| | INSPIRE: A European training network to foster research and training in cardiovascular safety pharmacology | INSPIRE: A European training network to foster research and training in cardiovascular safety pharmacology
INSPIRE: A European training network to foster research and training in cardiovascular safety pharmacology
Overview Safety pharmacology is an essential part of drug development aiming to identify, evaluate and investigate undesirable pharmacodynamic properties of a drug primarily prior to clinical trials. In particular, cardiovascular adverse drug reactions (ADR) have halted many drug development programs. Safety pharmacology has successfully implemented a screening strategy to detect cardiovascular liabilities, but there is room for further refinement. In this setting, we present the INSPIRE project, a European Training Network in safety pharmacology for Early-Stage Researchers (ESRs), funded by the European Commission's H2020-MSCA-ITN programme. INSPIRE has recruited 15 ESR fellows that will conduct an individual PhD-research project for a period of 36 months. INSPIRE aims to be complementary to ongoing research initiatives. With this as a goal, an inventory of collaborative research initiatives in safety pharmacology was created and the ESR projects have been designed to be complementary to this roadmap. Overall, INSPIRE aims to improve cardiovascular safety evaluation, either by investigating technological innovations or by adding mechanistic insight in emerging safety concerns, as observed in the field of cardio-oncology. Finally, in addition to its hands-on research pillar, INSPIRE will organize several summer schools and workshops that will be open to the wider community as well. In summary, INSPIRE aims to foster both research and training in safety pharmacology and hopes to inspire the future generation of safety scientists.
Authors Pieter-Jan D. Gunsa, et al.
Journal Journal of Pharmacological and Toxicological Methods | 3 | | R400.00 |  |
| | HIV and Aids | HIV and Aids
Overview
HIV disease is caused by infection with HIV-1 or HIV-2, which are retroviruses in the Retroviridae family, Lentivirus genus. Human immunodeficiency virus (HIV) is a blood-borne virus typically transmitted via sexual intercourse, shared intravenous drug paraphernalia, and mother-to-child transmission (MTCT), which can occur during the birth process or during breastfeeding. The patient with HIV may present with signs and symptoms of any of the stages of HIV infection. No physical findings are specific to HIV infection; the physical findings are those of the presenting infection or illness. Examples of manifestations include acute seroconversion manifests as a flulike illness, consisting of fever, malaise, generalized rash, generalized lymphadenopathy is common and may be a presenting symptom. This course covers the screening, diagnosis, medication and management of Aids.
Author: Sharespike | 3 | | R425.00 | |
| | Hypertension Part 2 | Hypertension Part 2
Overview Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment. As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | Ischemic Stroke Part 2 | Ischemic Stroke Part 2
Overview
Ischemic stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than haemorrhagic stroke.
We should consider stroke in any patient presenting with acute neurologic deficit or any alteration in level of consciousness. Although symptoms can occur alone, they are more likely to occur in combination. No historical feature distinguishes ischemic from haemorrhagic stroke, although nausea, vomiting, headache, and sudden change in level of consciousness are more common in haemorrhagic strokes. In younger patients, a history of recent trauma, coagulopathies, illicit drug use (especially cocaine), migraines, or use of oral contraceptives should be elicited.
Emergent brain imaging is essential for evaluation of acute ischemic stroke. Noncontrast computed tomography (CT) scanning is the most commonly used form of neuroimaging in the acute evaluation of patients with apparent acute stroke.
Involvement of a physician with a special interest and training in stroke is ideal. Stroke care units with specially trained nursing and allied healthcare personnel have clearly been shown to improve outcomes.
Author Sharespike
| 3 | | R410.00 | |
| | Ischemic Stroke Part 1 | Ischemic Stroke Part 1
Overview
Ischemic stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than haemorrhagic stroke.
We should consider stroke in any patient presenting with acute neurologic deficit or any alteration in level of consciousness. Although symptoms can occur alone, they are more likely to occur in combination. No historical feature distinguishes ischemic from haemorrhagic stroke, although nausea, vomiting, headache, and sudden change in level of consciousness are more common in haemorrhagic strokes. In younger patients, a history of recent trauma, coagulopathies, illicit drug use (especially cocaine), migraines, or use of oral contraceptives should be elicited.
Emergent brain imaging is essential for evaluation of acute ischemic stroke. Noncontrast computed tomography (CT) scanning is the most commonly used form of neuroimaging in the acute evaluation of patients with apparent acute stroke.
Involvement of a physician with a special interest and training in stroke is ideal. Stroke care units with specially trained nursing and allied healthcare personnel have clearly been shown to improve outcomes.
Author Sharespike
| 3 | | R410.00 | |
| | Vertigo, DIzziness and Imbalance | Vertigo, DIzziness and Imbalance
Vertigo, DIzziness and Imbalance
Overview
Dizziness and vertigo are among the most common symptoms causing patients to visit a physician (as common as back pain and headaches). Falling can be a direct consequence of dizziness in this population, and the risk is compounded in elderly persons with other neurologic deficits and chronic medical problems.
Mild hearing loss is the most common disability worldwide. The incidence of hearing loss is 25% in people younger than 25 years, and it reaches 40% in persons older than 40 years. About 25% of the population report tinnitus.
Primary care physicians evaluate most cases of dizziness and related symptoms. Their role and that of neurologists in this setting has increased over the past decade. This article outlines the clinical approach to dizziness with emphasis on differentiating peripheral from central dizziness and on office management of the most common diseases. It also addresses indications for referral to an otolaryngologist or neuro-otologist and for specialized auditory and vestibular testing.
To diagnose dizziness, physicians must use the essential tools of history, clinical examination, and follow-up. The etiology in most of these patients mainly involves a vestibular disorder, such as BPPV, Ménière disease, or bilateral vestibular hypofunction. Appropriate management and follow-up are necessary to improve the well-being of these patients.
Authors
Sharespike
| 3 | | R425.00 | |
| | Ventricular Tachycardia Part 2 | Ventricular Tachycardia Part 2
Ventricular Tachycardia Part 2
Overview
Ventricular tachycardia (VT) or ventricular fibrillation (VF) is responsible for most of the sudden cardiac deaths in the United States, at an estimated rate of approximately 300,000 deaths per year. VT refers to any rhythm faster than 100 (or 120) beats/min, with three or more irregular beats in a row, arising distal to the bundle of His. The rhythm may arise from the working ventricular myocardium, the distal conduction system, or both.
Symptoms of VT are often a function of the associated heart rate, or the causal process, such as an acute myocardial infarction (MI). They may include the following bulleted items. VT may also be asymptomatic, or the symptoms may be those of the associated triggered therapy (eg, an implantable cardioverter-defibrillator [ICD] shock).
Clinically, VT may be reflected in symptoms such as syncope, palpitations, and dyspnea. It is often, but not always, associated with hemodynamic compromise, particularly if the left ventricle is impaired or the heart rate is especially fast. With some exceptions, VT is associated with increased risk of sudden death.
Author Sharespike
| 3 | | R425.00 | |
| | Ventricular Tachycardia Part 1 | Ventricular Tachycardia Part 1
Ventricular Tachycardia Part 1
Overview
Ventricular tachycardia (VT) or ventricular fibrillation (VF) is responsible for most of the sudden cardiac deaths in the United States, at an estimated rate of approximately 300,000 deaths per year. VT refers to any rhythm faster than 100 (or 120) beats/min, with three or more irregular beats in a row, arising distal to the bundle of His. The rhythm may arise from the working ventricular myocardium, the distal conduction system, or both.
Symptoms of VT are often a function of the associated heart rate, or the causal process, such as an acute myocardial infarction (MI). They may include the following bulleted items. VT may also be asymptomatic, or the symptoms may be those of the associated triggered therapy (eg, an implantable cardioverter-defibrillator [ICD] shock).
Clinically, VT may be reflected in symptoms such as syncope, palpitations, and dyspnea. It is often, but not always, associated with hemodynamic compromise, particularly if the left ventricle is impaired or the heart rate is especially fast. With some exceptions, VT is associated with increased risk of sudden death.
Author Sharespike
| 3 | | R425.00 | |
| | Wide Complex Tachycardia | Wide Complex Tachycardia
Overview
Correct diagnosis of wide complex tachycardia (WCTs) can be challenging. With EMS providers' ever-expanding scope of practice, it is no longer safe to label any rhythm that is wide and fast as ventricular tachycardia (VT). Though many paramedic curricula do not address advanced cardiac dysrhythmias and treatments, several EMS departments have protocols that require advanced training in 12-lead ECG interpretation and treatment of specific cardiac dysrhythmias. One must possess the proper diagnostic tools and knowledge to decide whether a WCT is VT or SVT with aberrant conduction. EMS providers should be able to differentiate VT and SVT with aberrant conduction with confidence and a high degree of certainty. In order to understand the visual differences between VT and SVT with aberrant conduction, one must first understand the basic pathophysiology behind the two dysrhythmias. The first steps are maintenance of the patient’s airway with assisted breathing if necessary, cardiac monitoring to identify the heart rhythm, monitoring of blood pressure and oximetry, and establishing intravenous access. In the emergency setting, a wide-complex tachycardia always should be considered as ventricular tachycardia unless proven otherwise, as treatment must be initiated immediately to avoid degeneration into ventricular fibrillation.
| 3 | | R425.00 | |
| | Unstable Angina | Unstable Angina
Overview
Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which also includes ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Unstable angina is considered to be an ACS in which there is myocardial ischemia without detectable myocardial necrosis (ie, cardiac biomarkers of myocardial necrosis —such as creatine kinase MB isozyme, troponin, myoglobin—are not released into the circulation).
With unstable angina, symptoms may (1) occur at rest; (2) become more frequent, severe, or prolonged than the usual pattern of angina; (3) change from the usual pattern of angina; or (4) not respond to rest or nitro-glycerine. Symptoms of unstable angina are similar to those of myocardial infarction (MI).
The traditional term unstable angina was meant to signify the intermediate state between myocardial infarction (MI) and the more chronic state of stable angina. The old term pre-infarction angina conveys the clinical intent of intervening to attenuate the risk of MI or death. Patients with this condition have also been categorized by presentation, diagnostic test results, or course over time; these categories include new-onset angina, accelerating angina, rest angina, early postinfarct angina, and early post-revascularization angina.
