Hamannmunck6280

In these patients, we also observed an increase of inflammatory miRNAs. CONCLUSION The different expression of miRNAs and HDAC4 in genetic ALS vs. SALS and UMN cases is likely to be correlated to different pathogenic mechanisms.
.OBJECTIVE Low-molecular-weight heparins are frequently used to prevent venous thromboembolism. Vasopressor therapy may be associated with inadequate anti-factor Xa activity, thereby increasing the risk of venous thromboembolism. We aimed to assess the association between anti-factor Xa activity and norepinephrine dose in intensive care unit (ICU) patients treated with subcutaneous dalteparin for venous thromboembolism prophylaxis. MATERIALS AND METHODS This was a prospective observational pilot study in adult ICU patients treated with dalteparin 5,000 IU subcutaneously once daily and norepinephrine > 0.25 µg/kg/min. Peak anti-factor Xa activity was monitored and dalteparin doses were adjusted following a predefined dose algorithm. RESULTS From November 2016 to April 2018, 32 patients were included. No correlation was found between norepinephrine dose and anti-factor Xa activity (r = -0.01, 95% confidence interval = -0.47 - 0.27, p = 0.57). Furthermore, following dalteparin 5,000 IU once daily, 28% of the patients showed anti-factor Xa activity less then 0.10 IU/mL. Higher body mass index (BMI) (p less then 0.001) but not patients' norepinephrine dose, age, or serum creatinine were risk factors for anti-factor Xa activity less then 0.10 IU/mL. Dose increments to 7,500 IU once daily resulted in anti-factor Xa activity ≥ 0.10 IU/mL in all 5 patients (p = 0.043). CONCLUSION In this cohort of ICU patients, no association was found between norepinephrine dose and anti-factor Xa activity following subcutaneous dalteparin 5,000-IU administration once daily. Furthermore, nearly one-third of the patients showed anti-factor Xa activity below the target concentration for venous thromboembolism prophylaxis. Higher BMI was an independent risk factor for reduced anti-Xa activity.
.OBJECTIVE Vancomycin is a commonly used glycopeptide antibiotic due to its effectiveness in treating serious Gram-positive bacterial infections, especially methicillin-resistant Staphylococcus aureus (MRSA) infection. Pancytopenia is a rare, yet serious, complication of vancomycin. Previous isolated cases have been reported in adults but none in children. CASE REPORT A 16-month-old boy received vancomycin for treatment of osteomyelitis caused by MRSA. During his administration of vancomycin, reversible pancytopenia, pulmonary infection, and skin rash developed, which resolved after withdrawal. CONCLUSION This is the first known case of vancomycin causing reversible pancytopenia and skin rash in a child, suggesting that pancytopenia caused by vancomycin could complicate treatment of children, and the hypothesis that pancytopenia is an immune-mediated reaction seems to be preferable. According to drug hypersensitivity syndrome (DHS) risk assessment in 10-D assessment system, this case was at grade of no risk.
.OBJECTIVE Hurricane Harvey, which made landfall in Texas on August 24, 2017, caused catastrophic damage that resulted in the closure of many schools and school districts across 4 states. We evaluated the underlying reasons and characteristics of the unplanned school closures to gain insight on how communities may cope with recommended preemptive closures as an intervention for pandemic influenza. METHODS Information was extracted from news articles, school websites, and Twitter and Facebook posts previously collected through daily systematic searches of Google, Google News, and Lexis-Nexis. This information was sorted into predefined categories describing the characteristics that may be associated with unplanned school closures that occur during a natural disaster. RESULTS Across Texas, Louisiana, Kentucky, and Tennessee, there were 3026 unplanned closures. Sixty-three percent of the closures occurred in Texas. The main reasons for the closures were flooding, power outages, and structural damage. The closed schools in Texas were sometimes used as shelters or as locations for providing food or other resources. CONCLUSION School closures associated with Hurricane Harvey were attributed to both the effects of the hurricane and use for resource allocation. These findings can help inform preparedness planning and response for future hurricane seasons and other large-scale emergencies.Emergency medical services (EMS) provides a critical role in the rapid treatment, stabilization, and transfer of patients in the prehospital setting. The national EMS provider for Israel has developed a robust and unique organization of volunteers with advanced telecommunication strategies to activate and direct them in order to improve these processes. The volunteers include local high school students, international college students, emergency medical technicians, on-call volunteers, motorcyclists, and Life Guardian first responders. The telecommunication strategies include pagers, push-to-talk over cellular, and sophisticated smartphone-based software applications. These are monitored and directed via a central command and control station. Such processes, both on an organizational as well as technical level, can be adapted to improve prehospital emergency care.Many studies have been carried out to investigate the morphological structure of the syrinx in many bird species. read more However, the cellular organization of the syrinx in the fowls and pigeons is still unclear. The current study revealed that in fowl and pigeon, the syrinx is formed of three main parts including tympanum (cranial) part, intermediate syringeal part, and bronchosyringeal (caudal) part, in addition to pessulus and tympaniform membranes. A great variation in the structural characteristics of syrinx of fowl and pigeon was recorded. In fowl, the tympaniform membranes showed a characteristic distribution of elastic and collagen fibers which increase the elasticity of tympaniform membranes. Moreover, the bony pessulus helps the medial tympaniform membranes to be stiffer, vibrate more strongly so that louder sound will be generated. In pigeon, the lateral tympaniform membrane is of greater thickness so that the oscillation of this membrane is reduced and the amplitude is lower. Moreover, the pessulus is smaller in size and is formed mainly of connective tissue core (devoid of cartilaginous or bony plates), resulting in the failure of stretching and vibrating of the medial tympaniform membranes, that leads to the generation of deeper sound.