Notes

Power and employ of recent birth control pill strategies amongst wedded girls throughout Burkina Faso: any group evaluation.
he long-term use of marijuana for sleep/relaxation.
To review the use of Von Willebrand Factor (VWF) concentrate for treatment of acquired Von Willebrand syndrome (VWS)-related bleeding in adult extracorporeal membrane oxygenation (ECMO) patients and determine if it was associated with improved VWF laboratory parameters.

Retrospective observational cohort study.

Tertiary care academic medical center.

Adult ECMO patients who received VWF concentrate for treatment of acquired VWS- related bleeding.

None, observational study.

Ten adult ECMO patients received VWF concentrate for treatment of bleeding with evidence of acquired VWS over a 15-month period. Six patients were on veno-arterial ECMO and 4 were on veno-venous ECMO. The most common site of bleeding was airway or tracheal bleeding. The mean dose of VWF concentrate was 41 IU/kg. Mean VWF antigen was 263 ± 93 IU/dL before treatment and 394 ± 54 after treatment. Mean ristocetin cofactor activity was 127 ± 47 IU/dL before treatment and 240 ± 33 after treatment. The mean VWF ristocetin cofactor activity antigen ratio increased from 0.52 ± 0.14 before treatment to 0.62 ± 0.04 after treatment. Four of 10 patients had complete resolution of their bleeding within 24 hours, and 6 of 10 had complete resolution of their bleeding within 2- to- 4 days. There were 3 patients who had thrombotic events potentially related to VWF concentrate administration. No patient had an arterial thrombosis, stroke, or myocardial infarction.

VWF concentrate administration increases VWF function in adult ECMO patients, but also may be associated with increased thrombotic risk. Larger studies are needed to determine VWF concentrate's safety, efficacy, and optimal dosing in adult ECMO patients.
VWF concentrate administration increases VWF function in adult ECMO patients, but also may be associated with increased thrombotic risk. Larger studies are needed to determine VWF concentrate's safety, efficacy, and optimal dosing in adult ECMO patients.
To investigate the association of adenosine diphosphate (ADP)-induced platelet maximum amplitude (MA
) with postoperative bleeding and blood product transfusions in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).

This single-center observational study recruited 200 patients who underwent elective, first-time, isolated CABG with CPB. A rapid thromboelastography with platelet mapping test was conducted for all patients before the surgery. Patients were categorized by the preoperative MA
into ≤50 mm (MA
≤50 group [n = 87]) and MA
>50 mm (MA
>50 group [n = 113]). The primary outcome was postoperative bleeding at 6 and 24 hours as measured by chest tube drainage volume. click here The perioperative blood product transfusions, postoperative complications, postoperative time course, and in-hospital mortality also were evaluated.

University hospital.

Adult patients scheduled to undergo isolated primary CABG with CPB.

None.

The study included 200 patients wed to have significant ability to predict bleeding tendency, with a sensitivity of 76.2% and a specificity of 69.0%.

Preoperative MA
may play a potential role in the prediction of postoperative bleeding and allogeneic blood transfusions and guide clinicians in perioperative management of patients undergoing CABG with CPB.
Preoperative MAADP may play a potential role in the prediction of postoperative bleeding and allogeneic blood transfusions and guide clinicians in perioperative management of patients undergoing CABG with CPB.
To review and compare the anesthetic management of atrial septal defect (ASD) closures via mini lateral thoracotomy and sternotomy approaches.

Retrospective analysis.

Single- center pediatric quaternary care hospital.

Patients aged <8 years of age undergoing ASD closure.

None.

Outcome measures included anesthetic technique, total amount and type of analgesics, pain scores, procedure duration, complications, blood transfusion requirements, and duration of stay. Each group had 15 patients. All patients in the sternotomy group received 0.25% bupivacaine subcutaneous infiltration. Eleven of the 15 thoracotomy patients received a fascial plane block, including serratus anterior and erector spinae blocks, and 3 received subcutaneous infiltration. There was no difference in opioid consumption intraoperatively or in the first 24 hours after surgery (0.28 ± 0.24 mg/kg morphine equivalents in thoracotomy group and 0.21 ± 0.12 mg/kg in sternotomy group). Duration of procedure and cardiopulmonary bypass duration were longer in the thoracotomy group. There was no difference in cross-clamp duration between groups. There was no difference in intensive care unit or hospital stay.

The authors reviewed perioperative pain management strategies used in surgical ASD closures. Different fascial plane blocks were used. This study has paved way to design a randomized control trial to compare various regional techniques for cardiac surgeries and identified opportunities for improved pain assessment scoring in children after cardiac surgery.
The authors reviewed perioperative pain management strategies used in surgical ASD closures. Different fascial plane blocks were used. This study has paved way to design a randomized control trial to compare various regional techniques for cardiac surgeries and identified opportunities for improved pain assessment scoring in children after cardiac surgery.The development of percutaneous structural interventions in patients with acquired heart disease is happening at an exponential rate, and some of this technology is being used to treat patients with congenital heart disease. This review describes the pathophysiology of valvular abnormalities specific to congenital heart disease and discusses the application of structural procedures in this population. Although the overall experience has been encouraging, especially in high-risk patients, this article will highlight the reasons that a cautious approach to adoption of this technology is necessary in these patients.
The objective of the study was to characterize and compare the attitudes, beliefs, and perceptions about epilepsy across community and patient cohorts in Uganda.

