possible benefits, serious health risks of rectal herbal therapy have been described in literature. To design appropriate health education programs, it is essential to understand traditi

  20. Diabetes Medicines - Multiple Languages

    Science.gov (United States)

    ... V W XYZ List of All Topics All Diabetes Medicines - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) Chinese, Simplified (Mandarin dialect) (简体中文) Chinese, Traditional (Cantonese dialect) ( ...

  1. Antioxidants: real medicines?

    African Journals Online (AJOL)

    Repro

    that the antioxidants should have a salu- tary role to play in ... medicines? Antioxidants are widely recommended despite ... our dietary intake of an abundant supply of ... Table I. Examples of clinical disorders evoked by oxidative ... ly recognised, what is much less well known ..... and low in salt and saturated and trans-fatty ...

  2. Bioprinting in Regenerative Medicine

    Directory of Open Access Journals (Sweden)

    Manuela Monti

    2016-02-01

    Full Text Available Prof. Turksen is a very well known scientist in the stem cell biology field and he is also internationally known for his fundamental studies on claudin-6. In addition to his research activity he is editor for the Stem Cell Biology and Regenerative Medicine series (Humana Press and editor-in-chief of Stem Cell Reviews and Reports.....

  3. Dendrimers in Medicine

    DEFF Research Database (Denmark)

    Wu, Linping; Ficker, Mario; Christensen, Jørn Bolstad

    2015-01-01

    Dendrimers are three-dimensional macromolecular structures originating from a central core molecule and surrounded by successive addition of branching layers (generation). These structures exhibit a high degree of molecular uniformity, narrow molecular weight distribution, tunable size and shape ...... as challenging issues surrounding the future development of dendrimer-based medicines....

  4. Cytomics in regenerative medicine

    Science.gov (United States)

    Tárnok, Attila; Pierzchalski, Arkadiusz

    2008-02-01

    Cytomics is the high-content analysis of cell-systems [6, 78]. The area of Cytomics and Systems Biology received great attention during the last years as it harbours the promise to substantially impact on various fields of biomedicine, drug discovery, predictive medicine [6] and may have major potential for regenerative medicine. In regenerative medicine Cytomics includes process control of cell preparation and culturing using non-invasive detection techniques, quality control and standardization for GMP and GLP conformity and even prediction of cell fate based on sophisticated data analysis. Cytomics requires quantitative and stoichiometric single cell analysis. In some areas the leading cytometric techniques represent the cutting edge today. Many different applications/variations of multicolour staining were developed for flow- or slide-based cytometry (SBC) analysis of suspensions and sections to whole animal analysis [78]. SBC has become an important analytical technology in drug discovery, diagnosis and research and is an emerging technology for systems analysis [78]. It enables high-content high-throughput measurement of cell suspensions, cell cultures and tissues. In the last years various commercial SBC instruments were launched principally enabling to perform similar tasks. Standardisation as well as comparability of different instruments is a major challenge. Hyperspectral optical imaging may be implemented in SBC analysis for label free cell detection based on cellular autofluorescence [3]. All of these developments push the systemic approach of the analysis of biological specimens to enhance the outcome of regenerative medicine.

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... The special camera and imaging techniques used in nuclear medicine include the gamma camera and single-photon emission-computed tomography (SPECT). The gamma camera, also called a scintillation camera, detects radioactive energy that is emitted from the patient's body and ...

