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doi:10.1097/01.naj.0000470400.28683.97 pmid:26222473 fatcat:7maxod33frchnkpxr744zrigzm
1 The potency of a series of short-acting anaesthetics was established by measuring the duration of the loss of righting reflex following a single bolus injection into the tail vein of male Wistar rats. The agents were, in order of potency, etomidate, alphaxalone, methohexitone, alphadalone acetate and propanidid. 2 The potency of binary mixtures of these agents was also assessed to see whether the anaesthetic effects of different agents were additive as classical theories of anaesthesiadoi:10.1111/j.1476-5381.1981.tb09969.x pmid:6268237 pmcid:PMC2071874 fatcat:25oboi5o2zgejber2bfyxggaa4
more »... anaesthesia suggest. Mixtures of alphaxalone and alphadalone acetate, alphaxalone and propanidid and methohexitone and propanidid all showed simple additive effects. Mixtures of alphaxalone and etomidate and of alphaxalone and methohexitone showed a greater potency than would be expected if their effects were simply additive. Mixtures of etomidate and methohexitone were not examined. 3 Mixtures of alphaxalone and either methohexitone or pentobarbitone produced a greater depression of synaptic transmission in in vitropreparations of guinea-pig olfactory cortex than would have been expected from the sum of the activities of the individual anaesthetics. Other combinations of anaesthetics did not show similar effects although the interaction between alphaxalone and etomidate was not examined. 4 Neither alphaxalone nor pentobarbitone affected the membrane: buffer partition coefficient of the other for a model membrane system. 5 These results are interpreted as evidence against the classical unitary hypotheses of anaesthetic action based on correlations of anaesthetic potency with lipid solubility and as supporting the view that different anaesthetics act on different structures in the neuronal membranes to produce anaesthesia.
The PHASE research programme is an NHS-Executive funded, randomized controlled trial of assisted self-help for common mental disorders, delivered by practice nurses in primary care. The self-help guide -Managing anxiety and depression: a self-help guide published by the Mental Health Foundation -is conceptualized as a 'health technology' where the nurse's role is to educate patients how to get the best out of the technology, supervise its safe delivery and monitor its continued use by patientsdoi:10.1191/1463423602pc103oa fatcat:jxlmgrj4y5dfhit3ouo7v5kcme
more »... ed use by patients so that they can use it independently with little reliance on nurses or other health professionals. Twenty-three nurses were trained on one of ve, 3-day courses to deliver PHASE. As the nal task during the training course, nurses were asked to describe what they would say to a patient when delivering PHASE. From these data a qualitative thematic content analysis was used to develop a coding framework which showed that nurses were able to articulate a sophisticated health technology rationale, including relevant psychological models and the principle of an evidence base. This study demonstrates that it is possible to equip primary care nurses with both a highly developed understanding and the knowledge to deliver self-help mental health care. Training nurses using this model moves us away from traditional mental health training courses that have attempted to produce 'watered down' versions of specialist practitioners to a more appropriate skills and cultural 'health technology' t for delivering primary mental health care.
The purpose of this paper is to explore whether there are extant mechanisms that are utilized to meet the challenges of diverse corporate governance needs in modern global society. We adopt the nonlinear lens utilized in complex adaptive systems. The examination is advanced using three examples drawn from published academic research. The three examples selected allow consideration of differing levels of analysis, regions and entity types. Levels of analysis include societal, institutional anddoi:10.13189/ujaf.2016.040101 fatcat:qtri4edxv5hmtbxwkqvkaqyx6y
more »... institutional and firm. Regions include Asia Pacific, United States and international. The governance types are governmental, charitable and corporate. Distinct world views are represented by considering the holistic worldview of the indigenous Maori as well as an emerging CSR agenda for an international corporation. Diverse objectives are exemplified by the inclusion of required not-for-profit reporting.
