A Review of Chlorhexidine Oral Care in Patients Receiving Mechanical Ventilation.

Background: Chlorhexidine gluconate has been considered the criterion standard of oral care for patients receiving mechanical ventilation because of its ability to reduce the incidence of ventilator-associated events. Optimal concentrations and frequencies remain unclear, as do adverse events related to mortality in various intensive care unit populations.

Objective: To examine the current evidence for the efficacy of chlorhexidine gluconate in reducing the incidence of ventilator-associated events, mortality, intensive care unit length of stay, and duration of mechanical ventilation in patients receiving ventilator support.

Generation of a thermostable, oral Zika vaccine that protects against virus challenge in non-human primates.

Here we report the development of a thermally stable, orally administered, candidate Zika vaccine using human serotype 5 adenovirus (AdHu5). We engineered AdHu5 to express the genes for the envelope and NS1 proteins of Zika virus. AdHu5 was formulated using a proprietary platform, OraPro, comprising a mix of sugars and modified amino acids that can overcome elevated temperatures (37 C), and an enteric coated capsule that protects the integrity of the AdHu5 from the acid in the stomach.

Effectiveness of a multi-modal hospital-wide doctor mental health and wellness intervention.

Background: Doctors report high rates of workplace stress and are at increased risk of mental health disorders. However, there are few real-world studies evaluating the effectiveness of interventions aimed at addressing workplace risk factors and improving doctors' mental health in a hospital setting. This study was conducted over two years (2017-2019) to assess the effects of a multi-modal intervention on working conditions doctors' mental health and help-seeking for mental health problems in two Australian teaching hospitals.

Mindfulness-Based Cognitive Therapy for Young People and Their Carers: a Mixed-Method Feasibility Study.

We aimed to evaluate whether mindfulness-based cognitive therapy (MBCT) was feasible and acceptable for young people, their parents and the clinicians working with them; whether a parallel course for parents was a useful addition; and whether attendance at MBCT was associated with improved outcomes. The design was a mixed-method service evaluation of an eight-session MBCT programme for young people who were recovering from depression. The course was a manualised eight-session group intervention.

Chemotherapeutic Medications and Their Emergent Complications.

Patients with complications of chemotherapy, either acute or chronic, are frequently encountered in the emergency department (ED). Some patients present with complaints immediately after chemotherapy administration, whereas others may show subtle, secondary signs or may have no signs or symptoms of chemotoxicity. An increased index of suspicion prompts early recognition, diagnosis, and prevention of further iatrogenic injury.

Long-Term Deficits in Cortical Circuit Function after Asphyxial Cardiac Arrest and Resuscitation in Developing Rats.

Cardiac arrest is a common cause of global hypoxic-ischemic brain injury. Poor neurologic outcome among cardiac arrest survivors results not only from direct cellular injury but also from subsequent long-term dysfunction of neuronal circuits. Here, we investigated the long-term impact of cardiac arrest during development on the function of cortical layer IV (L4) barrel circuits in the rat primary somatosensory cortex.

Effect of surface treatments on the mechanical properties and antimicrobial activity of desiccated glass ionomers.

Objectives: The purpose of this study was to evaluate the effect of various surface treatments on the mechanical properties and antibacterial activity of desiccated glass-ionomer (GI) and resin-modified glass-ionomer (RMGI) materials.

Methods: One hundred GI and RMGI specimens were fabricated in a mold, stored in 100% humidity for 24h, placed in air to desiccate for 24h, and then stored for one week in one of the five media [casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), chlorhexidine (CHX), sodium fluoride (NaF), cetylpyridinium chloride (CPC), or 100% humidity (control)]. Fifty GI and RMGI specimens were tested in flexure to determine flexural strength and modulus, with the fragments used for Knoop hardness testing.

Chemotherapeutic medications and their emergent complications.

Patients with complications of chemotherapy, either acute or chronic, are frequently encountered in the emergency department (ED). Some patients present with complaints immediately after chemotherapy administration, whereas others may show subtle, secondary signs or may have no signs or symptoms of chemotoxicity. An increased index of suspicion prompts early recognition, diagnosis, and prevention of further iatrogenic injury.

Discovery and characterization of NVP-QAV680, a potent and selective CRTh2 receptor antagonist suitable for clinical testing in allergic diseases.

Optimization of a 7-azaindole-3-acetic acid CRTh2 receptor antagonist chemotype derived from high throughput screening furnished a highly selective compound NVP-QAV680 with low nM functional potency for inhibition of CRTh2 driven human eosinophil and Th2 lymphocyte activation in vitro. The molecule exhibited good oral bioavailability in the rat, combined with efficacy in rodent CRTh2-dependent mechanistic and allergic disease models and was suitable for clinical development.

The effect of antiplatelet and anticoagulant therapy on the clinical outcome of patients undergoing ureteroscopy.

Objective: To determine if there is any difference in the clinical outcome for patients receiving aspirin, clopidogrel, and warfarin undergoing ureteroscopy and laser lithotripsy for urolithiasis compared with patients on no antithrombotic medication.

Methods: We retrospectively reviewed patients who underwent ureteroscopy for urolithaisis from July 1, 2005 to October 1, 2010. If patients continued aspirin, clopidogrel, or warfarin within 48 hours of surgery, they were considered to be on antithrombotic therapy.