This course deals with the causes and management of unstable angina.
| 3 | | R425.00 | |
| | Severe Distress – COVID 19 | Severe Distress – COVID 19
Severe Distress – COVID 19
Overview
Since the emergence of the 2019 novel coronavirus (SARS-CoV-2) infection in December 2019, the coronavirus disease 2019 (COVID-19) has rapidly spread across the globe. The clinical spectrum of patients with COVID-19 ranges from asymptomatic or mild symptoms to critical disease with a high risk of mortality.
Coronavirus disease 2019 (COVID-19) is the illness associated with the novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was initially noted during an outbreak of respiratory illness in the population of Wuhan, the capital of Hubei province, China. The first cases were seen in November 2019, with COVID-19 quickly spreading throughout the city. The World Health Organization (WHO) was notified of the outbreak on December 31, 2019. The cases continued to spread outside of the area and then across the world. COVID-19 was reported as a global health emergency by the end of January 2020. As the worldwide case numbers increased, the WHO declared on March 11, 2020, that COVID-19 had reached the pandemic stage. The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic.
| 3 | | R425.00 | |
| | Dyspnea: Pathophysiology and a clinical approach - EMT | Dyspnea: Pathophysiology and a clinical approach - EMT
Dyspnea: Pathophysiology and a clinical approach - EMT
Overview
Dyspnea is defined as a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity and may either be acute or chronic. This is a common and often distressing symptom reported by patients, and accounts for nearly half of hospital admissions. The distinct sensations often reported by patients include effort/work of breathing, chest tightness, and air hunger (a feeling of not enough air on inspiration). Dyspnea should be assessed by the intensity of these sensations, the degree of distress involved, and its burden or impact on instrumental activities. Dyspnea is a common and often distressing symptom and a frequent reason for general practitioner and clinic visits. Dyspnea is symptom, and its experience is subjective and varies greatly among individuals exposed to the same stimuli or with similar pathologies. This differential experience of Dyspnea among individuals emanates from interactions among multiple physiological, psychological, social, and environmental factors that induce secondary physiological and behavioural responses. The management of Dyspnea will depend on the underlying cause.
Author
Sharespike | 3 | | R420.00 | |
| | Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma | Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma
Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma
Overview Emphysema and chronic bronchitis are airflow-limited states contained within the disease state known as chronic obstructive pulmonary disease (COPD). Just as asthma is no longer grouped with COPD, the current definition of COPD put forth by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) also no longer distinguishes between emphysema and chronic bronchitis.
Emphysema is pathologically defined as an abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of alveolar walls and without obvious fibrosis. This process leads to reduced gas exchange, changes in airway dynamics that impair expiratory airflow, and progressive air trapping. Clinically, the term emphysema is used interchangeably with chronic obstructive pulmonary disease, or COPD.
The theory surrounding this definition has been around since the 1950s, with a key concept of irreversibility and/or permanent acinar damage. However, new data posit that increased collagen deposition leads to active fibrosis, which inevitably is associated with breakdown of the lung’s elastic framework.
Discussions on how obstructive diseases share similar phenotypes have been emerging and evolving within the literature. This course provides a particularly good outline.
Author Sharespike
| 3 | | R435.00 | |
| | Hypertension Part 1 | Hypertension Part 1
Overview Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment. As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | The Value of Treating Opioid Use Disorder in Family Medicine: From the Patient Perspective | The Value of Treating Opioid Use Disorder in Family Medicine: From the Patient Perspective
The Value of Treating Opioid Use Disorder in Family Medicine: From the Patient Perspective
Overview Despite evidence demonstrating that medications for opioid use disorder (OUD) reduce morbidity and mortality, most patients do not receive treatment. The National Academies of Science call for more research exploring the patient’s perspective of treatment modalities to increase access to individualized, patient-centred care. The aim of this article is to build on existing literature by describing patient experiences treated for OUD in a rural family medicine setting. Participants’ experiences with OBOT were generally positive and shaped by societal structures and institutions, their life before treatment, their treatment history, and the kind of care they received in OBOT. Patients identified accessibility and privacy as advantages to receiving OBOT in primary care. This research identifies ways providers can provide individualized and effective OUD treatment within the family medicine setting.
Authors Claire Kane, BA, Catherine Leiner, Chase Harless, Kathleen A. Foley, E. Blake Fagan, and Courtenay Gilmore Wilson
Journal J Am Board Fam Med: first published as 10.3122/jabfm.2020.04.190389 on 16 July 2020
| 3 | | R385.00 | |
| | Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors | Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors
Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors
Overview To evaluate the prevalence of and factors associated with SARS-CoV-2 infection in general practitioners and nurses from primary care centres and nursing homes in the Healthcare Area of León (Spain). The work centre, type of profession, COVID-19 infection, level of exposure, compliance with preventive measures, isolation (if required) and diagnostic tests carried out were collected. The determination of infection was made by differentiated rapid diagnostic test (dRDT), using a finger-stick whole-blood sample. The association of variables with infection was assessed by multivariable non-conditional logistic regression. No statistically significant differences were observed by sex, type of professional, level of exposure or compliance with preventive measures. The prevalence of SARS-CoV-2 infection in this group is low. A high number of professionals remain susceptible to SARS-CoV-2 infection and therefore protective measures should be taken, especially for professionals working in nursing homes.
Authors: V. Martín, T. Fernández-Villa, M. Lamuedra Gil de Gomez, O. Mencía-Ares, A. Rivero Rodríguez, S. Reguero Celada, M. Montoro Gómez, M.T. Nuevo Guisado, C. Villa Aller, C. Díez Flecha, A. Carvajal, J.P. Fernández Vázquez
Journal: Semergen. 2020;46(S1):42---46 | 3 | | R400.00 | |
| | Preventing infectious diseases for healthy ageing: The VITAL public-private partnership project | Preventing infectious diseases for healthy ageing: The VITAL public-private partnership project
Preventing infectious diseases for healthy ageing: The VITAL public-private partnership project
Overview Prevention of infectious diseases through immunisation of the growing ageing adult population is essential to improve healthy ageing. However, many licenced and recommended vaccines for this age group show signs of waning of the protective effect due to declining immune responses (immunosenescence) and decreasing vaccine uptake. Today’s major challenge is to improve vaccine effectiveness and uptake and to deploy efficient vaccination strategies for this age group. The Vaccines and Infectious diseases in the Ageing population (VITAL) project, with partners from 17 academic & research groups and public institutes as well as seven industry collaborators, aims to address this challenge. The ambition is to provide evidence-based knowledge to local decision makers. Using a holistic and multidisciplinary approach and novel analytical methods, VITAL will provide tools that allow the development of targeted immunisation programs for ageing adults in European countries. The project is based on four pillars focussing on the assessment of the burden of vaccine-preventable diseases in ageing adults, the dissection of the mechanisms underlying immuno-senescence, the analysis of the clinical and economic public health impact of vaccination strategies and the development of educational resources for healthcare professionals.
Authors Debbie Van Baarle, Kaatje Bollaerts, Giuseppe Del Giudice, Stephen Lockhart, Christine Luxemburger, Maarten J. Postma, Aura Timen, Baudouin Standaert
Journal Vaccine 38 (2020) 5896–5904 https://doi.org/10.1016/j.vaccine.2020.07.005
URL https://www.sciencedirect.com/science/article/pii/S0264410X20309051?via%3Dihub | 3 | | R425.00 | |
| | Probiotics and Protection of the Stomach | Probiotics and Protection of the Stomach
Probiotics and Protection of the Stomach
Overview Probiotics are living organisms and have beneficial effects when they colonize the body, assuming they can stay alive long enough to do so. Probiotic treatments are packed with bacteria, but once swallowed, their numbers are dramatically diminished by the stomach's acidity, lowering the chances of therapeutic effect. Probiotics can live or die under a variety of circumstances. One such circumstance is time. Some bacteria make spores which can live for many years and then blossom and grow. Most probiotics do not make spores, so they gradually die off if they do not find a comfortable place to grow, meaning a moist, warm friendly environment like the colon. Stomach acid is extraordinarily strong. It does and will kill most bacteria that get into the stomach each day. Antibiotics can also kill the bacteria in your body. So, how do you protect the probiotic bacteria you take, from this bacteria execution chamber which everyone has inside them?
Acknowledgements Du Pont Dinesco Capsugel R&D Team and Dr Keith Hutchison Elsevier – LWT Food Science and Technology
| 2 | | R0.00 | |
| | Tuberculosis Part 2 | Tuberculosis Part 2
Overview
Tuberculosis (TB) (see the image below), a multisystemic disease with myriad presentations and manifestations, is the most common cause of infectious disease–related mortality worldwide. Although TB rates are decreasing in the United States, the disease is becoming more common in many parts of the world. In addition, the prevalence of drug-resistant TB is increasing worldwide. Classic clinical features associated with active pulmonary TB in elderly individuals with TB may not display typical signs and symptoms. The absence of any significant physical findings does not exclude active TB. Classic symptoms are often absent in high-risk patients, particularly those who are immunocompromised or elderly. It is important to isolate patients with possible TB in a private room with negative pressure.
Acknowledgements Authors:
Thomas E Herchline,Thomas E Herchline, Judith K Amorosa, Judith K Amorosa. | 3 | | R420.00 | |
| | Tuberculosis Part 1 | Tuberculosis Part 1
Overview Tuberculosis (TB) (see the image below), a multisystemic disease with myriad presentations and manifestations, is the most common cause of infectious disease–related mortality worldwide. Although TB rates are decreasing in the United States, the disease is becoming more common in many parts of the world. In addition, the prevalence of drug-resistant TB is increasing worldwide. Classic clinical features associated with active pulmonary TB in elderly individuals with TB may not display typical signs and symptoms. The absence of any significant physical findings does not exclude active TB. Classic symptoms are often absent in high-risk patients, particularly those who are immunocompromised or elderly. It is important to isolate patients with possible TB in a private room with negative pressure.
