Wulfflundqvist7964

creased intracranial displacement during frameless GKRS was associated with higher ECOG, male gender, increased treatment time and malignant tumors, while anxiolytics were shown to mitigate excessive motion. Radiosurgery teams should consider these patient factors when treating patients with mask immobilization. © 2020 Old City Publishing, Inc.Background Cerebral arteriovenous malformations or angiomas are congenital vascular anomalies defined by abnormal arteriovenous shunt. Materials and methods We conducted a retrospective study between January 1992 and December 2010 at the Timone Hospital radiosurgery unit, 1557 patients were treated by radiosurgery for arteriovenous malformation of which 53 for thalamic localization (3,4%). Results The mean age was 35.8-/+16.6 years (4-75). 14 patients underwent pre-radiosurgical embolization (26.4%), discovery mode for 47 patients (88.7%) was haemorrhage. The average treatment volume was 1.43 cm3. The average RBAS score was 1.36. The average prescription to the 50% isodose envelope delivered was 22.9 +/-2.9 Gy (12-30), the median margin dose was 24 Gy. Our global obliteration rate after one or two procedures 66.7% for an average follow-up period of 56.7 months. We noted 3.9% of mortality, 5.9% of bleeding after procedure and 3.9% of radio-induced neurological deficit. Conclusion Radiosurgery became indispensable in the treatment of thalamic AVM even when there is a persistent risk of haemorrhage until total recovery. © 2020 Old City Publishing, Inc.Introduction Stereotactic radiosurgery (SRS) for brain metastases is predominantly delivered via single-fraction Gamma Knife SRS (GKRS) or linear accelerator (LINAC) in up to five fractions. Predictors of SRS modality have been sparsely examined on a nationwide level. Methods An observational cohort study was performed on patients receiving SRS for brain metastases from non-small cell lung cancer from 2010 to 2016 at Commission on Cancer-accredited hospitals throughout the United States (US). A multivariable logistic regression model characterized SRS receipt, adjusting for patient age, dose, geographic location of treatment, facility type, and distance from treatment facility. Results A total of 2,684 patients received GKRS, while 1,643 patients received LINAC SRS. After adjusting for significant covariates, treatment at non-academic facilities was associated with increased LINAC SRS receipt, most prominently in the Midwestern (OR=6.23;p less then 0.001), Northeastern (OR=4.42;p less then 0.001), and Southern US (OR=1.96;p less then 0.001). Compared to patients receiving 12-17 Gy, patients receiving doses of 18-19 Gy (OR=1.42;p=0.025), 20-21 Gy (OR=1.82;p less then 0.001), and 22-24 Gy (OR=3.11;p less then 0.001) were more likely to receive LINAC SRS; similarly, patients located within 20 miles of a radiation treatment facility were more likely to receive LINAC SRS (OR=1.27;p=0.007). Conclusions Despite Gamma Knife being more prominently used over LINAC for SRS, patients treated at a non-academic facility outside of the Western US or requiring increased radiation dose were substantially more likely to receive LINAC over Gamma Knife. Additionally, patients residing in close proximity to a treatment center were 27% more likely to receive LINAC, likely indicative of the increased geographic accessibility of LINAC compared with GKRS. © 2020 Old City Publishing, Inc.Stereotactic radiosurgery (SRS) is used as a noninvasive treatment option for patients with trigeminal neuralgia (TN), but the effect of obesity on pain relief post SRS, if any, is unknown. The primary goal of our study was to evaluate the association between obesity and response to SRS in patients with TN. We conducted an IRB-approved retrospective review of patients treated with SRS for TN between 2010 and 2017. Barrow Neurologic Institute (BNI) Score was assigned pre-and post-SRS to quantify pain level. Thirty-two patients (65% female) between the ages of 24 and 96 were studied with a median follow-up time of 11 months. Patients with BMI >25 were significantly less likely to have improvement in their symptoms with SRS (p = 0.005). Elevated BMI may be associated with worsened response to SRS in the treatment of TN. © 2020 Old City Publishing, Inc.Clinical infection with malaria, caused by parasites of the genus Plasmodium, is considered a serious medical condition with the potential to become a life-threatening emergency. This is especially relevant to low-income countries in tropical and subtropical regions of the world where high rates of malaria-related morbidity and mortality are recorded. As a means to combat this major global public health threat, rapid and effective diagnosis remains the frontline action to initiate a timely and appropriate medical intervention. From all the approaches to parasite detection, rapid diagnostic tests, so-called RDTs, are the easiest to use and most cost-effective. However, some of the limitations inherent in this methodology could hinder effective patient treatment. A primary drawback is that the vast majority of commercially available RDTs detect only one of the five species of human malaria, P. falciparum. While this is the main cause of infection in many areas, it excludes the possibility of infection with another parasite (P. vivax, P. ovale, P. malariae, and P. knowlesi) or of mixed infections containing different species. Hence, a diagnosis of non-P. falciparum malaria is missed. Irbinitinib In turn, in resource-constrained settings where optimal microscopy is not available, a misdiagnosis of bacterial infection based on signs and symptoms alone often results in an inappropriate prescription of antibiotics. Here, we discuss how effective diagnosis of malaria and indiscriminate use of antibiotics in sub-Saharan Africa, a hot spot for P. falciparum