Assessing the effectiveness of a rural distribution program in reducing time to prothrombin complex concentrate administration in patients taking warfarin.

Study Objectives: Reversal of warfarin-induced anticoagulation using prothrombin complex concentrate (PCC4) is more rapidly achieved than with traditional methods such as fresh frozen plasma (FFP). In many rural facilities the availability of both FFP and PCC4 has been limited. A tertiary hospital instituted a program to provide PCC4 to rural sites using an air transport team and pharmacy exchange.

Loss-of-Function Variants in as Modifying Factors in Beta-Thalassemia.

It is well known that modifiers play a role in ameliorating or exacerbating disease phenotypes in patients and carriers of recessively inherited disorders such as sickle cell disease and thalassemia. Here, we give an overview of the literature concerning a recently described association in carriers of Loss-of-Function variants with a beta-thalassemia-like phenotype including the characteristic elevated levels of HbA. That acts as modifier in beta-thalassemia carriers became evident from three reported cases in whom combined heterozygosity of and gene variants was observed to resemble a mild beta-thalassemia intermedia phenotype.

Effective Treatment of Methotrexate Induced Oral Mucositis With a Morphine Mouthwash Solution: A Case Report.

Methotrexate (MTX) is a common medication used to treat rheumatoid arthritis (RA). MTX inhibits rapid cell turnover throughout the body which can lead to significant side effects. Patients who present with oral lesions may have suffered severe acute toxicity from MTX.

Training for Supervisors to Improve Sustainable Employment of Employees with a work Disability: A Longitudinal Effect and Process Evaluation from an Intervention Study with Matched Controls.

Purpose: Supervisors play a crucial role in sustainable employment of employees with a work disability. The 'Mentorwijs' (literal translation: Mentorwise) training was developed to train supervisors in knowledge, attitudes and skills needed to guide these employees. This study evaluated the effect of 'Mentorwijs' on employees' employment and supervisors' behavioral outcomes.