Reducing the receipt of contraindicated medications in patients with Parkinson disease.

Background: The administration of antidopaminergic medications to patients with Parkinson's disease (PD) can exacerbate symptoms, and in the hospital setting, can lead to complications and increased length of stay. Despite efforts to improve medication administration through provider education and patient-centered interventions, the problem persists, with an estimated 21-43% of hospitalized PD patients receiving dopamine blocking medications.

Methods: In this study, a best practice alert (BPA) was developed that was triggered when an antidopaminergic medication was ordered in the Emergency Department or hospital for a patient with a diagnosis of PD in the EMR.

Physical Compatibility of Y-site Pediatric Drug Administration: A Call for Question of US Pharmacopeia Standards.

Objective: To evaluate the physical intravenous Y-site compatibility of 29 combinations of medications at commonly used pediatric concentrations using both existing and novel techniques.

Methods: Medication combinations included were selected by a varied group of pediatric inpatient pharmacists, and then assessed by 3 independent reviewers for existing literature. For each combination, 2 different medications were mixed together in a 1:1 ratio and incubated at room temperature for 4 hours to simulate Y-site administration.

The mitochondrial genome of the planorbid snail .

The complete mitochondrial genome of a freshwater planorbid snail, (Mollusca, Gastropoda) was recovered from assembly of genomic sequences generated with the Illumina NextSeq500 platform. The mitogenome (14,217 base pairs) is AT rich (72.69%) and comprises 13 protein-coding genes, two ribosomal subunit genes, and 22 transfer RNAs.

Vessel wall perforation mechanism of the excimer laser-assisted non-occlusive anastomosis technique.

The excimer laser assisted non-occlusive anastomosis (ELANA) technique is used to make anastomoses on intracerebral arteries. This end-to-side anastomosis is created without temporary occlusion of the recipient artery using a 308-nm excimer laser with a ring-shaped multi-fiber catheter to punch an opening in the arterial wall. Over 500 patients have received an ELANA bypass.

Intervention versus standard medical treatment in patients with symptomatic occlusion of the internal carotid artery: a randomised oxygen-15 PET study.

Background: The aim of this randomised pilot study was to investigate the haemodynamic effects measured by oxygen-15 positron emission tomography (PET) of interventional treatment consisting of either endarterectomy or endovascular treatment of stenosed cerebropetal arteries, or tapering of antihypertensive medication in comparison with standard medical treatment alone in patients with symptomatic internal carotid artery (ICA) occlusion.

Methods: Twenty-three patients with symptomatic ICA occlusion underwent PET scanning at baseline and after 3 months. Twelve patients were randomised to intervention (either endarterectomy or endovascular treatment of stenosed cerebropetal arteries, or tapering of antihypertensive medication) and 11 to standard medical treatment alone.

Molecular screening of oral precancer.

Objectives: Early detection and treatment of high risk premalignant mucosal changes of the oral cavity, will expectedly improve survival and reduce treatment-related morbidity. Aims of this study were to evaluate a non-invasive screening approach and to assess the value of molecular markers to identify patients at risk for oral cancer.

Materials And Methods: Exfoliated cells and biopsies were obtained from oral leukoplakia lesions of 43 patients, of whom six developed oral cancer.

Understanding growers' decisions to manage invasive pathogens at the farm level.

Globalization causes plant production systems to be increasingly threatened by invasive pests and pathogens. Much research is devoted to support management of these risks. Yet, the role of growers' perceptions and behavior in risk management has remained insufficiently analyzed.

Prognostic value of DNA ploidy status in patients with oral leukoplakia.

Oral leukoplakia is a potentially malignant disorder that will develop into oral cancer at an estimated rate of 1-2% per year. Aim of the present study is to assess the possible predictive value of DNA ploidy for malignant progression of oral leukoplakia. A cohort of 62 leukoplakia patients was studied and their biopsy was examined with standard histopathology and DNA image cytometry.

Day-to-day test-retest variability of CBF, CMRO2, and OEF measurements using dynamic 15O PET studies.

