Leachklint3606

Further studies of clinical outcomes related to QBL are needed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.OBJECTIVE  This pilot study evaluated the relationship between maternal and neonatal R- and S-methadone and R- and S-2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) exposure and the severity of neonatal abstinence syndrome (NAS). The use of dried blood spots (DBS) as an alternative for plasma in assessing methadone and EDDP was also assessed. STUDY DESIGN  Women receiving methadone for medication assisted treatment of opioid use disorder during pregnancy were eligible for recruitment. Plasma and DBS samples were collected from mothers during labor, from cord blood, and from newborns during genetic screen. R-/S-methadone and EDDP were measured by high-performance liquid chromatography tandem mass spectrometry (HPLC/MS/MS). Associations between methadone exposure, neonatal morphine requirements, and severity of NAS were examined. RESULTS  Twenty women and infants completed the study. Epoxomicin Maternal methadone dose at delivery was 112 mg/day (range = 60-180 mg/day). Sixteen neonates experienced NAS requiring morphine; three also required phenobarbital. Higher cord blood concentrations of R-methadone, R- and S-EDDP were associated with higher maximum doses of morphine (p  less then  0.05). CONCLUSION  Maternal methadone and cord blood concentration at delivery are variable and may be potential markers of neonatal abstinence syndrome. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.OBJECTIVE  The aim was to identify the critical levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor-A in umbilical cord blood that could be used as markers for predicting the central nervous system (CNS) damage and retinopathy of prematurity (ROP) in preterm infants. STUDY DESIGN  A total of 158 preterm infants, born at 22 to 34 weeks of gestation, were evaluated in the first week after birth and at 36 to 37 weeks of postconceptual age. RESULTS  A significant relationship between CNS changes and concentrations of IL-6 (p 13.0 pg/mL (p  less then  0.05) in umbilical cord blood could predict 2 to 3/3 to 4 stages of ROP. CONCLUSION  Critical values of IL-6 and TNF-α in predicting ≥grade III intraventricular hemorrhage in the early adaptation and in predicting marked CNS damages and severe ROP stages in the later adaptation of preterm infants were determined. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.in English, German Die laparoskopische Cholezystektomie ist eine der am häufigsten durchgeführten Operationen weltweit. Gerade aufgrund der hohen Fallzahlen bleibt die iatrogene Verletzung des Ductus choledochus, so selten sie ist, ein nicht zu unterschätzendes Risiko des Eingriffs. Im Laufe der Jahre wurden unterschiedliche Methoden beschrieben, diese schwerwiegende Komplikation mit ihrer hohen Morbidität und sogar Mortalität zu vermeiden. Eine der sichersten Methoden der Vermeidung von Gallengangsläsionen ist die Etablierung des sog. „critical view of safety“ vor Durchtrennung jeglicher Strukturen, der in diesem Lehrvideo demonstriert werden soll.in English, German Von allen Krebserkrankungen hat das metastasierte Pankreaskarzinom die schlechteste Prognose. Mit nab-Paclitaxel/Gemcitabin, FOLFIRINOX und Gemcitabin/Erlotinib gibt es mehrere Therapieoptionen, die das Gesamtüberleben der Patienten verbessern. Insbesondere Patienten, die unter der Therapie mit Erlotinib einen Hautausschlag (Rash) entwickeln, können von der Gemcitabin-Erlotinib-Kombinationstherapie profitieren. Diese nichtinterventionelle Studie (NIS ML21284) untersuchte die Wirksamkeit und Verträglichkeit der Gemcitabin-Erlotinib-Kombinationstherapie in der Behandlungsroutine des metastasierten Pankreaskarzinoms, insbesondere hinsichtlich Rash.Zwischen 2007 und 2010 wurden die Behandlungsdaten von 433 Patienten aus 98 Zentren dokumentiert. Die erhobenen Parameter wurden deskriptiv ausgewertet.Nach einer Gemcitabin-Erlotinib-Behandlung war das mediane Gesamtüberleben der Patienten mit Rash-Grad ≥ 1 mit 9,90 (95 %-Konfidenzintervall [KI] 8,19–11,05) signifikant erhöht gegenüber 6,48 Monaten (95 %-KI 5,66–7,40) bei Patienten, die keinen Rash entwickelten (p = 0,0010). Dies gilt ebenso für das mediane progressionsfreie Überleben (Patienten mit Rash-Grad ≥ 1 5,43; 95 %-KI 4,90–6,12 vs. Patienten ohne Rash 3,98 Monate; 95 %-KI 3,52–5,03, p = 0,0131). Die Gesamtansprechrate lag bei den mit Erlotinib und Gemcitabin behandelten Patienten mit Rash-Grad ≥ 1 um 5,9 % höher als bei Patienten ohne Rash (31,7 % vs. 25,8 %).Zusammenfassend unterstreichen die Ergebnisse aus der täglichen Behandlungspraxis des metastasierten Pankreaskarzinoms die Bedeutung der Kombinationstherapie Gemcitabin und Erlotinib für die Patientensubgruppe, die unter der Behandlung Rash entwickelt.BACKGROUND  Information on homeopathic medicines is derived from "provings" or homeopathic pathogenetic trials (HPTs), in which people (often homeopaths and homeopathy students) are invited to take an unnamed and often untested highly diluted and serially succussed substance, and record in detail their experiences and perceived effects. HPTs are assumed to have an "excellent safety record", but there has been no academic research to date into provers' experiences of participating in an HPT. AIMS  This qualitative study aimed to explore the lived experience of participation in an HPT. It is hoped that the results from this study will inform the future conduct of HPTs. METHODS  Semi-structured interviews were conducted in person, by phone or via Skype, according to the interviewees' preferences. Thematic analysis was used for the generation of themes. RESULTS  Eight former provers were interviewed from across the European Union (EU) and Australia. Of these, seven were practicing homeopaths and one was not a practitioner. Overarching themes were identified as (1) the ethical conduct of HPTs, and (2) the impact of participation in HPTs. CONCLUSION  Former provers who participated in this study reported enthusiasm for, and trust in, the proving process. However, some also reported adverse events, which varied in intensity and duration. The process of gaining fully informed consent for participation in an HPT is complex and there were examples of both failure and inadequacy in terms of informed consent and support mechanisms. RECOMMENDATIONS  The researchers recommend that HPTs are subject to ethical approval processes and that consent is fully informed and ongoing. It is also recommended that appropriate and robust support mechanisms be developed. The Faculty of Homeopathy.