Abbottmcdonald2482
This study evaluated the protective effect of TiF4 and chitosan toothpaste on erosive tooth wear (ETW) in vitro. Enamel and dentin samples were randomly assigned to toothpastes (n = 12) (G1) TiF4 (1400 ppm F-), (G2) 0.5% chitosan (75% deacetylation, 500 mPas), (G3) TiF4 (1400 ppm F-) plus 0.5% chitosan (75% deacetylation, 500 mPas), (G4) Placebo, (G5) Erosion Protection (Elmex-GABA, 1400 ppm F-). Twelve samples were only eroded. All samples were submitted to erosive pH cycles and G1 to G5 to abrasive challenges using toothpastes' slurries plus 45 s of treatment, for 7 days. The final profile was overlaid to the baseline one for the ETW calculation (µm). The data were subjected to Kruskal-Wallis/Dunn tests. TiF4 toothpastes, regardless of the presence of chitosan, were able to significantly reduce ETW compared to placebo, while chitosan alone was similar to placebo for both tissues. The toothpastes containing TiF4 were even superior to the commercial Elmex toothpaste on enamel, while they were similar on dentin; both were also significantly different from placebo for both tissues. TiF4 and Elmex toothpastes minimized the impact of brushing on eroded surface. In conclusion, TiF4 toothpastes, regardless the presence of chitosan, showed to be effective in minimizing ETW in vitro.
The National Diabetes Surveillance System (NDSS) case definition, which identifies a case of diabetes using administrative health records as"two physician claims or one hospital discharge abstract record, within a 2-year period for a diagnosis bearingInternational Classification of Diseasecodes for diabetes," was compared with expanded case definitions, including pharmacy (PHARM) and laboratory (LAB) data. The PHARM definition included any therapeutic antihyperglycemic agents, and the LAB definition included thresholds of ≥1 glycated hemoglobin measurement of ≥6.5%, or 2 instances of random glucose ≥11.1 mmol/L or fasting glucose ≥7.0 mmol/L.
In this retrospective study we used administrative data from the Diabetes Infrastructure for Surveillance, Evaluation, and Research project. Descriptive statistics were used to characterize participants by several subgroups.
The NDSS identified 291,242 diabetes cases, indicating a provincial prevalence of 6.83%. Using LAB plus PHARM identified 52,040 additional case the yield for detection of diabetes cases in Alberta and provide a richer understanding of this population to target interventions to improve health outcomes.
To describe the clinical experience with dalbavancin in the treatment of diabetic foot infection in a multidisciplinary unit of a second level hospital.
A retrospective, descriptive study was made with all patients with diabetic foot infection treated with dalbavancin in the Diabetic Foot Unit of Hospital Universitario Fundación Alcorcón, covering the period from September 2016 to December 2019. Demographic parameters and comorbidities, characteristics of the infection and treatment with dalbavancin were recorded. The cure rate is estimated at 90 days after finishing the treatment.
A total of 23 patients with diabetic foot infection (osteomyelitis) started treatment with dalbavancin, 19 were men and the mean age was 65 years. The microorganisms most frequently isolated for the indication of treatment with dalbavancin were Staphylococcus aureus (11) and Corynebacterium striatum (7). Dalbavancin was used as a second choice therapy in 22 cases, in 11 due to toxicity from other antibiotics. The median duration of treatment was 5 (4-7) weeks; the most frequent dose of dalbavancin (8 patients) was 1000 mg followed by 500 mg weekly for 5 weeks. 3 patients presented mild side effects (nausea and gastrointestinal discomfort). At 90 days after completion of dalbavancin therapy, 87% (20) of the patients were cured (95% CI 65.2%-94.52%).
Patients with osteomyelitis due to gram-positive microorganisms who received as part of the multidisciplinary antibiotic treatment with dalbavancin, had a high rate of cure with adequate tolerance and few side effects. Dalbavancin offers a safe alternative in treating deep diabetic foot infection.
Patients with osteomyelitis due to gram-positive microorganisms who received as part of the multidisciplinary antibiotic treatment with dalbavancin, had a high rate of cure with adequate tolerance and few side effects. Dalbavancin offers a safe alternative in treating deep diabetic foot infection.
The COVID-19 pandemic has significantly challenged maternity provision internationally. selleck chemical Rapid and radical changes were implemented, with midwives facing anxiety and moral distress if not able to provide optimal and woman-centred care in line with professional values.
Healthcare professionals' stress and burnout are commonly reported during other global emergencies, which may eventually contribute to reduced quality of care. There is lack of evidence of the challenges faced by midwives in Italy during the COVID-19 pandemic.
To explore midwives' experiences of providing care to women and families during the COVID-19 pandemic.
Qualitative interpretive phenomenological approach, using semi-structured interviews and thematic analysis. The sample included 15 midwives. Ethical approval was obtained.
Four themes were identified 1) adjusting to the ever-evolving organisation of care; 2) physical, psychological and relational challenges; 3) support network; 4) deferred sense of awareness.