  6. Efficacy and safety of the HAA regimen as induction chemotherapy in 236 de novo acute myeloid leukemia

    Institute of Scientific and Technical Information of China (English)

    叶佩佩

    2013-01-01

    Objective To evaluate the efficacy and safety of the HAA regimen (homoharringtonine,cytarabine and aclarubicin) as induction chemotherapy in de novo acute myeloid leukemia (AML) .Methods The efficacy and safety of 236 de novo AML patients who received the HAA regimen as induction chemotherapy were retrospectively analyzed.The complete remission (CR) rate was assayed.Kaplan-Meier method was used to estimate overall survival (OS) and relapse free survival (RFS) ,and the differ-

  7. Impact of the components of Mediterranean nutrition regimen on long-term prognosis of diabetic patients with coronary artery disease

    OpenAIRE

    Mosharraf, Soheila; Sharifzadeh, Gholamreza; Darvishzadeh-Boroujeni, Pariya; Rouhi-Boroujeni, Hojjat

    2013-01-01

    BACKGROUND The impact of different nutritional regimens on long-term prognosis and outcome in diabetic patients with coronary artery disease (CAD) has been questioned. Therefore, the objective of the present study was to determine the effects of different nutritional components of Mediterranean regimen on long-term cardiovascular events in diabetic patients with CAD in the Iranian population. METHODS In a prospective cohort study, we recruited 233 consecutive patients with the diagnosis of ty...

  8. Twice-Daily versus Once-Daily Pramipexole Extended Release Dosage Regimens in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Ji Young Yun

    2017-01-01

    Full Text Available This open-label study aimed to compare once-daily and twice-daily pramipexole extended release (PER treatment in Parkinson’s disease (PD. PD patients on dopamine agonist therapy, but with unsatisfactory control, were enrolled. Existing agonist doses were switched into equivalent PER doses. Subjects were consecutively enrolled into either once-daily-first or twice-daily-first groups and received the prescribed amount in one or two, respectively, daily doses for 8 weeks. For the second period, subjects switched regimens in a crossover manner. The forty-four patients completed a questionnaire requesting preference during their last visit. We measured the UPDRS-III, Hoehn and Yahr stages (H&Y in medication-on state, Parkinson’s disease sleep scale (PDSS, and Epworth Sleepiness Scale. Eighteen patients preferred a twice-daily regimen, 12 preferred a once-daily regimen, and 14 had no preference. After the trial, 14 subjects wanted to be on a once-daily regimen, 25 chose a twice-daily regimen, and 5 wanted to maintain the prestudy regimen. Main reasons for choosing the twice-daily regimen were decreased off-duration, more tolerable off-symptoms, and psychological stability. The mean UPDRS-III, H&Y, and PDSS were not different. Daytime sleepiness was significantly high in the once-daily regimen, whereas nocturnal hallucinations were more common in the twice-daily. Multiple dosing should be considered if once-daily dosing is unsatisfactory. This study is registered as NCT01515774 at ClinicalTrials.gov.

  9. safe induction of labour with low-dose misoprostol, but less effective than the conventional dinoprostone regimen

    DEFF Research Database (Denmark)

    Petersen, Jesper Friis; Bergholt, Thomas; Løkkegaard, Ellen Christine L

    2013-01-01

    Off-label use of the prostaglandin-E1 analogue misoprostol has become standard practice when inducing labour. In Denmark, a low-dosage misoprostol regimen is common. The regimen consists of one 25 µg application on the first day of induction. The registered prostaglandin-E2 analogue dinoprostone...... is used in 3 and 6 mg doses. This study compared induction procedures with dinoprostone and misoprostol in terms of induction time, foetal outcome and maternal outcome....

  10. HERBAL MEDICINE AMONG COMPLEMENTARY AND ALTERNATIVE MEDICINE METHODS

    OpenAIRE

    A. Ruban; Rodioniva, T.

    2012-01-01

    Alternative medicine methods may incorporate or base themselves on traditional medicine [1], folk knowledge [2], spiritual beliefs, or newly conceived approaches to healing. The major complementary and alternative medicine systems have many common characteristics, treating the whole person, including a focus on individualizing treatments, promoting self-care and self-healing, and recognizing the spiritual nature of each individual. Complementary and alternative medicine often lacks or has onl...

  11. Cycloplegic Refraction in Hyperopic Children: Effectiveness of a 0.5% Tropicamide and 0.5% Phenylephrine Addition to 1% Cyclopentolate Regimen.

