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Autologous tenon tablet packing to treat posterior quit injure associated with infiltrating damage: An instance report.
We report the case of an 88-year old woman referred for evaluation of increased INR. Surprisingly supratherapeutic levels of rivaroxaban was detected. Upon scrutiny of the patient's medical history, a drug-drug interaction between amiodarone and rivaroxaban persisting 3 weeks after cessation of amiodaron remains the prime suspect causing the clinical picture. Both INR and rivaroxaban levels returned to normal within 3 days of cessation of rivaroxaban. The case highlights that rivaroxaban, although highly variably, does affect INR. learn more Furthermore, it highlights that the potential for DDIs involving amiodarone may persists for weeks or months after discontinuation. Amiodarone is predicted to increase rivaroxaban exposure, through inhibition of rivaroxaban elimination via CYP3A4 and P-gp. Elderly patients and patients with declining renal function are especially at risk of increased rivaroxaban exposure when a DDI with amiodarone occurs. © 2020 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).Ferroptosis is a form of regulated, non-apoptotic cell death characterized by excessive lipid peroxidation that can be triggered by inhibition of the cystine-glutamate antiporter, system Xc - . Sorafenib, an FDA-approved multi-kinase inhibitor drug that is used for treatment of hepatocellular carcinoma (HCC), has been shown to induce ferroptosis. Protein phosphorylation changes upon sorafenib treatment have been previously reported in patient studies and in cell culture. However, early phosphorylation changes during induction of ferroptosis are not reported. This work highlights these changes through a time course from 7 to 60 min of sorafenib treatment in human (SKHep1) HCC cells. A total of 6,170 unique phosphosites from 2,381 phosphoproteins were quantified, and phosphorylation changes occurred after as little as 30 minutes of sorafenib treatment. By 60 minutes, notable changes included phosphosites significantly changing on p53 (P04637), CAD protein (P27708), and proteins important for iron homeostasis, such as FTH1 (P02794), HMOX1 (P09601), and PCBP1 (Q15365). Additional sites on proteins in key regulatory pathways were identified, including sites in ferroptosis-related proteins, indicating the likely involvement of phospho-regulated signaling during ferroptosis induction. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Given that injuries to children during periods of hospitalization can lead to more serious health conditions in fragile children, preventing pediatric inpatient injuries should be a priority for the pediatric healthcare profession. This study was conducted to develop a conceptual model of factors affecting pediatric inpatient safety, including all injuries, not just fall injuries, in pediatric units. An explorative sequential mixed methods design was used. Qualitative interviews were conducted with 13 nurses working in pediatrics units and 17 parents of hospitalized children, and then 200 nurses in pediatrics units and parents of hospitalized children completed a self-report questionnaire. Based on the integration of both qualitative and quantitative data using building and weaving narrative integration, the Pediatric Inpatient Safety Accidents (PISA) model was proposed. The PISA model contains two main domains, the immediate and mediating domain and encompasses the six factors explain of the elements affecting the occurrence and prevention of pediatric inpatient safety accidents. The PISA model can serve as a model to understand child accidents in hospitals as well as to plan customized nursing interventions to prevent child accidents. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Metal sulfide minerals, including mercury sulfides (HgS), are widespread in hydrothermal vent systems where sulfur-oxidizing microbes are prevalent. Questions remain as to the impact of mineral composition and structure on sulfur-oxidizing microbial populations at deep-sea hydrothermal vents, including the possible role of microbial activity in remobilizing elemental Hg from HgS. In the present study, metal sulfides varying in metal composition, structure, and surface area were incubated for 13 days on and near a diffuse-flow hydrothermal vent at 9°50'N on the East Pacific Rise. Upon retrieval, incubated minerals were examined by scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDS), X-ray diffraction (XRD), and epifluorescence microscopy (EFM). DNA was extracted from mineral samples, and the 16S ribosomal RNA gene sequenced to characterize colonizing microbes. Sulfur-oxidizing genera common to newly exposed surfaces (Sulfurimonas, Sulfurovum, and Arcobacter) were present on all samples. Differences in their relative abundance between and within incubation sites point to constraining effects of the immediate environment and the minerals themselves. Greater variability in colonizing community composition on off-vent samples suggests that the bioavailability of mineral-derived sulfide (as influenced by surface area, crystal structure, and reactivity) exerted greater control on microbial colonization in the ambient environment than in the vent environment, where dissolved sulfide is more abundant. The availability of mineral-derived sulfide as an electron donor may thus be a key control on the activity and proliferation of deep-sea chemosynthetic communities, and this interpretation supports the potential for microbial dissolution of HgS at hydrothermal vents. © 2020 John Wiley & Sons Ltd.Thai trauma nurses play a vital role in neuro-protective nursing care of patients with moderate or severe traumatic brain injury. Nurses' knowledge of the evidence underpinning initial neuro-protective nursing care vital to safe and high quality patient care. However, the current state of knowledge of Thai trauma nurses is poorly understood. In this study, we investigated Thai nurses' knowledge of neuro-protective nursing care of patients with moderate or severe traumatic brain injury. Data were collected by a survey, comprising a section on participant characteristics and series of multiple-choice questions. All registered nurses (n = 22) and nursing assistants (n = 13) from trauma ward of a regional Thai hospital were invited to participate the response rate was 100%. Participants had limited knowledge of carbon dioxide monitoring; causes and implications of hypercapnia; mean arterial pressure and cerebral perfusion pressure targets; management of sedatives and analgesics; and management of hyperthermia. Improving their knowledge focusing on knowledge deficits through educational training and implementation of evidence-based practice is essential to improve the safety and quality of care for Thai patients with moderate or severe traumatic brain injury.
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