Oral carcinogenesis proceeds through a stepwise accumulation of genetic damage over time. Because the oral cavity is easy to examine and risk factors for oral cancer are known, there is great opportunity to improve patient outcomes through diagnosis and treatment of premalignant lesions before the development of invasive oral carcinoma. This review provides a summary of developments in detection and diagnosis of oral premalignant lesions and innovative approaches to management of early oraldoi:10.1007/s11912-006-0050-4 pmid:16507225 pmcid:PMC2773158 fatcat:bsye5mx2q5fy7p7ljas7gm5zr4
more »... t of early oral neoplasia. These technological and therapeutic advances are much needed to improve the poor outcomes associated with oral cancer due to our inability to diagnose and treat this disease at an early, curable stage. Oral Carcinogenesis Progression Model Like other solid tumors, oral cancers arise from sustained, stepwise accumulations of mutations resulting in transition of normal mucosa to dysplasia to invasive carcinoma over time [1,2]. Research efforts have identified specific mutations and molecular abnormalities that occur during these transitional steps [2,3••,4]. These mutations often involve inactivation of tumor suppressor genes such as FHIT, p53, and p16 and/or activation or overexpression of regulatory molecules such as cyclin D1, epidermal growth factor receptor (EGFR), and telomerase [5,6]. This knowledge is important for developing diagnostic and therapeutic interventions to identify, prevent, or reverse these specific molecular abnormalities. According to the theory of field cancerization, the entire lining of the upper aerodigestive tract exposed to carcinogens, such as those present in alcohol and tobacco, sustains damage and is at risk to develop squamous carcinomas [7•,8•]. The high rate (approximately 4% per year) of multiple primaries that occur in patients previously treated for oral SCC supports this theory. In these patients with chronic exposure to carcinogens, areas of clinically normal-appearing mucosa often have histologic and genetic changes [9,10]. Developing ways to identify the presence of this damage is important for early diagnosis and treatment of oral cancer.
Common mental health problems account for up to 40% of all general practitioner (GP) consultations. Patients have limited access to evidence-based psychological therapies. Cognitive behavioural therapy self-help strategies offer one potential solution. To determine differences in clinical outcome, patient satisfaction and costs, between a cognitive behavioural-based self-help package facilitated by practice nurses compared to ordinary care by GPs for mild to moderate anxiety and depression.pmid:14601351 pmcid:PMC1314708 fatcat:ssn6y5aydvex5kn6djs2tqvfki
more »... and depression. Randomised controlled trial. Seventeen primary healthcare teams. Patients presenting to their GP with mild to moderate anxiety and/or depression were recruited to the study and randomised to receive either a self-help intervention facilitated by practice nurses or ordinary care. The self-help intervention consisted of up to three appointments: two 1 week apart and a third 3 months later. There were no restrictions on ordinary care. Intention-to-treat analysis showed that patients treated with practice nurse-supported cognitive behavioural therapy self-help attained similar clinical outcomes for similar costs and were more satisfied than patients treated by GPs with ordinary care. On-treatment analysis showed patients receiving the facilitated cognitive behavioural therapy self-help were more likely to be below clinical threshold at 1 month compared to the ordinary care group (odds ratio [OR] = 3.65, 95% confidence interval [CI] = 1.87 to 4.37). This difference was less well marked at 3 months (OR = 1.36, 95% CI = 0.52 to 3.56). Facilitated cognitive behavioural self-help may provide a short-term cost-effective clinical benefit for patients with mild to moderate anxiety and depression. This has the potential to help primary care provide a choice of effective psychological as well as pharmacological treatments for mental health problems.
