Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?

Background: While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes.

MymA Bioactivated Thioalkylbenzoxazole Prodrug Family Active against .

Screening of a GSK-proprietary library against intracellular identified , a thioalkylbenzoxazole hit. Biological profiling and mutant analysis revealed that this compound is a prodrug that is bioactivated by the mycobacterial enzyme MymA. A hit-expansion program including design, synthesis, and profiling of a defined set of analogues with optimized drug-like properties led to the identification of an emerging lead compound, displaying potency against intracellular bacteria in the low micromolar range, high in vitro solubility and permeability, and excellent microsomal stability.

Evolutionary Plasticity of AmrZ Regulation in .

encodes a master regulator protein conserved across pseudomonads, which can be either a positive or negative regulator of swimming motility depending on the species examined. To better understand plasticity in the regulatory function of AmrZ, we characterized the mode of regulation for this protein for two different motility-related phenotypes in As in , AmrZ functions as a positive regulator of swimming motility within , which suggests that the functions of this protein with regard to swimming motility have switched at least twice across pseudomonads. Shifts in mode of regulation cannot be explained by changes in AmrZ sequence alone.

Synthesis and Structure-Activity Relationships of the Novel Antimalarials 5-Pyridinyl-4(1 H)-Pyridones.

Malaria is still one of the most prevalent parasitic infections in the world, with half of the world's population at risk for malaria. The effectiveness of current antimalarial therapies, even that of the most recent class of antimalarial drugs (artemisinin-combination therapies, ACTs), is under continuous threat by the spread of resistant Plasmodium strains. As a consequence, there is still an urgent requirement for new antimalarial drugs.

Extracorporeal membrane oxygenation system as a bridge to reparative surgery in ventricular septal defect complicating acute inferoposterior myocardial infarction.

Post-infarction ventricular septal defect (VSD) is a rare but potentially lethal complication of acute myocardial infarction. Medical management is usually futile, so definitive surgery remains the treatment of choice but the risk surgery is very high and the optimal timing for surgery is still under debate. A 55-year-old man with no previous medical history attended the emergency-room for 12 h evolution of oppressive chest pain and strong anginal pain 7 days ago.

The Discovery of Novel Antimalarial Aminoxadiazoles as a Promising Nonendoperoxide Scaffold.

Since the appearance of resistance to the current front-line antimalarial treatments, ACTs (artemisinin combination therapies), the discovery of novel chemical entities to treat the disease is recognized as a major global health priority. From the GSK antimalarial set, we identified an aminoxadiazole with an antiparasitic profile comparable with artemisinin (1), with no cross-resistance in a resistant strains panel and a potential new mode of action. A medicinal chemistry program allowed delivery of compounds such as 19 with high solubility in aqueous media, an acceptable toxicological profile, and oral efficacy.

Micronutrient Intake and the Contribution of Dietary Supplements in Hispanic Infants.

To calculate micronutrient adequacy among infants and toddlers and to determine the contribution of dietary supplements to this adequacy, micronutrient intake was assessed using two nonconsecutive 24-hour recalls in a sample of 296 infants aged 0-24 months. Micronutrient intake was calculated from foods and beverages and from supplements and compared between nonusers and users of supplements. Percentages of children below the Dietary Reference Intake (DRI) and above the tolerable upper limit intake (UL) were also compared between groups.

Hundreds of dual-stage antimalarial molecules discovered by a functional gametocyte screen.

Plasmodium falciparum stage V gametocytes are responsible for parasite transmission, and drugs targeting this stage are needed to support malaria elimination. We here screen the Tres Cantos Antimalarial Set (TCAMS) using the previously developed P. falciparum female gametocyte activation assay (Pf FGAA), which assesses stage V female gametocyte viability and functionality using Pfs25 expression.

Human metapnuemovirus infections in hospitalized children and comparison with other respiratory viruses. 2005-2014 prospective study.

Background: Human metapneumovirus (HMPV) has an important etiological role in acute lower respiratory infections in children under five years. Our objectives were to estimate the relative contribution of HMPV to hospitalization in children with acute respiratory infection, to define the clinical and epidemiological features of HMPV single and multiple infections, and to compare HMPV infections with respiratory syncytial virus (HRSV), rhinovirus (HRV), adenovirus and human bocavirus infections in the same population.

Methods And Findings: A prospective study performed on all children less than 14 years of age with a respiratory tract disease admitted to a secondary hospital between September 2005- June 2014.

A Semi-Quantitative Food Frequency Questionnaire Validated in Hispanic Infants and Toddlers Aged 0 to 24 Months.

Background: There are limited validated food frequency questionnaires (FFQs) for infants and toddlers, most of which were evaluated in Europe or Oceania, and the ones available for use in the United States have important limitations.

Objective: Our aim was to assess the validity of an FFQ developed for infants and toddlers.

Design: A semi-quantitative FFQ was developed that included 52 food items, their sources, and portion sizes.

Development of a Diet Quality Score for Infants and Toddlers and its association with weight.

Objective: To create a Diet Quality Index Score (DQIS) for infants and toddlers and to assess its relative validity.

Design: Three DQIS were created (0-5, 8-11 and 12-24 months) based on a validated food frequency questionnaire (FFQ). Nine components were included, scored from 0 (inadequate) to 5 (adequate consumption) based on guidelines for timing of food's introduction and portion sizes; the component on breastfeeding (Yes/No) was scored (0-15).

Achieving nano-gold stability through rational design.

