Use of allopurinol to manage skewed 6-mercaptopurine metabolism in pediatric maintenance acute lymphoblastic leukemia treatment.

Background: 6-mercaptopurine is a cornerstone of maintenance therapy for pediatric ALL. Response to 6MP is typically determined by the ANC. Therapeutic ANC range while receiving 6MP is between 500 and 1500/μL.

Medication Desensitization: Single Intravenous Bag Method, in 3 Pediatric Patients.

Chemotherapies and biologic agents are known to cause hypersensitivity reactions (HSRs). It is imperative that pediatric patients receive these agents to treat their cancer or other rare condition, as oftentimes there are no available therapeutic alternatives. Successful medication desensitization has been described previously with a 12-step method using 3 intravenous (IV) infusion bags of varying concentrations.

Variation in access to specialist services for neurosurgical procedures in adults with epilepsy in England, a cohort study.

Purpose: To understand if primary consultation at tertiary epilepsy centres (TEC) in England impacts access to neurosurgical procedures (resective surgery, vagus nerve stimulator [VNS], deep brain stimulator [DBS]).

Methods: Adults with epilepsy, and with a first neurology outpatient visit (index) between 01/01/2013 and 31/12/2015, were followed using English Hospital Episode Statistics from index date to 31/12/2019. Analyses were stratified by geographic location, learning disability record, and whether the index or follow-up visits were at a TEC.

Extra-axial haemorrhages in young children with skull fractures: abuse or accident?

Objective: Infant and toddler subdural haemorrhages (SDH) are often considered indicative of abuse or major trauma. However, accidental impact events, such as falls, cause contact extra-axial haemorrhages (EAHs). The current study sought to determine frequency and clinical behaviour of EAHs with infant and toddler accidental and abusive skull fractures.

Ultrafast relaxation dynamics of Au(SCH) monolayer-protected clusters resolved by two-dimensional electronic spectroscopy.

Electronic relaxation dynamics of neutral Au(SCH) monolayer-protected clusters (MPCs), following excitation of the mixed 15 875 cm charge transfer resonance, were studied using femtosecond transient absorption (fsTA) and two-dimensional electronic spectroscopy (2DES). The excited carriers relax by three different mechanisms, including an ∼100 fs HOMO to HOMO hole transfer, picosecond HOMO to HOMO hole transfer, and subsequent electron-hole recombination that persisted beyond the hundreds of picoseconds measurement range. The fsTA data revealed two transient bleach components at 15 820 and 15 625 cm, where the lower frequency component exhibited a delayed first-order buildup of 80 ± 25 fs that matched the decay of the high-energy bleach component (110 ± 45 fs).

Hospital admissions for stroke and bleeding in Hounslow following a quality improvement initiative.

Objective: Atrial fibrillation (AF) is the most common arrhythmia. Undiagnosed and poorly managed AF increases risk of stroke. The Hounslow AF quality improvement (QI) initiative was associated with improved quality of care for patients with AF through increased detection of AF and appropriate anticoagulation.

Characterization of Gene Repression by Designed Transcription Activator-like Effector Dimer Proteins.

Gene regulation by control of transcription initiation is a fundamental property of living cells. Much of our understanding of gene repression originated from studies of the Escherichia coli lac operon switch, in which DNA looping plays an essential role. To validate and generalize principles from lac for practical applications, we previously described artificial DNA looping driven by designed transcription activator-like effector dimer (TALED) proteins.

Using a pharmacist-community health worker collaboration to address medication adherence barriers.

Objective: Pharmacists are positioned to evaluate and educate patients regarding medication adherence; however, opportunities exist to leverage a collaborative approach in eliciting barriers encountered by patients, especially in minority groups. Community health workers (CHWs) are individuals from the communities who form relationships with patients and help increase their access to health care resources. This study aimed to evaluate the effectiveness of a collaboration between CHWs and pharmacists in identifying and addressing medication adherence barriers faced by hypertensive patients.

Opportunities and responsibilities for pharmacists to improve their effectiveness in addressing medication adherence through culturally sensitive collaborations with community health workers.

Objectives: Despite progress in addressing health disparities among vulnerable populations, minority populations are at risk for chronic health conditions associated with multiple determinants of health, which affects their health status and access to care. We offer a potential solution, which creates an unconventional medical team between a pharmacist and a community health worker (CHW). We explore weaknesses and challenges in our medication use system in the context of adherence as a drug therapy problem, the role of culture in shaping medication use, and finally offer a unique paradigm for a collaborative interprofessional team consisting of CHWs and pharmacists.