Acknowledgements Authors: Thomas E Herchline and Judith K Amorosa | 3 | | R420.00 | |
| | Viral Pneumonia Part 3 | Viral Pneumonia Part 3
Overview The reported incidence of viral pneumonia (see the image below) has increased during the past decade. In part, this apparent increase simply reflects improved diagnostic techniques, but an actual increase appears to have also occurred. Depending on the virulence of the organism, as well as the age and comorbidities of the patient, viral pneumonia can vary from a mild, self-limited illness to a life-threatening disease. This course is divided into 3 parts covering the aspects of Pneumonia leading into the much dreaded COVID 19 The influenza viruses are the most common viral cause of pneumonia. Primary influenza pneumonia manifests with persistent symptoms of cough, sore throat, headache, myalgia, and malaise for more than three to five days. Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in infants and children and the second most common viral cause of pneumonia in adults.
Parainfluenza virus (PIV) is second in importance only to RSV as a cause of lower respiratory tract disease in children and pneumonia and bronchiolitis in infants younger than 6 months. PIV pneumonia and bronchiolitis are caused primarily by the PIV-3 strain. The signs and symptoms include fever, cough, coryza, dyspnea with rales, and wheezing.
Acknowledgements Authors:
Zab Mosenifar and Richard Brawerman | 3 | | R420.00 | |
| | Viral Pneumonia Part 2 | Viral Pneumonia Part 2
Overview The reported incidence of viral pneumonia (see the image below) has increased during the past decade. In part, this apparent increase simply reflects improved diagnostic techniques, but an actual increase appears to have also occurred. Depending on the virulence of the organism, as well as the age and comorbidities of the patient, viral pneumonia can vary from a mild, self-limited illness to a life-threatening disease. This course is divided into 3 parts covering the aspects of Pneumonia leading into the much dreaded COVID 19. The influenza viruses are the most common viral cause of pneumonia. Primary influenza pneumonia manifests with persistent symptoms of cough, sore throat, headache, myalgia, and malaise for more than three to five days. Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in infants and children and the second most common viral cause of pneumonia in adults.
Parainfluenza virus (PIV) is second in importance only to RSV as a cause of lower respiratory tract disease in children and pneumonia and bronchiolitis in infants younger than 6 months. PIV pneumonia and bronchiolitis are caused primarily by the PIV-3 strain. The signs and symptoms include fever, cough, coryza, dyspnea with rales, and wheezing.
Acknowledgements Authors:
Zab Mosenifar and Richard BrawermanThe University of Pretoria | 3 | | R420.00 | |
| | Viral Pneumonia Part 1 | Viral Pneumonia Part 1
Overview The reported incidence of viral pneumonia (see the image below) has increased during the past decade. In part, this apparent increase simply reflects improved diagnostic techniques, but an actual increase appears to have also occurred. Depending on the virulence of the organism, as well as the age and comorbidities of the patient, viral pneumonia can vary from a mild, self-limited illness to a life-threatening disease.
This course is divided into 3 parts covering the aspects of Pneumonia leading into the much dreaded COVID 19. The influenza viruses are the most common viral cause of pneumonia. Primary influenza pneumonia manifests with persistent symptoms of cough, sore throat, headache, myalgia, and malaise for more than three to five days. Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in infants and children and the second most common viral cause of pneumonia in adults.
Parainfluenza virus (PIV) is second in importance only to RSV as a cause of lower respiratory tract disease in children and pneumonia and bronchiolitis in infants younger than 6 months. PIV pneumonia and bronchiolitis are caused primarily by the PIV-3 strain. The signs and symptoms include fever, cough, coryza, dyspnea with rales, and wheezing.
Acknowledgements
Authors:
Zab Mosenifar and Richard Brawerman | 3 | | R420.00 | |
| | Malaria | Malaria
Overview Malaria is a potentially life-threatening disease caused by infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito. Patients with malaria typically become symptomatic a few weeks after infection, though the symptomatology and incubation period may vary, depending on host factors and the causative species. Most patients with malaria have no specific physical findings, but splenomegaly may be present. In patients with suspected malaria, obtaining a history of recent or remote travel to an endemic area is critical. Asking explicitly if they travelled to a tropical area at any time in their life may enhance recall. Maintain a high index of suspicion for malaria in any patient exhibiting any malarial symptoms and having a history of travel to endemic areas.
It is also important to determine the patient's immune status, age, and pregnancy status; allergies or other medical conditions that he or she may have; and medications that he or she may be using.
Acknowledgements Authors:
Thomas E Herchline, Thomas E Herchline, Ryan Q Simon
| 3 | | R420.00 | |
| | Diabetes Mellitus Part 3 | Diabetes Mellitus Part 3
Overview Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. Poorly controlled type 2 diabetes is associated with an array of microvascular, macrovascular, and neuropathic complications.
Microvascular complications of diabetes include retinal, renal, and possibly neuropathic disease. Macrovascular complications include coronary artery and peripheral vascular disease. Diabetic neuropathy affects autonomic and peripheral nerves.
This course focuses on the diagnosis and treatment of type 2 diabetes and its acute and chronic complications, other than those directly associated with hypoglycemia and severe metabolic disturbances, such as hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA).
Acknowledgements Author:
Khardori
| 3 | | R420.00 | |
| | Diabetes Mellitus Part 2 | Diabetes Mellitus Part 2
Overview Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. Poorly controlled type 2 diabetes is associated with an array of microvascular, macrovascular, and neuropathic complications.
Microvascular complications of diabetes include retinal, renal, and possibly neuropathic disease. Macrovascular complications include coronary artery and peripheral vascular disease. Diabetic neuropathy affects autonomic and peripheral nerves.
This course focuses on the diagnosis and treatment of type 2 diabetes and its acute and chronic complications, other than those directly associated with hypoglycemia and severe metabolic disturbances, such as hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA).
Acknowledgements Author:
Khardori | 3 | | R420.00 | |
| | Diabetes Mellitus Part 1 | Diabetes Mellitus Part 1
Overview Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. Poorly controlled type 2 diabetes is associated with an array of microvascular, macrovascular, and neuropathic complications.
Microvascular complications of diabetes include retinal, renal, and possibly neuropathic disease. Macrovascular complications include coronary artery and peripheral vascular disease. Diabetic neuropathy affects autonomic and peripheral nerves.
This course focuses on the diagnosis and treatment of type 2 diabetes and its acute and chronic complications, other than those directly associated with hypoglycemia and severe metabolic disturbances, such as hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA).
Acknowledgements Author:
Khardori | 3 | | R420.00 | |
| | Hyperglycemia | Hyperglycemia
Overview:
Hyperglycemia (also spelled hyperglycaemia or hyperglycæmia), is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l (200 mg/dl), but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/l (~250–300 mg/dl). For diabetics, glucose levels that are too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. Hypoglycemia, also known as low blood sugar, is a fall in blood sugar to levels below normal. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures or death. A feeling of hunger, sweating, shakiness and weakness may also be present. Symptoms typically come on quickly. The most common cause of hypoglycemia is medications used to treat diabetes mellitus such as insulin and sulfonylureas. Risk is greater in diabetics who have eaten less than usual, exercised more than usual or drunk alcohol. Other causes of hypoglycemia include kidney failure, certain tumours (such as insulinoma), liver disease, hypothyroidism, starvation, inborn error of metabolism, severe infections, reactive hypoglycemia and several drugs including alcohol. Low blood sugar may occur in otherwise healthy babies who have not eaten for a few hours.
Acknowledgements:
Author:
Jasvinder Chawla
| 3 | | R410.00 | |
| | Pharmacological and Dietary Factors in preventing Colorectal Cancer | Pharmacological and Dietary Factors in preventing Colorectal Cancer
Pharmacological and Dietary Factors in preventing Colorectal Cancer
Overview
Colorectal cancer (CRC) is the third most prevalent neoplasm worldwide and fourth most frequent reason of cancer-related death throughout the world. About 70% of malignant tumours are related to lifestyle and environmental factors, and better knowledge of their significance might reduce the prevalence of CRC. The cyclo-oxygenase-2 (COX-2) inhibitory and other direct and indirect pathways of aspirin are translated to inhibition proliferation and enhanced apoptosis of cancer cells.
A high energy diet consisting of red meat, animal fat, highly processed foods and unsaturated fats increases the risk of CRC. Carcinogenic role of fat and cholesterol depends on increased production of primary bile acids. Fruits, vegetables and grain are considered to have protective effects against adenoma and CRC. Excessive alcohol consumption, smoking and physical inactivity are considered as important CRC risk factors.
This article briefly summarizes current state of knowledge about the role of pharmacological and dietary prevention of colorectal cancer. Moreover, it indicates that despite many studies some aspects of this issue are not clear and require future studies.
Acknowledgement
Author M. Waluga, M. Zorniak, J. Fichna, M. Kukla and M. Hartleb
Journal Journal of Physiology and Pharmacology 2018
| 3 | | R435.00 | |
| | Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that? | Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
Overview
Oral corticosteroids (OCS) are a mainstay of treatment for asthma exacerbations, and short-term OCS courses were generally considered to be safe. Our study aimed at investigating the integrity of the HPA axis in children with persistent asthma or recurrent wheezing at the beginning of an inhaled corticosteroids (ICS) trial. Morning basal cortisol was assessed just before the beginning of ICS, and 30, 60, and 90 days later, using Immulite® Siemens Medical Solutions Diagnostic chemiluminescent enzyme immunoassay (Los Angeles, USA; 2006).
In all, 140 children (0.3-15 years old) with persistent asthma or recurrent wheezing have been evaluated and 40% of them reported short-term OCS courses for up to 30 days before evaluation. Out of these, 12.5% had biochemical adrenal suppression but showed adrenal recovery during a three-month ICS trial treatment. In conclusion, short-term systemic courses of corticosteroids at conventional doses can put children at risk of HPA axis dysfunction. ICS treatment does not impair adrenal recovery from occurring. Health practitioners should be aware of the risk of a blunted cortisol response upon
Acknowledgement
Authors Cristina B. Barra, Maria Jussara F. Fontes, Marco Túlio G. Cintra, Renata C. Cruz, Janaína A. G. Rocha, Maíla Cristina C. Guimarães and Ivani Novato Silva
Journal Revista Da Associação Médica Brasileira
| 3 | | R420.00 | |
| | Evidence for increasing densities and geographic ranges of tick species of public health significance other than Ixodes scapularis in Quebec, Canada | Evidence for increasing densities and geographic ranges of tick species of public health significance other than Ixodes scapularis in Quebec, Canada
Evidence for increasing densities and geographic ranges of tick species of public health significance other than Ixodes scapularis in Quebec, Canada
Overview
Climate change is driving emergence and establishment of Ixodes scapularis, the main vector of Lyme disease in QueÂbec, Canada. As for the black-legged tick, I. scapularis Say, global warming may also favor northward expansion of other species of medically important ticks. The aims of this study were to determine (1) current diversity and abundance of ticks of public health significance other than I. scapularis, (2) sex and age of the human population bitten by these ticks (3), and the seasonal and geographic pattern of their occurrence.