This was a descriptive study utilizing two samples a randomly selected, national survey community sample and a hospital-based patient sample of people with epilepsy (PWE) and their caregivers attending clinic settings in Kampala and Mbarara, Uganda for epilepsy care. Both samples were surveyed about their beliefs about epilepsy, its treatment, and people who have the illness. Multivariate linear regression was used to examine group differences and variables associated with specific beliefs.

Among the 15,818 community survey participants who participated in this study, 435 study participants reported symptoms suggestive of recurrent seizures, and all 626 subjects in the hospital-based sample had confirmed epilepsy. Results revealed significant differences across groups in their endorsement of epilepsy as a contagion; 37% of people in the communiiefs and negative attitudes about epilepsy and PWE persist, and they not only contribute to stigma but also interfere with the patients' health-seeking behavior. Further confounding the care of PWE, the pluralistic healthcare system in Uganda is evident in endorsements spanning biomedical, traditional, and religious treatment methods. Focused awareness campaigns utilizing local epilepsy societies are needed to promote epilepsy health literacy, to favorably impact acceptance and opportunities for PWE in Uganda, and to facilitate efficient uptake of biomedical care. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease Epilepsy Care in Uganda".
Epilepsy is one of the most prevalent, treatable neurological diseases globally. In sub-Saharan Africa, people with epilepsy (PWE) frequently seek treatment from traditional or pastoral healers, who are more accessible than biomedical care providers. This often contributes to the substantial time delay in obtaining adequate biomedical care for these patients. In Uganda, the few biomedical providers who can treat epilepsy cannot meet the great need for epilepsy care. Additionally, patients are often hesitant to seek biomedical care, often preferring the easily accessible and trusted sociocultural treatment options. This study sought to elucidate the barriers to biomedical care for PWE as well as identify potential solutions to overcome these barriers from various stakeholder perspectives.

This study used qualitative research methods. Semistructured interviews and focus group discussions were conducted with four major stakeholder groups PWE or family members of PWE, neurologists and psychiatrists, traditionoving epilepsy care in Uganda the creation of dedicated epilepsy clinics, infrastructure strengthening to address medication stock-outs, community outreach programs for sensitization, and collaboration between biomedical providers and traditional healers. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease Epilepsy Care in Uganda".
Based on these findings, there are four critical interventions that should be considered for improving epilepsy care in Uganda the creation of dedicated epilepsy clinics, infrastructure strengthening to address medication stock-outs, community outreach programs for sensitization, and collaboration between biomedical providers and traditional healers. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease Epilepsy Care in Uganda".The production of secondary metabolites in the submerged co-cultures of Penicillium rubens Wisconsin 54-1255 and Aspergillus terreus ATCC 20542 was evaluated. The biosynthetic capabilities of the two strains were compared in a set of diverse liquid media that differed with respect to the initial levels of glucose, lactose and yeast extract, contained carrot juice or vegetable/turkey puree as additional nutrient sources or were supplemented with phenylacetic acid, the side-chain precursor of penicillin G. The main goal of the study was to investigate the interactions between A. terreus and P. rubens that might contribute to the changes of secondary metabolite titers. Briefly, the biosynthesis of octaketide metabolites (+)-geodin and asterric acid was visibly enhanced as a result of replacing the conventional monocultures with the co-culture systems, but solely in the media containing not more than 5 g L-1 of yeast extract. By contrast, no marked enhancement was observed with respect to the biosynthesis of penicillin G, lovastatin, chrysogine, 4a,5-dihydromevinolinic acid and 3α-hydroxy-3,5-dihydromonacolin L acid. It was shown that the relationships between medium composition and product titers were clearly different in monoculture variants than in the corresponding co-cultures. Finally, it was demonstrated that the utilization of penicillin precursors by P. rubens can be blocked under the conditions of co-cultivation.Four different pesticide residues used in barley planting were selected to investigate their effects on simulated beer brewing. The influences were found to be different by varied agricultural chemicals. Among the four types of pesticides, at 25 μg/mL, triadimefon or carbendazim barely affected the brewing progress. However, ethametsulfuron-methyl and carbaryl (15 μg/mL and 2.5 μg/mL, respectively) exhibited slightly inhibition on saccharification and significantly negative impacts on yeast growth and alcohol fermentation. After pretreated by 50 μL carbaryl-degrading enzyme with the Kcat value of 2.12 s-1 at 30°C for 90 min, the negative influence on simulated beer brewing brought by carbaryl can be eliminated in the fermentation system containing 2.5 μg/mL carbaryl. The efficiency of ethanol fermentation was improved, and the removal rate of carbaryl in the brewing system was greatly accelerated. Taken together, this study suggested a potential method for solving the fermentation inhibition by pesticide residues.
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