Purpose: We assessed test-retest variability of cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rate of oxygen (CMRO(2)), and oxygen extraction fraction (OEF) measurements derived from dynamic (15)O positron emission tomography (PET) scans.

Procedures: In seven healthy volunteers, complete test-retest (15)O PET studies were obtained; test-retest variability and left-to-right ratios of CBF, CBV, OEF, and CMRO(2) in arterial flow territories were calculated.

Results: Whole-brain test-retest coefficients of variation for CBF, CBV, CMRO(2), and OEF were 8.

Evaluation of cornulin, keratin 4, keratin 13 expression and grade of dysplasia for predicting malignant progression of oral leukoplakia.

Oral leukoplakia is defined as a white patch in the oral cavity that cannot be diagnosed as any other known disorder. These lesions carry an increased risk of malignant progression, and approximately 2-3% per year do progress to cancer. At present biopsies are histopathologically graded for dysplasia to assess the risk of progression, but this grading is somewhat subjective and of limited use for the individual patient.

Arterial spin labeling perfusion MRI at multiple delay times: a correlative study with H(2)(15)O positron emission tomography in patients with symptomatic carotid artery occlusion.

Arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) with image acquisition at multiple inversion times is a noninvasive ASL technique able to compensate for spatial heterogeneities in transit times caused by collateral blood flow in patients with severe stenosis of the cerebropetal blood vessels. Our aim was to compare ASL-MRI and H(2)(15)O positron emission tomography (PET), the gold standard for cerebral blood flow (CBF) assessment, in patients with a symptomatic internal carotid artery (ICA) occlusion. Fourteen patients (63+/-14 years) with a symptomatic ICA occlusion underwent both ASL-MRI and H(2)(15)O PET.

Predictors of patency of excimer laser-assisted nonocclusive extracranial-to-intracranial bypasses.

Object: Excimer laser-assisted nonocclusive anastomosis (ELANA) is a technique that can be used for extracranial-to-intracranial (EC-IC) bypasses, without the necessity of temporary occlusion of the donor or recipient artery. Information on predictors of patency of EC-IC bypasses in general and the ELANA bypass in particular is sparse. The authors studied 159 ELANA EC-IC bypasses to find predictors of patency.

Screening for oral precancer with noninvasive genetic cytology.

Oral squamous cell carcinomas develop in precancerous fields consisting of genetically altered mucosal epithelial cells. These precancerous fields may appear as clinically visible lesions, in particular, oral leukoplakia, but the large majority remains clinically undetectable. The aim of this study was to assess the potential value of a noninvasive screening approach to detect precancerous fields.

Comparative evaluation of genetic assays to identify oral pre-cancerous fields.

Background: Oral squamous cell carcinomas often develop in a pre-cancerous field, defined as mucosal epithelium with cancer-related genetic alterations, and which may appear as a clinically visible lesion. The test characteristics of three genetic assays that were developed to detect pre-cancerous fields were investigated and compared to histology.

Methods: In total, 10 pre-cancerous fields that were not visible at clinical inspection and gave rise to malignant transformation based on an identical TP53 mutation in tumor and mucosal epithelium in the surgical margin, as well as 10 normal oral mucosa specimens were analyzed for numerical chromosomal changes with multiplex ligation-dependent probe amplification (MLPA), for loss of heterozygosity (LOH), with microsatellite PCR and for DNA index alterations with DNA image analysis.

Assessment of the contribution of the external carotid artery to brain perfusion in patients with internal carotid artery occlusion.

Background And Purpose: The purpose of this study was to prospectively investigate the contribution of the ipsilateral external carotid artery (ECA) to cerebral perfusion in patients with internal carotid artery occlusion.

Methods: Institutional Review Board approval and informed consent were obtained. Thirty functionally independent patients (24 men, 6 women; mean age, 63 years) with an angiographically proven unilateral internal carotid artery occlusion and transient or minor disabling ischemic attacks ipsilateral to the side of the internal carotid artery occlusion were included.