Of the 862 people bitten by these ticks, 43.3% were I. cookei ticks removed from children aged < 10 years. These findings demonstrate the need for surveillance of all the tick species of medical importance in QueÂbec, particularly because climate may increase their abundance and geographic ranges, increasing the risk to the public of the diseases they transmit.
Acknowledgement
Author Salima Gasmi, Catherine Bouchard, Nicholas H. Ogden, Ariane Adam-Poupart, Yann Pelcat, Erin E. Rees, FrancËois Milord, Patrick A. Leighton, Robbin L. Lindsay, Jules K. Koffi and Karine Thivierge
Journal PLoS One
| 3 | | R420.00 | |
| | Extracorporeal human whole blood in motion, as a tool to predict first-infusion reactions and mechanism-of-action of immune-therapeutics | Extracorporeal human whole blood in motion, as a tool to predict first-infusion reactions and mechanism-of-action of immune-therapeutics
Extracorporeal human whole blood in motion, as a tool to predict first-infusion reactions and mechanism-of-action of immune-therapeutics
Overview
First infusion reactions along with severe anaphylactic responses can occur as a result of systemic administration of therapeutic antibodies. The underlying mechanisms by which monoclonal antibodies induce cytokine release syndrome (CRS) can involve direct agonistic effects via the drug target, or a combination of target-engagement along with innate receptor interactions.
One assay that has not been assessed for its capacity to predict CRS is the modified Chandler loop model. On the other hand, non-agonistic antibodies associated with no or low infusion reactions in the clinic, namely cetuximab and natalizumab, neither induce cytokine release nor cause false positive responses. Additionally, the value of an intact complement system in the assay is highlighted by the possibility to dissect out the mechanism-of-action of alemtuzumab and rituximab. The loop assay can either complement lymph node-like assays or stand-alone to investigate drug/blood interactions during preclinical development, or for individual safety screening prior to first-in-man clinical trial.
Acknowledgement
Authors Erika A.K. Fletcher, Mohamed Eltahir, Frida Lindqvist, Jonas Rieth, Gunilla Törnqvist, Justyna Leja-Jarblad and Sara M. Mangsbo
Journal International Immunopharmacology Volume 54
| 3 | | R410.00 | |
| | Flax oil from transgenic Linum Usitatissimum | Flax oil from transgenic Linum Usitatissimum
Flax oil from transgenic Linum Usitatissimum
Overview
Flax (Linum usitatissimum L.) - an annual plant, primarily cultivated for industrial purposes, as a source of fibers and oil, was recently genetically modified in order to enhance wound healing properties of the fibers.
Emulsions made of oils from transgenic flaxseeds significantly decreased in vitro proliferation of six tested human cancer cell lines in 48-h cultures. However, the emulsions also increased proliferation rate of normal human dermal fibroblasts and keratinocytes. Both inhibition of in vitro proliferation of human cancer cell lines and stimulation of proliferation of normal dermal fibroblasts and keratinocytes were especially strong with the emulsion type B and with emulsion type M.
Flaxseeds oils from transgenic plants could be considered as valuable adjunct to standard cytostatic drugs in the treatment course of human cancers and can be used to improve skin wound healing. Further in vitro studies should be focused on evaluation of intracellular content of the cytostatic drugs in cancer cells cultured in the presence of the tested emulsions.
Acknowledgement
Authors Tomasz Gebarowski, Katarzyna Gebczak, Benita Wiatrak, Anna Kulma, Katarzyna Pelc, Tadeusz Czuj, Jan Szopa and Kazimierz Gasiorowski.
Journal Acta Pol Pharm. Volume 74 Issue 2
| 3 | | R460.00 | |
| | Human Milk Oligosaccharides: 20-Fucosyllactose (20-FL) and Lacto-N-Neotetraose (LNnT) in Infant Formula | Human Milk Oligosaccharides: 20-Fucosyllactose (20-FL) and Lacto-N-Neotetraose (LNnT) in Infant Formula
Human Milk Oligosaccharides: 20-Fucosyllactose (20-FL) and Lacto-N-Neotetraose (LNnT) in Infant Formula
Overview
The authors reviewed the published evidence on the presence of oligosaccharides in human milk (HMO) and their benefits in in vitro and in vivo studies. The amount of HMOs in mother’s milk is a dynamic process as it changes over time. Many factors, such as duration of lactation, environmental, and genetic factors, influence the number of HMOs.
The limited clinical data suggest that the addition of HMOs to infant formula seems to be safe and well tolerated, inducing a normal growth and suggesting a trend towards health benefits. HMOs are one of the major differences between cow’s milk and human milk, and available evidence indicates that these components do have a health promoting benefit. The addition of one or two of these components to infant formula is safe and brings infant formula closer to human milk. More prospective, randomized trials in infants are needed to evaluate the clinical benefit of supplementing infant formula with HMOs.
Acknowledgement
Author Yvan Vandenplas, Bernard Berger, Virgilio Paolo Carnielli, Janusz Ksiazyk , Hanna Lagström, Manuel Sanchez Luna, Natalia Migacheva, Jean-Marc Mosselman, Jean-Charles Picaud, Mike Possner, Atul Singhal and Martin Wabitsch
Journal Nutrients 2018, Volume 10 Issue 9 Publisher MDPI
| 3 | | R380.00 | |
| | Immunogenomic Classification of Colo-rectal Cancer and Therapeutic Implications | Immunogenomic Classification of Colo-rectal Cancer and Therapeutic Implications
Immunogenomic Classification of Colo-rectal Cancer and Therapeutic Implications
Overview
The immune system has a substantial effect on colorectal cancer (CRC) progression. Additionally, the response to immunotherapeutic and conventional treatment options (e.g., chemotherapy, radiotherapy and targeted therapies) is influenced by the immune system.
The molecular characterization of colorectal cancer (CRC) has led to the identification of favourable and unfavourable immunological attributes linked to clinical outcome. With the definition of consensus molecular subtypes (CMSs) based on transcriptomic profiles, multiple characteristics have been proposed to be responsible for the development of the tumour immune microenvironment and corresponding mechanisms of immune escape.
In this review, a detailed description of proposed immune phenotypes as well as their interaction with different therapeutic modalities will be provided. Finally, possible strategies to shift the CRC immune phenotype towards a reactive, anti-tumour orientation are proposed per CMS. The recognition of the impact of the immune system on the progression of CRC has led to the identification and detailed characterization of tumour immune phenotypes.
Acknowledgement
Author Jessica Roelands, Peter J. K. Kuppen, Louis Vermeulen, Cristina Maccalli, Julie Decock, Ena Wang, Francesco M. Marincola, Davide Bedognetti and Wouter Hendrickx
Journal International Journal of Molecular Sciences Volume 18 Issue 10
Publisher PubMed | 3 | | R460.00 | |
| | In vitro immunotherapy potency assays using real-time cell analysis | In vitro immunotherapy potency assays using real-time cell analysis
In vitro immunotherapy potency assays using real-time cell analysis
Overview
A growing understanding of the molecular interactions between immune effector cells and target tumour cells, coupled with refined gene therapy approaches, are giving rise to novel cancer immuno-therapeutics with remarkable efficacy in the clinic against both solid and liquid tumours. Therefore, there is an urgent need for functional potency assays, in vitro and in vivo, that could model the complex interaction of immune cells with tumour cells and can be used to rapidly test the efficacy of different immunotherapy approaches, whether it is small molecule, biologics, cell therapies or combinations thereof.
Herein we report the development of an xCELLigence real-time cytolytic in vitro potency assay that uses cellular impedance to continuously monitor the viability of target tumour cells while they are being subjected to different types of treatments. In summary, our results demonstrate the xCELLigence platform to be well suited for potency assays, providing quantitative assessment with high reproducibility and a greatly simplified workflow.
Acknowledgement
Author Fabio Cerignoli, Yama A. Abassi, Brandon J. Lamarche, Garret Guenther, David Santa Ana, Diana Guimet, Wen Zhang, Jing Zhang and Biao Xi
Journal PLoS ONE Volume 13 Issue 3
Publisher Cross Mark
| 3 | | R360.00 | |
| | Phytochemicals in Helicobacter pylori Infections: What Are We Doing Now? | Phytochemicals in Helicobacter pylori Infections: What Are We Doing Now?
Phytochemicals in Helicobacter pylori Infections: What Are We Doing Now?
Overview
In this critical review, plant sources used as effective antibacterial agents against Helicobacter pylori infections are carefully described. The main intrinsic bioactive molecules, responsible for the observed effects are also underlined and their corresponding modes of action specifically highlighted. In addition to traditional uses as herbal remedies, in vitro and in vivo studies focusing on plant extracts and isolated bioactive compounds with anti-H. pylori activity are also critically discussed. Lastly, special attention was also given to plant extracts with urease inhibitory effects, with emphasis on involved modes of action.
Among the various opportunistic infections, those caused by Helicobacter pylori, a human opportunistic pathogen, is attracting much attention [29]. In fact, it is widely recognized that this bacterium plays an important role in the etiology of peptic and gastric ulcers and even gastric cancers and gastric lymphomas [29]. About half of the worldwide population is colonized by this bacterium, but there are only about 20% who manifest clinical symptoms, which has been linked to the ability of some H. pylori strains to both adapt to host’s immunological responses and to support an ever-changing gastric environment [29]. Relatedly, increasing rates of antibiotic-resistant H. pylori strains have been found, and therefore, the search for new eradication strategies and effective antibiotic therapies has become an issue of crucial importance [30]. Hence, research effort is focused on exploring plants as sources of anti-H. pylori agents.