    Science.gov (United States)

    Yoo, Seul Gi; Cho, Myung Jin; Kim, Ungsoo Samuel; Baek, Seung Hee

    2017-06-01

    To evaluate the effectiveness of a cycloplegic regimen using 0.5% tropicamide and 0.5% phenylephrine (Tropherine, Hanmi Pharm), in addition to 1% cyclopentolate, in hyperopic children. The medical records of hyperopic patients below the age of 14 years who had undergone cycloplegic retinoscopy were retrospectively reviewed. Cycloplegic refractions were performed using one of two cycloplegic regimens. Regimen 1 was a Tropherine-added regimen comprising the administration of one drop of 1% cyclopentolate followed by two to three drops of Tropherine added at 15-minute intervals. Regimen 2 was a cyclopentolate-only regimen comprising the administration of three to four drops of 1% cyclopentolate at 15-minute intervals. The mean difference between noncycloplegic and cycloplegic refraction was compared between the two regimens. A total of 308 eyes of 308 hyperopic children were included. The mean difference (±standard deviation) in the spherical equivalent (SE) between cycloplegic and noncycloplegic refraction was significantly larger in regimen 2 than in regimen 1, with values of +1.70 ± 1.03 diopters (D) and +1.25 ± 0.89 D, respectively (p=0.001). The SE change after cycloplegia was significantly different between the two regimens only in patients aged 5 years or younger (p=0.001), particularly in those with high hyperopia with an SE ≥5 D (p=0.005) or fully accommodative esotropia (p=0.009). There was no significant difference between the two regimens in patients older than 5 years, regardless of the presence of high hyperopia or fully accommodative esotropia. The Tropherine-added regimen exerted a weaker cycloplegic effect than the cyclopentolate-only regimen, particularly in children under the age of 5 years with high hyperopia or fully accommodative esotropia. However, the difference in refraction between the two regimens was small. A Tropherine-added regimen can be effective in hyperopic children, with less associated discomfort than the instillation of

  12. Immunogenicity of the 9-Valent HPV Vaccine Using 2-Dose Regimens in Girls and Boys vs a 3-Dose Regimen in Women.

    Science.gov (United States)

    Iversen, Ole-Erik; Miranda, Maria Jose; Ulied, Angels; Soerdal, Terje; Lazarus, Erica; Chokephaibulkit, Kulkanya; Block, Stan L; Skrivanek, Ales; Nur Azurah, Abdul Ghani; Fong, Siew Moy; Dvorak, Vladimir; Kim, Kyung-Hyo; Cestero, Ramon M; Berkovitch, Matitiahu; Ceyhan, Mehmet; Ellison, Misoo C; Ritter, Michael A; Yuan, Shuai S; DiNubile, Mark J; Saah, Alfred J; Luxembourg, Alain

    2016-12-13

    Human papillomavirus (HPV) infections cause anogenital cancers and warts. The 9-valent HPV vaccine provides protection against 7 high-risk types of HPV responsible for 90% of cervical cancers and 2 other HPV types accounting for 90% of genital warts. To determine whether HPV type-specific antibody responses would be noninferior among girls and boys aged 9 to 14 years after receiving 2 doses of the 9-valent HPV vaccine compared with adolescent girls and young women aged 16 to 26 years receiving 3 doses. Open-label, noninferiority, immunogenicity trial conducted at 52 ambulatory care sites in 15 countries. The study was initiated on December 16, 2013, with the last participant visit for this report on June 19, 2015. Five cohorts were enrolled: (1) girls aged 9 to 14 years to receive 2 doses 6 months apart (n = 301); (2) boys aged 9 to 14 years to receive 2 doses 6 months apart (n = 301); (3) girls and boys aged 9 to 14 years to receive 2 doses 12 months apart (n = 301); (4) girls aged 9 to 14 years to receive 3 doses over 6 months (n = 301); and (5) a control group of adolescent girls and young women aged 16 to 26 years to receive 3 doses over 6 months (n = 314). Two doses of the 9-valent HPV vaccine administered 6 or 12 months apart or 3 doses administered over 6 months. The primary end point was prespecified as the antibody response against each HPV type assessed 1 month after the last dose using a competitive immunoassay. Each of the three 2-dose regimens was compared with the standard 3-dose schedule in adolescent girls and young women using a noninferiority margin of 0.67 for the ratio of the antibody geometric mean titers. Of the 1518 participants (753 girls [mean age, 11.4 years]; 451 boys [mean age, 11.5 years]; and 314 adolescent girls and young women [mean age, 21.0 years]), 1474 completed the study and data from 1377 were analyzed. At 4 weeks after the last dose, HPV antibody responses in girls and boys given 2 doses were noninferior to