Development of epithelial precancer and cancer leads to well-documented molecular and structural changes in the epithelium. Recently, it has been recognized that stromal biology is also altered significantly with preinvasive disease. We used the finite-difference time-domain method, a popular technique in computational electromagnetics, to model light scattering from heterogeneous collagen fiber networks and to analyze how neoplastic changes alter stromal scattering properties. Threedimensionaldoi:10.1529/biophysj.106.089839 pmid:17307834 pmcid:PMC1852360 fatcat:wwrj6g3pj5bdzpxqgjojdeipue
more »... s. Threedimensional optical images from the stroma of fresh normal and neoplastic oral-cavity biopsies were acquired using fluorescence confocal microscopy. These optical sections were then processed to create realistic three-dimensional collagen networks as model input. Image analysis revealed that the volume fraction of collagen fibers in the stroma decreases with precancer and cancer progression, and fibers tend to be shorter and more disconnected in neoplastic stroma. The finite-difference time-domain modeling results showed that neoplastic fiber networks have smaller scattering cross sections compared to normal networks. Computed scattering-phase functions indicate that high-angle scattering probabilities tend to be higher for neoplastic networks. These results provide valuable insight into the micro-optical properties of normal and neoplastic stroma. Characterization of optical signals obtained from epithelial tissues can aid in development of optical spectroscopic and imaging techniques for noninvasive monitoring of early neoplastic changes.
Rutherford and Ann M. Hopkins ...doi:10.18632/oncotarget.26973 fatcat:cvgff6qurbdibfuivjvvpo3y6y
Ann Gillenwater has served as a paid consultant to Sanofi-Adventis, US LLC, has a minority equity interest in Onconome, Inc. and serves as an unpaid scientific advisor to Remicalm LLC. ...doi:10.2217/fon.10.79 pmid:20624126 pmcid:PMC2929485 fatcat:uu5j7dfaobg6rpfh6jezt4s3de
The disruptive behavior of persons with dementia is a problem ofconsiderable clinical interest and growing scientific concern. This paper offers a view ofthese behaviors as expressions of unmet needs or goals and provides a comprehensive conceptual framework to guide further research and clinical practice. Empiricalfindings and clinical impressions related to wandering, vocalizations and aggression to support and illustrate the framework are presented.doi:10.1177/153331759601100603 fatcat:o7jyerhaxzdqnoug3o6aae7ky4
Pigs are the only known animal reservoir of Yersinia enterocolitica strains pathogenic to humans. In this study 106 ail-positive pathogenic Y. enterocolitica isolates, previously recovered from 2793 swine fecal samples (3.8%) collected during National Animal Health Monitoring System's Swine 2000 study, were examined. The presence of the previously described virulence plasmid, expression of plasmid-associated virulence determinants, and serotype were correlated with genotype, expression of YopEdoi:10.1089/fpd.2008.0197 pmid:19278339 fatcat:52s3laekqndvxmetmhrnpwdwze
more »... expression of YopE protein, and antibiotic susceptibility. Pulsed-field gel electrophoresis using the enzyme XbaI showed that O:3 and O:5 isolates were highly clonal within a serotype regardless of geographic origin. Antimicrobial resistance profiles of 106 isolates of serotypes O:3 and O:5 were evaluated by agar disk diffusion methodology to 16 different antibiotics. All isolates were susceptible to 13 of the 16 tested antimicrobials; resistance was noted to ampicillin, cephalothin, and tetracycline. The presence of the ail gene, virulence plasmid, the expression of virulence determinants, and serotypes indicate that these isolates from U.S. swine are potentially capable of causing human foodborne illness.
Oral cancer is an important global health problem. There is an urgent need for improved methods to detect oral cancer and its precursors, because early detection is the best way to reduce oral cancer mortality and morbidity. In this work, we describe simple modifications to a surgical headlight system that enables direct visualization and digital image acquisition from oral tissue in multiple imaging modalities including fluorescence, white-light reflectance, and orthogonal polarizationdoi:10.1117/1.2907455 pmid:18601519 fatcat:cmnyfp6lyvffppfsdyuyssrxye
more »... olarization reflectance. Images obtained with the system in-vivo demonstrate that it is an attractive technology to explore for oral cancer screening in low-resource environments where clinical expertise is often unavailable.
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