Acknowledgement
Author Bahare Salehi 1,2, Farukh Sharopov 3, Miquel Martorell 4, Jovana Rajkovic 5, Adedayo Oluwaseun Ademiluyi 6, Mehdi Sharifi-Rad 7, Patrick Valere Tsouh Fokou 8 Natália Martins 9,10, Marcello Iriti 11, and Javad Sharifi-Rad 12,13
Journal
International Journal of Molecular Sciences Volume 19 Issue 8 | 3 | | R460.00 | |
| | Cancer and Heart Failure: Understanding the Intersection. | Cancer and Heart Failure: Understanding the Intersection.
Cancer and Heart Failure: Understanding the Intersection.
Overview
Cancer and cardiovascular disease account for nearly half of all deaths in the US. The majority of cancer therapies are known to cause potential cardiac toxicity in some form. Patients with underlying cardiac disease are at a particularly increased risk for worse outcomes following cancer therapy.
Cardiac risk factors include but are not limited to age, female gender, history of myocardial infarction or LVD and tachycardia, as this may be an early sign of cardiac damage.44 Cardiac biomarkers may provide an additive role in this setting. For patients considered to be at higher risk for the development of cardiotoxicity, a cardio-oncology consultation should be offered.
Whether patients with pre-existing cardiovascular disease require cancer therapy with potentially cardiotoxic agents or previously healthy patients develop cardiac complications from cancer therapy, a collaborative patient-centred approach between the cardiologist and oncologist is essential to successful patient care.
Most alarming is the potential for heart failure as a result of cancer treatment, which may lead to early disruption or withdrawal of life-saving cancer therapies and can potentially increase cardiovascular mortality. A multi-disciplinary cardio-oncology approach can improve outcomes through early surveillance, prevention and treatment strategies. Acknowledgement
Author Carine E Hamo and Michelle W Bloo Journal Cardiac Failure Review
Publisher Radcliffe Cardiology 2017
| 3 | | R425.00 | |
| | A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma | A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma
A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma
Overview
Cardiac angiosarcomas are extremely rare in childhood, they are rapidly progressive tumours that often present themselves as diagnostic dilemmas, resulting in delayed diagnosis. Also, extracardiac manifestations, including abdominal pain, are extremely rare in patients with intracardiac tumours. We herein present the case of a 15-year-old girl who presented with abdominal pain. Echocardiography and thoracic computed tomography showed right atrial mass.
Primary cardiac angiosarcomas in all age groups mostly occur in the right atrium. The most common complaints presented are dyspnea and chest pain, usually related to a malignant cardiac effusion. The pericardium is frequently involved with a right sided angiosarcoma; cardiac tamponade and pericardial effusion are common complications. Our patient had a massive pericardial effusion and malignant cells were seen in cytologic examination.
The patient underwent surgery, chemotherapy, and radiotherapy. Eight months after treatment, abdominal recurrence was detected. The abdominal mass was resected, and radiotherapy and new chemotherapy protocol were given. The present case illustrates a rare case of primary cardiac angiosarcoma posing a diagnostic dilemma in an adolescent girl. Acknowledgement
Authors Elvan Caglar Citak, MD, PhD; Murat Ozeren, MD; M. Kerem Karaca, MD; Derya Karpuz, MD; Feryal Karahan, MD; Eda , Bengi Yilmaz, MD; Yuksel Balci, MD; Pelin Ozcan Kara, MD; Rabia Bozdogan Arpaci, MD Journal Brazilian Journal of Cardiovascular Surgery
| 3 | | R460.00 | |
| | Antitumor Mechanisms of Curcumae Rhizoma Based on Network Pharmacology | Antitumor Mechanisms of Curcumae Rhizoma Based on Network Pharmacology
Antitumor Mechanisms of Curcumae Rhizoma Based on Network Pharmacology
Overview
Curcumae Rhizoma, a traditional Chinese medication, is commonly used in both traditional treatment and modern clinical care. Its anticancer effects have attracted a great deal of attention, but the mechanisms of action remain obscure. In this study, we screened for the active compounds of Curcumae Rhizoma using a drug-likeness approach. Candidate protein targets with functions related to cancer were predicted by reverse docking and then checked by manual search of the PubMed database. Potential target genes were uploaded to the GeneMANIA server and DAVID 6.8 database for analysis. Finally, compound-target, target-pathway, and compound-target-pathway networks were constructed using Cytoscape 3.3.
The results revealed that the anticancer activity of Curcumae Rhizoma potentially involves 13 active compounds, 33 potential targets, and 31 signaling pathways, thus constituting a “multiple compounds, multiple targets, and multiple pathways” network corresponding to the concept of systematic actions in TCM. These findings provide an overview of the anticancer action of Curcumae Rhizoma from a network perspective, as well as setting an example for future studies of other materials used in TCM.
Acknowledgements Yan-Hua Bi, Li-hua Zhang, Shao-jun Chen , and Qing-zhi Ling
Journal Evidence-Based Complementary and Alternative Medicine
Publisher Hindawi | 3 | | R390.00 | |
| | Role of viral and bacterial pathogens in causing pneumonia among Western Australian children | Role of viral and bacterial pathogens in causing pneumonia among Western Australian children
Role of viral and bacterial pathogens in causing pneumonia among Western Australian children
Overview
Pneumonia is the leading cause of childhood morbidity and mortality globally. Introduction of the conjugate Haemophilus influenzae B and multivalent pneumococcal vaccines in developed countries including Australia has significantly reduced the overall burden of bacterial pneumonia.
Many respiratory pathogens that are known to cause pneumonia are also identified in asymptomatic children, so the true contribution of these pathogens to childhood community-acquired pneumonia (CAP) remains unclear. We aim to determine the contribution of bacteria and viruses to childhood CAP to inform further development of effective diagnosis, treatment and preventive strategies.
Nasopharyngeal swabs are collected from both cases and controls to detect the presence of viruses and bacteria by PCR; pathogen load will be assessed by quantitative PCR. The prevalence of pathogens detected in cases and controls will be compared, the OR of detection and population attributable fraction to CAP for each pathogen will be determined; relationships between pathogen load and disease status and severity will be explored.
Acknowledgement
Authors Natalie Mejbah Uddin Bhuiyan, Thomas L Snelling, Rachel West, Jurissa Lang, Tasmina Rahman, Meredith L Borland, Ruth Thornton, Lea-Ann Kirkham, Chisha Sikazwe, Andrew C Martin, Peter C Richmond, David W Smith, Adam Jaffe, Christopher C Blyth.
Journal BMJ Open Publisher Cross Mark | 3 | | R430.00 | |
| | Effects of Aerobic Exercise on Brain Metabolism and Grey Matter Volume in Older Adults: Results of the Randomised Controlled SMART Trial | Effects of Aerobic Exercise on Brain Metabolism and Grey Matter Volume in Older Adults: Results of the Randomised Controlled SMART Trial
Effects of Aerobic Exercise on Brain Metabolism and Grey Matter Volume in Older Adults: Results of the Randomised Controlled SMART Trial
Effects of Aerobic Exercise on Brain Metabolism and Grey Matter Volume in Older Adults: Results of the Randomised Controlled SMART Trial
Overview
There is mounting evidence that aerobic exercise has a positive effect on cognitive functions in older adults. The present study used magnetic resonance spectroscopy and quantitative MRI to systematically explore the effects of physical activity on human brain metabolism and grey matter (GM) volume in healthy aging. The main outcomes were the change in cerebral metabolism and its association to brain-derived neurotrophic factor (BDNF) levels as well as changes in GM volume. We found that cerebral choline concentrations remained stable after 12 weeks of aerobic exercise in the intervention group, whereas they increased in the waiting control group.
No effect of training was seen on cerebral N-acetylaspartate concentrations, nor on markers of neuronal energy reserve or BDNF levels. Further, we observed no change in cortical GM volume in response to aerobic exercise. The finding of stable choline concentrations in the intervention group over the 3 month period might indicate a neuro-protective effect of aerobic exercise. Choline might constitute a valid marker for an effect of aerobic exercise on cerebral metabolism in healthy aging.
Acknowledgement
S Matura, J Fleckenstein, R Deichmann, T Engeroff, E Füzéki, E Hattingen, R Hellweg, B Lienerth, U Pilatus, S Schwarz, VA Tesky, L Vogt, W Banzer and J Pantel.
Journal Nature Translational Psychiatry (2017) 7, e1172
Publisher Unknown Creative Commons, Open Access doi:10.1038/tp.2017.135
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538117/pdf/tp2017135a.pdf
| 3 | | R445.00 | |
| | Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia | Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia
Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia
Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia
Overview
A cohort of pediatric patients with AML treated at hospitals contributing to the Pediatric Health Information System was used to evaluate differences in opioid utilization by sex, age, race, and insurance. Billing data were used to compute the prevalence of opioid exposure and to quantify rates of utilization among those exposed to opioids as days of use per 1000 inpatient days. Multivariable regressions were used to compare opioid prevalence, and rates of utilization among those exposed. The proportion of opioid-exposed patients increased with age, but did not differ by gender, race, or insurance status. There was moderate hospital-level variability in both the prevalence of opioid utilization overall and preference for specific opioid medications. There was greater inconsistency in practice concerning choices for supplemental and alternative opioids than in first-line opioid utilization. Additional work is needed to discern whether observed differences in opioid utilization by age and race reflect a difference in treatment or a difference in the experience of pain. Future studies should also explore the factors which guide decisions on opioid selections in an attempt to explain the variability across institutions.
Acknowledgement
Authors
Kelly D. Getz , Tamara P. Miller, Alix E. Seif , Yimei Li , Yuan-Shung V. Huang, Brian T. Fisher and Richard Aplenc.
Journal PLoS Medicine 2018 Feb Volume 13 Issue 2
Publisher Cross Mark Open Access URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805309/pdf/pone.0192529.pdf
| 3 | | R460.00 | |
| | Opioids and Immunosuppression in Oncological Postoperative Patients | Opioids and Immunosuppression in Oncological Postoperative Patients
Opioids and Immunosuppression in Oncological Postoperative Patients
Opioids and Immunosuppression in Oncological Postoperative Patients
Overview
Recent animal studies demonstrated immune-suppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anaesthesia Care Unit (PACU)-acquired infection after a schedule of sedo-analgesia of at least 6 days. All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion
Recent animal studies demonstrated immune-suppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anaesthesia Care Unit (PACU)-acquired infection after a schedule of sedo-analgesia of at least 6 days. All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion
Acknowledgement
Authors José Luis Bonilla-García, Manuel Cortiñas-Sáenz and Esperanza del Pozo-Gavilán.