  13. Successful engraftment of mismatched unrelated cord blood transplantation following reduced intensity preparative regimen using fludarabine and busulfan.

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    Komatsu, Tsunehiko; Narimatsu, Hiroto; Yoshimi, Ai; Kurita, Naoki; Kusakabe, Manabu; Hori, Akiko; Murashige, Naoko; Matsumura, Tomoko; Kobayashi, Kazuhiko; Yuji, Koichiro; Tanaka, Yuji; Kami, Masahiro

    2007-01-01

    We conducted a pilot study to evaluate the feasibility of reduced-intensity cord blood transplantation (RI-CBT) using a non-total body irradiation (TBI) regimen in adult patients with advanced hematologic malignancies. Seventeen patients with a median age of 58 years (range, 38-74) underwent RI-CBT at Tsukuba Memorial Hospital between April 2004 and November 2005. Preparative regimens were fludarabine 30 mg/m(2) for 6 days, and busulfan 4 mg/kg for 2 days. Tacrolimus was used for prophylaxis of graft-vs-host disease (GVHD). Median numbers of infused total nucleated were 2.6 x 10(7)/kg (range, 2.0-3.3). HLA disparity was found in 2/6 antigens (n=16) and 1/6 antigens (n=1). Underlying diseases progressed despite preparative regimens in four patients. Of the remaining 13 patients, nine patients achieved engraftment at a median of day 18 (range, 17-28). Six of the nine patients with engraftment achieved complete donor-type chimerism by day 100. Six patients were alive in remission at median follow-up of 13.1 months (range, 1.0-19.0). This study demonstrated the feasibility of RI-CBT using a non-TBI regimen in adults. When disease progression is controlled by the preparative regimen, RI-CBT carries a clinically significant graft-vs-tumor effect. Further studies are required to identify patients who benefit from this regimen.

  14. Dynamics of early histopathological changes in GVHD after busulphan/cyclophosphamide conditioning regimen.

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    Al-Hashmi, Sulaiman; Hassan, Zuzana; Sadeghi, Behnam; Rozell, Björn; Hassan, Moustapha

    2011-08-15

    Hematopoietic stem cell transplantation (HSCT) is a curative treatment for otherwise incurable diseases. Conditioning regimen is an important part of HSCT and consists of chemotherapy with or without irradiation. Conditioning exerts myelosuppressive, immunosuppressive and antitumor effects, but also contributes to HSCT-related complications including graft-versus-host disease (GVHD). Since almost 50% of the transplanted patients are conditioned with cytostatics without irradiation, we developed and characterized a GVHD mouse model following conditioning with busulphan and cyclophosphamide. Recipient Balb/c female mice were treated with busulphan (20 mg/kg/day for 4 days) and cyclophosphamide (100 mg/kg/day for two days). After one day of rest, recipient mice were transplanted with 2×10(7) bone marrow and 3×10(7) spleen cells from male C57BL/6 (allogeneic group) or female Balb/c (syngeneic/control group) mice. The allogeneic, but not syngeneic transplanted mice developed GVHD. Histopathology of the major internal organs (liver, pancreas, spleen, lungs, heart and kidney) was examined before conditioning start, after conditioning's end and 5, 7 and 21 days after transplantation using hematoxylin-eosin staining. Decreased spleen cellularity and diminished glycogen content in the liver were observed after conditioning regimen. Histopathological changes such as vasculitis, inflammation and apoptotic cell forms in liver, spleen, pancreas, lungs and heart were observed in allogeneic transplanted mice, however, only hypocellular spleen and extramedullar hematopoiesis were detected in syngeneic transplanted animals. No morphological changes were observed in kidney in either HSCT setting. This is the first study describing early histopathological changes after conditioning regimen with busulphan/cyclophosphamide and dynamics of GVHD development in several major internal organs.