Midwives faced propandemic, optimisation of midwives' physical, emotional and psychological wellbeing should be considered. Timely and comprehensive guidelines and appropriate resources should be provided to assist midwives in facilitating family-centred respectful maternity care and preserving childbirth as a bio-psychosocial event.
To document changes in urinary biomarker concentration and conventional diagnostic tests of acute kidney injury (AKI) following hypotension and fluid resuscitation in anaesthetized dogs.
Experimental, repeated measures, prospective study.
A group of six male adult Greyhound dogs.
Following general anaesthesia, severe hypotension was induced by phlebotomy, maintaining mean arterial blood pressure (MAP) < 40 mmHg for 60 minutes, followed by resuscitation with intravenous gelatine solution to maintain MAP > 60 mmHg for 3 hours. Following euthanasia, renal tissue was examined by light microscopy (LM) and transmission electron microscopy (TEM). Urinary and serum concentrations of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC), and gamma-glutamyl transpeptidase (GGT), serum creatinine and urine output were measured at baseline and hourly until euthanasia. Data are presented as mean and 95% confidence interval and analysed using repeated measures analysis of variance with Dunnett're consistently elevated within 1 hour of severe hypotension, suggesting that proximal renal tubules are damaged in the earliest stage of ischaemia-reperfusion AKI. Measurement of urinary biomarkers may allow early diagnosis of AKI in anaesthetized dogs. Urinary GGT concentration and UPC are particularly useful as they can be measured on standard biochemistry analysers.
The concept of integrating a clinical pharmacist (CP) within a Hospital-in-the-Home (HiTH) program is relatively new. Little is known about the role of a pharmacist in HiTH programs focused on mental health (MH).
To describe the role of a CP within an MH-HiTH program, focusing on the specific tasks performed by a pharmacist in this position, their benefits and limitations.
MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science and the grey literature were searched without any date limits for references in English that included 2 or more of the following key terms (or their synonyms) "HiTH", "clinical pharmacist" and "mental health". Two reviewers independently screened and analysed the data.
Of 60,482 screened references, 6 included all 3 key terms 2 were HiTH guideline documents, 2 were conference abstracts and 2 were journal articles. These papers discussed MH-HiTH programs or similar home-care services where a CP was incorporated in the treating team to address me describing the incorporation of a CP in an MH-HiTH program, preliminary evidence shows it can improve medication management. This has potential to improve patient outcomes as has been seen in similar home-based settings, but limitations such as time constraints are notable barriers. More robust studies are needed to evaluate these outcomes.Health technology assessment (HTA) typically uses average health-related quality of life gain as its main measure of benefit used in economic evaluation. Nevertheless, there have been calls to consider novel aspects of benefit including the "value of hope," defined as a patients' potential preferences for a wider distribution of treatment benefit with a positive skew, in the hope that they will be one of the lucky ones. The value of hope may also derive from feeling hopeful as a positive mental state, which may be missing from current measures of health-related quality of life. The value attributed to feeling hopeful could be related to, or additional to, the value derived from possible risk-seeking preferences. Here, we reflect upon the strength of the case for the inclusion of the "value of hope" taking a critical look at the commonly referenced evidence for including the "value of hope" as risk-seeking preferences. We also draw attention to other conceptions of hope-as an emotion, a cognitive process, or a combination of both-and reflect upon the potential of including these broader notions of hope into HTA. The case for the inclusion of the "value of hope" based on risk-seeking preferences is weak. We suggest research questions that could give further evidence on whether hope is an important missing value from HTA.
The COVID-19 pandemic necessitates time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research immediate approval, use only in research, approval with research (eg, emergency use authorization), or reject.
Using a cohort state-transition model for hospitalized patients with COVID-19, we estimated quality-adjusted life-years (QALYs) and costs associated with the following interventions hydroxychloroquine, remdesivir, casirivimab-imdevimab, dexamethasone, baricitinib-remdesivir, tocilizumab, lopinavir-ritonavir, interferon beta-1a, and usual care. We used the model outcomes to conduct cost-effectiveness and value of information analyses from a US healthcare perspective and a lifetime horizon.
Assuming a $100 000-per-QALY willingness-to-pay threshold, only remdesivir, casirivimab-imdevimab, dexamethasone, baricitinib-remdesivir, and tocilizumab were (cost-) effective (incrs and clinicians about the optimal moment to implement therapies and whether to perform further research.This paper examines the distinction drawn between endemic and epidemic yellow fever in the twentieth century and the policy implications of conceptualizing yellow fever as distinct in different world regions. The history of yellow fever research in Africa reveals how particular perceptions of place undergirded evolving scientific knowledge of yellow fever epidemiology. Efforts to map yellow fever endemicity in Africa and to understand the endemic threat of "jungle" yellow fever unfolded within a colonial framework that viewed Africa and Africans as "diseased." The study explores how the notions of place embedded in endemic versus epidemic disease translated into differential prevention strategies and access to vaccines leading to highly unequal burdens of yellow fever. The history of yellow fever research in Africa is potentially instructive for a range of health threats that have historically been mapped onto places and peoples in ways that privilege differential policy pathways.
