Neumannpadilla1795
Similar enhancements occurred with a temperature of only 41.0 °C with a simultaneous heat and radiation treatment. However, higher temperatures were needed with the introduction of any interval; at 42.5 °C, the enhancement was 2.5 with a simultaneous treatment, decreasing to a value within the carbon ion range with a 4-hour interval.
Combining hyperthermia with low LET radiation can be as effective as high LET at inducing tumor control, but the temperature needed depended on the time interval between the two modalities.
Combining hyperthermia with low LET radiation can be as effective as high LET at inducing tumor control, but the temperature needed depended on the time interval between the two modalities.Introduction Post-stroke depression (PSD) is common, serious and of considerable high risk of being chronic. Pharmacological treatment is highly recommended (class I recommendation) based on level B evidence. Still, treatment is often insufficient and the diagnosis can be challenging.Areas covered The present paper is an update on pharmacological treatment of PSD and a review of recent clinical guidelines. To put this into perspective, the authors highlight the risk factors that might help clinicians identify patients with PSD, and discuss pharmacological prevention, functional outcome, and safety of antidepressant treatment in stroke patients.Expert opinion Although there are still gaps in our knowledge of PSD, the seriousness should not be neglected, and pharmacological treatment should be recommended when relevant. A selective serotonin reuptake inhibitor (SSRI) is first choice, but is not always tolerated or effective. Close follow-up and dose adjustments as well as add-on possibilities are therefore important aspects of treatment as well. Antidepressant treatment prevents PSD but the effect on enhancement of stroke recovery is less clear.In various malaria-endemic regions, the appearance of resistance has precluded the use of pyrimidine-based antifolate drugs. Here, a three-step fragment screening was used to identify new non-pyrimidine Plasmodium falciparum dihydrofolate reductase (PfDHFR) inhibitors. Starting from a 1163-fragment commercial library, a two-step differential scanning fluorimetry screen identified 75 primary fragment hits. Subsequent enzyme inhibition assay identified 11 fragments displaying IC50 in the 28-695 μM range and selectivity for PfDHFR. In addition to the known pyrimidine, three new anti-PfDHFR chemotypes were identified. Shield-1 supplier Fragments from each chemotype were successfully co-crystallized with PfDHFR, revealing a binding in the active site, in the vicinity of catalytic residues, which was confirmed by molecular docking on all fragment hits. Finally, comparison with similar non-hit fragments provides preliminary input on available growth vectors for future drug development.
Computer simulations of hepatic radio-frequency ablation (RFA) were performed to (
) determine the dependence of the vessel wall heat transfer coefficient on geometrical parameters; (
) study the conditions required for the occurrence of the directional effect of blood; and (
) classify blood vessels according to their effect on the thermal lesion while considering blood coagulation. The information thus obtained supports the development of a multi-scale bio-heat model tailored for more accurate prediction of hepatic RFA outcomes in the vicinity of blood vessels.
The simulation geometry consisted of healthy tissue, tumor tissue, a mono-polar RF-needle, and a single cylindrical blood vessel. The geometrical parameters of interest were the RF-needle active length and those describing blood vessel configuration. A simple, novel method to incorporate the effects of blood coagulation into the simulation was developed and tested.
A closed form expression giving the dependence of the vessel wall heat transfer coefficient on geometrical parameters was obtained. Directional effects on the thermal lesion were found to occur for blood vessel radii between 0.4 mm and 0.5 mm. Below 0.4 mm blood coagulation blocked the flow.
The closed form expression for the heat transfer coefficient can be used in models of RFA to speed up computation. The conditions on vessel radii required for the occurrence of directional effects on the thermal lesion were determined. These conditions allow the classification of blood vessels. Different approximations to the thermal equation can thus be used for these vessel classes.
The closed form expression for the heat transfer coefficient can be used in models of RFA to speed up computation. The conditions on vessel radii required for the occurrence of directional effects on the thermal lesion were determined. These conditions allow the classification of blood vessels. Different approximations to the thermal equation can thus be used for these vessel classes.
The Rhode Island State Legislature passed the
in 2016 to limit opioid prescriptions. We aimed to objectively evaluate its effect on opioid prescribing for hand surgery patients and also identify risk factors for prolonged opioid use.
A 6-month period (January-June 2016) prior to passage of the law was compared with a period following its implementation (July-December 2017). Thumb carpometacarpal arthroplasty and distal radius fracture fixation were classified as "major surgery" and carpal tunnel and trigger finger release as "minor surgery." Prescription Drug Monitoring Database was used to review controlled substances filled during the study periods.
A total of 1380 patients met our inclusion criteria, with 644
and 736
. Patients undergoing "major surgery" saw a significant decrease in the number of pills issued in the first postoperative prescription (41.1 vs 21.0) and a corresponding decrease in morphine milligram equivalents (MMEs) (318.6 vs 159.2 MMEs) after implementation. A 30% decrease in MMEs was also seen in those undergoing "major surgery" in the first 30 days postoperatively (544.7 vs 381.7 MMEs). Risk factors for prolonged opioid use included male sex and preoperative opioid use.
In Rhode Island, opioid-limiting legislation resulted in a significant decrease in the number of pills and MMEs of the initial prescription and a 30% decrease in total MMEs in the 30-day postoperative period after "major hand surgery." Additional research is needed to explore the association between legislation and clinical outcomes.
In Rhode Island, opioid-limiting legislation resulted in a significant decrease in the number of pills and MMEs of the initial prescription and a 30% decrease in total MMEs in the 30-day postoperative period after "major hand surgery." Additional research is needed to explore the association between legislation and clinical outcomes.