Journal Rev Assoc Med Bras 2017; 63(9) URL: http://www.scielo.br/pdf/ramb/v63n9/0104-4230-ramb-63-09-0753.pdf
| 3 | | R485.00 | |
| | Advances in Pharmacotherapy of Tuberculosis | Advances in Pharmacotherapy of Tuberculosis
Advances in Pharmacotherapy of Tuberculosis
Advances in Pharmacotherapy of TuberculosisOverview
Tuberculosis remains a growing threat of infectious diseases of twenty-first century. An attempt to find new anti-tuberculosis agents was made especially to treat multidrug resistant and extensively drug-resistant tuberculosis. One of the most promising drugs is bedaquiline - a new drug approved by Food and Drug Administration (FDA) and by the European Union countries. This compound is intended to treat multi drug-resistant pulmonary tuberculosis in adult patients in combination regimens in case of impossibility of using other drugs. Alarming epidemiological indicators suggesting increased amount of incidents of tuberculosis tended to search for new compounds with potential anti-tuberculosis activity.
This paper is also focused on some interesting molecules in treating multidrug-resistant tuberculosis which are currently tested in clinical studies: delamanid, AZD5847, pretomanid , sutezolid and SQ109 - and some prospective molecules at the level of preclinical studies. Disturbing statistics of frequency of newly recognized tuberculosis or multi-drug resistant tuberculosis was a step to counteract this disease and give some perspectives in clinical trials. The hope in new anti-tuberculosis agents, still tested in clinical studies and the creation of new regimens.
Acknowledgement
Authors Michal Pstragowski, Malgorzata Zbrzezna and Magdalena Bujalska-ZadroØny
Journal Acta Poloniae Pharmaceutica
Publisher Pharmacodynamics, Medical University of Warsaw URL: http://ptfarm.pl/pub/File/Acta_Poloniae/2017/1/003.pdf
| 3 | | R460.00 | |
| | Structure and assembly of the Ebola virus nucleocapsid | Structure and assembly of the Ebola virus nucleocapsid
Structure and assembly of the Ebola virus nucleocapsid
Structure and assembly of the Ebola virus nucleocapsid
Overview
Ebola and Marburg viruses are filoviruses: filamentous, enveloped viruses that cause haemorrhagic fever1. Filoviruses are within the order Mononegavirales2 which also includes rabies virus, measles virus, and respiratory syncytial virus. Mononegaviruses have non-segmented, single-stranded negative-sense RNA genomes that are encapsidated by nucleoprotein (NP) and other viral proteins to form a helical nucleocapsid (NC). NC acts as a scaffold for virus assembly and as a template for genome transcription and replication. Insights into NP-NP interactions have been derived from structural studies of oligomerized, RNA-encapsidating NP3–6 and cryo-electron microscopy (cryo-EM) of NC7–12 or NC-like structures11–13. There have been no high-resolution reconstructions of complete mononegavirus NCs.
Here, we have applied cryo-electron tomography and sub-tomogram averaging to determine the structure of Ebola virus NC within intact viruses and recombinant NC-like assemblies. These structures reveal the identity and arrangement of the NC components, and suggest that the formation of an extended alpha-helix from the disordered C-terminal region of NP-core links NP oligomerization, NC condensation, RNA encapsidation, and accessory protein recruitment. Acknowledgement
Author William Wan, Larissa Kolesnikova, Mairi Clarke, Alexander Koehler, Takeshi Noda, Stephan Becker and John A. G. Briggs.
Journal Nature. 2017 November 16; 551(7680-397)
Publisher URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714281/pdf/emss-74396.pdf
| 3 | | R455.00 | |
| | Gabapentin, opioids, and the risk of opioid related death: A population-based nested case control study: | Gabapentin, opioids, and the risk of opioid related death: A population-based nested case control study:
Gabapentin, opioids, and the risk of opioid related death: A population-based nested case control study:
Gabapentin, opioids, and the risk of opioid related death: A population-based nested case control study:
Overview
Prescription opioid use is highly associated with risk of opioid-related death, with 1 of every 550 chronic opioid users dying within approximately 2.5 years of their first opioid prescription. Although gabapentin is widely perceived as safe, drug-induced respiratory depression has been described when gabapentin is used alone or in combination with other medications.
However, no published studies have examined whether concomitant gabapentin therapy is associated with an increased risk of accidental opioid related death in patients receiving opioids. The objective of this study was to investigate whether co-prescription of opioids and gabapentin is associated with an increased risk of accidental opioid-related mortality. We conducted a population-based nested case-control study among opioid users who were residents of Ontario, Canada.
In this study we found that among patients receiving prescription opioids, concomitant treatment with gabapentin was associated with a substantial increase in the risk of opioid-related death. Clinicians should consider carefully whether to continue prescribing this combination of products and, when the combination is deemed necessary, should closely monitor their patients and adjust opioid dose accordingly. Future research should investigate whether a similar interaction exists between pregabalin and opioids.
Acknowledgement
Author Tara Gomes, David N. Juurlink, Tony Antoniou, Muhammad M. Mamdani, J. Michael Paterson and Wim van den Brink.
Journal PLoS Medicine Volume 14 Issue 10
Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626029/pdf/pmed.1002396.pdf
| 3 | | R470.00 | |
| | Mitochondrial DNA depletion by ethidium bromide decreases neuronal mitochondrial creatine kinase. | Mitochondrial DNA depletion by ethidium bromide decreases neuronal mitochondrial creatine kinase.
Mitochondrial DNA depletion by ethidium bromide decreases neuronal mitochondrial creatine kinase.
Mitochondrial DNA depletion by ethidium bromide decreases neuronal mitochondrial creatine kinase.
Overview
Mitochondrial DNA (mtDNA), the discrete genome which encodes subunits of the mitochondrial respiratory chain, is present at highly variable copy numbers across cell types. Though severe mtDNA depletion dramatically reduces mitochondrial function, the impact of tissue-specific mtDNA reduction remains debated. Previously, our lab identified reduced mtDNA quantity in the putamen of Parkinson's Disease (PD) patients who had developed L-DOPA Induced Dyskinesia (LID), compared to PD patients who had not developed LID and healthy subjects.
Here, we present the consequences of mtDNA depletion by ethidium bromide (EtBr) treatment on the bioenergetic function of primary cultured neurons, astrocytes and neuron-enriched cocultures from rat striatum. EtBr also increases glycolytic activity in astrocytes, whereas in neurons it reduces the expression of mitochondrial creatine kinase mRNA and levels of phosphor-creatine. Further, we show that mitochondrial creatine kinase mRNA is similarly downregulated in dyskinetic PD patients, compared to both non-dyskinetic PD patients and healthy subjects.
Our data support a hypothesis that reduced striatal mtDNA contributes to energetic dysregulation in the dyskinetic striatum by destabilizing the energy buffering system of the phospho-creatine/creatine shuttle.
Acknowledgement
Author Emily Booth Warren, Aidan Edward Aicher, Joshua Patrick Fessel and Christine Konradi
Journal PLoS ONE
Publisher Cross Mark
| 3 | | R455.00 | |
| | 21st Century Cardio-Oncology: Identifying Cardiac Safety Signals in the Era of Personalised Medicine | 21st Century Cardio-Oncology: Identifying Cardiac Safety Signals in the Era of Personalised Medicine
21st Century Cardio-Oncology: Identifying Cardiac Safety Signals in the Era of Personalised Medicine
21st Century Cardio-Oncology: Identifying Cardiac Safety Signals
Overview
Cardiotoxicity is a well-established complication of oncology therapies. Cardio-myopathy resulting from anthracyclines is a classic example. However, some of our recent therapies have introduced an assortment of cardiovascular (CV) complications. At times, these devastating outcomes have only become apparent after drug approval and have limited the use of potent therapies. There is a growing need for better testing platforms, both for CV toxicity screening, as well as for elucidating mechanisms of cardio-toxicities of approved cancer therapies.
As the focus of anticancer therapies shifts from a broadly cytotoxic approach to more targeted molecular treatments, there is increasing concern for unexpected CV toxicities that have been reported through case reports and retrospective studies This review discusses the utility of nonclinical models (in vitro, in vivo, & in silico) available and highlights recent advancements in modalities like human stem cell-derived cardio-myocytes for developing more comprehensive cardio-toxicity testing and new means of cardio-protection with targeted anticancer therapies.}
Acknowledgement
Authors
Radek Calvin Chen Sheng, MD, Laleh Amiri-Kordestani, MD, Todd Palmby, PhD, Thomas Force, MD, Charles C. Hong, MD, PhD, Joseph C. Wu, MD, PhD, Kevin Croce, MD, PhD, Geoffrey Kim, MD, and Javid Moslehi, MD
Journal JACC Basic Transl Sci. 2016 August ; 1(5): 386–398.
Publisher Department of Health & Human Services USA
| 3 | | R450.00 | |
| | Medical Tourism. | Medical Tourism.
Overview
BACKGROUND: Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment.
OBJECTIVE:
This article provides an outline of the current research around medical tourism, especially its impact on Australians.
DISCUSSION:
Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad
Acknowledgement
Author:
Leggat P
Journal:
Australian family physician.
Publisher:
Focus Environmental
| 3 | | R360.00 | |
| | A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa. | A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa.
A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa.
Overview
The drugs that are used in treating any condition, be it an innocuous cough or a life-threatening cancer are the hard work of human clinical trials. Of course, these trials are the only credible way to determine the safety and efficiency of drugs. As a matter of fact, without clinical trials, pharmaceutical research will not advance to improve disease management as well and the quality of life in human beings.
This study was therefore designed to assess the relation between the number of clinical trials conducted as well as respective new drug approvals in India and South Africa. The research was nonetheless conducted in four different settings, namely, USA, Europe, India and South Africa. The research was done though the construction and analysis of a comprehensive database of completed randomized controlled clinical trials based on clinical trials.
The results from distribution of the market application approvals between the EU/USA as well as India and South Africa revealed that out of clinical trials with the participation of test centers in India and/or South Africa, 39.6% (India) clinical trials and 60.1% (South Africa) clinical trials led to market authorization in the EU/USA without a New Drug Application (NDA) approval in India or South Africa.