When Au is subdivided to the nanoscale its reactivity changes from an inert nature to one of incredible reactivity which is not replicated by other catalysts. When dispersed onto metal oxides such as TiO, nano-Au has shown high reactivities for a multitude of reduction and oxidation reactions of industrial importance with potential and current uses such as, CO oxidation, NO reduction, purification of hydrogen for fuel cells, water gas shift reactions, abatement of volatile organic compounds (VOC's) as well as pollution and emission control systems such as autocatalysts. However, many industrially important reactions and applications operate under harsh conditions where the catalyst is exposed to high temperatures and further needs to operate for extended periods of time.

Breastfeeding practices, timing of introduction of complementary beverages and foods and weight status in infants and toddlers participants of a WIC clinic in Puerto Rico.

Background: Breastfeeding is associated with lower rates of obesity; in addition, it is also associated with later introduction of beverages and foods; however, this has not been well studied among Hispanics. The objective was to assess breastfeeding practices and timing of introduction of beverages and solid foods in a sample of Hispanic infants and their association with weight status.

Subject And Methods: Cross-sectional study in 296 caregivers of infants and toddlers 0-24 months of age participants of a WIC clinic in Puerto Rico.

Negative-Pressure Therapy to Reduce the Risk of Wound Infection Following Diverting Loop Ileostomy Reversal: An Initial Study.

Objective: To evaluate if the application of a negative-pressure therapy system (Prevena Incision Management System, Kinetics Concepts Inc, [KCI] an Acelity Company, San Antonio, Texas) on ileostomy-closure surgical wounds would reduce surgical site infections (SSIs) in comparison with conventional closure and dressing.

Design: Prospective interventional pilot study.

Setting: La Paz University Hospital, tertiary care academic hospital in Madrid, Spain.

Twelve-month efficacy and safety of the conversion to everolimus in maintenance heart transplant recipients.

Aim: To determine the clinical reasons for conversion to everolimus (EVL) and long-term outcomes in heart transplant (HT) recipients.

Methods: A retrospective 12-mo study has been carried out in 14 Spanish centres to assess the efficacy and safety of conversion to EVL in maintenance HT recipients.

Results: Two hundred and twenty-two patients were included (mean age: 53 ± 10.

Health care and nonhealth care costs in the treatment of patients with symptomatic chronic heart failure in Spain.

Introduction And Objectives: Chronic heart failure is associated with high mortality and utilization of health care and social resources. The objective of this study was to quantify the use of health care and nonhealth care resources and identify variables that help to explain variability in their costs in Spain.

Methods: This prospective, multicenter, observational study with a 12-month follow-up period included 374 patients with symptomatic heart failure recruited from specialized cardiology clinics.

Seasonal blowfly distribution and abundance in fragmented landscapes. Is it useful in forensic inference about where a corpse has been decaying?

Blowflies are insects of forensic interest as they may indicate characteristics of the environment where a body has been laying prior to the discovery. In order to estimate changes in community related to landscape and to assess if blowfly species can be used as indicators of the landscape where a corpse has been decaying, we studied the blowfly community and how it is affected by landscape in a 7,000 km2 region during a whole year. Using baited traps deployed monthly we collected 28,507 individuals of 10 calliphorid species, 7 of them well represented and distributed in the study area.

Senescence-associated SIN3B promotes inflammation and pancreatic cancer progression.

Pancreatic ductal adenocarcinoma (PDAC) is strikingly resistant to conventional therapeutic approaches. We previously demonstrated that the histone deacetylase-associated protein SIN3B is essential for oncogene-induced senescence in cultured cells. Here, using a mouse model of pancreatic cancer, we have demonstrated that SIN3B is required for activated KRAS-induced senescence in vivo.

The development of an economic threshold for Nasonovia ribisnigri (Hemiptera: Aphididae) on lettuce in central Spain.

This study reports economic thresholds for the lettuce aphid Nasonovia ribisnigri (Mosley), based exclusively on cosmetic damage, that is, presence or absence of aphids at harvest time. Field trials were conducted in La Poveda Experimental Farm, Madrid (Spain) during autumn (2004 and 2005) and spring (2005 and 2006). Plants were arranged in plots and just before the formation of lettuce hearts they were infested with different densities of N.

Cost-effectiveness analysis of cardiac resynchronization therapy in patients with NYHA I and NYHA II heart failure in Spain.

Objectives: The aim of the study was to combine clinical results from the European Cohort of the REVERSE study and costs associated with the addition of cardiac resynchronization therapy (CRT) to optimal medical therapy (OMT) in patients with mild symptomatic (NYHA I-II) or asymptomatic left ventricular dysfunction and markers of cardiac dyssynchrony in Spain.

Methods: A Markov model was developed with CRT + OMT (CRT-ON) versus OMT only (CRT-OFF) based on a retrospective cost-effectiveness analysis. Raw data was derived from literature and expert opinion, reflecting clinical and economic consequences of patient's management in Spain.

Income-related inequalities and inequities in health and health care utilization in Mexico, 2000-2006.

Objective: To measure income-related inequalities and inequities in the distribution of health and health care utilization in Mexico.

Methods: The National Health Survey (NHS) 2000 and the National Health and Nutrition Survey (NHNS) 2006 were used to estimate concentration indices for health outcomes and health care utilization variables before and after standardization. The study analyzed 110 460 individuals 18 years or older for NHS 2000 and 124 149 individuals for NHNS 2006.

Ovarian aging: melatonin regulation of the cytometric and endocrine evolutive pattern.

We have investigated the effect of melatonin administration on the cytometric and endocrine functions of the ovary during aging. Young cyclic (3 months old), middle-aged pre-acyclic (13 months old), and old acyclic (22 months old) female Wistar rats were used for two months, in both control and melatonin-treated groups. Cell cycle by flow cytometry: the percentage of ovarian cells in the G0-G1 phase was the highest in both control and melatonin-treated rats.