Hickmantillman0578

Increased soil PO4 3- had no influence on Sb translocation from root to shoot. While As was toxic (impaired growth) at low PO4 3- soil concentration, no toxicity was observed in the high PO4 3- soil. No toxicity was observed for Sb at either low or high PO4 3- soils. Increased soil PO4 3- concentration ameliorated or masked As toxicity to plant growth and led to higher As concentration in the plant's edible parts. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Neonates are exquisitely susceptible to seizures due to several physiologic factors and combination of risks that are uniquely associated with gestation, delivery, and the immediate postnatal period. Neonatal seizures can be challenging to identify; therefore, it is imperative that clinicians have a high degree of suspicion for seizures based on the clinical history or the presence of encephalopathy with or without paroxysmal abnormal movements. Acute symptomatic neonatal seizures are due to an acute brain injury, whereas neonatal-onset epilepsy may be related to underlying structural, metabolic, or genetic disorders. Though initial, acute treatment is similar, long-term treatment and prognosis varies greatly based on underlying seizure etiology. Early identification and treatment are likely important for long-term outcomes in acute symptomatic seizures, though additional studies are needed to understand optimal seizure control metrics and the ideal duration of treatment. Advances in genetic medicine are increasingly expanding our understanding of neonatal-onset epilepsies and will continue to open doors for personalized medicine to optimize outcomes in this fragile population. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Acute flaccid myelitis (AFM) is an emerging disorder primarily affecting children that is characterized by acute flaccid paralysis accompanied by abnormalities of the spinal cord gray matter on magnetic resonance imaging. In most cases, prodromal fever or respiratory symptoms occur, followed by acute-onset flaccid limb weakness. Respiratory, axial, bulbar, facial, and extraocular muscles may also be affected. The clinical manifestations have been described as "polio-like," due to striking similarities to cases of poliomyelitis. The primary site of injury in AFM is the anterior horn cells of the spinal cord, resulting in a motor neuronopathy. Seasonal peaks of cases have occurred in the United States every 2 years since 2012. However, AFM remains a rare disease, which can make it challenging for physicians to recognize and differentiate from other causes of acute flaccid paralysis such as Guillain-Barre syndrome, spinal cord stroke, and transverse myelitis. Epidemiological evidence suggests that AFM is linked to a viral etiology, with nonpolio enteroviruses (in particular enterovirus D68) demonstrating a plausible association. The epidemiology, possible etiological factors, clinical features, differential diagnosis, treatment, and outcomes of AFM are discussed in this review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Infantile spasm (IS) is a distinct epilepsy syndrome characterized by epileptic spasms (the clinical seizure type) and hypsarrhythmia (the electrographic abnormality). IS is frequently accompanied by impaired neurodevelopment and is often associated with structural, genetic, or metabolic etiologies. Prompt treatment of this severe epileptic encephalopathy improves long-term outcomes but remains elusive in many situations. Despite common misconceptions, even patients with identified etiologies or preexisting developmental delay benefit from proven standard therapies, including adrenocorticotropic hormone (ACTH), oral corticosteroids, or vigabatrin. Treatment efficacy should be assessed with electroencephalography at 2 weeks, and an alternative therapy is indicated if epileptic spasms or hypsarrhythmia have not resolved. Collaboration with primary care providers is critical to mitigate the potentially serious adverse effects of standard treatments and also to provide developmental interventions. Although new approaches are on the horizon, addressing current challenges and opportunities now can dramatically improve patient outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.in English, German EINLEITUNG  Die Wirksamkeit der deutschen Disease-Management-Programme (DMP) Asthma und chronisch obstruktive Lungenerkrankung (COPD) kann mit den gesetzlich vorgeschriebenen Dokumentationen nicht gezeigt werden. Studien mit Vergleichsgruppen sind selten. Ziel war es, in einer Querschnittstudie zu untersuchen, ob sich die Krankheitskontrolle bei Teilnehmern (DMP+) und Nicht-Teilnehmern (DMP–) der DMP Asthma und COPD voneinander unterscheidet. METHODEN  Die Studie ist eine prospektive, multizentrische Querschnittstudie, die untersucht, inwieweit DMP+-Patienten sich von entsprechenden DMP–-Patienten im Hinblick auf ihre Krankheitskontrolle voneinander unterscheiden. Primärer Endpunkt war die Krankheitskontrolle, gemessen mit dem Asthma-Control-Test™ (ACT) im Studienteil Asthma sowie dem COPD-Assessment-Test™ (CAT) im Studienteil COPD. ERGEBNISSE  Insgesamt wurden 1038 Asthma-Patienten und 846 COPD-Patienten eingeschlossen, je mit etwa 70 % DMP-Teilnehmern. Der ACT-Score war bei den Asthma-DMP+-Patienten höher als bei den DMP– -Patienten (Mittelwertdifferenz 0,86; 95 % KI 0,29 – 1,43; p = 0,003), allerdings klinisch nicht relevant. Bei COPD-Patienten fand sich ebenfalls kein klinisch relevanter Unterschied in der Krankheitskontrolle (0,52; 95 % KI – 0,71 – 1,75; p = 0,405). Nur etwa 60 % der Patienten, die seit mindestens einem Jahr in das entsprechende DMP eingeschrieben