Head and neck cancer end of life care: complex challenges.

Head and neck cancers frequently carry a poor prognosis and are commonly associated with complex medical needs and symptoms. Timing of referral to specialist palliative care teams (SPCTs) is challenging. We present the case of a 57-year-old woman with locally highly advanced head and neck cancer.

Discovery and Optimization of 4-(8-(3-Fluorophenyl)-1,7-naphthyridin-6-yl)transcyclohexanecarboxylic Acid, an Improved PDE4 Inhibitor for the Treatment of Chronic Obstructive Pulmonary Disease (COPD).

Herein we describe the optimization of a series of PDE4 inhibitors, with special focus on solubility and pharamcokinetics, to clinical compound 2, 4-(8-(3-fluorophenyl)-1,7-naphthyridin-6-yl)transcyclohexanecarboxylic acid. Although compound 2 produces emesis in humans when given as a single dose, its exemplary pharmacokinetic properties enabled a novel dosing regime comprising multiple escalating doses and the resultant achievement of high plasma drug levels without associated nausea or emesis.

Solubility-driven optimization of phosphodiesterase-4 inhibitors leading to a clinical candidate.

The solubility-driven optimization of a series of 1,7-napthyridine phosphodiesterase-4 inhibitors is described. Directed structural changes resulted in increased aqueous solubility, enabling superior pharmacokinetic properties with retention of PDE4 inhibition. A range of potent and orally bioavailable compounds with good in vivo efficacy in animal models of inflammation and reduced emetic potential compared to previously described drugs were synthesized.

Emergency care for people with dementia.

As part of its commitment to improving dementia services, the Scottish Government has published six recommendations for developing care in emergency departments. This article looks at how each of these recommendations can be implemented by emergency nurses to make departments safer places for older people with confusion.

Making a broader case for the narrow view: where to begin?

Purpose: This final article covering the topic of the interplay between decoding, comprehension, and content versus structure knowledge describes a set of language initiatives that are focused toward content area learning. Inspired by the work of their colleagues from diverse fields and their own work, the authors offer suggestions to clinicians who are interested in creating and delivering curriculum-relevant and strategic-based language intervention to school-age students with language learning disabilities (LLD).

Method: The discussion covers selected topics that form the foundation for an evolving intervention framework, including (a) understanding the content and structural requirements of textbooks, (b) integrating metacognitive and metalinguistic techniques into intervention goals and objectives, and (c) emphasizing meaning-based activities that cut across connected discourse (macrostructure levels) and sentence/word components (microstructure levels) of spoken and written language.

The role of Th2 cytokines, chemokines and parasite products in eosinophil recruitment to the gastrointestinal mucosa during helminth infection.

Trichinella spiralis and Trichuris muris are nematode parasites of the mouse, dwelling in the small and large intestines, respectively: worm expulsion requires development of a Th2 immune response. The chemokine CCL11 is agonist for the chemokine receptor CCR3 and acts in synergy with IL-5 to recruit eosinophils to inflammatory sites. The role of CCL11 in gastrointestinal helminth infection has not been previously studied.

Management factors affecting stereotypies and body condition score in nonracing horses in Prince Edward Island.

In North America, there are few representative data about the effects of management practices on equine welfare. In a randomized survey of 312 nonracing horses in Prince Edward Island (response rate 68.4%), owners completed a pretested questionnaire and a veterinarian examined each horse.

A preliminary equine abuse policy with potential application to veterinary practice.

An equine abuse policy was developed as an adjunct to an equine management survey. If at least 3 of 5 categories caused concern, a report to the authorities was indicated. The policy was not used but, in the absence of other guidelines, it might assist veterinarians considering potential abuse cases.

A new orally bioavailable dual adenosine A2B/A3 receptor antagonist with therapeutic potential.

The synthesis and SAR of 5-heterocycle-substituted aminothiazole adenosine receptor antagonists is described. Several compounds show high affinity and selectivity for the A2B and A3 receptors. One compound (5f) shows good ADME properties in the rat and as such may be an important new compound in testing the current hypotheses proposing a therapeutic role for a dual A2B/A3 antagonist in allergic diseases.

Demographics, management, and welfare of nonracing horses in Prince Edward Island.

There are no detailed, representative, horse-level data about equine management practices in different parts of Canada. To help address this, the demographics, management, and welfare of 312 nonracing horses in Prince Edward Island were examined in a randomized, horse-level survey during summer 2002. Owners completed a pretested questionnaire, and a veterinarian examined each horse.

Expression of fibronectin-binding protein FbpA modulates adhesion in Streptococcus gordonii.

Fibronectin binding is considered to be an important virulence factor in streptococcal infections. Adhesion of the oral bacterium Streptococcus gordonii to immobilized forms of fibronectin is mediated, in part, by a high molecular mass wall-anchored protein designated CshA. In this study, a second fibronectin-binding protein of S.