  15. The choice of regimens based on bortezomib for patients with newly diagnosed multiple myeloma.

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    Jingsong He

    Full Text Available INTRODUCTION: Bortezomib has significantly improved multiple myeloma (MM response rates, but strategies for choosing bortezomib-based regimens for initial MM therapy are not standardized. Here, we describe four bortezomib-based therapies in Chinese MM patients to determine the optimal chemotherapeutic approach. METHODS: Newly diagnosed symptomatic MM patients at three hematological centers between February 1, 2006 and May 31, 2013 were treated with therapies including bortezomib plus dexamethasone (PD or combinations of PD with either adriamycin (PAD, cyclophosphamide (PCD or thalidomide (PTD for every 28 days. RESULTS: The overall response rate of all the 215 eligible patients was 90.2%. The ORR for PCD, PAD, PTD and PD were 97.4%, 93.2%, 85.3% and 77.8% while the effects with VGPR or better were 63.7%, 62.7%, 44.2% and 37.8%, respectively. The effect of ORR, VGPR and CR/nCR for the PCD regimen was better than the PD protocol. Median PFS for all patients was 29.0 months with significant differences observed among treatment groups. Median OS of all the patients was not reached, but three-drug combinations were superior to PD alone. Frequently observed toxicities were neutropenia, thrombocytopenia, fatigue, infection, herpes zoster, and peripheral neuropathy. The incidence of peripheral neuropathy (PN in PTD group was significantly higher than other three groups, especially grade 2-3 PN. Treatment with anti-viral agent acyclovir significantly reduced the incidence of herpes zoster. CONCLUSIONS: Our experience indicated that bortezomib-based regimens were effective and well-tolerated in the Chinese population studied; three-drug combinations PCD, PAD were superior to PD, especially with respect to PCD.

  16. Acid demineralization susceptibility of dental enamel submitted to different bleaching techniques and fluoridation regimens.

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    Salomão, Dlf; Santos, Dm; Nogueira, Rd; Palma-Dibb, Rg; Geraldo-Martins, Vr

    2014-01-01

    The aim of the current study was to assess the acid demineralization susceptibility of bleached dental enamel submitted to different fluoride regimens. One hundred bovine enamel blocks (6×6×3 mm) were randomly divided into 10 groups (n=10). Groups 1 and 2 received no bleaching. Groups 3 to 6 were submitted to an at-home bleaching technique using 6% hydrogen peroxide (HP; G3 and G4) or 10% carbamide peroxide (CP; G5 and G6). Groups 7 to 10 were submitted to an in-office bleaching technique using 35% HP (G7 and G8) or 35% CP (G9 and G10). During bleaching, a daily fluoridation regimen of 0.05% sodium fluoride (NaF) solution was performed on groups 3, 5, 7, and 9, while weekly fluoridation with a 2% NaF gel was performed on groups 4, 6, 8, and 10. The samples in groups 2 to 10 were pH cycled for 14 consecutive days. The samples from all groups were then assessed by cross-sectional Knoop microhardness at different depths from the outer enamel surface. The average Knoop hardness numbers (KHNs) were compared using one-way analysis of variance and Tukey tests (α=0.05). The comparison between groups 1 and 2 showed that the demineralization method was effective. The comparison among groups 2 to 6 showed the same susceptibility to acid demineralization, regardless of the fluoridation method used. However, the samples from groups 8 and 10 showed more susceptibility to acid demineralization when compared with group 2 (penamel to acid demineralization. However, the use of 35% HP and 35% CP must be associated with a daily fluoridation regimen, otherwise the in-office bleaching makes the bleached enamel more susceptible to acid demineralization.