waren, hatten an einer strukturierten Schulung teilgenommen. Zwischen geschulten und nicht geschulten Patienten fand sich kein Unterschied in der Krankheitskontrolle. DISKUSSION  Es fand sich kein klinisch relevanter Unterschied in der Krankheitskontrolle zwischen DMP+ - und DMP– -Patienten für die DMP Asthma und COPD. International wurde die Wirksamkeit von DMP bei Asthma und COPD in randomisierten Studien nachgewiesen. Auch in Deutschland sollten randomisierte Studien durchgeführt werden, um die Wirksamkeit der DMP Asthma und COPD zu belegen. REGISTRIERUNG  drks.de, DRKS00007664, Registrierungsdatum 15.01.2015.in English, German EINFüHRUNG  Inhalative Behandlungen mit Dosieraerosolen und Trockenpulverinhalatoren sind das Rückgrat der Pharmakotherapie für Asthma und COPD. Belinostat manufacturer In den letzten 10 Jahren wurden viele neue und generische inhalative Bronchodilatatoren auf den deutschen Markt eingeführt, sowohl Monotherapien als auch Fixdosis-Kombinationen aus 2 Bronchodilatatoren (LABA/LAMA, beta-Adrenergikum und Anticholinergikum) oder LABA und inhalatives Kortikosteroid- (ICS) und Triple-Kombinationen (LABA/LAMA/ICS). Laut 2 Umfragen, die unter Lungenfachärzten im Jahr 2015 durchgeführt wurden, erwarteten wir einen hohen Anteil von Patienten, die doppelte Verschreibungen erhielten, z. B. eine neue LABA/LAMA-Kombination zusätzlich zu einer bestehenden ICS/LABA-Therapie. METHODIK  Wir haben die Datenbank einer großen Versandapotheke (DocMorris) durchsucht, um doppelte Verordnungen von Inhalationspräparaten für einen Patienten von demselben Arzt am gleichen Tag oder von 2 oder mehreren verschiedenen Ärzten innerhalb von 3 Monaten zu identifizieren. ERGEBNISSE  Unerwartet fanden wir nur etwa 1 % doppelte Verschreibungen für den gleichen Patienten. Dabei wurden Doppelverordnungen mit Kombinationsprodukten deutlich häufiger beobachtet als solche mit verschiedenen Monoprodukten. Immerhin handelt es sich um mehrere Tausend Rezepte, die wir in einer einzigen großen Apotheke gezählt haben. FAZIT  Zumindest in der Datenbasis dieser großen Versandapotheke sind Doppelverordnungen von Inhalativa (d. h. kontraindizierte und potenziell gefährliche Kombinationen) relativ selten. Zur Vermeidung von Medikationsfehlern sollten sich Verordner und Apotheker dieser Problematik bewusst sein, insbesondere bei der Verordnung bzw. Prüfung und Belieferung von Kombinationsprodukten.BACKGROUND Heterotopic pregnancy refers to the simultaneous coexistence of an intrauterine and extrauterine pregnancy. In natural conception it is very rare, with a rising incidence in patients undergoing assisted reproduction technologies. It presents a serious diagnostic problem which is often misdiagnosed. Currently, there are no standard protocols for the treatment and diagnosis of heterotopic pregnancy. METHODS Two rare cases of spontaneous heterotopic pregnancy are presented. RESULT The first patient had a complete abortion upon which an extrauterine pregnancy was detected. The second patient, after an extrauterine pregnancy removal, progressed with an intrauterine pregnancy until full term and it ended with the delivery of a healthy infant. CONCLUSION Two demonstrated cases underscore that whenever abnormal adnexal findings are presented and the beta-hCG blood test is positive, the possibility of a heterotopic pregnancy should be suspected. © Georg Thieme Verlag KG Stuttgart · New York.INTRODUCTION  The efficacy of a stabilization exercise for the relief of neck pain remains controversial. We conducted a systematic review and meta-analysis to explore the effectiveness of a stabilization exercise on neck pain. METHODS  We searched Embase, Web of Science, EBSCO Information Services, and the Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the impact of a stabilization exercise on neck pain. This meta-analysis was performed using the random effects model. RESULTS  Six RCTs are included in the meta-analysis. Compared with the control group of patients with neck pain, a stabilization exercise can significantly reduce pain scores at 4 to 6 weeks (mean difference [MD] -2.41; 95% confidence interval [CI], -4.46 to -0.35; p = 0.02), Neck Disability Index [NDI] at 10 to 12 weeks (MD- 6.75; 95% CI, -11.71 to -1.79; p = 0.008), and depression scale at 4 to 6 weeks (MD -4.65; 95% CI, -7.00 to -2.31; p = 0.02), but it has no obvious impact on pain scores at 10 to 12 weeks (MD -1.07; 95% CI, -3.42 to 1.28; p = 0.37) or at 6 months (MD -1.02; 95% CI, -3.43 to 1.39; p = 0.41). CONCLUSIONS  A stabilization exercise can provide some benefits to control neck pain. Georg Thieme Verlag KG Stuttgart · New York.OBJECTIVE  Antenatal magnesium sulfate (MgSO4) treatment is associated with reduced risk of cerebral palsy in preterm infants. We aimed to investigate whether this treatment leads to any alterations on cerebral hemodynamics which could be detected by near-infrared spectroscopy (NIRS) readings in early postnatal life. STUDY DESIGN  Infants with gestational ages (GAs) ≤ 32 weeks were divided into two groups regarding their exposure to antenatal neuroprotective MgSO4 treatment or not. NIRS monitoring was performed to all infants, and readings were recorded for 2 hours each day during the first 3 days of life. The primary aim was to compare regional cerebral oxygen saturation (rcSO2) and cerebral fractional tissue oxygen extraction (cFTOE) between the groups. RESULTS  Sixty-six infants were exposed to antenatal MgSO4, while 64 of them did not. GA and birth weight were significantly lower in the treatment group (p  0.05). An insignificant reduction in severe intraventricular hemorrhage rates was observed (8 vs. 15%, p = 0.