transmission, may both be addressed by the development of innovative multiplexing RDTs that detect two or more species of Plasmodium. Copyright © 2020 Rasheed O. Makanjuola and Andrew W. link2 Taylor-Robinson.Drynariae Rhizome, widely distributed in southern China, was clinically used as a traditional treatment for cognitive disfunction, such as Alzheimer's disease (AD). The aim of our work was to evaluate the AChE inhibition activities of extracts of Drynariae Rhizome and pure compounds using a bioguided fractionation procedure. The classical approach for screening potential AChE inhibitors was developed by Ellman. However, the background color of compounds or herb extracts remained uncertain and frequently interfered with the detection of the secondary reaction, thereby easily yielding false positive or false negative results. Here, a high-throughput assay monitoring the transformation of iodized choline from iodized acetylcholine catalyzed by AChE was established based on UPLC-MS/MS. The bioguided fractionation of the extract using this method resulted in the isolation of eight AChE inhibitory flavonoids, including naringenin, eriodictyol, kaempferol, luteolin, astragalin, luteolin-7-O-β-D-glucoside, naringin, and neoeriocitrin, with the IC50 values of 3.81 ± 0.21 μM, 7.19 ± 0.62 μM, 11.09 ± 1.02 μM, 17.26 ± 0.23 μM, 18.24 ± 2.33 μM, 17.13 ± 1.02 μM, 26.4 ± 1.17 μM, and 22.49 ± 1.25 μM. It is assumed that the identified flavonoids contribute to the AChE inhibition activity of Drynariae Rhizome. These results are in agreement with the traditional uses of Drynariae Rhizome for AD. Copyright © 2020 Ming-Yang Liu et al.Background Drug use evaluation is a system of continuous, systematic, criteria-based drug evaluation that ensures the appropriate use of drugs. Rationalization of drug therapy in emergency medicine would be useful in managing the broad array of conditions that present for emergency care. High-quality drug utilization is associated with the use of a relatively limited number of essential medicines. The World Health Organization developed core drug use indicators for conducting drug utilization studies in healthcare setting. WHO core drug use indicators including prescribing indicators, patient care indicators, and health facility indicators are used nowadays. Objective The aim of this study was to evaluate the drug use pattern in the Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia, 2018. Methods A retrospective cross-sectional descriptive study was conducted in the emergency department (ED) of Dilchora Referral Hospital from July 20 to August 19, 2018, using structured data collection format. Result Out of 344 prescriptions analyzed, a total of 753 medications were prescribed. The average number of drugs per prescription was 2.19. Of drugs prescribed, 685 (90.97%) were in their generic names. Antibiotics were prescribed in 95 (27.62%) of encounters, and injections were prescribed in 154 (44.77%) of encounters. Among 753 medications prescribed, the name and strength of drugs are indicated in 100% and 95.22%, respectively. 679 (90.17%) of drugs were prescribed from the essential drug list of Ethiopia. Conclusion The findings of this study revealed that the drug utilization pattern was not optimal in accordance with the standard values of WHO prescribing indicators. Some of the prescribing indicators like overprescribing of antibiotics and injections were a problem. Therefore, it is very imperative for the concerned stakeholders and healthcare providers to work toward ensuring drug use according to the standard. Copyright © 2020 Kirubel M. Mishore et al.Objective The objective of the study was to use an ultrasound-based numerical scoring system for assessment of intravascular fluid estimate (SAFE) and test its validity. Methods A prospective, observational study was carried out in the surgical intensive care unit (ICU) of an urban tertiary care teaching hospital. Patient's intravascular volume status was assessed using the standard methods of heart rate, blood pressure, central venous pressure, cardiac output, lactate and saturation of venous oxygen, and others. This was compared with assessment using bedside ultrasound evaluation of the cardiac function, inferior vena cava, lungs, and the internal jugular vein. Applying a numerical scoring system was evaluated by Fisher's exact testing and multinomial logistic model to predict the volume status based on ultrasound scores and the classification accuracy. Results 61 patients in the ICU were evaluated. 21 (34.4% of total) patients diagnosed with hypovolemia, and their ultrasound volume score was -4 in 14 (66.7re likely represents hypovolemia, -1 to +1 more likely represents euvolemia, and +2 to +4 more likely to be hypervolemia. Copyright © 2020 Keith Killu et al.Objective Assessment of dietary iron intake in pregnant women in Europe. Design Review. Setting. Literature search of dietary surveys reporting the intake of dietary iron using the PubMed and Google Scholar databases covering the years 1990-2019. Subjects Healthy pregnant women. Results 24 dietary surveys/studies in 14 European countries were included. Nine studies (38%) used Food Frequency Questionnaires, which yielded significantly higher iron intake than studies using Dietary Records. Results from Dietary Record studies in 11 countries showed that iron intake varied between 8.3-15.4 mg/day with an estimated "median" value of 10-11 mg/day. Spain, Bosnia, and Poland reported an intake of 8.3-10.1 mg/day, Croatia, England, Norway, and Finland an intake of 10.2-11.4 mg/day, and Germany, Portugal, Czech Republic, and Greece an intake of 12.2-15.4 mg/day. link3 The recommended iron intake in the various countries varied from 14.8-30 mg/day. In all studies, 60-100% of the women had a dietary iron intake below the recommended intake.