Sutureless nonocclusive bypass surgery in combination with an expanded polytetrafluoroethylene graft. Laboratory investigation.

Object: Cerebral aneurysms that cannot be treated by clip or coil placement can be treated with high-flow bypass surgery using techniques such as the excimer laser-assisted nonocclusive anastomosis (ELANA). To simplify the technique, a sutureless ELANA (SELANA) was developed in combination with an expanded polytetrafluoroethylene (ePTFE) graft.

Methods: In 18 rabbits a bypass was constructed on the abdominal aorta using the SELANA technique with an ePTFE graft, resulting in 18 bypasses and 36 anastomoses.

The excimer laser-assisted nonocclusive anastomosis practice model: development and application of a tool for practicing microvascular anastomosis techniques.

Objective: To practice microsurgical skills, several experimental models are available that diminish the need for experimental animals. We defined criteria with which such models should comply, and we tested whether the models described in literature, as well as our own practice model, comply with these criteria.

Methods: We defined the criteria to which these models should comply, and we performed a literature search on microvascular practice models.

A noninvasive genetic screening test to detect oral preneoplastic lesions.

Early diagnosis of oral squamous cell carcinoma (OSCC) may have a major impact on survival and quality of life. Recent studies have shown that the majority of OSCC is preceded by precursor lesions characterized by genetic alterations. The aim of this study was to develop and evaluate a noninvasive screening test for oral preneoplastic lesions, based on genetic alterations as marker.

The ELANA technique: high flow revascularization of the brain.

High flow revascularization of the brain is hampered by the fact that temporary occusion of a major cerebral artery is necessary to create the distal anastomosis, which may result in brain ischemia. The excimer laser-assisted non-occlusive anastomosis (ELANA) technique circumvents this problem. In this paper we elucidate the development of a non-occlusive way to make anastomoses to the major cerebral arteries.

Hepatic and associated response of rats to pregnancy, lactation and simultaneous treatment with butylated hydroxytoluene.

This paper describes changes in the livers of rats fed diets containing butylated hydroxytoluene (BHT) over two generations in two separate studies. BHT did not produce tumours when tested for carcinogenicity in several studies by the conventional way. However, when BHT was given to rats in a two-generation carcinogenicity study, a high incidence of hepatic tumours was found in males but not in female rats of the F1 generation.

Pathology considerations for, and subsequent risk assessment of, chemicals identified as immunosuppressive in routine toxicology.

Several proposals have been made with the aim of assisting in the early identification of chemicals with immunotoxic potential. The Organisation for Economic Cooperation and Development is now likely to incorporate enhanced immunopathology into the test guideline for the 28-day rat study, which may be regarded as a Tier I investigation. However, no guidelines have yet been proposed either for how the new data generated will be evaluated, or for how a subsequent risk assessment will be made.

Investigations of the genotoxicity and cell proliferative activity of dichlorvos in mouse forestomach.

This study investigated the possible mechanism by which dichlorvos may have caused forestomach tumours in mice in a chronic corn oil gavage cancer bioassay [NTP (1989) Toxicology and carcinogenesis studies of dichlorvos in F344/N rats and B6C3F1 mice (gavage studies). National Toxicology Program Technical Report 342, NIH Publ. No 89-2598].

The identification of chemicals with sensitizing or immunosuppressive properties in routine toxicology.

In the context of this paper, immunotoxicity is taken to encompass immunosuppression/immunopotentiation and allergy. Over the last 10 to 15 years, well characterized methods for the assessment of altered immune competence have been reported. This has led to proposals for tiered testing schemes.

Review of the mutagenicity/genotoxicity of butylated hydroxytoluene.

Butylated hydroxytoluene (BHT) is an effective, widely used, low cost antioxidant. A host of studies examining the potential of BHT to cause point mutations have been published. They include in vitro studies on various bacterial species and strains and on various types of mammalian cell lines as well as in vivo studies on Drosophila melanogaster, silk worms and also the mouse specific locus test (involving long-term exposure).