  17. Treatment outcome of standardized regimen in patients with multidrug resistant tuberculosis

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    Kalpesh Jain

    2014-01-01

    Full Text Available Objective: To evaluate the treatment outcome of second line drugs used in directly observed treatment, short-course (DOTS-Plus regimen under Revised National Tuberculosis Control Program (RNTCP. Materials and Methods: A prospective, observational study was carried out on multidrug resistant tuberculosis (MDR-TB patients enrolled for DOTS-Plus regimen at TB and Chest Disease Department from January to December 2009. Demographic details, symptoms, sputum examination and adverse drug reactions were recorded in a case record form. Patients were followed up for 24 months. The data were analysed by Fisher′s exact test and paired student′s ′t′ test. Results: Out of 130 patients, 51 (39% were cured, 7 (5% completed the treatment, 25 (19% died, 30 (23% defaulted and 17 (13% failure. A significant increase in body weight (P < 0.0001 was observed at the end of the 24 months. Out of 89 patients with sputum culture conversion, majority (73 turned negative within first 3 months. Female gender (P < 0.05, conversion of sputum culture from positive to negative (P < 0.0001, and radiological improvement (P < 0.0001 were found to be positive predictors of a successful treatment outcome. While smoking habit (P < 0.05 and alcohol consumption (P < 0.05 were negative predictors of successful treatment outcome. Thirty five (26% patients developed ADRs that required withdrawal of causal drug. The most common ADR was joint pain due to pyrazinamide (11 followed by neurological and psychiatric disturbances due to cycloserine (9. Conclusion: The treatment outcome of standardized regimen in MDR-TB patients was low. The long duration of treatment and defaulters are major challenges for a successful outcome.

  18. In vivo biofilm formation on stainless steel bonded retainers during different oral health-care regimens

    Institute of Scientific and Technical Information of China (English)

    Marije A Jongsma; Henny C van der Mei; Jelly Atema-Smit; Henk J Busscher; Yijin Ren

    2015-01-01

    Retention wires permanently bonded to the anterior teeth are used after orthodontic treatment to prevent the teeth from relapsing to pre-treatment positions. A disadvantage of bonded retainers is biofilm accumulation on the wires, which produces a higher incidence of gingival recession, increased pocket depth and bleeding on probing. This study compares in vivo biofilm formation on single-strand and multi-strand retention wires with different oral health-care regimens. Two-centimetre wires were placed in brackets that were bonded to the buccal side of the first molars and second premolars in the upper arches of 22 volunteers. Volunteers used a selected toothpaste with or without the additional use of a mouthrinse containing essential oils. Brushing was performed manually. Regimens were maintained for 1 week, after which the wires were removed and the oral biofilm was collected to quantify the number of organisms and their viability, determine the microbial composition and visualize the bacteria by electron microscopy. A 6-week washout period was employed between regimens. Biofilm formation was reduced on single-strand wires compared with multi-strand wires;bacteria were observed to adhere between the strands. The use of antibacterial toothpastes marginally reduced the amount of biofilm on both wire types, but significantly reduced the viability of the biofilm organisms. Additional use of the mouthrinse did not result in significant changes in biofilm amount or viability. However, major shifts in biofilm composition were induced by combining a stannous fluoride-or triclosan-containing toothpaste with the mouthrinse. These shifts can be tentatively attributed to small changes in bacterial cell surface hydrophobicity after the adsorption of the toothpaste components, which stimulate bacterial adhesion to the hydrophobic oil, as illustrated for a Streptococcus mutans strain.