ACKNOWLEDGEMENT
AUTHORS: Dnyanesh Limaye, Janka Marisa Langer, Tjorben Rühling, Gerhard Fortwengel JOURNAL: BMJ Journals
PUBLISHERS: group.bmj.com URL: http://bmjopen.bmj.com/
| 3 | | R345.00 | |
| | Body Psychotherapeutic Treatment for Anxiety Disorders. | Body Psychotherapeutic Treatment for Anxiety Disorders.
Body Psychotherapeutic Treatment for Anxiety Disorders.
Edited By: David Wilson
An introduction to the field of body psychotherapy, which aims to address anxiety by intervening at the bodily level rather than the traditional reliance on verbal talking cures. Modern attachment theory has accumulated a rich source of data based on decades of audio-visual recordings, documenting the genesis of our earliest non-verbal patterns of interpersonal relating. It is hoped that this introduction will pave the way for clinicians frustrated with the limits of the talking cure to undertake further exploration in both theory and techniques suggested by body psychotherapeutic traditions as an adjunct to their existing clinical repertoire. | 3 | | R400.00 | |
| | Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study. | Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study.
Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study.
OVERVIEW
There are evidences that drugs used in treating attention-deficit/hyperactivity disorder (ADHD) are efficacious in reducing symptoms of impulsivity and hyperactivity in children,1 but concerns have been expressed about possible adverse cardiovascular events with the first line treatment, methylphenidate.
Thus, the aim of this study was to determine whether treatment with methylphenidate in children and young people with attention-deficit/ hyperactivity disorder (ADHD) was associated with cardiovascular events. The design for this study was a self-controlled case series analysis meanwhile the setting was the Nationwide Health Insurance database, from 1 January 2008 to 31 December 2011, in South Korea. Participants of this study were 1224 patients aged =17 who had experienced an incident cardiovascular event and with at least one incident prescription for methylphenidate.
Major results of this study indicated that increased risk of arrhythmia was observed in all exposed time periods, that is, periods of treatment with methylphenidate - (incidence rate ratio 1.61, 95% confidence interval 1.48 to 1.74), and the risk was highest in the children who had congenital heart disease.
ACKNOWLEDGEMENT
AUTHORS: Ju-Young Shin, Elizabeth E Roughead, Byung-Joo Park, Nicole L Pratt
JOURNAL: Eighth International Congress on Peer Review and Scientific Publication
PUBLISHER: BMJ Group
URL: http://www.bmj.com | 3 | | R380.00 | |
| | Comparative assessment of onabotulinumtoxinA and mirabegron for overactive bladder. | Comparative assessment of onabotulinumtoxinA and mirabegron for overactive bladder.
Comparative assessment of onabotulinumtoxinA and mirabegron for overactive bladder.
OVERVIEW
There are indications that OAB and urinary incontinence (UI) are associated with recurrent urinary tract infection and skin breakdown, infection, and/or ulceration. More so, UI is also largely associated to social stigma and may subsequently result to loss of independence thereby reducing the patient's health related quality of life. Thus, the objective of this study was to evaluate the relative efficacy of mirabegron and onabotulinumtoxinA in patients with idiopathic OAB.
The design of this study was a network meta-analysis while data was obtained by searching through 9 electronic databases, review documents, guidelines and websites. The methods used in carrying out this study were randomized trials that aimed at comparing any licensed dose of onabotulinumtoxinA or mirabegron with each other.
Results from the trials indicated that patients in the onabotulinumtoxinA trials had more urinary incontinence and urgency episodes at baseline than patients in the mirabegron trials and these differences were adjusted for using NMR. The results further indicated that both onabotulinumtoxinA and mirabegron were more efficacious than placebo at reducing the frequency of urinary incontinence, urgency, urination and nocturia.
ACKNOWLEDGEMENT
AUTHORS: Nick Freemantle, David A Ginsberg, Rachael McCool, Kelly Fleetwood, Mick Arber, Kristin Khalaf, Clara Loveman, Quanhong Ni, Julie Glanville
JOURNAL: BMJ Open Journal
PUBLISHER: group.bmj.com
URL: http://bmjopen.bmj.com | 3 | | R355.00 | |
| | Diagnosis and Management of Asthma in Children. | Diagnosis and Management of Asthma in Children.
Diagnosis and Management of Asthma in Children.
OVERVIEW
Asthma is a very common illness faced by children the world over. With that said, rather than escalating treatment in severe and problematic cases of childhood cancer, a more systematic approach is needed to find a solution to this problem. Elements of the systematic approach included a review of the diagnosis, adherence, the ability to take drugs correctly as well as the environment of the children in question.
The objective of this article was therefore to review other articles concerning the treatment and management of childhood asthma that should prompt a focused and urgent review of what trigger factors led to asthma attacks and whether the attacks were appropriately managed. Some of the articles that were reviewed during this research were obtained from PubMed and Cochrane database.
However, only articles related to the diagnosis and practical management of asthma were selected for this research. Also, small trials and case series were excluded if the findings had been subsumed into a meta-analysis or Cochrane review.
ACKNOWLEDGEMENT
AUTHORS: Andrew Bush, (paediatrics) and Louise Fleming (senior clinical lecturer)
JOURNAL: BMJ Journals
PUBLISHER: BMJ Open
URL: https://www.group.bmj.com
| 3 | | R400.00 | |
| | Differentiating Types of Stress: Coping Methods in Explaining Mechanisms Underlying Types of Burnout. | Differentiating Types of Stress: Coping Methods in Explaining Mechanisms Underlying Types of Burnout.
Differentiating Types of Stress: Coping Methods in Explaining Mechanisms Underlying Types of Burnout.
Edited By: David Wilson.
Burnout occurs when professionals use ineffective coping strategies to try to protect themselves from work-related stress. The dimensions of ‘overload’ lack of development’ and ‘neglect’, belonging to the ‘frenetic’, ’under-challenged’ and ‘worn out’ subtypes, respectively, compromise a brief typological definition of burnout. The aim of the present study was to estimate the explanatory power of the different coping strategies on the development of burnout subtypes.
| 3 | | R400.00 | |
| | Factors Influencing the Inclusion of Complementary and Alternative Medicine (CAM) in Undergraduate Medical Education. | Factors Influencing the Inclusion of Complementary and Alternative Medicine (CAM) in Undergraduate Medical Education.
Factors Influencing the Inclusion of Complementary and Alternative Medicine (CAM) in Undergraduate Medical Education.
OVERVIEW
This paper examines the inclusion (or otherwise) of complementary and alternative medicine (CAM) in medical syllabi in UK medical schools. The objective of this study was therefore to investigate the views and practices of UK medical schools regarding the inclusion (or exclusion) of complementary and alternative medicine (CAM) in undergraduate medical curricula.
This study was however done through an email survey of UK medical schools offering MBBS as well as its equivalent degrees. The results of this study suggested that all respondents indicated that their curricula included CAM elements. It is imperative to mention that the quantity of CAM within curricula varied widely between medical schools, as did the methods by which CAM education was delivered.
The results further suggested that the requirements of the General Medical Council were the strongest factor influencing the inclusion of CAM, medical student preferences were also important. This study was however concluded that it could be useful for the General Medical Council to clarify the extent to which CAM should be incorporated into the curriculum.
ACKNOWLEDGEMENT
AUTHORS: Kevin R Smith
JOURNAL: Journal of Epidemiology and Community Health
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com | 3 | | R330.00 | |
| | How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics. | How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics.
How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics.
OVERVIEW
Pain is a common experience in the daily lives of adolescents. However, headache, abdominal and musculoskeletal types of pain are the most common type of pain experienced by adolescents.
The objective of this research was to describe how different adolescents experience and manage pain in their daily life. Focus was however made their use of over-the counter analgesics. The design for this stud was qualitative semi structured interviews in which adolescents shared their experiences with pain, pain management and involvement of family and friends during pain. The participants of this study were 25 young people (both males and females) aged 15 to 16 from different junior high schools. These students were interviewed irrespective of their immigration background in their respective schools in Norway. The study was concluded that different involvement with the family during pain related to their pain perception and management by the adolescents.
At the end of the study it was recommended that Knowledge of the different ways of approaching pain is important when supporting adolescents and may be a subject for further research on the use of over-the-counter analgesics in the family.
ACKNOWLEDGEMENT
AUTHORS: Per Lagerløv, Elin Olaug Rosvold, Tanja Holager, Sølvi Helseth
JOURNAL: Stroke and Vascular Neurology
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com | 3 | | R425.00 | |
| | Improving the Management of Behaviour Associated with Dementia in Care Homes. | Improving the Management of Behaviour Associated with Dementia in Care Homes.
Improving the Management of Behaviour Associated with Dementia in Care Homes.
OVERVIEW
The inappropriate use of antipsychotics in people with dementia for behaviour that challenges is associated with an estimated 1800 deaths annually. However, solely focusing on antipsychotics may transfer prescribing to other equally dangerous psychotropics. Little is known about the role of pharmacists in the management of psychotropics used to treat behaviours that challenge.
This research aims to determine whether it is feasible to implement and measure the effectiveness of a combined pharmacy–health psychology intervention incorporating a medication review and staff training package to limit the prescription of psychotropics to manage behaviour that challenges in care home residents with dementia. 6 care homes within the West Midlands will be recruited. People with dementia receiving medication for behaviour that challenges, or their personal consultee, will be approached regarding participation. Medication used to treat behaviour that challenges will be reviewed by the pharmacist, in collaboration with the general practitioner (GP), person with dementia and carer.
The project has received a favourable opinion from the East Midlands REC (15/EM/3014). If potential participants lack capacity, a personal consultee will be consulted regarding participation in line with the Mental Capacity Act. Results will be published in peer-reviewed journals and presented at conferences.
ACKNOWLEDGEMENT
AUTHORS: Ian D Maidment et al.
JOURNAL: Mental Health
PUBLISHERS: BMJ Open
URL: http://bmjopen.bmj.com/ | 3 | | R335.00 | |
| | Initiating Antiretroviral Therapy for HIV at a Patient’s First Clinic Visit. | Initiating Antiretroviral Therapy for HIV at a Patient’s First Clinic Visit.
Initiating Antiretroviral Therapy for HIV at a Patient’s First Clinic Visit.