Three cases of subcutaneous granuloma annulare of the penis: a rare presentation of a common disease.

Objective: To describe three patients who presented to a single institution within four years of each other with isolated granuloma annulare of the penis. Granuloma annulare is an inflammatory disease of the dermis that can affect men of any age including childhood. Granuloma annulare of the penis is a remarkably uncommon presentation with only 12 cases previously reported.

Protein disulphide isomerase family members show distinct substrate specificity: P5 is targeted to BiP client proteins.

At least 17 members of the protein disulphide isomerase (PDI) family of oxidoreductases are present in the endoplasmic reticulum (ER) of mammalian cells. They are thought to catalyse disulphide formation to aid folding or to regulate protein function; however, little is known about their individual functions. Here, we show that some proteins that enter the ER are clients for single oxidoreductases, whereas others are clients for several PDI-like enzymes.

Association of asymptomatic peripheral arterial disease with vascular events in patients with stroke or transient ischemic attack.

Background And Purpose: Patients with stroke and patients with transient ischemic attack (TIA) are at high risk for vascular events and may not exhibit the signs and symptoms of peripheral arterial disease (PAD). We investigated if asymptomatic PAD detected by ankle brachial index <0.9 is independently associated with recurrent vascular events in patients with stroke or TIA.

Regulation of neuregulin 1beta1-induced MUC5AC and MUC5B expression in human airway epithelium.

Excessive mucus production has been linked to many of the pathologic features of respiratory diseases, including obstruction of the airways, decline in lung function, increased rates of mortality, and increased infections. The mucins, MUC5AC and MUC5B, contribute to the viscoelastic properties of mucus, and are found at elevated levels in the airways of individuals with chronic respiratory diseases. The T helper type 2 cell cytokine, IL-13, is known to regulate MUC5AC expression in goblet cells of the airways, although much less is known about the regulation of MUC5B expression.

Photoperiod alters central distribution of estrogen receptor alpha in brain regions that regulate aggression.

Testosterone or its metabolite, estrogen, regulates aggression in males of many mammalian species. Because plasma testosterone levels are typically positively correlated with both aggression and reproduction, aggression is expected to be higher when males are in reproductive condition. However, in some photoperiodic species such as Siberian hamsters (Phodopus sungorus), males are significantly more aggressive in short day lengths when the testes are regressed and circulating testosterone concentrations are reduced.

Assessment of comparative treatment satisfaction with sildenafil citrate and penile injection therapy in patients responding to both.

Objective: To survey patient satisfaction, using validated questionnaires, in a group of men with erectile dysfunction who had used and responded to both sildenafil citrate and intracavernosal injection (ICI) therapy.

Patients And Methods: In all, 300 patients on ICI therapy were mailed questionnaire packets containing a survey enquiring about the patients' medical history, and two sets of the International Index of Erectile Function (IIEF) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) sexual function surveys. If patients were using sildenafil alternating with ICI they were asked to complete the IIEF and EDITS questionnaires for each therapy.

Association of leukocyte count with progression of aortic atheroma in stroke/transient ischemic attack patients.

Background And Purpose: Leukocyte count is an independent predictor of stroke. We investigated the association between leukocyte count and progression of aortic atheroma over 12 months in stroke/transient ischemic attack (TIA) patients.

Methods: Consecutive ischemic stroke and transient ischemic attack patients underwent 12-month sequential transesophageal echocardiography and were assessed for total and differential leukocyte counts on admission.

Aortic arch atheroma progression and recurrent vascular events in patients with stroke or transient ischemic attack.

Background: It is not known whether progression of aortic arch (AA) atheroma is associated with vascular events in patients with stroke or transient ischemic attack (TIA).

Methods And Results: AA atheroma was detected on baseline transesophageal echocardiogram in 167 consecutive patients who had prevalent stroke or TIA. Of these, 125 consented to a follow-up transesophageal echocardiogram at 12 months.

Aging and overactive bladder may be associated with loss of urethral sensation in women.

Aims: To compare current perception thresholds (CPT) in the urethra and bladder of women with idiopathic overactive bladder to asymptomatic controls.

Methods: Women with > or =1 urge urinary incontinence (UUI) episode per week on 7-day diary, seeking treatment for UUI underwent CPT testing using a Neurometer(R) CPT device (Neurotron, Inc., Baltimore, MD).

Urethral and bladder current perception thresholds: normative data in women.

Purpose: Given increased evidence of sensory dysfunction in lower urinary tract pathology, we determined normative current perception threshold values in the lower urinary tract of asymptomatic women.

Materials And Methods: After receiving institutional review board approval women without lower urinary tract symptoms underwent current perception threshold testing of the urethra and bladder using a Neurometer constant current stimulator. Current perception threshold values were determined at 3 frequencies, including 2,000 Hz (corresponding to A-beta fibers), 250 Hz (corresponding to A-delta fibers) and 5 Hz (corresponding to C fibers).

Testicular torsion in a 68-year-old man.

Testicular torsion is a rare, yet often underrecognized, cause of scrotal pain in adult men. Few reports have commented on testicular torsion in the geriatric population. We report a case of a 68-year-old man initially diagnosed with epididymo-orchitis, who, on surgical exploration, was found to have intravaginal testicular torsion.