  19. Tuberculosis--advances in development of new drugs, treatment regimens, host-directed therapies, and biomarkers.

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    Wallis, Robert S; Maeurer, Markus; Mwaba, Peter; Chakaya, Jeremiah; Rustomjee, Roxana; Migliori, Giovanni Battista; Marais, Ben; Schito, Marco; Churchyard, Gavin; Swaminathan, Soumya; Hoelscher, Michael; Zumla, Alimuddin

    2016-04-01

    Tuberculosis is the leading infectious cause of death worldwide, with 9·6 million cases and 1·5 million deaths reported in 2014. WHO estimates 480,000 cases of these were multidrug resistant (MDR). Less than half of patients who entered into treatment for MDR tuberculosis successfully completed that treatment, mainly due to high mortality and loss to follow-up. These in turn illustrate weaknesses in current treatment regimens and national tuberculosis programmes, coupled with operational treatment challenges. In this Review we provide an update on recent developments in the tuberculosis drug-development pipeline (including new and repurposed antimicrobials and host-directed drugs) as they are applied to new regimens to shorten and improve outcomes of tuberculosis treatment. Several new or repurposed antimicrobial drugs are in advanced trial stages for MDR tuberculosis, and two new antimicrobial drug candidates are in early-stage trials. Several trials to reduce the duration of therapy in MDR and drug-susceptible tuberculosis are ongoing. A wide range of candidate host-directed therapies are being developed to accelerate eradication of infection, prevent new drug resistance, and prevent permanent lung injury. As these drugs have been approved for other clinical indications, they are now ready for repurposing for tuberculosis in phase 2 clinical trials. We assess risks associated with evaluation of new treatment regimens, and highlight opportunities to advance tuberculosis research generally through regulatory innovation in MDR tuberculosis. Progress in tuberculosis-specific biomarkers (including culture conversion, PET and CT imaging, and gene expression profiles) can support this innovation. Several global initiatives now provide unique opportunities to tackle the tuberculosis epidemic through collaborative partnerships between high-income countries and middle-income and low-income countries for clinical trials training and research, allowing funders to

  20. Central nervous system HIV infection in "less-drug regimen" antiretroviral therapy simplification strategies.

    Science.gov (United States)

    Ferretti, Francesca; Gianotti, Nicola; Lazzarin, Adriano; Cinque, Paola

    2014-02-01

    Less-drug regimens (LDR) refer to combinations of either two antiretroviral drugs or ritonavir-boosted protease inhibitor (PI) monotherapy. They may represent a simplification strategy in patients with persistently suppressed human immunodeficiency virus (HIV) viremia, with the main benefits of reducing drug-related toxicities and costs. Systemic virological efficacy of LDR is slightly lower as compared with combined antiretroviral therapy (cART), but patients with failure do not usually develop drug resistance and resuppress HIV replication after reintensification. A major concern of LDR is the lower efficacy in the virus reservoirs, especially in the central nervous system (CNS), where viral compartmentalization and independent evolution of infection may lead to CNS viral escape, often associated with neurologic symptoms. The authors reviewed studies of virological and functional CNS efficacy of LDR, particularly of boosted PI monotherapy regimens, for which more information is available. Symptomatic viral CSF escape was observed mainly in PI/r monotherapy patients with plasma failure and low nadir CD4+ cell counts, and resolved upon reintroduction of triple drug cART, whereas asymptomatic viral failure in CSF was not significantly more frequent in patients on PI/r monotherapy compared with patients on standard cART. In addition, there was no difference in functional outcomes between PI monotherapy and cART patients, irrespective of CSF viral escape. More data are needed on the CNS effect of dual ART regimens and, in general, on long-term efficacy of LDR. Simplification with LDR may be an attractive option in patients with suppressed viral load, if they are well selected and monitored for potential CNS complications.