OVERVIEW
The late presentation of patients for care and high rates of attrition from care between HIV testing and ART initiation, with baseline median CD4 cell counts remaining well below 200 cells/mm3 are some of the most persistent operational challenges facing antiretroviral therapy (ART) programs for HIV/AIDS in sub-Saharan.
The purpose of this study was therefore to estimate the effect on uptake of ART and viral suppression of an accelerated initiation algorithm that allowed treatment-eligible patients to be dispensed their first supply of antiretroviral medications on the day of their first HIV-related clinic visit. This study was nonetheless conducted in two public sector clinics in South Africa, notably a primary health clinic (PHC) and a hospital-based HIV clinic. The participants of this study were averagely 18 years old non-pregnant patients receiving a positive HIV test or first treatment-eligible CD4 count were randomized to standard or rapid initiation.
The study was however concluded that offering single-visit ART initiation to adult patients in South Africa increased uptake of ART by 36% and viral suppression by 26%.
ACKNOWLEDGEMENT
AUTHORS: Sydney Rosen, Mhairi Maskew, Matthew P. Fox, Cynthia Nyoni, Constance Mongwenyana, Given Malete, Ian Sanne, Dorah Bokaba, Celeste Sauls, Julia Rohr1, Lawrence Long
JOURNAL: PLOS Medicine
PUBLISHER: PLOS
URL: https://www.plos.org | 3 | | R365.00 | |
| | Peptic Ulcers | Peptic Ulcers
OVERVIEW
Peptic Ulcers are a common disease characterised by injuries of the gastrointestinal mucosa of the stomach or duodenum. The enzyme pepsin and gastric acid are factors involved in the pathogenesis of ulcers.
The most important risk factors for the development of peptic ulcers are infection with Helicobacter Pylori and the use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). If neither of these factors is present, an alternative aetiology must be sought, such as hypersecretory states (e.g. Zollinger-Ellison syndrome) or one of the other less common causes of ulcer disease, including Crohn's disease, vascular insufficiency, viral infection, radiation therapy, and cancer chemotherapy.
This study looks at the common causes and what medicine to treat with. | 3 | | R325.00 | |
| | Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis. | Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis.
Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis.
OVERVIEW
The objective of this study was to analyse the impact of placebo effects on outcome in trials of selected minimally invasive procedures and to assess reported adverse events in both trial arms. The design for this study was nonetheless a systematic review and meta-analysis.
The data for this study was selected by searching MEDLINE and Cochrane library so as to identify systematic reviews of musculoskeletal, neurological and cardiac conditions that were published between January 2009 and January 2014 comparing selected minimally invasive with placebo (sham) procedures. During this research, effect sizes (ES) in the active and placebo arms in the trials’ primary and pooled secondary end points were calculated. The association between end points in the active and sham groups were nevertheless analysed using the linear regression.
This study was however concluded that the generally small differences in ES between active treatment and sham suggest that nonspecific mechanisms, including placebo, are major predictors of the observed effects
ACKNOWLEDGEMENT
AUTHOR: Robin Holtedahl, Jens Ivar Brox, Ole Tjomsland
JOURNAL: Stroke and Vascular Neurology
PUBLISHER: BMJ Open
URL: http://bmjopen.bmj.com/ | 3 | | R375.00 | |
| | Practice Issues. | Practice Issues.
OVERVIEW
It is important to note that the responses to the various questions are the views independently expressed and are not necessarily opinions shared by cpdexpress.co.za. As matters involving Ethics and the law are subject to interpretation, the responses cannot, in any way, be regarded as binding or necessarily endorsed by the regulatory authorities.
There are ethical dilemmas regarding patients, colleagues and associates that one doesn’t even consider until they become issues in their practice. There are many questions to be asked regarding ethics, touting, canvassing, advertising, competition and many other issues that need to be addressed and this article addresses most of them. | 3 | | R450.00 | |
| | Private Practice: The Do's And Don'ts. | Private Practice: The Do's And Don'ts.
Private Practice: The Do's And Don'ts.
OVERVIEW
You have studied extensively to become a healthcare professional in your field of study. You have learned and become adept at identifying a vast range of conditions. You can diagnose and effectively treat those conditions within the scope of the discipline.
Now you are faced with a plethora of dilemmas. What is fair value for your services? What appliances are appropriate and reasonable? What commercial and legal structures are appropriate for you? What influence may these commercial and legal structures have on your clinical recommendations? Who may have access to your record cards? What responsibility can you delegate to your staff? Who carries final responsibility for payment of your claims – member or medical aid? What constitutes anti-competitive behavior?
This is a very informative article that will help you to run your practice within the various guidelines. | 3 | | R400.00 | |
| | Qualitative study to conceptualise a model of interprofessional collaboration between pharmacists and general practitioners to support patients’ adherence to medication. | Qualitative study to conceptualise a model of interprofessional collaboration between pharmacists and general practitioners to support patients’ adherence to medication.
Qualitative study to conceptualise a model of interprofessional collaboration between pharmacists and general practitioners to support patients’ adherence to medication.
OVERVIEW
Hospital admission for chronic obstructive pulmonary disease (COPD) is a One of the most significant issues for patients, prescribers and healthcare systems across the globe remains medication non-adherence. Therefore, pharmacists and general practitioners (GPs) face an increasing expectation to collaborate interprofessionally on many healthcare issues, including medication non-adherence.
This study aimed at proposing a model of interprofessional collaboration within the context of identifying and improving medication non-adherence in primary care. The setting of this study was in primary care in Sydney (Australia). During this study, three focus groups were conducted with pharmacists while the primary and secondary outcome measures were qualitative investigation of GP and pharmacist interactions with each other, specifically around supporting their patients’ medication adherence. During this study, audio recordings were transcribed verbatim and transcripts thematically analysed using a combination of manual and computer coding.
The results identified 3 themes pertaining to inter professional collaboration. The three themes included: (1) frequency, (2) co-collaborators and (3) nature of communication which included 2 subthemes (method of communication and type of communication).
ACKNOWLEDGEMENT
AUTHORS: Adam P Rathbone, Sarab M Mansoor, Ines Krass, Kim Hamrosi, Parisa Aslani
JOURNAL: BMJ Open
PUBLISHER: BMJ
URL: http://bmjopen.bmj.com
| 3 | | R325.00 | |
| | Sports Injuries and Rehabilitation: NSAIDS and Sports Injuries. | Sports Injuries and Rehabilitation: NSAIDS and Sports Injuries.
Sports Injuries and Rehabilitation: NSAIDS and Sports Injuries.
OVERVIEW
For many years the prescription of NSAIDs for all kinds of sport injuries (soft tissue injuries, tendon injuries and bone fractures) has been a staple of sports medicine. NSAIDs have well established analgesic effects, but also have proven side effects. Despite the risks, the medical community has considered the safety/efficiency ratio satisfactory enough to accept the administration of NSAIDs. But does this conventional wisdom still hold true?
This course looks at recent research around NSAIDs – some of which has produced surprising results. This information is important to every medical professional who frequently prescribes or recommends NSAIDs to deal with sports injuries. | 3 | | R400.00 | |
| | Synergies, tensions and challenges in HIV Prevention, treatment and cure research. | Synergies, tensions and challenges in HIV Prevention, treatment and cure research.
Synergies, tensions and challenges in HIV Prevention, treatment and cure research.
OVERVIEW
The ethical concerns associated with HIV prevention and treatment research have been widely explored in South Africa over the past 3 decades. Because HIV cure research is relatively new to the region, significant ethical and social challenges are anticipated.
In-depth interviews were conducted on a purposive sample of fourteen key informants in South Africa. Audiotaped interviews were transcribed verbatim with concurrent thematic analysis. The perspectives of HIV clinicians, researchers and activists were captured.
Participants described a symbiotic relationship between cure, treatment and prevention research necessitating collaboration. Assessing and managing knowledge and expectations around HIV cure research emerged as a central theme related to challenges to constructing ‘cure’ - how patients understand the idea of cure is important in explaining the complexity of cure research especially in the South African context where understanding of science is often challenging.
It was encouraging to note the desire for synergy amongst researchers and clinicians working in the fields of prevention, treatment and cure. Translation of complex HIV cure science into lay language is critical. It is hoped that knowledge and resource sharing in the context of collaboration between research scientists working in cure and those working in treatment and prevention will accelerate progress towards cure.
ACKNOWLEDGEMENT
AUTHORS: Keymanthri Moodley, Theresa Rossouw, Ciara Staunton and Christopher J. Colvin
JOURNAL: BMC Medical Ethics
PUBLISHER: Biomed Central
https://www.biomedcentral.com/
| 3 | | R89.00 | |
| | The Red Eye Causes and Presentation. | The Red Eye Causes and Presentation.
The Red Eye Causes and Presentation.
OVERVIEW
Every optometrist, doctor, health care worker, ophthalmologist has been confronted by a patient complaining of red, bloodshot eyes, affecting one or both eyes. All health care workers should know what The Red Eye is, and about its presentation, causes and treatment. If not treated or referred for treatment correctly The Red Eye can be a potentially dangerous condition to the health of the eye and even the patient. This article is a brief review of these aspects of The Red Eye.
Noticeable redness or pink discolouration of the sclera (the ‘white part’) of one or both eyes with or without symptoms or swelling of the involved tissues or eyelids, and with or without discharge from the eye. The Red Eye appearance is thus caused by swollen or dilated blood vessels on the sclera and /or conjunctiva, the white outer surface of the eye and its coverings, or bleeding from one of these vessels into the tissues visible on the sclera
OVERVIEW
Every optometrist, doctor, health care worker, ophthalmologist has been confronted by a patient complaining of red, bloodshot eyes, affecting one or both eyes. All health care workers should know what The Red Eye is, and about its presentation, causes and treatment. If not treated or referred for treatment correctly The Red Eye can be a potentially dangerous condition to the health of the eye and even the patient. This article is a brief review of these aspects of The Red Eye.
Noticeable redness or pink discolouration of the sclera (the ‘white part’) of one or both eyes with or without symptoms or swelling of the involved tissues or eyelids, and with or without discharge from the eye. The Red Eye appearance is thus caused by swollen or dilated blood vessels on the sclera and /or conjunctiva, the white outer surface of the eye and its coverings, or bleeding from one of these vessels into the tissues visible on the sclera.
| 3 | | R375.00 | |